Sample records for korean radiation oncologists
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Co-authorship patterns and networks of Korean radiation oncologists
International Nuclear Information System (INIS)
Choi, Jin Hyun; Kang, Jin Oh; Park, Seo Hyun; Kim, Sang Ki
2011-01-01
This research aimed to analyze the patterns of co-authorship network among the Korean radiation oncologists and to identify attributing factors for the formation of networks. A total of 1,447 articles including contents of 'Radiation Oncology' and 'Therapeutic Radiology' were searched from the KoreaMed database. The co-authorship was assorted by the author's full name, affiliation and specialties. UCINET 6.0 was used to figure out the author's network centrality and the cluster analysis, and KeyPlayer 1.44 program was used to get a result of key player index. Sociogram was analyzed with the Netdraw 2.090. The statistical comparison was performed by a t-test and ANOVA using SPSS 16.0 with p-value < 0.05 as the significant value. The number of articles written by a radiation oncologist as the fi rst author was 1,025 out of 1,447. The pattern of coauthorship was classified into fi ve groups. For articles of which the fi rst author was a radiation oncologist, the number of single author articles (type-A) was 81; single-institution articles (type-B) was 687; and multiple-author articles (type-C) was 257. For the articles which radiation oncologists participated in as a co-author, the number of single-institution articles (type-D) was 280 while multiple-institution articles (type-E) were 142. There were 8,895 authors from 1,366 co-authored articles, thus the average number of authors per article was 6.51. It was 5.73 for type-B, 6.44 for type-C, 7.90 for type-D, and 7.67 for type-E (p 0.000) in the average number of authors per article. The number of authors for articles from the hospitals published more than 100 articles was 7.23 while form others was 5.94 (p = 0.005). Its number was 5.94 and 7.16 for the articles published before and after 2001 (p = 0.000). The articles written by a radiation oncologist as the fi rst author had 5.92 authors while others for 7.82 (p = 0.025). Its number was 5.57 and 7.71 for the Journal of the Korean Society for Therapeutic Radiology
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International Nuclear Information System (INIS)
Kim, Jin Hee; Kim, Jae Sung; Ha, Sung Whan
2008-01-01
To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites (mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy (dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles (54.0∼73.8 Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide (60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost (SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer
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Radiation oncologists in 2000: demographic, professional, and practice characteristics
International Nuclear Information System (INIS)
Cypel, Yasmin; Sunshine, Jonathan H.; Schepps, Barbara
2002-01-01
Purpose: To describe the demographic, professional, and practice characteristics of radiation oncologists, emphasizing comparisons to data from a similar 1995 Survey. Methods and Materials: In spring 2000, we surveyed 603 randomly selected radiation oncologists by mail, using a one-page questionnaire - 455 responded. We weighted responses to make answers representative of all radiation oncologists in the United States. Results: Approximately 45% of post-training, professionally active, radiation oncologists were <45 years old and 22% were women. Forty-two percent of radiation oncologists in training were women. Thirty-three percent of radiation-oncology-only practices were solo practices. The greatest percentage of post-training, professionally active, radiation oncologists were in nonacademic private radiation oncology practices. Fifty-three percent of post-training, professionally active, radiation oncologists reported that their workload was about right. Eighteen percent of individuals 60-64 years old and approximately two-thirds of those ≥65 years old were not working (retired). The full-time equivalency of those aged 55-74 fell by 12 percentage points between 1995 and 2000. Conclusions: Most demographic, professional, and practice characteristics remained relatively constant between 1995 and 2000, with the exception of work status patterns. Radiation oncologists reported a more balanced workload than that reported by diagnostic radiologists. The surplus of radiation oncologists, which was predicted in the mid-1990s, was not demonstrated
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Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study
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Jagsi, Reshma; Abrahamse, Paul; Morrow, Monica; Hamilton, Ann S.; Graff, John J.; Katz, Steven J.
2012-01-01
Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.
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Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study
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Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Abrahamse, Paul [Department of Internal Medicine, University of Michigan, Ann Arbor, MI (United States); Morrow, Monica [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hamilton, Ann S. [Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA (United States); Graff, John J. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Katz, Steven J. [Department of Internal Medicine, Division of General Medicine and Department of Health Management and Policy, School of Public Health, University of Michigan Health System, Ann Arbor, MI (United States)
2012-04-01
Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.
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Kim, Do Yeun; Lee, Yun Gyoo; Kim, Bong-Seog
2017-07-01
This study was conducted to investigate the current role of medical oncologists in cancer care with a focus on increasing the recognition of medical oncology as an independent specialty. Questionnaires modified from the Medical Oncology Status in Europe Survey dealing with oncology structure, resources, research, and patterns of care given by medical oncologists were selected. Several modifications were made to the questionnaire after feedback from the insurance and policy committee of the Korean Association for Clinical Oncology (KACO). The online survey was then sent to KACO members. A total of 214 medical oncologists (45.8% of the total inquiries), including 71 directors of medical oncology institutions, took the survey. Most institutions had various resources, including a medical oncology department (94.1%) and a department of radiation oncology (82.4%). There was an average of four medical oncologists at each institution. Medical oncologists were involved in various treatments from diagnosis to end-of-life care. They were also chemotherapy providers from a wide range of institutions that treated many types of solid cancers. In addition, 86.2% of the institutions conducted research. This is the first national survey in Korea to show that medical oncologists are involved in a wide range of cancer treatments and care. This survey emphasizes the contributions and proper roles of medical oncologists in the evolving health care environment in Korea.
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International Nuclear Information System (INIS)
Evans, Suzanne B.; Yu, James B.; Chagpar, Anees
2012-01-01
Purpose: To analyze error disclosure attitudes of radiation oncologists and to correlate error disclosure beliefs with survey-assessed disclosure behavior. Methods and Materials: With institutional review board exemption, an anonymous online survey was devised. An email invitation was sent to radiation oncologists (American Society for Radiation Oncology [ASTRO] gold medal winners, program directors and chair persons of academic institutions, and former ASTRO lecturers) and residents. A disclosure score was calculated based on the number or full, partial, or no disclosure responses chosen to the vignette-based questions, and correlation was attempted with attitudes toward error disclosure. Results: The survey received 176 responses: 94.8% of respondents considered themselves more likely to disclose in the setting of a serious medical error; 72.7% of respondents did not feel it mattered who was responsible for the error in deciding to disclose, and 3.9% felt more likely to disclose if someone else was responsible; 38.0% of respondents felt that disclosure increased the likelihood of a lawsuit, and 32.4% felt disclosure decreased the likelihood of lawsuit; 71.6% of respondents felt near misses should not be disclosed; 51.7% thought that minor errors should not be disclosed; 64.7% viewed disclosure as an opportunity for forgiveness from the patient; and 44.6% considered the patient's level of confidence in them to be a factor in disclosure. For a scenario that could be considerable, a non-harmful error, 78.9% of respondents would not contact the family. Respondents with high disclosure scores were more likely to feel that disclosure was an opportunity for forgiveness (P=.003) and to have never seen major medical errors (P=.004). Conclusions: The surveyed radiation oncologists chose to respond with full disclosure at a high rate, although ideal disclosure practices were not uniformly adhered to beyond the initial decision to disclose the occurrence of the error.
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Education of Radiation Oncologists. Chapter 15
International Nuclear Information System (INIS)
Rosenblatt, E.; Leer, J.W.; Haffty, B.
2017-01-01
The availability of trained staff in adequate numbers is one of the main obstacles to the development of modern radiotherapy in developing countries. While radiation oncologists practising in affluent environments may not be aware of this reality, limited number of positions, low wages, limited access to sources of evidence and ‘brain drain’ are common in countries with limited resources. Epidemiological predictions of an increase in the crude incidence of cancer that will affect predominantly developing countries represent an alarming situation in which the countries that will face the steepest increase are those most poorly prepared to cope with it. Modern cancer radiotherapy is characterized by team work in which different professionals have different roles and responsibilities. The radiation oncologist is the physician who has been trained to participate in diagnosis, staging, prescription of the radiotherapy dose and patient follow-up.
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Patel, Yoshita; Bahlhorn, Hannah; Zafar, Saniya; Zwetchkenbaum, Samuel; Eisbruch, Avraham; Murdoch-Kinch, Carol Anne
2012-07-01
Oral complications of radiation therapy for head and neck cancer (HNC) are associated with a significant decline in oral health-related quality of life (OHQOL). The dentist, working with the radiation oncologist and the rest of the health care team, plays an important role in the prevention and management of these complications, but patients do not always receive care consistent with current guidelines. This study investigated barriers to recommended care. There is variability in knowledge and practice among dentists and radiation oncologists regarding the dental management of patients treated with head and neck radiotherapy (HNRT), and inadequate communication and collaboration between members of the patient's health care team contribute to inconsistencies in application of clinical care guidelines. There is on interest and need for continuing dental (CDE) and medical education (CME) on this topic. A questionnaire was developed to assess dentists' knowledge and practice of dental management of HNC patients and their interest in CDE on this topic. All members of the Michigan Dental Association (MDA) with email addresses were asked to complete the survey online, and a random sample of MDA members without email addresses was invited to complete a paper version of the same survey. All Michigan members of the American Society for Radiation Oncology (ASTRO) were invited to complete an online version of the survey modified for radiation oncologists. The response rate for dentists was 47.9% and radiation oncologists was 22.3%. Of the dentists who responded, 81% reported that a major barrier to providing dental treatment before radiotherapy was a lack of time between initial dental consultation and the start of radiation; inadequate communication between health care providers was blamed most frequently for this. Ten percent of the dentists and 25% of the radiation oncologists reported that they did not treat HNC patients because they lacked adequate training, and 55% of
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Gill, Beant S; Beriwal, Sushil; Rajagopalan, Malolan S; Wang, Hong; Hodges, Kimberly; Greenberger, Joel S
2015-01-01
Rapid development of sophisticated modalities has challenged radiation oncologists to evaluate workflow and care delivery processes. Our study assesses treatment modality use and willingness to alter management with anticipated limitations in reimbursement and resources. A web-based survey was sent to 43 radiation oncologists in a National Cancer Institute-designated comprehensive cancer center network. The survey contained 7 clinical cases with various acceptable treatment options based on our institutional clinical pathways. Each case was presented in 3 modules with varying situations: (1) unlimited resources with current reimbursement, (2) restricted reimbursement (bundled payment), and (3) both restricted reimbursement and resources. Reimbursement rates were based on the 2013 Medicare fee schedule. Adoption of lower reimbursing options (LROs) was defined as the percentage of scenarios in which a respondent selected an LRO compared with baseline. Forty-three physicians completed the survey, 11 (26%) at academic and 32 (74%) at community facilities. When bundled payment was imposed (module 1 vs 2), an increase in willingness to adopt LROs was observed (median 11.1%). When physicians were limited to both bundled payment and resource restriction, adoption of LROs was more pronounced (module 1 vs 3; median 22.2%, P 25 years, P = .02). Radiation oncologists were more likely to choose lower reimbursing treatment options when both resource restriction and bundled payment were presented. Those with fewer years of clinical practice were less inclined to alter management, perhaps reflecting modern residency training. Future cost-utility analyses may help to better guide radiation oncologists in selection of LROs. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
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What do Patients Want From Their Radiation Oncologist? Initial Results From a Prospective Trial
International Nuclear Information System (INIS)
Bhatnagar, Ajay K.; Land, Stephanie R.; Shogan, Alyson; Rodgers, Edwin E.; Heron, Dwight E.; Flickinger, John C.
2007-01-01
Purpose: To assess patients' initial physician preferences using a newly developed instrument. Methods and Materials: A total of 182 patients with a primary diagnosis of prostate, breast, or lung cancer referred for consultation to University of Pittsburgh Cancer Institute Department of Radiation Oncology enrolled in our institutional review board-approved protocol. All patients completed patient preference instrument surveys before meeting their radiation oncologist. Survey responses to 10 statements were categorized into three groups (agree, neutral, or disagree), and the association of survey responses by cancer site was tested with chi-squared tests. Results: Ninety-nine percent of all patients preferred to be addressed by their first name in encounters with their radiation oncologist. There were significant associations of Item 3 (hand holding) with gender (p = 0.039) and education (p = 0.028). The responses to Item 5, a statement that patients would feel uncomfortable if the radiation oncologist offered to hug them at the end of treatment, was significantly associated with disease site (p < 0.0001). Further analysis was performed for Item 5 and revealed that the male lung cancer patients had a much higher rate of disagreement with Item 5 compared with prostate cancer patients (37% vs. 18%). Conclusions: Results of this study may afford greater insight and foster better understanding of what patients want from their radiation oncologist. For breast, lung, and prostate cancer patients, initial preferences for their radiation oncologist are generally similar, according to this tool. However, there are important difference among cancer sites (and gender) regarding physical contact at the end of treatment
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Hoppe, Bradford S. [University of Florida Health Proton Therapy Institute, Jacksonville, Florida (United States); Hoppe, Richard T., E-mail: rhoppe@stanford.edu [Stanford Cancer Institute, Stanford, California (United States)
2015-05-01
Purpose: Recently, involved-site radiation therapy (ISRT) guidelines have been developed and published to replace the previous concept of involved-field radiation therapy for patients with lymphoma. However, these ISRT guidelines may be interpreted in different ways, posing difficulties for prospective clinical trials. This study reports survey results regarding interpretation of the ISRT guidelines. Methods and Materials: Forty-four expert lymphoma radiation oncologists were asked to participate in a survey that included 7 different cases associated with 9 questions. The questions pertained to ISRT contouring and asked respondents to choose between 2 different answers (no “correct” answer) and a third write-in option allowed. Results: Fifty-two percent of those surveyed responded to the questionnaire. Among those who responded, 72% have practiced for >10 years, 46% have treated >20 Hodgkin lymphoma cases annually, and 100% were familiar with the ISRT concept. Among the 9 questions associated with the 7 cases, 3 had concordance among the expert radiation oncologists of greater than 70%. Six of the questions had less than 70% concordance (range, 56%-67%). Conclusions: Even among expert radiation oncologists, interpretation of ISRT guidelines is variable. Further guidance for ISRT field design will be needed to reduce variability among practicing physicians.
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Nature of Medical Malpractice Claims Against Radiation Oncologists
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Marshall, Deborah; Tringale, Kathryn [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Connor, Michael [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); University of California Irvine School of Medicine, Irvine, California (United States); Punglia, Rinaa [Department of Radiation Oncology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (United States); Hattangadi-Gluth, Jona, E-mail: jhattangadi@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)
2017-05-01
Purpose: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials: Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. Results: There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included “improper performance” (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), “errors in diagnosis” (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and “no medical misadventure” (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. “Improper performance” was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Conclusions: Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against
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Stress, satisfaction and burnout amongst Australian and New Zealand radiation oncologists.
Leung, John; Rioseco, Pilar; Munro, Philip
2015-02-01
The aim of this study was to determine the self-reported prevalence of stress, job satisfaction and burnout among radiation oncologists in Australia and New Zealand. A secondary aim was to determine the association between stress and satisfaction parameters with burnout. An anonymous online survey was distributed to all radiation oncologists listed on Royal Australian and New Zealand College of Radiologists membership database. There were 37 Likert scale questions on stress, 17 Likert scale questions on job satisfaction and burnout assessed by the Maslach Burnout Inventory - Human Services Survey (MBI-HSS). A principal component analysis was done for stress and satisfaction to identify specific areas. Independent samples t-tests and analysis of variances were done. There were 220 responses out of 348 eligible respondents (63.2% response rate).For stress, a principal component analysis identified five areas: delivery demands, demands on time, continuing professional development (CPD), value and security, and interpersonal/teaching demands. Specialist radiation oncologists were more stressed by value and security than generalists (P stress associated with delivery demands, demands on time and CPD compared with others (P = 0.01). Those over 60 years were less stressed by delivery demands (P = 0.02), demands on time (P = 0.01) and CPD (P = 0.01) than their younger colleagues. Four satisfaction factors were identified in the principal component analysis: resources/remuneration, status/security, delivery of services and professional activities. [Correction added on 15 August 2014, after first online publication: stress/security was replaced with status/security.] Males and Australian radiation oncologists were more satisfied with professional activities (P = 0.02). Brachytherapy specialists were more satisfied with status/security (P = 0.01) while those interested in urology were more satisfied with resources/renumeration (P = 0.01) and
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Contemporary management of stage i testicular seminoma: a survey of Canadian radiation oncologists
Samant, R.; Alomary, I.; Genest, P.; Eapen, L.
2008-01-01
Recently published studies clearly indicate that there are now several acceptable options for managing stage i testicular seminoma patients after orchiectomy. We therefore decided to survey Canadian radiation oncologists to determine how they currently manage such patients and to compare the results with previous surveys. Our results demonstrate that adjuvant single-agent chemotherapy is being considered as an option by an increasing proportion of radiation oncologists (although it is not considered the preferred option), the routine use of radiotherapy is declining, and surveillance is becoming increasingly popular and is recommended most often. PMID:18769613
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Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Bosch, Walter [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Haas, Rick L.M. [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Olsen, Jeffrey R. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Deville, Curtiland [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Finkelstein, Steven E. [Translational Research Consortium, 21st Century Oncology, Scottsdale, Arizona (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)
2015-08-01
Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.
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International Nuclear Information System (INIS)
Baldini, Elizabeth H.; Abrams, Ross A.; Bosch, Walter; Roberge, David; Haas, Rick L.M.; Catton, Charles N.; Indelicato, Daniel J.; Olsen, Jeffrey R.; Deville, Curtiland; Chen, Yen-Lin; Finkelstein, Steven E.; DeLaney, Thomas F.; Wang, Dian
2015-01-01
Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed
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Garcia-Ramirez, M; Maugey, S; Burgaud, L; Carpentey, F; Parezys, E; Carricaburu, M
2014-11-01
The aim of this prospective study was to evaluate daily set-up by a radiation oncologist and by radiation therapists using on-board imaging of patients with head and neck cancer in order to calculate margin to PTV (planning target volume) and intent partial delegation of positioning images control. The files of 11 patients with head and neck cancer treated on a Synergy™ (Elekta™) accelerator with on-board imaging system were evaluated. Daily kV-kV images were double-blind reviewed by radiation therapists (7 participants) and by one radiation oncologist. The radiation oncologist's measures were used for margin calculation from CTV to PTV. The difference of measures and the concordance of decisions between radiation therapists and the radiation oncologist were calculated. The 325 measures made by the radiation oncologist resulted in a margin of 5mm to be applied to the CTV in each direction. Nine hundred seventy-seven measures were made by the radiation oncologist and radiation therapists with a difference of 3mm or less in 98.46%. The concordance of decision for a 4mm difference or less to the isocenter was 96.7%. This study confirms the 5mm PTV margin mostly used in ORL. The small gap between the radiation oncologist's and therapists' measures allows a partial delegation of positioning images control. Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.
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The stucture of Korean radiation oncology in 1997
International Nuclear Information System (INIS)
Kim, Mi Sook; Yoo, Seoung Yul; Cho, Chul Koo; Yoo, Hyung Jun; Yang, Kwang Mo; Ji, Young Hoon; Kim, Do Jun
1999-01-01
To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipment and patient loads between Korea and developed countries. Mail surveys were conducted in 1998 and data on treatment machines, personnel and performed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole contry were summarized using Microsoft Excel program. In Korea during 1997, 42 facilities delivered megavoltage radiation therapy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelerates at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator. Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there
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Mowery, Yvonne M; Salama, Joseph K; Zafar, S Yousuf; Moore, Harvey G; Willett, Christopher G; Czito, Brian G; Hopkins, M Benjamin; Palta, Manisha
2017-04-15
Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice. Of 1659 contactable physicians, 182 responses (11%) were received. Approximately 83% treated at least 5 patients with rectal cancer annually. The majority of responding radiation oncologists (96%) preferred neoadjuvant LC-CRT for the treatment of patients with locally advanced rectal cancer and 44% never used SC-RT. Among radiation oncologists using SC-RT, respondents indicated they would not recommend this regimen for patients with low (74%) or bulky tumors (70%) and/or concern for a positive circumferential surgical resection margin (69%). The most frequent reasons for not offering SC-RT were insufficient downstaging for sphincter preservation (53%) and a desire for longer follow-up (45%). Many radiation oncologists indicated they would prescribe SC-RT for patients not receiving chemotherapy (62%) or patients with a geographic barrier to receiving LC-CRT (82%). Patient comorbidities appeared to influence regimen preferences for 79% of respondents. Approximately 20% of respondents indicated that altered oncology care reimbursement using capitated payment by diagnosis would impact their consideration of SC-RT. US radiation oncologists rarely use neoadjuvant SC-RT despite 3 randomized controlled trials demonstrating no significant differences in outcome compared with LC-CRT. Further research is necessary to determine whether longer follow-up coupled with the benefits of lower cost, increased
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International Nuclear Information System (INIS)
Han, Leona C.; Delpe, Sophia; Shah, Nilay D.; Ziegenfuss, Jeanette Y.; Tilburt, Jon C.; Karnes, R. Jeffrey; Nguyen, Paul L.; Gross, Cary P.; Yu, James B.; Trinh, Quoc-Dien; Sun, Maxine; Ranasinghe, Weranja K.B.; Kim, Simon P.
2014-01-01
Purpose: To perform a national survey of radiation oncologists and urologists about the type of resources used and the level of evidence needed to change clinical practice in localized prostate cancer. Methods and Materials: From a random sample, 1422 physicians were mailed a survey assessing the types of information used and what level of evidence could alter their clinical practice in prostate cancer. Multivariable logistic regression models were used to identify differences in physician characteristics for each outcome. Results: Survey response rates were similar for radiation oncologists and urologists (44% vs 46%; P=.46). Specialty-specific journals represented the most commonly used resource for informing the clinical practice for radiation oncologists (65%) and urologists (70%). Relative to radiation oncologists, urologists were less likely to report utilizing top-tier medical journals (25% vs 39%; adjusted odds ratio [OR] 0.50; P=.01) or cancer journals (22% vs 51%; adjusted OR 0.50; P<.001) but more likely to rely on clinical guidelines (46% vs 38%; adjusted OR 1.6; P=.006). Both radiation oncologists and urologists most commonly reported large randomized, clinical trials as the level of evidence to change treatment recommendations for localized prostate cancer (85% vs 77%; P=.009). Conclusions: Both specialties rely on their own specialty-specific journals and view randomized, clinical trials as the level of evidence needed to change clinical practice. Our study provides a context on meaningful ways of disseminating evidence for localized prostate cancer
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International Nuclear Information System (INIS)
Mampuya, Wambaka Ange; Matsuo, Yukinori; Nakamura, Akira; Hiraoka, Masahiro
2017-01-01
This study aimed to evaluate the self-reported prevalence of burnout and psychological morbidity among radiation oncologists members of the Kyoto Radiation Oncology Study Group (KROSG) and to identify factors contributing to burnout. We mailed an anonymous survey to 125 radiation oncologists members of the KROSG. The survey included; the demographic data, the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) and the 12-item General Health Questionnaire (GHQ-12). There were 87 responses out of 125 eligible respondents (69.6% response rate). In terms of burnout, three participants (3.4%) fulfilled the MBI-HSS criteria of having simultaneously high emotional exhaustion (EE), high depersonalization (DP) and low sense of personal accomplishment (PA). Eighteen (20.6%) reported a high score for either EE or DP meeting the alternative criteria for burnout with three of these simultaneously having high EE and high DP. The prevalence of psychological morbidity estimated using GHQ-12 was 32%. A high level of EE and low level of PA significantly correlated with high level of psychological morbidity with P < 0.001 and <0.01 respectively. Having palliative care activities other than radiotherapy and number of patients treated per year were the only factors associated with burnout. This is the first study investigating the prevalence of burnout and psychological morbidity among radiation oncologists in Japan. Compared with other studies involving radiation oncologists, the prevalence of low personal accomplishment was particularly high in the present study. The prevalence of psychological morbidity was almost the double that of the Japanese general population and was significantly associated with low PA and high EE.
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Energy Technology Data Exchange (ETDEWEB)
Jairam, Vikram [Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)
2016-01-01
Purpose: To use the Centers for Medicare and Medicaid Services Open Payments database to characterize payments made to radiation oncologists and compare their payment profile with that of medical and surgical oncologists. Methods and Materials: The June 2015 release of the Open Payments database was accessed, containing all payments made to physicians in 2014. The general payments dataset was used for analysis. Data on payments made to medical, surgical, and radiation oncologists was obtained and compared. Within radiation oncology, data regarding payment category, sponsorship, and geographic distribution were identified. Basic statistics including mean, median, range, and sum were calculated by provider and by transaction. Results: Among the 3 oncologic specialties, radiation oncology had the smallest proportion (58%) of compensated physicians and the lowest mean ($1620) and median ($112) payment per provider. Surgical oncology had the highest proportion (84%) of compensated physicians, whereas medical oncology had the highest mean ($6371) and median ($448) payment per physician. Within radiation oncology, nonconsulting services accounted for the most money to physicians ($1,042,556), whereas the majority of the sponsors were medical device companies (52%). Radiation oncologists in the West accepted the most money ($2,041,603) of any US Census region. Conclusions: Radiation oncologists in 2014 received a large number of payments from industry, although less than their medical or surgical counterparts. As the Open Payments database continues to be improved, it remains to be seen whether this information will be used by patients to inform choice of providers or by lawmakers to enact policy regulating physician–industry relationships.
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Breast cancer biology for the radiation oncologist
Energy Technology Data Exchange (ETDEWEB)
Strauss, Jonathan [Northwestern Univ., Chicago, IL (United States). Dept. of Radiation Oncology; Small, William [Loyola Univ. Chicago, Maywood, IL (United States). Stritch School of Medicine, Cardianl Bernardin Cancer Center; Woloschak, Gayle E. (ed.) [Northwestern Univ. Feinberg, Chicago, IL (United States). School of Medicine
2015-10-01
This is the first textbook of its kind devoted to describing the biological complexities of breast cancer in a way that is relevant to the radiation oncologist. Radiation Oncology has long treated breast cancer as a single biological entity, with all treatment decisions being based on clinical and pathologic risk factors. We are now beginning to understand that biological subtypes of breast cancer may have different risks of recurrence as well as different intrinsic sensitivity to radiotherapy. Multi-gene arrays that have for years been used to predict the risk of distant recurrence and the value of systemic chemotherapy may also have utility in predicting the risk of local recurrence. Additionally, the targeted agents used to treat breast cancer may interact with radiotherapy in ways that can be beneficial or undesirable. All of these emerging issues are extensively discussed in this book, and practical evidence-based treatment recommendations are presented whenever possible.
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Breast cancer biology for the radiation oncologist
International Nuclear Information System (INIS)
Strauss, Jonathan; Small, William; Woloschak, Gayle E.
2015-01-01
This is the first textbook of its kind devoted to describing the biological complexities of breast cancer in a way that is relevant to the radiation oncologist. Radiation Oncology has long treated breast cancer as a single biological entity, with all treatment decisions being based on clinical and pathologic risk factors. We are now beginning to understand that biological subtypes of breast cancer may have different risks of recurrence as well as different intrinsic sensitivity to radiotherapy. Multi-gene arrays that have for years been used to predict the risk of distant recurrence and the value of systemic chemotherapy may also have utility in predicting the risk of local recurrence. Additionally, the targeted agents used to treat breast cancer may interact with radiotherapy in ways that can be beneficial or undesirable. All of these emerging issues are extensively discussed in this book, and practical evidence-based treatment recommendations are presented whenever possible.
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Current status of SCI and SCIE publications in the field of radiation oncology in Korea
International Nuclear Information System (INIS)
Kang, Jin Oh
2007-01-01
To investigate current status of SCI (Science Citation Index) and SCI Expanded publication of Korean radiation oncologists. Published SCI and SCIE articles the conditions of first author's address as 'Korea' and 'Radiation Oncology' or 'Therapeutic Radiology' were searched from Pubmed database. From 1990 to 2006, 146 SCI articles and 32 SCIE articles were published. Most frequently published journal was international Journal of Radiation Oncology Biology Physics, where 56 articles were found. Articles with 30 or more citations were only five and 10 or more citations were 26. Yonsei University, which had 57 published articles, was the top among 19 affiliations which had one or more SCI and SCIE articles. Authors with five or more articles were 9 and Seong J. of Yonsei University was the top with 19 articles. The investigations showed disappointing results. The members of Korean Society of Radiation Oncologists must consider a strategy to increase SCI and SCIE publications
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Kachnic, Lisa A; Bruner, Deborah W; Qureshi, Muhammad M; Russo, Gregory A
Vaginal stenosis (VS) is a recognized complication of pelvic and vaginal radiation therapy (RT). A 26-item survey assessing the signs/symptoms, risk factors, diagnosis, prevention, treatment, and impact of VS on women's sexual health was distributed to radiation oncologists. Descriptive statistics were calculated. Chi-square tests examined differences in categorical responses. A total of 233 (10.5%) participants completed the entire survey. Twelve percent, 21%, and 68% report treating gynecologic (GYN) tumors only, non-GYN pelvic tumors only, or both, respectively. Regarding risk factors, 78% believed that VS can be caused by pelvic RT alone, 91% by vaginal brachytherapy alone, and 98% by combined pelvic RT and vaginal brachytherapy. Approximately one-half of respondents felt that being postmenopausal and having a hysterectomy before radiation therapy were risk factors for VS, whereas the other half felt that these were not risk factors. All respondents agreed that VS is a clinical diagnosis. Respondents indicated that VS symptoms include dyspareunia, vaginal pain, dryness, and/or bleeding (100%, 90%, 85%, and 72%, respectively); 65% indicated all 4. The most commonly recommended treatment for VS is vaginal dilator use. Radiation oncologists who treat GYN-only versus non-GYN cancers were more likely to perform a vaginal examination, to distribute written instructions regarding vaginal dilator use (P = .002), to have vaginal bleeding reported after RT (P = .001), and to refer patients to a sexual counselor (P = .007). Most providers (73%) expressed willingness to participate in prospective research on the diagnosis and treatment of VS. This is the first large-scale survey of radiation oncologists' perceptions and practices regarding VS. There is agreement among providers regarding the signs/symptoms of VS and strategies for its prevention/treatment using vaginal dilators. Further prospective and observational research is needed. This survey shows a willingness on
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Shakespeare, Thomas P
2015-11-18
Positron emission tomography (PET) imaging is routinely used in many cancer types, although is not yet a standard modality for prostate carcinoma. Prostate-specific membrane antigen (PSMA) PET is a promising new modality for staging prostate cancer, with recent studies showing potential advantages over traditional computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine bone scan imaging. However, the impact of PSMA PET on the decision-making of radiation oncologists and outcomes after radiotherapy is yet to be determined. Our aim was to determine the impact of PSMA PET on a radiation oncologist's clinical practice. Patients in a radiation oncology clinic who underwent PSMA PET were prospectively recorded in an electronic oncology record. Patient demographics, outcomes of imaging, and impact on decision-making were evaluated. Fifty-four patients underwent PSMA PET between January and May 2015. The major reasons for undergoing PET included staging before definitive (14.8%) or post-prostatectomy (33.3%) radiotherapy, and investigation of PSA failures following definitive (16.7%) or post-prostatectomy (33.3%) radiotherapy. In 46.3% of patients PSMA was positive after negative traditional imaging, in 9.3% PSMA was positive after equivocal imaging, and in 13.0% PSMA was negative after equivocal imaging. PSMA PET changed radiotherapy management in 46.3% of cases, and hormone therapy in 33.3% of patients, with an overall change in decision-making in 53.7% of patients. PSMA PET has the potential to significantly alter the decision-making of radiation oncologists, and may become a valuable imaging tool in the future.
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Managing an Older Adult with Cancer: Considerations for Radiation Oncologists
Directory of Open Access Journals (Sweden)
Sanders Chang
2017-01-01
Full Text Available Older adults with cancer present a unique set of management complexities for oncologists and radiation oncologists. Prognosis and resilience to cancer treatments are notably dependent on the presence or risk of “geriatric syndromes,” in addition to cancer stage and histology. Recognition, proper evaluation, and management of these conditions in conjunction with management of the cancer itself are critical and can be accomplished by utilization of various geriatric assessment tools. Here we review principles of the geriatric assessment, common geriatric syndromes, and application of these concepts to multidisciplinary oncologic treatment. Older patients may experience toxicities related to treatments that impact treatment effectiveness, quality of life, treatment-related mortality, and treatment compliance. Treatment-related burdens from radiotherapy are increasingly important considerations and include procedural demands, travel, costs, and temporary or permanent loss of functional independence. An overall approach to delivering radiotherapy to an older cancer patient requires a comprehensive assessment of both physical and nonphysical factors that may impact treatment outcome. Patient and family-centered communication is also an important part of developing a shared understanding of illness and reasonable expectations of treatment.
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Post, Carl M; Jain, Aditya; Degnin, Catherine; Chen, Yiyi; Craycraft, Mike; Hung, Arthur Y; Jaboin, Jerry J; Thomas, Charles R; Mitin, Timur
2018-01-16
Patients with testicular seminoma may face fertility issues because of their underlying disease as well as treatments they undergo. The current patterns of practice among U.S. radiation oncologists aimed at assessing and preserving fertility in patients with Stage I seminoma are unknown. We surveyed practicing U.S. radiation oncologists via an Institutional Review Board-approved online questionnaire. Respondents' characteristics and perceived patient infertility rates were analyzed for association with treatment recommendations. We received 353 responses, of whom one quarter (23%) consider themselves experts. A vast majority (84%) recommend observation as a default strategy. Fifty-two percent routinely advise fertility assessment for patients before observation or chemotherapy, and 74% routinely do so before adjuvant radiation therapy (RT). Forty-one percent and 43% believe that 10% and 30% of patients are infertile following orchiectomy, respectively. Thirty-seven percent and 22% believe infertility rates following para-aortic RT to be 30% and 50%, respectively. Eighty percent routinely use clamshell scrotal shielding. Responders with higher perceived infertility rates are more likely to recommend fertility assessment/sperm banking (Fisher's exact p < 0.0001). Responders who routinely advised fertility assessment were more likely to use clamshell shielding (Cochran-Armitage trend test p = 0.0007). Clamshell use was positively correlated with higher perceived infertility rates following para-aortic RT (Spearman's correlation coefficient = 0.006). Despite a clear knowledge of fertility issues in men diagnosed with seminoma, there is no universal adoption of fertility assessment among U.S. radiation oncologists.
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Lewis, Stephen L; Porceddu, Sandro; Nakamura, Naoki; Palma, David A; Lo, Simon S; Hoskin, Peter; Moghanaki, Drew; Chmura, Steven J; Salama, Joseph K
2017-08-01
Stereotactic body radiotherapy (SBRT) is often used to treat patients with oligometastases (OM). Yet, patterns of SBRT practice for OM are unknown. Therefore, we surveyed radiation oncologists internationally, to understand how and when SBRT is used for OM. A 25-question survey was distributed to radiation oncologists. Respondents using SBRT for OM were asked how long they have been treating OM, number of patients treated, organs treated, primary reason for use, doses used, and future intentions. Respondents not using SBRT for OM were asked reasons why SBRT was not used and intentions for future adoption. Data were analyzed anonymously. We received 1007 surveys from 43 countries. Eighty-three percent began using SBRT after 2005 and greater than one third after 2010. Eighty-four percent cited perceived treatment response/durability as the primary reason for using SBRT in OM patients. Commonly treated organs were lung (90%), liver (75%), and spine (70%). SBRT dose/fractionation schemes varied widely. Most would offer a second course to new OM. Nearly all (99%) planned to continue and 66% planned to increase SBRT for OM. Of those not using SBRT, 59% plan to start soon. The most common reason for not using SBRT was lack of clinical efficacy (48%) or lack of necessary image guidance equipment (34%). Radiation oncologists are increasingly using SBRT for OM. The main reason for not using SBRT for OM is a perceived lack of evidence demonstrating clinical advantages. These data strengthen the need for robust prospective clinical trials (ongoing and in development) to demonstrate clinical efficacy given the widespread adoption of SBRT for OM.
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International Nuclear Information System (INIS)
2013-01-01
Cervical cancer remains a significant cause of morbidity and mortality among women globally, even though it is the cancer with the greatest demonstrated potential for secondary prevention. In some regions of the world the incidence is alarmingly high, such as in sub-Saharan Africa, some countries in Latin America, India and South-East Asia. This disease is highly preventable and curable at a relatively low risk and low cost when screening of asymptomatic women is available, together with appropriate diagnosis, treatment and follow-up. In developing clinical guidelines, the International Atomic Energy Agency (IAEA) has selected forms of cancer or clinical situations that are very common in low and middle income Member States and for which radiation oncologists consistently express a need for guidance. Clinical guidelines for the management of cervical cancer do exist in the published literature. However, these guidelines have usually been developed in and for affluent environments where all modern diagnosis and treatment modalities are available for the practitioner. In limited resource environments, the radiation oncologist is faced with the question, what would be the minimally acceptable line of action with the limited resources available? Clinical guidelines focusing on low and middle income countries provide a practical tool to these practitioners. This publication is aimed at the radiation oncologist working in centres with limited resources and treating a large number of patients with cervical cancer on a daily basis. The approach and techniques are intended to be simple, feasible and resource sparing to the extent that this is possible when dealing with a complex treatment modality. The Division of Human Health is placing special emphasis on the subject of cervical cancer, which is addressed not only in this guide but also in regional training courses and coordinated research projects on the subject
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International Nuclear Information System (INIS)
Rodrigues, George; D'Souza, David; Crook, Juanita; Malone, Shawn; Sathya, Jinka; Morton, Gerard
2003-01-01
Objective: To survey radiation oncology practice in the utilization of hormonal and radiation therapy in the primary, adjuvant and salvage treatment of localized prostate cancer. Materials and methods: Genitourinary radiation oncologists practicing in Ontario were invited to participate in a practice survey examining staging, hormonal and radiation management, and radiation technique for a variety of common clinical scenarios. Background demographic information was collected on all respondents. The survey consisted of three cases relating to the hormonal/radiation management of low-, intermediate-, and high-risk prostate cancer as well as two adjuvant and one salvage post-prostatectomy scenarios. The survey response rate was 70% (26/37). Results: Clinicians were more likely to utilize laboratory and imaging studies for staging as the risk categorization increased. Low-risk disease was managed with radiation alone in 26/26 (70 Gy in 65%, 74-79.8 Gy in 35%). Intermediate-risk disease was managed with radiation (70 Gy in 46%, 74-79.8 Gy in 54%) with neoadjuvant hormones in 58%. All respondents managed high-risk disease with adjuvant hormones in addition to radiation therapy (70-71 Gy in 85%, and 76 Gy in 15%). In the pT3a, margin negative (PSA undetectable) scenario, most individuals would not recommend adjuvant radiation (73%). If margins were positive, 30% would still not recommend adjuvant radiation. In the salvage scenario (slowly rising PSA 4 years post-prostatectomy for pT2a close margin disease), all respondents would manage with radiation therapy. Hormones were not routinely recommended in the initial management of the adjuvant and salvage scenarios. Radiation doses utilized for both adjuvant and salvage treatment ranged from 60-70 Gy (median 66 Gy). Conclusions: General agreement exists for the management of low- and high-risk disease and in the post-prostatectomy salvage setting. Use of dose-escalation and neoadjuvant hormones in the intermediate
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Lloyd, Shane; Dosoretz, Arie P; Yu, James B; Evans, Suzanne B; Decker, Roy H
2016-02-01
There has been increasing scrutiny about cancer treatment for patients very near the end of life (EoL), yet a substantial number receive palliative radiation therapy (RT) in this setting. Our aim was to document the attitudes and intentions of thought leaders and trainees in giving RT near the EoL. We distributed an anonymous survey to 473 radiation oncologists and residents. The survey examined the clinical and psychosocial factors considered as well as intentions and expectations in the delivery of RT near the EoL. Factors surrounding unfinished treatment courses, and the formative factors that shape opinions about RT at the EoL were also explored. We received 139 responses (29%). Eighty-nine percent of respondents worked at academic institutions. The factors that respondents most often consider very or extremely important to offer RT near the EoL were the preference of the patient to be treated (94%), the ability to tolerate treatment (88%), and palliative intent (70%). After instances when their patients were unable to complete treatment near the EoL, 42% of respondents said they would prescribe a shorter treatment the next time they see a similar patient. Personal experience (71%) was most often listed as very or extremely important in shaping their opinions about RT near the EoL. Survey respondents, 89% of whom were academic radiation oncologists, have a positive view of palliative RT near the EoL. They favor shorter fractionation for patients near the EoL. Personal experience is most important in shaping practices and attitudes.
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Projected requirements for radiation oncologists and trainees in Australia and New Zealand to 2007
International Nuclear Information System (INIS)
Morgan, G.; Wigg, D.; Childs, J.
2000-01-01
Workloads in radiation oncology facilities in Australia and New Zealand have been increasing steadily for many years and it is anticipated that this trend will continue. In the present paper the projected number of radiation oncologists required to meet this demand to the year 2007 are estimated, along with the number of trainees required. The estimates are based on data from regular surveys by the Royal Australian and New Zealand College of Radiologists (RANZCR) for the years 1988-97 (inclusive). From these surveys profiles of numbers, age and gender of specialists and trainees are documented together with increases from the training programme and losses from retirement. It is concluded that if the current trainee numbers are increased by 12 in Australia and two in New Zealand, there will be approximately 10 radiation oncologists per million of population by the year 2007. This number is considered appropriate vue the anticipated increase in demands and complexity of treatment. Because projections too far forward are unreliable, careful monitoring of progress is essential to obtain the appropriate balance between requirement and supply. Comparisons are made with other estimates of needs including the 1998 Australian Medical Workforce Advisory Committee (AMWAC) Report and the New Zealand Clinical Agency Workforce Project Report in 1997. Copyright (1999) Blackwell Science Pty Ltd
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International Nuclear Information System (INIS)
Hanna, Gerard G.; Carson, Kathryn J.; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P.; Eakin, Ruth L.; Stewart, David P.; Zatari, Ashraf; O'Sullivan, Joe M.; Hounsell, Alan R.
2010-01-01
Purpose: 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. Methods and Materials: RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV CT ) and on fused PET/CT images (GTV PETCT ). The mean percentage volume change (PVC) between GTV CT and GTV PETCT for the radiation oncologists and the PVC between GTV CT and GTV PETCT for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV CT and GTV PETCT in a single measurement. Results: For all patients, a significant difference in PVC from GTV CT to GTV PETCT exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV CT and GTV FUSED for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Conclusions: Percentage volume changes from GTV CT to GTV PETCT were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP.
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Hanna, Gerard G; Carson, Kathryn J; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P; Eakin, Ruth L; Stewart, David P; Zatari, Ashraf; O'Sullivan, Joe M; Hounsell, Alan R
2010-11-15
(18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV(CT)) and on fused PET/CT images (GTV(PETCT)). The mean percentage volume change (PVC) between GTV(CT) and GTV(PETCT) for the radiation oncologists and the PVC between GTV(CT) and GTV(PETCT) for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV(CT) and GTV(PETCT) in a single measurement. For all patients, a significant difference in PVC from GTV(CT) to GTV(PETCT) exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV(CT) and GTV(FUSED) for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Percentage volume changes from GTV(CT) to GTV(PETCT) were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP. Copyright © 2010 Elsevier Inc. All rights reserved.
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Current status of brachytherapy in Korea: a national survey of radiation oncologists.
Kim, Haeyoung; Kim, Joo Young; Kim, Juree; Park, Won; Kim, Young Seok; Kim, Hak Jae; Kim, Yong Bae
2016-07-01
The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.
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The role of ASTRO and the radiation oncologist in preparedness
International Nuclear Information System (INIS)
Daly, N.
2003-01-01
The events on September 11, 2001 were unpredictable and tragic, however it is not inconceivable that a similar terrorist event could occur again, this time involving radiologic or nuclear material. In order to prepare for this American Society for Therapeutic Radiology and Oncology (ASTRO) convened a task force. Initially the task force worked with the American College of Radiology (ACR)and the American Society of Physicists in Medicine (AAPM)to publish a PRIMER entitled 'Disaster Preparedness for Radiology Professionals'. The PRIMER serve as a quick reference in the event of a radiation disaster and is available on the ASTRO Web site (www.astro.org). The task force has also developed a detailed and extensive training program, in partnership with the U.S. Department of Energy's Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge (TN), that will equip radiation oncologists with the necessary expertise to train hospital radiation oncology departments and other healthcare personnel who are responsible for implementing and carrying out hospital planning for disasters involving radioactive materials. This presentation will outline the effort ASTRO has been involved with since September 11, 2001 to prepare the professional community it represent in the event of a radiation/nuclear disaster
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Energy Technology Data Exchange (ETDEWEB)
Jereczek-Fossa, B.A.; Pobbiati, C.; Fanti, P. [European Institute of Oncology, Department of Radiation Oncology, Milan (Italy); University of Milan, Milan (Italy); Santoro, L. [European Institute of Oncology, Department of Epidemiology and Biostatistics, Milan (Italy); Fodor, C.; Zerini, D. [European Institute of Oncology, Department of Radiation Oncology, Milan (Italy); Vigorito, S. [European Institute of Oncology, Department of Medical Physics, Milan (Italy); Baroni, G. [Politecnico di Milano, Department of Electronics Information and Bioengineering, Milan (Italy); De Cobelli, O. [European Institute of Oncology, Department of Urology, Milan (Italy); University of Milan, Milan (Italy); Orecchia, R. [European Institute of Oncology, Department of Radiation Oncology, Milan (Italy); National Center for Oncological Hadrontherapy (CNAO) Foundation, Pavia (Italy); University of Milan, Milan (Italy)
2014-01-15
To check the interobserver agreement between radiation oncologists and therapists (RTT) using an on- and off-line cone-beam computer tomography (CBCT) protocol for setup verification in the radiotherapy of prostate cancer. The CBCT data from six prostate cancer patients treated with hypofractionated intensity-modulated radiotherapy (IMRT) were independently reviewed off-line by four observers (one radiation oncologist, one junior and two senior RTTs) and benchmarked with on-line CBCT positioning performed by a radiation oncologist immediately prior to treatment. CBCT positioning was based on manual soft-tissue registration. Agreement between observers was evaluated using weighted Cohen's kappa statistics. In total, 152 CBCT-based prostate positioning procedures were reviewed by each observer. The mean (± standard deviation) of the differences between off- and on-line CBCT-simCT registration translations along the three directions (antero-posterior, latero-lateral and cranio-caudal) and rotation around the antero-posterior axis were - 0.7 (3.6) mm, 1.9 (2.7) mm, 0.9 (3.6) mm and - 1.8 (5.0) degrees, respectively. Satisfactory interobserver agreement was found, being substantial (weighted kappa > 0.6) in 10 of 16 comparisons and moderate (0.41-0.60) in the remaining six comparisons. CBCT interpretation performed by RTTs is comparable to that of radiation oncologists. Our study might be helpful in the quality assurance of radiotherapy and the optimization of competencies. Further investigation should include larger sample sizes, a greater number of observers and validated methodology in order to assess interobserver variability and its impact on high-precision prostate cancer IGRT. In the future, it should enable the wider implementation of complex and evolving radiotherapy technologies. (orig.)
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Variability Among Breast Radiation Oncologists in Delineation of the Postsurgical Lumpectomy Cavity
International Nuclear Information System (INIS)
Landis, Daniel M.; Luo Weixiu; Song Jun; Bellon, Jennifer R.; Punglia, Rinaa S.; Wong, Julia S.; Killoran, Joseph H.; Gelman, Rebecca; Harris, Jay R.
2007-01-01
Purpose: Partial breast irradiation (PBI) is becoming more widely used. Accurate determination of the surgical lumpectomy cavity volume is more critical with PBI than with whole breast radiation therapy. We examined the interobserver variability in delineation of the lumpectomy cavity among four academic radiation oncologists who specialize in the treatment of breast cancer. Methods and Materials: Thirty-four lumpectomy cavities in 33 consecutive patients were evaluated. Each physician contoured the cavity and a 1.5-cm margin was added to define the planning target volume (PTV). A cavity visualization score (CVS) was assigned (1-5). To eliminate bias, the physician of record was eliminated from the analysis in all cases. Three measures of variability of the PTV were developed: average shift of the center of mass (COM), average percent overlap between the PTV of two physicians (PVO), and standard deviation of the PTV. Results: Of variables examined, pathologic resection volume was significantly correlated with CVS, with larger volumes more easily visualized. Shift of the COM decreased and PVO increased significantly as CVS increased. For CVS 4 and 5 cases, the average COM shift was 3 mm and 2 mm, respectively, and PVO was 77% and 87%, respectively. In multiple linear regression, pathologic diameter >4 cm and CVS ≥3 were significantly associated with smaller COM shift. When CVS was omitted from analysis, PVO was significantly larger with pathologic diameter ≥5 cm, days to planning <36, and older age. Conclusions: Even among radiation oncologists who specialize in breast radiotherapy, there can be substantial differences in delineation of the postsurgical radiotherapy target volume. Large treatment margins may be prudent if the cavity is not clearly defined
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Norwegian Oncologists' Expectations of Intensity-modulated Radiotherapy
International Nuclear Information System (INIS)
Muren, Ludvig P.; Mella, Olav; Hafslund, Rune; Dahl, Olav
2002-01-01
Although intensity-modulated radiotherapy (IMRT) may increase the therapeutic ratio of radiotherapy for a range of malignancies, only a few IMRT treatments have yet been performed in the Nordic countries. The scores derived from a national survey to assess Norwegian oncologists' expectations of IMRT are presented. A questionnaire was distributed to all consultants in oncology at Norwegian radiotherapy clinics. Summary scores of daily general radiotherapy workload (DGRTW), acquaintance with IMRT (AI) and expectations of IMRT (EI) were derived. Thirty-nine questionnaires (67%) were returned from a total of 58 oncologists. The oncologists' scores on the AI scale (mean score: 7.5 out of 21) were rather low. Their AI scores were found to be positively correlated with their DGRTW. Higher scores on the EI scale were documented (mean score: 6.2 out of 14): 15 oncologists (39%) rated IMRT as one of the three major contributors to potentially increased cancer survival. Oncologists treating patients with prostate, head and neck, gastrointestinal and CNS tumours had higher EI scores than the other oncologists (7.7 vs. 5.1; p=0.01). The Norwegian radiation oncologists' expectations of IMRT are high in terms of both the potential clinical benefit and the rate of implementation. This should encourage the radiotherapy communities to continue (or rapidly initiate) their efforts in providing the routines required for safe implementation of IMRT
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Energy Technology Data Exchange (ETDEWEB)
Kim, Jong Hoon; Park, Jin Hong; Kim, Dae Yong [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others
2003-06-01
To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns of Care Study. A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all Korean hospitals (48 hospitals). Thirty three (69%) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields for rectal cancer. The following guidelines were developed: superior border between the lower tip of the L5 vertebral body and upper sacroiliac joint; inferior border 2-3 cm distal to the anastomosis in patient whose sphincter was saved, and 2-3 cm distal to the perineal scar in patients whose anal sphincter was sacrificed; anterior margin at the posterior tip of the symphysis pubis or 2-3 cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin 1.5-2 cm posterior to the anterior surface of the sacrum, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases (70%), the inferior margin after sphincter saving surgery in 13 (39%), the inferior margin after abdominoperineal resection in 32 (97%), the lateral margin in 32 (97%), the posterior margins in 32 (97%) and the anterior margin in 16 (45%). These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved by following the Korean Patterns of Care
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International Nuclear Information System (INIS)
Kim, Jong Hoon; Park, Jin Hong; Kim, Dae Yong
2003-01-01
To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns of Care Study. A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all Korean hospitals (48 hospitals). Thirty three (69%) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields for rectal cancer. The following guidelines were developed: superior border between the lower tip of the L5 vertebral body and upper sacroiliac joint; inferior border 2-3 cm distal to the anastomosis in patient whose sphincter was saved, and 2-3 cm distal to the perineal scar in patients whose anal sphincter was sacrificed; anterior margin at the posterior tip of the symphysis pubis or 2-3 cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin 1.5-2 cm posterior to the anterior surface of the sacrum, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases (70%), the inferior margin after sphincter saving surgery in 13 (39%), the inferior margin after abdominoperineal resection in 32 (97%), the lateral margin in 32 (97%), the posterior margins in 32 (97%) and the anterior margin in 16 (45%). These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved by following the Korean Patterns of Care Study
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Attitude of the Korean dentists towards radiation safety and selection criteria
International Nuclear Information System (INIS)
Lee, Byung Do; Ludlow, John B.
2013-01-01
X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.
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Attitude of the Korean dentists towards radiation safety and selection criteria
Energy Technology Data Exchange (ETDEWEB)
Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Ludlow, John B. [Graduate Program in Oral and Maxillofacial Radiology, School of Dentistry, University of North Carolina, Chapel Hill (United States)
2013-09-15
X-ray exposure should be clinically justified and each exposure should be expected to give patients benefits. Since dental radiographic examination is one of the most frequent radiological procedures, radiation hazard becomes an important public health concern. The purpose of this study was to investigate the attitude of Korean dentists about radiation safety and use of criteria for selecting the frequency and type of radiographic examinations. The study included 267 Korean dentists. Five questions related to radiation safety were asked of each of them. These questions were about factors associated with radiation protection of patients and operators including the use of radiographic selection criteria for intraoral radiographic procedures. The frequency of prescription of routine radiographic examination (an example is a panoramic radiograph for screening process for occult disease) was 34.1%, while that of selective radiography was 64.0%. Dentists' discussion of radiation risk and benefit with patients was infrequent. More than half of the operators held the image receptor by themselves during intraoral radiographic examinations. Lead apron/thyroid collars for patient protection were used by fewer than 22% of dental offices. Rectangular collimation was utilized by fewer than 15% of dental offices. The majority of Korean dentists in the study did not practice radiation protection procedures which would be required to minimize exposure to unnecessary radiation for patients and dental professionals. Mandatory continuing professional education in radiation safety and development of Korean radiographic selection criteria is recommended.
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International Nuclear Information System (INIS)
Huynh-Le, Minh-Phuong; Zhang, Zhe; Tran, Phuoc T.; DeWeese, Theodore L.; Song, Daniel Y.
2014-01-01
Purpose: To measure concordance among genitourinary radiation oncologists in using the National Cancer Institute Common Toxicity Criteria (NCI CTC) and Radiation Therapy Oncology Group (RTOG) grading scales to grade rectal bleeding. Methods and Materials: From June 2013 to January 2014, a Web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes in which patients received radiation therapy and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participants were also asked whether they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1-2 vs high grades 3-4) was also assessed, using the κ statistic for multiple respondents. Results: Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC 0.52, 95% confidence interval [CI] 0.47-0.58) when using NCI CTC and fair using the RTOG scale (ICC 0.28, 95% CI 0.20-0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (P<.0001). Using the dichotomous scale, we observed moderate agreement (κ = 0.42, 95% CI 0.40-0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (κ = 0.19, 95% CI 0.17-0.21). Conclusion: Low interrater reliability was observed among radiation oncologists grading rectal bleeding using 2 common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability and avoid ambiguity in both
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Studies on the reference Korean and estimation of radiation exposure dose
International Nuclear Information System (INIS)
Kim, Y.J.; Lee, K.S.; Chun, K.J.; Kim, J.B.; Chung, G.H.; Kim, S.R.
1982-01-01
For the purpose of establishment of Reference Korean and estimation of internal and external exposure doses in the Reference Korean, we have surveyed reference values for Koreans such as physical standards including height, weight, and body surface area, food consumption rate of daily intake of radioactive substances and exposure dose from natural radiation. (Author)
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Energy Technology Data Exchange (ETDEWEB)
NONE
2016-12-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2016. It was held on Dec. 1, 2016 Phoenix Island in Jeju, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2016. This proceedings is comprised of 5 sessions. The main topic titles of session are as follows: Radiation protection, Biotechnology of radiation, Radiation measurement, Radiation environment and prevention, Radiation epidemiography.
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International Nuclear Information System (INIS)
2009-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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Energy Technology Data Exchange (ETDEWEB)
NONE
2017-04-15
This proceedings contains articles of the Korean Association for Radiation Protection Spring Meeting, 2017. It was held on 13 April 2017 Gunsan Saemangeum Covention Center in Gunsan, Korea and subject of the Korean Association for Radiation Protection Spring Meeting 2017. This proceedings is comprised of 5 ssessions. The main topic titles of session are as follows: Radiation protection, Biotechnology of radiation, Radiation measurement and prevention, Radiation epidemiography.
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International Nuclear Information System (INIS)
2017-04-01
This proceedings contains articles of the Korean Association for Radiation Protection Spring Meeting, 2017. It was held on 13 April 2017 Gunsan Saemangeum Covention Center in Gunsan, Korea and subject of the Korean Association for Radiation Protection Spring Meeting 2017. This proceedings is comprised of 5 ssessions. The main topic titles of session are as follows: Radiation protection, Biotechnology of radiation, Radiation measurement and prevention, Radiation epidemiography.
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International Nuclear Information System (INIS)
2016-04-01
This proceedings contains articles of the Korean Association for Radiation Protection Spring Meeting, 2016. It was held on Apr. 6-8, 2016 Daemyung Resort in Byeonsan, Korea and subject of the Korean Association for Radiation Protection Spring Meeting 2016. This proceedings is comprised of 4 sessions. The main topic titles of session are as follows: Radiation protection, Biotechnology of radiation, Radiation Measurement, Radiation environment and prevention
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International Nuclear Information System (INIS)
Cmelak, Anthony J.; Choy, Hak; Shyr, Yu; Mohr, Peter; Glantz, Michael J.; Johnson, David H.
1999-01-01
Purpose: Prophylactic cranial irradiation (PCI) in the treatment of small cell lung cancer (SCLC) patients remains controversial in the oncology community because of its potential for long-term toxicity and unproven survival benefit in randomized trials. A national survey of 9176 oncologists was conducted to characterize the use of PCI with regard to physician demographics, patient characteristics, and oncologists' beliefs. Methods: Data was collected via a questionnaire letter survey. Biographical data, treatment patterns, and clinical impressions were analyzed by the generalized linear model and generalized estimating equations method. Results: There were 1231 responders overall (13.4% of those surveyed), including 628 (51%) radiation oncologists (RO), 587 (48%) medical oncologists (MO), 8 (0.6%) surgical oncologists, and 8 (0.6%) from other oncology subspecialties. Of respondents, 74% overall recommend PCI in limited-stage patients, including 65% of MO and 82% RO (p = 0.001). Of responders who recommend PCI in limited-stage patients, 67% do so only after complete response to initial therapy. Only 30% of respondents recommend PCI for extensive-stage SCLC patients (p = 0.001), and 94% of these recommend PCI only when those patients have a complete response after initial therapy. Interestingly, 38% of responding MO feel that PCI improves survival of limited-stage patients, but only 11% believe PCI improves quality of life. Of the RO, 48% believe PCI improves survival in limited-stage SCLC, and 36% feel PCI improves quality of life (p < 0.05 and p < 0.01, respectively). MO responders believe PCI causes late neurological sequelae more often than do RO responders (95% vs. 84%, p < 0.05), with impaired memory (37%), chronic fatigue (19%), and loss of motivation (13%) as most commonly seen side effects. Only 1.5% overall, however, routinely obtain neuropsychiatric testing in PCI patients, and 42% overall never obtain them. Conclusion: Results confirm that oncologic
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Effect of radiation on disinfection and mechanical properties of Korean traditional paper, Hanji
International Nuclear Information System (INIS)
Choi, Jong-il; Chung, Yong Jae; Kang, Dai Ill; Lee, Kyu Shik; Lee, Ju-Woon
2012-01-01
Fumigants, including methyl bromide and ethylene oxide, are generally used for the preservation of the Korean cultural heritage, especially paper products like letters and books. However, the use of fumigants is banned because of their harmful effects on humans and the environment. Gamma irradiation is being considered as an alternative for the sterilization of insects and fungi in organic products. Therefore, the purpose of this study was to investigate the sterilization effects of radiation and its effect on the mechanical properties of the Korean traditional paper—Hanji. Treatment doses of 9 kGy and 8 kGy of gamma irradiation inactivated 5 log units of Aspergillus niger and Bacillus cereus spores inoculated on Hanji, respectively. The gamma irradiations up to an absorbed dose of 50 kGy resulted in no significant changes in the tensile strength, bursting strength, and appearance of Hanji. These results confirmed that radiation treatment disinfects the Korean traditional paper efficiently without changing its properties and that this treatment could be used to prevent the damage of Korean ancient archives by molds and fungi. - Highlights: ► Radiation sensitivity of mold was tested on Korean traditional paper, Hanji. ► Mechanical properties of Hanji were measured to investigate the effect of irradiation. ► This result is useful to conserve the Korean cultural heritages made by Hanji with the radiation technology.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2014-11-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2014. It was held on Nov.19-21, 2014 in Jeju, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2014. This proceedings is comprised of 8 sessions. The main topic titles of session are as follows: Radiation protection 1, Medical treatment and Biology 1, Radiation measurement 1, Radiation environment and protection 1, Radiation protection 2, Medical treatment and Biology 2, Radiation Measurement 2, Radiation environment and protection 2.
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International Nuclear Information System (INIS)
2014-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths … worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious
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International Nuclear Information System (INIS)
2013-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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International Nuclear Information System (INIS)
2014-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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International Nuclear Information System (INIS)
2014-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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International Nuclear Information System (INIS)
2014-01-01
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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Managing a national radiation oncologist workforce: A workforce planning model
International Nuclear Information System (INIS)
Stuckless, Teri; Milosevic, Michael; Metz, Catherine de; Parliament, Matthew; Tompkins, Brent; Brundage, Michael
2012-01-01
Purpose: The specialty of radiation oncology has experienced significant workforce planning challenges in many countries. Our purpose was to develop and validate a workforce-planning model that would forecast the balance between supply of, and demand for, radiation oncologists in Canada over a minimum 10-year time frame, to identify the model parameters that most influenced this balance, and to suggest how this model may be applicable to other countries. Methods: A forward calculation model was created and populated with data obtained from national sources. Validation was confirmed using a historical prospective approach. Results: Under baseline assumptions, the model predicts a short-term surplus of RO trainees followed by a projected deficit in 2020. Sensitivity analyses showed that access to radiotherapy (proportion of incident cases referred), individual RO workload, average age of retirement and resident training intake most influenced balance of supply and demand. Within plausible ranges of these parameters, substantial shortages or excess of graduates is possible, underscoring the need for ongoing monitoring. Conclusions: Workforce planning in radiation oncology is possible using a projection calculation model based on current system characteristics and modifiable parameters that influence projections. The workload projections should inform policy decision making regarding growth of the specialty and training program resident intake required to meet oncology health services needs. The methods used are applicable to workforce planning for radiation oncology in other countries and for other comparable medical specialties.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2015-10-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2015. It was held on Oct.23, 2015 Mayfield Hotel in Seoul, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2015. This proceedings is comprised of 8 sessions. The main topic titles of session are as follows: Radiation protection 1, Medical treatment and Biology 1, Radiation Measurement 1, Radiation environment and disasters prevention 1, Radiation protection 2, Medical treatment and Biology 2, Radiation Measurement 2, Radiation environment and disasters prevention 2.
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International Nuclear Information System (INIS)
Shakespeare, Thomas P.
2015-01-01
Positron emission tomography (PET) imaging is routinely used in many cancer types, although is not yet a standard modality for prostate carcinoma. Prostate-specific membrane antigen (PSMA) PET is a promising new modality for staging prostate cancer, with recent studies showing potential advantages over traditional computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine bone scan imaging. However, the impact of PSMA PET on the decision-making of radiation oncologists and outcomes after radiotherapy is yet to be determined. Our aim was to determine the impact of PSMA PET on a radiation oncologist’s clinical practice. Patients in a radiation oncology clinic who underwent PSMA PET were prospectively recorded in an electronic oncology record. Patient demographics, outcomes of imaging, and impact on decision-making were evaluated. Fifty-four patients underwent PSMA PET between January and May 2015. The major reasons for undergoing PET included staging before definitive (14.8 %) or post-prostatectomy (33.3 %) radiotherapy, and investigation of PSA failures following definitive (16.7 %) or post-prostatectomy (33.3 %) radiotherapy. In 46.3 % of patients PSMA was positive after negative traditional imaging, in 9.3 % PSMA was positive after equivocal imaging, and in 13.0 % PSMA was negative after equivocal imaging. PSMA PET changed radiotherapy management in 46.3 % of cases, and hormone therapy in 33.3 % of patients, with an overall change in decision-making in 53.7 % of patients. PSMA PET has the potential to significantly alter the decision-making of radiation oncologists, and may become a valuable imaging tool in the future
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Energy Technology Data Exchange (ETDEWEB)
NONE
2011-11-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2011. It was held on Nov.17-18, 2011 the ocean resort in Yeosu, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2011. This proceedings is comprised of 14 sessions.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2013-11-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2013. It was held on Nov.20-22, 2013 Ramada Plaza Hotel in Suwon, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2013. This proceedings is comprised of 7 sessions. The main topic titles of session are as follows: Medical treatment and Biology 1, Measurement and Analysis 1, Radiation protection1, Medical treatment and Biology 2, Measurement and Analysis 2, Radiation protection 2, Radiation protection 3.
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Energy Technology Data Exchange (ETDEWEB)
Pascau, Javier, E-mail: jpascau@mce.hggm.es [Unidad de Medicina y Cirugia Experimental, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Departamento de Bioingenieria e Ingenieria Aeroespacial, Universidad Carlos III de Madrid, Madrid (Spain); Santos Miranda, Juan Antonio [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Calvo, Felipe A. [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Departamento de Oncologia, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Bouche, Ana; Morillo, Virgina [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); Gonzalez-San Segundo, Carmen [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Ferrer, Carlos; Lopez Tarjuelo, Juan [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); and others
2012-06-01
Purpose: Intraoperative electron beam radiation therapy (IOERT) involves a modified strategy of conventional radiation therapy and surgery. The lack of specific planning tools limits the spread of this technique. The purpose of the present study is to describe a new simulation and planning tool and its initial evaluation by clinical users. Methods and Materials: The tool works on a preoperative computed tomography scan. A physician contours regions to be treated and protected and simulates applicator positioning, calculating isodoses and the corresponding dose-volume histograms depending on the selected electron energy. Three radiation oncologists evaluated data from 15 IOERT patients, including different tumor locations. Segmentation masks, applicator positions, and treatment parameters were compared. Results: High parameter agreement was found in the following cases: three breast and three rectal cancer, retroperitoneal sarcoma, and rectal and ovary monotopic recurrences. All radiation oncologists performed similar segmentations of tumors and high-risk areas. The average applicator position difference was 1.2 {+-} 0.95 cm. The remaining cancer sites showed higher deviations because of differences in the criteria for segmenting high-risk areas (one rectal, one pancreas) and different surgical access simulated (two rectal, one Ewing sarcoma). Conclusions: The results show that this new tool can be used to simulate IOERT cases involving different anatomic locations, and that preplanning has to be carried out with specialized surgical input.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2014-04-15
This proceedings contains articles of the Korean Association for Radiation Protection Spring Meeting, 2014. It was held on Apr.23-25, 2014 Grand Hotel in Busan, Korea and subject of the Korean Association for Radiation Protection Spring Meeting 2014. This proceedings is comprised of 8 sessions. The main topic titles of session are as follows: Medical treatment and Biology 1, Measurement and Analysis 1, Measurement and Analysis 2, Radiation protection 1, Radiation protection 2, Medical treatment and Biology 2, Measurement and Analysis 3, Radiation protection 3.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2012-11-15
This proceedings contains articles of the Korean Association for Radiation Protection Fall Meeting, 2012. It was held on Nov. 28-30, 2012 Phoenix Island in Jeju, Korea and subject of the Korean Association for Radiation Protection Fall Meeting 2012. This proceedings is comprised of 8 sessions. The main topic titles of session are as follows: The main topic titles of session are as follows: Medical treatment and Biology 1, Measurement and Analysis 1, Measurement and Analysis 2, Radiation protection 1, Radiation protection 2, Medical treatment and Biology 2, Measurement and Analysis 3, Radiation protection 3.
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Energy Technology Data Exchange (ETDEWEB)
NONE
2013-04-15
This proceedings contains articles of the Korean Association for Radiation Protection Spring Meeting, 2013. It was held on Apr.24-26, 2013 Hotel Hyundai Mokpo in Mokpo, Korea and subject of the Korean Association for Radiation Protection Spring Meeting 2013. This proceedings is comprised of 6 sessions. The main topic titles of session are as follows: Medical treatment and Biology 1, Measurement and Analysis 1, Radiation protection1, Medical treatment and Biology 2, Measurement and Analysis 2, Radiation protection 2.
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Estimating radiation risk induced by CT screening for Korean population
Yang, Won Seok; Yang, Hye Jeong; Min, Byung In
2017-02-01
The purposes of this study are to estimate the radiation risks induced by chest/abdomen computed tomography (CT) screening for healthcare and to determine the cancer risk level of the Korean population compared to other populations. We used an ImPACT CT Patient Dosimetry Calculator to compute the organ effective dose induced by CT screening (chest, low-dose chest, abdomen/pelvis, and chest/abdomen/pelvis CT). A risk model was applied using principles based on the BEIR VII Report in order to estimate the lifetime attributable risk (LAR) using the Korean Life Table 2010. In addition, several countries including Hong Kong, the United States (U.S.), and the United Kingdom, were selected for comparison. Herein, each population exposed radiation dose of 100 mSv was classified according to country, gender and age. For each CT screening the total organ effective dose calculated by ImPACT was 6.2, 1.5, 5.2 and 11.4 mSv, respectively. In the case of Korean female LAR, it was similar to Hong Kong female but lower than those of U.S. and U.K. females, except for those in their twenties. The LAR of Korean males was the highest for all types of CT screening. However, the difference of the risk level was negligible because of the quite low value.
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Finding peace from Hiroshima. One oncologist's fight to rectify the damage caused by radiation
International Nuclear Information System (INIS)
Skoufalos, M.N.
2006-01-01
The article informs about one oncologist's fight to rectify the damage caused by radiation. In a small town just outside Osaka, Japan, Ritsuko Komaki was born, quite literally, into the atomic age. She was just an infant in 1945 when the first atomic bomb ever detonated on a human population devastated her family's ancestral home of Hiroshima. One of her friends, Sasaki was diagnosed with leukemia, and was later hospitalized with bone marrow suppression. Her grandmother had been exposed to the same chemical radiation that Sasaki had, yet never contracted leukemia despite presenting with all the other side effects of exposure. Komaki wa wondering why her grandmother never had any leukemia, but Sadako did? She never had any cancer, but she had all the symptoms of exposure, e.g. hair loss, diarrhea and bone marrow problems. During medical school, Komaki volunteered her summers at the Atomic Bomb Casualty Commission, the institute the United States built in Japan to examine the victims of atomic exposure. Anyone diagnosed as anemic underwent a bone marrow exam, and Komaki learned a great deal about chromosomal abnormalities by performing blood tests alongside visiting researchers from Yale University and other American hospitals. The bombings of Hiroshima and Nagasaki had fostered a national paranoia about radiation and radioactivity. In Japan, they hate radiation, and for so many years, they did not want to hear about radiation therapy. Patients had an illogical fear of it that delayed offering it as treatment there. In Japan, the majority of cancer treatment culminated in surgery. Radiation oncology was not a recognized specialization; oncologists were grouped in with diagnostic radiation techs. Yet today, Ritsuko Komaki, MD, is the chief operating officer of one of the most sophisticated radiation oncology treatment facilities in the United States: the 120 million US Dollar M.D. Anderson Cancer Center in Houston. And ironically, the technical equipment that forms
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Effect of radiation on disinfection and mechanical properties of Korean traditional paper, Hanji
Choi, Jong-il; Chung, Yong Jae; Kang, Dai Ill; Lee, Kyu Shik; Lee, Ju-Woon
2012-08-01
Fumigants, including methyl bromide and ethylene oxide, are generally used for the preservation of the Korean cultural heritage, especially paper products like letters and books. However, the use of fumigants is banned because of their harmful effects on humans and the environment. Gamma irradiation is being considered as an alternative for the sterilization of insects and fungi in organic products. Therefore, the purpose of this study was to investigate the sterilization effects of radiation and its effect on the mechanical properties of the Korean traditional paper—Hanji. Treatment doses of 9 kGy and 8 kGy of gamma irradiation inactivated 5 log units of Aspergillus niger and Bacillus cereus spores inoculated on Hanji, respectively. The gamma irradiations up to an absorbed dose of 50 kGy resulted in no significant changes in the tensile strength, bursting strength, and appearance of Hanji. These results confirmed that radiation treatment disinfects the Korean traditional paper efficiently without changing its properties and that this treatment could be used to prevent the damage of Korean ancient archives by molds and fungi.
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International Nuclear Information System (INIS)
Pohar, Surjeet; Fung, Claire Y.; Hopkins, Shane; Miller, Robert; Azawi, Samar; Arnone, Anna; Patton, Caroline; Olsen, Christine
2013-01-01
Purpose: The American Society for Radiation Oncology (ASTRO) conducted the 2012 Radiation Oncology Workforce Survey to obtain an up-to-date picture of the workforce, assess its needs and concerns, and identify quality and safety improvement opportunities. The results pertaining to radiation oncologists (ROs) and residents (RORs) are presented here. Methods: The ASTRO Workforce Subcommittee, in collaboration with allied radiation oncology professional societies, conducted a survey study in early 2012. An online survey questionnaire was sent to all segments of the radiation oncology workforce. Respondents who were actively working were included in the analysis. This manuscript describes the data for ROs and RORs. Results: A total of 3618 ROs and 568 RORs were surveyed. The response rate for both groups was 29%, with 1047 RO and 165 ROR responses. Among ROs, the 2 most common racial groups were white (80%) and Asian (15%), and the male-to-female ratio was 2.85 (74% male). The median age of ROs was 51. ROs averaged 253.4 new patient consults in a year and 22.9 on-treatment patients. More than 86% of ROs reported being satisfied or very satisfied overall with their career. Close to half of ROs reported having burnout feelings. There was a trend toward more frequent burnout feelings with increasing numbers of new patient consults. ROs' top concerns were related to documentation, reimbursement, and patients' health insurance coverage. Ninety-five percent of ROs felt confident when implementing new technology. Fifty-one percent of ROs thought that the supply of ROs was balanced with demand, and 33% perceived an oversupply. Conclusions: This study provides a current snapshot of the 2012 radiation oncology physician workforce. There was a predominance of whites and men. Job satisfaction level was high. However a substantial fraction of ROs reported burnout feelings. Perceptions about supply and demand balance were mixed. ROs top concerns reflect areas of attention for the
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International Nuclear Information System (INIS)
Bhargavan, Mythreyi; Sunshine, Jonathan H.; Schepps, Barbara
2002-01-01
Purpose: To aid in understanding the employment market for radiation oncologists, we present annual data for 1991 to 2000 from the American College of Radiology's placement service, the Professional Bureau. This data series is twice as long as any previously available. Secondarily, we compare these data with other data on the employment market. Methods and Materials: The trends in job listings, job seekers, and listings per seeker in the Bureau are tabulated and graphed. We calculate correlations and graph relationships between the last of these and measures of the job market calculated from annual surveys. Results: Bureau data show listings per job seeker declined from 0.53 in 1991 to a nadir of 0.30 in 1995 and then recovered to 1.48 in 2000. Bureau listings and job seekers, each considered separately, show a similar pattern of job market decline and then eventual recovery to better than the 1991 situation. Bureau listings per job seeker correlate 0.895 with a survey-derived index of program directors' perceptions of the job market, but statistical significance is limited (p=0.04), because very few years of survey data are available. Conclusions: The employment market for radiation oncologists weakened in the first half of the 1990s, as had been widely reported; we present the first systematic data showing this. Data from a professional society placement service provide useful and inexpensive information on the employment market
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Cancer patients’ trust in their oncologist
Hillen, M.A.
2013-01-01
In this thesis we aimed to unravel cancer patients’ trust in their oncologist. We investigated patients’ explanations of trust in-depth, and developed an oncology-specific questionnaire to assess trust. Using the resulting Trust in Oncologist Scale, we experimentally established the influence of oncologist communication on trust. Specifically, patients report stronger trust if the oncologist expresses medical competence, communicates in an open and honest manner, and conveys involvement and c...
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Strategies for the Management of Localized Prostate Cancer: A Guide for Radiation Oncologists
Energy Technology Data Exchange (ETDEWEB)
NONE
2014-09-15
Prostate cancer is a serious health issue, especially considering the recent epidemiological trend and its corresponding socioeconomic impact. Challenges encountered by treating physicians include the long natural history of the disease, the fact that it is more prevalent in the elderly and the difficulty in performing a complete critical review of medical evidence due to the plethora of available information. In addition, the difficulty in deciding if and when therapeutic intervention should be initiated is an important issue pertaining to this type of malignancy. However, there is one area where there is a uniform consensus: the applicability of the multidisciplinary approach in the management of prostate cancer. Clinical guidelines are systematically developed statements designed to help practitioners, managers and patients make decisions about appropriate health care for specific circumstances. Clinicians need simple, patient specific, user friendly guidelines. The main purposes of clinical guidelines are to: (a) provide recommendations for the treatment of individual patients by practitioners; (b) help develop standards to assess the individual practice of health professionals; (c) be used in the education and training of health professionals; (d) assist patients in making informed decisions; and (e) improve communication between patients and health professionals. Clinical guidelines for the management of prostate cancer exist in the published literature. However, these guidelines have usually been developed in and for affluent health care environments where all modern diagnostic and treatment modalities are available. In limited resource environments, the radiation oncologist is faced with the question of what the minimum acceptable (evidence based) line of action would be, considering the limited resources available. Clinical guidelines focusing on low to middle income countries aim to provide these practitioners with a practical tool. This publication is
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Strategies for the Management of Localized Prostate Cancer: A Guide for Radiation Oncologists
International Nuclear Information System (INIS)
2014-01-01
Prostate cancer is a serious health issue, especially considering the recent epidemiological trend and its corresponding socioeconomic impact. Challenges encountered by treating physicians include the long natural history of the disease, the fact that it is more prevalent in the elderly and the difficulty in performing a complete critical review of medical evidence due to the plethora of available information. In addition, the difficulty in deciding if and when therapeutic intervention should be initiated is an important issue pertaining to this type of malignancy. However, there is one area where there is a uniform consensus: the applicability of the multidisciplinary approach in the management of prostate cancer. Clinical guidelines are systematically developed statements designed to help practitioners, managers and patients make decisions about appropriate health care for specific circumstances. Clinicians need simple, patient specific, user friendly guidelines. The main purposes of clinical guidelines are to: (a) provide recommendations for the treatment of individual patients by practitioners; (b) help develop standards to assess the individual practice of health professionals; (c) be used in the education and training of health professionals; (d) assist patients in making informed decisions; and (e) improve communication between patients and health professionals. Clinical guidelines for the management of prostate cancer exist in the published literature. However, these guidelines have usually been developed in and for affluent health care environments where all modern diagnostic and treatment modalities are available. In limited resource environments, the radiation oncologist is faced with the question of what the minimum acceptable (evidence based) line of action would be, considering the limited resources available. Clinical guidelines focusing on low to middle income countries aim to provide these practitioners with a practical tool. This publication is
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Ghazeeri, Ghina; Zebian, Dina; Nassar, Anwar H; Harajly, Sally; Abdallah, Alain; Hakimian, Stephanie; Skaiff, Bassem; Abbas, Hussein A; Awwad, Johnny
2016-06-01
Fertility preservation (FP) aims to help individuals overcome the infertility associated with cancer treatments such as chemotherapy and radiation. The objective of this study was to assess the awareness, attitudes and knowledge of oncologists' and clinical practitioners' (CPs) about fertility preservation and its options in Lebanon. This was a cross-sectional study with surveys carried out between March 2012 and February 2013 on CPs at the American University of Beirut Medical Centre and Saint Jude's Children Cancer Centre as well as all registered oncologists in Lebanon. Ninety percent of CPs (n = 88) and 94% of oncologists (n = 53) agreed that fertility preservation should be discussed with patient before their cancer treatment. Our data showed a gender bias in relation to patients being informed of their FP options, as well as conflicting knowledge of FP options available in Lebanon among oncologists. The CPs were more likely to have accurate knowledge of FP options and treatment than oncologists. A proactive approach is required to: (1) increase the awareness and knowledge of FP; (2) improve attitudes towards FP; and (3) encourage its communication between CPs, oncologists and patients in Lebanon. Increased education programs, awareness campaigns and development of dedicated FP centres are needed.
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Energy Technology Data Exchange (ETDEWEB)
Pohar, Surjeet, E-mail: spohar@iuhealth.org [Indiana University Health East, Indianapolis, Indiana (United States); Fung, Claire Y. [Commonwealth Newburyport Cancer Center, Newburyport, Massachusetts (United States); Hopkins, Shane [William R. Bliss Cancer Center, Ames, Iowa (United States); Miller, Robert [Mayo Clinic, Rochester, Minnesota (United States); Azawi, Samar [VA Veteran Hospital/University of California Irvine, Newport Beach, California (United States); Arnone, Anna; Patton, Caroline [ASTRO, Fairfax, Virginia (United States); Olsen, Christine [Massachusetts General Hospital, Boston, Massachusetts (United States)
2013-12-01
Purpose: The American Society for Radiation Oncology (ASTRO) conducted the 2012 Radiation Oncology Workforce Survey to obtain an up-to-date picture of the workforce, assess its needs and concerns, and identify quality and safety improvement opportunities. The results pertaining to radiation oncologists (ROs) and residents (RORs) are presented here. Methods: The ASTRO Workforce Subcommittee, in collaboration with allied radiation oncology professional societies, conducted a survey study in early 2012. An online survey questionnaire was sent to all segments of the radiation oncology workforce. Respondents who were actively working were included in the analysis. This manuscript describes the data for ROs and RORs. Results: A total of 3618 ROs and 568 RORs were surveyed. The response rate for both groups was 29%, with 1047 RO and 165 ROR responses. Among ROs, the 2 most common racial groups were white (80%) and Asian (15%), and the male-to-female ratio was 2.85 (74% male). The median age of ROs was 51. ROs averaged 253.4 new patient consults in a year and 22.9 on-treatment patients. More than 86% of ROs reported being satisfied or very satisfied overall with their career. Close to half of ROs reported having burnout feelings. There was a trend toward more frequent burnout feelings with increasing numbers of new patient consults. ROs' top concerns were related to documentation, reimbursement, and patients' health insurance coverage. Ninety-five percent of ROs felt confident when implementing new technology. Fifty-one percent of ROs thought that the supply of ROs was balanced with demand, and 33% perceived an oversupply. Conclusions: This study provides a current snapshot of the 2012 radiation oncology physician workforce. There was a predominance of whites and men. Job satisfaction level was high. However a substantial fraction of ROs reported burnout feelings. Perceptions about supply and demand balance were mixed. ROs top concerns reflect areas of attention
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International Nuclear Information System (INIS)
Steenbakkers, Roel J.H.M.; Duppen, Joop C.; Fitton, Isabelle; Deurloo, Kirsten E.I.; Zijp, Lambert; Uitterhoeve, Apollonia L.J.; Rodrigus, Patrick T.R.; Kramer, Gijsbert W.P.; Bussink, Johan; Jaeger, Katrien De; Belderbos, Jose S.A.; Hart, Augustinus A.M.; Nowak, Peter J.C.M.; Herk, Marcel van; Rasch, Coen R.N.
2005-01-01
Background and purpose: To evaluate the process of target volume delineation in lung cancer for optimization of imaging, delineation protocol and delineation software. Patients and methods: Eleven radiation oncologists (observers) from five different institutions delineated the Gross Tumor Volume (GTV) including positive lymph nodes of 22 lung cancer patients (stages I-IIIB) on CT only. All radiation oncologist-computer interactions were recorded with a tool called 'Big Brother'. For each radiation oncologist and patient the following issues were analyzed: delineation time, number of delineated points and corrections, zoom levels, level and window (L/W) settings, CT slice changes, use of side windows (coronal and sagittal) and software button use. Results: The mean delineation time per GTV was 16 min (SD 10 min). The mean delineation time for lymph node positive patients was on average 3 min larger (P=0.02) than for lymph node negative patients. Many corrections (55%) were due to L/W change (e.g. delineating in mediastinum L/W and then correcting in lung L/W). For the lymph node region, a relatively large number of corrections was found (3.7 corr/cm 2 ), indicating that it was difficult to delineate lymph nodes. For the tumor-atelectasis region, a relative small number of corrections was found (1.0 corr/cm 2 ), indicating that including or excluding atelectasis into the GTV was a clinical decision. Inappropriate use of L/W settings was frequently found (e.g. 46% of all delineated points in the tumor-lung region were delineated in mediastinum L/W settings). Despite a large observer variation in cranial and caudal direction of 0.72 cm (1 SD), the coronal and sagittal side windows were not used in 45 and 60% of the cases, respectively. For the more difficult cases, observer variation was smaller when the coronal and sagittal side windows were used. Conclusions: With the 'Big Brother' tool a method was developed to trace the delineation process. The differences between
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Energy Technology Data Exchange (ETDEWEB)
Bibault, Jean-Emmanuel, E-mail: jebibault@gmail.com [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Leroy, Thomas [Academic Radiation Oncology Department, Oscar Lambret Center, Lille (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Blanchard, Pierre [Academic Radiation Oncology Department, Gustave Roussy Institute, Villejuif Cedex (France); Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif Cedex (France); Biau, Julian [Radiation Oncology Department, Jean-Perrin Center, Clermont-Ferrand cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Cervellera, Mathilde [Radiation Oncology Department, Jean-Godinot Center, Reims (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Diaz, Olivia [Radiation Oncology Department, Lyon Sud University Hospital, Pierre-Bénite Cedex (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); Faivre, Jean Christophe [Academic Radiation Oncology and Brachytherapy Departement, Alexis-Vautrin Center, Avenue de Bourgogne, 54511 Vandoeuvre-lès-Nancy (France); French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, Paris (France); and others
2014-09-01
Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital.
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Bibault, Jean-Emmanuel; Leroy, Thomas; Blanchard, Pierre; Biau, Julian; Cervellera, Mathilde; Diaz, Olivia; Faivre, Jean Christophe; Fumagalli, Ingrid; Lescut, Nicolas; Martin, Valentine; Pichon, Baptiste; Riou, Olivier; Thureau, Sébastien; Giraud, Philippe
2014-09-01
Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital. Copyright © 2014 Elsevier Inc. All rights reserved.
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International Nuclear Information System (INIS)
Bibault, Jean-Emmanuel; Leroy, Thomas; Blanchard, Pierre; Biau, Julian; Cervellera, Mathilde; Diaz, Olivia; Faivre, Jean Christophe
2014-01-01
Purpose: Social media and mobile technology are transforming the way in which young physicians are learning and practicing medicine. The true impact of such technologies has yet to be evaluated. Methods and Materials: We performed a nationwide cross-sectional survey to better assess how young radiation oncologists used these technologies. An online survey was sent out between April 24, 2013, and June 1, 2013. All residents attending the 2013 radiation oncology French summer course were invited to complete the survey. Logistic regressions were performed to assess predictors of use of these tools in the hospital on various clinical endpoints. Results: In all, 131 of 140 (93.6%) French young radiation oncologists answered the survey. Of these individuals, 93% owned a smartphone and 32.8% owned a tablet. The majority (78.6%) of the residents owning a smartphone used it to work in their department. A total of 33.5% had more than 5 medical applications installed. Only 60.3% of the residents verified the validity of the apps that they used. In all, 82.9% of the residents had a social network account. Conclusions: Most of the residents in radiation oncology use their smartphone to work in their department for a wide variety of tasks. However, the residents do not consistently check the validity of the apps that they use. Residents also use social networks, with only a limited impact on their relationship with their patients. Overall, this study highlights the irruption and the risks of new technologies in the clinical practice and raises the question of a possible regulation of their use in the hospital
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International Nuclear Information System (INIS)
Kunneman, Marleen; Pieterse, Arwen H.; Stiggelbout, Anne M.; Marijnen, Corrie A.M.
2015-01-01
Background and purpose: We previously found considerable variation in information provision on preoperative radiotherapy (PRT) in rectal cancer. Our aims were to reach consensus among patients and oncologists on which benefits/harms of PRT should be addressed during the consultation, and to assess congruence with daily clinical practice. Materials and methods: A four-round Delphi-study was conducted with two expert panels: (1) 31 treated rectal cancer patients and (2) 35 radiation oncologists. Thirty-seven possible benefits/harms were shown. Participants indicated whether addressing the benefit/harm was (1) essential, (2) desired, (3) not necessary, or (4) to be avoided. Consensus was assumed when ⩾80% of the panel agreed. Results were compared to 81 audio-taped consultations. Results: The panels reached consensus that six topics should be addressed in all patients (local control, survival, long term altered defecation pattern and faecal incontinence, perineal wound healing problems, advice to avoid pregnancy), three in male patients (erectile dysfunction, ejaculation disorder, infertility), and four in female patients (vaginal dryness, pain during intercourse, menopause, infertility). On average, less than half of these topics were addressed in daily clinical practice. Conclusions: This study showed substantial overlap between benefits/harms that patients and oncologists consider important to address during the consultation, and at the same time poor congruence with daily clinical practice
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Radiation injury to the nervous system
International Nuclear Information System (INIS)
Gutin, P.H.; Leibel, S.A.; Sneline, G.E.
1991-01-01
This book is designed to describe to the radiation biologist, radiation oncologist, neurologist, neurosurgeon, medical oncologist, and neuro-oncologist, the current state of knowledge about the tolerance of the nervous system to various kinds of radiation, the mechanisms of radiation injury, and how nervous system tolerance and injury are related to the more general problem of radiation damage to normal tissue of all types. The information collected here should stimulate interest in and facilitate the growing research effort into radiation injury to the nervous system
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Park, Ji-Hye; Oh, Minsuk; Yoon, Yong Jin; Lee, Chul Won; Jones, Lee W; Kim, Seung Il; Kim, Nam Kyu; Jeon, Justin Y
2015-04-10
The purpose of the present study was to examine 1) characteristics and attitudes of oncologists toward exercise and toward recommending exercise to their patients, 2) association among oncologists' own physical activity levels, exercise recommendations, and their attitudes toward recommending exercise. A total of 167 oncologists participated in this survey study (41 surgeons, 78 medical oncologists, 25 radiation oncologists, and 21 others). Most oncologists included in the study treat more than one type of cancer, including colorectal, gastric, breast, lung, and liver cancer. To analyze the data, the one-way ANOVA, and t-test were used. All data were indicated for mean, SD, and proportions. Most oncologists agreed that exercise is beneficial (72.8%) and important (69.6%), but only 39.2% of them agreed that exercise is safe, and only 7.2% believed that cancer patients manage to exercise during cancer treatment. Forty-six percentage of the surveyed oncologists recommended exercise to their patients during the past month. The average amount of participation in physical activity by oncologists who participated in the study was 139.5 ± 120.3 min per week, and 11.4% of the study participants met the American College of Sports Medicine (ACSM) guidelines. Oncologists' own physical activity levels were associated with their attitudes toward recommending exercise. Belief in the benefits of exercise in the performance of daily tasks, improvement of mental health, and the attenuation of physical decline from treatment were the three most prevalent reasons why oncologists recommend exercise to their patients. Barriers to recommending exercise to patients included lack of time, unclear exercise recommendations, and the safety of patients. Oncologists have favorable attitudes toward exercise and toward recommending exercise to their patients during treatment. However, they also experience barriers to recommending exercise, including lack of time, unclear exercise guidelines
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Determining an Imaging Literacy Curriculum for Radiation Oncologists: An International Delphi Study
Energy Technology Data Exchange (ETDEWEB)
Giuliani, Meredith E., E-mail: Meredith.Giuliani@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Gillan, Caitlin [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Milne, Robin A. [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Uchino, Minako; Millar, Barbara-Ann; Catton, Pamela [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada)
2014-03-15
Purpose: Rapid evolution of imaging technologies and their integration into radiation therapy practice demands that radiation oncology (RO) training curricula be updated. The purpose of this study was to develop an entry-to-practice image literacy competency profile. Methods and Materials: A list of 263 potential imaging competency items were assembled from international objectives of training. Expert panel eliminated redundant or irrelevant items to create a list of 97 unique potential competency items. An international 2-round Delphi process was conducted with experts in RO. In round 1, all experts scored, on a 9-point Likert scale, the degree to which they agreed an item should be included in the competency profile. Items with a mean score ≥7 were included, those 4 to 6 were reviewed in round 2, and items scored <4 were excluded. In round 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile. Results: Forty-nine radiation oncologists were invited to participate in round 1, and 32 (65%) did so. Participants represented 24 centers in 6 countries. Of the 97 items ranked in round 1, 80 had a mean score ≥7, 1 item had a score <4, and 16 items with a mean score of 4 to 6 were reviewed and rescored in round 2. In round 2, 4 items had >75% of participants voting for inclusion and were included; the remaining 12 were excluded. The final list of 84 items formed the final competency profile. The 84 enabling competency items were aggregated into the following 4 thematic groups of key competencies: (1) imaging fundamentals (42 items); (2) clinical application (27 items); (3) clinical management (5 items); and (4) professional practice (10 items). Conclusions: We present an imaging literacy competency profile which could constitute the minimum training standards in radiation oncology residency programs.
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Determining an Imaging Literacy Curriculum for Radiation Oncologists: An International Delphi Study
International Nuclear Information System (INIS)
Giuliani, Meredith E.; Gillan, Caitlin; Milne, Robin A.; Uchino, Minako; Millar, Barbara-Ann; Catton, Pamela
2014-01-01
Purpose: Rapid evolution of imaging technologies and their integration into radiation therapy practice demands that radiation oncology (RO) training curricula be updated. The purpose of this study was to develop an entry-to-practice image literacy competency profile. Methods and Materials: A list of 263 potential imaging competency items were assembled from international objectives of training. Expert panel eliminated redundant or irrelevant items to create a list of 97 unique potential competency items. An international 2-round Delphi process was conducted with experts in RO. In round 1, all experts scored, on a 9-point Likert scale, the degree to which they agreed an item should be included in the competency profile. Items with a mean score ≥7 were included, those 4 to 6 were reviewed in round 2, and items scored <4 were excluded. In round 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile. Results: Forty-nine radiation oncologists were invited to participate in round 1, and 32 (65%) did so. Participants represented 24 centers in 6 countries. Of the 97 items ranked in round 1, 80 had a mean score ≥7, 1 item had a score <4, and 16 items with a mean score of 4 to 6 were reviewed and rescored in round 2. In round 2, 4 items had >75% of participants voting for inclusion and were included; the remaining 12 were excluded. The final list of 84 items formed the final competency profile. The 84 enabling competency items were aggregated into the following 4 thematic groups of key competencies: (1) imaging fundamentals (42 items); (2) clinical application (27 items); (3) clinical management (5 items); and (4) professional practice (10 items). Conclusions: We present an imaging literacy competency profile which could constitute the minimum training standards in radiation oncology residency programs
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International Nuclear Information System (INIS)
Yoon, Yong Su; Kim, Jung Min; Kim, Ji Hyun; Choi, In Seok; Sung, Dong Wook; Do, Kyung Hyun; Jung, Seung Eun; Kim, Hyung Soo
2013-01-01
There are many concerns about radiation exposure in Korea after Fukushima Nuclear Plant Accident on 2011 in Japan. As some isotope materials are detected in Korea, people get worried about the radioactive material. In addition, the mass media create an air of anxiety that jump on the people’s fear instead of scientific approach. Therefore, for curbing this flow, health, medical institute from the world provide a variety of information about medical radiation safety and hold the campaign which can give people the image that medical radiation is safe. At this, the Korean Food and Drug Administration(KFDA) suggested that make the alliance of medical radiation safety and culture on August, 2011. Seven societies and institutions related medical radiation started to research and advertise the culture of medical radiation safety in Korea. In this report, mainly introduce the activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) for spreading culture of medical radiation safety from 2011 to 2012
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Energy Technology Data Exchange (ETDEWEB)
Yoon, Yong Su; Kim, Jung Min; Kim, Ji Hyun; Choi, In Seok [Dept. of Radiologic Science, Korea University, Seoul (Korea, Republic of); Sung, Dong Wook [Dept. of Radiology, Kyunghee University Hospital, Seoul (Korea, Republic of); Do, Kyung Hyun [Dept. of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Jung, Seung Eun [Dept. of Radiology, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Hyung Soo [Dept. of Radiation Safety, National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration, Seoul (Korea, Republic of)
2013-09-15
There are many concerns about radiation exposure in Korea after Fukushima Nuclear Plant Accident on 2011 in Japan. As some isotope materials are detected in Korea, people get worried about the radioactive material. In addition, the mass media create an air of anxiety that jump on the people’s fear instead of scientific approach. Therefore, for curbing this flow, health, medical institute from the world provide a variety of information about medical radiation safety and hold the campaign which can give people the image that medical radiation is safe. At this, the Korean Food and Drug Administration(KFDA) suggested that make the alliance of medical radiation safety and culture on August, 2011. Seven societies and institutions related medical radiation started to research and advertise the culture of medical radiation safety in Korea. In this report, mainly introduce the activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) for spreading culture of medical radiation safety from 2011 to 2012.
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Management of Psychosocial Distress by Oncologists
Muriel, Anna C.; Hwang, Vivian S.; Kornblith, Alice; Greer, Joseph; Greenberg, Donna B.; Temel, Jennifer; Schapira, Lidia; Pirl, William
2010-01-01
Objective Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines. Methods A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care. Results Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean± SD=38%±22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines. Conclusions Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services. PMID:19648204
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Energy Technology Data Exchange (ETDEWEB)
Numasaki, Hodaka [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka (Japan); Shibuya, Hitoshi [Department of Radiology, Tokyo Medical and Dental University, Tokyo (Japan); Nishio, Masamichi [Department of Radiology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido (Japan); Ikeda, Hiroshi [Department of Radiology, Sakai Municipal Hospital, Sakai, Osaka (Japan); Sekiguchi, Kenji [Department of Radiation Oncology, St. Luke' s International Hospital, Tokyo (Japan); Kamikonya, Norihiko [Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo (Japan); Koizumi, Masahiko [Oncology Center, Osaka University Hospital, Suita, Osaka (Japan); Tago, Masao [Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki, Kanagawa (Japan); Ando, Yutaka [Department of Medical Informatics, Heavy Ion Medical Center, National Institute of Radiological Sciences, Chiba (Japan); Tsukamoto, Nobuhiro [Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama (Japan); Terahara, Atsuro [Department of Radiology, Toho University Omori Medical Center, Tokyo (Japan); Nakamura, Katsumasa [Department of Radiology, Kyushu University Hospital at Beppu, Oita (Japan); Mitsumori, Michihide [Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine Kyoto University, Kyoto (Japan); Nishimura, Tetsuo [Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka (Japan); Hareyama, Masato [Department of Radiology, Sapporo Medical University, Hokkaido (Japan); Teshima, Teruki, E-mail: teshima@sahs.med.osaka-u.ac.jp [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka (Japan)
2012-01-01
Purpose: To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. Methods and Materials: In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). Results: The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). Conclusions: ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists.
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Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi; Ikeda, Hiroshi; Sekiguchi, Kenji; Kamikonya, Norihiko; Koizumi, Masahiko; Tago, Masao; Ando, Yutaka; Tsukamoto, Nobuhiro; Terahara, Atsuro; Nakamura, Katsumasa; Mitsumori, Michihide; Nishimura, Tetsuo; Hareyama, Masato; Teshima, Teruki
2012-01-01
To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists. Copyright © 2012 Elsevier Inc. All rights reserved.
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Risk management of radiation therapy. Survey by north Japan radiation therapy oncology group
International Nuclear Information System (INIS)
Aoki, Masahiko; Abe, Yoshinao; Yamada, Shogo; Hareyama, Masato; Nakamura, Ryuji; Sugita, Tadashi; Miyano, Takashi
2004-01-01
A North Japan Radiation Oncology Group (NJRTOG) survey was carried out to disclose the risk management of radiation therapy. During April 2002, we sent questionnaires to radiation therapy facilities in northern Japan. There were 31 replies from 27 facilities. Many incidents and accidents were reported, including old cases. Although 60% of facilities had a risk management manual and/or risk manager, only 20% had risk management manuals for radiation therapy. Eighty five percent of radiation oncologists thought that incidents may be due to a lack of manpower. Ninety percent of radiation oncologists want to know the type of cases happened in other facilities. The risk management system is still insufficient for radiation therapy. We hope that our data will be a great help to develop risk management strategies for radiation therapy for all radiation oncologists in Japan. (author)
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Barriers against psychosocial communication: oncologists' perceptions.
Fagerlind, Hanna; Kettis, Åsa; Glimelius, Bengt; Ring, Lena
2013-10-20
To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication. A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers. Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.
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Seo, Songwon; Lim, Wan Young; Lee, Dal Nim; Kim, Jung Un; Cha, Eun Shil; Bang, Ye Jin; Lee, Won Jin; Park, Sunhoo; Jin, Young Woo
2018-03-30
The cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure. Approximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose-response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status. This study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings
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Paradox of Prescribing Late Chemotherapy: Oncologists Explain.
Bluhm, Minnie; Connell, Cathleen M; De Vries, Raymond G; Janz, Nancy K; Bickel, Kathleen E; Silveira, Maria J
2016-12-01
The value of chemotherapy for patients with cancer in the last weeks of life warrants examination. Late chemotherapy may not improve survival or quality of life but typically precludes hospice enrollment and may result in additional symptoms, increased use of other aggressive treatments, and worsening quality of life. Few studies have explored oncologists' rationales for administering chemotherapy near death. This study examines the self-reported factors that influence oncologists' decisions about late chemotherapy. In-depth individual interviews were conducted with 17 oncologists through a semistructured interview guide. Interviews were audio recorded and transcribed verbatim. Transcripts were coded and analyzed using conventional content analysis, a qualitative method that allows the detection and analysis of patterns in the data. Clinical factors take priority in determining late chemotherapy decisions when clear treatment choices exist. When clinical factors are ambiguous, emotion becomes a highly salient influence. Oncologists view late chemotherapy to be patient driven and use it to palliate emotional distress and maintain patient hope even when physical benefit is unexpected. Oncologists experience unique and difficult challenges when caring for dying patients, including emotionally draining communication, overwhelming responsibility for life/death, limitations of oncology to heal, and prognostic uncertainty. These challenges are also eased by offering late chemotherapy. The findings reveal a nuanced understanding of why oncologists find it difficult to refuse chemotherapy treatment for patients near death. Optimal end-of-life treatment decisions require supportive interventions and system change, both of which must take into account the challenges oncologists face.
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Cancer patients’ trust in their oncologist
Hillen, M.A.
2013-01-01
In this thesis we aimed to unravel cancer patients’ trust in their oncologist. We investigated patients’ explanations of trust in-depth, and developed an oncology-specific questionnaire to assess trust. Using the resulting Trust in Oncologist Scale, we experimentally established the influence of
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Kirkwood, M Kelsey; Bruinooge, Suanna S; Goldstein, Michael A; Bajorin, Dean F; Kosty, Michael P
2014-01-01
The American Society of Clinical Oncology (ASCO) 2007 workforce report projected US oncologist shortages by 2020. Intervening years have witnessed shifting trends in both supply and demand, demonstrating the need to capture data in a dynamic manner. The ASCO Workforce Information System (WIS) provides an infrastructure to update annually emerging characteristics of US oncologists (medical oncologists, hematologist/oncologists, and hematologists). Several possible data sources exist to capture the number of oncologists in the United States. The WIS primarily uses the American Medical Association Physician Masterfile database because it provides detailed demographics. This analysis also compares total counts of oncologists from American Board of Internal Medicine (ABIM) certification reports, the National Provider Identifier (NPI) database, and Medicare Physician Compare data. The analysis also examines geographic distribution of oncologists by age and US population data. For each of the data sources, we pulled 2013 data. The Masterfile identified 13,409 oncologists. ABIM reported 13,757 oncologists. NPI listed 11,664 oncologists. Physician Compare identified 11,343 oncologists. Mapping of these data identifies distinct areas (primarily in central United States, Alaska, and Hawaii) that seem to lack ready access to oncologists. Efforts to survey oncologists about practice patterns will help determine if productivity and service delivery will change significantly. ASCO is committed to tracking oncologist supply and demand, as well as to providing timely analysis of strategies that will help address any shortages that may occur in specific regions or practice settings.
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International Nuclear Information System (INIS)
Mueller, Arndt-Christian; Oorschot, Birgitt van; Micke, Oliver; Guckenberger, Matthias
2018-01-01
We aim to introduce and discuss the statements and recommendations of the German S3 guideline on renal cell cancer for daily practice of radiation oncologists. This report comprises indication, treatment decision, dose prescription and current literature including treatment of oligometastatic disease. According to different stages of the disease and the structure of the guideline we focus on five treatment situations and recommendations for decision making: (1) Neo-/adjuvant treatment before or after nephrectomy: No indication for radiotherapy. (2) Small renal mass: Stereotactic ablative radiotherapy is currently seen as experimental option due to small patient numbers reported in the literature. However, local tumor control achieved by SBRT appears favourable with >90% at 2 years. (3) Oligometastasis: Radiation treatment with higher local doses or stereotactic treatment is possible after interdisciplinary discussion. Indications for palliative (4) and symptomatic treatment (5) are not different compared to other tumor entities. Currently, there is no evidence-based indication for radiation treatment in the primary setting (adjuvant/neoadjuvant or definitive) of renal cell cancer. In the future stereotactic radiotherapy should have a stronger role in the treatment of medically inoperable patients with primary renal cell cancer and especially in the setting of oligometastasis. (orig.) [de
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Breaking bad news issues: A survey among radiation oncologists
Directory of Open Access Journals (Sweden)
Milind Kumar
2009-01-01
Full Text Available Introduction: Discussion of bad news and resuscitation in terminal cancer is an important but difficult and often neglected issue in day-to-day oncology practice. Materials and Methods: We interviewed 35 radiation oncologists using an indigenous 15-item questionnaire on their beliefs about breaking bad news and resuscitation to terminal cancer patients. Results: Most responders had an oncology experience of three to seven years (20/35.Thirty-two were comfortable discussing cancer diagnosis, prognosis and life expectancy-related issues. A similar number believed all cancer-related information should be disclosed, while only four believed in imparting all information in one visit. All agreed that disclosing sensitive information did not affect survival. When requested by relatives to withhold truth from patients, 11 said they would not comply, 22 agreed to tell the truth only if asked and two agreed to avoid difficult questions. Twenty responders denied having been adequately trained in breaking bad news and were keen on dedicated classes or sessions in this area of practice. Most (33/35 believed that Indian patients were keen on knowing their diagnosis and prognosis. Although all agreed to the importance of discussing resuscitation, only 17 believed patients should be involved. Majority (20/35 agreed that the issue needs to be discussed while the patient was conscious. Patients with unsalvageable disease were deemed unsuitable for aggressive resuscitation by 30 responders while the rest believed it should be offered to all. Most (21/35 admitted to feeling depressed after breaking bad news though only seven felt disclosure was more stressful than untruthful statements. Only four knew of a law regarding resuscitation in cancer. Conclusion: Observing the widely varied beliefs and practices for disclosing bad news, it is recommended that such training be a regular part of medicine curriculum, especially in the Oncology setting.
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Faculty of Radiation Oncology 2014 workforce census.
Leung, John; Munro, Philip L; James, Melissa
2015-12-01
This paper reports the key findings of the Faculty of Radiation Oncology 2014 workforce census and compares the results with earlier surveys. The census was conducted in mid-2014 with distribution to all radiation oncologists, educational affiliates and trainees listed on the college database. There were six email reminders and responses were anonymous. The overall response rate was 76.1%. The age range of fellows was 32-96 (mean = 49 years, median = 47 years). The majority of the radiation oncologists were male (n = 263, 63%). The minority of radiation oncologists were of Asian descent (n = 43, 13.4%). Radiation oncologists graduated from medical school on average 23 years ago (median = 22 years). A minority of fellows (n = 66, 20%) held another postgraduate qualification. Most radiation oncologists worked, on average, at two practices (median = 2, range 1-7). Practising radiation oncologists worked predominantly in the public sector (n = 131, 49%), but many worked in both the public and private sectors (n = 94, 37%), and a minority worked in the private sector only (n = 38, 14%). The largest proportion of the workforce was from New South Wales accounting for 29% of radiation oncologists. Radiation oncologists worked an average of 43 h/week (median = 43 h, range 6-80). Radiation oncologists who worked in the private sector worked less hours than their public sector or public/private sector colleagues. (38.3 vs. 42.9 vs. 44.3 h, P = 0.042). Victorians worked the fewest average hours per week at 38 h and West Australians the most at 46 h/week. Radiation oncologists averaged 48 min for each new case, 17 min per follow up and 11 min for a treatment review. Radiation oncologists averaged 246 new patients per year (median = 250, range = 20-600) with men (average = 268), Western Australians (average = 354) and those in private practice seeing more (average = 275). Most radiation
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Chaos theory: A fascinating concept for oncologists
International Nuclear Information System (INIS)
Denis, F.; Letellier, C.
2012-01-01
The oncologist is confronted daily by questions related to the fact that any patient presents a specific evolution for his cancer: he is challenged by very different, unexpected and often unpredictable outcomes, in some of his patients. The mathematical approach used today to describe this evolution has recourse to statistics and probability laws: such an approach does not ultimately apply to one particular patient, but to a given more or less heterogeneous population. This approach therefore poorly characterizes the dynamics of this disease and does not allow to state whether a patient is cured, to predict if he will relapse and when this could occur, and in what form, nor to predict the response to treatment and, in particular, to radiation therapy. Chaos theory, not well known by oncologists, could allow a better understanding of these issues. Developed to investigate complex systems producing behaviours that cannot be predicted due to a great sensitivity to initial conditions, chaos theory is rich of suitable concepts for a new approach of cancer dynamics. This article is three-fold: to provide a brief introduction to chaos theory, to clarify the main connecting points between chaos and carcinogenesis and to point out few promising research perspectives, especially in radiotherapy. (authors)
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Müller, Arndt-Christian; van Oorschot, Birgitt; Micke, Oliver; Guckenberger, Matthias
2018-01-01
We aim to introduce and discuss the statements and recommendations of the German S3 guideline on renal cell cancer for daily practice of radiation oncologists. This report comprises indication, treatment decision, dose prescription and current literature including treatment of oligometastatic disease. According to different stages of the disease and the structure of the guideline we focus on five treatment situations and recommendations for decision making: (1) Neo-/adjuvant treatment before or after nephrectomy: No indication for radiotherapy. (2) Small renal mass: Stereotactic ablative radiotherapy is currently seen as experimental option due to small patient numbers reported in the literature. However, local tumor control achieved by SBRT appears favourable with >90% at 2 years. (3) Oligometastasis: Radiation treatment with higher local doses or stereotactic treatment is possible after interdisciplinary discussion. Indications for palliative (4) and symptomatic treatment (5) are not different compared to other tumor entities. Currently, there is no evidence-based indication for radiation treatment in the primary setting (adjuvant/neoadjuvant or definitive) of renal cell cancer. In the future stereotactic radiotherapy should have a stronger role in the treatment of medically inoperable patients with primary renal cell cancer and especially in the setting of oligometastasis.
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Evolution of radiation therapy: technology of today
International Nuclear Information System (INIS)
Shrivastava, S.K.; Mishra, Shagun
2013-01-01
The three well established arms of treatment are surgery, radiation therapy and chemotherapy. The management of cancer is multidisciplinary; Radiation Oncologists along with Surgical Oncologists and Medical Oncologists are responsible for cancer therapeutics. They all work in close collaboration with Pathologists and Radiologists for cancer diagnosis and staging and rely on Oncology Nurses, Physiotherapists, Occupational Therapists, Nutritionists and Social Workers for optimal treatment and rehabilitation of cancer patients. Therefore cancer management is a team work for getting the best results. Radiation therapy is one of the most effective methods of treating cancer
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Ahmed, Awad A; Holliday, Emma B; Deville, Curtiland; Jagsi, Reshma; Haffty, Bruce G; Wilson, Lynn D
2015-12-01
A significant physician shortage has been projected to occur by 2025, and demand for oncologists is expected to outpace supply to an even greater degree. In response to this, many have called to increase the number of radiation oncology residency positions. The purpose of this study is to evaluate National Resident Matching Program (NRMP) data for the number of residency positions between 2004 and 2015 as well as the number and caliber of applicants for those positions and to compare radiation oncology to all residency specialties. NRMP data for all specialties participating in the match, including radiation oncology, were assessed over time examining the number of programs participating in the match, the number of positions offered, and the ratio of applicants to positions in the match from 2004 to 2015. From 2004 to 2015, the number of total programs participating in the match has increased by 26.7%, compared to the increase of 28.6% in the number of radiation oncology programs from during the same time period. The total number of positions offered in the match increased by 53.4%, whereas radiation oncology positions increased by 56.3%, during the same time period. The ratio of applicants (defined as those selecting a specialty as their first or only choice) to positions for all specialties has fluctuated over this time period and has gone from 1.21 to 1.15, whereas radiation oncology experienced a decrease from 1.45 to 1.14. NRMP data suggest that senior medical student applications to radiation oncology are decreasing compared to those of other specialties. If we hope to continue to attract the best and brightest to enter our field, we must continue to support early exposure to radiation oncology, positive educational experiences, and dedicated mentorship to interested medical students. Copyright © 2015 Elsevier Inc. All rights reserved.
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Energy Technology Data Exchange (ETDEWEB)
Ahmed, Awad A., E-mail: Awad.ahmed@jhsmiami.org [Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Haffty, Bruce G. [Department of Radiation Oncology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut (United States)
2015-12-01
Purpose: A significant physician shortage has been projected to occur by 2025, and demand for oncologists is expected to outpace supply to an even greater degree. In response to this, many have called to increase the number of radiation oncology residency positions. The purpose of this study is to evaluate National Resident Matching Program (NRMP) data for the number of residency positions between 2004 and 2015 as well as the number and caliber of applicants for those positions and to compare radiation oncology to all residency specialties. Methods: NRMP data for all specialties participating in the match, including radiation oncology, were assessed over time examining the number of programs participating in the match, the number of positions offered, and the ratio of applicants to positions in the match from 2004 to 2015. Results: From 2004 to 2015, the number of total programs participating in the match has increased by 26.7%, compared to the increase of 28.6% in the number of radiation oncology programs from during the same time period. The total number of positions offered in the match increased by 53.4%, whereas radiation oncology positions increased by 56.3%, during the same time period. The ratio of applicants (defined as those selecting a specialty as their first or only choice) to positions for all specialties has fluctuated over this time period and has gone from 1.21 to 1.15, whereas radiation oncology experienced a decrease from 1.45 to 1.14. Conclusions: NRMP data suggest that senior medical student applications to radiation oncology are decreasing compared to those of other specialties. If we hope to continue to attract the best and brightest to enter our field, we must continue to support early exposure to radiation oncology, positive educational experiences, and dedicated mentorship to interested medical students.
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Rock, Calvin B; Prabhu, Arpan V; Fuller, C David; Thomas, Charles R; Holliday, Emma B
2018-03-01
Publication metrics are useful in evaluating academic faculty for awarding grants, recruitment, and promotion. A new metric, the relative citation ratio (RCR), was recently released by the National Institutes of Health (NIH); however, no benchmark data yet exist. We sought to create benchmark data for physician faculty in academic radiation oncology (RO) and analyze correlations associated with increased academic productivity. Citation database searches were performed for all US radiation oncologists affiliated with academic RO programs. Gender, NIH funding, career duration, academic rank, RCR, and weighted RCR were collected for each faculty. RCR and weighted RCR were calculated and compared between each subgroup of interest. RCR percentiles were also created for reference. A total of 1,299 RO physician faculty members from 75 institutions were included in the analysis. Overall, RO physician were very productive and influential with a mean RCR of 1.57 ± 1.53 SD and median RCR (interquartile range) of 1.32 (0.87-1.94). Academic rank, career duration, and NIH funding were associated with increased mean RCR and weighted RCR. Male gender and having a PhD were associated with an increased weighted RCR but not an increased mean RCR. Current academic radiation oncologists have a high mean RCR value relative to the benchmark NIH RCR value of 1. All subgroups analyzed had an RCR value above 1 with professor or chair and previous NIH funding having the highest RCR and weighted RCR values overall. These data may be useful for self-evaluation of ROs as well as evaluation of faculty by institutional and departmental leaders. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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Space Radiation Measurement on the Polar Route onboard the Korean Commercial Flights
Directory of Open Access Journals (Sweden)
Junga Hwang
2010-03-01
Full Text Available This study was performed by the policy research project of Ministry of Land, Transport and Maritime Affairs, which title is “Developing safety standards and management of space radiation on the polar route”. In this research, total six experiments were performed using Korean commercial flights (B747. Three of those are on the polar route and the other three are on the north pacific route. Space radiation exposure measured on the polar route is the average 84.7 uSv. The simulation result using CARI-6M program gives 84.9 uSv, which is very similar to measured value. For the departure flight using the north pacific route, the measured space radiation is the average 74.4 uSv. It seems that is not so different to use the polar route or not for the return flight because the higher latitude effect causing the increase of space radiation is compensated by the shortened flight time effect causing decreasing space radiation exposure.
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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.
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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)
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International Nuclear Information System (INIS)
Yong Ki Chi; Bokyun Seo; Wantae Kim
2015-01-01
Although most of the sky-shine radiation levels in industrial radiography are below regulatory limits, sky-shine radiation could make a valuable contribution to the total radiation level near shielding facility with little shielding and open field without shielding. Therefore sky-shine radiation should be thoroughly predicted and supervised with the ALARA principle. In this study, we simulated sky-shine radiation for mobile irradiators using MCNP and newly suggested the equation for calculating sky-shine radiation. Also these results were applied to developing Korean regulatory guidance about industrial radiography and to recommending the requirement of the facility design, controlled or supervised area at work places. (author)
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[Chaos theory: a fascinating concept for oncologists].
Denis, F; Letellier, C
2012-05-01
The oncologist is confronted daily by questions related to the fact that any patient presents a specific evolution for his cancer: he is challenged by very different, unexpected and often unpredictable outcomes, in some of his patients. The mathematical approach used today to describe this evolution has recourse to statistics and probability laws: such an approach does not ultimately apply to one particular patient, but to a given more or less heterogeneous population. This approach therefore poorly characterizes the dynamics of this disease and does not allow to state whether a patient is cured, to predict if he will relapse and when this could occur, and in what form, nor to predict the response to treatment and, in particular, to radiation therapy. Chaos theory, not well known by oncologists, could allow a better understanding of these issues. Developed to investigate complex systems producing behaviours that cannot be predicted due to a great sensitivity to initial conditions, chaos theory is rich of suitable concepts for a new approach of cancer dynamics. This article is three-fold: to provide a brief introduction to chaos theory, to clarify the main connecting points between chaos and carcinogenesis and to point out few promising research perspectives, especially in radiotherapy. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.
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Faculty of Radiation Oncology 2010 workforce survey.
Leung, John; Vukolova, Natalia
2011-12-01
This paper outlines the key results of the Faculty of Radiation Oncology 2010 workforce survey and compares these results with earlier data. The workforce survey was conducted in mid-2010 using a custom-designed 17-question survey. The overall response rate was 76%. The majority of radiation oncologist respondents were male (n = 212, 71%), but the majority of trainee respondents were female (n = 59, 52.7%). The age range of fellows was 32-92 years (median: 47 years; mean: 49 years) and that of trainees was 27-44 years (median: 31 years; mean: 31.7 years). Most radiation oncologists worked at more than one practice (average: two practices). The majority of radiation oncologists worked in the public sector (n = 169, 64.5%), with some working in 'combination' of public and private sectors (n = 65, 24.8%) and a minority working in the private sector only (n = 28, 10.7%). The hours worked per week ranged from 1 to 85 (mean: 44 h; median: 45 h) for radiation oncologists, while for trainees the range was 16-90 (mean: 47 h; median: 45 h). The number of new cases seen in a year ranged from 1 to 1100 (mean: 275; median: 250). Most radiation oncologists considered themselves generalists with a preferred sub-specialty (43.3%) or specialists (41.9%), while a minority considered themselves as generalists (14.8%). There are a relatively large and increasing number of radiation oncologists and trainees compared with previous years. The excessive workloads evident in previous surveys appear to have diminished. However, further work is required on assessing the impact of ongoing feminisation and sub-specialisation. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.
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Arslan, Deniz; Koca, Timur; Tastekin, Didem; Basaran, Hamit; Bozcuk, Hakan
2014-01-01
Currently poster presentations offer a common visual medium for knowledge transfer by a wide range of health professionals. Our study aimed to determine the scientific importance of poster presentations for Medical and Radiation Oncologists. A survey form including 40 questions was distributed to a total of 131 oncologists experienced in poster presentations. One hundred completed survey forms were included in the study. Descriptive statistics and modified thematic analyses were performed on the responses. Overall 64% of the participants agreed that posters were a good medium for knowledge transfer. Some 88% agreed that concise and clear styled presentations would increase appealing interests for poster contents. Visual appearance was cited more influential than content of the subject; 70% of participants agreed that appearances of posters could help to draw more viewer attention. Of respondents, 63% believed that posters accompanied by their author were more attractive for congress attendees, and 33% of them declared that the halo effect of the poster presenter was also important. The present study indicated that intelligibility, appearance and visuality of posters are most important factors from the aspect of oncologist participants. Presenters must take into account these important points when preparing their academic posters.
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Oncologists' non-verbal behavior and analog patients' recall of information.
Hillen, Marij A; de Haes, Hanneke C J M; van Tienhoven, Geertjan; van Laarhoven, Hanneke W M; van Weert, Julia C M; Vermeulen, Daniëlle M; Smets, Ellen M A
2016-06-01
Background Information in oncological consultations is often excessive. Those patients who better recall information are more satisfied, less anxious and more adherent. Optimal recall may be enhanced by the oncologist's non-verbal communication. We tested the influence of three non-verbal behaviors, i.e. eye contact, body posture and smiling, on patients' recall of information and perceived friendliness of the oncologist. Moreover, the influence of patient characteristics on recall was examined, both directly or as a moderator of non-verbal communication. Material and methods Non-verbal communication of an oncologist was experimentally varied using video vignettes. In total 194 breast cancer patients/survivors and healthy women participated as 'analog patients', viewing a randomly selected video version while imagining themselves in the role of the patient. Directly after viewing, they evaluated the oncologist. From 24 to 48 hours later, participants' passive recall, i.e. recognition, and free recall of information provided by the oncologist were assessed. Results Participants' recognition was higher if the oncologist maintained more consistent eye contact (β = 0.17). More eye contact and smiling led to a perception of the oncologist as more friendly. Body posture and smiling did not significantly influence recall. Older age predicted significantly worse recognition (β = -0.28) and free recall (β = -0.34) of information. Conclusion Oncologists may be able to facilitate their patients' recall functioning through consistent eye contact. This seems particularly relevant for older patients, whose recall is significantly worse. These findings can be used in training, focused on how to maintain eye contact while managing computer tasks.
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International Nuclear Information System (INIS)
Bungay, Peter M.; Carrington, Bernadette M.; Corgie, Delphine; Eardley, Anne
2002-01-01
AIM: To audit the relationship between Cancer Centre oncologists visiting peripheral hospitals and peripheral hospital radiologists by assessing (i) oncologists' knowledge of local radiological services; (ii) oncologists' perceptions of peripheral radiological services; (iii) peripheral radiologist's perceptions of oncologists; (iv) barriers to communication. MATERIALS AND METHODS: A postal questionnaire was sent to all radiology departments visited by an oncologist, and to all medical and clinical oncologists from two regional oncology centres. RESULTS: The response rate was 100% (21 peripheral hospital radiology departments and all 35 oncologists). (i) Oncologists' knowledge of peripheral hospital imaging modalities was limited (especially MRI and intervention). (ii) 72% of oncologists rated the peripheral hospital radiology service as excellent or good, 46% rated the radiology report quality excellent to good. Deficiencies in oncological reports were identified. (iii) 44% of radiologists thought the oncologist did not relate well with the local radiology department. 50% of radiologists did not know the visiting oncologist's specialist interest. (iv) 69% of oncologists did not regularly attend peripheral hospital clinico-radiological meetings. Lack of written and oral information was hampering both specialities. CONCLUSION: Communication between oncologists and the local radiology department should include: (1) information about local radiology services for visiting oncologists (including trainees) and on the oncology team for radiologists; (2) standardized report content; (3) improved clinical information for radiologists; (4) regular clinico-radiological meetings. Bungay, P.M. et al. (2002)
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Energy Technology Data Exchange (ETDEWEB)
NONE
2014-03-15
Cancer is one of the leading causes of death globally and cancer incidence is predicted to increase, especially in developing countries. Almost 13% of all deaths worldwide are caused by cancer. In 2005, there were more than 7.6 million cancer deaths worldwide and 10 million newly diagnosed cases of cancer. Today there are more new cancer cases every year in lowmiddle income (LMI) countries than in industrialized countries, and cancer rates are projected to increase significantly in developing countries. By 2020, two-thirds of the projected 10 million annual cancer deaths will be in developing countries. Radiotherapy plays a fundamental role in the continuum of cancer care. However, this technology is not comprehensively provided and in some countries not provided at all. According to the IAEA's Directory of Radiotherapy Centers (DIRAC), as of January 2004 there were about 2000 radiotherapy centres in the developing world with fewer than 2500 teletherapy machines dedicated to cancer therapy. The deficit is not just one of machines - each radiotherapy facility needs trained staff (radiation oncologists, medical physicists, technologists, radiation oncology nurses and maintenance engineers) as well as appropriate arrangements for radiation protection, safety, security and a continuing and ongoing effort to ensure the quality of the radiotherapy process. Strengthening the capability of ministries of health and other health sector institutions for assessing options, formulating policies, and setting priorities is also crucial. The International Atomic Energy Agency (IAEA) has been assisting its Member States in the establishment, operation and upgrading of radiation oncology facilities for many years. Human resource development, which includes training of radiation oncologists, medical physicists, radiation therapy technologists and radiation oncology nurses, is an integral part of the assistance as shortage of such trained professionals would be a serious obstacle to
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James, Melissa; Munro, Philip M; Leung, John
2015-04-17
This paper outlines the key results of the Royal Australian and New Zealand College of Radiologists (RANZCR) Faculty of Radiation Oncology (FRO) 2014 workforce census, and compares the results of New Zealand and Australian responses in order to identify similarities and differences in workforce characteristics. The workforce census was conducted online in mid-2014. The census was distributed to all radiation oncologists (Fellows, life members, educational affiliates, retired) and radiation oncology trainees on the RANZCR membership database. Six weekly reminders were sent to non-respondents and all responses were aggregated for analysis. This paper addresses only consultant radiation oncologist responses. The combined response rate for New Zealand radiation oncologists was 85.7% (compared with 76% from Australian respondents). The census found that the demographic characteristics of New Zealand and Australian radiation oncologists are similar. Points of difference include (i) the role of educational affiliates in New Zealand, (ii) New Zealand radiation oncologists reporting higher hours spent at work, (iii) New Zealand radiation oncologists spending a higher proportion of time on clinical duties, (iv) A lower proportion of New Zealand radiation oncologists with higher degrees, and (v) private/ public workplace mix. A comparison by country would suggest that there are many similarities, but also some important differences that may affect workforce issues in New Zealand. Separate datasets are useful for RANZCR to better inform members, governments and other key stakeholders in each country. Separate datasets also provide a basis for comparison with future surveys to facilitate the monitoring of trends.
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Energy Technology Data Exchange (ETDEWEB)
Ko, Seul Ki; Lee, Won Jin [Dept. of Preventive Medicine, Korea University College of Medicine, Seoul (Korea, Republic of)
2016-12-15
The use of radiology examinations in medicine has been growing worldwide. Annually an estimated 3.1 billion radiologic exams are performed. According to this expansion of medical radiation exposure, it has been hard to pay no attention to the effects of medical radiation exposures in the exposure from different types of radiation source. This study, therefore, was aimed to assess the association of medical and occupational radiation exposure in Korean radiologic technologists and evaluate necessity for its consideration in occupational studies. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure.
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International Nuclear Information System (INIS)
Ko, Seul Ki; Lee, Won Jin
2016-01-01
The use of radiology examinations in medicine has been growing worldwide. Annually an estimated 3.1 billion radiologic exams are performed. According to this expansion of medical radiation exposure, it has been hard to pay no attention to the effects of medical radiation exposures in the exposure from different types of radiation source. This study, therefore, was aimed to assess the association of medical and occupational radiation exposure in Korean radiologic technologists and evaluate necessity for its consideration in occupational studies. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure. This study did not show the strong association between medical radiation exposure and occupational radiation exposure except several modalities with specific frequency. These results are preliminary but certainly meaningful for interpretation of epidemiologic finding, therefore, we need further evaluation specially for the repeatedly exposed imaging tests and high dose procedures that presented somewhat weak relationship in this study linked with health outcomes of radiation exposure.
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Community Oncologists' Decision-Making for Treatment of Older Patients With Cancer.
Mohile, Supriya G; Magnuson, Allison; Pandya, Chintan; Velarde, Carla; Duberstein, Paul; Hurria, Arti; Loh, Kah Poh; Wells, Megan; Plumb, Sandy; Gilmore, Nikesha; Flannery, Marie; Wittink, Marsha; Epstein, Ronald; Heckler, Charles E; Janelsins, Michelle; Mustian, Karen; Hopkins, Judith O; Liu, Jane; Peri, Srihari; Dale, William
2018-03-01
Background: This study's objectives were to describe community oncologists' beliefs about and confidence with geriatric care and to determine whether geriatric-relevant information influences cancer treatment decisions. Methods: Community oncologists were recruited to participate in 2 multisite geriatric oncology trials. Participants shared their beliefs about and confidence in caring for older adults. They were also asked to make a first-line chemotherapy recommendation (combination vs single-agent vs no chemotherapy) for a hypothetical vignette of an older patient with advanced pancreatic cancer. Each oncologist received one randomly chosen vignette that varied on 3 variables: age (72/84 years), impaired function (yes/no), and cognitive impairment (yes/no). Other patient characteristics were held constant. Logistic regression models were used to identify associations between oncologist/vignette-patient characteristics and treatment decisions. Results: Oncologist response rate was 61% (n=305/498). Most oncologists agreed that "the care of older adults with cancer needs to be improved" (89%) and that "geriatrics training is essential" (72%). However, decision to treat: younger age (adjusted odds ratio [aOR], 5.01; 95% CI, 2.73-9.20), normal cognition (aOR, 5.42; 95% CI, 3.01-9.76), and being functionally intact (aOR, 3.85; 95% CI, 2.12-7.00). Accounting for all vignettes across all scenarios, 161 oncologists (52%) said they would offer chemotherapy. All variables were independently associated with prescribing single-agent over combination chemotherapy (older age: aOR, 3.22; 95% CI 1.43-7.25, impaired cognition: aOR, 3.13; 95% CI, 1.36-7.20, impaired function: aOR, 2.48; 95% CI, 1.12-5.72). Oncologists' characteristics were not associated with decisions about providing chemotherapy. Conclusion: Geriatric-relevant information, when available, strongly influences community oncologists' treatment decisions. Copyright © 2018 by the National Comprehensive Cancer Network.
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Responding to family requests for nondisclosure: the impact of oncologists' cultural background.
Chittem, Mahati; Butow, Phyllis
2015-01-01
Nondisclosure of cancer diagnosis is common in many Eastern countries. Consequently, immigrant families often approach oncologists with requests for nondisclosure in Western countries. To explore differences in the attitudes and practices of Western-born and nonWestern born oncologists in Australia when faced with a nondisclosure request. Using a cross-sectional design, oncologists were interviewed over the telephone. Using the snowball method, 14 Australian (Western = 9, non-Western = 5) oncologists were recruited. Oncologists participated in a semi-structured interview exploring their experiences of, and response to, a request for nondisclosure, and their perceptions of how their cultural background influenced these attitudes and responses. The interviews were transcribed and analyzed using interpretative phenomenological analysis. Six main themes emerged from the study: (1) Barriers to truthful communication, (2) an ethical and moral dilemma, (3) high costs of nondisclosure, (4) cultural influences on interpretation and understanding of requests for nondisclosure, (5) emotional impact of bad news on patients, families and oncologists, and (6) truthful disclosure as a gentle balancing act. All oncologists felt that the family request for nondisclosure was difficult, with many cultural and emotional nuances to take into consideration. Some immigrant Australian oncologists who had a similar cultural background as the patient/family, felt they could better understand the desire for nondisclosure. Irrespective of their cultural background, all oncologists acknowledged that breaking bad news had to be done in a gentle, gradual manner. The study suggests a need to develop a culturally sensitive cancer communication model.
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Palliative or curative treatment intent affects communication in radiation therapy consultations.
Timmermans, L.; Maazen, R.W.M. van der; Leer, J.W.H.; Kraaimaat, F.W.
2006-01-01
OBJECTIVE: To assess whether communication in radiotherapy consultations is affected by palliative or curative treatment intent. SUBJECTS AND METHODS: The study involved 160 patients and 8 radiation oncologists. Eighty patients visited the radiation oncologist (RO) for palliative treatment and 80
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Vu, Charles C; Lanni, Thomas B; Robertson, John M
2016-04-01
The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (Preimbursement. The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other specialists. Male sex and rural practice location are independent predictors of higher total Medicare reimbursements. Copyright © 2016 Elsevier Inc. All rights reserved.
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International Nuclear Information System (INIS)
Vu, Charles C.; Lanni, Thomas B.; Robertson, John M.
2016-01-01
Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other
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Energy Technology Data Exchange (ETDEWEB)
Vu, Charles C.; Lanni, Thomas B.; Robertson, John M., E-mail: JRobertson@beaumont.edu
2016-04-01
Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other
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WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists
Energy Technology Data Exchange (ETDEWEB)
Hendrickson, K. [University of Washington (United States)
2016-06-15
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiation oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.
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WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists
International Nuclear Information System (INIS)
Hendrickson, K.
2016-01-01
Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiation oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.
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Oncologists' negative attitudes towards expressing emotion over patient death and burnout.
Granek, Leeat; Ben-David, Merav; Nakash, Ora; Cohen, Michal; Barbera, Lisa; Ariad, Samuel; Krzyzanowska, Monika K
2017-05-01
The aims of this study were to examine the relationship between negative attitudes towards expressing emotion following patient death and burnout in oncologists and to explore oncologists' preferences for institutional interventions to deal with patient death. The participants included a convenience sample of 177 oncologists from Israel and Canada. Oncologists completed a questionnaire package that included a sociodemographic survey, a burnout measure, a survey assessing negative attitudes towards expressing emotion, and a survey assessing desired interventions to cope with patient death. To examine the association between burnout and negative attitudes while controlling for the effect of sociodemographic variables, a hierarchical linear regression was computed. Higher burnout scores were related to higher negative attitudes towards perceived expressed emotion (partial r = .25, p training) helpful in coping with patient death. Our findings suggest that high burnout scores are associated with negative attitudes towards expressing emotion and that there is a wide variation in oncologist preferences in coping with patient death. Institutions should promote interventions that are varied and that focus on the needs of oncologists in order to reduce burnout. Interventions that legitimize expression of emotion about patient death may be useful. Another way to reduce stigma would be to require oncologists to "opt out" rather than "opt in" to accessing a selection of social and/or individual interventions.
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ONCOLOGISTS' BARRIERS AND FACILITATORS FOR ONCOTYPE DX USE: QUALITATIVE STUDY.
Roberts, Megan C; Bryson, Amy; Weinberger, Morris; Dusetzina, Stacie B; Dinan, Michaela A; Reeder-Hayes, Katherine; Wheeler, Stephanie B
2016-01-01
Oncotype DX (ODX), a tumor gene profiling test, has been incorporated into clinical guidelines to aid in adjuvant chemotherapy decision making for early-stage, hormone receptor positive breast cancer patients. Despite United States (U.S.) guidelines, less than half of eligible women receive testing. Reasons for low usage are unclear: Our objective was to better understand U.S. oncologists' ODX uptake and how they use ODX during adjuvant chemotherapy decision making. We conducted semi-structured, ~30-minute phone interviews with medical and surgical oncologists in one U.S. State using purposive sampling. Oncologists were included if they saw greater than or equal to five breast cancer patients per week. Recruitment ended upon thematic saturation. Interviews were recorded, transcribed, and double-coded using template analysis. During analysis, themes emerged across three domains. First, organizational factors (i.e., departmental structure, ODX marketing, and medical/insurance guidelines) influenced ease of ODX use. Second, oncologists referenced the influence of interpersonal factors (e.g., normative beliefs and peer use of ODX) over their own practices and recommendations. Third, intrapersonal factors (e.g., oncologist attitudes, perceived barriers, and research gaps) were discussed: although oncologists largely held positive attitudes about ODX, they reported challenges with interpreting intermediate scores for treatment decisions and explaining test results to patients. Finally, oncologists identified several research gaps. As more tumor gene profiling tests are incorporated into cancer care for treatment decision making, it is important to understand their use in clinical practice. This study identified multi-level factors that influence ODX uptake into clinical practice, providing insights into facilitators and modifiable barriers that can be leveraged for improving ODX uptake to aid treatment decision making.
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International Nuclear Information System (INIS)
Engel-Nitz, Nicole M; Alemayehu, Berhanu; Parry, David; Nathan, Faith
2011-01-01
Differences in treatment patterns, health care resource utilization, and costs between patients with castration-resistant prostate cancer (CRPC) treated by oncologists and those treated by urologists were examined. Patients aged ≥40 with CRPC were identified using claims from a large US managed health care plan between July 2001 and December 2007. A 6-month baseline period was used to assess patient characteristics. Patients with visits to an urologist, without visits to an oncologist, were assigned to the urology cohort, and patients with visits to an oncologist, with or without visits to an urologist, were assigned to the oncology cohort. Treatment patterns, health care resource utilization, and costs during a variable follow-up period were compared between cohorts using descriptive statistics and Lin’s regression. The urology cohort had fewer comorbid illnesses (P < 0.001) and patients were less likely to have other cancers during baseline (P < 0.001) or to die during follow-up (P = 0.004) compared with the oncology cohort. The oncology cohort patients were significantly more likely to have a claim for hormones (74.5% vs 61.1%; P < 0.001), chemotherapy (46.9% vs 10.2%, P < 0.001), and radiation (22.3% vs 3.7%, P < 0.0001) over follow-up. Mean unadjusted health care costs were higher in the oncology vs the urology cohort (US$31,896 vs US$15,318, respectively; P < 0.001). At 6 years follow-up, cumulative adjusted CRPC-specific costs were significantly higher among patients treated by oncologists with chemotherapy than among patients treated by urologists. CRPC patients treated by oncologists had greater use of hormones, chemotherapy, and radiation; higher percentages of patients with inpatient stays, emergency room, and ambulatory visits; and higher health care costs, than patients treated by urologists
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International Nuclear Information System (INIS)
Roberge, David; Menard, Cynthia; Bauman, Glenn; Chan, Alex; Mulroy, Liam; Sahgal, Arjun; Malone, Shawn; McKenzie, Michael; Schroeder, Garry; Fortin, Marie-Andree; Ebacher, Annie; Milosevic, Michael
2010-01-01
Radiosurgery has a long history in Canada. Since the treatment of the first patient at the McGill University Health Center in 1985, radiosurgery programs have been developed from coast to coast. These have included multidisciplinary teams of radiation oncologists, neurosurgeons, medical physicists, radiation technologists and other health professionals. In 2008, the CARO Board of Directors requested that a working group be formed to define the role of the radiation oncologist in the practice of radiosurgery. Taking into account evolving technology, changing clinical practice and current scope of practice literature, the working group made recommendations as to the role of the radiation oncologists. These recommendations were endorsed by the Canadian Association of Radiation Oncology board of directors in September 2009 and are present herein. It is recognized that patients benefit from a team approach to their care but it is recommended that qualified radiation oncologists be involved in radiosurgery delivery from patient consultation to follow-up. In addition, radiation oncologists should continue to be involved in the administrative aspects of radiosurgery programs, from equipment selection to ongoing quality assurance/quality improvement.
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Smith, Benjamin D; Haffty, Bruce G; Wilson, Lynn D; Smith, Grace L; Patel, Akshar N; Buchholz, Thomas A
2010-12-10
Prior studies forecasted an incipient shortage of medical oncologists as a result of the aging US population, but the radiation oncology workforce has not been studied. Accordingly, we projected demand for radiation therapy and supply of radiation oncologists in 2010 and 2020 to determine whether a similar shortage may exist for this specialty. Demand for radiation therapy in 2010 and 2020 was estimated by multiplying current radiation utilization rates (as calculated with Surveillance, Epidemiology, and End Results data) by population projections from the Census Bureau. Supply of radiation oncologists was projected using data from the American Board of Radiology inclusive of current radiation oncologists and active residents, accounting for variation in full-time equivalent status and expected survival by age and sex. Between 2010 and 2020, the total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 22%, from 470,000 per year to 575,000 per year. In contrast, assuming that the current graduation rate of 140 residents per year remains constant, the number of full-time equivalent radiation oncologists is expected to increase by only 2%, from 3,943 to 4,022. The size of residency training classes for the years 2014 to 2019 would have to double to 280 residents per year in order for growth in supply of radiation oncologists to equal expected growth in demand. Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020. Research is needed to explore strategies to enhance capacity to deliver quality radiation therapy despite increased patient loads.
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International Nuclear Information System (INIS)
Shakespeare, Thomas Philip; Dwyer, Mary; Mukherjee, Rahul; Yeghiaian-Alvandi, Roland; Gebski, Val
2002-01-01
Purpose: Estimating the risks of radiotherapy (RT) toxicity is important for informed consent; however, the consistency in estimates has not been studied. This study aimed to explore the variability and factors affecting risk estimates (REs). Methods and Materials: A survey was mailed to Australian radiation oncologists, who were asked to estimate risks of RT complications given 49 clinical scenarios. The REs were assessed for association with oncologist experience, subspecialization, and private practice. Results: The REs were extremely variable, with a 50-fold median variability. The least variability (sevenfold) was for estimates of late, small intestinal perforation/obstruction after a one-third volume received 50 Gy with concurrent 5-fluorouracil (RE range 5-35%). The variation between the smallest and largest REs in 17 scenarios was ≥100-fold. The years of experience was significantly associated with REs of soft/connective-tissue toxicity (p=0.01) but inversely associated with estimates of neurologic/central nervous system toxicity (p=0.08). Ninety-six percent of respondents believed REs were important to RT practice; only 24% rated evidence to support their estimates as good. Sixty-seven percent believed national/international groups should pursue the issue further. Conclusion: Enormous variability exists in REs for normal tissue complications due to RT that is influenced by the years of experience. Risk estimation is perceived as an important issue without a good evidence base. Additional studies are strongly recommended
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Breast reconstruction and post-mastectomy radiation practice
International Nuclear Information System (INIS)
Chen, Susie A; Hiley, Crispin; Nickleach, Dana; Petsuksiri, Janjira; Andic, Fundagul; Riesterer, Oliver; Switchenko, Jeffrey M; Torres, Mylin A
2013-01-01
The goal of this study was to explore the perspectives and practice of radiation oncologists who treat breast cancer patients who have had breast reconstruction. In 2010, an original electronic survey was sent to all physician members of the American Society of Radiation Oncology, National Cancer Research Institute-Breast Cancer Studies Group in the United Kingdom, Thai Society of Therapeutic Radiology and Oncology, Swiss Society of Radiation Oncology, and Turkish Radiation Oncology Society. We identified factors associated with radiation oncologists who treat breast cancer patients with reconstruction performed prior to radiation and obtained information regarding radiation management of the breast reconstruction. 358 radiation oncologists responded, and 60% of the physicians were from the United States. While 64% of participants agree or strongly agree that breast image affects a woman’s quality of life during radiation, 57% feel that reconstruction challenges their ability to deliver effective breast radiation. Compared with other countries, treatment within the United States was associated with a high reconstruction rate (>/= 50% of mastectomy patients) prior to radiation (p < 0.05). Delayed-immediate reconstruction with a temporary tissue expander was more common in the United States than in other countries (52% vs. 23%, p = 0.01). Among physicians who treat patients with tissue expanders, the majority (60%) prefer a moderately inflated implant with 150-250 cc of fluid rather than a completely deflated (13%) or inflated expander (28%) during radiation. Among radiation oncologists who treat reconstructions, 49% never use bolus and 40% never boost a breast reconstruction. United States physicians were more likely than physicians from other countries to boost or bolus the reconstruction irrespective of the type of reconstruction seen in their clinic patients (p < 0.01). Great variation in practice is evident from our study of radiation treatment for breast
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International Nuclear Information System (INIS)
Bader, J.L.; Glatstein, E.
1987-01-01
The radiation oncologist encounters the critically ill immunosuppressed patient in four settings. First, the newly diagnosed cancer patient presents for initial evaluation and treatment, with immunosuppression from the cancer itself, malnutrition, concomitant infectious disease, prior drug or alcohol abuse or other medical problems. Second, the previously treated cancer patient presents with metastatic or recurrent primary cancer causing local symptoms. Immune dysfunction in this setting may be due to prior chemotherapy and/or radiation as well as any of the original factors. Third, the patient previously treated with radiation presents with a life-threatening problem possibly due to complications of prior therapy. In this setting, the radiation oncologist is asked to evaluate the clinical problem and to suggest whether radiation might be causing part or all of the problem and what can be done to treat these sequelae of radiation. Fourth, the patient with a benign diagnosis (not cancer) is seen with a problem potentially emeliorated by radiation (e.g., kidney transplant rejection, preparation for transplant, or intractable rheumatoid arthritis). This chapter reviews these four issues and presents clinical and radiobiologic principles on which recommendations for therapy are based
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The Effects of Interruptions on Oncologists' Patient Assessment and Medication Ordering Practices
Directory of Open Access Journals (Sweden)
Patricia L. Trbovich
2013-01-01
Full Text Available Interruptions are causal factors in medication errors. Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to (1 document the nature, frequency, and timing of interruptions during medication ordering, and (2 quantify the use of coping mechanisms by oncologists. On average, oncologists were interrupted 17 % of their time, and were frequently interrupted during safety-critical stages of medication ordering. When confronted with interruptions, oncologists engaged/multitasked more often than resorting to deferring/blocking. While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.
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Radiation treatment and radiation reactions in dermatology. 2. ed.
Energy Technology Data Exchange (ETDEWEB)
Panizzon, Renato G. [Univ. Hospital CHUV, Lausanne (Switzerland). Dept. of Dermatology; Seegenschmiedt, M. Heinrich (ed.) [Strahlenzentrum Hamburg (Germany)
2015-03-01
Explains the use of radiation treatment in the full range of skin cancers and precancerous lesions. Covers physical and radiobiological principles, dose definitions, radiation reactions, and risk assessments. Revised and updated edition that includes new chapters and numerous additional figures. In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies - including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor - as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.
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Radiation treatment and radiation reactions in dermatology. 2. ed.
International Nuclear Information System (INIS)
Panizzon, Renato G.
2015-01-01
Explains the use of radiation treatment in the full range of skin cancers and precancerous lesions. Covers physical and radiobiological principles, dose definitions, radiation reactions, and risk assessments. Revised and updated edition that includes new chapters and numerous additional figures. In this book, leading experts in the dermatological and oncological field describe the use of radiation therapy for the treatment of the full range of dermatological malignancies - including basal cell carcinoma, squamous cell carcinoma, cutaneous lymphomas, Kaposi's sarcoma, melanoma, and Merkel cell tumor - as well as those precancerous lesions and non-malignant dermatological disorders which are amenable to radiation therapy. In each case the specific indications for the use of radiotherapy and its application are clearly explained with the aid of numerous high-quality illustrations. In addition, the book provides a concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, radiation reactions, and risk assessments. The new edition has been thoroughly revised and updated to reflect advances in practical knowledge and clinical practice. It will be an invaluable source of information on the management of skin tumors and related non-malignant disorders for both dermatologists, oncologists and radiation oncologists.
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Negative emotions in cancer care: do oncologists' responses depend on severity and type of emotion?
Kennifer, Sarah L; Alexander, Stewart C; Pollak, Kathryn I; Jeffreys, Amy S; Olsen, Maren K; Rodriguez, Keri L; Arnold, Robert M; Tulsky, James A
2009-07-01
To examine how type and severity of patients' negative emotions influence oncologists' responses and subsequent conversations. We analyzed 264 audio-recorded conversations between advanced cancer patients and their oncologists. Conversations were coded for patients' expressions of negative emotion, which were categorized by type of emotion and severity. Oncologists' responses were coded as using either empathic language or blocking and distancing approaches. Patients presented fear more often than anger or sadness; severity of disclosures was most often moderate. Oncologists responded to 35% of these negative emotional disclosures with empathic language. They were most empathic when patients presented intense emotions. Responding empathically to patients' emotional disclosures lengthened discussions by an average of only 21s. Greater response rates to severe emotions suggest oncologists may recognize negative emotions better when patients express them more intensely. Oncologists were least responsive to patient fear and responded with greatest empathy to sadness. Oncologists may benefit from additional training to recognize negative emotions, even when displayed without intensity. Teaching cancer patients to better articulate their emotional concerns may also enhance patient-oncologist communication.
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Satisfaction with work-life balance and the career and retirement plans of US oncologists.
Shanafelt, Tait D; Raymond, Marilyn; Kosty, Michael; Satele, Daniel; Horn, Leora; Pippen, John; Chu, Quyen; Chew, Helen; Clark, William Benton; Hanley, Amy E; Sloan, Jeff; Gradishar, William J
2014-04-10
To evaluate satisfaction with work-life balance (WLB) and career plans of US oncologists. The American Society of Clinical Oncology conducted a survey of US oncologists evaluating satisfaction with WLB and career plans between October 2012 and March 2013. The sample included equal numbers of men and women from all career stages. Of 2,998 oncologists contacted, 1,490 (49.7%) returned surveys. From 1,117 oncologists (37.3% of overall sample) completing full-length surveys, we evaluated satisfaction with WLB and career plans among the 1,058 who were not yet retired. The proportion of oncologists satisfied with WLB (n = 345; 33.4%) ranked lower than that reported for all other medical specialties in a recent national study. Regarding career plans, 270 oncologists (26.5%) reported a moderate or higher likelihood of reducing their clinical work hours in the next 12 months, 351 (34.3%) indicated a moderate or higher likelihood of leaving their current position within 24 months, and 273 (28.5%) planned to retire before 65 years of age. Multivariable analyses found women oncologists (odds ratio [OR], 0.458; P hour, 0.977; P work hours and leave current position on multivariable analysis. Satisfaction with WLB among US oncologists seems lower than for other medical specialties. Dissatisfaction with WLB shows a strong relationship with plans to reduce hours and leave current practice. Given the pending US oncologist shortage, additional studies exploring interactions among WLB, burnout, and career satisfaction and their impact on career and retirement plans are warranted.
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International Nuclear Information System (INIS)
Niibe, Hideo
1998-01-01
Estimations suggest that about 60% of all cancer patients will require some form of radiation therapy during their lifetime. Although 40 to 50% of cancer patients in Europe and the United States receive radiation therapy, only about 20% of patients with cancer in Japan undergo such treatment. This is largely due to the lack of understanding of the role of radiation therapy by many medical personnel in Japan, as well as to ''''radiation allergy'''' among many of the general population in Japan, a country that has been undergone atomic bombing. From our perspective as specialists in radiation therapy, the chronic shortage of radiation oncologist also poses a serious problem. Although there are approximately 700 hospitals throughout Japan where radiation therapy is available, no more than half this number of medical facilities have a full-time radiation oncologist. Perhaps the reason for this is that radiation therapy is perceived as unnecessary in Japan. However, it is absolutely essential. In our experience, the 5-year relative survival rate of patients with malignant tumors who have undergone radiation therapy in our clinic is 65 percent. Thus, radiation therapy has proven very useful in the treatment of malignant tumors. Moreover, better estimates of prognosis of cancer patients treated with radiation therapy are becoming possible. This article discusses the role of radiation therapy, from a radiation pathological perspective, in a multidisciplinary approach to treatment of cancer patients. I also emphasize the critical importance of training radiation oncologists who can function as part of multidisciplinary teams that care for patients with malignant tumors. (author). 50 refs
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Stereotactic body radiation therapy
Energy Technology Data Exchange (ETDEWEB)
Lo, Simon S. [Univ. Hospitals Seidman Cancer Center, Cleveland, OH (United States). Dept. of Radiation Oncology; Case Western Reserve Univ., Cleveland, OH (United States). Case Comprehensive Cancer Center; Teh, Bin S. [The Methodist Hospital Cancer Center and Research Institute, Houston, TX (United States). Weill Cornell Medical College; Lu, Jiade J. [National Univ. of Singapore (Singapore). Dept. of Radiation Oncology; Schefter, Tracey E. (eds.) [Colorado Univ., Aurora, CO (United States). Dept. of Radiation Oncology
2012-11-01
Comprehensive an up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. Examines in detail retrospective studies and prospective clinical trials for various organ sites from around the world. Written by world-renowned experts in SBRT from North America, Asia and Europe. Stereotactic body radiation therapy (SBRT) has emerged as an innovative treatment for various primary and metastatic cancers, and the past five years have witnessed a quantum leap in its use. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.
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International Nuclear Information System (INIS)
Kurtz, J.M.
1994-01-01
A questionnaire regarding the current practice of breast cancer radiotherapy and possible future trends in this field was filled out by 13 radiation oncologists active in breast cancer research. In the opinion of this small group, radiotherapy is presently included in the initial treatment of the large majority of early breast cancers, particularly in the framework of breast-conserving therapy, which is currently used in >50% of these patients. Indications for post-mastectomy irradiation vary greatly among respondents, as do attitudes toward the potentially negative aspects of adjuvant radiotherapy. Most respondents feel that their future practices will be significantly influenced by an increase in screen-detected cancers, the aging of the population, the increasing influence of medical oncologists, participation in clinical trials, and increased patient participation in treatment decisions. An increase is foreseen in the use of breast-conserving approaches, radiotherapy, and systemic therapies, and a decrease in the use of both total mastectomy and axillary dissection. Most respondents feel that there will be a modest decrease in the percentage of conservatively operated patients receiving radiotherapy. A future role is seen for neo-adjuvant chemotherapy, at least in well-defined subgroups, increasing the number of patients offered breast-conserving approaches. Most respondents expect that irradiation of lymph nodal areas will gain new credibility and be used more often. No majority opinion could be elicited regarding ways of improving the therapeutic ratio in breast cancer radiotherapy. (author)
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International Nuclear Information System (INIS)
Tseng, Yolanda D.; Krishnan, Monica S.; Sullivan, Adam J.; Jones, Joshua A.; Chow, Edward; Balboni, Tracy A.
2013-01-01
Purpose: We surveyed how radiation oncologists think about and incorporate a palliative cancer patient’s life expectancy (LE) into their treatment recommendations. Methods and Materials: A 41-item survey was e-mailed to 113 radiation oncology attending physicians and residents at radiation oncology centers within the Boston area. Physicians estimated how frequently they assessed the LE of their palliative cancer patients and rated the importance of 18 factors in formulating LE estimates. For 3 common palliative case scenarios, physicians estimated LE and reported whether they had an LE threshold below which they would modify their treatment recommendation. LE estimates were considered accurate when within the 95% confidence interval of median survival estimates from an established prognostic model. Results: Among 92 respondents (81%), the majority were male (62%), from an academic practice (75%), and an attending physician (70%). Physicians reported assessing LE in 91% of their evaluations and most frequently rated performance status (92%), overall metastatic burden (90%), presence of central nervous system metastases (75%), and primary cancer site (73%) as “very important” in assessing LE. Across the 3 cases, most (88%-97%) had LE thresholds that would alter treatment recommendations. Overall, physicians’ LE estimates were 22% accurate with 67% over the range predicted by the prognostic model. Conclusions: Physicians often incorporate LE estimates into palliative cancer care and identify important prognostic factors. Most have LE thresholds that guide their treatment recommendations. However, physicians overestimated patient survival times in most cases. Future studies focused on improving LE assessment are needed
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Energy Technology Data Exchange (ETDEWEB)
Tseng, Yolanda D., E-mail: ydtseng@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Krishnan, Monica S. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Sullivan, Adam J. [Department of Biostatistics, Harvard University, Cambridge, Massachusetts (United States); Jones, Joshua A. [Harvard Palliative Medicine Fellowship Program, Boston, Massachusetts (United States); Chow, Edward [Department of Radiation Oncology, University of Toronto, Toronto (Canada); Balboni, Tracy A. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)
2013-11-01
Purpose: We surveyed how radiation oncologists think about and incorporate a palliative cancer patient’s life expectancy (LE) into their treatment recommendations. Methods and Materials: A 41-item survey was e-mailed to 113 radiation oncology attending physicians and residents at radiation oncology centers within the Boston area. Physicians estimated how frequently they assessed the LE of their palliative cancer patients and rated the importance of 18 factors in formulating LE estimates. For 3 common palliative case scenarios, physicians estimated LE and reported whether they had an LE threshold below which they would modify their treatment recommendation. LE estimates were considered accurate when within the 95% confidence interval of median survival estimates from an established prognostic model. Results: Among 92 respondents (81%), the majority were male (62%), from an academic practice (75%), and an attending physician (70%). Physicians reported assessing LE in 91% of their evaluations and most frequently rated performance status (92%), overall metastatic burden (90%), presence of central nervous system metastases (75%), and primary cancer site (73%) as “very important” in assessing LE. Across the 3 cases, most (88%-97%) had LE thresholds that would alter treatment recommendations. Overall, physicians’ LE estimates were 22% accurate with 67% over the range predicted by the prognostic model. Conclusions: Physicians often incorporate LE estimates into palliative cancer care and identify important prognostic factors. Most have LE thresholds that guide their treatment recommendations. However, physicians overestimated patient survival times in most cases. Future studies focused on improving LE assessment are needed.
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Closing the patient-oncologist communication gap: a review of historic and current efforts.
Pham, A Khoa; Bauer, Marianne T; Balan, Stefan
2014-03-01
Effective communication is essential in developing any relationship--this is particularly true between oncologists and their patients. The patient-oncologist relationship is one of the most delicate in medicine, and given the strong emotions associated with cancer, successful communication plays a paramount role in the wellbeing of patients and oncologists. Significant advances to close the communication gap have occurred over the past several decades, largely by addressing deficiencies in the various stages of an oncologist's lengthy training: undergraduate medical education, residency and fellowship, and continuing medical education. Stemming from several milestones achieved by highly motivated groups of individuals, including the creation of consensus statements and guidelines by communication education experts, progress has been made to improve patient-oncologist communication. This progress is marked by the development of evidence-based communication skills training programs, such as Oncotalk and Comskil, in addition to the creation of distant-learning modalities, such as the Studying Communication in Oncologist-Patient Encounters trial. This review article outlines the history of communication education during medical education and training, and brings to light more recent efforts to promote competent, communication-minded physicians necessary for effective cancer care.
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International Nuclear Information System (INIS)
Hadjieva, T.; Bildirev, N.; Koleva, I.; Zahariev, Z.; Vasileva, V.; Encheva, E.; Sultanov, B.
2010-01-01
Biological images provided by 18F-FDG PET in combination with structural X ray picture currently offer the most accurate available information on tumour staging, curative antitumour effect for prognosis, impairment of organ function after treatment, as well as primary tumour detection in unknown primary metastatic disease. The authors as radiation oncologists critically have analyzed numerous clinical trials and two guidelines to prove PET/ CT benefit in radiotherapy practice. At present they found lack of scientific evidence to confirm that patient outcomes are superior as a result of the use of PET in RT planning. PET/CT offers a best image for tumour delineation only in some cases of lung cancer, mediastinal lymph nodes and malignant lymphomas. 11C methionin PET adds additional information on postoperative MRI image for brain tumours. Inflammation as postradiation phenomenon, as well as physiological organ movements leads to false-positive PET signal. High tech radiotherapy methods require delineation on precise images given after multidisciplinary team expertise - a practice that is possible only in clinical trials, These unsolved problems have raised many ethical challenges in medical, scientific and social aspect, if wide and routine use of FDG-PET u PET/CT is advocated. (authors)
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Oncologists' strategies and barriers to effective communication about the end of life.
Granek, Leeat; Krzyzanowska, Monika K; Tozer, Richard; Mazzotta, Paolo
2013-07-01
Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients. Twenty oncologists were interviewed at three hospitals about their communication strategies on end-of-life issues with patients. The data were analyzed using the grounded theory method. The findings revealed the strategies to effective communication about the end of life included: being open and honest; having ongoing, early conversations; communicating about modifying treatment goals; and balancing hope and reality. Barriers to implementing these strategies fell broadly into three domains, including physician factors, patient factors, and institutional factors. Physician factors included difficulty with treatment and palliation, personal discomfort with death and dying, diffusion of responsibility among colleagues, using the "death-defying mode," lack of experience, and lack of mentorship. Patient factors included, patients and/or families being reluctant to talk about the end of life, language barriers, and younger age. Institutional factors included stigma around palliative care, lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues. We conclude by drawing implications from our study and suggest that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.
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Radiation treatment for cervical esophagus: patterns of practice study in Canada, 1996
International Nuclear Information System (INIS)
Tai, Patricia; Van Dyk, Jake; Yu, Edward; Battista, Jerry; Schmid, Matthew; Stitt, Larry; Tonita, Jon; Coad, Terry
2000-01-01
Purpose: To assess the patterns of practice among Canadian radiation oncologists who treat esophageal cancers, using a trans-Canada survey, completed at the end of 1996. Methods and Materials: One of 3 case presentations of different stages of cervical esophageal cancer was randomly assigned and sent to participating radiation oncologists by mail. Respondents were asked to fill in questionnaires regarding treatment techniques and to outline target volumes for the boost phase of radiotherapy. Radiation oncologists from 26 of 27 (96%) of all Canadian centers participated. Results: High-energy X-rays (no. >=no. 10 MV) were employed by 68% of the respondents in part of the treatment course. The majority (83%) of the radiation oncologists used at least two phases of treatment. Very few, 10 of 59 (17%), responses started with multifield treatment. The most frequently used prescription dose was 60 Gy/30 fractions/6 weeks, given with concurrent chemotherapy. Dose prescriptions were to the isocenter in 39 of 48 (81%) or to a particular isodose line in 9 of 48 (19%) of respondents. Conclusion: There was a variety of radiation treatment techniques in this trans-Canada survey. The majority of the patients had combined cisplatin-based chemoradiation. The isocenter was not used consistently as a dose prescription point
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International Nuclear Information System (INIS)
Lee, B. I.; Suh, D. H.; Kim, S. I.; Jeong, M. S.; Lim, Y. K.
2008-01-01
The monetary value of the man-mSv for operators of Korean nuclear power plants (NPPs) was calculated using a radiation aversion factor based on a survey of NPP workers. Initially, the life expectancy in the population is 79.4 y, the average age of cancer occurrence is 60 y, the average annual wage for an electric worker is 56 000 $ y -1 and the nominal risk coefficient induced by radiation is 4.2 E-5 mSv were used to evaluate the basic monetary value (α base) resulting in 45.6 $ mSv -1 . To investigate the degree of radiation aversion, the subject of the investigation was selected as the working radiation workers in 10 NPPs in Korea (Kori 1-2, Yeonggwang 1-3, Ulchin 1-3 and Wolseong 1-2). In August 2010, with the cooperation of KHNP and partner companies, a total of 2500 survey questionnaires to 10 NPPs (or 250 surveys to each NPP) were distributed to currently employed radiation workers. From these, 2157 responses were obtained between August and October 2010. The assessed radiation aversion factor and the monetary value of the man-mSv from the calculated radiation aversion factor were 1.26 and ∼50 $ in the 0-1 mSv range, 1.38 and ∼200 $ in the 1-5 mSv range, 1.52 and ∼1000 $ in the 5-10 mSv range, 1.65 and ∼4000 $ in the 10-20 mSv range and 1.74 and ∼8500 $ >20 mSv. (authors)
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Hillen, Marij A.; de Haes, Hanneke C. J. M.; van Tienhoven, Geertjan; Bijker, Nina; van Laarhoven, Hanneke W. M.; Vermeulen, Dani?lle M.; Smets, Ellen M. A.
2015-01-01
Trust in the oncologist is crucial for breast cancer patients. It reduces worry, enhances decision making, and stimulates adherence. Optimal nonverbal communication by the oncologist, particularly eye contact, body posture, and smiling, presumably benefits patients? trust. We were the first to experimentally examine (1) how the oncologist?s nonverbal behavior influences trust, and (2) individual differences in breast cancer patients? trust. Analogue patients (APs) viewed one out of eight vers...
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Brown, Richard; Bylund, Carma L; Siminoff, Laura A; Slovin, Susan F
2011-04-01
Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. Subjects were consecutive cancer patients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions. Copyright © 2010 John Wiley & Sons, Ltd.
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Step, Mary M; Siminoff, Laura A; Rose, Julia H
2009-11-01
The objective of this study was to assess potential age-related differences in oncologist communication during conversations about adjuvant therapy decisions and subsequent patient decision outcomes. Communication was observed between a cross-section of female patients aged 40 to 80 with early-stage breast cancer (n=180) and their oncologists (n=36) in 14 academic and community oncology practices in two states. Sources of data included audio recordings of visits, followed by post-visit patient interviews. Communication during the visit was assessed using the Siminoff Communication Content and Affect Program. Patient outcome measures included self-reported satisfaction with decision, decision conflict, and decision regret. Results showed that oncologists were significantly more fluent and more direct with older than middle-aged patients and trended toward expressing their own treatment preferences more with older patients. Satisfaction with treatment decisions was highest for women in their 50s and 60s. Decision conflict was significantly associated with more discussion of oncologist treatment preferences and prognosis. Decision regret was significantly associated with patient age and education. Older adults considering adjuvant therapy may find that oncologists' communication accommodations to perceived deficiencies in older adult cognition or communication challenge their decision-making involvement. Oncologists should carefully assess patient decision-making preferences and be mindful of accommodating their speech to age-related stereotypes.
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Radiation Biology: A Handbook for Teachers and Students
International Nuclear Information System (INIS)
2010-01-01
Knowledge of the radiobiology of normal tissues and tumours is a core prerequisite for the practice of radiation oncology. As such the study of radiobiology is mandatory for gaining qualification as a radiation oncologist in most countries. Teaching is done partly by qualified radiobiologists in some countries, and this is supplemented by teaching from knowledgeable radiation oncologists. In low and middle income (LMI) countries the teachers are often radiation oncologists and/or medical physicists. In Europe, a master's course on radiobiology is taught jointly by a consortium of five European Universities. This is aimed at young scientists from both Western and Eastern Europe, training in this discipline. Recently the European Society for Therapeutic Radiology and Oncology (ESTRO) initiated the launch of a radiobiology teaching course outside Europe (Beijing, 2007; Shanghai, 2009). Radiation protection activities are governed by many regulations and recommendations. These are based on knowledge gained from epidemiological studies of health effects from low as well as from high dose radiation exposures. Organizations like the International Commission on Radiological Protection (ICRP) have put a lot of effort into reviewing and evaluating the biological basis to radiological protection practices. Personnel being trained as future radiation protection personnel should have a basic understanding of the biological and clinical basis to the exposure limitations that they are subject to and that they implement for industrial workers and the public at large. It is for these reasons that aspects of Radiobiology related to protection issues are included in this teaching syllabus. In LMI countries, many more teachers are needed in radiobiology, and the establishment of regional training centres or special regional training courses in radiobiology, are really the only options to solve the obvious deficit in knowledge of radiobiology in such countries. Radiobiology teaching
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Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan
2018-06-01
Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.
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How attachment style and locus of control influence patients' trust in their oncologist
Hillen, Marij A.; de Haes, Hanneke C. J. M.; Stalpers, Lukas J. A.; Klinkenbijl, Jean H. G.; Eddes, Eric-Hans; Verdam, Mathilde G. E.; Smets, Ellen M. A.
2014-01-01
Cancer patients need to trust their oncologist. How the oncologist communicates probably contributes to patients' trust. Yet, patient characteristics such as their attachment style and health locus of control may influence how such communication is perceived. We examined how these personality
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How attachment style and locus of control influence patients' trust in their oncologist
Hillen, M.A.; de Haes, H.C.J.M.; Stalpers, L.J.A.; Klinkenbijl, J.H.G.; Eddes, E.-H.; Verdam, M.G.E.; Smets, E.M.A.
2014-01-01
Objective: Cancer patients need to trust their oncologist. How the oncologist communicates probably contributes to patients' trust. Yet, patient characteristics such as their attachment style and health locus of control may influence how such communication is perceived. We examined how these
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Shanafelt, Tait D; Novotny, Paul; Johnson, Mary E; Zhao, Xinghua; Steensma, David P; Lacy, Martha Q; Rubin, Joseph; Sloan, Jeff
2005-01-01
The well-being of oncologists is important to the well-being of their patients. While much is known about oncologist distress, little is known about oncologist well-being. We set out to evaluate oncologist well-being and the personal wellness promotion strategies used by oncologists. We performed a cross-sectional survey of medical oncologists in the North Central Cancer Treatment Group using a validated instrument to measure quality of life. Study-specific questions explored stressors, wellness promotion strategies and career satisfaction. Of 241 responding oncologists (response rate 61%), 121 (50%) reported high overall well-being. Being age 50 or younger (57 vs. 41%; p = 0.01), male (53 vs. 31%; p = 0.01) and working 60 h or less per week (50 vs. 33%; p = 0.005) were associated with increased overall well-being on bivariate analysis. Ratings of the importance of a number of personal wellness promotion strategies differed for oncologists with high well-being compared with those without high well-being. Developing an approach/philosophy to dealing with death and end-of-life care, using recreation/hobbies/exercise, taking a positive outlook and incorporating a philosophy of balance between personal and professional life were all rated as substantially more important wellness strategies by oncologists with high well-being (p values career satisfaction. Half of medical oncologists experience high overall well-being. Use of specific personal wellness promotion strategies appears to be associated with oncologist well-being. Further investigations of the prevalence, promotion, causes, inequities and clinical impact of physician well-being are needed. .
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International Nuclear Information System (INIS)
Potten, C.S.; Hendry, J.H.
1995-08-01
Texts on gut with reference to radiation (or other cytotoxic and carcinogenic agents) consist of primary research papers, review articles, or books which are now very out-of-date. With this in mind, the present book was conceived. Here, with chapters by experts in the field, we cover the basic structure and cell replacement process in the gut, the physical situation relevant for gut radiation exposure and a description of some of the techniques used to study radiation effects, in particular the clonal regeneration assay that assesses stem cell functional capacity. Chapters comprehensively cover the effects of radiation in experimental animal model systems and clinical experiences. The effects of radiation on the supportive tissue of the gut is also reviewed. The special radiation situation involving ingested radionuclides is reviewed and the most important late response-carcinogenesis-within the gut is considered. This book follows a volume on 'Radiation and Skin' (1985) and another on 'Radiation and Bone Marrow' is in preparation. The present volume is intended to cover the anatomy and renewal characteristics of the gut, and its response in terms of carcinogenicity and tissue injury in mammalian species including in particular man. The book is expected to be useful to students and teachers in these topics, as well as clinical oncologists (radiotherapists) and medical oncologists, and industrial health personnel. 70 figs., 20 tabs., 869 refs
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Grief symptoms and difficult patient loss for oncologists in response to patient death.
Granek, Leeat; Ben-David, Merav; Shapira, Shahar; Bar-Sela, Gil; Ariad, Samuel
2017-07-01
The study aimed to explore oncologist's grief symptoms over patient death and to identify why and which losses are particularly challenging when patients die. The grounded theory method was used to collect and analyze the data. Twenty-two oncologists were interviewed between March 2013 and June 2014 from three adult oncology centers in the north, center, and south of Israel. Oncologists were at different stages of their careers and varied in their sub-specialties, gender, and personal and professional backgrounds. Grief begun when the patient died, in anticipation of the patient's death, many days after the death, or when the patient received a poor prognosis. The phenomenological experience of grief for oncologists included behavioral, cognitive, physical, and emotional symptoms in response to patient death. Behavioral symptoms included crying and difficulties sleeping. Cognitive symptoms included self-doubt and rumination about the patient and the care the patient had received before death. Physical symptoms included chest pain, fatigue, and general physical discomfort. Emotional symptoms included sadness, anxiety, helplessness, guilt, relief, irritability, and loss. Difficult patient loss was caused by patient-related factors, family-related factors, and disease-related factors. Patient deaths result in behavioral, cognitive, physical, and emotional symptoms of grief in oncologists. These symptoms become particularly intense in the context of patient, family, and disease-related factors. Educational and supportive interventions for managing grief related to patient death are needed in order to support oncologists in their emotionally and mentally taxing work. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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Hillen, Marij A; de Haes, Hanneke C J M; van Tienhoven, Geertjan; Bijker, Nina; van Laarhoven, Hanneke W M; Vermeulen, Daniëlle M; Smets, Ellen M A
2015-08-01
Trust in the oncologist is crucial for breast cancer patients. It reduces worry, enhances decision making, and stimulates adherence. Optimal nonverbal communication by the oncologist, particularly eye contact, body posture, and smiling, presumably benefits patients' trust. We were the first to experimentally examine (1) how the oncologist's nonverbal behavior influences trust, and (2) individual differences in breast cancer patients' trust. Analogue patients (APs) viewed one out of eight versions of a video vignette displaying a consultation about chemotherapy treatment. All eight versions varied only in the oncologist's amount of eye contact (consistent vs. inconsistent), body posture (forward leaning vs. varying), and smiling (occasional smiling vs. no smiling). Primary outcome was trust in the observed oncologist (Trust in Oncologist Scale). 214 APs participated. Consistent eye contact led to stronger trust (β = -.13, p = .04). This effect was largely explained by lower educated patients, for whom the effect of consistent eye contact was stronger than for higher educated patients (β = .18, p = .01). A forward leaning body posture did not influence trust, nor did smiling. However, if the oncologist smiled more, he was perceived as more friendly (rs = .31, p < .001) and caring (rs = .18, p = .01). Older (β = .17, p = .01) and lower educated APs (β = -.25, p < .001) were more trusting. Trust was weaker for more avoidantly attached APs (β = -.16, p = .03). We experimentally demonstrated the importance of maintaining consistent eye contact for breast cancer patients' trust, especially among lower educated patients. These findings need to be translated into training for oncologists in how to optimize their nonverbal communication with breast cancer patients while simultaneously managing increased time pressure and computer use during the consultation.
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Innovations in radiation oncology
International Nuclear Information System (INIS)
Withers, H.R.
1988-01-01
The series 'Medical Radiology - Diagnostic Imaging and Radiation Oncology' is the successor to the well known 'Encyclopedia of Medical Radiology/Handbuch der medizinischen Radiologie'. 'Medical Radiology' brings the state of the art on special topics in a timely fashion. This volume 'Innovation in Radiation Oncology', edited by H.R. Withers and L.J. Peters, presents data on the development of new therapeutic strategies in different oncologic diseases. 57 authors wrote 32 chapters covering a braod range of topics. The contributors have written their chapters with the practicing radiation oncologist in mind. The first chapter sets the stage by reviewing the quality of radiation oncology as it is practiced in the majority of radiation oncology centers in the United States. The second chapter examines how we may better predict the possible causes of failure of conventional radiotherapy in order that the most appropriate of a variety of therapeutic options may eventually be offered to patients on an individual basis. The third chapter discussed how our therapeutic endeavors affect the quality of life, a problem created by our ability to be successful. Following these three introductory chapters there are 29 chapters by highly qualified specialists discussing the newest ideas in subjects of concern to the practicing radiation oncologist. With 111 figs
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Miyashita, Mitsunori; Kawakami, Sachiko; Kato, Daiki; Yamashita, Hideomi; Igaki, Hiroshi; Nakano, Kimiko; Kuroda, Yujiro; Nakagawa, Keiichi
2015-01-01
The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer." We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes. Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES] = -1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES = -1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 0.001). Patients who emphasized "maintaining hope and pleasure" (P = 0.0001), "unawareness of death" (P = 0.0001), and "good relationship with family" (P = 0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P = 0.004). The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.
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Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.
2009-01-01
Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281
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2009 Canadian Radiation Oncology Resident Survey
International Nuclear Information System (INIS)
Debenham, Brock; Banerjee, Robyn; Fairchild, Alysa; Dundas, George; Trotter, Theresa; Yee, Don
2012-01-01
Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.
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2009 Canadian Radiation Oncology Resident Survey
Energy Technology Data Exchange (ETDEWEB)
Debenham, Brock, E-mail: debenham@ualberta.net [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada); Banerjee, Robyn [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Fairchild, Alysa; Dundas, George [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada); Trotter, Theresa [Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta (Canada); Yee, Don [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta (Canada)
2012-03-15
Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual program directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.
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The management plan of liquid effluent in Korean advanced light water reactor
International Nuclear Information System (INIS)
Kim, S. H.; Lim, H. S.; Jeong, D. W.; Jeong, D. Y.
2001-01-01
Non-radioactive liquid effluent in Korean Advanced Light Water Reactor is transferred and treated in centralized waste treatment facility after the radioactivity in effluent is checked within power block. The liquid effluent from centralized waste treatment facility will be discharged by way of discharge canal in order to be in the sufficient condition. As a result of investigating the radiation monitoring design in accordance with 20 provisions by Korean Regulatory Authority, each effluent radiation monitoring with 20 provisions by Korean Regulatory Authority, each effluent radiation monitoring design satisfies the regulatory guideline. In relation to sampling and analyses, most systems satisfy the regulatory guideline except for some effluents from turbine building. And, though sampling and analyses are performed after radioactivity is monitored at each system in turbine building, these exceptions in turbine building effluents are expected to cause no significant problems because radioactivity is monitored by direct or indirect methods prior to release from turbine building. Integrated monitoring on liquid effluent from the centralized waste water treatment facility is not necessary because radiation monitoring, sampling and analyses on each system within power block are performed, and operational effectiveness compared with cost according to adding the radiation monitoring equipment is too low. So, whether the radiation monitoring in this effluent is reflected on design or not is planned to be determined through discussion with regulatory authority
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International Nuclear Information System (INIS)
Anscher, Mitchell S.; Anscher, Barbara M.; Bradley, Cathy J.
2010-01-01
Purpose: To survey radiation oncology training programs to determine the impact of ownership of radiation oncology facilities by non-radiation oncologists on these training programs and to place these findings in a health policy context based on data from the literature. Methods and Materials: A survey was designed and e-mailed to directors of all 81 U.S. radiation oncology training programs in this country. Also, the medical and health economic literature was reviewed to determine the impact that ownership of radiation oncology facilities by non-radiation oncologists may have on patient care and health care costs. Prostate cancer treatment is used to illustrate the primary findings. Results: Seventy-three percent of the surveyed programs responded. Ownership of radiation oncology facilities by non-radiation oncologists is a widespread phenomenon. More than 50% of survey respondents reported the existence of these arrangements in their communities, with a resultant reduction in patient volumes 87% of the time. Twenty-seven percent of programs in communities with these business arrangements reported a negative impact on residency training as a result of decreased referrals to their centers. Furthermore, the literature suggests that ownership of radiation oncology facilities by non-radiation oncologists is associated with both increased utilization and increased costs but is not associated with increased access to services in traditionally underserved areas. Conclusions: Ownership of radiation oncology facilities by non-radiation oncologists appears to have a negative impact on residency training by shifting patients away from training programs and into community practices. In addition, the literature supports the conclusion that self-referral results in overutilization of expensive services without benefit to patients. As a result of these findings, recommendations are made to study further how physician ownership of radiation oncology facilities influence graduate
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The Radiation Oncology Job Market: The Economics and Policy of Workforce Regulation
International Nuclear Information System (INIS)
Falit, Benjamin P.; Pan, Hubert Y.; Smith, Benjamin D.; Alexander, Brian M.; Zietman, Anthony L.
2016-01-01
Examinations of the US radiation oncology workforce offer inconsistent conclusions, but recent data raise significant concerns about an oversupply of physicians. Despite these concerns, residency slots continue to expand at an unprecedented pace. Employed radiation oncologists and professional corporations with weak contracts or loose ties to hospital administrators would be expected to suffer the greatest harm from an oversupply. The reduced cost of labor, however, would be expected to increase profitability for equipment owners, technology vendors, and entrenched professional groups. Policymakers must recognize that the number of practicing radiation oncologists is a poor surrogate for clinical capacity. There is likely to be significant opportunity to augment capacity without increasing the number of radiation oncologists by improving clinic efficiency and offering targeted incentives for geographic redistribution. Payment policy changes significantly threaten radiation oncologists' income, which may encourage physicians to care for greater patient loads, thereby obviating more personnel. Furthermore, the implementation of alternative payment models such as Medicare's Oncology Care Model threatens to decrease both the utilization and price of radiation therapy by turning referring providers into cost-conscious consumers. Medicare funds the vast majority of graduate medical education, but the extent to which the expansion in radiation oncology residency slots has been externally funded is unclear. Excess physician capacity carries a significant risk of harm to society by suboptimally allocating intellectual resources and creating comparative shortages in other, more needed disciplines. There are practical concerns associated with a market-based solution in which medical students self-regulate according to job availability, but antitrust law would likely forbid collaborative self-regulation that purports to restrict supply. Because Congress is unlikely to create
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The Radiation Oncology Job Market: The Economics and Policy of Workforce Regulation
Energy Technology Data Exchange (ETDEWEB)
Falit, Benjamin P., E-mail: bfalit2@allianceoncology.com [Pacific Cancer Institute, Wailuku, Hawaii (United States); Pan, Hubert Y.; Smith, Benjamin D. [MD Anderson Cancer Center, Houston, Texas (United States); Alexander, Brian M. [Dana Farber Cancer Institute, Boston, Massachusetts (United States); Zietman, Anthony L. [Massachusetts General Hospital, Boston, Massachusetts (United States)
2016-11-01
Examinations of the US radiation oncology workforce offer inconsistent conclusions, but recent data raise significant concerns about an oversupply of physicians. Despite these concerns, residency slots continue to expand at an unprecedented pace. Employed radiation oncologists and professional corporations with weak contracts or loose ties to hospital administrators would be expected to suffer the greatest harm from an oversupply. The reduced cost of labor, however, would be expected to increase profitability for equipment owners, technology vendors, and entrenched professional groups. Policymakers must recognize that the number of practicing radiation oncologists is a poor surrogate for clinical capacity. There is likely to be significant opportunity to augment capacity without increasing the number of radiation oncologists by improving clinic efficiency and offering targeted incentives for geographic redistribution. Payment policy changes significantly threaten radiation oncologists' income, which may encourage physicians to care for greater patient loads, thereby obviating more personnel. Furthermore, the implementation of alternative payment models such as Medicare's Oncology Care Model threatens to decrease both the utilization and price of radiation therapy by turning referring providers into cost-conscious consumers. Medicare funds the vast majority of graduate medical education, but the extent to which the expansion in radiation oncology residency slots has been externally funded is unclear. Excess physician capacity carries a significant risk of harm to society by suboptimally allocating intellectual resources and creating comparative shortages in other, more needed disciplines. There are practical concerns associated with a market-based solution in which medical students self-regulate according to job availability, but antitrust law would likely forbid collaborative self-regulation that purports to restrict supply. Because Congress is unlikely
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Nuclear disasters: current plans and future directions for oncologists.
Goffman, Thomas E
2008-01-01
To show that there is a significant role for oncologists in the event of a terrorist nuclear disaster. Professionals need data on current political issues regarding a nuclear attack already put in place by the administration and the military. Review of what actually occurs during a fission bomb's explosion helps to point out what medical care will be most needed. The author contends that those trained in the oncologies could play a major part. Modern-day America. Potential civilian survivors. Large gaps noted in statewide disaster plans in the public domain. Oncologists must get involved now in disaster planning; statewide plans are necessary throughout the nation; the public needs to know the basics of what to do in the advent of a nuclear bomb explosion.
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Klabunde, C N; Haggstrom, D; Kahn, K L; Gray, S W; Kim, B; Liu, B; Eisenstein, J; Keating, N L
2017-07-01
Post-treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors' post-treatment care coordination, including oncologists' use of electronic technologies such as e-mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012-2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes. Oncologists reported their frequency and mode of communication with PCPs, and role in providing post-treatment care. Seventy-five per cent said that they directly communicated with PCPs about post-treatment status and care recommendations for all/most patients. Among those directly communicating with PCPs, 70% always/usually used written correspondence, while 36% always/usually used integrated EHRs; telephone and e-mail were less used. Eighty per cent reported co-managing with PCPs at least one post-treatment general medical care need. In multivariate-adjusted analyses, neither communication mode nor intensity were associated with co-managing survivors' care. Oncologists' reliance on written correspondence to communicate with PCPs may be a barrier to care coordination. We discuss new research directions for enhancing communication and care coordination between oncologists and PCPs, and to better meet the needs of cancer survivors post-treatment. © 2017 John Wiley & Sons Ltd.
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Satisfaction with work-life balance among U.S. gynecologic oncologists, a cross-sectional study
Szender, J Brian; Grzankowski, Kassondra S; Eng, Kevin H; Lele, Shashikant B; Odunsi, Kunle; Frederick, Peter J
2016-01-01
Objectives To evaluate the satisfaction with work-life balance (WLB) and career satisfaction of gynecologic oncologists. Methods In August 2014, members of the Society of Gynecologic Oncology (SGO) were sent an anonymous, cross-sectional survey evaluating demographic variables, practice characteristics, career satisfaction, fatigue, and satisfaction with WLB. Fatigue was assessed using a visual-analog scale. Career satisfaction and WLB were assessed with a Likert scale. Inferential statistics were computed with type I error rates of 0.05. Results Out of the 1002 gynecologic oncologists surveyed, 290 (28.9%) responded. Only 18.6% of respondents were satisfied with WLB and there were significant associations between gender (P = 0.0157), time spent in work related activities at home (P = 0.0024), on weekends (P = 0.0017), and in the hospital (P = 0.0001). More than 84% of physicians reported they would choose medicine as a career again and of those 90% would choose to be a gynecologic oncologist again. Fatigue was strongly associated with dissatisfaction with WLB in univariate and multivariate analysis (P < 0.0001). Conclusions Although gynecologic oncologists indicated they are satisfied with their careers, most are not satisfied with their WLB. Given the forecast shortage of gynecologic oncologists and projected increased cancer rates, understanding the factors associated with career satisfaction may assist the SGO in meeting future gynecologic cancer care needs. PMID:27088113
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Pushing up daisies: implicit and explicit language in oncologist-patient communication about death.
Rodriguez, Keri L; Gambino, Frank J; Butow, Phyllis; Hagerty, Rebecca; Arnold, Robert M
2007-02-01
Although there are guidelines regarding how conversations with patients about prognosis in life-limiting illness should occur, there are little data about what doctors actually say. This study was designed to qualitatively analyze the language that oncologists and cancer patients use when talking about death. We recruited 29 adults who had incurable forms of cancer, were scheduled for a first-time visit with one of six oncologists affiliated with a teaching hospital in Australia, and consented to having their visit audiotaped and transcribed. Using content analytic techniques, we coded various features of language usage. Of the 29 visits, 23 (79.3%) included prognostic utterances about treatment-related and disease-related outcomes. In 12 (52.2%) of these 23 visits, explicit language about death ("terminal," variations of "death") was used. It was most commonly used by the oncologist after the physical examination, but it was sometimes used by patients or their kin, usually before the examination and involving emotional questioning about the patient's future. In all 23 (100%) visits, implicit language (euphemistic or indirect talk) was used in discussing death and focused on an anticipated life span (mentioned in 87.0% of visits), estimated time frame (69.6%), or projected survival (47.8%). Instead of using the word "death," most participants used some alternative phrase, including implicit language. Although oncologists are more likely than patients and their kin to use explicit language in discussing death, the oncologists tend to couple it with implicit language, possibly to mitigate the message effects.
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The role of imaging in pediatric radiation oncology
International Nuclear Information System (INIS)
Stowe, S.M.
1985-01-01
The pediatric radiation oncologist is involved in treating a different spectrum of tumors that is generally seen by the adult radiation oncologist. More than one-third of pediatric patients with malignancies suffer from acute lymphocytic leukemia and lymphomas. Approximately one-quarter of the patients have primary tumors of the brain and central nervous system, while the remaining patients mostly present with mesenchymal sarcomas as opposed to the carcinomas more generally seen in adult practice. Pediatric tumors are frequently deep seated and therefore more difficult to evaluate by physical examination that the typical adult epithelial tumors. In the following sections, the various tumor types and locations are discussed with reference to the specific imaging requirements for each of the groups. This is preceded by a brief introduction to modern radiation oncology in order to clarify the role of these modalities
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Chang, Roberta
Presented in this booklet are brief descriptions of items and activities that are symbolic of Korean culture. Some of the items and activities described include traditional Korean clothing and accessories, dolls, fans, a Korean game called "yut," tape recordings of Korean music, a "buhk" (drum), and brass eating utensils. A map of Korea, some…
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Energy Technology Data Exchange (ETDEWEB)
Pastor Sanchis, V.; Martinez Sanchez, J. M.; Palma Copete, J. D.; Crispin Contreras, V.; Casal Zamorano, E.; Dolores Alemany, V. de los; Gonzalez Perez, V.; Gimeno Olmo, J.; Guardino de la Flor, C.
2011-07-01
In this paper we determine the equivalent dose received by the operator and patient lung biopsies using thermoluminescence dosimeters, are established recommendations that this dose is as low as possible. It also reviews the acquisition protocols in both CT scans in early diagnosis program cited as the acquisition of CT for treatment planning dosimetric radiation oncologist in breast cancer.
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Girgis, Afaf; Cockburn, Jill; Butow, Phyllis; Bowman, Deborah; Schofield, Penelope; Stojanovski, Elizabeth; D'Este, Catherine; Tattersall, Martin H N; Doran, Christopher; Turner, Jane
2009-12-01
To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients' emotional functioning and reducing psychological distress. Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n=15) or usual-care group (n=14). The CST consisted of a 1.5-day face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n=192 in CST group, n=183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs. Despite high patient functioning at baseline, anxiety significantly improved at 1-week follow-up in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups. Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation. Video-conferencing after a short training course may be an effective strategy for delivering CST.
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Construction of Korean adult voxel phantoms for radiation dosimetry and their applications
Energy Technology Data Exchange (ETDEWEB)
Lee, Choon Sik
2002-08-15
Although contribution of the MIRD-type mathematical anthropomorphic phantoms to computational radiation dosimetry, especially in determining the effective dose to the exposed personnel, is very significant, there remain some questions on possible deviation in the resulting dosimetric quantities from the true values. This is particularly the case for those organ or tissues having complicated geometry difficult to model with simple geometrical body elements. As an alternative approach to resolve the problem, there have been efforts to use voxel phantoms, which can very precisely describe both the external shape and the internal organs by virtue of fast advances in medical imaging technology as well as in computing power. In this study, Korean adult male and female voxel phantoms were constructed by processing whole-body MR images of healthy volunteers who belong to middle group of Korean in height and weight. Organs and tissues on tomographic images were manually segmented and indexed using the graphic software PL-400 . Due to limited resolution of the raw MR images, voxels of rather large size, 2 mmx2 mmx8 mm for the woman and 2mmx2mmx10mm for the man, were used. The resulting male and female voxel phantoms were named KRMAN and KRWOMAN, respectively. To assess utility of the voxel phatoms, calculations were carried out with the Monte Carlo code MCNP4B for two illustrative problems. A program VOXELMAKER1.0 was developed to convert the voxel phantom data into MCNP geometry input format. In the first example, organ equivalent doses and effective doses were evaluated for phantoms in broad parallel photon fields of different energies and directions and were compared to corresponding values given in ICRP 74 which were derived with the MIRD-type phantoms. No significant deviations between MIRD and voxel phantoms were found in the effective doses. Significant differences up to around factor of 2, however, were observed in organ equivalent doses for some organs including
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Energy Technology Data Exchange (ETDEWEB)
Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna [ASTRO, Fairfax, Virginia (United States); Olsen, Christine [Massachusetts General Hospital, Boston, Massachusetts, (United States); Fung, Claire Y. [Commonwealth Newburyport Cancer Center, Newburyport, Massachusetts (United States); Hopkins, Shane [William R. Bliss Cancer Center, Ames, Iowa (United States); Pohar, Surjeet, E-mail: spohar@netzero.net [Indiana University Health Cancer Center East, Indiana University, Indianapolis, Indiana (United States)
2013-12-01
Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for
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International Nuclear Information System (INIS)
Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna; Olsen, Christine; Fung, Claire Y.; Hopkins, Shane; Pohar, Surjeet
2013-01-01
Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for
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Development of new on line statistical program for the Korean society for radiation oncology
International Nuclear Information System (INIS)
Song, Si Yeol; Ahn, Seung Do; Choi, Eun Kyung; Chung, Weon Kuu; Shin, Kyung Hwan; Cho, Kwan Ho
2015-01-01
To develop new on-line statistical program for the Korean Society for Radiation Oncology (KOSRO) to collect and extract medical data in radiation oncology more efficiently. The statistical program is a web-based program. The directory was placed in a sub-folder of the homepage of KOSRO and its web address is http://www.kosro.or.kr/asda. The operating systems server is Linux and the webserver is the Apache HTTP server. For database (DB) server, MySQL is adopted and dedicated scripting language is the PHP. Each ID and password are controlled independently and all screen pages for data input or analysis are made to be friendly to users. Scroll-down menu is actively used for the convenience of user and the consistence of data analysis. Year of data is one of top categories and main topics include human resource, equipment, clinical statistics, specialized treatment and research achievement. Each topic or category has several subcategorized topics. Real-time on-line report of analysis is produced immediately after entering each data and the administrator is able to monitor status of data input of each hospital. Backup of data as spread sheets can be accessed by the administrator and be used for academic works by any members of the KOSRO. The new on-line statistical program was developed to collect data from nationwide departments of radiation oncology. Intuitive screen and consistent input structure are expected to promote entering data of member hospitals and annual statistics should be a cornerstone of advance in radiation oncology
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Development of new on-line statistical program for the Korean Society for Radiation Oncology.
Song, Si Yeol; Ahn, Seung Do; Chung, Weon Kuu; Shin, Kyung Hwan; Choi, Eun Kyung; Cho, Kwan Ho
2015-06-01
To develop new on-line statistical program for the Korean Society for Radiation Oncology (KOSRO) to collect and extract medical data in radiation oncology more efficiently. The statistical program is a web-based program. The directory was placed in a sub-folder of the homepage of KOSRO and its web address is http://www.kosro.or.kr/asda. The operating systems server is Linux and the webserver is the Apache HTTP server. For database (DB) server, MySQL is adopted and dedicated scripting language is the PHP. Each ID and password are controlled independently and all screen pages for data input or analysis are made to be friendly to users. Scroll-down menu is actively used for the convenience of user and the consistence of data analysis. Year of data is one of top categories and main topics include human resource, equipment, clinical statistics, specialized treatment and research achievement. Each topic or category has several subcategorized topics. Real-time on-line report of analysis is produced immediately after entering each data and the administrator is able to monitor status of data input of each hospital. Backup of data as spread sheets can be accessed by the administrator and be used for academic works by any members of the KOSRO. The new on-line statistical program was developed to collect data from nationwide departments of radiation oncology. Intuitive screen and consistent input structure are expected to promote entering data of member hospitals and annual statistics should be a cornerstone of advance in radiation oncology.
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Development of new on line statistical program for the Korean society for radiation oncology
Energy Technology Data Exchange (ETDEWEB)
Song, Si Yeol; Ahn, Seung Do; Choi, Eun Kyung [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Chung, Weon Kuu [Dept. of Radiation Oncology, Kyung Hee University Hospital at Kangdong, Kyung Hee University School of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cho, Kwan Ho [Dept. of Radiation Oncology, Proton Therapy Center, National Cancer Center Hospital, Goyang (Korea, Republic of)
2015-06-15
To develop new on-line statistical program for the Korean Society for Radiation Oncology (KOSRO) to collect and extract medical data in radiation oncology more efficiently. The statistical program is a web-based program. The directory was placed in a sub-folder of the homepage of KOSRO and its web address is http://www.kosro.or.kr/asda. The operating systems server is Linux and the webserver is the Apache HTTP server. For database (DB) server, MySQL is adopted and dedicated scripting language is the PHP. Each ID and password are controlled independently and all screen pages for data input or analysis are made to be friendly to users. Scroll-down menu is actively used for the convenience of user and the consistence of data analysis. Year of data is one of top categories and main topics include human resource, equipment, clinical statistics, specialized treatment and research achievement. Each topic or category has several subcategorized topics. Real-time on-line report of analysis is produced immediately after entering each data and the administrator is able to monitor status of data input of each hospital. Backup of data as spread sheets can be accessed by the administrator and be used for academic works by any members of the KOSRO. The new on-line statistical program was developed to collect data from nationwide departments of radiation oncology. Intuitive screen and consistent input structure are expected to promote entering data of member hospitals and annual statistics should be a cornerstone of advance in radiation oncology.
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Hillen, Marij A.; de Haes, Hanneke C. J. M.; van Tienhoven, Geertjan; Bijker, Nina; van Laarhoven, Hanneke W. M.; Vermeulen, Daniëlle M.; Smets, Ellen M. A.
2015-01-01
Trust in the oncologist is crucial for breast cancer patients. It reduces worry, enhances decision making, and stimulates adherence. Optimal nonverbal communication by the oncologist, particularly eye contact, body posture, and smiling, presumably benefits patients' trust. We were the first to
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International Nuclear Information System (INIS)
Kim, Chan Hyeong; Jeong, Jong Hwi; Choi, Sang Hyoun; Lee, Choonsik; Chung, Min Suk
2008-01-01
A Korean voxel model, named 'High-Definition Reference Korean-Man (HDRK-Man)', was constructed using high-resolution color photographic images that were obtained by serially sectioning the cadaver of a 33-year-old Korean adult male. The body height and weight, the skeletal mass and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The resulting model was then implemented into a Monte Carlo particle transport code, MCNPX, to calculate the dose conversion coefficients for the internal organs and tissues. The calculated values, overall, were reasonable in comparison with the values from other adult voxel models. HDRK-Man showed higher dose conversion coefficients than other models, due to the facts that HDRK-Man has a smaller torso and that the arms of HDRK-Man are shifted backward. The developed model is believed to adequately represent average Korean radiation workers and thus can be used for more accurate calculation of dose conversion coefficients for Korean radiation workers in the future
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Energy Technology Data Exchange (ETDEWEB)
Kim, Chan Hyeong; Jeong, Jong Hwi [Department of Nuclear Engineering, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791 (Korea, Republic of); Choi, Sang Hyoun [Department of radiation oncology, Inha University, 7-206, 3-ga, Shinheumg-dong, Jung-gu, Incheon, 400-711 (Korea, Republic of); Lee, Choonsik [Department of Nuclear and Radiological Engineering, University of Florida, Gainesville, FL 32611 (United States); Chung, Min Suk [Department of Anatomy, Ajou University School of Medicine, San 5 Wonchon-dong, Yeongtong-gu, Suwon 443-749 (Korea, Republic of)], E-mail: chkim@hanyang.ac.kr
2008-08-07
A Korean voxel model, named 'High-Definition Reference Korean-Man (HDRK-Man)', was constructed using high-resolution color photographic images that were obtained by serially sectioning the cadaver of a 33-year-old Korean adult male. The body height and weight, the skeletal mass and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The resulting model was then implemented into a Monte Carlo particle transport code, MCNPX, to calculate the dose conversion coefficients for the internal organs and tissues. The calculated values, overall, were reasonable in comparison with the values from other adult voxel models. HDRK-Man showed higher dose conversion coefficients than other models, due to the facts that HDRK-Man has a smaller torso and that the arms of HDRK-Man are shifted backward. The developed model is believed to adequately represent average Korean radiation workers and thus can be used for more accurate calculation of dose conversion coefficients for Korean radiation workers in the future.
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Energy Technology Data Exchange (ETDEWEB)
Grover, Surbhi, E-mail: Surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Chadha, Manjeet [Mount Sinai Beth Israel Health System, Icahn School of Medicine, New York, New York (United States); Rengan, Ramesh [Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Williams, Tim R. [Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, Florida (United States); Morris, Zachary S. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Seattle, Washington (United States); Morgan, David A.L. [Breast Services, Sherwood Forest Hospitals NHS Trust, Nottinghamshire (United Kingdom); Tripuraneni, Prabhakar [Department of Radiation Oncology, Scripps Green Hospital, La Jolla, California (United States); Hu, Kenneth [Department of Radiation Oncology, NYU Lagone Medical Center, New York, New York (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)
2015-12-01
Purpose: To conduct a survey of radiation oncologists in India, to better understand specific educational needs of radiation oncology in India and define areas of collaboration with US institutions. Methods and Materials: A 20-question survey was distributed to members of the Association of Indian Radiation Oncologists and the Indian Brachytherapy Society between November 2013 and May 2014. Results: We received a total of 132 responses. Over 50% of the physicians treat more than 200 patients per day, use 2-dimensional or 3-dimensional treatment planning techniques, and approximately 50% use image guided techniques. For education needs, most respondents agreed that further education in intensity modulated radiation therapy, image guided radiation therapy, stereotactic radiation therapy, biostatistics, and research methods for medical residents would be useful areas of collaboration with institutions in the United States. Other areas of collaboration include developing a structured training module for nursing, physics training, and developing a second-opinion clinic for difficult cases with faculty in the United States. Conclusion: Various areas of potential collaboration in radiation oncology education were identified through this survey. These include the following: establishing education programs focused on current technology, facilitating exchange programs for trainees in India to the United States, promoting training in research methods, establishing training modules for physicists and oncology nurses, and creating an Indo–US. Tumor Board. It would require collaboration between the Association of Indian Radiation Oncologists and the American Society for Radiation Oncology to develop these educational initiatives.
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International Nuclear Information System (INIS)
Grover, Surbhi; Chadha, Manjeet; Rengan, Ramesh; Williams, Tim R.; Morris, Zachary S.; Morgan, David A.L.; Tripuraneni, Prabhakar; Hu, Kenneth; Viswanathan, Akila N.
2015-01-01
Purpose: To conduct a survey of radiation oncologists in India, to better understand specific educational needs of radiation oncology in India and define areas of collaboration with US institutions. Methods and Materials: A 20-question survey was distributed to members of the Association of Indian Radiation Oncologists and the Indian Brachytherapy Society between November 2013 and May 2014. Results: We received a total of 132 responses. Over 50% of the physicians treat more than 200 patients per day, use 2-dimensional or 3-dimensional treatment planning techniques, and approximately 50% use image guided techniques. For education needs, most respondents agreed that further education in intensity modulated radiation therapy, image guided radiation therapy, stereotactic radiation therapy, biostatistics, and research methods for medical residents would be useful areas of collaboration with institutions in the United States. Other areas of collaboration include developing a structured training module for nursing, physics training, and developing a second-opinion clinic for difficult cases with faculty in the United States. Conclusion: Various areas of potential collaboration in radiation oncology education were identified through this survey. These include the following: establishing education programs focused on current technology, facilitating exchange programs for trainees in India to the United States, promoting training in research methods, establishing training modules for physicists and oncology nurses, and creating an Indo–US. Tumor Board. It would require collaboration between the Association of Indian Radiation Oncologists and the American Society for Radiation Oncology to develop these educational initiatives.
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Grover, Surbhi; Chadha, Manjeet; Rengan, Ramesh; Williams, Tim R; Morris, Zachary S; Morgan, David A L; Tripuraneni, Prabhakar; Hu, Kenneth; Viswanathan, Akila N
2015-12-01
To conduct a survey of radiation oncologists in India, to better understand specific educational needs of radiation oncology in India and define areas of collaboration with US institutions. A 20-question survey was distributed to members of the Association of Indian Radiation Oncologists and the Indian Brachytherapy Society between November 2013 and May 2014. We received a total of 132 responses. Over 50% of the physicians treat more than 200 patients per day, use 2-dimensional or 3-dimensional treatment planning techniques, and approximately 50% use image guided techniques. For education needs, most respondents agreed that further education in intensity modulated radiation therapy, image guided radiation therapy, stereotactic radiation therapy, biostatistics, and research methods for medical residents would be useful areas of collaboration with institutions in the United States. Other areas of collaboration include developing a structured training module for nursing, physics training, and developing a second-opinion clinic for difficult cases with faculty in the United States. Various areas of potential collaboration in radiation oncology education were identified through this survey. These include the following: establishing education programs focused on current technology, facilitating exchange programs for trainees in India to the United States, promoting training in research methods, establishing training modules for physicists and oncology nurses, and creating an Indo-US. Tumor Board. It would require collaboration between the Association of Indian Radiation Oncologists and the American Society for Radiation Oncology to develop these educational initiatives. Copyright © 2015 Elsevier Inc. All rights reserved.
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International Nuclear Information System (INIS)
Ge Jin; Fishman, Jessica; Vapiwala, Neha; Li, Susan Q.; Desai, Krupali; Xie, Sharon X.; Mao, Jun J.
2013-01-01
Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients’ discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.
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Tanriverdi, Ozgur; Barista, Ibrahim; Paydas, Semra; Nayir, Erdinc; Karakas, Yusuf
2017-11-26
In this study, we aimed to determine the perspectives of medical and radiation oncologists regarding consolidation radiotherapy in patients with a complete response after chemotherapy for Hodgkin’s and non-Hodgkin’s lymphomas. The survey was designed to identify demographic and occupational features of medical and radiation oncologists and their views on application of consolidation radiotherapy in their clinical practices, as based on a five-point Likert scale (never, rarely, sometimes, often, and always). The study covered 263, out of 935, physicians working in the oncology field as either medical or radiation oncologists; the rate of return on the invitations to participate was 28%. The majority of the participants were male radiation oncologists, with a duration of between 5 and 10 years of work as a university hospital official, and the mean age was 38 ± 14 (years). Although the most commonly followed international guidelines were NCCN, among the physicians, the majority of the respondents suggested that the guidelines were unclear regarding recommendations for consolidative radiotherapy. The administered dose for consolidative radiotherapy in lymphoma patients was indicated as 40 Gy by 49% of all the physicians and the most common cause of hesitancy concerning consolidative radiation treatment was the risk of secondary malignancies as a long-term adverse effect (54%). In conclusion, we suggest that medical oncologists could be most active in the treatment of lymphoma through a continuous training program about lymphomas and current national guidelines. Creative Commons Attribution License
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Hugh-Yeun, Kiara; Kumar, Divjot; Moghaddamjou, Ali; Ruan, Jenny Y; Cheung, Winson Y
2017-06-01
Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician's roles and responsibilities. A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations. Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient's most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001). Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults. Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can
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Mainali, Apeksha; Sumanth, K N; Ongole, Ravikiran; Denny, Ceena
2011-01-01
Mouth and pharyngeal cancers account for approximately 6% of cancers worldwide. Radiotherapy is one of the means of treatment of head and neck cancer. Consultation with a dental team experienced in caring for patients undergoing treatment for head and neck cancer will improve the quality of life of such patients. To evaluate the attitude of oncologists toward dental consultation to patients planning for/prior to/undergoing/post radiation therapy for head and neck cancers and to evaluate the number of radiation oncologists who encounter oral complaints and consider worth referring to a dentist. A questionnaire-based study was carried out following mailing of covering letter and self-administered questionnaire comprising 11 items, to 25 radiation oncology centers selected in India based on convenient sampling. Out of the 25 centers, we received response from 20 centers with 60 completely filled questionnaires. Five centers did not respond for further correspondences. The study indicated a need for awareness and education among radiation oncologists regarding dental consultation in patients planned/undergoing /post radiation therapy for head and neck cancer.
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Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L
2015-03-15
Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.
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Giuliani, Meredith; Gospodarowicz, Mary
2018-01-01
In this article we provide an overview of the Canadian healthcare system and the cancer care system in Canada as it pertains to the governance, funding and delivery of radiotherapy programmes. We also review the training and practice for radiation oncologists, medical physicists and radiation therapists in Canada. We describe the clinical practice of radiation medicine from patients' referral, assessment, case conferences and the radiotherapy process. Finally, we provide an overview of the practice culture for Radiation Oncology in Canada. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Oncologists' identification of mental health distress in cancer patients: Strategies and barriers.
Granek, L; Nakash, O; Ariad, S; Shapira, S; Ben-David, M
2018-03-06
The purpose of this research was to examine oncologists' perspectives on indicators of mental health distress in patients: what strategies they use to identify these indicators, and what barriers they face in this task. Twenty-three oncologists were interviewed, and the grounded theory method of data collection and analysis was used. Oncologists perceived distress to be a normative part of having cancer and looked for affective, physical, verbal and behavioural indicators using a number of strategies. Barriers to identification of mental health distress included difficulty in differentiating between mental health distress and symptoms of the disease, and lack of training. A systematic, time-efficient assessment of symptoms of emotional distress is critical for identification of psychiatric disorders among patients and differentiating normative emotional responses from psychopathology. Clinical bias and misdiagnosis can be a consequence of an ad hoc, intuitive approach to assessment, which can have consequences for patients and their families. Once elevated risk is identified for mental health distress, the patient can be referred to specialised care that can offer evidence-based treatments. © 2018 John Wiley & Sons Ltd.
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Global curriculum in research literacy for the surgical oncologist.
Are, C; Yanala, U; Malhotra, G; Hall, B; Smith, L; Cummings, C; Lecoq, C; Wyld, L; Audisio, R A; Berman, R S
2018-01-01
The ability to provide optimal care to cancer patients depends on awareness of current evidence-based practices emanating from research or involvement in research where circumstances permit. The significant global variations in cancer-related research activity and its correlation to cancer-specific outcomes may have an influence on the care provided to cancer patients and their outcomes. The aim of this project is to develop a global curriculum in research literacy for the surgical oncologist. The leadership of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in research literacy for the Surgical Oncologist. A global curriculum in research literacy is developed to incorporate the required domains considered to be essential to interpret the published research or become involved in research activity where circumstances permit. The purpose of this curriculum is to promote research literacy for the surgical oncologist, wherever they are based. It does not mandate direct research participation which may not be feasible due to restrictions within the local health-care delivery environment, socio-economic priorities and the educational environment of the individual institution where they work. A global curriculum in research literacy is proposed which may promote research literacy or encourage involvement in research activity where circumstances permit. It is hoped that this will enhance cancer-related research activity, promote awareness of optimal evidence-based practices and improve outcomes for cancer patients globally. Copyright © 2017 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.
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Rivera, F; Andres, R; Felip, E; Garcia-Campelo, R; Lianes, P; Llombart, A; Piera, J M; Puente, J; Rodriguez, C A; Vera, R; Virizuela, J A; Martin, M; Garrido, P
2017-04-01
The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.
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Koh, Su-Jin; Kim, Shinmi; Kim, JinShil; Keam, Bhumsuk; Heo, Dae Seog; Lee, Kyung Hee; Kim, Bong-Seog; Kim, Jee Hyun; Chang, Hye Jung; Baek, Sun Kyung
2018-04-01
The aims of this study were to explore how oncologists and resident physicians practice end-of-life (EOL) discussions and to solicit their opinions on EOL discussions as a means to improve the quality of EOL care. A survey questionnaire was developed to explore the experiences and opinions about EOL discussions among oncologists and residents. Descriptive statistics, the t test, and the chisquare test were performed for the analyses. A total of 147 oncologists and 229 residents participated in this study. The study respondents reported diverse definitions of "terminal state," and mostrespondents tried to disclose the patient's condition to the patient and/or family members. Both groups were involved in EOL care discussions, with a rather low satisfaction level (57.82/100). The best timing to initiate discussionwas consideredwhen metastasis or disease recurrence occurred orwhen withdrawal of chemotherapy was anticipated. Furthermore, the study respondents suggested that patients and their family members should be included in the EOL discussion. Medical, legal, and ethical knowledge and communication difficulties along with practical issues were revealed as barriers and facilitators for EOL discussion. This study explored various perspectives of oncologists and resident physicians for EOL discussion. Since the Life-Sustaining-Treatment Decision-Making Act will be implemented shortly in Korea, now is the time for oncologists and residents to prepare themselves by acquiring legal knowledge and communication skills. To achieve this, education, training, and clinical tools for healthcare professionals are required.
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Breast conservation therapy for breast cancer. Radiation oncologist's point of view
International Nuclear Information System (INIS)
Hiraoka, Masahiro; Mitsumori, Michihide; Kokubo, Masaki; Fujishiro, Satsuki
1998-01-01
The roles and problems of radiation therapy in breast conserving therapy for breast cancer were presented. The roles of radiation therapy include decrease in breast recurrence, an alternative to axillary dissection for N0 cases, and neo-adjuvant radiation therapy. On the other hand, problems associated with radiation therapy are question of using radiation therapy for all cases, complications and worsening of cosmetics, and relatively high breast recurrence rates for margin-positive cases. The concept of breast conserving therapy is to improve QOL without decreasing treatment outcomes. It is considered that we should be more concentrated on the aspects of QOL because treatment outcomes of breast conserving therapy in Japan demonstrated sofar appear excellent. (author)
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Multidisciplinary approach of early breast cancer: The biology applied to radiation oncology
International Nuclear Information System (INIS)
Bourgier, Céline; Ozsahin, Mahmut; Azria, David
2010-01-01
Early breast cancer treatment is based on a multimodality approach with the application of clinical and histological prognostic factors to determine locoregional and systemic treatments. The entire scientific community is strongly involved in the management of this disease: radiologists for screening and early diagnosis, gynecologists, surgical oncologists and radiation oncologists for locoregional treatment, pathologists and biologists for personalized characterization, genetic counselors for BRCA mutation history and medical oncologists for systemic therapies. Recently, new biological tools have established various prognostic subsets of breast cancer and developed predictive markers for miscellaneous treatments. The aim of this article is to highlight the contribution of biological tools in the locoregional management of early breast cancer
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Survey of advanced radiation technologies used at designated cancer care hospitals in Japan
International Nuclear Information System (INIS)
Shikama, Naoto; Tsujino, Kayoko; Nakamura, Katsumasa; Ishikura, Satoshi
2014-01-01
Our survey assessed the use of advanced radiotherapy technologies at the designated cancer care hospitals in Japan, and we identified several issues to be addressed. We collected the data of 397 designated cancer care hospitals, including information on staffing in the department of radiation oncology (e.g. radiation oncologists, medical physicists and radiation therapists), the number of linear accelerators and the implementation of advanced radiotherapy technologies from the Center for Cancer Control and Information Services of the National Cancer Center, Japan. Only 53% prefectural designated cancer care hospitals and 16% regional designated cancer care hospitals have implemented intensity-modulated radiotherapy for head and neck cancers, and 62% prefectural designated cancer care hospitals and 23% regional designated cancer care hospitals use intensity-modulated radiotherapy for prostate cancer. Seventy-four percent prefectural designated cancer care hospitals and 40% regional designated cancer care hospitals employ stereotactic body radiotherapy for lung cancer. Our multivariate analysis of prefectural designated cancer care hospitals which satisfy the institute's qualifications for advanced technologies revealed the number of radiation oncologists (P=0.01) and that of radiation therapists (P=0.003) were significantly correlated with the implementation of intensity-modulated radiotherapy for prostate cancer, and the number of radiation oncologists (P=0.02) was correlated with the implementation of stereotactic body radiotherapy. There was a trend to correlate the number of medical physicists with the implementation of stereotactic body radiotherapy (P=0.07). Only 175 (51%) regional designated cancer care hospitals satisfy the institute's qualification of stereotactic body radiotherapy and 76 (22%) satisfy that of intensity-modulated radiotherapy. Seventeen percent prefectural designated cancer care hospitals and 13% regional designated cancer care hospitals
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Energy Technology Data Exchange (ETDEWEB)
Baumann, Brian C. [Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Bosch, Walter R. [Washington University in St. Louis, St. Louis, Missouri (United States); Bahl, Amit [University Hospitals Bristol NHS Foundation Trust, Bristol (United Kingdom); Birtle, Alison J. [Royal Preston Hospital, Preston (United Kingdom); Breau, Rodney H. [University of Ottawa, Ottawa, Ontario (Canada); Challapalli, Amarnath [University Hospitals Bristol NHS Foundation Trust, Bristol (United Kingdom); Chang, Albert J. [University of California San Francisco, San Francisco, California (United States); Choudhury, Ananya [Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester (United Kingdom); The University of Manchester, Manchester Academic Heath Science Centre, Manchester (United Kingdom); Daneshmand, Sia [University of Southern California, Los Angeles, California (United States); El-Gayed, Ali [Saskatoon Cancer Centre, Saskatoon (Canada); Feldman, Adam [Massachusetts General Hospital, Boston, Massachusetts (United States); Finkelstein, Steven E. [Cancer Treatment Centers of America, Tulsa, Oklahoma (United States); Guzzo, Thomas J. [Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hilman, Serena [University Hospitals Bristol NHS Foundation Trust, Bristol (United Kingdom); Jani, Ashesh [Emory University, Atlanta, Georgia (United States); Malkowicz, S. Bruce [Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Mantz, Constantine A. [21st Century Oncology, Scottsdale, Arizona (United States); 21st Century Oncology, Fort Myers, Florida (United States); Master, Viraj [Emory University, Atlanta, Georgia (United States); Mitra, Anita V. [University College London Hospital, London (United Kingdom); Murthy, Vedang [Tata Memorial Center, Mumbai (India); and others
2016-09-01
Purpose: To develop multi-institutional consensus clinical target volumes (CTVs) and organs at risk (OARs) for male and female bladder cancer patients undergoing adjuvant radiation therapy (RT) in clinical trials. Methods and Materials: We convened a multidisciplinary group of bladder cancer specialists from 15 centers and 5 countries. Six radiation oncologists and 7 urologists participated in the development of the initial contours. The group proposed initial language for the CTVs and OARs, and each radiation oncologist contoured them on computed tomography scans of a male and female cystectomy patient with input from ≥1 urologist. On the basis of the initial contouring, the group updated its CTV and OAR descriptions. The cystectomy bed, the area of greatest controversy, was contoured by another 6 radiation oncologists, and the cystectomy bed contouring language was again updated. To determine whether the revised language produced consistent contours, CTVs and OARs were redrawn by 6 additional radiation oncologists. We evaluated their contours for level of agreement using the Landis-Koch interpretation of the κ statistic. Results: The group proposed that patients at elevated risk for local-regional failure with negative margins should be treated to the pelvic nodes alone (internal/external iliac, distal common iliac, obturator, and presacral), whereas patients with positive margins should be treated to the pelvic nodes and cystectomy bed. Proposed OARs included the rectum, bowel space, bone marrow, and urinary diversion. Consensus language describing the CTVs and OARs was developed and externally validated. The revised instructions were found to produce consistent contours. Conclusions: Consensus descriptions of CTVs and OARs were successfully developed and can be used in clinical trials of adjuvant radiation therapy for bladder cancer.
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Wong, W K Tim; Kirby, Emma; Broom, Alex; Sibbritt, David; Francis, Kay; Karapetis, Christos S; Karikios, Deme; Harrup, Rosemary; Lwin, Zarnie
2018-01-26
A viable and sustainable medical oncology profession is integral for meeting the increasing demand for quality cancer care. The aim of this study was to explore the workforce-related experiences, perceptions and career expectations of early-career medical oncologists in Australia. A mixed-methods design, including a survey (n = 170) and nested qualitative semistructured interviews (n = 14) with early-career medical oncologists. Recruitment was through the Medical Oncology Group of Australia. Qualitative data were thematically analyzed and for the survey results, logistic regression modeling was conducted. Early-career medical oncologists experienced uncertainty regarding their future employment opportunities. The competitive job market has made them cautious about securing a preferred job leading to a perceived need to improve their qualifications through higher degree training and research activities. The following themes and trends were identified from the qualitative and quantitative analyses: age, career stage and associated early-career uncertainty; locale, professional competition and training preferences; participation in research and evolving professional expectations; and workload and career development opportunities as linked to career uncertainty. Perceived diminished employment opportunities in the medical oncology profession, and shifting expectations to be "more qualified," have increased uncertainty among junior medical oncologists in terms of their future career prospects. Structural factors relating to adequate funding of medical oncology positions may facilitate or inhibit progressive change in the workforce and its sustainability. Workforce planning and strategies informed by findings from this study will be necessary in ensuring that both the needs of cancer patients and of medical oncologists are met. © 2018 John Wiley & Sons Australia, Ltd.
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Patient-oncologist cost communication, financial distress, and medication adherence.
Bestvina, Christine M; Zullig, Leah L; Rushing, Christel; Chino, Fumiko; Samsa, Gregory P; Altomare, Ivy; Tulsky, James; Ubel, Peter; Schrag, Deborah; Nicolla, Jon; Abernethy, Amy P; Peppercorn, Jeffrey; Zafar, S Yousuf
2014-05-01
Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. We surveyed insured adults receiving anticancer therapy. Patients were asked if they had discussed OOP cost with their oncologist. Medication nonadherence was defined as skipping doses or taking less medication than prescribed to make prescriptions last longer, or not filling prescriptions because of cost. Multivariable analysis assessed the association between nonadherence and cost discussions. Among 300 respondents (86% response), 16% (n = 49) reported high or overwhelming financial distress. Nineteen percent (n = 56) reported talking to their oncologist about cost. Twenty-seven percent (n = 77) reported medication nonadherence. To make a prescription last longer, 14% (n = 42) skipped medication doses, and 11% (n = 33) took less medication than prescribed; 22% (n = 66) did not fill a prescription because of cost. Five percent (n = 14) reported chemotherapy nonadherence. To make a prescription last longer, 1% (n = 3) skipped chemotherapy doses, and 2% (n = 5) took less chemotherapy; 3% (n = 10) did not fill a chemotherapy prescription because of cost. In adjusted analyses, cost discussion (odds ratio [OR] = 2.58; 95% CI, 1.14 to 5.85; P = .02), financial distress (OR = 1.64, 95% CI, 1.38 to 1.96; P financial burden than expected (OR = 2.89; 95% CI, 1.41 to 5.89; P financial distress were associated with medication nonadherence, suggesting that cost discussions are important for patients forced to make cost-related behavior alterations. Future research should examine the timing, content, and quality of cost-discussions. Copyright © 2014 by American Society of Clinical Oncology.
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Trevino, Kelly M; Abbott, Caroline H; Fisch, Michael J; Friedlander, Robert J; Duberstein, Paul R; Prigerson, Holly G
2014-08-01
Young adults with cancer are at an increased risk of suicidal ideation. To the authors' knowledge, the impact of the patient-oncologist alliance on suicidal ideation has not been examined to date. The current study examined the relationship between the patient-oncologist therapeutic alliance and suicidal ideation in young adults with advanced cancer. A total of 93 young adult patients (aged 20 years-40 years) with incurable, recurrent, or metastatic cancer were evaluated by trained interviewers. Suicidal ideation was assessed with the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Predictors included diagnoses of major depressive disorder and posttraumatic stress disorder, physical quality of life, social support, and use of mental health and supportive care services. The Human Connection Scale, dichotomized into a strong (upper third) and weak (lower two-thirds) therapeutic alliance, assessed the strength of the patients' perceived oncologist alliance. Approximately 22.6% of patients screened positive for suicidal ideation. Patients with a strong therapeutic alliance were found to be at reduced risk of suicidal ideation after controlling for confounding influences of cancer diagnosis, Karnofsky performance status, number of physical symptoms, physical quality of life, major depressive disorder, posttraumatic stress disorder, and social support. A strong therapeutic alliance was also associated with a reduced risk of suicidal ideation after controlling for mental health discussions with health care providers and use of mental health interventions. The patient-oncologist alliance was found to be a robust predictor of suicidal ideation and provided better protection against suicidal ideation than mental health interventions, including psychotropic medications. Oncologists may significantly influence patients' mental health and may benefit from training and guidance in building strong alliances with their young adult patients.
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International Nuclear Information System (INIS)
Leong, Cheng Nang; Shakespeare, Thomas Philip; Mukherjee, Rahul K.; Back, Michael F.; Lee, Khai Mun; Lu, Jiade Jay; Wynne, Christopher J.; Lim, Keith; Tang, Johann; Zhang Xiaojian
2006-01-01
Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence
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Kim, Eunhyun
2010-01-01
Multicultural children's and young adult literature provides readers with various opportunities: to mirror their lives and reflect the meanings of their own experiences; to gain insight on social issues as well as personal issues; and to enhance cross-cultural awareness. How might Korean/Korean American youth cope with everyday life as a minority…
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Directory of Open Access Journals (Sweden)
Daley Amanda J
2008-09-01
Full Text Available Abstract Evidence has shown that physical activity may attenuate the negative physical, psychological and functional effects of treatment in women diagnosed with breast cancer. Physical activity levels also decline substantially during and after completion of treatment for cancer, highlighting the importance of strategies to promote participation in regular physical activity in this population. Oncologists and surgeons may serve as an influential source of motivation to be physically activity in cancer patients, by conveying the importance of a healthy lifestyle. The primary purpose of the present study was to investigate whether oncologists and surgeons routinely discuss physical activity with their breast cancer patients and to investigate the nature of any information/advice provided during consultations. A secondary aim was to examine whether physically active oncologists and surgeons were more likely to provide advice about physical activity to patients, than inactive oncologists and surgeons. A brief postal questionnaire was sent to 710 consultant breast cancer oncologists and surgeons throughout the UK and 102 responded (response rate = 14.4%. Of responders, most (55.9% did not routinely discuss physical activity with their patients. Amongst oncologists/surgeons (clinicians who did offer advice, most focussed on discussing the benefits of physical activity for physical and functional health gains and for facilitating weight control and maintenance. A number of clinicians indicated they advised patients that physical activity may decrease risk of recurrence and improve survival, despite the lack of evidence from RCTs to support this suggestion. There was no significant association between the physical activity status of oncologists/surgeons and the likelihood that they discussed physical activity with patients. Educational strategies aimed at encouraging clinicians to promote physical activity in consultations need to be targeted widely
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Shin, Dong Wook; Cho, Juhee; Roter, Debra L; Kim, So Young; Yang, Hyung Kook; Park, Keeho; Kim, Hyung Jin; Shin, Hee-Young; Kwon, Tae Gyun; Park, Jong Hyock
2017-06-01
To investigate how cancer patients, family caregiver, and their treating oncologist view the risks and benefits of family involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding family involvement in cancer TDM. Most participants (>90%) thought that family should be involved in cancer TDM. When asked if the oncologist should allow family involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported family involvement. Patients were significantly more likely to skew their responses toward patient rather than family decisional control than were their caregivers (P family decisional control than caregivers (P family involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P family caregivers, and, to a lesser degree, oncologists expect and valued family involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and family caregivers can be seen as a unit for autonomous decision. Copyright © 2016 John Wiley & Sons, Ltd.
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Rios Velazquez, Emmanuel; Aerts, Hugo J W L; Gu, Yuhua; Goldgof, Dmitry B; De Ruysscher, Dirk; Dekker, Andre; Korn, René; Gillies, Robert J; Lambin, Philippe
2012-11-01
To assess the clinical relevance of a semiautomatic CT-based ensemble segmentation method, by comparing it to pathology and to CT/PET manual delineations by five independent radiation oncologists in non-small cell lung cancer (NSCLC). For 20 NSCLC patients (stages Ib-IIIb) the primary tumor was delineated manually on CT/PET scans by five independent radiation oncologists and segmented using a CT based semi-automatic tool. Tumor volume and overlap fractions between manual and semiautomatic-segmented volumes were compared. All measurements were correlated with the maximal diameter on macroscopic examination of the surgical specimen. Imaging data are available on www.cancerdata.org. High overlap fractions were observed between the semi-automatically segmented volumes and the intersection (92.5±9.0, mean±SD) and union (94.2±6.8) of the manual delineations. No statistically significant differences in tumor volume were observed between the semiautomatic segmentation (71.4±83.2 cm(3), mean±SD) and manual delineations (81.9±94.1 cm(3); p=0.57). The maximal tumor diameter of the semiautomatic-segmented tumor correlated strongly with the macroscopic diameter of the primary tumor (r=0.96). Semiautomatic segmentation of the primary tumor on CT demonstrated high agreement with CT/PET manual delineations and strongly correlated with the macroscopic diameter considered as the "gold standard". This method may be used routinely in clinical practice and could be employed as a starting point for treatment planning, target definition in multi-center clinical trials or for high throughput data mining research. This method is particularly suitable for peripherally located tumors. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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Whole-brain radiation therapy for brain metastases: detrimental or beneficial?
International Nuclear Information System (INIS)
Gemici, Cengiz; Yaprak, Gokhan
2015-01-01
Stereotactic radiosurgery is frequently used, either alone or together with whole-brain radiation therapy to treat brain metastases from solid tumors. Certain experts and radiation oncology groups have proposed replacing whole-brain radiation therapy with stereotactic radiosurgery alone for the management of brain metastases. Although randomized trials have favored adding whole-brain radiation therapy to stereotactic radiosurgery for most end points, a recent meta-analysis demonstrated a survival disadvantage for patients treated with whole-brain radiation therapy and stereotactic radiosurgery compared with patients treated with stereotactic radiosurgery alone. However the apparent detrimental effect of adding whole-brain radiation therapy to stereotactic radiosurgery reported in this meta-analysis may be the result of inhomogeneous distribution of the patients with respect to tumor histologies, molecular histologic subtypes, and extracranial tumor stages between the groups rather than a real effect. Unfortunately, soon after this meta-analysis was published, even as an abstract, use of whole-brain radiation therapy in managing brain metastases has become controversial among radiation oncologists. The American Society of Radiation Oncology recently recommended, in their “Choose Wisely” campaign, against routinely adding whole-brain radiation therapy to stereotactic radiosurgery to treat brain metastases. However, this situation creates conflict for radiation oncologists who believe that there are enough high level of evidence for the effectiveness of whole-brain radiation therapy in the treatment of brain metastases
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Oncologists' non-verbal behavior and analog patients' recall of information
Hillen, Marij A.; de Haes, Hanneke C. J. M.; van Tienhoven, Geertjan; van Laarhoven, Hanneke W. M.; van Weert, Julia C. M.; Vermeulen, Daniëlle M.; Smets, Ellen M. A.
2016-01-01
Background Information in oncological consultations is often excessive. Those patients who better recall information are more satisfied, less anxious and more adherent. Optimal recall may be enhanced by the oncologist's non-verbal communication. We tested the influence of three non-verbal behaviors,
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Adaptation in South Korean Society of North Korean Elite Defectors
Directory of Open Access Journals (Sweden)
Levi Nicolas
2017-10-01
Full Text Available This paper aims to explain the adaptation of North Korean elite defectors who fled from North Korea. Data used for the purpose of this article came from surveys of North Korean defectors conducted in the late 2000’s. Findings of the realized research indicate that the majority of senior defectors are experiencing less psychological and material issues when adjusting to society than regular North Korean defectors. The paper will proceed in three steps: explaining the notion of defectors, outlining their background, and focusing on their adaptation in South. Although defectors as a whole has emerged as of the most research group as a minority in South Korea, the so-called senior defectors have hardly been spotlighted. Basically North Korean senior defectors are supposed to strengthen the anti-Kim movement and legitimize the power of the South Korean government and the image of South Korea abroad. What has to be enlightened upon is the fact that North Korean senior defectors partially disagree with the integration policy of South Korean authorities. A major research question emerges: How are the experience of elite defectors localized in South Korea? How do their specific identities impact their opinion within the South Korean society? The aim of the article is also to categorize senior defectors and to provide in a single document a list of senior North Korea defectors based abroad. This kind of information is only available for Korean speaking readers. I wanted to make it accessible to the Englishspeaking community.
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Digestive oncologist in the gastroenterology training curriculum
Mulder, Chris Jacob Johan; Peeters, Marc; Cats, Annemieke; Dahele, Anna; Droste, Jochim Terhaar sive
2011-01-01
Until the late 1980s, gastroenterology (GE) was considered a subspecialty of Internal Medicine. Today, GE also incorporates Hepatology. However, Digestive Oncology training is poorly defined in the Hepatogastroenterology (HGE)-curriculum. Therefore, a Digestive Oncology curriculum should be developed and this document might be a starting point for such a curriculum. HGE-specialists are increasingly resisting the paradigm in which they play only a diagnostic and technical role in the management of digestive tumors. We suggest minimum end-points in the standard HGE-curriculum for oncology, and recommend a focus year in the Netherlands for Digestive Oncology in the HGE-curriculum. To produce well-trained digestive oncologists, an advanced Digestive Oncology training program with specific qualifications in Digestive Oncology (2 years) has been developed. The schedule in Belgium includes a period of at least 6 mo to be spent in a medical oncology department. The goal of these programs remains the production of well-trained digestive oncologists. HGE specialists are part of the multidisciplinary oncological teams, and some have been administering chemotherapy in their countries for years. In this article, we provide a road map for the organization of a proper training in Digestive Oncology. We hope that the World Gastroenterology Organisation and other (inter)national societies will support the necessary certifications for this specific training in the HGE-curriculum. PMID:21556128
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History of Korean Neurosurgery.
Hwang, Sung-nam
2015-08-01
The year 2012 was the 50th anniversary of the Korean Neurosurgical Society, and in 2013, the 15th World Congress of Neurosurgery took place in Seoul, Korea. Thus, it is an appropriate occasion to introduce the world to the history of the Korean Neurosurgical Society and the foundation, development, and growth of Korean neurosurgery. Historical materials and pictures were collected and reviewed from the history book and photo albums of the Korean Neurosurgical Society. During the last 50 years, the Korean Neurosurgical Society and Korean neurosurgery have developed and grown enormously not only in quantity but also in quality. In every aspect, the turning point from the old to the new era of the Korean Neurosurgical Society and Korean neurosurgery was the year 1980. Copyright © 2015. Published by Elsevier Inc.
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Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study
Turner, Sandra; Seel, Matthew; Trotter, Theresa; Giuliani, Meredith; Benstead, Kim; Eriksen, Jesper G.; Poortmans, Philip; Verfaillie, Christine; Westerveld, Henrike; Cross, Shamira; Chan, Ming-Ka; Shaw, Timothy
2017-01-01
The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al.,
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Tanriverdi, Ozgur
2013-06-01
The increasing incidence of cancer is at the same time one of the leading causes of death all over the world. Many clinical studies show that the psychological disorders are more frequent in cancer patients than the normal population. That is the reason why "psycho-oncology" is getting popular each day. On the other hand, clinical studies about psychological status of the oncologists who are in contact with cancer patients ceaselessly and who are mostly responsible to give the "bad news" to the cancer patients are very limited. In fact, if the clinical studies which show that the frequency of depression and burnout syndrome are increasing among physicians are taken into consideration, one can say that psycho-oncology must cover all the medical personnel who are dealing with cancer patients. It is determined that the rate of depression and burnout syndrome is high among oncologists when referred to the literature. Several solutions are proposed for the psychological conditions of the oncologists and other related personnel who empathize with the patients and deliver "bad news" and also try to adopt ideal "patient-physician" communication model. The knowledge on the psychological conditions of oncology professionals and their behaviour and the results of the clinical studies on this subject will be discussed and the personal opinion will also be presented in this paper.
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Future Supply and Demand for Oncologists : Challenges to Assuring Access to Oncology Services
Erikson, Clese; Salsberg, Edward; Forte, Gaetano; Bruinooge, Suanna; Goldstein, Michael
2007-01-01
Purpose To conduct a comprehensive analysis of supply of and demand for oncology services through 2020. This study was commissioned by the Board of Directors of ASCO. Methods New data on physician supply gathered from surveys of practicing oncologists, oncology fellows, and fellowship program directors were analyzed, along with 2005 American Medical Association Masterfile data on practicing medical oncologists, hematologists/oncologists, and gynecologic oncologists, to determine the baseline capacity and to forecast visit capacity through 2020. Demand for visits was calculated by applying age-, sex-, and time-from-diagnosis-visit rate data from the National Cancer Institute's analysis of the 1998 to 2002 Surveillance, Epidemiology and End Results (SEER) database to the National Cancer Institute's cancer incidence and prevalence projections. The cancer incidence and prevalence projections were calculated by applying a 3-year average (2000–2002) of age- and sex-specific cancer rates from SEER to the US Census Bureau population projections released on March 2004. The baseline supply and demand forecasts assume no change in cancer care delivery and physician practice patterns. Alternate scenarios were constructed by changing assumptions in the baseline models. Results Demand for oncology services is expected to rise rapidly, driven by the aging and growth of the population and improvements in cancer survival rates, at the same time the oncology workforce is aging and retiring in increasing numbers. Demand is expected to rise 48% between 2005 and 2020. The supply of services provided by oncologists during this time is expected to grow more slowly, approximately 14%, based on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions. This translates into a shortage of 9.4 to 15.0 million visits, or 2,550 to 4,080 oncologists—roughly one-quarter to one-third of the 2005 supply. The baseline projections do not
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McClelland, Shearwood; Sandler, Kiri A; Degnin, Catherine; Chen, Yiyi; Mitin, Timur
2018-06-01
Three randomized clinical trials have established brachytherapy (BT) boost in combination with external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT) as superior to definitive EBRT and ADT alone in terms of biochemical control (but not overall survival) at the expense of increased toxicity in men with high-risk (HR) prostate cancer (PCa). The current view regarding these 2 treatment algorithms among North American genitourinary (GU) experts is not known. A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to opinions regarding BT as monotherapy for low-risk PCa and BT boost for HR PCa. Responders were asked to self-identify as BT experts versus non-experts. Treatment recommendations were correlated with practice patterns using the Fisher exact test. Forty-two radiation oncologists completed the survey, of whom 23 (55%) recommend EBRT and ADT alone and 19 (45%) recommend addition of BT boost. Twenty-five participants (60%) identified themselves as BT experts. Nearly 90% of those recommending BT boost were BT experts versus approximately 10% of non-BT experts (P < .001). Responders who recommended BT monotherapy as first-choice treatment for low-risk PCa were more likely to recommend BT boost for HR PCa (P < .0001). There is a dramatic polarization in opinions regarding incorporation of BT boost into EBRT + ADT therapy for patients with HR PCa among North American GU radiation oncology experts, who serve on decision-making committees and influence the national treatment guidelines and future clinical trials. Those who identify themselves as BT experts are significantly more likely to recommend BT boost. These findings are likely to influence the national guidelines and implementation of BT boost in current and future North American PCa clinical studies. Copyright © 2018 Elsevier Inc. All rights reserved.
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Turner, Taylor B; Dilley, Sarah E; Smith, Haller J; Huh, Warner K; Modesitt, Susan C; Rose, Stephen L; Rice, Laurel W; Fowler, Jeffrey M; Straughn, J Michael
2017-09-01
Physician burnout is associated with mental illness, alcohol abuse, and job dissatisfaction. Our objective was to estimate the impact of burnout on productivity of gynecologic oncologists during the first half of their career. A decision model evaluated the impact of burnout on total relative value (RVU) production during the first 15years of practice for gynecologic oncologists entering the workforce from 2011 to 2015. The SGO practice survey provided physician demographics and mean annual RVUs. Published data were used to estimate probability of burnout for male and female gynecologic oncologists, and the impact of depression, alcohol abuse, and early retirement. Academic productivity was defined as annual PubMed publications since finishing fellowship. Without burnout, RVU production for the cohort of 250 gynecologic oncologists was 26.2 million (M) RVUs over 15years. With burnout, RVU production decreased by 1.6 M (5.9% decrease). Disproportionate rates of burnout among females resulted in 1.1 M lost RVUs for females vs. 488 K for males. Academic production without burnout was estimated at 9277 publications for the cohort. Burnout resulted in 1383 estimated fewer publications over 15years (14.9%). The impact of burnout on clinical and academic productivity is substantial across all specialties. As health care systems struggle with human resource shortages, this study highlights the need for effective burnout prevention and wellness programs for gynecologic oncologists. Unless significant resources are designated to wellness programs, burnout will increasingly affect the care of our patients and the advancement of our field. Copyright © 2017 Elsevier Inc. All rights reserved.
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Yeom, Yeon Soo; Jeong, Jong Hwi; Kim, Chan Hyeong; Han, Min Cheol; Ham, Bo Kyoung; Cho, Kun Woo; Hwang, Sung Bae
2014-07-01
In a previous study, we constructed a male reference Korean phantom; HDRK-Man (High-Definition Reference Korean-Man), to represent Korean adult males for radiation protection purposes. In the present study, a female phantom; HDRK-Woman (High-Definition Reference Korean-Woman), was constructed to represent Korean adult females. High-resolution color photographic images obtained by serial sectioning of a 26 year-old Korean adult female cadaver were utilized. The body height and weight, the skeletal mass, and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The phantom was then compared with the International Commission on Radiological Protection (ICRP) female reference phantom in terms of calculated organ doses and organ-depth distributions. Additionally, the effective doses were calculated using both the HDRK-Man and HDRK-Woman phantoms, and the values were compared with those of the ICRP reference phantoms.
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International Nuclear Information System (INIS)
Yeom, Yeon Soo; Kim, Chan Hyeong; Han, Min Cheol; Jeong, Jong Hwi; Ham, Bo Kyoung; Cho, Kun Woo; Hwang, Sung Bae
2014-01-01
In a previous study, we constructed a male reference Korean phantom; HDRK-Man (High-Definition Reference Korean-Man), to represent Korean adult males for radiation protection purposes. In the present study, a female phantom; HDRK-Woman (High-Definition Reference Korean-Woman), was constructed to represent Korean adult females. High-resolution color photographic images obtained by serial sectioning of a 26 year-old Korean adult female cadaver were utilized. The body height and weight, the skeletal mass, and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The phantom was then compared with the International Commission on Radiological Protection (ICRP) female reference phantom in terms of calculated organ doses and organ-depth distributions. Additionally, the effective doses were calculated using both the HDRK-Man and HDRK-Woman phantoms, and the values were compared with those of the ICRP reference phantoms. (paper)
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Yeom, Yeon Soo; Jeong, Jong Hwi; Kim, Chan Hyeong; Han, Min Cheol; Ham, Bo Kyoung; Cho, Kun Woo; Hwang, Sung Bae
2014-07-21
In a previous study, we constructed a male reference Korean phantom; HDRK-Man (High-Definition Reference Korean-Man), to represent Korean adult males for radiation protection purposes. In the present study, a female phantom; HDRK-Woman (High-Definition Reference Korean-Woman), was constructed to represent Korean adult females. High-resolution color photographic images obtained by serial sectioning of a 26 year-old Korean adult female cadaver were utilized. The body height and weight, the skeletal mass, and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The phantom was then compared with the International Commission on Radiological Protection (ICRP) female reference phantom in terms of calculated organ doses and organ-depth distributions. Additionally, the effective doses were calculated using both the HDRK-Man and HDRK-Woman phantoms, and the values were compared with those of the ICRP reference phantoms.
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Studies on the preservation of Korean Ginseng by irradiation
International Nuclear Information System (INIS)
Sung, H.S.; Park, M.H.; Lee, K.S.; Cho, H.O.
1982-01-01
In order to evaluate the feasibility for the sterilization of Korean red and white ginseng powder by irradiation, red and white ginseng powder (120 mesh) was irradiated by 0.1, 0.3, 0.5, 0.7, 1.0 and 2.0 Mrad with 60 Co irradiator (dose rate: 4000 rad/h). Extraction rate of crude saponins by buthanol and by 50% ethanol were slightly increased according to the irradiation dose (buthanol ex. 1.7%, 50% ethanol ex. 2.6%) at 1.0 Mrad irradiation. There are no remarkable changes in HPLC patterns of crude saponins by radiation. It was found that irradiation up to 1 Mrad on Korean ginseng products have no significant effect on proximate component, reducing sugar and amino nitrogen of ginseng powder and on the color density of ginseng extract with 50% ethanol. Irradiation up to 1 Mrad could be utilized for the sterilization of Korean ginseng powder without changes of physicochemical properties. (Author)
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Guidelines for respiratory motion management in radiation therapy
International Nuclear Information System (INIS)
Matsuo, Yukinori; Onishi, Hiroshi; Nakagawa, Keiichi
2013-01-01
Respiratory motion management (RMM) systems in external and stereotactic radiotherapies have been developed in the past two decades. Japanese medical service fee regulations introduced reimbursement for RMM from April 2012. Based on thorough discussions among the four academic societies concerned, these Guidelines have been developed to enable staff (radiation oncologists, radiological technologists, medical physicists, radiotherapy quality managers, radiation oncology nurses, and others) to apply RMM to radiation therapy for tumors subject to respiratory motion, safely and appropriately. (author)
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The physics of radiation therapy
Khan, Faiz M
2009-01-01
Dr. Khan's classic textbook on radiation oncology physics is now in its thoroughly revised and updated Fourth Edition. It provides the entire radiation therapy team—radiation oncologists, medical physicists, dosimetrists, and radiation therapists—with a thorough understanding of the physics and practical clinical applications of advanced radiation therapy technologies, including 3D-CRT, stereotactic radiotherapy, HDR, IMRT, IGRT, and proton beam therapy. These technologies are discussed along with the physical concepts underlying treatment planning, treatment delivery, and dosimetry. This Fourth Edition includes brand-new chapters on image-guided radiation therapy (IGRT) and proton beam therapy. Other chapters have been revised to incorporate the most recent developments in the field. This edition also features more than 100 full-color illustrations throughout.
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Energy Technology Data Exchange (ETDEWEB)
Yoon, Ji Hyun; Lee, Bong Sang [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
2017-08-15
The precise prediction of radiation embrittlement of aged reactor pressure vessels (RPVs) is a prerequisite for the long-term operation of nuclear power plants beyond their original design life. The expiration of the operation licenses for Korean reactors the RPVs of which are made from SA533B-1 plates and welds is imminent. Korean regulatory rules have adopted the US Nuclear Regulatory Commission's transition temperature shift (TTS) models to the prediction of the embrittlement of Korean reactor pressure vessels. The applicability of the TTS model to predict the embrittlement of Korean RPVs made of SA533B-1 plates and welds was investigated in this study. It was concluded that the TTS model of 10 CFR 50.61a matched the trends of the radiation embrittlement in the SA533B-1 plates and welds better than did that of Regulatory Guide (RG) 1.99 Rev. 2. This is attributed to the fact that the prediction performance of 10 CFR 50.61a was enhanced by considering the difference in radiation embrittlement sensitivity among the different types of RPV materials.
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Satisfaction with work-life balance among U.S. gynecologic oncologists, a cross-sectional study.
Szender, J Brian; Grzankowski, Kassondra S; Eng, Kevin H; Lele, Shashikant B; Odunsi, Kunle; Frederick, Peter J
To evaluate the satisfaction with work-life balance (WLB) and career satisfaction of gynecologic oncologists. In August 2014, members of the Society of Gynecologic Oncology (SGO) were sent an anonymous, cross-sectional survey evaluating demographic variables, practice characteristics, career satisfaction, fatigue, and satisfaction with WLB. Fatigue was assessed using a visual-analog scale. Career satisfaction and WLB were assessed with a Likert scale. Inferential statistics were computed with type I error rates of 0.05. Out of the 1002 gynecologic oncologists surveyed, 290 (28.9%) responded. Only 18.6% of respondents were satisfied with WLB and there were significant associations between gender (P = 0.0157), time spent in work related activities at home (P = 0.0024), on weekends (P = 0.0017), and in the hospital (P = 0.0001). More than 84% of physicians reported they would choose medicine as a career again and of those 90% would choose to be a gynecologic oncologist again. Fatigue was strongly associated with dissatisfaction with WLB in univariate and multivariate analysis (P satisfaction may assist the SGO in meeting future gynecologic cancer care needs.
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Korean anatomical reference data for adults for use in radiological protection
Choi, Chansoo; Yeom, Yeon Soo; Nguyen, Thang Tat; Lee, Hanjin; Han, Haegin; Shin, Bangho; Zhang, Xujia; Kim, Chan Hyeong; Chung, Beom Sun
2018-01-01
For radiological protection from exposure to ionizing radiation, in which a population-averaged dose evaluation is used, establishing a system of reference anatomical and physiological data for a specific population of interest is important. Some studies were done in the past to establish Korean reference data; however, the data provided the mass values only for a limited number of organs/tissues. In addition, the standing height and total body mass are based on 20-year-old data. In the present study, a new set of Korean reference anatomical values was established for use in the radiological protection of Korean workers and members of the public. The established Korean reference data provide the masses of 58 organs/tissues, including those needed to calculate the effective dose, which were derived by collecting and analyzing various scientific reports in the literature and data. In addition, the data provide not only standing height and total body mass, but also 131 additional anthropometric parameters; these values were derived from the most recent Korean national survey project, 7 th Size Korea. The characteristics of the data were also compared with several other population data, including the Asian and the International Commission on Radiological Protection (ICRP) reference data.
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Supply and Demand for Radiation Oncology in the United States: Updated Projections for 2015 to 2025
International Nuclear Information System (INIS)
Pan, Hubert Y.; Haffty, Bruce G.; Falit, Benjamin P.; Buchholz, Thomas A.; Wilson, Lynn D.; Hahn, Stephen M.; Smith, Benjamin D.
2016-01-01
Purpose: Prior studies have forecasted demand for radiation therapy to grow 10 times faster than the supply between 2010 and 2020. We updated these projections for 2015 to 2025 to determine whether this imbalance persists and to assess the accuracy of prior projections. Methods and Materials: The demand for radiation therapy between 2015 and 2025 was estimated by combining current radiation utilization rates determined by the Surveillance, Epidemiology, and End Results data with population projections provided by the US Census Bureau. The supply of radiation oncologists was forecast by using workforce demographics and full-time equivalent (FTE) status provided by the American Society for Radiation Oncology (ASTRO), current resident class sizes, and expected survival per life tables from the US Centers for Disease Control. Results: Between 2015 and 2025, the annual total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 19%, from 490,000 to 580,000. Assuming a graduating resident class size of 200, the number of FTE physicians is expected to increase by 27%, from 3903 to 4965. In comparison with prior projections, the new projected demand for radiation therapy in 2020 dropped by 24,000 cases (a 4% relative decline). This decrease is attributable to an overall reduction in the use of radiation to treat cancer, from 28% of all newly diagnosed cancers in the prior projections down to 26% for the new projections. By contrast, the new projected supply of radiation oncologists in 2020 increased by 275 FTEs in comparison with the prior projection for 2020 (a 7% relative increase), attributable to rising residency class sizes. Conclusion: The supply of radiation oncologists is expected to grow more quickly than the demand for radiation therapy from 2015 to 2025. Further research is needed to determine whether this is an appropriate correction or will result in excess capacity.
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Supply and Demand for Radiation Oncology in the United States: Updated Projections for 2015 to 2025
Energy Technology Data Exchange (ETDEWEB)
Pan, Hubert Y. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Haffty, Bruce G. [Department of Radiation Oncology, Robert Wood Johnson Medical School – University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (United States); Falit, Benjamin P. [Radiation Oncology Associates, Lowell, Massachusetts (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Hahn, Stephen M. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
2016-11-01
Purpose: Prior studies have forecasted demand for radiation therapy to grow 10 times faster than the supply between 2010 and 2020. We updated these projections for 2015 to 2025 to determine whether this imbalance persists and to assess the accuracy of prior projections. Methods and Materials: The demand for radiation therapy between 2015 and 2025 was estimated by combining current radiation utilization rates determined by the Surveillance, Epidemiology, and End Results data with population projections provided by the US Census Bureau. The supply of radiation oncologists was forecast by using workforce demographics and full-time equivalent (FTE) status provided by the American Society for Radiation Oncology (ASTRO), current resident class sizes, and expected survival per life tables from the US Centers for Disease Control. Results: Between 2015 and 2025, the annual total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 19%, from 490,000 to 580,000. Assuming a graduating resident class size of 200, the number of FTE physicians is expected to increase by 27%, from 3903 to 4965. In comparison with prior projections, the new projected demand for radiation therapy in 2020 dropped by 24,000 cases (a 4% relative decline). This decrease is attributable to an overall reduction in the use of radiation to treat cancer, from 28% of all newly diagnosed cancers in the prior projections down to 26% for the new projections. By contrast, the new projected supply of radiation oncologists in 2020 increased by 275 FTEs in comparison with the prior projection for 2020 (a 7% relative increase), attributable to rising residency class sizes. Conclusion: The supply of radiation oncologists is expected to grow more quickly than the demand for radiation therapy from 2015 to 2025. Further research is needed to determine whether this is an appropriate correction or will result in excess capacity.
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Protection of the patient in radiation therapy
International Nuclear Information System (INIS)
1991-01-01
In the ICRP report (ICRP-Pub-44) a broad picture of radiotheraphy is presented useful to all involved in the care of cancer patients, for instance to physicians, including medical oncologists, and to medical physicists, radiographers, dosimetrists, and administrators. Information is given on the general principles of radiation therapy including external beam therapy and brachytherapy; the accuracy of radiation delivery and quality assurance; the biological radiation response; the expected risk to specific organs or tissues from therapeutic irradiation; the absorbed dose to tissues inside and outside the useful radiation beams; the organization and planning of radiation oncology services; radiation therapy staff education, training and duties; and finally medical research involving the use of radiation therapy. (orig./HP) [de
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Applicable approach of the wireless technology for Korean nuclear power plants
International Nuclear Information System (INIS)
Ko, Do Young; Lee, Soo Ill
2013-01-01
Highlights: • To apply wireless technology for Korean NPPs, several stipulations are proposed. • WLAN is proposed as the most appropriate wireless technology for Korean NPPs. • WLAN can be applied to the specific fields except in the control system. • An attitude survey on wireless showed that 94.7% agree with the necessity of wireless. - Abstract: Recently, many nuclear power plants (NPPs) over the world use various types of wireless systems for the advantages. Unfortunately, wireless technologies are not currently installed in any Korean NPPs because it is difficult to solve the negative impact of unexpected outcomes or failures from the influence of the wireless technologies, which is electromagnetic interference and radio-frequency interference (EMI/RFI). Moreover, a lack of desire on the part of Korean nuclear industry to implement it leads to give up benefit from the wireless technologies. To install the wireless technologies with maximum benefit and minimum risk, a systematic approach, which quantify the negative impact and prevent the influence, is essential; therefore, this paper describes an applicable research result on the wireless technology for Korean NPPs based on regulatory guides and current wireless hardware and software technologies. Also, survey on the needs for the wireless technology for Korean nuclear power plants was conducted, because the level of awareness of workers in NPPs regarding wireless technologies is very important issue. In this paper, we propose an applicable system to enhance the applicability for the wireless technology for Korean NPPs. The result based on proposed applicable system shows that wireless local area network (WLAN) is the representative candidate for Korean NPPs, which can be applied to the specific fields of radiation monitoring, voice and data communication, component monitoring and instrumentation, and wireless cameras
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Applicable approach of the wireless technology for Korean nuclear power plants
Energy Technology Data Exchange (ETDEWEB)
Ko, Do Young, E-mail: kodoyoung@khnp.co.kr; Lee, Soo Ill
2013-12-15
Highlights: • To apply wireless technology for Korean NPPs, several stipulations are proposed. • WLAN is proposed as the most appropriate wireless technology for Korean NPPs. • WLAN can be applied to the specific fields except in the control system. • An attitude survey on wireless showed that 94.7% agree with the necessity of wireless. - Abstract: Recently, many nuclear power plants (NPPs) over the world use various types of wireless systems for the advantages. Unfortunately, wireless technologies are not currently installed in any Korean NPPs because it is difficult to solve the negative impact of unexpected outcomes or failures from the influence of the wireless technologies, which is electromagnetic interference and radio-frequency interference (EMI/RFI). Moreover, a lack of desire on the part of Korean nuclear industry to implement it leads to give up benefit from the wireless technologies. To install the wireless technologies with maximum benefit and minimum risk, a systematic approach, which quantify the negative impact and prevent the influence, is essential; therefore, this paper describes an applicable research result on the wireless technology for Korean NPPs based on regulatory guides and current wireless hardware and software technologies. Also, survey on the needs for the wireless technology for Korean nuclear power plants was conducted, because the level of awareness of workers in NPPs regarding wireless technologies is very important issue. In this paper, we propose an applicable system to enhance the applicability for the wireless technology for Korean NPPs. The result based on proposed applicable system shows that wireless local area network (WLAN) is the representative candidate for Korean NPPs, which can be applied to the specific fields of radiation monitoring, voice and data communication, component monitoring and instrumentation, and wireless cameras.
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On Being There: Korean in Japan.
Maher, John C.; Kawanishi, Yumiko
1995-01-01
Examines the experiences of ethnic Koreans and the Korean language in Japan since 1945, focusing on Japanese attitudes toward Koreans and the Korean language, provisions for Korean and bilingual education, and the increasing influence of Koreans in Japanese society. (18 references) (MDM)
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International Nuclear Information System (INIS)
Rose, Christopher M.; Botnick, Leslie E.; Hinkle, Milton; Linden, Jeffrey
1997-01-01
Radiation Oncology is an important component in multi-modality cancer care. Managed care has defined a number of different ways that radiation oncologists can interact with the other members of the cancer team. This course will review those options. The change in health care delivery is forcing radiation oncologists to examine every aspect of how they organize themselves, deliver care, evaluate that care, and how they are reimbursed for this process. This course will attempt to examine how the pressures of the new paradigms of health care delivery; managed care and outcomes research are impacting upon radiation therapy practice, and what radiation oncologists can do to maintain patient care standards. I. Introduction: A. Managed Care: What it is and where it is going 1. PPO's 2. HMO's 3. POS plans 4. Carve-outs B. Outcomes Research: What it can and cannot do 1. Patterns of care and SEER 2. Rand 3. ''Surrogate outcomes:'' patient satisfaction, quality of life indicators II. Moving from QA and CQI and Benchmarking A. Radiation Oncologists cannot take anything for granted B. Using analytical tools to evaluate all aspects of the radiation oncology practice. 1. Capital Purchases 2. Operational Aspects III Evaluating Staffing Needs A. What traditional jobs in the department should stay? B. Is the cross-training seen in the rest of the hospital appropriate in radiation oncology C. Outsourcing and multi-department organization as ways to improve efficiency D. What about physician extenders? E. What residents, newly trained radiation oncologists, and physician-practice managers must acknowledge to each other IV. Evaluating Technology A. See second and third talks in this series B. Improving efficiency: how does this help when one is not at capacity C. Increasing throughput D. Decreasing cost V. Informatics A. See second and third talks in this series B. What should one expect the computer to do for you C. Some personal observations VI. Gains from Share Services A. Should
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Proceedings of the Korean Radioactive Waste Society Spring 2010
International Nuclear Information System (INIS)
2010-01-01
This proceedings contains articles of the Korean Radioactive Waste Society Spring 2010. It was held on May 13-14, 2010 in Yesan, Korea. The main topics are as follows: Radioactive wastes policy and decontamination and decommissioning, Radioactive waste treatment, Radioactive waste disposal and site selection, Spent fuel and fuel cycle and Radiation safety and environment. (Yi, J. H.)
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Professional Burnout in European Young Oncologists
DEFF Research Database (Denmark)
Banerjee, Sutanuka; Califano, R; Corral, Javier
2017-01-01
≤40 (YOs). Methods: A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were performed to identify factors associated with burnout. Results: 737 surveys (all ages) were collected from 41 European......Background: Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists...... = 0.0001 ) and low accomplishment was highest in the 26-30 age group ( p work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors ( p
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North Korean nuclear negotiation drama
International Nuclear Information System (INIS)
Kim, Jai Bok
1995-06-01
This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.
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North Korean nuclear negotiation drama
Energy Technology Data Exchange (ETDEWEB)
Kim, Jai Bok
1995-06-15
This book reports negotiation on North Korean nuclear among South Korea, North Korea and U. S. It includes an account about international issues on North Korean nuclear activities, a new aspect on the problems of North Korean nuclear, pressure on North Korea and startup for dialogue trying to solve problems by communication, investigation by IAEA, IAEA resolution and high tension on Korean peninsula with North Korean nuclear.
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International Nuclear Information System (INIS)
Kim, Jung Hoon; Kim, Tae Man; Whang, Joo Ho
2005-01-01
Radiation dosimetry will prove helpful to active approaches, such as limiting the amount of radiation exposure, which can be called the negative effect of radiation on the body, or using radiation to treat diseases. Defective nuclear fuel at a nuclear power plant or 131 I used for oral thyroid gland examination and treatment of cancer may cause internal exposure during the replacement of nuclear fuel, or maintenance. Also, it is reported that, clinically, 131 I has the negative function of increasing the radiation exposure of the other organs as well as the positive function related to thyroid gland diagnosis and cancer treatment. Estimation of internal exposure to 131 I must take the physical properties of 131 I and the physiological properties of individuals into account. The extracorporeal excretion rate of radionuclides and the proportion remaining in the body may vary depending on the physiological properties of the Oriental and Occidental people. The existing physiological properties are data originating from Westerners, so if the data are applied to Koreans, differences in dietary life and physiological properties may lead to underestimation or overestimation of internal exposure. Therefore, this study aims at measuring the radionuclide absorption and excretion rates in human organs to establish the physiological radionuclide metabolism fit to Koreans and the Oriental people whose physique is similar to that of Koreans
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Lin, Chun Chieh; Bruinooge, Suanna S; Kirkwood, M Kelsey; Hershman, Dawn L; Jemal, Ahmedin; Guadagnolo, B Ashleigh; Yu, James B; Hopkins, Shane; Goldstein, Michael; Bajorin, Dean; Giordano, Sharon H; Kosty, Michael; Arnone, Anna; Hanley, Amy; Stevens, Stephanie; Olsen, Christine
2016-03-15
Trimodality therapy (chemoradiation and surgery) is the standard of care for stage II/III rectal cancer but nearly one third of patients do not receive radiation therapy (RT). We examined the relationship between the density of radiation oncologists and the travel distance to receipt of RT. A retrospective study based on the National Cancer Data Base identified 26,845 patients aged 18 to 80 years with stage II/III rectal cancer diagnosed from 2007 to 2010. Radiation oncologists were identified through the Physician Compare dataset. Generalized estimating equations clustering by hospital service area was used to examine the association between geographic access and receipt of RT, controlling for patient sociodemographic and clinical characteristics. Of the 26,845 patients, 70% received RT within 180 days of diagnosis or within 90 days of surgery. Compared with a travel distance of traveled ≥50 miles had a decreased likelihood of receipt of RT (50-249 miles, adjusted odds ratio 0.75, Ptravel burden was associated with a decreased likelihood of receiving RT for patients with stage II/III rectal cancer, all else being equal; however, radiation oncologist density was not. Further research of geographic access and establishing transportation assistance programs or lodging services for patients with an unmet need might help decrease geographic barriers and improve the quality of rectal cancer care. Copyright © 2016 Elsevier Inc. All rights reserved.
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Construction of Korean male tomographic model segmented from PET-CT data
International Nuclear Information System (INIS)
Lee, Choon Sik; Park, Sang Kyun; Lee, Jai Ki
2004-01-01
Tomographic human models provide currently the most realistic representation of human anatomy for radiation dosimetry calculation. Most of the models have been constructed by using computed tomographic (CT) or magnetic resonance (MR) images obtained from a single individual. Each scan has its inherent advantages and disadvantages. CT scan gives a considerable radiation dose to a subject, and MR scan takes too long time to get clear images of an immobile subject. An emerging source of medical images for the construction of tomographic models is PET-CT, which is performed when looking for cancer. In this study, a tomographic model of Korean adult male was developed by processing whole-body CT images of a PET-CT-scanned healthy volunteer. The 343 slices of the CT images were semi-automatically segmented layer by layer using a graphic software and screen digitizer. The 3rd Korean tomographic model, named KRMAN-2, consisting of 300x150x344 voxels of a size of 2x2x5mm 3 , was constructed. Examples of application to Monte Carlo radiation dosimetry calculation in idealized whole-body irradiations were given and discussed
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Radiation oncology training in Poland: results of a national survey (2007)
International Nuclear Information System (INIS)
Niemiec, M.; Kepka, L.; Lindner, B.; Bujko, K.; Lindner, B.; Maciejewski, B.
2008-01-01
The aim of this survey was to evaluate the quality of training in radiation oncology in Poland in relation to the ESTRO recommendations, and to learn motivations, level of satisfaction, complaints, suggestions and career plans of radiation oncologists.The detailed questionnaire was addressed to radiation oncologists from all centres in Poland who have been certified as specialists after 1990. Of the 212 approached, 103 radiation oncologists responded to the questionnaire (49%). In general, 40% of respondents declared that the majority of tutors/supervisors devoted sufficient time to their training (60% in academic, 28% in regional centres); 60% had access to the literature, and 50% to the internet. The number of treated patients during the training period ranged from 10 to 3000 (median: 375). 69% of the respondents completed a training in another Polish oncology centre (median duration - 2 months), 21% underwent such training abroad, 55% attended international courses/ conferences. Respondents from academic centres had access and attended national and/or international training more often than those from regional centres. Financial matters have been listed as a major obstacle for out-door training by 93% of respondents. 64% of respondents were pleased or rather pleased with the general quality of training, and the remaining 36% were unsatisfied (these mainly from regional centres). Considering career plans, 72% respondents wanted to continue practice at their employing institutions; however 24% have declared a wish to continue their career abroad. This first national survey has shown some weak points in radiotherapy training in Poland, mainly the quality differences between the departments in favour of academic centres. Some of the problems can and should be solved by the Polish Society of Radiation Oncology, others need legislation changes and decisions at the level of the Ministry of Health. (authors)
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Cherny, Nathan I
2012-01-01
Difficult dialogues with patients facing life-changing decisions are an intrinsic part of oncologic practice and a major source of stress. Having a sophisticated approach to the concepts of autonomy, paternalism, and culture can help in addressing difficult dilemmas that arise around the issues of disclosure and decision making. This article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture. It introduces the new concept of"voluntary diminished autonomy" and describes the implications this concept has for the consent process. It also attempts to bring clarity to common problems and misconceptions relating to culture, paternalism, and therapeutic privilege as these pertain to the communication practices of oncologists.
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Energy Technology Data Exchange (ETDEWEB)
Bahig, Houda [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montréal, Montreal, QC (Canada); Roberge, David, E-mail: david.roberge.chum@ssss.gouv.qc.ca [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montréal, Montreal, QC (Canada); Bosch, Walter [Department of Radiation Oncology, Washington University, St Louis, Missouri (United States); Levin, William [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Petersen, Ivy; Haddock, Michael [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Freeman, Carolyn [Division of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Indelicato, Danny J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Baldini, Elizabeth H. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Hitchcock, Ying [Department of Radiation Oncology, University of Utah Medical Center, Salt Lake City, Utah (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Kozak, Kevin R. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Wolfson, Aaron [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); and others
2013-06-01
Purpose: Peritumoral edema may harbor sarcoma cells. The extent of suspicious edema (SE) included in the treatment volume is subject to clinical judgment, balancing the risk of missing tumor cells with excess toxicity. Our goal was to determine variability in SE delineation by sarcoma radiation oncologists (RO). Methods and Materials: Twelve expert ROs were provided with T1 gadolinium and T2-weighted MR images of 10 patients with high-grade extremity soft-tissue sarcoma. Gross tumor volume, clinical target volume (CTV)3cm (3 cm longitudinal and 1.5 cm radial margin), and CTV2cm (2 cm longitudinal and 1 cm radial margin) were contoured by a single observer. Suspicious peritumoral edema, defined as abnormal signal on T2 images, was independently delineated by all 12 ROs. Contouring agreement was analyzed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: The mean volumes of GTV, CTV2cm, and CTV3cm were, respectively, 130 cm{sup 3} (7-413 cm{sup 3}), 280 cm{sup 3} and 360 cm{sup 3}. The mean consensus volume computed using the STAPLE algorithm at 95% confidence interval was 188 cm{sup 3} (24-565 cm{sup 3}) with a substantial overall agreement corrected for chance (mean kappa = 0.71; range: 0.32-0.87). The minimum, maximum, and mean volume of SE (excluding the GTV) were 4, 182, and 58 cm{sup 3} (representing a median of 29% of the GTV volume). The median volume of SE not included in the CTV2cm and in the CTV3cm was 5 and 0.3 cm{sup 3}, respectively. There were 3 large tumors with >30 cm{sup 3} of SE not included in the CTV3cm volume. Conclusion: Despite the fact that SE would empirically seem to be a more subjective volume, a substantial or near-perfect interobserver agreement was observed in SE delineation in most cases with high-grade soft-tissue sarcomas of the extremity. A median of 97% of the consensus SE is within the CTV2cm (99.8% within the CTV3cm). In a minority of cases, however, significant
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Bahig, Houda; Roberge, David; Bosch, Walter; Levin, William; Petersen, Ivy; Haddock, Michael; Freeman, Carolyn; Delaney, Thomas F; Abrams, Ross A; Indelicato, Danny J; Baldini, Elizabeth H; Hitchcock, Ying; Kirsch, David G; Kozak, Kevin R; Wolfson, Aaron; Wang, Dian
2013-06-01
Peritumoral edema may harbor sarcoma cells. The extent of suspicious edema (SE) included in the treatment volume is subject to clinical judgment, balancing the risk of missing tumor cells with excess toxicity. Our goal was to determine variability in SE delineation by sarcoma radiation oncologists (RO). Twelve expert ROs were provided with T1 gadolinium and T2-weighted MR images of 10 patients with high-grade extremity soft-tissue sarcoma. Gross tumor volume, clinical target volume (CTV)3cm (3 cm longitudinal and 1.5 cm radial margin), and CTV2cm (2 cm longitudinal and 1 cm radial margin) were contoured by a single observer. Suspicious peritumoral edema, defined as abnormal signal on T2 images, was independently delineated by all 12 ROs. Contouring agreement was analyzed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. The mean volumes of GTV, CTV2cm, and CTV3cm were, respectively, 130 cm(3) (7-413 cm(3)), 280 cm(3) and 360 cm(3). The mean consensus volume computed using the STAPLE algorithm at 95% confidence interval was 188 cm(3) (24-565 cm(3)) with a substantial overall agreement corrected for chance (mean kappa = 0.71; range: 0.32-0.87). The minimum, maximum, and mean volume of SE (excluding the GTV) were 4, 182, and 58 cm(3) (representing a median of 29% of the GTV volume). The median volume of SE not included in the CTV2cm and in the CTV3cm was 5 and 0.3 cm(3), respectively. There were 3 large tumors with >30 cm(3) of SE not included in the CTV3cm volume. Despite the fact that SE would empirically seem to be a more subjective volume, a substantial or near-perfect interobserver agreement was observed in SE delineation in most cases with high-grade soft-tissue sarcomas of the extremity. A median of 97% of the consensus SE is within the CTV2cm (99.8% within the CTV3cm). In a minority of cases, however, significant expansion of the CTVs is required to cover SE. Copyright © 2013 Elsevier Inc. All rights
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International Nuclear Information System (INIS)
Bahig, Houda; Roberge, David; Bosch, Walter; Levin, William; Petersen, Ivy; Haddock, Michael; Freeman, Carolyn; DeLaney, Thomas F.; Abrams, Ross A.; Indelicato, Danny J.; Baldini, Elizabeth H.; Hitchcock, Ying; Kirsch, David G.; Kozak, Kevin R.; Wolfson, Aaron
2013-01-01
Purpose: Peritumoral edema may harbor sarcoma cells. The extent of suspicious edema (SE) included in the treatment volume is subject to clinical judgment, balancing the risk of missing tumor cells with excess toxicity. Our goal was to determine variability in SE delineation by sarcoma radiation oncologists (RO). Methods and Materials: Twelve expert ROs were provided with T1 gadolinium and T2-weighted MR images of 10 patients with high-grade extremity soft-tissue sarcoma. Gross tumor volume, clinical target volume (CTV)3cm (3 cm longitudinal and 1.5 cm radial margin), and CTV2cm (2 cm longitudinal and 1 cm radial margin) were contoured by a single observer. Suspicious peritumoral edema, defined as abnormal signal on T2 images, was independently delineated by all 12 ROs. Contouring agreement was analyzed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: The mean volumes of GTV, CTV2cm, and CTV3cm were, respectively, 130 cm 3 (7-413 cm 3 ), 280 cm 3 and 360 cm 3 . The mean consensus volume computed using the STAPLE algorithm at 95% confidence interval was 188 cm 3 (24-565 cm 3 ) with a substantial overall agreement corrected for chance (mean kappa = 0.71; range: 0.32-0.87). The minimum, maximum, and mean volume of SE (excluding the GTV) were 4, 182, and 58 cm 3 (representing a median of 29% of the GTV volume). The median volume of SE not included in the CTV2cm and in the CTV3cm was 5 and 0.3 cm 3 , respectively. There were 3 large tumors with >30 cm 3 of SE not included in the CTV3cm volume. Conclusion: Despite the fact that SE would empirically seem to be a more subjective volume, a substantial or near-perfect interobserver agreement was observed in SE delineation in most cases with high-grade soft-tissue sarcomas of the extremity. A median of 97% of the consensus SE is within the CTV2cm (99.8% within the CTV3cm). In a minority of cases, however, significant expansion of the CTVs is required to cover SE
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Hahn, Erin E; Munoz-Plaza, Corrine; Wang, Jianjin; Garcia Delgadillo, Jazmine; Schottinger, Joanne E; Mittman, Brian S; Gould, Michael K
2017-01-01
Breast cancer offers several opportunities for reducing use of ineffective practices based on American Society of Clinical Oncology guidelines. We assessed oncologist-perceived factors associated with use of one such practice-serum tumor markers for post-treatment breast cancer surveillance-focusing on medical oncologists with high, medium, or low test use. Using a mixed-methods design, we identified patients who had been treated for early-stage breast cancer diagnosed between January 1, 2009, and December 31, 2012, within Kaiser Permanente Southern California and calculated the number of tests ordered from January 1, 2010, to December 31, 2014. We identified oncologists with high, medium, or low use and subsequently performed semistructured interviews. We used patient satisfaction data to assess association between pattern of use and satisfaction score. We identified 7,363 patients, with 40,114 tests ordered. High-use oncologists were defined as those ordering at least one test annually for 35% of patients or more, low-use oncologists as those ordering at least one test for 5% of patients or less; 42% of oncologists were high, 27% low, and 31% medium users. We interviewed 17 oncologists: six high, eight low, and three medium users. Factors associated with high use included: perceived patient anxiety, oncologist anxiety, belief that there was nothing else to offer, concern about satisfaction, patient competition, peer use, and system barriers. Factors associated with low use included: beliefs about consequences (eg, causes harms) and medical center culture (eg, collective decision to follow guidelines). We found no association between satisfaction score and pattern of use. Barriers to deimplementation are numerous and complex. Traditional strategies of practice change alone are unlikely to be effective. Multifaceted, multilevel strategies deployed to address patient-, clinician-, and system-related barriers may be required.
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Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans
Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.
2015-01-01
Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…
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Jena, R
2014-04-01
11 years ago, the European Network for Light Ion Therapy (ENLIGHT) was established as a multidisciplinary network of engineers, physicists and clinicians with a common interest in the development of hadron therapy in Europe. ENLIGHT is coordinated from the European Centre for Nuclear Research (CERN), the home of the Large Hadron Collider. The network has evolved into a mature platform for research, with more than 100 researchers working in CERN and its allied research centres. One of the benefits of hosting this network at CERN is the ability to translate hardware and software developments, originally developed in the High Energy Physics domain, into clinical applications. From the perspective of a clinical radiation oncologist within the network, this commentary reviews the ways in which leading edge technological developments in detectors and solid state physics, Monte-Carlo simulation, grid computing and accelerator design have trickled down into real-world clinical applications.
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Understanding Korean food culture from Korean paintings
Hae Kyung Chung; Kyung Rhan Chung; Hung Ju Kim
2016-01-01
Background: In Korea, there are many traditional foods that have developed along with the country's rich history. In addition, various food cultures have developed through agricultural traditions, ritual ceremonies, and the sharing of affection. Paintings, works of calligraphy, and music demonstrate some of these cultural characteristics of Korean foods. Further research and analysis of Korean food culture using these data sources is currently underway. Methods: This paper focuses on the c...
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Directory of Open Access Journals (Sweden)
Alex Broom
Full Text Available Medical oncology is a steadily evolving field of medical practice and professional pathway for doctors, offering value, opportunity and challenge to those who chose this medical specialty. This study examines the experiences of a group of Australian medical oncologists, with an emphasis on their professional practice, career experiences, and existing and emerging challenges across career stages.In-depth qualitative interviews were conducted with 22 medical oncologists, including advanced trainees, early-career consultants and senior consultants, focusing on: professional values and experiences; career prospects and pathways; and, the nexus of the characteristics of the profession and delivery of care.The following themes were emergent from the interviews: the need for professional reinvention and the pressure to perform; the importance, and often absence, of mentoring and feedback loops; the emotional labour of oncology; and, the impact of cascading workload volume on practice sustainability.Understanding professional experiences, career trajectories and challenges at the workforce level are crucial for understanding what drives the oncological care day-to-day. The results indicate that there are considerable potential tensions between the realities of professional, workforce demands and expectations for patient care. Such tensions have real and significant consequences on individual medical oncologists with respect to their futures, aspirations, satisfaction with work, caring practices, interactions with patients and potentially therapeutic outcomes.
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Construction of Korean female voxel phantom and its application to dosimetry
Energy Technology Data Exchange (ETDEWEB)
Lee, Choon Ik
2001-08-15
A Korean female voxel phantom was constructed to overcome the limitations of anatomical description of the existing MRD-type mathematical anthropomorphic phantom and the example dose calculations were carried out for the radiation protection by using it. This whole body voxel phantom was based on the MRIs of the Korean adult female who falls into the reference Korean female group. The cross sectional human pictures from VHP of NLM was adopted for the modification and compensation of the missing MRIs of Korean adult female that include legs below upper thighs. From the gastrointestinal and respiratory organ which make obscure organ edges because of their continuing motion, the general anatomical knowledge were applied for the segmentation process. The Korean female whole body voxel phantom named in HYWOMAN is composed of 1,392,400 voxels that have width x length x height of 4mm x 4mm x 8mm for each with the total of 20 organs identified. With MDNP4B code the tissue equivalent doses were calculated for the four different energies of 0.4, 0.8, 2 and 8 MeV broad parallel gamma beam in AP, PA, LLAT and RLAT directions. The tissue equivalent doses were compared with those of ORNL adult female phantom under the same irradiation conditions. Despite of the small organ differences there could be found the considerable differences in tissue equivalent doses for some organs including thyroid, esophagus, kidneys and spleen. The cause of these discrepancies were proved to be the position of the organs in the phantom and the consequent shielding effects. With the methodology of this study, Korean reference male and female age-grouped voxel phantoms can be constructed and consequently the dosimetry system for typical Korean people is to be established.
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Construction of Korean female voxel phantom and its application to dosimetry
International Nuclear Information System (INIS)
Lee, Choon Ik
2001-08-01
A Korean female voxel phantom was constructed to overcome the limitations of anatomical description of the existing MRD-type mathematical anthropomorphic phantom and the example dose calculations were carried out for the radiation protection by using it. This whole body voxel phantom was based on the MRIs of the Korean adult female who falls into the reference Korean female group. The cross sectional human pictures from VHP of NLM was adopted for the modification and compensation of the missing MRIs of Korean adult female that include legs below upper thighs. From the gastrointestinal and respiratory organ which make obscure organ edges because of their continuing motion, the general anatomical knowledge were applied for the segmentation process. The Korean female whole body voxel phantom named in HYWOMAN is composed of 1,392,400 voxels that have width x length x height of 4mm x 4mm x 8mm for each with the total of 20 organs identified. With MDNP4B code the tissue equivalent doses were calculated for the four different energies of 0.4, 0.8, 2 and 8 MeV broad parallel gamma beam in AP, PA, LLAT and RLAT directions. The tissue equivalent doses were compared with those of ORNL adult female phantom under the same irradiation conditions. Despite of the small organ differences there could be found the considerable differences in tissue equivalent doses for some organs including thyroid, esophagus, kidneys and spleen. The cause of these discrepancies were proved to be the position of the organs in the phantom and the consequent shielding effects. With the methodology of this study, Korean reference male and female age-grouped voxel phantoms can be constructed and consequently the dosimetry system for typical Korean people is to be established
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Energy Technology Data Exchange (ETDEWEB)
Lin, Chun Chieh, E-mail: anna.lin@cancer.org [American Cancer Society, Atlanta, Georgia (United States); Bruinooge, Suanna S.; Kirkwood, M. Kelsey [American Society of Clinical Oncology, Alexandria, Virginia (United States); Hershman, Dawn L. [Columbia University Medical Center, New York, New York (United States); Jemal, Ahmedin [American Cancer Society, Atlanta, Georgia (United States); Guadagnolo, B. Ashleigh [MD Anderson Cancer Center, Houston, Texas (United States); Yu, James B. [Yale University School of Medicine, New Haven, Connecticut (United States); Hopkins, Shane [William R. Bliss Cancer Center, Ames, Iowa (United States); Goldstein, Michael [Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Bajorin, Dean [Memorial Sloan Kettering Cancer Center, New York, New York (United States); Giordano, Sharon H. [MD Anderson Cancer Center, Houston, Texas (United States); Kosty, Michael [Scripps Clinic, San Diego, California (United States); Arnone, Anna [American Society for Radiation Oncology, Fairfax, Virginia (United States); Hanley, Amy [American Society of Clinical Oncology, Alexandria, Virginia (United States); Stevens, Stephanie [American Society for Radiation Oncology, Fairfax, Virginia (United States); Olsen, Christine [Massachusetts General Hospital, Boston, Massachusetts (United States)
2016-03-15
Purpose: Trimodality therapy (chemoradiation and surgery) is the standard of care for stage II/III rectal cancer but nearly one third of patients do not receive radiation therapy (RT). We examined the relationship between the density of radiation oncologists and the travel distance to receipt of RT. Methods and Materials: A retrospective study based on the National Cancer Data Base identified 26,845 patients aged 18 to 80 years with stage II/III rectal cancer diagnosed from 2007 to 2010. Radiation oncologists were identified through the Physician Compare dataset. Generalized estimating equations clustering by hospital service area was used to examine the association between geographic access and receipt of RT, controlling for patient sociodemographic and clinical characteristics. Results: Of the 26,845 patients, 70% received RT within 180 days of diagnosis or within 90 days of surgery. Compared with a travel distance of <12.5 miles, patients diagnosed at a reporting facility who traveled ≥50 miles had a decreased likelihood of receipt of RT (50-249 miles, adjusted odds ratio 0.75, P<.001; ≥250 miles, adjusted odds ratio 0.46; P=.002), all else being equal. The density level of radiation oncologists was not significantly associated with the receipt of RT. Patients who were female, nonwhite, and aged ≥50 years and had comorbidities were less likely to receive RT (P<.05). Patients who were uninsured but self-paid for their medical services, initially diagnosed elsewhere but treated at a reporting facility, and resided in Midwest had an increased the likelihood of receipt of RT (P<.05). Conclusions: An increased travel burden was associated with a decreased likelihood of receiving RT for patients with stage II/III rectal cancer, all else being equal; however, radiation oncologist density was not. Further research of geographic access and establishing transportation assistance programs or lodging services for patients with an unmet need might help decrease
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International Nuclear Information System (INIS)
Lin, Chun Chieh; Bruinooge, Suanna S.; Kirkwood, M. Kelsey; Hershman, Dawn L.; Jemal, Ahmedin; Guadagnolo, B. Ashleigh; Yu, James B.; Hopkins, Shane; Goldstein, Michael; Bajorin, Dean; Giordano, Sharon H.; Kosty, Michael; Arnone, Anna; Hanley, Amy; Stevens, Stephanie; Olsen, Christine
2016-01-01
Purpose: Trimodality therapy (chemoradiation and surgery) is the standard of care for stage II/III rectal cancer but nearly one third of patients do not receive radiation therapy (RT). We examined the relationship between the density of radiation oncologists and the travel distance to receipt of RT. Methods and Materials: A retrospective study based on the National Cancer Data Base identified 26,845 patients aged 18 to 80 years with stage II/III rectal cancer diagnosed from 2007 to 2010. Radiation oncologists were identified through the Physician Compare dataset. Generalized estimating equations clustering by hospital service area was used to examine the association between geographic access and receipt of RT, controlling for patient sociodemographic and clinical characteristics. Results: Of the 26,845 patients, 70% received RT within 180 days of diagnosis or within 90 days of surgery. Compared with a travel distance of <12.5 miles, patients diagnosed at a reporting facility who traveled ≥50 miles had a decreased likelihood of receipt of RT (50-249 miles, adjusted odds ratio 0.75, P<.001; ≥250 miles, adjusted odds ratio 0.46; P=.002), all else being equal. The density level of radiation oncologists was not significantly associated with the receipt of RT. Patients who were female, nonwhite, and aged ≥50 years and had comorbidities were less likely to receive RT (P<.05). Patients who were uninsured but self-paid for their medical services, initially diagnosed elsewhere but treated at a reporting facility, and resided in Midwest had an increased the likelihood of receipt of RT (P<.05). Conclusions: An increased travel burden was associated with a decreased likelihood of receiving RT for patients with stage II/III rectal cancer, all else being equal; however, radiation oncologist density was not. Further research of geographic access and establishing transportation assistance programs or lodging services for patients with an unmet need might help decrease
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The reality of economics for oncologists.
Taylor, David
2017-06-01
This article outlines the historical development of health economics and its present role in oncology related health technology assessments (HTAs). Despite concerns about the prices and immediate costs of new anticancer medicines for indications such as breast cancer overall spending on such treatments is affordable and offers long term value for money in countries such as the US, Canada and those of Western Europe. Oncologists wishing to protect the interests of current and future patients with both advanced and earlier stage cancers may be regarded as having a responsibility to understand the nature of health economic evaluations, and to be actively involved in decisions affecting access to current treatments and future levels of investment in incrementally improving therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun
2016-01-01
We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (PKaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.
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Koreans in Japan: Their Influence on Korean-Japanese Relations.
1979-09-01
1963. 31. The Republic of Korea National Red Cross, The Dispersed Families in Korea, Seoul, 1977. 32. Sato , Shoki, Koreans in Japan - The...1975. 34. Sumiya, Mikio , Kankoku no Keizai (The Korean Economy), Iwanami Shoten, Tokyo, Japan, 1974. 35. U.S. Government Printing Office, U.S. Army Area
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Target volume definition in radiation oncology
Grosu, Anca-Ligia
2015-01-01
The main objective of this book is to provide radiation oncologists with a clear, up-to-date guide to tumor delineation and contouring of organs at risk. With this in mind, a detailed overview of recent advances in imaging for radiation treatment planning is presented. Novel concepts for target volume delineation are explained, taking into account the innovations in imaging technology. Special attention is paid to the role of the newer imaging modalities, such as positron emission tomography and diffusion and perfusion magnetic resonance imaging. All of the most important tumor entities treate
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Nitzsche, Anika; Neumann, Melanie; Groß, Sophie E; Ansmann, Lena; Pfaff, Holger; Baumann, Walter; Wirtz, Markus; Schmitz, Stephan; Ernstmann, Nicole
2017-04-01
Hematologists and oncologists in private practice play a central role in the care provided for cancer patients. The present study analyzes stress and relaxation aspects in the work of hematologists and oncologists in private practice in Germany in relation to emotional exhaustion, as a core dimension of burnout syndrome. The study focuses on the opportunities for internal recovery using breaks and time out during the working day, the frequency of working on weekends and on vacation, and the physician's work-home and home-work conflict. Postulated associations between the constructs were analyzed using a structural equation model. If work leads to conflicts in private life (work-home conflict), it is associated with greater emotional exhaustion. Working frequently at the weekend is associated with greater work-home conflict and indirectly with greater emotional exhaustion. By contrast, the availability of opportunities to relax and recover during the working day is associated with less work-home conflict and indirectly with less emotional exhaustion. These results underline the importance of internal recovery opportunities during the working day and a successful interplay between working and private life for the health of outpatient hematologists and oncologists.
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A Comparison of Adaptation to Childhood Disability in Korean Immigrant and Korean Mothers.
Cho, Su-Je; Singer, George H. S.; Brenner, Betsy (Mary)
2003-01-01
A study examined the variables that exacerbated or buffered the impact of child problem behaviors and/or physical differences on 16 Korean mothers and 16 Korean American mothers of children with disabilities. Overall findings from data analyses were consistent with qualitative findings that Korean mothers experienced more difficulties than their…
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Pediatric oncologist willingness to offer germline TP53 testing in osteosarcoma.
Shaul, Eliana; Roth, Michael; Lo, Yungtai; Geller, David S; Hoang, Bang; Yang, Rui; Malkin, David; Gorlick, Richard; Gill, Jonathan
2018-03-15
Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by mutations in the tumor-suppressor gene TP53. Osteosarcoma is a sentinel cancer in LFS. Prior studies using Sanger sequencing platforms have demonstrated that 3% of individuals with osteosarcoma harbor a mutation in TP53. New data from next-generation sequencing have demonstrated that 3.8% of patients with osteosarcoma have a known pathogenic variant, and an additional 5.7% carry exonic variants of unknown significance in TP53. Pediatric oncologists were e-mailed an anonymous 18-question survey assessing their willingness to offer TP53 germline testing to a child with osteosarcoma with or without a family history, and they were evaluated for changes in their choices with the prior data and the new data. One hundred seventy-seven pediatric oncologists (22%) responded to the survey. Respondents were more likely to offer TP53 testing to a patient with a positive family history (77.4% vs 12.4%; P offer TP53 testing once they were provided with the new data (25.4% vs 12.4%; P = .0038). The proportion of providers who responded that they were unsure increased significantly when they were presented with the new data (25.4% vs 10.2%; P = .0002). Potential implications for other family members and the possibility that surveillance imaging would detect new malignancies at an earlier stage were important factors influencing a provider's decision to offer TP53 testing. Recent data increase the proportion of providers willing to offer testing, and this suggests concern on the part of pediatric oncologists that variants of unknown significance may be disease-defining in rare cancers. Cancer 2018;124:1242-50. © 2018 American Cancer Society. © 2018 American Cancer Society.
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Key diagnostic information for the oncologist
International Nuclear Information System (INIS)
Zlatareva, D.
2012-01-01
Full text: The radiologists use many modalities for imaging of oncologic patients. In order to get the most out of these imaging studies oncologist have to provide with precise information: what is the working diagnosis, what treatment the patients has had and what is the clinical question should be answered by imaging study. The main indications for imaging are confirmation of diagnosis, evaluation of the patient for surgery or assessment of response to the therapy. These will influence the choice of the test, the protocol and interpretation of the results. Imaging plays a vital role in the management of patients with cancer. It is important not only for diagnosis, indicating sites of abnormality, and guiding biopsies, but it is also crucial in assessing disease extent and thereby determining treatment. The stage of cancer at the time of diagnosis is a key factor to define prognosis and is important element in determining appropriate treatment. The most clinically used cancer staging system is tumor node metastasis (TNM). Stage is determined from information on the tumor, regional nodes, and metastases and by grouping cases with similar prognosis. The criteria for defining anatomic extent of disease are specific for tumors at different anatomic sites and of different histologic types. Therefore, the criteria for T, N and M are defined separately for each tumor and histologic type. For Hodgkin and other lymphomas, a different system for the extent of disease and prognosis is used. It is mandatory for the radiologist to learn TNM system to provide the oncologist with key diagnostic information. Learning objectives: To understand TNM staging system for the most common malignancies To review the changes from the sixth to the seven edition of the American Joint committee on cancer staging manual To describe diagnostic information provided by CT and MRI in preoperative planning and after therapy To discuss the role of PET/CT imaging in oncology
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Granek, Leeat; Nakash, Ora; Cohen, Michal; Ben-David, Merav; Ariad, Samuel
2017-11-01
Oncologists must communicate effectively with patients and their families about end of life (EOL). Despite the importance of communicating on this topic, many oncologists avoid these conversations. The objective of this study was to examine the associations between secondary traumatic stress and compassion satisfaction and approach and avoidant communication about EOL with cancer patients. A convenience sample of 79 oncologists (n = 27 men, n = 52 women) participated in the study. Oncologists completed a survey that included a sociodemographic and clinical information questionnaire, the Professional Quality of Life Scale, and Communication about End of Life Survey. To examine the effect of secondary traumatic stress and compassion satisfaction on approach and avoidant communication, while controlling for gender and age, 2 hierarchical linear regression analyses were computed. Oncologists reported high levels of secondary traumatic stress and high compassion satisfaction. Scores on the approach and avoidant communication scales were in the mid-range of the scale. Lower reports of secondary traumatic stress and higher compassion satisfaction were associated with higher approach communication strategies: however, only higher secondary traumatic stress was associated with higher avoidant communication strategies. Our findings indicate that there is an association between emotional factors and approach communication. The findings have clinical implications in designing effective communication skills training. Further research and training should take secondary traumatic stress and compassion satisfaction into consideration to be able to ensure that terminal patients and their families receive the best quality EOL care. Copyright © 2016 John Wiley & Sons, Ltd.
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Alpert, Jordan M; Morris, Bonny B; Thomson, Maria D; Matin, Khalid; Brown, Richard F
2018-03-26
Providing patients with unrestricted access to their electronic medical records through patient portals has impacted patient-provider communication and patients' personal health knowledge. However, little is known about how patient portals are used in oncology. The aim of this study was to understand attitudes of the portal's adoption for oncology and to identify the advantages and disadvantages of using the portal to communicate and view medical information. In-depth semistructured interviews were conducted with 60 participants: 35 patients, 13 oncologists, and 12 medical informaticists. Interviews were recorded, transcribed, and thematically analyzed to identify critical incidents and general attitudes encountered by participants. Two primary themes were discovered: (1) implementation practices influence attitudes, in which the decision-making and execution process of introducing portals throughout the hospital did not include the input of oncologists. Lack of oncologists' involvement led to a lack of knowledge about portal functionality, such as not knowing the time period when test results would be disclosed to patients; (2) perceptions of portals as communication tools varies by user type, meaning that each participant group (patients, oncologists, and medical informaticists) had varied opinions about how the portal should be used to transmit and receive information. Oncologists and medical informaticists had difficulty understanding one another's culture and communication processes in their fields, while patients had preferences for how they would like to receive communication, but it largely depended upon the type of test being disclosed. The majority of patients (54%, 19/35) who participated in this study viewed lab results or scan reports via the portal before being contacted by a clinician. Most were relatively comfortable with this manner of disclosure but still preferred face-to-face or telephone communication. Findings from this study indicate that
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DEFF Research Database (Denmark)
Screen Cultures sets out to redress this imbalance with a broad selection of essays spanning both North and South as well as different methodological approaches, from ethnographic and audience studies to cultural materialist readings. The first section of the book, «The South», highlights popular media...... new approaches to Korean popular culture beyond national borders and includes work on K-pop and Korean television drama. This book is a vital addition to existing scholarship on Korean popular culture, offering a unique view by providing an imaginary unification of the two Koreas negotiated through...
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Prevalence of the burnout syndrome among Brazilian medical oncologists
Directory of Open Access Journals (Sweden)
João Glasberg
2007-02-01
Full Text Available INTRODUCTION: Burnout syndrome which is prevalent among oncologists is characterized by three aspects: emotional exhaustion, depersonalization and low personal accomplishment. The purpose was to evaluate prevalence of the burnout syndrome among Brazilian medical oncologists and the variables that correlate with its presence. METHODS: A survey was conducted with members of the Brazilian Society of Medical Oncology (SBOC who received three questionnaires (general, Maslach burnout questionnaire and an opinion survey mailed to all 458 members. RESULTS: Response rate was of 22.3%. According to the criteria proposed by Grunfeld, which consider burnout present when at least one of the aspects is severely abnormal, prevalence of this syndrome was 68.6% (95% confidence interval, CI: 58.68% to 77.45%. By multivariate analysis having a hobby/physical activity, a religious affiliation, older age, living with a companion and rating vacation time as sufficient were correlated significantly and independently with burnout syndrome. CONCLUSIONS: The burnout syndrome is prevalent among Brazilian oncologists. Oncologists having sufficient personal and social resources to engage in a hobby, physical activity, have enough vacation time and religious activities are at lower risk of developing burnout.INTRODUÇÃO: A Síndrome da Estafa Profissional (SEP é considerada uma doença caracterizada por três componentes básicos: exaustão emocional (EE, despersonalização (DP e reduzida realização pessoal (RP, sendo identificada em oncologistas. OBJETIVO: Analisar a prevalência da SEP entre oncologistas clínicos e possíveis fatores relacionados. MÉTODOS: Foram enviados três questionários (Questionário Geral, Questionário Maslach de Burnout e Questionário de Opinião para 458 cancerologistas cadastrados na Sociedade Brasileira de Oncologia Clínica (SBOC. RESULTADOS: A taxa de resposta foi de 20%. 43,3% dos entrevistados demonstraram nível baixo de EE, 57
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Huang, Yongyuan
2018-04-01
The modern education institutes play an important role in fostering professional talents, reproducing knowledge and studies, and forming the identities of certain academic fields and vocational communities. It is a matter of common knowledge that the absence of an official Korean medicine medical school during the Japanese colonial era was a severely disadvantageous factor in the aspects of academic progress, fostering follow-up personnel, and establishment of social capability. Therefore, the then Korean medicine circle put emphasis on inadequate official education institutes as the main factor behind oppression. Furthermore, as the measure to promote the continuance of Korean medicine, the circle regarded establishing civilian Korean medicine training schools as their long-cherished wish and strived to accomplish the mission even after liberation. This study looked into how the Korean medicine circle during the Japanese colonial era utilized civilian training schools to conduct the Korean medicine education conforming to modern medical school and examined how the operation of these training schools influenced the changes in the traditional Korean medicine. After the introduction of the Western medical science, the Korean medicine circle aimed to improve the quality of Korean medicine doctors by establishing modern Korean medicine medical schools. However, after the annexation of Korea and Japan, official Korean medicine medical schools were not established since policies were organized centered on the Western medical science. In this light, the Korean medicine circle strived to nurture the younger generation of Korean medicine by establishing and operating the civilian Korean medicine training schools after the annexation between Korea and Japan. The schools were limited in terms of scale and status but possessed the forms conforming to the modern medical schools in terms of education system. In other words, the civilian training schools not only adhered to the
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Posttreatment follow-up of radiation oncology patients in a managed care environment
International Nuclear Information System (INIS)
Steinberg, Michael L.; Rose, Christopher M.
1996-01-01
Purpose: Health care delivery in the United States is in the midst of a structural revolution called managed care. Demands for cost control within the managed care environment force radiation oncologists to defend the need and obligation to follow their patients. Methods and Materials: We have analyzed this follow-up requirement from six potential justifications: patient care, medical-legal, quality assurance, outcome measurement, cost, and improvement of care. Results: Practical recommendations for discussing the need for follow-up with the medical directors and primary care physicians of managed care entities are given. Follow-up without valid documentation of benefit is hard to justify in this era of managed care. Conclusions: Collaborative follow-up between the referring physician, the treating radiation oncologist, and the other oncologic specialists will allow for outcome measurement and improvement in practice without driving up cost or exposing the patient to undue risk.
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International Nuclear Information System (INIS)
Mitchell, J.S.; Hlasivec, Z.
1984-01-01
It is generally accepted that the clinical radiotherapeutic oncologist must be a well educated doctor, with wide knowledge and experience, able to deal with the many difficult problems that can arise in connection with radiotherapy, curative, palliative or prophylactic. The management, treatment and care of the individual patient with malignant disease is a major task of medicine, requiring up-to-date knowledge in a number of rapidly advancing fields. To be efficient, it is essential for the clinical radiation oncologist to continue his education throughout his life, by reading the literature, attending lectures, conferences and advanced 'refresher' courses, and by visiting other centres. The clinical radiation oncologist will discover that it is wise, where at all possible, to spend a proportion of his time working with other specialists on clinical trials and research, with formal publication of the results. The disciplines of such work will deepen his understanding, not only of his own speciality, but of the whole field of oncology, and will further co-operation between the many different specialists on whose combined efforts the cure of each individual patient and the advances in the treatment of cancer must ultimately depend
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International Nuclear Information System (INIS)
Lambert, Carole; Gagnon, Robert; Nguyen, David; Charlin, Bernard
2009-01-01
The Script Concordance test (SCT) is a reliable and valid tool to evaluate clinical reasoning in complex situations where experts' opinions may be divided. Scores reflect the degree of concordance between the performance of examinees and that of a reference panel of experienced physicians. The purpose of this study is to demonstrate SCT's usefulness in radiation oncology. A 90 items radiation oncology SCT was administered to 155 participants. Three levels of experience were tested: medical students (n = 70), radiation oncology residents (n = 38) and radiation oncologists (n = 47). Statistical tests were performed to assess reliability and to document validity. After item optimization, the test comprised 30 cases and 70 questions. Cronbach alpha was 0.90. Mean scores were 51.62 (± 8.19) for students, 71.20 (± 9.45) for residents and 76.67 (± 6.14) for radiation oncologists. The difference between the three groups was statistically significant when compared by the Kruskall-Wallis test (p < 0.001). The SCT is reliable and useful to discriminate among participants according to their level of experience in radiation oncology. It appears as a useful tool to document the progression of reasoning during residency training
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Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists.
Whippen, D A; Canellos, G P
1991-10-01
Burnout, the end result of stress, can occur in any profession. We set out to determine the extent of burnout among a representative group of American oncologists. A questionnaire with 12 specific points was designed and prepared by the authors. It was mailed to 1,000 randomly selected physician subscribers to the Journal of Clinical Oncology. Five hundred ninety-eight completed surveys (60%) were returned before the cut-off date and included in the analysis. Overall, 56% of the respondents reported experiencing burnout in their professional life. No significance was found between the incidence of burnout and specialty within oncology, year medical training ended, or practice location. Significance was found, however, between type of practice and the incidence of burnout; institution- or university-based oncologists reported a lower incidence of burnout (47%) versus all other types of practice (66% burnout rate for oncology plus internal medicine, 63% for private adult oncology only, 39% for pediatric oncologists [there were too few pediatric oncologists for this rate to be significant], and 64% for others; P = .0003). Frustration or a sense of failure was the most frequently chosen (56%) description of burnout, and insufficient personal and/or vacation time was the most frequent reason (57%) chosen to explain the existence of burnout. To alleviate burnout, the majority (69%) of respondents indicated the need for more vacation or personal time. Administering palliative or terminal care, reimbursement issues, and a heavy work load were identified as contributing factors to burnout. Given the high response to the questionnaire and a 56% incidence of burnout in the surveyed population, it is concluded that further research on this issue is required.
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Radiation therapy in the treatment of cancer of the cervix
International Nuclear Information System (INIS)
Brown, G.S.
1987-01-01
The success of radiotherapy in dealing with cancer of the cervix lies in the understanding of its natural history and staging as well as the major forms of treatment. It is, therefore, imperative that all gynecological and radiation oncologists have at their command a thorough understanding of carcinoma of the cervix
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Rêgo, Juliana Florinda M; Lopes, Gilberto; Riechelmann, Rachel P; Sternberg, Cinthya; Ferrari, Claudio; Fernandes, Gustavo
2017-01-01
Patients who are treating cancer have often used alternative therapies. In the internet era, information can be broadcasted widely, and this happened with phosphoethanolamine in Brazil, where this substance was claimed by the population to be the "cure for cancer." This is a cross-sectional study developed by the Brazilian Society of Clinical Oncology (SBOC). An objectively structured questionnaire was sent by e-mail and SMS to active MDs members of the SBOC. Descriptive statistics was used to evaluate the data. Statistical significance between the variables was tested by Pearson's Chi-squared test (p<0.05 was considered significance). The survey was sent to 1,072 oncologists, and 398 (37.1%) answered at least part of it. One hundred and fifteen (28.9%) had followed patients who had used phosphoethanolamine. Among these, 14 (12.2%) observed adverse events and four (3.5%) attributed clinical benefit to the substance. Most of the oncologists (n=331; 83.2%) believe that it should only be used as part of a clinical trial protocol. Most physicians did not recommend this drug to their patients (n=311; 78.1%). Oncologists in Southeast, South and Midwest Brazil were more likely to have patients taking the drug compared to the Northern and Northeastern regions. This is the first survey to assess the opinion and experience of oncologists about this alternative therapy. Most oncologists in Brazil do not believe that synthetic phosphoethanolamine is active in cancer treatment, do not recommend its use without proper evaluation, and state that it should only be available to patients in the context of clinical trials.
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Epstein, Ronald M.; Duberstein, Paul R.; Fenton, Joshua J.; Fiscella, Kevin; Hoerger, Michael; Tancredi, Daniel J.; Xing, Guibo; Gramling, Robert; Mohile, Supriya; Franks, Peter; Kaesberg, Paul; Plumb, Sandy; Cipri, Camille S.; Street, Richard L.; Shields, Cleveland G.; Back, Anthony L.; Butow, Phyllis; Walczak, Adam; Tattersall, Martin; Venuti, Alison; Sullivan, Peter; Robinson, Mark; Hoh, Beth; Lewis, Linda; Kravitz, Richard L.
2018-01-01
IMPORTANCE Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. OBJECTIVE To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life. DESIGN, SETTING, AND PARTICIPANTS Cluster RCT at community- and hospital-based cancer clinics in Western New York and Northern California; 38 medical oncologists (mean age 44.6 years; 11 (29%) female) and 265 community-dwelling adult patients with advanced nonhematologic cancer participated (mean age, 64.4 years, 146 [55.0%] female, 235 [89%] white; enrolled August 2012 to June 2014; followed for 3 years); 194 patients had participating caregivers. INTERVENTIONS Oncologists received individualized communication training using standardized patient instructors while patients received question prompt lists and individualized communication coaching to identify issues to address during an upcoming oncologist visit. Both interventions focused on engaging patients in consultations, responding to emotions, informing patients about prognosis and treatment choices, and balanced framing of information. Control participants received no training. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was a composite measure of patient-centered communication coded from audio recordings of the first oncologist visit following patient coaching (intervention group) or enrollment (control). Secondary outcomes included the patient-physician relationship, shared understanding of prognosis, QOL, and aggressive treatments and hospice use in the last 30 days of life. RESULTS Data from 38 oncologists (19 randomized
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Medical legal aspects of radiation oncology
International Nuclear Information System (INIS)
Wall, Terry J.
1996-01-01
The theoretical basis of, and practical experience in, legal liability in the clinical practice of radiation oncology is reviewed, with a view to developing suggestions to help practitioners limit their exposure to liability. New information regarding the number, size, and legal theories of litigation against radiation oncologists is presented. The most common legal bases of liability are then explored in greater detail, including 'malpractice', and informed consent, with suggestions of improving the specialty's record of documenting informed consent. Collateral consequences of suffering a malpractice claim (i.e., the National Practitioner Data Bank) will also be briefly discussed
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IMRT for adjuvant radiation in gastric cancer: A preferred plan?
International Nuclear Information System (INIS)
Ringash, Jolie; Perkins, Greg; Brierley, James; Lockwood, Gina; Islam, Mohammad; Catton, Pamela; Cummings, Bernard; Kim, John; Wong, Rebecca; Dawson, Laura
2005-01-01
Purpose: To assess the potential advantage of intensity-modulated radiotherapy (IMRT) over conformal planning for postoperative adjuvant radiotherapy in patients with gastric carcinoma. Methods and Materials: Twenty patients who had undergone treatment planning with conformal beam arrangements for 4500 cGy adjuvant radiotherapy between 2000 and 2001 underwent repeat planning using IMRT techniques. Conformal five-field plans were compared with seven- to nine-field coplanar sliding-window IMRT plans. For each patient, the cumulative dose-volume histograms and organ-dose summaries (without distributions or digitally reconstructed radiographs) were provided to two independent, 'blinded' GI radiation oncologists. The oncologists indicated which plan provided better planning target volume coverage and critical organ sparing, any safety concerns with either plan, and which plan they would choose to treat the patient. Results: In 18 (90%) of 20 cases, both oncologists chose the same plan. Cases with disagreement were given to a third 'blinded' reviewer. A 'preferred plan' could be determined in 19 (95%) of 20 cases. IMRT was preferred in 17 (89%) of 19 cases. In 4 (20%) of 20 IMRT plans at least one radiation oncologist had safety concerns because of the spinal cord dose (3 cases) or small bowel dose (2 cases). Of 42 ratings, IMRT was thought to provide better planning target volume coverage in 36 (86%) and better sparing of the spinal cord in 31 (74%) of 42, kidneys in 29 (69%), liver in 30 (71%), and heart in 29 (69%) of 42 ratings. The median underdose volume (1.7 vs. 4.1 cm 3 ), maximal dose to the spinal cord (36.85 vs. 45.65 Gy), and dose to 50% of the liver (17.29 vs. 27.97), heart (12.89 vs. 15.50 Gy), and left kidney (15.50 vs. 16.06 Gy) were lower with IMRT than with the conformal plans. Conclusion: Compared with the conformal plans, oncologists frequently preferred IMRT plans when using dose-volume histogram data. The advantages of IMRT plans include both
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Mailhot Vega, Raymond; Talcott, Wesley; Ishaq, Omar; Cohen, Patrice; Small, Christina J; Duckworth, Tamara; Sarria Bardales, Gustavo; Perez, Carmen A; Schiff, Peter B; Small, William; Harkenrider, Matthew M
Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
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Smartphone Applications for the Clinical Oncologist in UK Practice.
Rozati, Hamoun; Shah, Sonya Pratik; Shah, Neha
2015-06-01
A number of medical smartphone applications have been developed to assist clinical oncology specialists. Concerns have arisen that the information provided may not be under sufficient scrutiny. This study aims to analyse the current applications available for clinical oncologists in the UK. Applications aimed specifically at physician clinical oncologists were searched for on the major smartphone operating systems: Apple iOS; Google Android; Microsoft Windows OS; and Blackberry OS. All applications were installed and analysed. The applications were scrutinised to assess the following information: cost; whether the information included was referenced; when the information was last updated; and whether they made any reference to UK guidelines. A novel rating score based on these criteria was applied to each application. Fifty applications were identified: 24 for Apple's iOS; 23 for Google's Android; 2 for Blackberry OS; and 1 for Windows OS. The categories of applications available were: drug reference; journal reference; learning; clinical calculators; decision support; guidelines; and dictionaries. Journal reference and guideline applications scored highly on our rating system. Drug reference application costs were prohibitive. Learning tools were poorly referenced and not up-to-date. Smartphones provide easy access to information. There are numerous applications devoted to oncology physicians, many of which are free and contain referenced, up-to-date data. The cost and quality of drug reference and learning applications have significant scope for improvement. A regulatory body is needed to ensure the presence of peer-reviewed, validated applications to ensure their reliability.
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Historic Factors Influencing Korean Higher Education. Korean Studies Series, No. 17.
Jeong-kyu, Lee
This book examines the religious and philosophical factors historically affecting Korean higher education, and the characteristics of contemporary Korean higher education in relation to organizational structure, leadership, and organizational culture. The book is organized into 4 parts, with 11 chapters. Part One focuses on identifying the problem…
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Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System
Court, Laurence E.; Kisling, Kelly; McCarroll, Rachel; Zhang, Lifei; Yang, Jinzhong; Simonds, Hannah; du Toit, Monique; Trauernicht, Chris; Burger, Hester; Parkes, Jeannette; Mejia, Mike; Bojador, Maureen; Balter, Peter; Branco, Daniela; Steinmann, Angela; Baltz, Garrett; Gay, Skylar; Anderson, Brian; Cardenas, Carlos; Jhingran, Anuja; Shaitelman, Simona; Bogler, Oliver; Schmeller, Kathleen; Followill, David; Howell, Rebecca; Nelson, Christopher; Peterson, Christine; Beadle, Beth
2018-01-01
The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated arc therapy (VMAT) plans for patients with head/neck cancer and 4-field box plans for patients with cervical cancer. It is a combination of specially developed in-house software that uses an application programming interface to communicate with a commercial radiotherapy treatment planning system. It also interfaces with a commercial secondary dose verification software. The necessary inputs to the system are a Treatment Plan Order, approved by the radiation oncologist, and a simulation computed tomography (CT) image, approved by the radiographer. The RPA then generates a complete radiotherapy treatment plan. For the cervical cancer treatment plans, no additional user intervention is necessary until the plan is complete. For head/neck treatment plans, after the normal tissue and some of the target structures are automatically delineated on the CT image, the radiation oncologist must review the contours, making edits if necessary. They also delineate the gross tumor volume. The RPA then completes the treatment planning process, creating a VMAT plan. Finally, the completed plan must be reviewed by qualified clinical staff. PMID:29708544
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Buckley de Meritens, Alexandre; Margolis, Benjamin; Blinderman, Craig; Prigerson, Holly G; Maciejewski, Paul K; Shen, Megan J; Hou, June Y; Burke, William M; Wright, Jason D; Tergas, Ana I
2017-09-01
We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions. Of the 145 respondents, 71% were attending physicians and 58% worked at an academic medical center. The vast majority (92%) had palliative care services available for consultation at their hospital; 48% thought that palliative care services were appropriately used, 51% thought they were underused, and 1% thought they were overused. Thirty percent of respondents thought that palliative care services should be incorporated at first recurrence, whereas 42% thought palliative care should be incorporated when prognosis for life expectancy is ≤ 6 months. Most participants (75%) responded that palliative care consultation is reasonable for symptom control at any stage of disease. Respondents were most likely to consult palliative care services for pain control (53%) and other symptoms (63%). Eighty-three percent of respondents thought that communicating prognosis is the primary team's responsibility, whereas the responsibilities for pain and symptom control, resuscitation status, and goals of care discussions were split between the primary team only and both teams. The main barrier for consulting palliative care services was the concern that patients and families would feel abandoned by the primary oncologist (73%). Ninety-seven percent of respondents answered that palliative care services are useful to improve patient care. The majority of gynecologic oncologists perceived palliative care as a useful collaboration that is underused. Fear of perceived abandonment by the patient and family members was identified as a
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Improving patient safety in radiation oncology
International Nuclear Information System (INIS)
Hendee, William R.; Herman, Michael G.
2011-01-01
Beginning in the 1990s, and emphasized in 2000 with the release of an Institute of Medicine report, healthcare providers and institutions have dedicated time and resources to reducing errors that impact the safety and well-being of patients. But in January 2010 the first of a series of articles appeared in the New York Times that described errors in radiation oncology that grievously impacted patients. In response, the American Association of Physicists in Medicine and the American Society of Radiation Oncology sponsored a working meeting entitled ''Safety in Radiation Therapy: A Call to Action''. The meeting attracted 400 attendees, including medical physicists, radiation oncologists, medical dosimetrists, radiation therapists, hospital administrators, regulators, and representatives of equipment manufacturers. The meeting was cohosted by 14 organizations in the United States and Canada. The meeting yielded 20 recommendations that provide a pathway to reducing errors and improving patient safety in radiation therapy facilities everywhere.
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Kanagalingam, Jeevendra; Wahid, Mohamed Ibrahim A; Lin, Jin-Ching; Cupino, Nonette A; Liu, Edward; Kang, Jin-Hyoung; Bazarbashi, Shouki; Bender Moreira, Nicole; Arumugam, Harsha; Mueller, Stefan; Moon, Hanlim
2018-07-01
This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management. Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire. Oncologists and patients ranked treatment-induced OM among the three most important toxicities of cancer therapy requiring intervention. The most frequent OM symptoms reported by patients were oral ulcers (74%), dry mouth (73%), and difficulty swallowing (62%). Oncologists expected mild OM symptoms to last slightly longer than 1 week, whereas patients reported mild symptoms for more than 2 weeks. In mild-to-moderate OM, oncologists underestimated patients' pain experience. Overall, only 45% of oncologists said they would initiate OM prophylaxis when cancer therapy started. Of the 87% of patients who said they used their prescribed medications, only 16% reported using prophylactically prescribed medication. While oncologists' concerns related to the delays and interruptions of cancer treatment, patients tended to focus on the effects of OM on eating, drinking, and talking. Oncologists' and patients' perceptions about treatment-induced OM differ. To overcome discordant perspectives, there is a need to raise general awareness and improve proactive management of OM. As noted in recent guidelines, supportive cancer care is critical for ensuring optimal therapy and for improving the patient's experience.
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A comparison of the structure of radiation oncology in the United States and Japan
International Nuclear Information System (INIS)
Owen, Jean B.; Hanks, Gerald E.; Teshima, Teruki; Sato, Shinichiro; Tsunemoto, Hiroshi; Inoue, Toshihiko
1996-01-01
Purpose: The United States and Japan have very different backgrounds in their medical care systems. In the field of radiation oncology, national surveys on structure have been conducted for both countries and compared to illustrate any similarities and differences present from 1989-1990. Methods and Materials: The Patterns of Care Study Facility Survey conducted in 1989 in the United States and the National Survey of Structure in Japan in 1990 were compared to evaluate the equipment pattern, staffing pattern, compliance rate with the 'blue book' (3) guideline, and the geographic distribution of institutions. Results: In the United States, a total of 598,184 (49% of the total of newly diagnosed) patients were treated with radiation therapy. In Japan, 62,829 (approximately 15% of the total of newly diagnosed) patients were treated. The numbers of external megavoltage treatment machines were 2,397 in the United States and 494 in Japan. The numbers of full time equivalent (FTE) radiation oncologists were 2,335 in the United States and 366 in Japan. Only 15% of United States facilities and 11% of Japan facilities complied with the narrow blue book guideline for the patients per FTE radiation oncologist (200-250), while the most common ratio was 151-200 patients/FTE in the United States and 51-100 in Japan. In Japan, more than 60% of institutions were staffed by a part-time radiation oncologist (FTE < 1.0). Between geographic regions, there was variation in the percentage of cancer patients treated with radiation therapy for both the United States (42-56%) and Japan (6-25%). Conclusion: There is a major difference in the usage of radiation therapy for treating cancer between the United States and Japan with 49% of all new cancer patients treated in the United States and approximately 15% treated in Japan. Equipment structure in the United States is more complete than in Japan with important differences in treatment simulators, treatment planning computers, and support
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Aesthetics of Korean foods: The symbol of Korean culture
Directory of Open Access Journals (Sweden)
Hae-Kyung Chung
2016-09-01
Full Text Available Advances in transportation and communication have broken down critical barriers within the global economy, pushing us towards a more unified world. In keeping with this trend, processes of communication, transportation, and production are becoming increasingly standardized, mechanized, and automated. Yet as this global era of uniformity progresses, people and individuals will inevitably encounter identity confusion. Numerous individuals, ethnicities, nationalities, and countries around the world are working to counteract such identity confusion. As globalization progresses, groups and nationalities that fail to preserve their identities will dwindle and become absorbed by stronger entities. Therefore, many societies are investing great efforts into rediscovering and revamping their indigenous traditions, cultures, and customs. When travelers visit another country, one of the simplest avenues for them to experience the local culture is food. Unlike other cultural elements, many of which have become diluted because of globalization, native cuisines are still perceived as retaining the traditions, uniqueness, and diversity of individual cultures. It is more important than ever for people and countries to expand and preserve their respective cultural currencies. In this respect, taking a cultural approach to Korean cuisine is a fascinating and meaningful endeavor. In light of the recent publication of a few articles dealing with the symbolic significance and meaning behind Korean cuisine, an effort to compile a list of the distinctive cultural properties of Korean food seems vital. Furthermore, presenting the aesthetics of Korean food through a method that integrates science and culture is a very significant task. The authors of this paper firmly believe in its potential to advance the globalization of Korean food.
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Korean Variant Archive (KOVA): a reference database of genetic variations in the Korean population.
Lee, Sangmoon; Seo, Jihae; Park, Jinman; Nam, Jae-Yong; Choi, Ahyoung; Ignatius, Jason S; Bjornson, Robert D; Chae, Jong-Hee; Jang, In-Jin; Lee, Sanghyuk; Park, Woong-Yang; Baek, Daehyun; Choi, Murim
2017-06-27
Despite efforts to interrogate human genome variation through large-scale databases, systematic preference toward populations of Caucasian descendants has resulted in unintended reduction of power in studying non-Caucasians. Here we report a compilation of coding variants from 1,055 healthy Korean individuals (KOVA; Korean Variant Archive). The samples were sequenced to a mean depth of 75x, yielding 101 singleton variants per individual. Population genetics analysis demonstrates that the Korean population is a distinct ethnic group comparable to other discrete ethnic groups in Africa and Europe, providing a rationale for such independent genomic datasets. Indeed, KOVA conferred 22.8% increased variant filtering power in addition to Exome Aggregation Consortium (ExAC) when used on Korean exomes. Functional assessment of nonsynonymous variant supported the presence of purifying selection in Koreans. Analysis of copy number variants detected 5.2 deletions and 10.3 amplifications per individual with an increased fraction of novel variants among smaller and rarer copy number variable segments. We also report a list of germline variants that are associated with increased tumor susceptibility. This catalog can function as a critical addition to the pre-existing variant databases in pursuing genetic studies of Korean individuals.
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Cha, Hyejung; Park, Hee Chul; Yu, Jeong Il; Kim, Tae Hyun; Nam, Taek-Keun; Yoon, Sang Min; Yoon, Won Sup; Kim, Jun Won; Kim, Mi Sook; Jang, Hong Seok; Choi, Youngmin; Kim, Jin Hee; Kay, Chul Seung; Jung, Inkyung; Seong, Jinsil
2017-01-01
Purpose The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC). Materials and Methods We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions. Results The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy10 vs. 56.3 Gy10). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT. Conclusion Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival. PMID:27338036
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Energy Technology Data Exchange (ETDEWEB)
Yoon, Yeon Yee E. [Dept. of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seoul (Korea, Republic of); Hong, Yoo Jin; Choi, Eui Young [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others
2015-04-15
The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
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Energy Technology Data Exchange (ETDEWEB)
Yoon, Yeonyee E. [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Hong, Yoo Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kim, Hyung-Kwan [Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Jeong A [Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706 (Korea, Republic of); Na, Jin Oh [Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703 (Korea, Republic of); Yang, Dong Hyun [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736 (Korea, Republic of); Kim, Young Jin [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Choi, Eui-Young [Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)
2014-07-01
Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
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International Nuclear Information System (INIS)
Yoon, Yeon Yee E.; Hong, Yoo Jin; Choi, Eui Young
2015-01-01
The use of cardiac magnetic resonance (CMR) imaging is increasing for the assessment of certain cardiovascular diseases, due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there has been no guideline for the use of CMR in Korean people. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates, and patients to improve the overall performances in medical system. By addressing CMR usage and creating these guidelines, we hope to contribute to the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
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Non-physician practitioners in radiation oncology: advanced practice nurses and physician assistants
International Nuclear Information System (INIS)
Kelvin, Joanne Frankel; Moore-Higgs, Giselle J.; Maher, Karen E.; Dubey, Ajay K.; Austin-Seymour, Mary M.; Daly, Nancy Riese; Mendenhall, Nancy Price; Kuehn, Eric F.
1999-01-01
Purpose: With changes in reimbursement and a decrease in the number of residents, there is a need to explore new ways of achieving high quality patient care in radiation oncology. One mechanism is the implementation of non-physician practitioner roles, such as the advanced practice nurse (APN) and physician assistant (PA). This paper provides information for radiation oncologists and nurses making decisions about: (1) whether or not APNs or PAs are appropriate for their practice, (2) which type of provider would be most effective, and (3) how best to implement this role. Methods: Review of the literature and personal perspective. Conclusions: Specific issues addressed regarding APN and PA roles in radiation oncology include: definition of roles, regulation, prescriptive authority, reimbursement, considerations in implementation of the role, educational needs, and impact on resident training. A point of emphasis is that the non-physician practitioner is not a replacement or substitute for either a resident or a radiation oncologist. Instead, this role is a complementary one. The non-physician practitioner can assist in the diagnostic work-up of patients, manage symptoms, provide education to patients and families, and assist them in coping. This support facilitates the physician's ability to focus on the technical aspects of prescribing radiotherapy
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Adjuvant chemotherapy in node negative breast cancer: patterns of use and oncologists' preferences
Stiggelbout, A. M.; de Haes, J. C.; van de Velde, C. J.
2000-01-01
BACKGROUND: A worldwide variation in policy is seen regarding adjuvant systemic treatment for node negative breast cancer (NNBC). After the first presentations of the 10-year EBCTCG results, a study was carried out in the Netherlands to assess patterns of care and to obtain the views of oncologists
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Shinan-Altman, Shiri; Cohen, Miri; Rasmussen, Victoria; Turnell, Adrienne; Butow, Phyllis
2017-12-19
Psychosocial oncologists may be particularly vulnerable to burnout. This study aimed to assess burnout among Israeli psychosocial oncologists in relation to the Job Demands-Resources model and the coping strategies model. Participants included 85 of 128 listed psychosocial oncologists currently working with cancer patients. They completed a questionnaire assessing emotional exhaustion, depersonalization, job demands, job resources, work engagement, overcommitment, and perceived value of work. The mean level of burnout was low, whereas 16.3% experienced high levels of emotional exhaustion and only 2.4% experienced high levels of depersonalization. According to mediation analysis, overcommitment, partially mediated job demands-burnout associations, and work engagement mediated the perceived value-burnout association. Job resources and burnout were not related, either directly or indirectly. Significance of results The study extended the Job Demands-Resources model to include perceived value as an additional resource, and work-engagement and overcommitment as coping strategies. Two distinct patterns of associations were found between work characteristics and burnout: the positive-protective pattern (perceived value and work engagement) and the negative pattern (job demands and overcommitment). These two patterns should be considered for further research and for implementing preventive interventions to reduce burnout in the workplace setting.
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The teaching of physics and related courses to residents in radiation oncology
International Nuclear Information System (INIS)
Dunscombe, P.
1989-01-01
A survey of physics and related teaching to radiation oncology residents in 21 Canadian cancer centres was undertaken in December 1987 and January 1988. This survey illustrates a very considerable variation in the formal teaching of physics to aspiring radiation oncologists with, for example, the number of hours offered ranging from 40 to 160 in those 10 centres that have a training program. It would appear to be of benefit to radiation oncology residents, those charged with teaching them, and the radiation oncology community as a whole, to develop specific guidelines for this aspect of resident education. (8 refs., tab.)
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Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study.
Turner, Sandra; Seel, Matthew; Trotter, Theresa; Giuliani, Meredith; Benstead, Kim; Eriksen, Jesper G; Poortmans, Philip; Verfaillie, Christine; Westerveld, Henrike; Cross, Shamira; Chan, Ming-Ka; Shaw, Timothy
2017-05-01
The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al., 2012). The objective of this study was to define a globally applicable competency set specific to radiation oncology for the CanMEDS Leader Role (Frank et al., 2015). A modified Delphi consensus process delivering two rounds of on-line surveys was used. Participants included trainees, radiation/clinical oncologists and other RO team members (radiation therapists, physicists, and nurses), professional educators and patients. 72 of 95 (76%) invitees from nine countries completed the Round 1 (R1) survey. Of the 72 respondents to RI, 70 completed Round 2 (R2) (97%). In R1, 35 items were deemed for 'inclusion' and 21 for 'exclusion', leaving 41 'undetermined'. After review of items, informed by participant comments, 14 competencies from the 'inclusion' group went into the final curriculum; 12 from the 'undetermined' group went to R2. In R2, 6 items reached consensus for inclusion. This process resulted in 20 RO Leader Role competencies with apparent global applicability. This is the first step towards developing learning, teaching and assessment tools for this important area of training. Copyright © 2017 Elsevier B.V. All rights reserved.
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50-year-old history of the Korean physical society
International Nuclear Information System (INIS)
2002-12-01
This book introduces the root of Korean physics, the dawning of Korean physics, foundation and childhood of Korean physics society, growth of Korean physics society, revival of Korean physics society, corporation Korean physics society, leap of Korean physics society and challenges towards future. It also deals with 50-year-old history of the Korean physical society according to committees, special interest groups, branches in cities and provinces, branches in universities, laboratories, society bureau, and commemoration business to celebrate 50th anniversary.
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E.F. Eriksen (Erik); R.C. Beavis; A.J. Coffey (Alison); J-W.H. Leer (Jan-Willem); S.M. Magrini (Stefano); K. Benstead (Kim); T. Boelling (Tobias); M. Hjälm-Eriksson (Marie); R. Kantor (Rami); B. MacIejewski (Boguslaw); M. Mezeckis (Maris); A. Oliveira (Angelo); P. Thirion (Pierre); P. Vitek (Pavel); D.R. Olsen (Dag Rune); T. Eudaldo (Teresa); W. Enghardt (Wolfgang); P. Francois (Patrice); C. Garibaldi (Cristina); B.J.M. Heijmen (Ben); M. Josipovic (Mirjana); T. Major (Tibor); S. Nikoletopoulos (Stylianos); A. Rijnders (Alex); M. Waligorski (Michael); M. Wasilewska-Radwanska (Marta); L. Mullaney (Laura); A. Boejen (Annette); A. Vaandering (Aude); W. Vandevelde (Wouter); C. Verfaillie (Christine); R. Pötter (Richard)
2012-01-01
textabstractIntroduction: In 2007 ESTRO proposed a revision and harmonisation of the core curricula for radiation oncologists, medical physicists and RTTs to encourage harmonised education programmes for the professional disciplines, to facilitate mobility between EU member states, to reflect the
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Eriksen, J.G.; Beavis, A.W.; Coffey, M.A.; Leer, J.W.H.; Magrini, S.M.; Benstead, K.; Boelling, T.; Hjalm-Eriksson, M.; Kantor, G.; Maciejewski, B.; Mezeckis, M.; Oliveira, A.; Thirion, P.; Vitek, P.; Olsen, D.R.; Eudaldo, T.; Enghardt, W.; Francois, P.; Garibaldi, C.; Heijmen, B.; Josipovic, M.; Major, T.; Nikoletopoulos, S.; Rijnders, A.; Waligorski, M.; Wasilewska-Radwanska, M.; Mullaney, L.; Boejen, A.; Vaandering, A.; Vandevelde, G.; Verfaillie, C.; Potter, R.
2012-01-01
INTRODUCTION: In 2007 ESTRO proposed a revision and harmonisation of the core curricula for radiation oncologists, medical physicists and RTTs to encourage harmonised education programmes for the professional disciplines, to facilitate mobility between EU member states, to reflect the rapid
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A study into the review and verification of breast images treated with isocentric technique
International Nuclear Information System (INIS)
Mitchell, Fiona
2007-01-01
In radiation therapy practice, portal imaging is a common occurrence. Radiation Oncologists want to be able to view the actual treatment port and compare it to the simulated view for quality assurance. Historically, this has been the domain of oncologists only but with the changes in imaging technology, this area of practice is now more commonly shared with the radiation therapists. Purpose: The primary aim of this study was to compare the Radiation Therapists' result versus the Radiation Oncologists' practice of review and verification of electronic portal imaging in the treatment of breast cancer. A secondary result was enhancement of electronic portal imaging use. Methods: The study was divided into two parts. Part 1 reviewed imaging of tangential breast treatment and part 2 reviewed mono-isocentric four-field breast technique. The review and verification of the images were conducted by the Radiation Therapists and Radiation Oncologists and their subsequent results were compared. Results: Overall the Radiation Oncologist agreed with 96.9% of the images approved by the Radiation Therapists. This makes for a rejection rate of 3.1%. In general, Radiation Therapists adhered to the guidelines more closely than the Radiation Oncologist hence the rejection rate of Radiation Therapists was greater than the Radiation Oncologist by 7.0%. Conclusions: The practice of electronic portal imaging review and verification in the treatment of breast cancer can be streamlined and achieved more efficiently. The Radiation Therapists consistently demonstrated their ability to review and verify the portal images, as equivalent to the Radiation Oncologist. Given the high standard of accuracy demonstrated the process of portal image review should be transferred to the Radiation Therapist. This transfer leads to reduction in duplicity of task, an increase in the use of technology, an improvement in efficiencies, and an increase in the quality of care, which will potentially lead to more
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Directory of Open Access Journals (Sweden)
Anusheel Munshi
2016-01-01
Conclusion: The results of the first such questionnaire based study have been presented. Most oncologists consider cell-phones a useful tool in patient care. More RO are aware of potential cell-phone hazards compared to non-RO's.
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International Nuclear Information System (INIS)
Teshima, Teruki; Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi; Ikeda, Hiroshi; Ito, Hisao; Sekiguchi, Kenji; Kamikonya, Norihiko; Koizumi, Masahiko; Tago, Masao; Nagata, Yasushi; Masaki, Hidekazu; Nishimura, Tetsuo; Yamada, Shogo
2008-01-01
Purpose: To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. Methods and Materials: A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. Results: The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765 linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 60 Co remote-controlled after-loading systems, and 119 192 Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload. Conclusions: The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control
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Kleiner, Sibyl; Wallace, Jean E
2017-09-11
Oncologists are at high risk of poor mental health. Prior research has focused on burnout, and has identified heavy workload as a key predictor. Compassion fatigue among physicians has generally received less attention, although medical specialties such as oncology may be especially at risk of compassion fatigue. We contribute to research by identifying predictors of both burnout and compassion fatigue among oncologists. In doing so, we distinguish between quantitative workload (e.g., work hours) and subjective work pressure, and test whether work-family conflict mediates the relationships between work pressure and burnout or compassion fatigue. In a cross-sectional study, oncologists from across Canada (n = 312) completed questionnaires assessing burnout, compassion fatigue, workload, time pressure at work, work-family conflict, and other personal, family, and occupational characteristics. Analyses use Ordinary Least Squares regression. Subjective time pressure at work is a key predictor of both burnout and compassion fatigue. Our results also show that work-family conflict fully mediates these relationships. Overall, the models explain more of the variation in burnout as compared to compassion fatigue. Our study highlights the need to consider oncologists' subjective time pressure, in addition to quantitative workload, in interventions to improve mental health. The findings also highlight a need to better understand additional predictors of compassion fatigue.
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In vivo organ mass of Korean adults obtained from whole-body magnetic resonance data
International Nuclear Information System (INIS)
Park, S.; Lee, J. K.; Kim, J. I.; Lee, Y. J.; Lim, Y. K.; Kim, C. S.; Lee, C.
2006-01-01
In vivo organ mass of the Korean adult, male and female were presented for the purpose of radiation protection. A total of 121 healthy volunteers (66 males and 55 females), whose body dimensions were close to that of average Korean adults, were recruited for this study. Whole-body magnetic resonance (MR) images were obtained, and contours of 15 organs (brain, eye, gall bladder, heart, kidney, liver, lung, pancreas, stomach, spleen, testes, thymus, thyroid, urinary bladder and uterus) and 9 bones (femur, tibia + fibula, humerus, radius + ulna, pelvis, cervical spine, thoracic and lumber spine, skull and clavicle) were segmented for organ volume rendering by anatomists using commercial software. Organ and bone masses were calculated by multiplying the Asian reference densities of the corresponding organs and bones by the measured volumes. The resulting organ and bone masses were compared with those of the International Commission of Radiological Protection (ICRP) and the Asian reference data. Significantly large standard deviation was shown in the moving organs of the respiratory and circulatory systems and in the alimentary and urogenital organs that are variable in volume in a single person. Gall bladder and pancreas showed unique Korean organ masses compared with those of ICRP and the Asian reference adults. Different from anatomical data based on autopsy, the in vivo volume and mass in this study can more exactly describe the organ volume of a living human subject for radiation protection. A larger sample size would be required for obtaining statistically more reliable results. It is also needed to establish the reference organ mass of younger age groups for which it is difficult to recruit volunteers and to immobilise the subjects for long-time MR scanning. At present, the data from this study will contribute to the establishment of a Korean reference database. (authors)
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Developing a national radiation oncology registry: From acorns to oaks.
Palta, Jatinder R; Efstathiou, Jason A; Bekelman, Justin E; Mutic, Sasa; Bogardus, Carl R; McNutt, Todd R; Gabriel, Peter E; Lawton, Colleen A; Zietman, Anthony L; Rose, Christopher M
2012-01-01
The National Radiation Oncology Registry (NROR) is a collaborative initiative of the Radiation Oncology Institute and the American Society of Radiation Oncology, with input and guidance from other major stakeholders in oncology. The overarching mission of the NROR is to improve the care of cancer patients by capturing reliable information on treatment delivery and health outcomes. The NROR will collect patient-specific radiotherapy data electronically to allow for rapid comparison of the many competing treatment modalities and account for effectiveness, outcome, utilization, quality, safety, and cost. It will provide benchmark data and quality improvement tools for individual practitioners. The NROR steering committee has determined that prostate cancer provides an appropriate model to test the concept and the data capturing software in a limited number of sites. The NROR pilot project will begin with this disease-gathering treatment and outcomes data from a limited number of treatment sites across the range of practice; once feasibility is proven, it will scale up to more sites and diseases. When the NROR is fully implemented, all radiotherapy facilities, along with their radiation oncologists, will be solicited to participate in it. With the broader participation of the radiation oncology community, NROR has the potential to serve as a resource for determining national patterns of care, gaps in treatment quality, comparative effectiveness, and hypothesis generation to identify new linkages between therapeutic processes and outcomes. The NROR will benefit radiation oncologists and other care providers, payors, vendors, policy-makers, and, most importantly, cancer patients by capturing reliable information on population-based radiation treatment delivery. Copyright © 2012 (c) 2010 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved. Published by Elsevier Inc. All rights reserved.
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Assessment of minute volume of lung in NPP workers for Korean reference man
International Nuclear Information System (INIS)
Lee, Y. J.; Song, S. H.; Lee, J.; Jin, Y. W.; Yim, Y. K.; Kim, J. S.
2001-01-01
To formulation of the reference Korean for radiation protection purpose, we measured the forced vital capacity(FVC), forced expiratory volume in second(FEVI), minute ventilation(MV) of Nuclear Power Plant workers using SP-1 Spirometry Unit(Schiller AG. 1998) and eatimated the liters of breathed for working and resting, also compared these data with ICRP 23
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Assessment of minute volume of lung in NPP workers for Korean reference man
Energy Technology Data Exchange (ETDEWEB)
Lee, Y. J.; Song, S. H.; Lee, J.; Jin, Y. W.; Yim, Y. K.; Kim, J. S. [KNETEC, Seoul (Korea, Republic of)
2001-05-01
To formulation of the reference Korean for radiation protection purpose, we measured the forced vital capacity(FVC), forced expiratory volume in second(FEVI), minute ventilation(MV) of Nuclear Power Plant workers using SP-1 Spirometry Unit(Schiller AG. 1998) and eatimated the liters of breathed for working and resting, also compared these data with ICRP 23.
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DEFF Research Database (Denmark)
Morgan, Gilberto; Lambertini, Matteo; Kourie, Hampig Raphael
2016-01-01
The European Society for Medical Oncology (ESMO) is one of the leading societies of oncology professionals in the world. Approximately 30% of the 13 000 ESMO members are below the age of 40 and thus meet the society's definition of young oncologists (YOs). ESMO has identified the training...... and development of YOs as a priority and has therefore established a comprehensive career development programme. This includes a leadership development programme to help identify and develop the future leaders in oncology. Well-trained and highly motivated future generations of multidisciplinary oncologists...... are essential to ensure the optimal evolution of the field of oncology with the ultimate goal of providing the best possible care to patients with cancer. ESMO's career development portfolio is managed and continuously optimised by several dedicated committees composed of ESMO officers and is directly...
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DEFF Research Database (Denmark)
Eriksen, Jesper G; Beavis, Andrew W; Coffey, Mary A
2012-01-01
In 2007 ESTRO proposed a revision and harmonisation of the core curricula for radiation oncologists, medical physicists and RTTs to encourage harmonised education programmes for the professional disciplines, to facilitate mobility between EU member states, to reflect the rapid development of the ...
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Language-specific dysgraphia in Korean stroke patients.
Yoon, Ji Hye; Suh, Mee Kyung; Kim, HyangHee
2010-12-01
We investigated how changes in the writing of 14 Korean stroke patients reflect the unique features of the Korean writing system. The Korean writing system, Han-geul, has both linguistic and visuospatial/constructive characteristics. In the visuospatial construction of a syllable, the component consonant(s) and vowel(s) must be arranged from top-to-bottom and/or left-to-right within the form of a square. This syllabic organization, unique to Korean writing, may distinguish dysgraphia in Korean patients from the disorder in other languages, and reveal the effects of stroke on visuospatial/constructive abilities. We compared 2 groups of patients affected by stroke, 1 group with left hemisphere (LH) lesions and the other with right hemisphere (RH) lesions. We instructed them to write from a dictation of 90 monosyllabic stimuli, each presented with a real word cue. Patients had to repeat a target syllable and a word cue, and then to write the target syllable only. Patients with LH and RH lesions produced qualitatively different error patterns. While the LH lesion group produced primarily linguistic errors, visuospatial/constructive errors predominated in the group with RH lesions. With regard to language-specific features, these Korean patients with RH lesions produced diverse visuospatial/constructive errors not commonly observed in dysgraphia of the English language. Language-specific writing errors by Korean stroke patients reflect the unique characteristics of Korean writing, which include the arrangement of strokes and graphemes within a square syllabic form by dimensional and spatial rules. These findings support the notion that the Korean writing system possesses a language-specific nature with both linguistic and visuospatial/constructive processes. Distinctive patterns of dysgraphia in the Korean language also suggest interactivity between linguistic and visuospatial/constructive levels of processing. This study is noteworthy for its systematic description of
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Attitudes of medical oncologists in Qatar toward palliative care.
Zeinah, Ghaith F Abu; Al-Kindi, Sadeer G; Hassan, Azza Adel
2013-09-01
The first and only palliative care (PC) unit in Qatar was established in 2008 to serve adult patients with cancer. As PC was only recently introduced to oncology practice in Qatar and the region, raising awareness among physicians is crucial. This survey study is designed to outline the level of awareness and knowledge of oncologists in Qatar toward PC. In this cross-sectional survey study, copies of a self-constructed questionnaire were distributed to 49 physicians at the National Center for Cancer Care and Research in Qatar during January 2012 and collected for data analysis. The physician response rate was 100%. Less than half of the responders (36.7%) had official training in PC, but the majority (89.8%) showed interest in the field. Only 57.8% of the physicians reported self-competence in providing good PC to the dying patient. On the other hand, up to 69.4% are aware of the guidelines for pain relief and 58.7% apply them in their clinical practice. The concept of PC hospice was familiar to 77.1% of participants. On one hand, 85.7% of the physicians advocated that every medical center should have PC service, while up to 70.8% preferred that patients with short survival expectancy die in the community, rather than in a hospital setting. There is relatively good awareness and knowledge among health care providers specialized in cancer treatment in our hospital, despite the lack of formal training. Further training and informative sessions are required to raise awareness among oncologists and encourage utilization of PC services and thus optimize patient accessibility to PC.
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Odeniyi, Folasade; Nathanson, Pamela G; Schall, Theodore E; Walter, Jennifer K
2017-12-01
The families of oncology patients requiring intensive care often face increasing complexity in communication with their providers, particularly when patients are cared for by providers from different disciplines. The objective of this study was to describe experiences and challenges faced by pediatric oncologists and intensivists and how the oncologist-intensivist relationship impacts communication and initiation of goals of care discussions (GCDs). We conducted semi-structured interviews with a convenience sample of 10 physicians, including pediatric oncology and intensive care attendings and fellows. We identified key themes (three barriers and four facilitators) to having GCDs with families of oncology patients who have received intensive care. Barriers included challenges to communication within teams because of hierarchy and between teams due to incomplete sharing of information and confusion about who should initiate GCDs; provider experiences of internal conflict about how to engage parents in decision-making and about the "right thing to do" for patients; and lack of education and training in communication. Facilitators included team preparation for family meetings; skills for partnering with families; the presence of palliative care specialists; and informal education in communication and willingness for further training in communication. Notably, the education theme was identified as both a barrier and resource. We identified barriers to communication with families both within and between teams and for individual physicians. Formal communication training and processes that standardize communication to ensure completeness and role delineation between clinical teams may improve oncologists' and intensivists' ability to initiate GCDs, thereby fulfilling their ethical obligations of decision support. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Epidemiological studies on radiation workers in Korea
International Nuclear Information System (INIS)
Soo Yong Choi; Hai Won Chung
2007-01-01
Complete text of publication follows. Objectives: The aim of this study is to analyze the occupational exposure for external radiation and to evaluate radiation effects on Korean radiation workers. Methods: The National Dose Registry contains radiation exposure records for all monitored radiation workers since its creation in 1983. We are carrying out epidemiological survey for radiation workers. The items of information included personal identification, employment and dose data. The frequencies of various types of chromosome aberrations in radiation workers were compared with controls. The data were analyzed according to year, sex, age, duration of occupation, exposure dose, etc. using SPSS statistical package(version 15.0). The goodness-of-fit test for Poisson assumption and dispersion test for detecting heterogeneity for Poisson distribution were done with chromosomal aberrations among study subjects. Results: The total number of workers registered from 1983 to 2005 was 61,610. The number of workers steadily increased and the accumulated dose somewhat increased. The collective annual dose of radiation workers was 345.823 man Sv and the mean annual dose was 1.34mSv. The frequencies of chromosome aberrations in 102 workers were compared with those in 42 controls. The frequencies of all types of chromosome aberrations in the exposed subjects were higher than those in the control group. Poisson regression analysis showed that there was significant association of chromosome aberrations with radiation dose, duration of work, age and alcohol intake. We started to survey radiation workers in order to evaluate radiation effects, collected epidemiological data for 9,157 workers at present and analyzed their lifetime radiation exposure doses. Follow-up is carrying out using the Korean Mortality Data, Cancer Registry and individual investigation. Among study patients, 11 of 38 deaths were identified with cancer. Conclusions: The data on occupational doses shows that
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Female visibility through Korean literature: Feminist theological critique
Directory of Open Access Journals (Sweden)
Eun Ok Jeong
2003-10-01
Full Text Available This article introduces Korean women’s experience as seen through the lense of social and cultural backgrounds, from the premodern through to the postmodern era. Korean literature is used as a source to investigate Korean women’s experiences and perspectives. By means of feminist critique this article explores men-centered influences in Korean literature. It aims to illustrate the importance of the issue of female visibility through Korean literature from a Korean woman’s perspective. Two texts are analyzed and critiqued: the first is the myth of Korean origin. The second is a story of Gasi Gogi (a thorny fish. The article is intended to stimulate debate on gender, voices, and authority from a feminist perspective, in order to transcend the more traditional interpretations.
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Perception of low dose radiation risks among radiation researchers in Korea.
Seong, Ki Moon; Kwon, TaeWoo; Seo, Songwon; Lee, Dalnim; Park, Sunhoo; Jin, Young Woo; Lee, Seung-Sook
2017-01-01
Expert's risk evaluation of radiation exposure strongly influences the public's risk perception. Experts can inform laypersons of significant radiation information including health knowledge based on experimental data. However, some experts' radiation risk perception is often based on non-conclusive scientific evidence (i.e., radiation levels below 100 millisievert), which is currently under debate. Examining perception levels among experts is important for communication with the public since these individual's opinions have often exacerbated the public's confusion. We conducted a survey of Korean radiation researchers to investigate their perceptions of the risks associated with radiation exposure below 100 millisievert. A linear regression analysis revealed that having ≥ 11 years' research experience was a critical factor associated with radiation risk perception, which was inversely correlated with each other. Increased opportunities to understand radiation effects at perception of radiation exposure. In addition, radiation researchers conceived that more scientific evidence reducing the uncertainty for radiation effects perception of radiation exposure.
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Perception of low dose radiation risks among radiation researchers in Korea
Seo, Songwon; Lee, Dalnim; Park, Sunhoo; Jin, Young Woo; Lee, Seung-Sook
2017-01-01
Expert’s risk evaluation of radiation exposure strongly influences the public’s risk perception. Experts can inform laypersons of significant radiation information including health knowledge based on experimental data. However, some experts’ radiation risk perception is often based on non-conclusive scientific evidence (i.e., radiation levels below 100 millisievert), which is currently under debate. Examining perception levels among experts is important for communication with the public since these individual’s opinions have often exacerbated the public’s confusion. We conducted a survey of Korean radiation researchers to investigate their perceptions of the risks associated with radiation exposure below 100 millisievert. A linear regression analysis revealed that having ≥ 11 years’ research experience was a critical factor associated with radiation risk perception, which was inversely correlated with each other. Increased opportunities to understand radiation effects at risk perception of radiation exposure. In addition, radiation researchers conceived that more scientific evidence reducing the uncertainty for radiation effects risk perception of radiation exposure. PMID:28166286
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Puts, Martine T E; Sattar, Schroder; McWatters, Kara; Lee, Katherine; Kulik, Michael; MacDonald, Mary-Ellen; Jang, Raymond; Amir, Eitan; Krzyzanowska, Monika K; Leighl, Natasha; Fitch, Margaret; Joshua, Anthony M; Warde, Padraig; Tourangeau, Ann E; Alibhai, Shabbir M H
2017-03-01
Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis. There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the
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Korean Culture and Autism Spectrum Disorders
Kang-Yi, Christina D.; Grinker, Roy R.; Mandell, David S.
2013-01-01
This paper reviews the literature on early child development among Koreans, with a focus on autism spectrum disorders (ASD). The literature review of 951 abstracts in English, 101 abstracts in Korean and 27 full articles published from 1994 to 2011 was performed to understand the presentation of and response to ASD in Korean culture. Based on…
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Lee, Diane Sookyoung; Padilla, Amado M.
2014-01-01
In this study we examined acculturative stress and coping among 86 students of Korean heritage at an American university. Participants indicated their stress levels on 3 scales of cultural adaptation: discrimination, language and cultural ties, and social distance. Findings show that self-identified Korean students displayed higher levels of…
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Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...
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1985-09-20
Pyongyang station, the South Korean delegation boarded 16 Mercedes Benz sedans and seven buses, then headed for the Koryo Hotel. The South Korean...money-making, loudly advertising "relief of hungry children, "relief of the destitute" and "programme for the rebirth of narcotic addicts. It was with... market are twin pains these days. When they convert what they earned on the bearish stock exchange into dol- lars, their returns show minus gains
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History of Korean gochu, gochujang, and kimchi
Directory of Open Access Journals (Sweden)
Dae Young Kwon
2014-12-01
Full Text Available The gochu (Korean red pepper that goes into Korean traditional fermented foods such as kimchi (fermented cabbage and gochujang (spicy red pepper paste should have a mild spiciness and its Scoville heat unit (the unit that measures spiciness is <1,000. The kimchi and gochujang that are fermented only with Korean gochu can be eaten. Kimchi and gochujang cannot be prepared even with cheongyangkochu (Scoville heat unit is approximately 3,000, which is a hybrid of Korean gochu and Thai gochu. When these foods are prepared with other spicier gochu, such as Thai pepper, Southern Asian red pepper, Central American red pepper, or Mexico's aji (which is 500 times spicier than Korean gochu, they will be too spicy to consume. Biologically, Korean gochu is different from the red peppers of Central American countries (such as Mexico and Colombia, Indonesia, India, and Thailand. Therefore, the statement that the Central American red pepper came to Korea during the Japanese invasion of Korea in 1592 is not true. We can refer to a research paper in the magazine “Nature” that Korea's gochu arrived at the Korean peninsula millions of years ago, having been spread by birds. It states that gochu has evolved for millions of years, therefore, we can infer that Korean gochu existed as a completely different variety. In addition, gochujang and kimchi can be made using gochu only, which proves that people in Korea cultivated gochu thousands of years ago and have been eating it since then. Furthermore, many old Korean documents support the fact that Koreans have been planting and harvesting gochu for the last 1,500 years.
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Guidelines for radiation therapy in clinical research on bladder cancer
International Nuclear Information System (INIS)
Shipley, W.U.; VanderSchueren, E.; Kitagawa, T.; Gospodarowicz, M.K.; Frommhold, H.; Magno, L.; Mochizuki, S.; VanderBogaert, W.; VanderWerf-Messing, B.
1986-01-01
Bladder cancer is a heterogeneous disease and that there are important tumor characteristics that will predict significant differences in radiation responsiveness. These should in all instances be well documented prospectively in any treatment protocol. However, in this chapter the authors stress a number of factors related to the tumor at presentation as well as the administration of the radiation therapy that can importantly affect the efficacy of the radiation on the patient's tumor, as well as on his or her normal tissues. As Radiation Oncologists, they are most interested in the conducting and reporting of prospective clinical investigations in the use of radiation therapy in the treatment of patients with bladder carcinoma who will be treated with planned preservation of their bladder, but whose radiation therapy may be combined with additional planned bladder-sparing surgery, intraoperative radiation therapy, or chemotherapy
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International Nuclear Information System (INIS)
Anon.
1977-01-01
The Radiation Oncology Division has had as its main objectives both to operate an academic training program and to carry out research on radiation therapy of cancer. Since fiscal year 1975, following a directive from ERDA, increased effort has been given to research. The research activities have been complemented by the training program, which has been oriented toward producing radiation oncologists, giving physicians short-term experience in radiation oncology, and teaching medical students about clinical cancer and its radiation therapy. The purpose of the research effort is to improve present modalities of radiation therapy of cancer. As in previous years, the Division has operated as the Radiation Oncology Program of the Department of Radiological Sciences of the University of Puerto Rico School of Medicine. It has provided radiation oncology support to patients at the University Hospital and to academic programs of the University of Puerto Rico Medical Sciences Campus. The patients, in turn, have provided the clinical basis for the educational and research projects of the Division. Funding has been primarily from PRNC (approx. 40%) and from National Cancer Institute grants channeled through the School of Medicine (approx. 60%). Special inter-institutional relationships with the San Juan Veterans Administration Hospital and the Metropolitan Hospital in San Juan have permitted inclusion of patients from these institutions in the Division's research projects. Medical physics and radiotherapy consultations have been provided to the Radiotherapy Department of the VA Hospital
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Directory of Open Access Journals (Sweden)
Jae-Buhm Hwang
2014-06-01
Full Text Available This study examines the significant influence of the early Korean Protestant churches in general and the Korean Presbyterian Church in particular on the early phases of Korea’s democratisation. Firstly, the Western Protestant mission works in general were visibly conducive for dissemination and cultivation of egalitarian and democratic ideals, with the mission churches becoming sites of do-it-yourself democracy. Secondly, the Nevius (Mission Methods of the Korean Presbyterian Church came to foster the democratic spirit of self-support and self-government, resulting in its rapid growth. Thirdly, with the implementation of a nationwide, representative and democratic polity (presbytery with a constitution, the church even facilitated law-binding and institutional democracy for Koreans in general and Korean Christians in particular. Fourthly, the church’s democratic working deeply inspired Korean democratic politicians, especially Mr Changho Ahn, who had an important influence on the making of the Provisional Government of Korea and its Constitution.
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End-of-Life Care for Blood Cancers: A Series of Focus Groups With Hematologic Oncologists
Odejide, Oreofe O.; Salas Coronado, Diana Y.; Watts, Corey D.; Wright, Alexi A.; Abel, Gregory A.
2014-01-01
Purpose: Hematologic cancers are associated with aggressive cancer-directed care near death and underuse of hospice and palliative care services. We sought to explore hematologic oncologists' perspectives and decision-making processes regarding end-of-life (EOL) care. Methods: Between September 2013 and January 2014, 20 hematologic oncologists from the Dana-Farber/Harvard Cancer Center participated in four focus groups regarding EOL care for leukemia, lymphoma, multiple myeloma, and hematopoietic stem-cell transplantation. Focus groups employed a semistructured format with case vignettes and open-ended questions and were followed by thematic analysis. Results: Many participants felt that identifying the EOL phase for patients with hematologic cancers was challenging as a result of the continuing potential for cure with advanced disease and the often rapid pace of decline near death. This difficulty was reported to result in later initiation of EOL care. Barriers to high-quality EOL care were also reported to be multifactorial, including unrealistic expectations from both physicians and patients, long-term patient-physician relationships resulting in difficulty conducting EOL discussions, and inadequacy of existing home-based EOL services. Participants also expressed concern that some EOL quality measures developed for solid tumors may be unacceptable for patients with blood cancers given their unique needs at the EOL (eg, palliative transfusions). Conclusion: Our analysis suggests that hematologic oncologists need better clinical markers for when to initiate EOL care. In addition, current quality measures may be inappropriate for identifying overly aggressive care for patients with blood cancers. Further research is needed to develop effective interventions to improve EOL care for this patient population. PMID:25294393
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Radiation therapy in retroperitoneal sarcoma management.
Haas, Rick L; Baldini, Elizabeth H; Chung, Peter W; van Coevorden, Frits; DeLaney, Thomas F
2018-01-01
Surgery is potentially curative for primary non-metastatic retroperitoneal soft tissue sarcomas (RPS), although patients remain at risk for local recurrence. To reduce this risk, the addition of radiotherapy to radical surgery may be considered. Nevertheless, level I evidence to support radiotherapy is currently lacking. The results from the EORTC-STBSG 62092-22092 studying this question are awaited. This manuscript addresses issues to consider when radiation-oncologists engage in a multidisciplinary treatment approach for RPS patients, including radiotherapy. © 2017 Wiley Periodicals, Inc.
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Practicing radiation oncology today - Part I: Meeting the challenge of managed care
International Nuclear Information System (INIS)
Botnick, Leslie E.; Cohen, Hilary H.; Hinkle, Milton; Rose, Christopher M.
1996-01-01
Objective: The change in health care delivery is forcing radiation oncologists to examine every aspect of how they organize themselves, deliver care, evaluate the quality of that care, and how they are reimbursed for this process. While managed care has been implicated as the new paradigm that will change the way that health care is delivered, the authors maintain that outcomes research may be just as important a stimulus for change. This course will attempt to examine how managed care and outcomes research are impacting upon radiation oncology practice, and what radiation oncologists can do to maintain patient care standards. This course will introduce certain concepts that will be discussed in subsequent courses on Informatics and Evaluating New Technology. Topics Covered: 1. The Managed Care Nomenclature Explained: HMO's, PPO's, POS's, Carve-Outs 2. Outcomes Research: What it can and cannot do 3. Moving from QA to CQI to Benchmarking 4. Using Analytical Tools to Evaluate Capital Purchases and Operational Requirements 5. Evaluating Staffing Needs: Traditional jobs, Cross-training, Outsourcing, Physician extenders 6. Introduction to Evaluation of Technology 7. Introduction to Evaluation of Informatics 8. Potential gains from Shared Services 9. Networking vs. Mergers vs. Oncology IPA's vs. MSO's 10. Evaluating Managed Care Strategies and Contracts
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Directory of Open Access Journals (Sweden)
Kristen Sun
2015-08-01
Full Text Available This article analyzes three contemporary South Korean films that (represent alternate histories of the Korean War: 2009 Lost Memories (2009 Rosŭt’ŭmemorichŭ (Lee Simyung (I Simyŏng, 2002, Welcome to Dongmakgol (Welk’ŏm t’u Tongmakkol (Park Kwang-hyun (Pak Kwanghyŏn, 2005, and Joint Security Area (Park Chan-wook, 2000. Despite focusing on different eras of history, I argue that they rewrite dominant narratives of the Korean War (Cold War logics of anticommunism v. communism and instead focus on North Korean- South Korean friendships/collaborations. Each film also presents similar situations in which a group of disparate “heroes” (made up of unified Koreans band together to circumvent the circumstances of division. This article analyzes historical conditions that influence the emergence of these similarly-themed films as well as film content in order to further think through memorial legacies of the Korean War, as well as to take seriously the radical possibilities of a different future that each film presents.
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Korean Clinic Based Outcome Measure Studies
Directory of Open Access Journals (Sweden)
Jongbae Park
2003-02-01
Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures
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International Nuclear Information System (INIS)
Bolla, M.; Giraud, J.Y.; Mazeron, J.J.; Mornex, F.; Ardiet, J.M.; Renody, N.; Depenwiller, C.; Letallec, P.; Piollet, I.; Bernard, B.
2009-01-01
Further to the Epinal events, Health Ministers P. Bas then R. Bachelot-Narquin have launched a plan of work devoted to radiotherapy; they have also committed the S.F.R.O. President, within the framework of a mission, to make proposals taking into account the demography of professionals and their level of competence, valorization of careers, cooperation with medical oncologists, delegations of authorities, mutualization of human and material resources. Due to the numerous actions of the road map managed by the tutelages, the aim of the mission was focused on the modalities of work of the professionals linked to radiotherapy: radiation oncologists, radiographers and physicists. (authors)
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Ability of radiation therapists to assess radiation-induced skin toxicity
International Nuclear Information System (INIS)
Acharya, Urvi; Cox, Jennifer; Rinks, Marianne; Gaur, Pankaj; Back, Michael
2013-01-01
Radiation therapy has seen enhancement of the radiation therapist (RT) role, with RTs and nurses performing duties that were traditionally in the radiation oncologist's (RO) domain. This study aimed to assess whether RTs can consistently grade radiation-induced skin toxicity and their concordance with the gradings given by ROs. Digital photographs of skin reactions were taken at weeks 1, 3 and 6 of radiotherapy on nine patients with breast cancer. The randomly ordered photographs were reviewed once by eight ROs and four RO registrars and on two occasions separated by 6 weeks by 17 RTs. All graded the skin toxicities using the revised Radiation Therapy Oncology Group system. No significant difference was seen between the median scores of the RTs at the first scoring session and the RO/Registrar group. The RTs at both measurement times showed greater inter-rater reliability than the RO/Registrars (W=0.6866, time 1 and 0.6981 time 2, vs. 0.6517), with the experienced RTs the most consistent (W=0.7078). The RTs also showed high intra-rater reliability (rho=0.8461, P<0.0010). These results from RTs with no specific preparation indicate that experienced RTs could assess breast cancer skin toxicity as part of their role.
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Prevalence and Risk Factors of Adolescents Smoking: Difference Between Korean and Korean-Chinese
Directory of Open Access Journals (Sweden)
SoonBok E. Park, RN, PhD
2011-09-01
Conclusion: These results highlight the differences of smoking prevalence and risk factors between Korean-Chinese students and Korean students. The findings may help health educators and researchers to better understand adolescent smoking and risk factors cross culturally and aid in the development of more effective education programs, which could lead to preventing tobacco use among these populations.
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Apps for Radiation Oncology. A Comprehensive Review
Directory of Open Access Journals (Sweden)
J.J. Calero
2017-02-01
Full Text Available Introduction: Software applications executed on a smart-phone or mobile device (“Apps” are increasingly used by oncologists in their daily work. A comprehensive critical review was conducted on Apps specifically designed for Radiation Oncology, which aims to provide scientific support for these tools and to guide users in choosing the most suited to their needs. Material and methods: A systematic search was conducted in mobile platforms, iOS and Android, returning 157 Apps. Excluding those whose purpose did not match the scope of the study, 31 Apps were methodically analyzed by the following items: Objective Features, List of Functionalities, Consistency in Outcomes and Usability. Results: Apps are presented in groups of features, as Dose Calculators (7 Apps, Clinical Calculators (4, Tools for Staging (7, Multipurpose (7 and Others (6. Each App is presented with the list of attributes and a brief comment. A short summary is provided at the end of each group. Discussion and Recommendations: There are numerous Apps with useful tools at the disposal of radiation oncologists. The most advisable Apps do not match the more expensive. Three all-in-one apps seem advisable above all: RadOnc Reference (in English, Easy Oncology (in German and iOncoR (in Spanish. Others recommendations are suggested for specific tasks: dose calculators, treatment-decision and staging.
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Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates.
Loewen, Shaun K; Halperin, Ross; Lefresne, Shilo; Trotter, Theresa; Stuckless, Teri; Brundage, Michael
2015-10-01
To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada. Copyright © 2015 Elsevier Inc. All rights reserved.
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Radiation oncology a physicist's-eye view
Goitein, Michael
2007-01-01
Radiation Oncology: A Physicist's-Eye View was written for both physicists and medical oncologists with the aim of helping them approach the use of radiation in the treatment of cancer with understanding, confidence, and imagination. The book will let practitioners in one field understand the problems of, and find solutions for, practitioners in the other. It will help them to know "why" certain approaches are fruitful while, at the same time, encouraging them to ask the question "Why not?" in the face of assertions that some proposal of theirs is impractical, unreasonable, or impossible. Unlike a textbook, formal and complete developments of the topics are not among the goals. Instead, the reader will develop a foundation for understanding what the author has found to be matters of importance in radiation oncology during over thirty years of experience. Presentations cover, in largely non-technical language, the principal physical and biological aspects of radiation treatment and address practical clinical c...
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International Nuclear Information System (INIS)
Kim, Hee Geun; Kong, Tae Young
2008-01-01
In Korean Nuclear Power Plants (NPPs), two ThermoLuminescent Dosimeters (TLD) were provided to workers who work in an inhomogeneous radiation field; one on the chest and the other on the head. In this way, the effective dose for radiation workers at NPPs was determined by the high deep dose between two radiation dose from these TLDs. This represented a conservative method of evaluating the degree of exposure to radiation. In this study, to prevent the overestimation of the effective dose, field application experiments were implemented using two-dosimeter algorithms developed by several international institutes for the selection of an optimal algorithm. The algorithms used by the Canadian Ontario Power Generation (OPG) and American ANSI HPS N13.41, NCRP (55/50), NCRP (70/30), EPRI (NRC), Lakshmanan, and Kim (Texas A and M University) were extensively analyzed as two-dosimeter algorithms. In particular, three additional TLDs were provided to radiation workers who wore them on the head, chest, and back during maintenance periods, and the measured value were analyzed. The results found no significant differences among the calculated effective doses, apart from Lakshmanan's algorithm. Thus, this paper recommends the NCRP(55/50) algorithm as an optimal two-dosimeter algorithm in consideration of the solid technical background of NCRP and the convenience of radiation works. In addition, it was determined that a two-dosimeter is provided to a single task which is expected to produce a dose rate of more than 1 mSv/hr, a difference of dose rates depending on specific parts of the body of more than 30%, and an exposure dose of more than 2 mSv
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Gonçalves, José António Ferraz
2010-10-01
The aim of this study was to determine the attitude of Portuguese oncologists toward end-of-life situations other than euthanasia and assisted suicide. This study used a survey of 450 Portuguese oncologists by postal means and personal contact. The response rate was 33% (143). Only 7.7% doctors would give lethal doses of drugs to someone with an incurable, advanced, and progressive disease that is unable to make decisions, at the request of a family member or other close person. However, 30 doctors (21.3%) would prefer, in the event they were in such a situation, that the drugs be given them at their request. None of the 12.4% who have received such requests admitted to committing any of those acts. Almost 70% of the doctors would withdraw life support measures at the patient's request if the same had an incurable, advanced, and progressive disease, and a further 14% would do it in certain circumstances, but only 41% would withdraw measures such as nutrition and hydration. Fewer doctors would withdraw such measures including nutrition and hydration at a family member's request or on their own initiative. Religion has a major influence on the doctors' opinion. Most doctors (96.5%) agreed with the administration of drugs for symptom control even foreseeing that they could shorten life. Most Portuguese oncologists respect patients' autonomy, favoring the withdrawal of life support treatment at the patients' request when appropriate and much less do so on the request of others or by their own initiative. They appropriately do not confuse those practices with symptom relief even when hastened death can be envisaged.
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Investigation and analysis of oncologists' knowledge of morphine usage in cancer pain treatment
Directory of Open Access Journals (Sweden)
Liu W
2014-05-01
Full Text Available Weiran Liu,1,* Shumin Xie,2,* Lin Yue,3,* Jiahao Liu,2 Stephanie Mu-Lian Woo,4 Weilin Liu,2 Adam R Miller,5 Jing Zhang,6 Lijun Huang,7 Lei Zhang8,*1Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Department of Anesthesia, Tianjin, People's Republic of China; 2The Xiangya Medical School of Central-South University, Changsha, People's Republic of China; 3Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Outpatient Service, Tianjin, People's Republic of China; 4Harvard University, Cambridge, MA, USA; 5Indiana University School of Medicine, Indianapolis, IN, USA; 6Tianjin Medical University, Tianjin, People's Republic of China; 7Hunan Provincial Tumor Hospital, Department of Lymphoma and Hematology, Changsha, People's Republic of China; 8Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Department of Thoracic Surgery, Tianjin, People's Republic of China *These authors contributed equally to this paperPurpose: To examine oncologists' knowledge of cancer pain and morphine's clinical application in the People's Republic of China. In addition, this study analyzes and discusses the negative factors that currently affect the clinical application of morphine.Patients and methods: A questionnaire survey was given to a random sample of 150 oncologists from Tianjin Medical University Cancer Institute and Hospital. The statistical results were analyzed and processed using SPSS version 21.0 and Matlab version 2012a statistical software. Single-factor analysis of variance, Kruskal–Wallis nonparametric test, and independent samples t-test were adopted to analyze the difference in knowledge scores of morphine usage. The study
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Directory of Open Access Journals (Sweden)
Changzoo Song
2016-03-01
Full Text Available The half-million Soviet Koreans (or Koryŏ saram in the former Soviet Union are the descendants of the ethnic Koreans who migrated to the Russian Far East in the late 19th and early 20th centuries from the northern parts of the Korean peninsula. Their settlements were established in the wide areas of the Russian Far East, including the urban areas around Vladivostok. They were, however, forced-migrated to Central Asia in late 1937 under Stalin's rule. From Central Asia, these Soviet Koreans were further dispersed to other parts of the Soviet Union in the post-Stalin era. These multiple dispersions of Soviet Koreans not only transformed their culinary habit, but also helped Korean food spread among the peoples of the Soviet Union. As a result, Korean food, such as kimchi, miyŏk (edible kelp, and others, were introduced and widely consumed throughout the Soviet Union. This paper explores this unusual spread and popularity of Korean food in the Soviet Union, focusing on the migration history of the Soviet Koreans and Soviet culinary culture. This work is based on the author's fieldwork in the Soviet Union in the early 1900s and again in mid-2000s. The unusual diffusion and popularity of the Korean food in the former Soviet Union provides us with important insights on migration and globalization of ethnic food.
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International Nuclear Information System (INIS)
Holliday, Emma B.; Jagsi, Reshma; Thomas, Charles R.; Wilson, Lynn D.; Fuller, Clifton D.
2014-01-01
Purpose: To analyze survey information regarding mentorship practices and cross-correlate the results with objective metrics of academic productivity among academic radiation oncologists at US Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs. Methods and Materials: An institutional review board-approved survey for the Radiation Oncology Academic Development and Mentorship Assessment Project (ROADMAP) was sent to 1031 radiation oncologists employed at an ACGME-accredited residency training program and administered using an international secure web application designed exclusively to support data capture for research studies. Data collected included demographics, presence of mentorship, and the nature of specific mentoring activities. Productivity metrics, including number of publications, number of citations, h-index, and date of first publication, were collected for each survey respondent from a commercially available online database, and m-index was calculated. Results: A total of 158 academic radiation oncologists completed the survey, 96 of whom reported having an academic/scientific mentor. Faculty with a mentor had higher numbers of publications, citations, and h- and m-indices. Differences in gender and race/ethnicity were not associated with significant differences in mentorship rates, but those with a mentor were more likely to have a PhD degree and were more likely to have more time protected for research. Bivariate fit regression modeling showed a positive correlation between a mentor's h-index and their mentee's h-index (R 2 = 0.16; P<.001). Linear regression also showed significant correlates of higher h-index, in addition to having a mentor (P=.001), included a longer career duration (P<.001) and fewer patients in treatment (P=.02). Conclusions: Mentorship is widely believed to be important to career development and academic productivity. These results emphasize the importance of identifying and
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Energy Technology Data Exchange (ETDEWEB)
Holliday, Emma B. [The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jagsi, Reshma [The University of Michigan, Ann Arbor, Michigan (United States); Thomas, Charles R. [Oregon Health Science Center Knight Cancer Institute, Portland, Oregon (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, Yale Cancer Center, New Haven, Connecticut (United States); Fuller, Clifton D., E-mail: cdfuller@mdanderson.org [The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Oregon Health Science Center Knight Cancer Institute, Portland, Oregon (United States)
2014-01-01
Purpose: To analyze survey information regarding mentorship practices and cross-correlate the results with objective metrics of academic productivity among academic radiation oncologists at US Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs. Methods and Materials: An institutional review board-approved survey for the Radiation Oncology Academic Development and Mentorship Assessment Project (ROADMAP) was sent to 1031 radiation oncologists employed at an ACGME-accredited residency training program and administered using an international secure web application designed exclusively to support data capture for research studies. Data collected included demographics, presence of mentorship, and the nature of specific mentoring activities. Productivity metrics, including number of publications, number of citations, h-index, and date of first publication, were collected for each survey respondent from a commercially available online database, and m-index was calculated. Results: A total of 158 academic radiation oncologists completed the survey, 96 of whom reported having an academic/scientific mentor. Faculty with a mentor had higher numbers of publications, citations, and h- and m-indices. Differences in gender and race/ethnicity were not associated with significant differences in mentorship rates, but those with a mentor were more likely to have a PhD degree and were more likely to have more time protected for research. Bivariate fit regression modeling showed a positive correlation between a mentor's h-index and their mentee's h-index (R{sup 2} = 0.16; P<.001). Linear regression also showed significant correlates of higher h-index, in addition to having a mentor (P=.001), included a longer career duration (P<.001) and fewer patients in treatment (P=.02). Conclusions: Mentorship is widely believed to be important to career development and academic productivity. These results emphasize the importance of
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Kim, Suk Sun; Reed, Pamela G; Kang, Youngmi; Oh, Jina
2012-12-01
The purpose of this study was to translate the Spiritual Perspective Scale (SPS) and Self-transcendence Scale (STS) into Korean and test the psychometric properties of the instruments with Korean elders. A cross-sectional survey design was used to implement the three stages of the study. Stage I consisted of translating and reviewing the scales by six experts. In Stage II, equivalence was tested by comparing the responses between the Korean and English versions among 71 bilingual adults. Stage III established the psychometric properties of the Korean versions SPS-K and STS-K among 154 Korean elders. Cronbach's alpha of the SPS-K and the STS-K .97, and .85 respectively with Korean elders. Factor analysis showed that the SPS-K had one factor; the STS-K had four factors with one factor clearly representing self-transcendence as theorized. Both scales showed good reliability and validity for the translated Korean versions. However, continued study of the construct validity of the STS-K is needed. Study findings indicate that the SPS-K and the STS-K could be useful for nurses and geriatric researchers to assess a broadly defined spirituality, and to conduct research on spirituality and health among Korean elders. Use of these scales within a theory-based study may contribute to further knowledge about the role of spirituality in the health and well-being of Korean people facing health crises.
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Energy Technology Data Exchange (ETDEWEB)
Sponseller, Patricia, E-mail: sponselp@uw.edu; Pelly, Nicole; Trister, Andrew; Ford, Eric; Ermoian, Ralph
2015-10-01
Radiation therapy for pediatric patients often includes the use of intravenous anesthesia with supplemental oxygen delivered via the nasal cannula. Here, we describe the use of an adaptive anesthesia technique for electron irradiation of the right naris in a preschool-aged patient treated under anesthesia. The need for an intranasal bolus plug precluded the use of standard oxygen supplementation. This novel technique required the multidisciplinary expertise of anesthesiologists, radiation therapists, medical dosimetrists, medical physicists, and radiation oncologists to ensure a safe and reproducible treatment course.
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International Nuclear Information System (INIS)
Sponseller, Patricia; Pelly, Nicole; Trister, Andrew; Ford, Eric; Ermoian, Ralph
2015-01-01
Radiation therapy for pediatric patients often includes the use of intravenous anesthesia with supplemental oxygen delivered via the nasal cannula. Here, we describe the use of an adaptive anesthesia technique for electron irradiation of the right naris in a preschool-aged patient treated under anesthesia. The need for an intranasal bolus plug precluded the use of standard oxygen supplementation. This novel technique required the multidisciplinary expertise of anesthesiologists, radiation therapists, medical dosimetrists, medical physicists, and radiation oncologists to ensure a safe and reproducible treatment course
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Clinical trial experience using erythropoietin during radiation therapy
International Nuclear Information System (INIS)
Lavey, R.S.
1998-01-01
Oncologists have several reasons for trying to maintain or increase hemoglobin levels in their patients during therapy. Relief of the symptoms of anemia, including fatigue and dyspnea, are traditional, well-accepted indications. A newer rationale is to enhance the efficacy of radiation therapy and/or chemotherapy in controlling tumors. A laboratory animal study found that administration of recombinant human erythropoietin (rHuEPO) increased intratumoral median oxygen levels and diminished the proportion of measurements in the very low ( [de
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Synergism between diabetic and radiation retinotherapy: case report and review
International Nuclear Information System (INIS)
Viebahn, M.; Barricks, M.E.; Osterloh, M.D.
1991-01-01
It is suspected that radiation retinopathy is more likely to develop in an eye with preexisting diabetic retinopathy than in a normal eye. However, there is only one report of this occurring, at a radiation dose of 4500 rads. We present a woman with minimal diabetic retinopathy who had breast carcinoma which was treated with chemotherapy but metastasised to the choroid. Within nine months of external beam radiation (3000 rads in fractions of 200 rads) a fulminant retinopathy evolved in that eye, while the non-radiated eye showed no change. The histopathology of radiation and diabetic retinopathy and causes for possible synergism are discussed. As this case report shows, radiation oncologists and ophthalmologists need to be aware of the risk that patients with minimal diabetic retinopathy who have undergone chemotherapy may suffer a dramatic visual loss from radiation therapy despite a radiation dose which is considered adequate, safe, and properly fractionated. (author)
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Jacobs, M.
2015-01-01
The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and following esophageal surgery, the barriers and facilitators patients experienced when discussing their information needs with their oncologist, and the development of a web-based question prompt shee...
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The North Korean Nuclear Crisis: Outcome and Resolution
International Nuclear Information System (INIS)
Lee, Seung-Keun
2011-01-01
This paper focuses on the North Korean nuclear crisis and how to find the best method of dismantling the North's nuclear facilities. From empirical studies of North Korean negotiating behavior, strategy, intentions and future of the regime, North Korea seems unlikely to abandon its nuclear program, if left unconstrained. This paper analyzes North Korean nuclear strategy and discusses problems concerned with the North Korean nuclear issues. It will propose some resolutions for a comprehensive approach in order to find a solution to the North Korean nuclear threat: restarting the six-party talks; preparation of a sophisticated nuclear elimination road-map; encouraging the gradual transformation of North Korea and its integration into the international community. In the long run, when North Korean nuclear strategy is considered, dialogue and engagement combined with international pressure or proper sanctions is needed
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Clinical management of gastric cancer: results of a multicentre survey
International Nuclear Information System (INIS)
Zhang, Xiaolong; Wen, Feng; Jiang, Yu; Xu, Feng; Feng, Hong; Bi, Feng; Li, Qiu; Li, Nanjing; Wei, Wen; Yao, Wenxiu; Xie, Ke; Hu, Jiankun; Shen, Lida; Ji, Weizheng; Lu, You
2011-01-01
The National Comprehensive Cancer Network clinical practice guidelines in oncology-gastric cancer guidelines have been widely used to provide appropriate recommendations for the treatment of patients with gastric cancer. The aim of this study was to examine the adherence of surgical oncologists, medical oncologists, and radiation oncologists' to the recommended guidelines. A questionnaire asking the treatment options for gastric cancer cases was sent to 394 Chinese oncology specialists, including surgical oncologists, medical oncologists, and radiation oncologists working in hospitals joined in The Western Cooperative Gastrointestinal Oncology Group of China. The questionnaire involved a series of clinical scenarios regarding the interpretation of surgery, neoadjuvant, adjuvant, and advanced treatment planning of gastric cancer. Analysis of 358 respondents (91%) showed variations between each specialization and from the recommended guidelines in the management approaches to specific clinical scenarios. The majority of specialists admitted that less than 50% of patients received multidisciplinary evaluation before treatment. The participants gave different responses to questions involving adjuvant, neoadjuvant, and advanced settings, compared to the recommended guidelines. These results highlight the heterogeneity of the treatment of gastric cancer. Surgical oncologists, medical oncologists, and radiation oncologists are not adhering to the recommended guidelines
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DESCRIPTIVE STUDY OF HONORIFIC USE IN KOREAN EMAIL DISCOURSE
Directory of Open Access Journals (Sweden)
Jaegu Kim
2016-07-01
Full Text Available It is a relatively new field that examines how Korean culture affects Korean language use in terms of age difference in a corpus of computer mediated email discourse. The purpose of this descriptive study and experiment is to prove the close relationship between Korean language and culture. This paper shows the descriptive study of Korean culture in relation to language use. Korean culture acknowledges an inherent hierarchy with regard to age, and considers [+age] as relating socially to [+power]. When younger Koreans converse with older ones, they express different morpho-syntactic patterns, which is an age complex. The main task of the experiment was to examine the way through which the age complex is reflected by Korean honorific linguistic system in email discourse. I asked 15 Korean native speakers between the ages of 20 to 25 to write emails expressing an impositive request to [+age (46-50 years old], [-age (below 25 years old] and [=age] recipients. The results show significant differences in the use of grammatical features in emails written to [+age] recipients, as compared to emails written to [-age] and [=age] recipients. The implication of the findings is that the cultural values that are attached to age and aging in the Korean society affects Koreans’ language use, which means Korean language and culture are closely intermingled.
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A multi-professional software tool for radiation therapy treatment verification
International Nuclear Information System (INIS)
Fox, Tim; Brooks, Ken; Davis, Larry
1996-01-01
Purpose: Verification of patient setup is important in conformal therapy because it provides a means of quality assurance for treatment delivery. Electronic portal imaging systems have led to software tools for performing digital comparison and verification of patient setup. However, these software tools are typically designed from a radiation oncologist's perspective even though treatment verification is a team effort involving oncologists, physicists, and therapists. A new software tool, Treatment Verification Tool (TVT), has been developed as an interactive, multi-professional application for reviewing and verifying treatment plan setup using conventional personal computers. This study will describe our approach to electronic treatment verification and demonstrate the features of TVT. Methods and Materials: TVT is an object-oriented software tool written in C++ using the PC-based Windows NT environment. The software utilizes the selection of a patient's images from a database. The software is also developed as a single window interface to reduce the amount of windows presented to the user. However, the user can select from four different possible views of the patient data. One of the views is side-by-side comparison of portal images (on-line portal images or digitized port film) with a prescription image (digitized simulator film or digitally reconstructed radiograph), and another view is a textual summary of the grades of each portal image. The grades of a portal image are assigned by a radiation oncologist using an evaluation method, and the physicists and therapists may only review these results. All users of TVT can perform image enhancement processes, measure distances, and perform semi-automated registration methods. An electronic dialogue can be established through a set of annotations and notes among the radiation oncologists and the technical staff. Results: Features of TVT include: 1) side-by-side comparison of portal images and a prescription image; 2
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Ethnic Mobilization among Korean Dry Cleaners
Thomas, Ward F; Ong, Paul
2015-01-01
Korean immigrants in the U.S. rely heavily on ethnic resources to start small businesses. Ethnic resources include business networks and knowledge, start-up capital, and access to labor power that are embedded in networks of family, friends, and co-ethnics. This paper shows how Korean dry cleaners in Southern California used ethnic resources to mobilize in response to an environmental policy initiated by the South Coast Air Quality Management District (AQMD). While Korean immigrants used e...
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Lim, Kyung-Choon; Waters, Catherine M; Froelicher, Erika S; Kayser-Jones, Jeanie S
2008-01-01
People can live longer and healthier lives by engaging in physical activity (PA). The purpose of this article is to assess the social cognitive theory (SCT) in relation to its relevance to produce cultural-specific directions for gerontological nursing practice in order to guide the design of PA interventions for Korean-American elders. SCT is compared to the Korean cultural, social, and health belief system and is analyzed and evaluated based on 3 criteria: assumptions of the theory, completeness and consistency, and essence of nursing. Within the Korean culture, as presumed in the SCT and the nursing paradigm, health-promoting behavior, such as PA, is conceptualized as the desire for a higher level of health rather than a fear of disease as is proposed by other health behavior theories. SCT with the integration of Korean culture recognizes cultural, developmental, societal, and other external constraints that may help in formulating interventions and better understanding of the limits faced by older Korean-Americans (OKAs) in their pursuit of routine PA.
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A sketch of language history in the Korean Peninsula.
Lee, Sean
2015-01-01
Among 7100 languages spoken on Earth, the Koreanic language is the 13th largest, with about 77 million speakers in and around the Korean Peninsula. In comparison to other languages of similar size, however, surprisingly little is known about the evolution of the Koreanic language. This is mainly due to two reasons. The first reason is that the genealogical relationship of the Koreanic to other neighboring languages remains uncertain, and thus inference from the linguistic comparative method provides only provisional evidence. The second reason is that, as the ancestral Koreanic speakers lacked their own writing system until around 500 years ago, there are scant historical materials to peer into the past, except for those preserved in Sinitic characters that we have no straightforward way of interpreting. Here I attempt to overcome these disadvantages and shed some light on the linguistic history of the Korean Peninsula, by analyzing the internal variation of the Koreanic language with methods adopted from evolutionary biology. The preliminary results presented here suggest that the evolutionary history of the Koreanic language is characterized by a weak hierarchical structure, and intensive gene/culture flows within the Korean Peninsula seem to have promoted linguistic homogeneity among the Koreanic variants. Despite the gene/culture flows, however, there are still three detectable linguistic barriers in the Korean Peninsula that appear to have been shaped by geographical features such as mountains, elevated areas, and ocean. I discuss these findings in an inclusive manner to lay the groundwork for future studies.
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Energy Technology Data Exchange (ETDEWEB)
Datta, Niloy R., E-mail: niloyranjan.datta@ksa.ch [Centre for Radiation Oncology, Kantonsspital Aarau - Kantonsspital Baden, Kantonsspital Aarau, Aarau (Switzerland); Samiei, Massoud [Consultancy Practice, Vienna (Austria); Bodis, Stephan [Centre for Radiation Oncology, Kantonsspital Aarau - Kantonsspital Baden, Kantonsspital Aarau, Aarau, Switzerland, and Department of Radiation Oncology, University Hospital Zurich (Switzerland)
2014-07-01
Purpose: Radiation therapy, a key component of cancer management, is required in more than half of new cancer patients, particularly in low- and middle-income countries (LMICs). The projected rise in cancer incidence over the next decades in LMICs will result in an increasing demand for radiation therapy services. Considering the present cancer incidence and that projected for 2020 (as listed in GLOBOCAN), we evaluated the current and anticipated needs for radiation therapy infrastructure and staffing by 2020 for each of the LMICs. Methods and Materials: Based on World Bank classification, 139 countries fall in the category of LMICs. Details of teletherapy, radiation oncologists, medical physicists, and radiation therapy technologists were available for 84 LMICs from the International Atomic Energy Agency–Directory of Radiotherapy Centres (IAEA-DIRAC) database. Present requirements and those for 2020 were estimated according to recommendations from the IAEA and European Society for Radiotherapy and Oncology (ESTRO-QUARTS). Results: Only 4 of the 139 LMICs have the requisite number of teletherapy units, and 55 (39.5%) have no radiation therapy facilities at present. Patient access to radiation therapy in the remaining 80 LMICs ranges from 2.3% to 98.8% (median: 36.7%). By 2020, these 84 LMICs would additionally need 9169 teletherapy units, 12,149 radiation oncologists, 9915 medical physicists, and 29,140 radiation therapy technologists. Moreover, de novo radiation therapy facilities would have to be considered for those with no services. Conclusions: Twelve pragmatic steps are proposed for consideration at national and international levels to narrow the gap in radiation therapy access. Multipronged and coordinated action from all national and international stakeholders is required to develop realistic strategies to curb this impending global crisis.
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International Nuclear Information System (INIS)
Datta, Niloy R.; Samiei, Massoud; Bodis, Stephan
2014-01-01
Purpose: Radiation therapy, a key component of cancer management, is required in more than half of new cancer patients, particularly in low- and middle-income countries (LMICs). The projected rise in cancer incidence over the next decades in LMICs will result in an increasing demand for radiation therapy services. Considering the present cancer incidence and that projected for 2020 (as listed in GLOBOCAN), we evaluated the current and anticipated needs for radiation therapy infrastructure and staffing by 2020 for each of the LMICs. Methods and Materials: Based on World Bank classification, 139 countries fall in the category of LMICs. Details of teletherapy, radiation oncologists, medical physicists, and radiation therapy technologists were available for 84 LMICs from the International Atomic Energy Agency–Directory of Radiotherapy Centres (IAEA-DIRAC) database. Present requirements and those for 2020 were estimated according to recommendations from the IAEA and European Society for Radiotherapy and Oncology (ESTRO-QUARTS). Results: Only 4 of the 139 LMICs have the requisite number of teletherapy units, and 55 (39.5%) have no radiation therapy facilities at present. Patient access to radiation therapy in the remaining 80 LMICs ranges from 2.3% to 98.8% (median: 36.7%). By 2020, these 84 LMICs would additionally need 9169 teletherapy units, 12,149 radiation oncologists, 9915 medical physicists, and 29,140 radiation therapy technologists. Moreover, de novo radiation therapy facilities would have to be considered for those with no services. Conclusions: Twelve pragmatic steps are proposed for consideration at national and international levels to narrow the gap in radiation therapy access. Multipronged and coordinated action from all national and international stakeholders is required to develop realistic strategies to curb this impending global crisis
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Geographic Analysis of the Radiation Oncology Workforce
Energy Technology Data Exchange (ETDEWEB)
Aneja, Sanjay [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Smith, Benjamin D. [University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gross, Cary P. [Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Department of General Internal Medicine, Yale University School of Medicine, New Haven, CT (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Cancer Institute of New Jersey, New Brunswick, NJ (United States); Roberts, Kenneth [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States)
2012-04-01
Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.
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Geographic Analysis of the Radiation Oncology Workforce
International Nuclear Information System (INIS)
Aneja, Sanjay; Smith, Benjamin D.; Gross, Cary P.; Wilson, Lynn D.; Haffty, Bruce G.; Roberts, Kenneth; Yu, James B.
2012-01-01
Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.
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Guidelines for safe practice of stereotactic body (ablative) radiation therapy
International Nuclear Information System (INIS)
Foote, Matthew; Barry, Tamara; Bailey, Michael; Smith, Leigh; Seeley, Anna; Siva, Shankar; Hegi-Johnson, Fiona; Booth, Jeremy; Ball, David; Thwaites, David
2015-01-01
The uptake of stereotactic ablative body radiation therapy (SABR) / stereotactic body radiation therapy (SBRT) worldwide has been rapid. The Australian and New Zealand Faculty of Radiation Oncology (FRO) assembled an expert panel of radiation oncologists, radiation oncology medical physicists and radiation therapists to establish guidelines for safe practice of SABR. Draft guidelines were reviewed by a number of international experts in the field and then distributed through the membership of the FRO. Members of the Australian Institute of Radiography and the Australasian College of Physical Scientists and Engineers in Medicine were also asked to comment on the draft. Evidence-based recommendations (where applicable) address aspects of departmental staffing, procedures and equipment, quality assurance measures, as well as organisational considerations for delivery of SABR treatments. Central to the guidelines is a set of key recommendations for departments undertaking SABR. These guidelines were developed collaboratively to provide an educational guide and reference for radiation therapy service providers to ensure appropriate care of patients receiving SABR.
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Chang, Miya
2018-01-01
This study examines the prevalence of elder abuse and the relationship between sociodemographic factors and elder abuse among older Koreans in the United States and Korea. Survey data from older Koreans aged between 60 and 79 years from the two countries ( n = 480) were analyzed descriptively and in binary logistic regressions. This study found a similar prevalence of elder abuse in the two samples, with 26% of older Korean immigrants in the United States reporting abuse and 23% of older Koreans in Korea reporting abuse. However, there were significant differences in the types of emotional abuse experienced by older Koreans in both countries. Reports of some types of emotional abuse, such as 'name calling' and 'silent treatment,' were significantly higher in the United States than in Korea. These findings expand our knowledge of the experience of elder abuse among older Koreans in both countries.
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Schwekendiek, Daniel J
2017-04-01
This paper investigates the trend in height among adult Korean orphans who were adopted in early life into affluent Western nations. Final heights of 148 females were analyzed based on a Korean government survey conducted in 2008. Height of the orphans was descriptively compared against final heights of South and North Koreans. Furthermore, statistical determinants of orphan height were investigated in multivariate regressions. Mean height of Korean orphans was 160.44 cm (SD 5.89), which was higher than that of South Koreans at 158.83 cm (SD 5.01). Both Korean orphans and South Koreans were taller than North Koreans at 155.30 cm (SD 4.94). However, height of Korean orphans stagnated at around 160-161 cm while those of North and South Koreans improved over time. In the regression analysis, the socioeconomic status of the adoptive family was statistically significant in all models, while dummies for the adoptive nations and age at adoption were insignificant. This study shows that the mean final height of women experiencing extreme environmental improvements in early-life is capped at 160-161 cm, tentatively suggesting that social stress factors in the host nation or early-life factors in the birth nation might have offset some of the environmental enrichment effects achieved through intercountry adoption.
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Labranche, Leah; Johnson, Marjorie; Palma, David; D'Souza, Leah; Jaswal, Jasbir
2015-01-01
Radiation oncologists require an in-depth understanding of anatomical relationships for modern clinical practice, although most do not receive formal anatomy training during residency. To fulfill the need for instruction in relevant anatomy, a series of four multidisciplinary, interactive learning modules were developed for a cohort of radiation…
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A Critical Content Analysis of Korean-to-English and English-to-Korean Translated Picture Books
Chang, Mi-Kyoung
2013-01-01
This study explores cultural representations and cultural adaptations made by translators in translated children's picture books. This study has two focuses. In the first part of this study, which is a critical content analysis, I examine the cultural representations depicted in Korean-to-English and English-to-Korean translated picture books,…
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Kong, Eun-Hi
2007-03-01
The purpose of this review is to explore cultural influences on the experiences of Korean, Korean American, and Caucasian American family caregivers caring for frail older adults in terms of the selection of a primary caregiver, caregiving motivation, support/help-seeking, and negative emotional responses(depression and burden). Seven electronic databases were searched to retrieve studies from 1966 to 2005. Thirty-two studies were identified. This review supported cultural influences on the selection of primary caregiver, caregiving motivation, and support/help-seeking among the three caregiver groups. In Korean caregivers, the major primary caregivers were daughters-in-law while among Korean American and Caucasian American caregivers, the major primary caregivers were daughters or spouses. As a major caregiving motivation, Caucasian American caregivers reported filial affection while Korean caregivers and Korean American caregivers reported filial obligation. Korean caregivers reported higher extended family support, while Caucasian American caregivers reported higher utilization of formal support. Korean caregivers showed the highest levels of depression followed by Korean American caregivers and Caucasian American caregivers. In order to develop culturally appropriate interventions and policies, more research is needed to further explain these differences among the three groups, especially regarding support/help-seeking and negative emotional responses.
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Chung, Jane; Thompson, Hilaire J; Joe, Jonathan; Hall, Amanda; Demiris, George
2017-01-01
Despite the increasing use of home-based monitoring technologies by older adults, few studies have examined older adults' acceptance of these technologies, especially among people from diverse cultural groups. The purpose of this study was to explore Korean and Korean American older adults' attitudes toward and perceptions of home-based monitoring technologies in a cultural context. A qualitative analysis of focus groups and individual interviews using inductive coding methods and a constant comparative approach for emerging themes was conducted. Several cultural factors that determine the acceptability of home-based monitoring technologies were identified. Most notably, the necessity of living alone due to loosened filial tradition and immigration was a main motivator for adopting these technologies for both Korean and Korean Americans. The level of satisfaction with the health care system or therapeutic interaction affected participants' perceived need for technologies. Compared with the Korean American group, Korean older adults regarded the government's role as more important in increasing adoption and use of new technologies. Contextual factors need to be considered when explaining perceptions of home-based monitoring technologies among older adults from various ethnic groups and developing diffusion strategies according to end users' attitudes, experiences, and cultural backgrounds.
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Directory of Open Access Journals (Sweden)
Victoria Lee
2013-07-01
Full Text Available The common stereotype of the inexpressive Asian, holding all emotions at bay, continues in our expectations of how Asian couples relate in intimate relationships. There is also a widely held belief that Asian marriages embrace more covenant-oriented commitments, compromising individual freedom and expression for the sake of harmony and integration of the couple. The current study attempted to test these stereotypes among Koreans living in the United States and Native Koreans. Results indicated that the dominant culture significantly shapes the expression and importance of alexithymia among Koreans, but when Koreans are a minority group, traditional beliefs may exert an even greater influence on the covenantal aspects of the couple relationship. Most interestingly, couples with only one Korean member had very different results than the other groups; most notably in a strong significant negative relationship between emotional intelligence and relationship satisfaction.
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Directory of Open Access Journals (Sweden)
Sumi YOON
2012-01-01
The informants in the present study consisted of four groups: Japanese university students who live in their own country, Japanese university students who live in the U.S., Korean university students who live in their own country and Korean university students who live in the U.S. A Discourse Complete Test (DCT was completed by Japanese and Korean university students to compare the differences in speaker responsibility in apologies. The results suggest that Korean should be classified as a speaker-responsible language for understanding in conversations, since Korean speakers produce many more utterances and convey more information per utterance to the interlocutor than Japanese speakers. Furthermore, it is found that the responsibility for the understanding of utterances correlate with daily use of American English, especially in the case of Japanese university students.
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The Korean nuclear ODA policy development
International Nuclear Information System (INIS)
Lee, Seung Hyun; Min, Kim Yoo; Park, Young Il
2012-01-01
Korean nuclear Official Development Assistance (ODA) is established with support from institutes such as the Korea International Cooperation Agency (KOICA) and the Korea Atomic Energy Research Institute (KAERI). KOICA's grant aid mainly made through the activities including IAEA's training program, and KAERI currently runs the inter-regional education and training cooperation called Asian Network for Education in Nuclear Technology(ANENT) which aimed to achieve the goal of encouraging web based education training network via cooperation with IAEA. Yet now these programs are focusing more on assisting nuclear infrastructure rather than highlighting nuclear education and training. This paper aims to, first, do a self-evaluation about the Korean ODA policy; second, to study the transition of the international nuclear atmosphere; and third, by apprehending the trend of the subjects of Korean nuclear ODA policy, to discuss the overall appropriate trajectory of Korean nuclear ODA
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Directory of Open Access Journals (Sweden)
Naveen Salins
2016-01-01
Conclusion: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.
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Lee, Kyung Won; Cho, Mi Sook
2014-01-01
The traditional Korean diet has several healthy components, including abundant vegetables, fermented foods, a variety of foodstuffs, and a balance of animal and vegetable food intake. Although the traditional Korean diet has many healthy components, few studies have been conducted on the health advantages of the Korean dietary pattern. This study is intended to clarify the relationship between Korean dietary patterns and chronic diseases using the Integrated Korean Dietary Pattern Score (I-KDPS). I-KDPS is an index for measuring Korean dietary patterns based on traditional Korean meals and reflects the complex and multifaceted characteristics of Korean food culture. I-KDPS is composed of seven items to measure the level of balance and adequacy of Korean food consumption, with a maximum score of 60. When I-KDPS was applied to the Korean National Health and Nutrition Examination Survey (1998-2009), a nationwide survey, I-KDPS was closely related to the risk of metabolic syndrome. Even though there were a few differences among the years surveyed, the risk of metabolic syndrome, obesity, hypertension, and hypertriglyceridemia significantly decreased as I-KDPS increased. These results indicate that risk of diseases, including metabolic syndrome, decreases in individuals adhering to traditional Korean dietary patterns in adequate levels and those who eat a balanced diet. The result of this study shows that the traditional Korean table setting, which comprises side dishes, including seasoned vegetables, grilled dishes, and fermented products with cooked rice (bap), soup (guk), and kimchi, contains traits that help prevent metabolic syndrome. I-KDPS coupled with the basic study of the healthfulness of the Korean dietary lifestyle is expected to help establish a foundation for continuous development of health promoting Korean foods and dietary culture.
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Impact of social media for the hematologist/oncologist.
Abuhadra, Nour; Majhail, Navneet S; Nazha, Aziz
2017-10-01
In the era of modern communication, the physician and patient relationship has evolved to include an entirely new dimension-social media. This new dimension offers several opportunities for patient education, research and its dissemination, and professional development for health care providers; it can also serve as a platform for addressing important public health issues. However, these advantages come with challenges such as threats to patient and professional privacy. In this article, we dissect the benefits and drawbacks of this social evolution on the practicing hematologist-oncologist. We also perform a review of the current literature on the integration of social media in the practice of hematology/oncology; examine available guidelines for information exchange between health care professionals, industry, pharmaceutical companies, advocacy groups, and patients; and offer ways to create its seamless integration into clinical hematology-oncology practice. Copyright © 2017 Elsevier Inc. All rights reserved.
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Acculturation and Health of Korean American Adults.
Shin, Cha-Nam; Lach, Helen W
2014-07-01
Increasing cultural diversity in the United States and significant health disparities among immigrant populations make acculturation an important concept to measure in health research. The purpose of this cross-sectional, descriptive study was to examine acculturation and health of Korean American adults. A convenience sample of 517 Korean American adults in a Midwestern city completed a survey in either English or Korean. All four groups of Berry's acculturation model were identified using cluster analysis with Lee's Acculturation Scale. Assimilation, integration, and separation were found in the English survey sample, whereas integration, separation, and marginalization were found in the Korean survey sample. Moreover, the findings revealed that acculturation is a bidimensional process, and the unique nature of samples may determine acculturation groups. Physical health and mental health were significantly related to acculturation in the English survey sample. However, there was not a significant relationship between health and acculturation in the Korean survey sample. © The Author(s) 2014.
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Na, Peter J; Kim, Kim B; Lee-Tauler, Su Yeon; Han, Hae-Ra; Kim, Miyong T; Lee, Hochang B
2017-12-01
Our aim is to investigate the prevalence and predictors of suicidal ideation among Korean American older adults and assess the self-rated mental health of Korean American older adults with suicidal ideation with or without depressive syndrome. The Memory and Aging Study of Koreans is a cross-sectional, epidemiologic study of a community-representative sample of Korean American older adults (N = 1116) residing in the Baltimore-Washington area. Participants were interviewed using the Korean version of the Patient Health Questionnaire (PHQ-9K). In addition, demographic information, self-rated mental health, and self-rated physical health status were obtained. In this study, 14.7% of Korean American older adults reported suicidal ideation. Predictors of suicidal ideation included living alone, major or minor depressive syndrome (diagnosed by the PHQ-9K), shorter duration of residency in the USA, and poorer self-rated mental health status. Of those who reported suicidal ideation, 64% did not have minor or major depressive syndrome. However, their self-rated mental health was as poor as that of those with major or minor depressive syndrome but without suicidal ideation. Suicidal ideation without depressive syndromes was common among Korean American older adults. For this group of elders with poor self-rated mental health, future studies should look to improving early detection of suicide risks and developing feasible suicide prevention interventions. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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Aestheticized politics : the workings of North Korean art
Yoon, Min-Kyung
2014-01-01
My dissertation is a study of North Korean art as a site where politics, history, and culture meet. Art in North Korea fulfills a clear purpose. This is most apparent in the depiction of historical themes in North Korean art. History serves the political legitimization of the North Korean state and
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The internationalization of the Korean radiological society
International Nuclear Information System (INIS)
Choi, Byung Ihn; Kim, Seung Hyup; Han, Man Chung; Kim, Young Goo; Kim, Kun Sang
1995-01-01
Toward the beginning of the twenty-first century, the world experiences the dramatic changes in politics, economics and culture, and it is evident that the Korean medical field will not be able to survive provided it doesn't prepare ourselves to adapt to those changes. The Korean Medical Society held a forum for the active operation of the medical society, inviting several leading affiliated societies, to meet the needs of the times. This review describes the summary of the presentation that the authors made on behalf of the Korean Radiological Society in the forum, including the organization, current status of academic activity, current status of international communication, and problems encountered in the internationalization of the Korean Radiological Society
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Characteristics of Watermelon Mosaic Virus Transmission Occurring in Korean Ginseng
Directory of Open Access Journals (Sweden)
Seung-Kook Choi
2014-09-01
Full Text Available Korean ginseng (Panax ginseng is the most popular herb for medical purpose in Korea. Recently, viral diseases from Korean ginseng showing various degrees of severe mottling, variegation and mosaic symptoms have caused quantity losses of Korean ginseng in a large number of farms. Watermelon mosaic virus (named WMVgin was identified as a causal agent for the disease of Korean ginseng. Interestingly, WMV-gin failed to infect both Korean ginseng plant and susceptible host species including cucurbitaceous plants by mechanical inoculation. However, WMV-gin could successfully infect Korean ginseng by transmission of two aphid species (Myzus persicae and Aphis gossypii. It is likely that transmission of WMV-gin was done by both the aphid species during feeding behavior of the two aphid species on Korean ginseng, though the aphids dislike feeding in Korea ginseng. Similarly, a strain of WMV (WMV-wm isolated from watermelon was transmitted successfully to Korean ginseng plant by the two aphid species, but not by mechanical inoculations. Transmission assays using M. persicae and A. gossypii clearly showed both WMV-gin and WMV-wm were not transmitted from infected Korean ginseng plant to cucurbit species that are good host species for WMV. These results suggest WMV disease occurring in Korean ginseng plant can be controlled by ecological approaches.
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Prototype demonstration of radiation therapy planning code system
International Nuclear Information System (INIS)
Little, R.C.; Adams, K.J.; Estes, G.P.; Hughes, L.S. III; Waters, L.S.
1996-01-01
This is the final report of a one-year, Laboratory-Directed Research and Development project at the Los Alamos National Laboratory (LANL). Radiation therapy planning is the process by which a radiation oncologist plans a treatment protocol for a patient preparing to undergo radiation therapy. The objective is to develop a protocol that delivers sufficient radiation dose to the entire tumor volume, while minimizing dose to healthy tissue. Radiation therapy planning, as currently practiced in the field, suffers from inaccuracies made in modeling patient anatomy and radiation transport. This project investigated the ability to automatically model patient-specific, three-dimensional (3-D) geometries in advanced Los Alamos radiation transport codes (such as MCNP), and to efficiently generate accurate radiation dose profiles in these geometries via sophisticated physics modeling. Modem scientific visualization techniques were utilized. The long-term goal is that such a system could be used by a non-expert in a distributed computing environment to help plan the treatment protocol for any candidate radiation source. The improved accuracy offered by such a system promises increased efficacy and reduced costs for this important aspect of health care
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Kraan, C.F.; Drossaert, Constance H.C.; Taal, Erik; Smit, Willem A.; Seydel, E.R.; van de Laar, Mart A F J
2010-01-01
The objective of this study is to explore the experiences and attitudes of rheumatologists and oncologists with regard to their patients’ health-related Internet use. In addition, we explored how often physicians referred their patients to health-related Internet sites. We sent a questionnaire to
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Minimum requirements on a QA program in radiation oncology
International Nuclear Information System (INIS)
Almond, P.R.
1996-01-01
In April, 1994, the American Association of Physicists in Medicine published a ''Comprehensive QA for radiation oncology:'' a report of the AAPM Radiation Therapy Committee. This is a comprehensive QA program which is likely to become the standard for such programs in the United States. The program stresses the interdisciplinary nature of QA in radiation oncology involving the radiation oncologists, the radiotherapy technologies (radiographers), dosimetrists, and accelerator engineers, as well as the medical physicists. This paper describes a comprehensive quality assurance program with the main emphasis on the quality assurance in radiation therapy using a linear accelerator. The paper deals with QA for a linear accelerator and simulator and QA for treatment planning computers. Next the treatment planning process and QA for individual patients is described. The main features of this report, which should apply to QA programs in any country, emphasizes the responsibilities of the medical physicist. (author). 7 refs, 9 tabs
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Minimum requirements on a QA program in radiation oncology
Energy Technology Data Exchange (ETDEWEB)
Almond, P R [Louisville Univ., Louisville, KY (United States). J.G. Brown Cancer Center
1996-08-01
In April, 1994, the American Association of Physicists in Medicine published a ``Comprehensive QA for radiation oncology:`` a report of the AAPM Radiation Therapy Committee. This is a comprehensive QA program which is likely to become the standard for such programs in the United States. The program stresses the interdisciplinary nature of QA in radiation oncology involving the radiation oncologists, the radiotherapy technologies (radiographers), dosimetrists, and accelerator engineers, as well as the medical physicists. This paper describes a comprehensive quality assurance program with the main emphasis on the quality assurance in radiation therapy using a linear accelerator. The paper deals with QA for a linear accelerator and simulator and QA for treatment planning computers. Next the treatment planning process and QA for individual patients is described. The main features of this report, which should apply to QA programs in any country, emphasizes the responsibilities of the medical physicist. (author). 7 refs, 9 tabs.
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Tanriverdi, Ozgur; Aydemir, Nil Fatma
2014-01-01
Music therapy is a common complementary and alternative therapy in addition to medical treatment for patients with cancer. If music therapy, which is known has a positive effect on human emotions and behaviors, is a useful additional therapy, it should be more integrated into pyscho-oncology. In this study, we aimed to determine medical oncologist attitudes to music therapy for patients with cancer and knowledge about musicology and music therapy in Turkey. This survey study included questions about participant attitudes and knowledge regarding music therapy as well as demographic characteristics. The population of the study were 402 physicians working in medical oncology in Turkey and the sample covered 112 participants in the the survey. For statistical analyses the chi-square test, Fischer exact test, and Mann-Whitney U analysis are applied. In our study the rate for medical oncologists who were interested in music therapy was 28% (n=112). Some 30% (n=34) of medical oncologists recommended music therapy for their patients and 55% (n=61) recommended music therapy to prevent anxiety in patients with cancer. In this study, for more harmony with patients and in order to ensure management of adverse effect, it was concluded that music therapy should be regrded as an additional therapy in oncology clinics.
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Effects of Psychiatric Symptoms on Attention in North Korean Refugees.
Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young; Kim, Seog Ju
2016-09-01
We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task. North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation.
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Effect of gamma irradiation on Korean traditional multicolored paintwork
Yoon, Minchul; Kim, Dae-Woon; Choi, Jong-il; Chung, Yong-Jae; Kang, Dai-Ill; Hoon Kim, Gwang; Son, Kwang-Tae; Park, Hae-Jun; Lee, Ju-Woon
2015-10-01
Gamma irradiation can destroy fungi and insects involved in the bio-deterioration of organic cultural heritages. However, this irradiation procedure can alter optical and structural properties of historical pigments used in wooden cultural heritage paintings. The crystal structure and color centers of these paintings must be maintained after application of the irradiation procedure. In this study, we investigated the effects of gamma irradiation on Korean traditional multicolored paintwork (Dancheong) for the preservation of wooden cultural heritages. The main pigments in Korean traditional wooden cultural heritages, Sukganju (Hematite; Fe2O3), Jangdan (Minium; Pb3O4), Whangyun (Crocoite; PbCrO4), and Jidang (Rutile; TiO2), were irradiated by gamma radiation at doses of 1, 5, and 20 kGy. After irradiation, changes in Commision Internationale d'Eclairage (CIE) color values (L*, a*, b*) were measured using the color difference meter, and their structural changes were analyzed using X-ray diffraction (XRD) analysis. The slightly change in less than 1 dE* unit by gamma irradiation was observed, and structural changes in the Dancheong were stable after exposure to 20 kGy gamma irradiation. In addition, gamma irradiation could be applied to painted wooden cultural properties from the Korean Temple. Based on the color values, gamma irradiation of 20 kGy did not affect the Dancheong and stability was maintained for five months. In addition, the fungicidal and insecticidal effect by less than 5 kGy gamma irradiation was conformed. Therefore, the optical and structural properties of Dancheong were maintained after gamma irradiation, which suggested that gamma irradiation can be used for the preservation of wooden cultural heritages painted with Dancheong.
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International Nuclear Information System (INIS)
Eriksen, Jesper G.; Beavis, Andrew W.; Coffey, Mary A.; Leer, Jan Willem H.; Magrini, Stefano M.; Benstead, Kim; Boelling, Tobias; Hjälm-Eriksson, Marie; Kantor, Guy; Maciejewski, Boguslaw; Mezeckis, Maris; Oliveira, Angelo; Thirion, Pierre; Vitek, Pavel
2012-01-01
Introduction: In 2007 ESTRO proposed a revision and harmonisation of the core curricula for radiation oncologists, medical physicists and RTTs to encourage harmonised education programmes for the professional disciplines, to facilitate mobility between EU member states, to reflect the rapid development of the professions and to secure the best evidence-based education across Europe. Material and methods: Working parties for each core curriculum were established and included a broad representation with geographic spread and different experience with education from the ESTRO Educational Committee, local representatives appointed by the National Societies and support from ESTRO staff. Results: The revised curricula have been presented for the ESTRO community and endorsement is ongoing. All three curricula have been changed to competency based education and training, teaching methodology and assessment and include the recent introduction of the new dose planning and delivery techniques and the integration of drugs and radiation. The curricula can be downloaded at (http://www.estro-education.org/europeantraining/Pages/EuropeanCurricula.aspx). Conclusion: The main objective of the ESTRO core curricula is to update and harmonise training of the radiation oncologists, medical physicists and RTTs in Europe. It is recommended that the authorities in charge of the respective training programmes throughout Europe harmonise their own curricula according to the common framework.
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An examination of human factors in external beam radiation therapy: Findings and implications
International Nuclear Information System (INIS)
Henriksen, K.; Kaye, R.D.; Jones, R.E. Jr.; Morisseau, D.S.; Persensky, J.J.
1994-01-01
To better understand the contributing factors to human error in external beam radiation therapy, the US Nuclear Regulatory Commission has undertaken a series of human factors evaluations. A team of human factors specialists, assisted by a panel of radiation oncologists, medical physicists, and radiation technologists, conducted visits to 24 radiation oncology departments at community hospitals, university centers, and free-standing clinics. A function and task analysis was initially performed to guide subsequent evaluations in the areas of human-system interfaces, procedures, training and qualifications, and organizational policies and practices. Representative findings and implications for improvement are discussed within the context of a dynamic model which holds that misadministration likely results from the unanticipated interaction of several necessary but singly insufficient conditions
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Korean society of mechanical engineers 60 years
International Nuclear Information System (INIS)
2005-12-01
This book introduces 60 years of Korean society of mechanical engineers with birth, foundation, development process, change of enforcement regulation and articles of association, important data of this association, 60 years of parts, committee and branch, business of association like academic event, publication, technical development business, supporting research centers, bond Korean society of mechanical engineers and mechanical industry and development of related organizations, development for industrial fields and development direction of Korean society of mechanical engineers.
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A Nuclear Dilemma--Korean War Deja Vu
2006-03-08
USAWC STRATEGY RESEARCH PROJECT A NUCLEAR DILEMMA—KOREAN WAR DEJA VU by Lieutenant Colonel Trent A. Pickering United States Air Force Colonel William...Lieutenant Colonel Trent A. Pickering TITLE: A Nuclear Dilemma—Korean War Deja Vu FORMAT: Strategy Research Project DATE: 8 March 2006 WORD COUNT: 19,270...1. REPORT DATE 15 MAR 2006 2. REPORT TYPE 3. DATES COVERED 00-00-2005 to 00-00-2006 4. TITLE AND SUBTITLE Nuclear Dilemma--Korean War Deja
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Handbook for Teaching Korean-American Students.
California State Dept. of Education, Sacramento. Bilingual Education Office.
This handbook is designed for teachers, administrators, and other school personnel. It provides an explanation of the sociocultural and linguistic characteristics of Korean-Americans so educators can address their needs more effectively and orchestrate a better teaching environment by understanding and supporting the Korean-American cultural…
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Bullying Involvement of Korean Children in Germany and in Korea
Bae, Hwa-ok
2016-01-01
This study compared bullying involvement of Korean or Korean-German children living in Germany with children in Korea, and examined children's perceptions of school environment associated with bullying involvement of the children. This study included 105 Korean or Korean-German children living in the Bayern State of Germany as the study sample and…
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Principles of radiation therapy
International Nuclear Information System (INIS)
Richter, M.P.; Share, F.S.; Goodman, R.L.
1985-01-01
Radiation oncology now represents the integration of knowledge obtained over an 80-year period from the physics and biology laboratories and the medical clinic. Such integration is recent; until the supervoltage era following World War II, the chief developments in these three areas for the most part were realized independently. The physics and engineering laboratories have now developed a dependable family of sources of ionizing radiations that can be precisely directed at tumor volumes at various depths within the body. The biology laboratory has provided the basic scientific support underlying the intensive clinical experience and currently is suggesting ways of using ionizing radiations more effectively, such as modified fractionation schedules relating to cell cycle kinetics and the use of drugs and chemicals as modifiers of radiation response and normal tissue reaction. The radiation therapy clinic has provided the patient stratum on which the acute and chronic effects of irradiation have been assessed, and the patterns of treatment success and failure identified. The radiation therapist has shared with the surgeon and medical oncologist the responsibility for clarifying the natural history of a large number of human neoplasms, and through such clarifications, has developed more effective treatment strategies. Several examples of this include the improved results in the treatment of Hodgkin's disease, squamous cell carcinoma of the cervix, seminoma, and epithelial neoplasms of the upper aerodigestive tract
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Chemosensitized repeat radiation in assortment of squamous cell carcinoma recurrence-MAMC experience
International Nuclear Information System (INIS)
Sharma, Manoj; Saxena, Y.K.; Baruah, J.D.
1998-01-01
The recurrence of already irradiated squamous cell carcinoma poses multifold problems to an oncologist. If it is the fear of insensitivity due to hypoxia and over dose than prescribed tolerated dose to a radio therapist, it is the fear of inoperatibility and pre/post operative morbidity to a surgeon and fear of post radiation dense fibrosis in the tumour bed and hence poor drug diffusion to a chemotherapist
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The value of an educational video before consultation with a radiation oncologist.
Matsuyama, Robin K; Lyckholm, Laurie J; Molisani, Anthony; Moghanaki, Drew
2013-06-01
This study aims to assess the efficacy of a radiation therapy (RT) education video for patients referred for treatment. The investigators produced a 23-min guide to radiation therapy DVD, combining didactic material and patient narratives. Patients (n=32) had not yet received their initial consultation. Baseline awareness about cancer and treatment was assessed by surveys including the rapid estimate of adult literacy in medicine. Knowledge about RT was assessed before and after viewing the video with a separate 21 question survey. Differences in benefit for sociodemographic subgroups including age, gender, ethnicity, income, education, and health literacy level were explored. Baseline assessments identified 78 % of patients regardless of sociodemographic status had "little" to "no" basic knowledge of RT. The mean number of correct responses in the 21 question survey assessing how RT works improved from 9.8 to 11.1 after watching the video (peducation (p=0.002). Patient satisfaction with the video was high. Knowledge among cancer patients regarding RT is poor, regardless of sociodemographic factors. This pilot study demonstrates the utility of a brief video to universally improve patient awareness about RT. While patients may ultimately learn about RT during their course of treatment, we advocate for any tools that can improve patient knowledge at the time of initial consultation as this is typically the time they are asked to acknowledge informed consent for treatment.
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Trace of Korean mechanical industry
International Nuclear Information System (INIS)
1996-12-01
This book reports 50 years of Korean mechanical engineers, which includes birth and history, remembrance and future of Korean society of mechanical engineers, current situation and development of mechanical industry such as national industry and 50 years of mechanical industry, track, airline industry, ship and marine engine, a precision instrument, cutting work, casting, welding, plastic working freeze and air handling nuclear power and textile machinery.
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Lee, Jong-Hyun; Kim, Hyo-Eun; Kang, Ji-Hun; Shin, Jin-Young; Song, Yun-Mi
2014-01-01
Background Although hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified. Methods We analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors. Results Overall pre...
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Changzoo Song
2016-01-01
The half-million Soviet Koreans (or Koryŏ saram) in the former Soviet Union are the descendants of the ethnic Koreans who migrated to the Russian Far East in the late 19th and early 20th centuries from the northern parts of the Korean peninsula. Their settlements were established in the wide areas of the Russian Far East, including the urban areas around Vladivostok. They were, however, forced-migrated to Central Asia in late 1937 under Stalin's rule. From Central Asia, these Soviet Koreans w...
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Group Psychodrama for Korean College Students
Chae, Soo Eun; Kim, Soo Jin
2017-01-01
Psychodrama was first introduced in the Korean literature in 1972, but its generalization to college students did not occur until the 1990s. Despite findings from psychodrama studies with Korean college students supporting psychodrama as effective for developing and maintaining good interpersonal relationships, as well as decreasing anxiety and…
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Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates
Energy Technology Data Exchange (ETDEWEB)
Loewen, Shaun K., E-mail: shaun.loewen@cancercare.mb.ca [CancerCare Manitoba, Winnipeg, MB (Canada); Halperin, Ross; Lefresne, Shilo [BC Cancer Agency, Vancouver, BC (Canada); Trotter, Theresa [Tom Baker Cancer Centre, Calgary, AB (Canada); Stuckless, Teri [Dr H. Bliss Murphy Cancer Centre, St. John' s, NL (Canada); Brundage, Michael [Cancer Centre of Southeastern Ontario, Kingston, ON (Canada)
2015-10-01
Purpose: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. Methods and Materials: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Results: Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Conclusions: Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada.
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Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates
International Nuclear Information System (INIS)
Loewen, Shaun K.; Halperin, Ross; Lefresne, Shilo; Trotter, Theresa; Stuckless, Teri; Brundage, Michael
2015-01-01
Purpose: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. Methods and Materials: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Results: Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Conclusions: Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada
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Park, Subin; Lee, Yeeun; Jun, Jin Yong
2017-11-01
North Korean adolescent defectors experience adaptation difficulties along with a wide range of psychosocial problems, but no study has yet examined their Internet addiction symptoms. We compared early traumatic experiences, self-esteem, negative cognition, and Internet addiction symptoms, as well as the relationships between these variables, between North Korean adolescent defectors and South Korean adolescents. Fifty-six North Korean adolescent defectors and 112 age- and sex- matched South Korean adolescents participated. The analyses examined the relationship between traumatic experiences and Internet addiction symptoms, with negative automatic thoughts or low self-esteem as mediators of these relations. North Korean adolescent defectors tended to have higher levels of negative automatic thoughts and more severe Internet addiction symptoms, as well as better self-esteem, than did South Korean adolescents. Furthermore, only among North Korean adolescent defectors, traumatic experiences were positively associated with Internet addition symptoms via increasing negative automatic thoughts. North Korean adolescent defectors are more susceptible to Internet addiction, negative cognitions, and early traumatic experiences compared to South Korean adolescents. However, the cross-sectional design of this study precludes consideration of the causality of these relationships. Interventions aiming to correct negative cognitions and increase self-esteem may be helpful for North Korean adolescent defectors with problematic Internet use. Copyright © 2017 Elsevier B.V. All rights reserved.
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Lee, Myoungsook; Chae, Soo Wan; Cha, Youn-Soo; Cho, Mi Sook; Oh, Hea Young
2013-01-01
The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population. PMID:23424060
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First-generation Korean-American parents' perceptions of discipline.
Kim, Eunjung; Hong, Seunghye
2007-01-01
Nurses not only need to be familiar with professional guidelines of discipline and but also need to be aware of variances in styles of acceptable discipline across cultural groups. The goal of this study was to explore cultural influences in relation to (1) first-generation Korean-American parents' perceptions of common discipline strategies in the United States, and (2) discipline strategies commonly used among first-generation Korean-American parents. Inductive content analysis was used to analyze interview data from seven first-generation Korean-American parents. Derived themes indicated that parents considered spanking/hitting and less hugging/kissing as Korean style, and time-out, use of sticker charts, hugging/kissing, removing/adding privileges, and giving chores as American style. Recent immigrant parents were not familiar with common positive discipline strategies in the United States. As they adapted to mainstream society, they discontinued what they perceived to be negative aspects of Korean style and adopted positive aspects of American style. They were sensitive to children's views on discipline, and they experienced communication difficulties with children. These findings indicated that Korean-American parents' perceptions of discipline strategies were shaped by living in two cultures and were different from western viewpoints.
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How to romanize Korean characters in international journals
Directory of Open Access Journals (Sweden)
Sun Huh
2017-08-01
Full Text Available For editors and manuscript editors, the romanization of Korean characters is a topic that should be understood thoroughly, because Korean proper nouns have become more widely used worldwide due to phenomena such as Hallyu (the Korean wave. In this report, I describe the 2 major romanization systems used in Korea: the Korean government’s romanization system and the McCune-Reischauer system. I also describe the transliteration guidelines presented in a variety of reference styles, such as the CSE (Council of Science Editors, ACS (American Chemical Society, AMA (American Medical Association, APA (American Psychological Association, IEEE (Institute of Electrical and Electronics Engineers styles and the NLM (National Library of Medicine style guide. I found that 2 journals have adopted the Korean government’s romanization system, while 10 use the McCune-Reischauer system. Other journals do not specifically mention a romanization system. Editors should select a romanization system and use it consistently. When presenting a reference that includes romanized text, the journal’s house style should be followed, based on international reference citation styles. Chinese characters in documents published in Korea should be romanized according to the Korean pronunciation.
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Development of the Reference Korean Female Voxel Phantom
International Nuclear Information System (INIS)
Ham, Bo Kyoung; Cho, Kun Woo; Yeom, Yoen Soo; Jeong, Jong Hwi; Kim, Chan Hyeong; Han, Min Cheol
2012-01-01
The objective of this study is for development of the reference Korean female phantom, HDRK-Woman. The phantom was constructed by adjusting a Korean woman voxel phantom to the Reference Korean data. The Korean woman phantom had been developed based on the high-resolution color slice images obtained from an adult Korean female cadaver. There were a total of 39 organs including the 27 organs specified in ICRP 103 for effective dose calculation. The voxel resolution of the phantom was 1.967 X 1.967 X X 2.0619 mm 3 and the voxel array size is 261 X 109 X 825 in the x, y and z directions. Then, the voxel resolution was changed to 2.0351 X 2.0351 X 2.0747 mm 3 for adjustment of the height and total bone mass of the phantom to the Reference Korean data. Finally, the internal organs and tissue were adjusted using in-house software program developed for 3D volume adjustment of the organs and tissue. The effective dose values of HDRK phantoms were calculated for broad parallel photon beams using MCNPX Monte Carlo code and compared with those of ICRP phantoms.
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Development of the Reference Korean Female Voxel Phantom
Energy Technology Data Exchange (ETDEWEB)
Ham, Bo Kyoung; Cho, Kun Woo [University of Science and Technology, Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Yeom, Yoen Soo; Jeong, Jong Hwi; Kim, Chan Hyeong; Han, Min Cheol [Hanyang University, Seoul (Korea, Republic of)
2012-03-15
The objective of this study is for development of the reference Korean female phantom, HDRK-Woman. The phantom was constructed by adjusting a Korean woman voxel phantom to the Reference Korean data. The Korean woman phantom had been developed based on the high-resolution color slice images obtained from an adult Korean female cadaver. There were a total of 39 organs including the 27 organs specified in ICRP 103 for effective dose calculation. The voxel resolution of the phantom was 1.967 X 1.967 X X 2.0619 mm{sup 3} and the voxel array size is 261 X 109 X 825 in the x, y and z directions. Then, the voxel resolution was changed to 2.0351 X 2.0351 X 2.0747 mm{sup 3} for adjustment of the height and total bone mass of the phantom to the Reference Korean data. Finally, the internal organs and tissue were adjusted using in-house software program developed for 3D volume adjustment of the organs and tissue. The effective dose values of HDRK phantoms were calculated for broad parallel photon beams using MCNPX Monte Carlo code and compared with those of ICRP phantoms.
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Development of Safe Food Handling Guidelines for Korean Consumers.
Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon
2015-08-01
The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers.
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International Nuclear Information System (INIS)
Jeon Bu-Guan
1994-01-01
A realistic approach to North-South arms control and disarmament would require a step-by-step formula encompassing measures for political and military confidence building, arms limitation and reduction. The most fundamental and important condition for achieving meaningful results in disarmament talks is securing political and military confidence. The problem which arose on the Korean peninsula originates from relations of North Korea and IAEA. North Korean position poses a serious threat to the Non-proliferation Treaty, in particular to the IAEA Safeguards regime. Nuclear non-proliferation and the ultimate elimination of nuclear weapons are the primary concerns of the post-cold war era. The Government of South Korea hopes that this issue can be solved through dialogue and negotiations
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Lim, Jung Sub; Lim, Se Won; Ahn, Ju Hyun; Song, Bong Sub; Shim, Kye Shik; Hwang, Il Tae
2014-09-01
To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.
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International Nuclear Information System (INIS)
Roberts, Kenneth B.; Soulos, Pamela R.; Herrin, Jeph; Yu, James B.; Long, Jessica B.; Dostaler, Edward
2013-01-01
Purpose: New radiation therapy modalities have broadened treatment options for older women with breast cancer, but it is unclear how clinical factors, geographic region, and physician preference affect the choice of radiation therapy modality. Methods and Materials: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify women diagnosed with stage I-III breast cancer from 1998 to 2007 who underwent breast-conserving surgery. We assessed the temporal trends in, and costs of, the adoption of intensity modulated radiation therapy (IMRT) and brachytherapy. Using hierarchical logistic regression, we evaluated the relationship between the use of these new modalities and patient and regional characteristics. Results: Of 35,060 patients, 69.9% received conventional external beam radiation therapy (EBRT). Although overall radiation therapy use remained constant, the use of IMRT increased from 0.0% to 12.6% from 1998 to 2007, and brachytherapy increased from 0.7% to 9.0%. The statistical variation in brachytherapy use attributable to the radiation oncologist and geographic region was 41.4% and 9.5%, respectively (for IMRT: 23.8% and 22.1%, respectively). Women undergoing treatment at a free-standing radiation facility were significantly more likely to receive IMRT than were women treated at a hospital-based facility (odds ratio for IMRT vs EBRT: 3.89 [95% confidence interval, 2.78-5.45]). No such association was seen for brachytherapy. The median radiation therapy cost per treated patient increased from $5389 in 2001 to $8539 in 2007. Conclusions: IMRT and brachytherapy use increased substantially from 1998 to 2007; overall, radiation therapy costs increased by more than 50%. Radiation oncologists played an important role in treatment choice for both types of radiation therapy, whereas geographic region played a bigger role in the use of IMRT than brachytherapy
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Energy Technology Data Exchange (ETDEWEB)
Roberts, Kenneth B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Soulos, Pamela R. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); Herrin, Jeph [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Health Research and Educational Trust, Chicago, Illinois (United States); Yu, James B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Long, Jessica B. [Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Comprehensive Cancer Center and Yale University School of Medicine, New Haven, Connecticut (United States); Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); Dostaler, Edward [Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut (United States); and others
2013-04-01
Purpose: New radiation therapy modalities have broadened treatment options for older women with breast cancer, but it is unclear how clinical factors, geographic region, and physician preference affect the choice of radiation therapy modality. Methods and Materials: We used the Surveillance, Epidemiology, and End Results-Medicare database to identify women diagnosed with stage I-III breast cancer from 1998 to 2007 who underwent breast-conserving surgery. We assessed the temporal trends in, and costs of, the adoption of intensity modulated radiation therapy (IMRT) and brachytherapy. Using hierarchical logistic regression, we evaluated the relationship between the use of these new modalities and patient and regional characteristics. Results: Of 35,060 patients, 69.9% received conventional external beam radiation therapy (EBRT). Although overall radiation therapy use remained constant, the use of IMRT increased from 0.0% to 12.6% from 1998 to 2007, and brachytherapy increased from 0.7% to 9.0%. The statistical variation in brachytherapy use attributable to the radiation oncologist and geographic region was 41.4% and 9.5%, respectively (for IMRT: 23.8% and 22.1%, respectively). Women undergoing treatment at a free-standing radiation facility were significantly more likely to receive IMRT than were women treated at a hospital-based facility (odds ratio for IMRT vs EBRT: 3.89 [95% confidence interval, 2.78-5.45]). No such association was seen for brachytherapy. The median radiation therapy cost per treated patient increased from $5389 in 2001 to $8539 in 2007. Conclusions: IMRT and brachytherapy use increased substantially from 1998 to 2007; overall, radiation therapy costs increased by more than 50%. Radiation oncologists played an important role in treatment choice for both types of radiation therapy, whereas geographic region played a bigger role in the use of IMRT than brachytherapy.
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Korean species of the genus Perlomyia Banks, 1906 (Plecoptera: Leuctridae).
Murányi, Dávid; Jeon, Mi Jeong; Hwang, Jeong Mi; Seo, Hong Yul
2014-11-04
Eight species of the genus Perlomyia (Plecoptera: Leuctridae) are reported from Korea, six are new records for the Korean Peninsula. Two species, known only as unassociated females are described under informal unnamed designations. Previous Korean records are discussed, taxonomic characters of the Korean specimens and Korean distribution are presented for these species. Zoogeographic notes on the Asian Perlomyia are also given.
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Language and Family Dispersion: North Korean Linguist Kim Su-gyŏng and the Korean War
Directory of Open Access Journals (Sweden)
Ryuta Itagaki
2017-03-01
Full Text Available This article analyzes the unpublished memoir of Kim Su-gyŏng (1918–2000, a linguist who was active in North Korea from the mid-1940s until the late 1960s, and situates his account of his experience of the Korean War within the context of his linguistic essays and correspondence. In doing so, the article considers the role that the personal and the social play in language, utilizing Saussure’s theoretical framework, with which Kim himself was well versed. Kim wrote his memoirs in the 1990s to his family, from whom he had become separated during the Korean War and who now lived in Toronto. In this text, he writes in “personal” language that reveals his uncertainty and his feelings for his family, but then immediately negates these feelings through the use of “social” language, which resonates with his interpretation of the linguistic thesis that Josef Stalin developed during the Korean War on language and national identity. For Kim, the relationship between language and nation was not at all self-evident, but something that he idealized in response to the dispersal of his family. By offering a reflexive reading of a memoir written by a North Korean linguist, this article makes a breakthrough in the investigation of North Korean wartime academic history, which has not risen above the level of analyzing articles in the field of linguistics that were published at the time.
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Gender, Acculturation, Food Patterns, and Overweight in Korean Immigrants
Jasti, Sunitha; Lee, Chang Hyun; Doak, Colleen
2011-01-01
Objective: To describe acculturation, food patterns, overweight, and gender differences among Korean immigrants in the United States. Methods: A cross-sectional exploratory survey assessed acculturation, food frequencies, and weight status of 195 Korean immigrants. Results: Acculturated Korean immigrants (score greater than or equal to] 2.5) were…
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Catalogue of Korean manuscripts and rare books
DEFF Research Database (Denmark)
Lerbæk Pedersen, Bent
2014-01-01
Catalogue of Korean manuscripts and rare books in The Royal Library, Copenhagen and the National Museum of Denmark......Catalogue of Korean manuscripts and rare books in The Royal Library, Copenhagen and the National Museum of Denmark...
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Bieber, Christiane; Nicolai, Jennifer; Gschwendtner, Kathrin; Müller, Nicole; Reuter, Katrin; Buchholz, Angela; Kallinowski, Birgit; Härter, Martin; Eich, Wolfgang
2018-06-01
The aims of this study are to assess patients' preferred and perceived decision-making roles and preference matching in a sample of German breast and colon cancer patients and to investigate how a shared decision-making (SDM) intervention for oncologists influences patients' preferred and perceived decision-making roles and the attainment of preference matches. This study is a post hoc analysis of a randomised controlled trial (RCT) on the effects of an SDM intervention. The SDM intervention was a 12-h SDM training program for physicians in combination with decision board use. For this study, we analysed a subgroup of 107 breast and colon cancer patients faced with serious treatment decisions who provided data on specific questionnaires with regard to their preferred and perceived decision-making roles (passive, SDM or active). Patients filled in questionnaires immediately following a decision-relevant consultation (t1) with their oncologist. Eleven of these patients' 27 treating oncologists had received the SDM intervention within the RCT. A majority of cancer patients (60%) preferred SDM. A match between preferred and perceived decision-making roles was reached for 72% of patients. The patients treated by SDM-trained physicians perceived greater autonomy in their decision making (p < 0.05) with more patients perceiving SDM or an active role, but their preference matching was not influenced. A SDM intervention for oncologists boosted patient autonomy but did not improve preference matching. This highlights the already well-known reluctance of physicians to engage in explicit role clarification. German Clinical Trials Register DRKS00000539; Funding Source: German Cancer Aid.
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Understanding Korean food culture from Korean paintings
Directory of Open Access Journals (Sweden)
Hae Kyung Chung
2016-03-01
Conclusion: Beyond the basic value of food in maximizing nutrients and energy, Korean food culture has developed distinctive cultural characteristics through more than 5,000 years of agricultural history. Although the genre paintings analyzed in this paper are limited to a certain era, this paper will serve as a milestone in providing direction for future studies.
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Stereotactic Radiosurgery and Stereotactic Body Radiotherapy (SBRT)
... The radiation oncologist and, in some cases, a neurosurgeon lead the treatment team and oversee the treatment; ... In the case of the Gamma Knife, the neurosurgeon and/or radiation oncologist may help position the ...
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Correlates of Perceived Smoking Prevalence Among Korean American Emerging Adults.
Cerrada, Christian J; Unger, Jennifer B; Huh, Jimi
2016-10-01
Perceived smoking prevalence, a strong predictor of actual smoking behavior, may be influenced by the ethnicity and gender of the reference group presented to Korean American emerging adults. Self-identifying Korean and Korean Americans aged 18-25 (N = 475), were invited to complete a 15-20 min online survey about their attitudes towards smoking. Predictors of perceived smoking prevalence were evaluated separately for four reference groups: Caucasian Americans, Korean Americans in general, Korean American men, and Korean American women. Respondents' smoking status was associated with perceived smoking prevalence for all reference groups except Caucasian Americans, even among light smokers. Father's smoking status was associated with perceived smoking prevalence for Korean American men, only among females respondents. Findings suggest that ethnicity and gender of both the reference group and respondents influence smoking rate estimates. Tailoring intervention content to the target population's gender and ethnicity may be a way to enhance smoking prevention strategies.
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Computed tomography in radiation therapy planning: Thoracic region
International Nuclear Information System (INIS)
Seydel, H.G.; Zingas, A.; Haghbin, M.; Mondalek, P.; Smereka, R.
1983-01-01
With the explosive spread of computed tomographic (CT) scanning throughout the United States, one of the main applications has been in patients who are treated for cancer by surgery, radiation therapy, or chemotherapy. For the radiation oncologist, the desire to provide local tumor control and avoid geographic misses to achieve an expected prolongation of survival has led to the use of large radiation fields in the treatment of intrathoracic cancer, including bronchogenic carcinoma, cancer of the esophagus, and other malignant tumors. The optimal radiation therapy plan is a balance between local tumor control and the necessity to preserve normal structures by the use of directed and limited fields for bulk disease. CT scanning has been employed to accurately demonstrate the extent of tumor as well as to determine the isodose distribution of radiation, including the spatial distribution of radiation portals in single planar and three-dimensional aspects as well as consideration of tissue inhomogeneities. The accurate planning of the distribution of therapeutic irradiation includes both the tumor-bearing target volume and the critical normal tissues. This chapter provides information regarding these aspects of the application of CT scanning to radiation therapy for bronchogenic carcinoma and carcinoma of the esophagus
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Tisnado, Diana; Malin, Jennifer; Kahn, Katherine; Landrum, Mary Beth; Fletcher, Robert; Klabunde, Carrie; Clauser, Steven; Rogers, Selwyn O; Keating, Nancy L
2016-07-01
Chemotherapy prolongs survival in patients with advanced non-small-cell lung cancer. However, few studies have included patients with poor performance status. This study examined rates of oncologists' recommendations for chemotherapy by patient performance status and symptoms and how physician characteristics influence chemotherapy recommendations. We surveyed medical oncologists involved in the care of a population-based cohort of patients with lung cancer from the CanCORS (Cancer Care Outcomes Research and Surveillance) study. Physicians were queried about their likelihood to recommend chemotherapy to patients with stage IV lung cancer with varying performance status (Eastern Cooperative Oncology Group performance status 0 [good] v 3 [poor]) and presence or absence of tumor-related pain. Repeated measures logistic regression was used to estimate the independent associations of patients' performance status and symptoms and physicians' demographic and practice characteristics with chemotherapy recommendations. Nearly all physicians (adjusted rate, 97% to 99%) recommended chemotherapy for patients with good performance status, and approximately half (adjusted rate, 38% to 53%) recommended chemotherapy for patients with poor performance status (P factors, physician and practice characteristics were less strongly associated with chemotherapy recommendations in adjusted analyses. Strong consensus among oncologists exists for chemotherapy in patients with advanced non-small-cell lung cancer and good performance status. However, the relatively high rate of chemotherapy recommendations for patients with poor performance status despite the unfavorable risk-benefit profile highlights the need for ongoing work to define high-value care in oncology and to implement and evaluate strategies to align incentives for such care. Copyright © 2016 by American Society of Clinical Oncology.
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Auto-segmentation of low-risk clinical target volume for head and neck radiation therapy.
Yang, Jinzhong; Beadle, Beth M; Garden, Adam S; Gunn, Brandon; Rosenthal, David; Ang, Kian; Frank, Steven; Williamson, Ryan; Balter, Peter; Court, Laurence; Dong, Lei
2014-01-01
To investigate atlas-based auto-segmentation methods to improve the quality of the delineation of low-risk clinical target volumes (CTVs) of unilateral tonsil cancers. Sixteen patients received intensity modulated radiation therapy for left tonsil tumors. These patients were treated by a total of 8 oncologists, who delineated all contours manually on the planning CT image. We chose 6 of the patients as atlas cases and used atlas-based auto-segmentation to map each the atlas CTV to the other 10 patients (test patients). For each test patient, the final contour was produced by combining the 6 individual segmentations from the atlases using the simultaneous truth and performance level estimation algorithm. In addition, for each test patient, we identified a single atlas that produced deformed contours best matching the physician's manual contours. The auto-segmented contours were compared with the physician's manual contours using the slice-wise Hausdorff distance (HD), the slice-wise Dice similarity coefficient (DSC), and a total volume overlap index. No single atlas consistently produced good results for all 10 test cases. The multiatlas segmentation achieved a good agreement between auto-segmented contours and manual contours, with a median slice-wise HD of 7.4 ± 1.0 mm, median slice-wise DSC of 80.2% ± 5.9%, and total volume overlap of 77.8% ± 3.3% over the 10 test cases. For radiation oncologists who contoured both the test case and one of the atlas cases, the best atlas for a test case had almost always been contoured by the oncologist who had contoured that test case, indicating that individual physician's practice dominated in target delineation and was an important factor in optimal atlas selection. Multiatlas segmentation may improve the quality of CTV delineation in clinical practice for unilateral tonsil cancers. We also showed that individual physician's practice was an important factor in selecting the optimal atlas for atlas-based auto
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Radiation therapy facilities in the United States
International Nuclear Information System (INIS)
Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah; Minsky, Bruce D.; Bach, Peter B.
2006-01-01
Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA), as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care
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Working Papers on Asian American Studies: Annotated Bibliography on Koreans in America.
Kim, Christopher
This classified annotated bibliography on Koreans in America includes references on the following topics: (1) Korean American directories, (2) immigration history, (3) deportation cases, (4) Korean students in the U.S., (5) Korean Americans in the Asian American Movement, (6) state and federal legislation affecting Koreans in America, (7) Korean…
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[Emotional display rules of Japanese and Koreans].
Lee, Ye-jin; Matsumoto, Yoshiyuki
2011-12-01
Hypothetical stories designed to arouse feelings of happiness, sadness, or anger were presented to Japanese (n = 310) and Koreans (n = 286) university students. They were asked to rate the intensity of the emotion experienced, and to select the corresponding facial expression to display in an individual situation and in a social situation. Analyses of covariance were conducted on the rating scores of facial expression using the intensities of emotion as the covariance, except for happiness where the within-class regression coefficients were not homogeneous. The results showed that Japanese and Koreans shared the emotional display rules about the expressions of emotions in individual situations more than in social situations. Japanese thought that they should suppress emotions more than Koreans did. Moreover, the differences in facial expressions between Japanese and Koreans were greater in the individual situations than in the social situations.
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Participation Patterns of Korean Adolescents in School-Based Career Exploration Activities
Rojewski, Jay W.; Lee, In Heok; Hill, Roger B.
2014-01-01
Variations in the school-based career exploration activities of Korean high school students were examined. Data represented 5,227 Korean adolescents in Grade 11 contained in the Korean Education Longitudinal Study of 2005, a nationally representative longitudinal database administered by the Korean Educational Development Institute. Latent class…
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Korean risk assessment model for breast cancer risk prediction.
Park, Boyoung; Ma, Seung Hyun; Shin, Aesun; Chang, Myung-Chul; Choi, Ji-Yeob; Kim, Sungwan; Han, Wonshik; Noh, Dong-Young; Ahn, Sei-Hyun; Kang, Daehee; Yoo, Keun-Young; Park, Sue K
2013-01-01
We evaluated the performance of the Gail model for a Korean population and developed a Korean breast cancer risk assessment tool (KoBCRAT) based upon equations developed for the Gail model for predicting breast cancer risk. Using 3,789 sets of cases and controls, risk factors for breast cancer among Koreans were identified. Individual probabilities were projected using Gail's equations and Korean hazard data. We compared the 5-year and lifetime risk produced using the modified Gail model which applied Korean incidence and mortality data and the parameter estimators from the original Gail model with those produced using the KoBCRAT. We validated the KoBCRAT based on the expected/observed breast cancer incidence and area under the curve (AUC) using two Korean cohorts: the Korean Multicenter Cancer Cohort (KMCC) and National Cancer Center (NCC) cohort. The major risk factors under the age of 50 were family history, age at menarche, age at first full-term pregnancy, menopausal status, breastfeeding duration, oral contraceptive usage, and exercise, while those at and over the age of 50 were family history, age at menarche, age at menopause, pregnancy experience, body mass index, oral contraceptive usage, and exercise. The modified Gail model produced lower 5-year risk for the cases than for the controls (p = 0.017), while the KoBCRAT produced higher 5-year and lifetime risk for the cases than for the controls (pKorean women, especially urban women.
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Comparatives Korean and Mongolian Achievement In Higher Education
Uranchimeg Julia Agvaantseren; Park Sae Hoon
2013-01-01
The purpose of this paper is to introduce the transition of Korean higher education reform and to study of Korean and Mongolian experience and achievement in contemporary higher education. And also paper provides a description of the higher education in Mongolia in an effort to identify important financial issues and concern while comparing with Korean high education experience and tries to attract attention of policy makers for better alternative...
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A Study of Renogram in Korean Hemorrhagic Fever
International Nuclear Information System (INIS)
Choi, Tae Kyu; Lee, Jung Sang; Koh, Chang Soon; Lee, Mun Ho
1974-01-01
The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using 131 I-ortho-iodohippurate and hippuran renogram was analysed means of quantitative and qualitative methods in 26 patients of Korean hemorrhagic fever. The results obtained with this study were as follows;1) During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairment of renal function and grave prognosis than the group with obstructive pattern of renogram. 2) During the diuretic phase, the renogram showed obstructive or dysfunction ar normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3) During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4) The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5) There was significant correlationship between the pattern of renogram and the decrease of renal plasma flow in the patients with Korean hemorrhagic fever. The decrease of renal plasma flow was marked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairment, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.
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Korean standard of postero-anterior cephalography
Energy Technology Data Exchange (ETDEWEB)
Ahn, Hyung Kyu [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)
1974-11-15
The author conducted an experiment using P-A Cephalography of 242 male and female subjects of ages ranging 2-6, 7- 15, and adult group. By means of Nakago's method of measurement, the standard value of Korean was obtained. The results were as follows; 1. In the group of an age, the male value was slightly greater than female value. 2. In each age group the difference between the right and left widths could be recognizable, however, it was not much great. 3. In each group, regardless of sex, the growth relation was clearly distinguishable at PO, ARI, ARE, MG, AG, and CAW. 4. When the standard value of adult Korean was compared with that of Japanese, that of Japanese was great with respect to the width of maxillary portion and that of Korean was great with respect to the width of mandibular portion. 5. Maximum head width of white man was almost similar to that of Korean, however, maxillary alveolar base width of white man was considerably small or the dental arch was narrow.
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Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team
Directory of Open Access Journals (Sweden)
Changsop Yang
2016-01-01
Full Text Available The purpose of this study was to report the current state of Korean medicine (KM treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%, low back (13.3%, elbow, and ankle (8.4% injuries were most common. Joint (41.6% and muscle (30.7% were major injured tissues. KM team medical doctors utilized acupuncture (40.4%, chuna manual therapy (16.0%, physical therapy (15.2%, taping (9.0%, and cupping (7.8% to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%. This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine.
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Prevalence of mood disorders and utility of the PRIME-MD in patients undergoing radiation therapy
International Nuclear Information System (INIS)
Leopold, Kenneth A.; Ahles, Tim A.; Walch, Susan; Amdur, Robert J.; Mott, Leila A.; Wiegand-Packard, Linda; Oxman, Thomas E.
1998-01-01
Purpose: To validate a short, structured interview procedure that allows practicing oncologists to quickly and reliably identify mood disorders in their patients, and to estimate the prevalence and types of mood disorders in a radiation therapy patient setting, noting relationships between mood disorders and patient characteristics. Methods: Consecutive, eligible adult patients from the practices of two radiation oncologists were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) by the treating physician. A subset of these patients was also evaluated with the SCID, administered by trained mental health care personnel. Agreement between the two instruments was examined using the kappa statistic. Prevalence of mood disorders was determined from the PRIME-MD. The significance of relationships between patient characteristics and mood disorders was examined by chi-square and ANOVA analysis, and subsequently by multivariate logistic regression analysis. Results: One hundred twenty-two patients were studied. Fifty-three of these were administered the SCID. Agreement between the two instruments was very good (kappa = 0.70). A diagnosis of a depressive or anxiety disorder by the PRIME-MD was made in 59 of the 122 patients (48%, 95% confidence interval = 39%, 58%). Multivariate analysis showed that a diagnosis of a depressive mood disorder was significantly related to pain intensity and prior history of depression. Conclusion: We have demonstrated the validity and feasibility of the PRIME-MD administered by oncologists in making diagnoses of mood disorders. The prevalence of mood disorders in our set of patients undergoing a course of RT was nearly 50%. Future studies should describe the natural history of these disorders, and determine optimal intervention strategies
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International Nuclear Information System (INIS)
Lee, Seo-Hang
1992-01-01
Recognizing the recent changes in international environment security structures suited for specific situations should be conceived. In order to achieve the way to regional security in North-East Asia the outstanding issue left over from the cold war, divided Korean peninsula, and other subregional disputes have to be solved. In building confidence between the two countries the recently adopted security related accords ('The Agreement on Reconciliation, Non-aggression and Exchange and Cooperation between the South and the North' and the 'Joint declaration on the Denuclearization of the Korean peninsula') provide a framework for improvements of relations
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Siwonhan-mat: The third taste of Korean foods
Directory of Open Access Journals (Sweden)
Soon Ah Kang
2016-03-01
Conclusion: Siwonhan-mat is a unique sensation found in Korean food. Understanding siwonhan-mat is a key to learning about Korean food and its food culture. Therefore, this paper serves an important role in understanding Korean food. Siwonhan-mat is often mistranslated using words to describe temperature, such as cool. This misinterpretation has resulted in confusion over the original meaning of siwonhan-mat and contributed to the incorrect usage of the word.
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Development of the two Korean adult tomographic computational phantoms for organ dosimetry
International Nuclear Information System (INIS)
Lee, Choonsik; Lee, Choonik; Park, Sang-Hyun; Lee, Jai-Ki
2006-01-01
Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300x150x344 voxels with a voxel resolution of 2x2x5 mm 3 for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and
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Yang, Jaeseok
2017-01-01
This case study explores the language attitudes and perceptions of Korean parents, with regard to their children's native language maintenance and ESL education in the US. The primary focuses are on (1) what aspects are held by Korean parents toward the maintenance of the native language in the US, and (2) how these perspectives operate in their…
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Radiation therapy for cancer in elderly patients over 80 years of age
International Nuclear Information System (INIS)
Nozaki, Miwako; Murakami, Yuko; Furuta, Masaya; Izawa, Yasuyuki; Iwasaki, Naoya
1998-01-01
The elderly population has recently increased, and the need for cancer care and treatment for the elderly is likely to grow. We report on radiation therapy for cancer in elderly patients over 80 years of age. During the period from 1985 to 1996, 90 elderly patients (54 men, 36 women) aged over 80 years were treated with radiation therapy. Many patients had primary tumors of the esophagus, head and neck, and lungs, in that order of frequency. Fifty-seven percent of the patients were treated with radical radiotherapy, and 70% were treated with radiotherapy alone. The rate of completion of radiation therapy was 90%, and the response rate was 82%. Radiation therapy played an important role in the treatment of the patients over 80 years of age. The half of our patients had concurrent medical problems, and were dependent on their home physicians both before and after radiation therapy. We consider that radiation oncologists should make an effort to form a good relationship with home physicians. (author)
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Radiation therapy for head and neck cancers a case-based review
Beyzadeoglu, Murat; Selek, Ugur
2014-01-01
This evidence-based guide to the current management of cancer cases at all head and neck sites will assist in the appropriate selection and delineation of tumor volumes/fields for intensity-modulated radiation therapy (IMRT), including volumetric modulated arc therapy (VMAT). Each tumor site-related chapter presents, from the perspective of an academic expert, several actual cases at different stages in order to clarify specific clinical concepts. The coverage includes case presentation, a case-related literature review, patient preparation, simulation, contouring, treatment planning, treatment delivery, and follow-up. The text is accompanied by illustrations ranging from slice-by-slice delineations on planning CT images to finalized plan evaluations based on detailed acceptance criteria. The book will be of value for residents, fellows, practicing radiation oncologists, and medical physicists interested in clinical radiation oncology.
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Nuclear proliferation in Northeast Asia: South Korean perspective
International Nuclear Information System (INIS)
Seo-Hang Lee
1995-01-01
Under new circumstances, that is after the end of the Cold War, the current security situation in Northeast Asia and Korean peninsula is reviewed. The South Korean Non-proliferation policy and its strong commitment to the NPT is embodied in the following: treaty commitments; government officials' statements; presidential declarations; North/South joint declarations; and domestic laws and regulations.Korea has made efforts towards denuclearisation of Korean peninsula. Its nuclear policy is based on peaceful uses of nuclear energy and on maintaining a strong commitment to the NPT. The ultimate goal of its policy is to deter North Korea from developing nuclear weapons and thus secure a nuclear-free Korean peninsula. This could lay foundation for the ultimate creation of region-wide nuclear-free zone in Northeast Asia
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Decision making in radiation oncology. Vol. 1
International Nuclear Information System (INIS)
Lu, Jiade J.; Brady, Luther W.
2011-01-01
Decision Making in Radiation Oncology is a reference book designed to enable radiation oncologists, including those in training, to make diagnostic and treatment decisions effectively and efficiently. The orientation of this groundbreaking publication is entirely practical, in that the focus is on issues relating to cancer management. The design has been carefully chosen based on the belief that ''a picture is worth a thousand words'': Knowledge is conveyed through an illustrative approach using algorithms, schemas, graphics, and tables. Text is kept to a minimum, reducing the effort involved in reading while enhancing understanding. Detailed guidelines are provided for multidisciplinary cancer management as well as for radiation therapy techniques. In addition to the attention-riveting algorithms for diagnosis and treatment, strategies for the management of disease at individual stages are detailed for all the commonly diagnosed malignancies. Detailed attention is given to the core evidence that has shaped the current treatment standards and advanced radiation therapy techniques. Clinical trials that have yielded ''gold standard'' treatment and their results are documented in the schemas. Moreover, radiation techniques, including treatment planning and delivery, are also presented in an illustrative way. (orig.)
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Decision making in radiation oncology. Vol. 1
Energy Technology Data Exchange (ETDEWEB)
Lu, Jiade J. [National Univ. of Singapore (Singapore). Dept. of Radiation Oncology; Brady, Luther W. (eds.) [Drexel Univ., Philadelphia, PA (United States). Dept. of Radiation Oncology
2011-10-15
Decision Making in Radiation Oncology is a reference book designed to enable radiation oncologists, including those in training, to make diagnostic and treatment decisions effectively and efficiently. The orientation of this groundbreaking publication is entirely practical, in that the focus is on issues relating to cancer management. The design has been carefully chosen based on the belief that ''a picture is worth a thousand words'': Knowledge is conveyed through an illustrative approach using algorithms, schemas, graphics, and tables. Text is kept to a minimum, reducing the effort involved in reading while enhancing understanding. Detailed guidelines are provided for multidisciplinary cancer management as well as for radiation therapy techniques. In addition to the attention-riveting algorithms for diagnosis and treatment, strategies for the management of disease at individual stages are detailed for all the commonly diagnosed malignancies. Detailed attention is given to the core evidence that has shaped the current treatment standards and advanced radiation therapy techniques. Clinical trials that have yielded ''gold standard'' treatment and their results are documented in the schemas. Moreover, radiation techniques, including treatment planning and delivery, are also presented in an illustrative way. (orig.)
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Multifractal analysis of the Korean agricultural market
Kim, Hongseok; Oh, Gabjin; Kim, Seunghwan
2011-11-01
We have studied the long-term memory effects of the Korean agricultural market using the detrended fluctuation analysis (DFA) method. In general, the return time series of various financial data, including stock indices, foreign exchange rates, and commodity prices, are uncorrelated in time, while the volatility time series are strongly correlated. However, we found that the return time series of Korean agricultural commodity prices are anti-correlated in time, while the volatility time series are correlated. The n-point correlations of time series were also examined, and it was found that a multifractal structure exists in Korean agricultural market prices.
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International Nuclear Information System (INIS)
Lee, Gyeong Geun; Lee, Yong Bok; Kim, Min Chul; Kwon, Junh Yun
2012-01-01
Neutron irradiation to reactor pressure vessel (RPV) steels causes a decrease in fracture toughness and an increase in yield strength while in service. It is generally accepted that the growth of point defect cluster (PDC) and copper rich precipitate (CRP) affects radiation hardening of RPV steels. A number of models have been proposed to account for the embrittlement of RPV steels. The rate theory based modeling mathematically described the evolution of radiation induced microstructures of ferritic steels under neutron irradiation. In this work, we compared the rate theory based modeling calculation with the surveillance test results of Korean Light Water Reactors (LWRs)
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The Power of Cinema on the Korean Peninsula
Samyel Lee
2015-01-01
Abstract: The Korean peninsula is constantly in a dynamic discussion of identity and direction. For South Korean society, it is no surprise that the Korean War and the existential threat that North Korea poses loom large over its collective conscience. Although mostly disregarded within scholarly discussions in international relations, cinema has always been, and continues to be, an insightful, powerful, and transformative forum. This essay discusses the ways in which cinema as an art form ha...
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K- Popping: Korean Women, K-Pop, and Fandom
Kim, Jungwon
2017-01-01
Korean popular music (hereafter K-pop) can be understood as an inclusive cultural phenomenon. K-pop fandom constitutes a sizeable portion of this phenomenon and is characteristic, to a large degree, of K-pop culture. However, female fans, especially in Korea, are frequently disdained in mainstream Korean culture, and their fandom has been undervalued and derided. Challenging this negative view of female fans, I autoethnographically examine Korean female K-pop fandom, based on my field researc...
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Management of immune thrombocytopenia: Korean experts recommendation in 2017.
Jang, Jun Ho; Kim, Ji Yoon; Mun, Yeung-Chul; Bang, Soo-Mee; Lim, Yeon Jung; Shin, Dong-Yeop; Choi, Young Bae; Yhim, Ho-Young; Lee, Jong Wook; Kook, Hoon
2017-12-01
Management options for patients with immune thrombocytopenia (ITP) have evolved substantially over the past decades. The American Society of Hematology published a treatment guideline for clinicians referring to the management of ITP in 2011. This evidence-based practice guideline for ITP enables the appropriate treatment of a larger proportion of patients and the maintenance of normal platelet counts. Korean authority operates a unified mandatory national health insurance system. Even though we have a uniform standard guideline enforced by insurance reimbursement, there are several unsolved issues in real practice in ITP treatment. To optimize the management of Korean ITP patients, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the consensus and the Korean data on the clinical practices of ITP therapy. Here, we report a Korean expert recommendation guide for the management of ITP.
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Kung, A; Hastings, K G; Kapphahn, K I; Wang, E J; Cullen, M R; Ivey, S L; Palaniappan, L P; Chung, S
2018-02-01
Korea has the highest suicide rate of developed countries, two times higher than the USA. Suicide trends among Koreans Americans living in the USA during the same period have not yet been described. We report suicide mortality rates and trends for four groups: (1) Korean Americans, (2) non-Hispanic White (NHW) Americans, (3) selected Asian American subgroups and (4) Koreans living in the Republic of Korea. We used US national (n = 18 113 585) and World Health Organization (WHO) (n = 232 919 253) mortality records for Korea from 2003 to 2012 to calculate suicide rates, all expressed per 100 000 persons. We assessed temporal trends and differences in age, gender and race/ethnicity using binomial regression. Suicide rates are highest in Koreans living in the Republic of Korea (32.4 for men and 14.8 for women). Suicide rates in Korean Americans (13.9 for men and 6.5 for women) have nearly doubled from 2003 to 2012 and exceed rates for all other Asian American subgroups (5.4-10.7 for men and 1.6-4.2 for women). Suicide rates among NHWs (21.0 for men and 5.6 for women) remain high. Among elders, suicide in Korean Americans (32.9 for men and 15.4 for women) is the highest of all examined racial/ethnic groups in the USA. Suicide in Korean Americans is higher than for other Asian Americans and follows temporal patterns more similar to Korea than the USA. Interventions to prevent suicide in Korean American populations, particularly among the elderly, are needed.
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DECISION OF TURKEY SENDING SOLDIER TO KOREAN IN NATIONAL PRESS
GÜL, Tülay
2014-01-01
After the World War II, Korean Peninsula was divided among two contrary different states in terms of ideology. In 25 June 1950, the war started between two states, Democratic People's Republic of Korea ( North Korean), Republic of Korean (South Korean). Following this development, The United Nations' Security Council held an emergency meeting with attempt of The U.S. and invited to participate in studies to conduct by states connected with its. Turkish governmet, founded by Democrat...
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Oh, Hyunsung; Jeong, Chung Hyeon
2017-10-01
Culture has been pinpointed as a culprit of disparities in health insurance coverage between Korean immigrants and other ethnic groups. This study explored specific mechanisms by which culture influences a decision to buy health insurance among self-employed Korean immigrants living in ethnic enclaves by focusing on the structure and functions of social networks. Between March and June 2015, we recruited 24 Korean immigrant adults (aged 18 or older) who identified as self-employed and being uninsured for substantial periods before 2014 in Southern California. Interviews were conducted in Korean, and Korean transcripts were translated into English by two bilingual interpreters. Using constant comparative analysis, we explored why participants didn't purchase health insurance after migrating to the United States and how their social networks influenced their decisions whether to purchase health insurance. Results indicate Korean immigrants sought health information from dense and homogeneous social networks whose members are mostly Korean immigrants embedded in similar social contexts. Social learning was frequently observed when people sought health care while uninsured. However, respondents often noted social ties do not provide helpful information about benefits, costs, and ways to use health insurance. "Koreans don't buy health insurance" was a dominant social norm reported by most respondents. Findings indicate that social learning and normative influence occur inside social networks and these mechanisms seemingly prevent purchasing of health insurance. In addition to the individual mandate in the Patient Protection and Affordable Care Act, more targeted approaches that consider the structure and functions of social networks could improve the public health of Korean immigrants. Copyright © 2017 Elsevier Ltd. All rights reserved.
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The oncologist as coordinator of the nutritional approach.
Bozzetti, Federico
2015-04-01
Although the nutritional approach, especially when delivered through a gastric or jejunal tube or in a central vein, is handled by the nutritional support team or a specialist in nutrition, it is the responsibility of the oncologist, who knows the natural history of the disease and the impact of the oncologic therapy, to identify the potential candidates for the nutritional support, to recommend the nutritional strategy and to integrate it within the oncologic program. If gastrointestinal function is preserved, the initial nutritional approach should be through oral supplementation, followed by tube feeding if previous attempts are unsuccessful or upper gastrointestinal tract is not accessible. Parenteral nutrition is the obligatory resort when patients are (sub)obstructed but it may also be a practical way to integrate an insufficient oral nutrient intake (so called "supplemental" parenteral nutrition). Depending on the patient's condition and the disease's stage, artificial nutrition may have a "permissive" role in patients receiving aggressive oncologic therapy or represent just a supportive treatment in patients likely to succumb from starvation sooner than from tumor progression. Copyright © 2015 Elsevier Inc. All rights reserved.
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Jeon, Jae Pil; Shim, Sung Mi; Jung, Jong Sun; Nam, Hye Young; Lee, Hye Jin; Oh, Berm Seok; Kim, Kuchan; Kim, Hyung Lae; Han, Bok Ghee
2009-09-30
To examine copy number variations among the Korean population, we compared individual genomes with the Korean reference genome assembly using the publicly available Korean HapMap SNP 50 k chip data from 90 individuals. Korean individuals exhibited 123 copy number variation regions (CNVRs) covering 27.2 mb, equivalent to 1.0% of the genome in the copy number variation (CNV) analysis using the combined criteria of P value (Por= 0.25) among study subjects. In contrast, when compared to the Affymetrix reference genome assembly from multiple ethnic groups, considerably more CNVRs (n=643) were detected in larger proportions (5.0%) of the genome covering 135.1 mb even by more stringent criteria (Por=0.25), reflecting ethnic diversity of structural variations between Korean and other populations. Some CNVRs were validated by the quantitative multiplex PCR of short fluorescent fragment (QMPSF) method, and then copy number invariant regions were detected among the study subjects. These copy number invariant regions would be used as good internal controls for further CNV studies. Lastly, we demonstrated that the CNV information could stratify even a single ethnic population with a proper reference genome assembly from multiple heterogeneous populations.
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Validation of a Korean version of the Fibromyalgia Impact Questionnaire.
Kim, Yun-A; Lee, Shin-Seok; Park, Kyeongsoo
2002-01-01
The aim of this study was to translate the Fibromyalgia Impact Questionnaire (FIQ) into Korean and to evaluate its reliability and validity for use with Korean-speaking patients with fibromyalgia (FM). After translating the FIQ into Korean, we administered it to 55 patients with FM (28 patients filled out the questionnaire again 7 days later) together with a Korean version of the Health Assessment Questionnaire (HAQ) and the Symptom Checklist-90-Revision (SCL-90-R). The tender-point count (TP...
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The Cultural Negotiations of Korean Immigrant Youth
Yeh, Christine J.; Ma, Pei-Wen; Madan-Bahel, Anvita; Hunter, Carla D.; Jung, Sunna; Kim, Angela B.; Akitaya, Kyoko; Sasaki, Kiyoko
2005-01-01
The authors investigated the process of cultural adjustment among 13 Korean immigrant youths using consensual qualitative research (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997). Results indicate that Korean youth are expected to negotiate and shift their identities to meet differing expectations across various interpersonal contexts.…
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International Nuclear Information System (INIS)
Hayman, James; Weeks, Jane; Mauch, Peter
1996-01-01
Payers are increasingly interested in knowing whether they are receiving value for the dollars they spend on health care. Because economic analyses will be used as a means of evaluating radiation therapy, it is important that radiation oncologists understand the basic methodology employed in such analyses. This review article describes the four basic types of economic analyses: cost minimization, cost effectiveness, cost utility, and cost benefit. Specification of alternative therapies, choice of perspective of the analysis, measurements of costs and benefits, and the role of discounting and sensitivity analyses are discussed. Published economic analyses that pertain directly to treatment with radiation therapy are reviewed. Finally, we close with a brief discussion of the potential areas for future economic outcomes research in radiation oncology
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Church-Based Recruitment to Reach Korean Immigrants: An Integrative Review.
Park, Chorong; Jang, Myoungock; Nam, Soohyun; Grey, Margaret; Whittemore, Robin
2017-04-01
Although the Korean church has been frequently used to recruit Korean immigrants in research, little is known about the specific strategies and process. The purpose of this integrative review was to describe recruitment strategies in studies of Korean immigrants and to identify the process of Korean church-based recruitment. Thirty-three studies met inclusion criteria. Four stages of church-based recruitment were identified: initiation, endorsement, advertisement, and implementation. This review identified aspects of the church-based recruitment process in Korean immigrants, which are different from the Black and Hispanic literature, due to their hierarchical culture and language barriers. Getting permission from pastors and announcing the study by pastors at Sunday services were identified as the key components of the process. Using the church newsletter to advertise the study was the most effective strategy for the advertisement stage. Despite several limitations, church-based recruitment is a very feasible and effective way to recruit Korean immigrants.
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The internet radiation oncology journal club - a multi-institutional collaborative education project
International Nuclear Information System (INIS)
Goldsmith, Brian J.; Donaldson, Sarah S.; Mendenhall, William M.; Recht, Abram; Hoppe, Richard T.; Grigsby, Perry W.; Turrisi, Andrew T.; Tepper, Joel E.; Roach, Mack; Larson, David A.; Withers, H. Rodney; Purdy, James A.
1997-01-01
Purpose/Objective: The high volume of literature publication in radiation oncology poses a substantial selection and reading challenge. Busy health care providers may, from time to time, fail to identify and read important papers, resulting in delays in improvement of practice standards. Residency training programs have historically used journal clubs as a solution to this education challenge. In June 1995, radiation oncologists and scientists from nine institutions began the Internet Radiation Oncology Journal Club (IROJC) - a pilot project created to improve radiation oncology education worldwide by identifying noteworthy literature and stimulating an internet-based forum for literature discussion. Materials and Methods: The IROJC is a free-of-charge, moderated e-mailing list hosted by BIOSCI - a set of electronic communication forums used by biological scientists worldwide. Eleven radiation oncologists and scientists with internationally-recognized subspecialty expertise serve as IROJC editors. Each month, editors select noteworthy contemporary literature for inclusion. Selected references, often accompanied by editorial comments, are transmitted over the internet to IROJC readers. Readers request subscription by sending an e-mail message to biosci-server at net.bio.net, with 'subscribe radoncjc' in the body of the message. A website (www.bio.net/hypermail/RADIATION-ONCOLOGY), which includes an archive of back issues, is also available. Results: By February 1997, the IROJC's email-format enrollment numbered more than 670 readers from over 14 countries, its website was browsed by an average of 25 unique readers per week, and both figures were increasing steadily. An exciting online dialogue of literature- and practice-based comments and questions had emerged with increasing readership participation. Conclusion: Our pilot experience with the IROJC project has been promising. The observed increase in enrollment, website use, and readership discourse suggests
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[Dentistry in Korean during the Japanese occupation].
Shin, Jae-Eu
2004-12-01
The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893, and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in September, 1905. The imperialist Japan licensed the dental technicians (yipchisa) without limit and controlled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed.) Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulations for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentists Suk-Tae Ham was register No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some Korean people that contributed to Japanese colonization. It made progress with the help of Japan, it was was given the approval of the establishment of the professional school in January the 25th, 1929. It was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. The Japanese forcefully annexed the Association of Hansung Dentists (Koreans only) to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche' -- 'Japan and Korea and one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese controlled
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[A study on Korean concepts of relaxation].
Park, J S
1992-01-01
Relaxation technique is an independent nursing intervention used in various stressful situations. The concept of relaxation must be explored for the meaning given by the people in their traditional thought and philosophy. Korean relaxation technique, wanting to become culturally acceptable and effective, is learning to recognize and develop Korean concepts, experiences, and musics of relaxation. This study was aimed at discovering Korean concepts, experiences and musics of relaxation and contributing the development of the relaxation technique for Korean people. The subjects were 59 nursing students, 39 hospitalized patients, 61 housewives, 21 rural residents and 16 researchers. Data were collected from September 4th to October 24th, 1991 by interviews or questionnaires. The data analysis was done by qualitative research method, and validity assured by conformation of the concept and category by 2 nursing scientists who had written a Master's thesis on the relaxation technique. The results of the study were summarized as follows; 1. The meaning of the relaxation concept; From 298 statements, 107 concepts were extracted and then 5 categories "Physical domain", "Psychological domain", "Complex domain", "Situation", and "environment" were organized. 'Don't have discomforts, 'don't have muscle tension', 'don't have energy (him in Korean)', 'don't have activities' subcategories were included in "Physical domain". 'Don't have anxiety', 'feel good', 'emotional stability', 'don't have wordly thoughts', 'feel one's brain muddled', 'loss of desire' subcategories were included in "physical domain" 'Comfort body and mind', 'don't have tension of body and mind', 'be sagged' 'liveliness of thoughts' subcategories were included in "Complex domain". 'Rest', 'sleep', 'others' subcategories were included in "Situation domain". And 'quite environment' & 'comfortable environment' subcategories were included in "Environmental domain". 2. The experiences of the relaxation; From 151
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Diagnosis and treatment of radiation injuries
International Nuclear Information System (INIS)
1998-01-01
This publication is directed at medical professionals who may be involved in the management of radiation injuries starting from the first few hours or days after an exposure of undefined severity (i.e. those handling the emergency situation may not know the extent and severity of the accident). Experience has shown that in addition to occupational physicians, the complete management of an emergency case involves other professionals such as haematologists, oncologists, plastic surgeons, dermatologists, vascular surgeons, psychiatrists and consultants in other medical specialities. The principal aim of this publication is to provide guidelines to enable medical professionals to carry out prompt diagnostic measures and to offer emergency treatment. This report provides information in tabulated form on clinical criteria for dose assessment. Additionally, it discusses the appropriate dose-effect relationship in cases of external radiation involving either total body or local exposures, as well as internal contamination
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Genome-wide analysis of the diversity and ancestry of Korean dogs.
Choi, Bong Hwan; Wijayananda, Hasini I; Lee, Soo Hyun; Lee, Doo Ho; Kim, Jong Seok; Oh, Seok Il; Park, Eung Woo; Lee, Cheul Koo; Lee, Seung Hwan
2017-01-01
There are various hypotheses on dog domestication based on archeological and genetic studies. Although many studies have been conducted on the origin of dogs, the existing literature about the ancestry, diversity, and population structure of Korean dogs is sparse. Therefore, this study is focused on the origin, diversity and population structure of Korean dogs. The study sample comprised four major categories, including non-dogs (coyotes and wolves), ancient, modern and Korean dogs. Selected samples were genotyped using an Illumina CanineHD array containing 173,662 single nucleotide polymorphisms. The genome-wide data were filtered using quality control parameters in PLINK 1.9. Only autosomal chromosomes were used for further analysis. The negative off-diagonal variance of the genetic relationship matrix analysis depicted, the variability of samples in each population. FIS (inbreeding rate within a population) values indicated, a low level of inbreeding within populations, and the patterns were in concordance with the results of Nei's genetic distance analysis. The lowest FST (inbreeding rate between populations) values among Korean and Chinese breeds, using a phylogenetic tree, multi-dimensional scaling, and a TreeMix likelihood tree showed Korean breeds are highly related to Chinese breeds. The Korean breeds possessed a unique and large diversity of admixtures compared with other breeds. The highest and lowest effective population sizes were observed in Korean Jindo Black (485) and Korean Donggyeong White (109), respectively. The historical effective population size of all Korean dogs showed declining trend from the past to present. It is important to take immediate action to protect the Korean dog population while conserving their diversity. Furthermore, this study suggests that Korean dogs have unique diversity and are one of the basal lineages of East Asian dogs, originating from China.
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Genome-wide analysis of the diversity and ancestry of Korean dogs.
Directory of Open Access Journals (Sweden)
Bong Hwan Choi
Full Text Available There are various hypotheses on dog domestication based on archeological and genetic studies. Although many studies have been conducted on the origin of dogs, the existing literature about the ancestry, diversity, and population structure of Korean dogs is sparse. Therefore, this study is focused on the origin, diversity and population structure of Korean dogs. The study sample comprised four major categories, including non-dogs (coyotes and wolves, ancient, modern and Korean dogs. Selected samples were genotyped using an Illumina CanineHD array containing 173,662 single nucleotide polymorphisms. The genome-wide data were filtered using quality control parameters in PLINK 1.9. Only autosomal chromosomes were used for further analysis. The negative off-diagonal variance of the genetic relationship matrix analysis depicted, the variability of samples in each population. FIS (inbreeding rate within a population values indicated, a low level of inbreeding within populations, and the patterns were in concordance with the results of Nei's genetic distance analysis. The lowest FST (inbreeding rate between populations values among Korean and Chinese breeds, using a phylogenetic tree, multi-dimensional scaling, and a TreeMix likelihood tree showed Korean breeds are highly related to Chinese breeds. The Korean breeds possessed a unique and large diversity of admixtures compared with other breeds. The highest and lowest effective population sizes were observed in Korean Jindo Black (485 and Korean Donggyeong White (109, respectively. The historical effective population size of all Korean dogs showed declining trend from the past to present. It is important to take immediate action to protect the Korean dog population while conserving their diversity. Furthermore, this study suggests that Korean dogs have unique diversity and are one of the basal lineages of East Asian dogs, originating from China.
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Directory of Open Access Journals (Sweden)
Seung-June Oh
2012-06-01
Full Text Available Purpose Psychometric properties of the overactive bladder questionnaire (OAB-q were recently examined. However, since the cross-cultural adaptation of a non-English version of the OAB-q has never been demonstrated, we evaluated the psychometric properties of a Korean version of the OAB-q in a Korean population with OAB. Methods A prospective cohort study involving 116 women with 58 OAB and 58 control subjects was performed and convergent validity was assessed. Total and subscale OAB-q scores of the control and OAB groups were compared to their sensitivity to score changes before and after administering anti-cholinergic medication for 12 weeks. Short form 36 and King's health questionnaire (KHQ were also used for comparison or correlation. Results Assessment of face validity showed that the Korean version of the OAB-q was reasonable with OAB-q subscale scores being significantly different between the control and patient groups. Significant correlation (range, -0.29 to -0.81 was found between the OAB-q scores and KHQ results for the OAB patients. Cronbach's alpha coefficients (range, 0.77 to 0.95 indicated excellent internal consistency and test-retest analysis involving 35 OAB patients showed that each questions as well as subscale scores were reproducible. Each score of OAB-q also showed statistically significant sensitivity to changes following anti-muscarinic treatment for OAB (n=27, P<0.001 except for social, P=0.059. Conclusions The Korean version of the OAB-q is a valid and reliable instrument to measure outcomes in Korean patients with OAB.
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2003 survey of Canadian radiation oncology residents
International Nuclear Information System (INIS)
Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George
2005-01-01
Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada
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Korean Gifted Education: Domain-Specific Developmental Focus
Cho, Seokhee; Suh, Yewon
2016-01-01
The current Korean gifted education system is designed to help gifted children have a balance between excellence and emotional and social wellbeing. In this article, the current status of Korean gifted education is presented, reflecting on the history, purpose, theoretical foundation, infrastructure, and state of art of gifted education with…
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Directory of Open Access Journals (Sweden)
Seung Jin Han
2016-12-01
Full Text Available BackgroundThe aim of this study was to investigate the prevalence of obesity in Korean men with Klinefelter syndrome (KS and the associated risk factors for obesity and hyperglycemia.MethodsData were collected retrospectively from medical records from 11 university hospitals in Korea between 1994 and 2014. Subjects aged ≥18 years with newly diagnosed KS were enrolled. The following parameters were recorded at baseline before treatment: chief complaint, height, weight, fasting glucose level, lipid panel, blood pressure, testosterone, luteinizing hormone, follicle-stimulating hormone, karyotyping patterns, and history of hypertension, diabetes, and dyslipidemia.ResultsData were analyzed from 376 of 544 initially enrolled patients. The rate of the 47 XXY chromosomal pattern was 94.1%. The prevalence of obesity (body mass index ≥25 kg/m2 in Korean men with KS was 42.6%. The testosterone level was an independent risk factor for obesity and hyperglycemia.ConclusionObesity is common in Korean men with KS. Hypogonadism in patients with KS was associated with obesity and hyperglycemia.
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A Tribute to the Japanese Literature of Korean Writers in Japan
Directory of Open Access Journals (Sweden)
Elise Foxworth
2006-12-01
Full Text Available As a recipient of a Japan Foundation Fellowship in 2000, I was able to commence doctoral studies on the little-known Japanese literature of zainichi Koreans in Japan. The term ‘zainichi Korean’, as opposed to ‘newcomer Korean,’ refers to Koreans and their descendants whose presence in Japan is a direct result of Japan’s thirty-five year occupation of the Korean Peninsula, which began in 1910. My overarching goal was to achieve a nuanced understanding of postwar Japanese society, one that encompassed zainichi Korean perspectives, which are generally overlooked by mainstream studies.
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Current status on educational program for radiation emergency medical preparedness in Korea
International Nuclear Information System (INIS)
Kim, E. S.; Kong, H. J.; Noh, J. H.; Kim, C. S.
2002-01-01
There are several educational programs in worldwide for the user of radiation, radioisotopes, and nuclear power plant. REAC/TS is one of the most famous centers for radiation emergency personnel. REMPAN, one of the World Health Organization is also to promote the medical preparedness for radiation accident and provide advice and assistance in the case of radiation accident and radiological emergency. There are a variety of educational programs of radiation emergency, but not many programs of medical preparedness in Korea. Therefore, it is introduced here Korean current environment and future direction of educational programs for the radiation emergency medical preparedness
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Revised dietary guidelines for Koreans.
Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il
2008-01-01
With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.
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Korean kimchi: promoting healthy meals through cultural tradition
Directory of Open Access Journals (Sweden)
Nobuko Hongu
2017-09-01
Conclusion: The availability and many varieties of kimchi exist in the US. Despite new trends and changes in the US, kimchi continues to be a significant important staple in many Korean and non-Korean families in the US.
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Energy Technology Data Exchange (ETDEWEB)
Kim, Dong Ho; Jo, Min Ho [Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup (Korea, Republic of)
2017-06-15
Patulin is a mycotoxin produced by a variety of molds, especially within genera Penicillium, Aspergillus and Byssochlamys growing on various fruits. In this study, patulin producing activities and the effects of a gamma irradiation on the control and/or sterilization of fungal strains isolated from Korean apples, Malus pumila var. dulcissima, were evaluated. Nine fungal strains; five strains of genus Penicillium and one strains of genus Glomerella, Giberella, Alternaria and Galactomyces were isolated and identified by the similarity analysis based on the nucleotide sequence of the ITS5-5.8S-ITS4 region. Among the isolated strains, four Penicillium strains and a Glomerella showed patulin producing activities. The maximal patulin-producing activity of P. griseofulvum ATCC 46037, a standard strain of patulin-producing fungi, was 1,211.5 ppm in a 5-GYEP broth medium, while those of the isolated fungi reached to 27.4⁓134.2 ppm. Patulin-producing levels were dependent on the carbon sources and maximal production of the patulin by P. griseofulvum, P. crustosum, I-3, I-6, I-7 and I-8 was observed in a broth media containing glycerol, fructose, glycerol, glucose, lactose and fructose, respectively. The D10-values of the conidia of tested strains in an aqueous suspension were calculated in the range of 0.25⁓0.64 kGy. In conclusion, although the patulin producing activities of the isolated fungi were significantly lower than those of standard strains, it cannot deny the possibility of an patulin contamination of the Korean apples. Therefore, gamma ray irradiation (1.0 kGy) after harvest of apples could be applied to prevent the growth of a patulin producing molds for a safe distribution.
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International Nuclear Information System (INIS)
Kim, Dong Ho; Jo, Min Ho
2017-01-01
Patulin is a mycotoxin produced by a variety of molds, especially within genera Penicillium, Aspergillus and Byssochlamys growing on various fruits. In this study, patulin producing activities and the effects of a gamma irradiation on the control and/or sterilization of fungal strains isolated from Korean apples, Malus pumila var. dulcissima, were evaluated. Nine fungal strains; five strains of genus Penicillium and one strains of genus Glomerella, Giberella, Alternaria and Galactomyces were isolated and identified by the similarity analysis based on the nucleotide sequence of the ITS5-5.8S-ITS4 region. Among the isolated strains, four Penicillium strains and a Glomerella showed patulin producing activities. The maximal patulin-producing activity of P. griseofulvum ATCC 46037, a standard strain of patulin-producing fungi, was 1,211.5 ppm in a 5-GYEP broth medium, while those of the isolated fungi reached to 27.4⁓134.2 ppm. Patulin-producing levels were dependent on the carbon sources and maximal production of the patulin by P. griseofulvum, P. crustosum, I-3, I-6, I-7 and I-8 was observed in a broth media containing glycerol, fructose, glycerol, glucose, lactose and fructose, respectively. The D10-values of the conidia of tested strains in an aqueous suspension were calculated in the range of 0.25⁓0.64 kGy. In conclusion, although the patulin producing activities of the isolated fungi were significantly lower than those of standard strains, it cannot deny the possibility of an patulin contamination of the Korean apples. Therefore, gamma ray irradiation (1.0 kGy) after harvest of apples could be applied to prevent the growth of a patulin producing molds for a safe distribution
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Theories and Messages in South Korean Antismoking Advertising.
Ha, Jin Hong; Aikat, Debashis Deb; Jung, Eun Hwa
2015-01-01
This study evaluated antismoking advertisements in South Korean television by drawing upon a Health Communication article by Cohen, Shumate, and Gold (2007) and on Gold, Cohen, and Shumate's (2008) typology. This study examined the theories and messages in South Korean antismoking advertisements. First, South Korean antismoking advertisements primarily targeted adults. In addition, the advertisements for adults normally used statistical evidence, whereas those for adolescents often used testimonial evidence. In terms of the type of performance, narration was often used in advertisements for both adults and adolescents. Second, the most prevalent persuasive health message used social norms, whereas the most prevalent affective appeal used fear appeals. Third, antismoking advertisements in South Korea mentioned more benefits of not smoking than barriers to not smoking. This study also identified the message difference in the U.S. and South Korean antismoking advertisements.
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Korean American males' interracial contact experiences during serious leisure activity
KangJae Jerry Lee; David. Scott
2012-01-01
This study investigated serious leisure among Korean Americans and examined the ways in which Koreans' marginalized status impact their pursuit of serious leisure and participation patterns in the context of recreational sports. Face-to-face, in-depth, and semi-structured interviews were conducted with 11 Korean basketball players and 4 soccer players.
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The aesthetics of cuteness in Korean pop music
Han, Ae Jin
2016-01-01
The aesthetic of ‘cuteness’ in South Korean popular music (known as K-pop) is a pivotal concept in Korean media and culture and is frequently used to describe performances by both male and female K-pop groups. Aegyo is a fundamental part of this aesthetic, also called ‘K-cute’, and it refers to the behaviour of ‘acting cute’ that denotes a particular coquettish style not only in K-pop but also in South Korean society in a broader sense.\\ud \\ud This thesis explores K-pop performance from the m...
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The North Korean Economy: Leverage and Policy Analysis
2008-08-26
rapid growth and trade liberalization to China, Thailand, Malaysia and other Asian nations. The “Stalinist” North Korean economy can be...2006. processing done under contract) by North Koreans.119 The companies included Daewoo (jackets, bags), Samsung Electronics (communications
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Energy Technology Data Exchange (ETDEWEB)
Mueller, Arndt-Christian [Eberhard Karls University, Department of Radiation Oncology, Tuebingen (Germany); Oorschot, Birgitt van [Julius Maximilians University, Department of Radiation Oncology, Wuerzburg (Germany); Micke, Oliver [Franziskus Hospital Bielefeld, Department of Radiotherapy and Radiation Oncology, Bielefeld (Germany); Guckenberger, Matthias [University of Zurich, Department of Radiation Oncology, Zuerich (Switzerland)
2018-01-15
We aim to introduce and discuss the statements and recommendations of the German S3 guideline on renal cell cancer for daily practice of radiation oncologists. This report comprises indication, treatment decision, dose prescription and current literature including treatment of oligometastatic disease. According to different stages of the disease and the structure of the guideline we focus on five treatment situations and recommendations for decision making: (1) Neo-/adjuvant treatment before or after nephrectomy: No indication for radiotherapy. (2) Small renal mass: Stereotactic ablative radiotherapy is currently seen as experimental option due to small patient numbers reported in the literature. However, local tumor control achieved by SBRT appears favourable with >90% at 2 years. (3) Oligometastasis: Radiation treatment with higher local doses or stereotactic treatment is possible after interdisciplinary discussion. Indications for palliative (4) and symptomatic treatment (5) are not different compared to other tumor entities. Currently, there is no evidence-based indication for radiation treatment in the primary setting (adjuvant/neoadjuvant or definitive) of renal cell cancer. In the future stereotactic radiotherapy should have a stronger role in the treatment of medically inoperable patients with primary renal cell cancer and especially in the setting of oligometastasis. (orig.) [German] Ziel dieser Arbeit ist es, dem Radioonkologen die Empfehlungen und Diskussionswege der neuen S3-Leitlinie zum Nierenzellkarzinom fuer die taegliche Praxis pointiert darzustellen. Es werden Indikationsstellung, Dosisverschreibung, technische Durchfuehrung sowie aktuelle Literatur fuer den Strahlentherapeuten, vor allem mit Fokus auf die Behandlung der Oligometastasierung, zusammengefasst. Entsprechend der unterschiedlichen Erkrankungsstadien und der Gliederung der Leitlinie werden fuenf radiotherapeutische Therapiesituationen und die Empfehlungen dazu vorgestellt: (1
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German and Korean mothers' sensitivity and related parenting beliefs
Ziehm, Jeanette; Trommsdorff, Gisela; Heikamp, Tobias; Park, Seong-Yeon
2013-01-01
This study contributes to a differentiated understanding of maternal sensitivity in cultural and situational context. We investigated differences and similarities in German and Korean mothers' maternal sensitivity. We interviewed 92 German and 100 Korean mothers of first graders about their preference for proactive (anticipating children's needs) or reactive sensitivity (responding to children's direct cues) in different scenarios. Related parenting beliefs were assessed by asking the mothers to explain the reasons why they would prefer specific parenting behaviors. Results revealed significant cultural differences in reactive vs. proactive sensitivity preferences. Overall, German mothers were more likely to indicate that a mother should respond reactively and less likely to report that a mother should act proactively than were Korean mothers. Korean mothers gave preference to both reactive and proactive sensitivity depending on the scenario. With regard to parenting beliefs, analyses revealed that German and Korean mothers who preferred reactive sensitivity mainly explained their choices as attempts to encourage children's development of independence. In contrast, Korean and German mothers with a preference for proactive sensitivity were more likely to report that mothers would assist their children due to their immaturity in dealing with emotional distress. Results are discussed in the framework of the different meanings and functions of maternal sensitivity for socialization in different cultural contexts. PMID:23986740
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Current Trends in Korean Adolescents’ Social Purpose
Directory of Open Access Journals (Sweden)
Shin Jongho
2014-06-01
Full Text Available In the research presented we investigated the features of Korean adolescents’ social purpose as compared with other life goals in terms of different aspects of psychological well-being (study 1. We also examine the perceptions of high achieving Korean adolescents on social purpose and factors affecting it (study 2.The results of study 1 showed that the pursuit of social purpose significantly predicted psychological well-being compared to the other two life goals. Results of study 2 showed Korean adolescents value and pursue social purpose as a life goal. They explicitly accepted their social responsibility to serve their country in line with idyllic Confucianism values and Collectivistic roles. However, further analysis revealed that they had implicitly pursued individualistic desires of materialistic wealth and fame in parallel with their explicit social purpose. Implications of the results are discussed from the socio-cultural perspective on social purpose in regards to how to understand the features of social purpose that Korean adolescents have and how to foster its development.
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The radiation oncologist`s perspective; Le point de vue du radiotherapeute
Energy Technology Data Exchange (ETDEWEB)
Schlienger, M.; Touboul, E. [Hopital Tenon, 75 - Paris (France)
1998-03-01
During the last decade, stereotactic radiotherapy has widely improved in France. Thus one should study the present situation and its future trend. Fractionation of irradiation nowadays seems mandatory for most intracranial tumors except metastases and small regular arteriovenous malformations. Heterogeneity of lesion dose is related to the geometry and the physics of convergent fixed or mobile beams. It can be improved and the healthy tissue irradiation can be diminished using the multi-isocentric planning for complex lesion or with micro multi leaf collimators. For neurinomas of the acoustic nerve, fractionated stereotactic radiotherapy yields few of the complications published after single dose stereotactic radiotherapy. The same can be said for meningiomas although some series reported very few complications after single dose stereotactic radiotherapy. Solitary metastases without systemic evolution, not situated on the mid-line, are favorable candidates For palliative single dose stereotactic radiotherapy. The conjunction with total brain irradiation seems to be useful. Small arteriovenous malformations will be treated with single dose stereotactic radiotherapy, whereas voluminous and/or geometrically complex nidus could benefit from protons or photon beams modulated by micro multi leaf collimators and a few fractions. Single dose stereotactic radiotherapy and fractionated stereotactic radiotherapy will be used as boost in various situations such as massif facial and in all sorts of tumors in the body specially when lesions are close to critical organs. (author)
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Treatment choices for patients with invasive lobular breast cancer: a doctor survey.
Jacobs, Carmel; Ibrahim, Mohamed F K; Clemons, Mark; Hutton, Brian; Simos, Demetrios; Caudrelier, Jean-Michel; Graham, Ian D; Smith, Stephanie; Addison, Christina; Arnaout, Angel
2015-08-01
Invasive lobular breast cancer (ILC) has distinct features that present challenges for management. We surveyed doctors regarding management approaches, opinions on quality of evidence supporting their practice, and future research needs. An online questionnaire was developed and circulated to breast cancer surgical, radiation and medical oncologists. The questionnaire was completed by 88/428 doctors (20.6%); 22/56 (39.3%) surgeons, 21/64 (32.8%) radiation oncologists and 45/308 (14.6%) medical oncologists. The majority (65%) of surgeons were comfortable treating ILC patients using the same surgical management as patients with invasive ductal cancers (IDC). Furthermore, 25% would perform a similar surgery but would obtain larger gross margins. There was equipoise for radiation oncologists regarding whether or not ILC was an independent risk factor for local-regional recurrence after either breast-conserving surgery or mastectomy. Of those radiation oncologists who believe ILC is an independent risk factor for recurrence after mastectomy, 44.4% would offer radiation in the absence of usual indications. Medical oncologists approached systemic therapy for ILC patients similarly to those with comparable IDCs. Areas identified as most controversial and requiring future research were preoperative magnetic resonance imaging, radiotherapy post-mastectomy and the responsiveness of ILC to adjuvant chemotherapy compared with endocrine therapy. There is a variation in doctors' beliefs, management and opinions regarding the quality of evidence for the management of ILC. Clinical trials specifically assessing the management of ILC are required to guide clinical practice. © 2015 John Wiley & Sons, Ltd.
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Lee, Myung Ha; Kim, Hyeon Chang; Thomas, G Neil; Ahn, Song Vogue; Hur, Nam Wook; Choi, Dong Phil; Suh, Il
2011-09-01
To investigate the familial concordance of metabolic syndrome and its components in a nationally representative survey in Korean. We used data from the Korean National Health and Nutrition Examination Survey (KNHANES), a nationwide survey examining the general health and nutritional status of the Korean people. We enrolled 1641 married couples and 1527 parents-1342 offspring. Prevalence of the metabolic syndrome was 17.1% for husbands, 11.7% for wives, 14.3% for parents, and 7.2% for offspring. After adjustment for age, there were strong positive correlations between family members for the metabolic variables. Compared with husbands whose wives did not have metabolic syndrome, adjusted odds ratio in husbands whose wives had metabolic syndrome was 1.43 (95% CI: 1.10-1.87) for the risk of having metabolic syndrome. Similarly, wives whose husbands had metabolic syndrome had 1.41 (95% CI: 1.08-1.84) times higher risk of having metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, adjusted odds ratio in children with at least one parent with the metabolic syndrome was 2.56 (95% CI: 1.09-5.98) for the metabolic syndrome. Our study revealed that there is significant familial concordance for metabolic syndrome and its components in Korean families. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Korean Clinic Based Outcome Measure Studies
Jongbae Park
2003-01-01
Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...
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Smoking habits and nicotine dependence of North Korean male defectors.
Kim, Sei Won; Lee, Jong Min; Ban, Woo Ho; Park, Chan Kwon; Yoon, Hyoung Kyu; Lee, Sang Haak
2016-07-01
The smoking rates and patterns in the North Korean population are not well known. More than 20,000 North Korean defectors have settled in South Korea; thus, we can estimate the current North Korean smoking situation using this group. All North Korean defectors spend their first 3 months in a South Korean facility learning to adapt to their new home. We retrospectively analyzed the results from a questionnaire conducted among North Korean male defectors in this facility from August 2012 to February 2014. Of 272 men, 84.2% were current smokers, 12.5% were ex-smokers, and 3.3% were non-smokers. The mean age of this group was 35.9 ± 11.3 years, and smoking initiation occurred at a mean age of 18.2 ± 4.7 years. Among the subjects, 78.1% had a family member who smoked. Of the 221 current smokers, 67.4% responded that they intended to quit smoking. Fagerström test and Kano test for social nicotine dependence (KTSND) results for current smokers were 3.35 ± 2.26 and 13.76 ± 4.87, respectively. Question 9 on the KTSND (doctors exaggerate the ill effects of smoking) earned a significantly higher score relative to the other questions and a significantly higher score in current smokers compared with non-smokers. The smoking rate in North Korean male defectors was higher than that indicated previously. However, interest in smoking cessation was high and nicotine dependence was less severe than expected. Further investigation is needed to identify an efficient method for North Korean smokers to stop smoking.
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Smoking Topography in Korean American and White Men: Preliminary Findings
Chung, Sangkeun; Kim, Sun S; Kini, Nisha; Fang, Hua J; Kalman, David; Ziedonis, Douglas M.
2013-01-01
Introduction This is the first study of Korean Americans’ smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. population. Methods Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libitum with a portable smoking topography device for 24 hours. Results Compared to White men (N = 26), Korean American men (N = 27) were more likely to smoke low nicotine-yield cigarettes (p < 0.001) and have lower Fagerstrom nicotine dependence scores (p = 0.04). Koreans smoked fewer cigarettes with the device (p = 0.01) than Whites. Controlling for the number of cigarettes smoked, Koreans smoked with higher average puff flows (p = 0.05), greater peak puff flows (p = 0.02), and shorter interpuff intervals (p < 0.001) than Whites. Puff counts, puff volumes, and puff durations did not differ between the two groups. Conclusions This study offers preliminary insight into unique smoking patterns among Korean American men who are likely to smoke low nicotine-yield cigarettes. We found that Korean American men compensated their lower number and low nicotine-yield cigarettes by smoking more frequently with greater puff flows than White men, which may suggest exposures to similar amounts of nicotine and harmful tobacco toxins by both groups. Clinicians will need to consider in identifying and treating smokers in a mutually aggressive manner, irrespective of cigarette type and number of cigarette smoked per day. PMID:24068611
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International Nuclear Information System (INIS)
Lawton, Colleen A.F.; Michalski, Jeff; El-Naqa, Issam; Kuban, Deborah; Lee, W. Robert; Rosenthal, Seth A.; Zietman, Anthony; Sandler, Howard; Shipley, William; Ritter, Mark; Valicenti, Richard; Catton, Charles; Roach, Mack; Pisansky, Thomas M.; Seider, Michael
2009-01-01
Purpose: We conducted a comparative study of clinical target volume (CTV) definition of pelvic lymph nodes by multiple genitourinary (GU) radiation oncologists looking at the levels of discrepancies amongst this group. Methods and Materials: Pelvic computed tomography (CT) scans from 2 men were distributed to 14 Radiation Therapy Oncology Group GU radiation oncologists with instructions to define CTVs for the iliac and presacral lymph nodes. The CT data with contours were then returned for analysis. In addition, a questionnaire was completed that described the physicians' method for target volume definition. Results: Significant variation in the definition of the iliac and presacral CTVs was seen among the physicians. The minimum, maximum, mean (SD) iliac volumes (mL) were 81.8, 876.6, 337.6 ± 203 for case 1 and 60.3, 627.7, 251.8 ± 159.3 for case 2. The volume of 100% agreement was 30.6 and 17.4 for case 1 and 2 and the volume of the union of all contours was 1,012.0 and 807.4 for case 1 and 2, respectively. The overall agreement was judged to be moderate in both cases (kappa = 0.53 (p < 0.0001) and kappa = 0.48 (p < 0.0001). There was no volume of 100% agreement for either of the two presacral volumes. These variations were confirmed in the responses to the associated questionnaire. Conclusions: Significant disagreement exists in the definition of the CTV for pelvic nodal radiation therapy among GU radiation oncology specialists. A consensus needs to be developed so as to accurately assess the merit and safety of such treatment.
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Site-Specific Atmospheric Dispersion Characteristics of Korean Nuclear Power Plant Sites
International Nuclear Information System (INIS)
Han, M. H.; Kim, E. H.; Suh, K. S.; Hwang, W. T.; Choi, Y. G.
2001-01-01
Site-specific atmospheric dispersion characteristics have been analyzed. The northwest and the southwest wind prevail on nuclear sites of Korea. The annual isobaric surface averaged for twenty years around Korean peninsula shows that west wind prevails. The prevailing west wind is profitable in the viewpoint of radiation protection because three of four nuclear sites are located in the east side. Large scale field tracer experiments over nuclear sites have been conducted for the purpose of analyzing the atmospheric dispersion characteristics and validating a real-time atmospheric dispersion and dose assessment system FADAS. To analyze the site-specific atmospheric dispersion characteristics is essential for making effective countermeasures against a nuclear emergency
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Does siwonhan-mat represent delicious in Korean foods?
Directory of Open Access Journals (Sweden)
Dai Ja Jang
2016-06-01
Conclusion: Balancing kan is a determining factor of siwonhan-mat in Korean cuisine. Particularly, a strong association between siwonhan-mat and deliciousness was found in kuk and tang, suggesting the importance of siwonhan-mat in experiencing the best flavor in Korean food.
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Progressive pituitary hormone deficiency following radiation therapy in adults
International Nuclear Information System (INIS)
Loureiro, Rafaela A.; Vaisman, Mario
2004-01-01
Hypopituitarism can be caused by radiation therapy, even when it is not directly applied on the hypothalamic-pituitary axis, and can lead to anterior pituitary deficiency mainly due to hypothalamic damage. The progressive loss of the anterior pituitary hormones usually occurs in the following order: growth hormone, gonadotropin hormones, adrenocorticotropic hormone and thyroid-stimulating hormone. Although there are several different tests available to confirm anterior pituitary deficiency, this paper will focus on the gold standard tests for patients submitted to radiation therapy. We emphasize that the decline of anterior pituitary function is time- and dose-dependent with some variability among the different axes. Therefore, awareness of the need of a joint management by endocrinologists and oncologists is essential to improve treatment and quality of life of the patients. (author)
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International Nuclear Information System (INIS)
Choi, Mehee; Fuller, Clifton D.; Thomas, Charles R.
2009-01-01
Purpose: Advancement in academic radiation oncology is largely contingent on research productivity and the perceived external influence of an individual's scholarly work. The purpose of this study was to use the Hirsch index (h-index) to estimate the research productivity of current radiation oncology faculty at U.S. academic institutions between 1996 and 2007. Methods and Materials: We performed bibliometric citation database searches for available radiation oncology faculty at domestic residency-training institutions (n = 826). The outcomes analyzed included the total number of manuscripts, total number of citations, and the h-index between 1996 and 2007. Analysis of overall h-index rankings with stratification by academic ranking, junior vs. senior faculty status, and gender was performed. Results: Of the 826 radiation oncologists, the mean h-index was 8.5. Of the individuals in the top 10% by the h-index, 34% were chairpersons, 88% were senior faculty, and 13% were women. A greater h-index was associated with a higher academic ranking and senior faculty status. Recursive partitioning analysis revealed an h-index threshold of 15 (p <0.0001) as an identified breakpoint between the senior and junior faculty. Overall, women had lower h-indexes compared with men (mean, 6.4 vs. 9.4); however, when stratified by academic ranking, the gender differential all but disappeared. Conclusion: Using the h-index as a partial surrogate for research productivity, it appears that radiation oncologists in academia today comprise a prolific group, however, with a highly skewed distribution. According to the present analysis, the h-index correlated with academic ranking. Thus, it potentially has utility in the process of promotion decisions. Overall, women in radiation oncology were less academically productive than men; the possible reasons for the gender differential are discussed.
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Detecting Positive Selection of Korean Native Goat Populations Using Next-Generation Sequencing
Lee, Wonseok; Ahn, Sojin; Taye, Mengistie; Sung, Samsun; Lee, Hyun-Jeong; Cho, Seoae; Kim, Heebal
2016-01-01
Goats (Capra hircus) are one of the oldest species of domesticated animals. Native Korean goats are a particularly interesting group, as they are indigenous to the area and were raised in the Korean peninsula almost 2,000 years ago. Although they have a small body size and produce low volumes of milk and meat, they are quite resistant to lumbar paralysis. Our study aimed to reveal the distinct genetic features and patterns of selection in native Korean goats by comparing the genomes of native Korean goat and crossbred goat populations. We sequenced the whole genome of 15 native Korean goats and 11 crossbred goats using next-generation sequencing (Illumina platform) to compare the genomes of the two populations. We found decreased nucleotide diversity in the native Korean goats compared to the crossbred goats. Genetic structural analysis demonstrated that the native Korean goat and crossbred goat populations shared a common ancestry, but were clearly distinct. Finally, to reveal the native Korean goat’s selective sweep region, selective sweep signals were identified in the native Korean goat genome using cross-population extended haplotype homozygosity (XP-EHH) and a cross-population composite likelihood ratio test (XP-CLR). As a result, we were able to identify candidate genes for recent selection, such as the CCR3 gene, which is related to lumbar paralysis resistance. Combined with future studies and recent goat genome information, this study will contribute to a thorough understanding of the native Korean goat genome. PMID:27989103
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Detecting Positive Selection of Korean Native Goat Populations Using Next-Generation Sequencing.
Lee, Wonseok; Ahn, Sojin; Taye, Mengistie; Sung, Samsun; Lee, Hyun-Jeong; Cho, Seoae; Kim, Heebal
2016-12-01
Goats ( Capra hircus ) are one of the oldest species of domesticated animals. Native Korean goats are a particularly interesting group, as they are indigenous to the area and were raised in the Korean peninsula almost 2,000 years ago. Although they have a small body size and produce low volumes of milk and meat, they are quite resistant to lumbar paralysis. Our study aimed to reveal the distinct genetic features and patterns of selection in native Korean goats by comparing the genomes of native Korean goat and crossbred goat populations. We sequenced the whole genome of 15 native Korean goats and 11 crossbred goats using next-generation sequencing (Illumina platform) to compare the genomes of the two populations. We found decreased nucleotide diversity in the native Korean goats compared to the crossbred goats. Genetic structural analysis demonstrated that the native Korean goat and crossbred goat populations shared a common ancestry, but were clearly distinct. Finally, to reveal the native Korean goat's selective sweep region, selective sweep signals were identified in the native Korean goat genome using cross-population extended haplotype homozygosity (XP-EHH) and a cross-population composite likelihood ratio test (XP-CLR). As a result, we were able to identify candidate genes for recent selection, such as the CCR3 gene, which is related to lumbar paralysis resistance. Combined with future studies and recent goat genome information, this study will contribute to a thorough understanding of the native Korean goat genome.
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Experience of wireless local area network in a radiation oncology department.
Mandal, Abhijit; Asthana, Anupam Kumar; Aggarwal, Lalit Mohan
2010-01-01
The aim of this work is to develop a wireless local area network (LAN) between different types of users (Radiation Oncologists, Radiological Physicists, Radiation Technologists, etc) for efficient patient data management and to made easy the availability of information (chair side) to improve the quality of patient care in Radiation Oncology department. We have used mobile workstations (Laptops) and stationary workstations, all equipped with wireless-fidelity (Wi-Fi) access. Wireless standard 802.11g (as recommended by Institute of Electrical and Electronic Engineers (IEEE, Piscataway, NJ) has been used. The wireless networking was configured with the Service Set Identifier (SSID), Media Access Control (MAC) address filtering, and Wired Equivalent Privacy (WEP) network securities. We are successfully using this wireless network in sharing the indigenously developed patient information management software. The proper selection of the hardware and the software combined with a secure wireless LAN setup will lead to a more efficient and productive radiation oncology department.
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Health benefits of dancing activity among Korean middle-aged women.
Kim, Min Jeong; Lee, Chul Won
2016-01-01
The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women.
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Health benefits of dancing activity among Korean middle-aged women
Kim, Min Jeong; Lee, Chul Won
2016-01-01
The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women. PMID:27389818