WorldWideScience

Sample records for oncology group experience

  1. Conducting Nursing Intervention Research in a Cooperative Group Setting – A Gynecologic Oncology Group (GOG) Experience

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    Donovan, Heidi S.; Nolte, Susan; Edwards, Robert P.; Wenzel, Lari

    2014-01-01

    Objectives To provide a history on nursing science within the Gynecology Oncology Group (GOG); to discuss challenges and facilitators of nursing science in the cooperative group (CG) using a current nurse-led protocol (GOG-0259) as an exemplar; and to propose recommendations aimed at advancing nursing science in the CG setting. Data Source GOG reports and protocol databases, online databases of indexed citations, and experiences from the development and implementation of GOG-0259. Conclusions Benefits of CG research include opportunities for inter-disciplinary collaboration and ability to rapidly accrue large national samples. Challenges include limited financial resources to support non-treatment trials, a cumbersome protocol approval process, and lack of experience with nursing/quality of life intervention studies. Formal structures within GOG need to be created to encourage nurse scientists to become active members; promote collaboration between experienced GOG advanced practice nurses and new nurse scientists to identify nursing research priorities; and consider innovative funding structures to support pilot intervention studies. Implications for Nursing Practice Understanding the CG research process is critical for nurse scientists. A multi-disciplinary team of CG leaders can help investigators navigate a complex research environment and can increase awareness of the value of nursing research. PMID:24559780

  2. A strategy for young members within national radiation oncology societies: the Italian experience (AIRO Giovani group).

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    Filippi, Andrea Riccardo; Alongi, Filippo; Ciammella, Patrizia; De Bari, Berardino; Franco, Pierfrancesco; Livi, Lorenzo

    2012-09-01

    To briefly review history, structure, past events and future projects of AIRO (Associazione Italiana Radioterapia Oncologica) young group (AIRO Giovani), focusing on its specific commitment to multidisciplnary networking among junior clinical oncologists at a national and international level. AIRO Giovani is a part of AIRO composed by members under 40 years old. Its main activities are scientific and educational meetings dedicated to young Italian radiation oncologists and collaborative research projects. AIRO Giovani structure, events organized and supported by AIRO giovani as well as scientific activities are here reported from its creation in 2007 up to current days. AIRO Giovani group was able to create a consolidated network between Italian junior radiation oncologists, while opening the possibility to collaborate with junior groups of other national scientific societies in the field of oncology and with ESTRO young members. Scientific projects carried out by the group have been successful and will be further implemented in next years. AIRO Giovani is still in its infancy, but its early positive experience supports the creation and development of young groups within national radiation oncology societies.

  3. A strategy for young members within national radiation oncology societies: the Italian experience (AIRO Giovani group)

    Science.gov (United States)

    Filippi, Andrea Riccardo; Alongi, Filippo; Ciammella, Patrizia; De Bari, Berardino; Franco, Pierfrancesco; Livi, Lorenzo

    2012-01-01

    Aim To briefly review history, structure, past events and future projects of AIRO (Associazione Italiana Radioterapia Oncologica) young group (AIRO Giovani), focusing on its specific commitment to multidisciplnary networking among junior clinical oncologists at a national and international level. Background AIRO Giovani is a part of AIRO composed by members under 40 years old. Its main activities are scientific and educational meetings dedicated to young Italian radiation oncologists and collaborative research projects. Materials and Methods AIRO Giovani structure, events organized and supported by AIRO giovani as well as scientific activities are here reported from its creation in 2007 up to current days. Results AIRO Giovani group was able to create a consolidated network between Italian junior radiation oncologists, while opening the possibility to collaborate with junior groups of other national scientific societies in the field of oncology and with ESTRO young members. Scientific projects carried out by the group have been successful and will be further implemented in next years. Conclusions AIRO Giovani is still in its infancy, but its early positive experience supports the creation and development of young groups within national radiation oncology societies. PMID:24669305

  4. Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

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    Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Dabaja, Bouthaina S. [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Filippi, Andrea R. [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Illidge, Tim [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Petersen, Peter M.; Schut, Deborah A. [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Garcia, John [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Headley, Jayne [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Parent, Amy; Guibord, Benoit [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ragona, Riccardo [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Specht, Lena [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark)

    2015-05-01

    Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs.

  5. Radiation therapy planning for early-stage Hodgkin lymphoma: experience of the International Lymphoma Radiation Oncology Group.

    Science.gov (United States)

    Maraldo, Maja V; Dabaja, Bouthaina S; Filippi, Andrea R; Illidge, Tim; Tsang, Richard; Ricardi, Umberto; Petersen, Peter M; Schut, Deborah A; Garcia, John; Headley, Jayne; Parent, Amy; Guibord, Benoit; Ragona, Riccardo; Specht, Lena

    2015-05-01

    Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG).

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    Koutsoukos, Konstantinos; Tzannis, Kimon; Christodoulou, Christos; Karavasilis, Vasilios; Bakoyiannis, Charalambos; Makatsoris, Thomas; Papandreou, C N; Pectasides, Dimitrios; Dimopoulos, Meletios A; Bamias, Aristotelis

    2016-06-01

    Following the establishment of adjuvant carboplatin in stage I testicular seminoma as a standard, we adopted this treatment for all stage I seminoma patients. We report our 8-year experience and compare these results with our previous adjuvant etoposide/cisplatin (EP) strategy. Patients with stage I seminoma, treated with adjuvant carboplatin and with a minimum follow-up of 1 year, were included. Two cycles of carboplatin [area under the curve (AUC) 6] were administered. A total of 138 patients with median age of 34 years, treated from September 2003 to December 2011, were selected. There were 5 relapses [5-year relapse-free rate (RFR) 96.8 % (95 % confidence interval 91.6-98.8)]: 3 relapses at retroperitoneal lymph nodes, 1 relapse at the adrenal gland, and 1 isolated brain metastasis. Four patients with relapse were cured with salvage chemotherapy. All patients with relapse had tumor diameter ≥4 cm and/or age ≤34 years. Patients with at least 1 of the above risk factors (n = 111) had a significantly higher relapse rate compared with a similar population (n = 64) treated with 2 cycles of adjuvant EP: 5-year RFR was 95 % (SE 2 %) versus 100 % (SE 0 %), (p = 0.067). Age and tumor diameter were associated with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age ≤34 and/or tumor diameter ≥4 cm is associated with higher relapse rates than EP, the prognosis of these patients is excellent, and therefore, the use of less toxic treatment is justified.

  7. Perceptions, attitudes, and experiences of hematology/oncology fellows toward incorporating geriatrics in their training.

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    Maggiore, Ronald J; Gorawara-Bhat, Rita; Levine, Stacie K; Dale, William

    2014-01-01

    The aging of the U.S. population continues to highlight emerging issues in providing care generally for older adults and specifically for older adults with cancer. The majority of patients with cancer in the U.S. are currently 65 years of age or older; therefore, training and research in geriatrics and geriatric oncology are viewed to be integral in meeting the needs of this vulnerable population. Yet, the ways to develop and integrate best geriatrics training within the context of hematology/oncology fellowship remain unclear. Toward this end, the current study seeks to evaluate the prior and current geriatric experiences and perspectives of hematology/oncology fellows. To gain insight into these experiences, focus groups of hematology/oncology fellows were conducted. Emergent themes included: 1) perceived lack of formal geriatric oncology didactics among fellows; 2) a considerable amount of variability exists in pre-fellowship geriatric experiences; 3) shared desire to participate in a geriatric oncology-based clinic; 4) differences across training levels in confidence in managing older adults with cancer; and 5) identification of specific criteria on how best to approach older adults with cancer in a particular clinical scenario. The present findings will help guide future studies in evaluating geriatrics among hematology/oncology fellows across institutions. They will also have implications in the development of geriatrics curricula and competencies specific to hematology/oncology training. © 2013.

  8. About the Community Oncology and Prevention Trials Research Group | Division of Cancer Prevention

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    The Community Oncology and Prevention Trials Research Group supports clinical oncology trials in cancer prevention and control in community settings. The group also supports investigator-initiated research projects in supportive, palliative and end-of-life care, and coordinates clinical oncology research projects with other NCI programs to be done in the community setting. |

  9. Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

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    Vivek Arora

    2010-11-01

    Full Text Available Vivek Arora, Shannon Philp, Kathryn Nattress, Selvan Pather, Christopher Dalrymple, Kenneth Atkinson, Sofia Smirnova, Stephen Cotterell, Jonathan CarterSydney Gynecological Oncology Group, Royal Prince Alfred Hospital, University of Sydney, Sydney, AustraliaPurpose: Patient satisfaction with the provision of hospital oncology services can have a significant impact on their overall treatment experience.Aims: To assess patient satisfaction with the inpatient hospital services in the gynecological oncology setting using the IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC.Methods: A modified version of the IN-PATSAT32 questionnaire with additional 16 items was administered to 52 adult surgical inpatients admitted with the Sydney Gynecological Oncology Group. All participants were provided with an information leaflet regarding the survey and written consent obtained.Results: A high response rate (100% from patients with varied social, ethnic, and educational backgrounds confirmed the acceptability of the survey. Standard of medical care provided, frequency of doctors’ visits, exchange of information with doctors, friendliness of the staff, and state of the room ranked highly (>95% on the patient satisfaction scales. Problems were identified with ease of access to and within the hospital, quality of food, and exchange of information with other hospital staff.Conclusions: Overall the satisfaction with inpatient care was rated very highly in most areas. Deficiencies in certain elements of provision of medical care to the patients were identified and steps have been taken to improve upon these shortcomings.Keywords: patient satisfaction, EORTC, IN-PATSAT32, gynecological oncology, survey

  10. The oncologic radiotherapy experience for patients: a poison-drug

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    Rosani Manfrin Muniz; Marcia Maria Fontão Zago

    2008-01-01

    The study aimed at understanding the patients' experience with oncologic radiotherapy. The anthropological interpretative approach and the ethnographic method guided the investigation. Ten patients took part in the study. They were of both genders, within the age range from 34 to 80 years old and monitored during radiotherapy treatment. Data were collected through semi-structured interviews, participative observation and medical records. The analysis of the respondents' statements allowed for...

  11. [Minimally Invasive Surgery in Pediatric Oncology. Tertiary center experience].

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    Gómez-Chacón Villalba, J; Rodríguez Caraballo, L; Marco Macián, A; Segarra Llido, V; Vila Carbó, J J

    2015-07-20

    To describe our experience using Minimally Invasive Surgery (MIS) techniques in tertiary center with specific oncological pediatric surgery unit. Retrospective review of patients undergoing MIS techniques in pediatric oncology surgery unit between January 2011 and December 2014. MIS procedures were considered made by both techniques such as laparoscopy and thoracoscopy with both diagnostic and therapeutic intent. 4 procedures were diagnostic and the rest were therapeutic: During the study, 56 procedures were performed by MIS. By type of technique, 13 were thoracoscopic (7 metastasectomies, 6 thoracic masses) and 43 laparoscopic (3 hepatic masses, 3 pancreatic masses 7 abdominal masses, 2 ovarian masses, 2 typhlitis 1 splenic mass and 25 oophorectomy for ovarian cryopreservation). In 5 cases (2 thoracic masses 1 pancreatic mass abdominal masses) conversion to open surgery to complete the procedure (2 for caution in the absence of vascular control bleeding 1 and 2 for lack of space) was necessary. In all cases safety principles of oncological surgery were respected. Providing an adecuate selection of patiens, MIS techniques are safe, reproducible and fulfill the objectives of quality of cancer surgery.

  12. Immunotherapy Response Assessment in Neuro-Oncology (iRANO): A Report of the RANO Working Group

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    Okada, Hideho; Weller, Michael; Huang, Raymond; Finocchiaro, Gaetano; Gilbert, Mark R.; Wick, Wolfgang; Ellingson, Benjamin M.; Hashimoto, Naoya; Pollack, Ian F.; Brandes, Alba A.; Franceschi, Enrico; Herold-Mende, Christel; Nayak, Lakshmi; Panigrahy, Ashok; Pope, Whitney B.; Prins, Robert; Sampson, John H.; Wen, Patrick Y.; Reardon, David A.

    2015-01-01

    Immunotherapy represents a promising area of therapy among neuro-oncology patients. However, early phase studies reveal unique challenges associated with assessment of radiological changes reflecting delayed responses or therapy-induced inflammation. Clinical benefit, including long-term survival and tumor regression, can still occur following initial apparent progression or appearance of new lesions. Refinement of response assessment criteria for neuro-oncology patients undergoing immunotherapy is therefore warranted. A multinational and multidisciplinary panel of neuro-oncology immunotherapy experts describes immunotherapy response assessment for neuro-oncology (iRANO) criteria that are based on guidance for determination of tumor progression outlined by the immune-related response criteria (irRC) and the response assessment in neuro-oncology (RANO) working group. Among patients who demonstrate imaging findings meeting RANO criteria for progressive disease (PD) within six months of initiating immunotherapy including the development of new lesions, confirmation of radiographic progression on follow-up imaging is recommended provided that the patient is not significantly worse clinically. The proposed criteria also include guidelines for use of corticosteroids. The role of advanced imaging techniques and measurement of clinical benefit endpoints including neurologic and immunologic functions are reviewed. The iRANO guidelines put forth herein will evolve successively to improve their utility as further experience from immunotherapy trials in neuro-oncology accumulate. PMID:26545842

  13. [Quality assurance in oncology: experiences of an ISO certification].

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    Szentirmay, Zoltán; Cseh, Lujza; Ottó, Szabolcs; Kásler, Miklós

    2002-01-01

    The ISO 9001 quality assurance of the National Institute of Oncology has been achieved successfully. We give an account of the brief history and the structure of the assurance system of the Institute, the process of setting our goals, and also the experience gained from drafting ISO 9001 handbook and flowcharts. Apart from the bureaucratic nature of quality assurance, it is a good opportunity for us to investigate our everyday work, put it into orderly manner and work more reliably. Experience has shown that the introduction of a quality assurance system increases the level of patient care, the documentation helps the Institute or some of its departments, or even individuals prevent law suits, and serves as a sound basis for proposing promotion, salary increases and bonuses, or even honors.

  14. Group Therapy with Patients in the Waiting Room of an Oncology Clinic.

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    Arnowitz, Edward; And Others

    1983-01-01

    Describes a therapy group for cancer patients, conducted by cotherapists in an oncology waiting room. Group members provided mutual support and shared concerns and coping methods. Medical staff members became more involved and were more able to address the affective needs of the patients and their families. (JAC)

  15. Postgraduate Training in Clinical Oncology. Report on a WHO Working Group (The Hague, The Netherlands, December 6-8, 1978).

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    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    The 1978 report of the Working Group of Postgraduate Training in Clinical Oncology, convened by the World Health Organization (WHO) Regional Office for Europe in collaboration with the government of The Netherlands, is presented. The groups analyzed models of postgraduate training in clinical oncology and evaluated their suitability in relation to…

  16. Control group design, contamination and drop-out in exercise oncology trials: a systematic review.

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    Steins Bisschop, Charlotte N; Courneya, Kerry S; Velthuis, Miranda J; Monninkhof, Evelyn M; Jones, Lee W; Friedenreich, Christine; van der Wall, Elsken; Peeters, Petra H M; May, Anne M

    2015-01-01

    Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of exercise-oncology trials and explores the association with contamination and drop-out rates. Randomized controlled exercise-oncology trials from two Cochrane reviews were included. Additionally, a computer-aided search using Medline (Pubmed), Embase and CINAHL was conducted after completion date of the Cochrane reviews. Eligible studies were classified according to three control group design characteristics: the exercise instruction given to controls before start of the study (exercise allowed or not); and the intervention the control group was offered during (any (e.g., education sessions or telephone contacts) or none) or after (any (e.g., cross-over or exercise instruction) or none) the intervention period. Contamination (yes or no) and excess drop-out rates (i.e., drop-out rate of the control group minus the drop-out rate exercise group) were described according to the three design characteristics of the control group and according to the combinations of these three characteristics; so we additionally made subgroups based on combinations of type and timing of instructions received. 40 exercise-oncology trials were included based on pre-specified eligibility criteria. The lowest contamination (7.1% of studies) and low drop-out rates (excess drop-out rate -4.7±9.2) were found in control groups offered an intervention after the intervention period. When control groups were offered an intervention both during and after the intervention period, contamination (0%) and excess drop-out rates (-10.0±12.8%) were even lower. Control groups receiving an intervention during and after the study intervention period have lower contamination and drop-out rates. The present findings can be

  17. Accommodation in pediatric oncology: parental experiences, preferences and unmet needs.

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    Daniel, Gunar; Wakefield, Claire E; Ryan, Barbara; Fleming, Catharine Ak; Levett, Nicole; Cohn, Richard J

    2013-01-01

    For families of children diagnosed with cancer, proximity to the treatment center and staying close to immediate family members are essential for proper patient management. Accommodation services are therefore a key consideration in pediatric oncology. This descriptive study explored the accommodation used, and preferred, by parents of pediatric cancer patients at Sydney Children's Hospital, Randwick (SCH), Australia, and investigated their accommodation and practical needs. Forty-two parents from 25 families participated in individual semi-structured telephone interviews. Interviews were recorded, transcribed verbatim and coded line-by-line. Coding was facilitated by data analysis software QSR NVivo v8 (www.qsrinternational.com). Emergent themes were numerically assessed to minimize the potential for researcher bias. Nine families (36%) lived near SCH and were able to stay at their own residence during treatment (mean distance of 15.4 km from SCH). The remaining families were categorized 'local, but requiring accommodation' (n=3 families represented by five parent interviews; mean distance of 82.22 km from SCH),'inner regional' (IR) (n=8 families, 15 parent interviews; mean distance of 396.75 km from SCH) or 'outer regional' (OR) (n=3 families, 5 interviews; mean distance of 547.4 km from SCH) according to the Australian Standard Geographical Classification (ASGC) remoteness ratings. Accommodation provided for families from both IR and OR areas was mixed, with several families using multiple accommodation options during treatment, including Ronald Macdonald House (RMH), private accommodation or a rental property close to the hospital for the duration of the treatment. Six IR and one OR family utilized hotel or motel accommodation as an alternative to RMH due to unavailability of rooms. The majority of parents (37/42) preferred to stay on the hospital campus, near their child. Seven out of 11 IR and OR mothers preferred self-contained accommodation, while three out

  18. Implementation of electronic checklists in an oncology medical record: initial clinical experience.

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    Albuquerque, Kevin V; Miller, Alexis A; Roeske, John C

    2011-07-01

    The quality of any medical treatment depends on the accurate processing of multiple complex components of information, with proper delivery to the patient. This is true for radiation oncology, in which treatment delivery is as complex as a surgical procedure but more dependent on hardware and software technology. Uncorrected errors, even if small or infrequent, can result in catastrophic consequences for the patient. We developed electronic checklists (ECLs) within the oncology electronic medical record (EMR) and evaluated their use and report on our initial clinical experience. Using the Mosaiq EMR, we developed checklists within the clinical assessment section. These checklists are based on the process flow of information from one group to another within the clinic and enable the processing, confirmation, and documentation of relevant patient information before the delivery of radiation therapy. The clinical use of the ECL was documented by means of a customized report. Use of ECL has reduced the number of times that physicians were called to the treatment unit. In particular, the ECL has ensured that therapists have a better understanding of the treatment plan before the initiation of treatment. An evaluation of ECL compliance showed that, with additional staff training, > 94% of the records were completed. The ECL can be used to ensure standardization of procedures and documentation that the pretreatment checks have been performed before patient treatment. We believe that the implementation of ECLs will improve patient safety and reduce the likelihood of treatment errors.

  19. Response of chronic myelogenous leukemia patients to COAP-splenectomy. A Southwest Oncology Group study.

    Science.gov (United States)

    Hester, J P; Waddell, C C; Coltman, C A; Morrison, F S; Stephens, R L; Balcerzak, S P; Baker, L H; Chen, T T

    1984-11-01

    Eighty-seven patients from 18 institutions with a confirmed diagnosis of chronic myelogenous leukemia were registered on a Southwest Oncology Group protocol for multiagent induction and single-agent maintenance chemotherapy, with randomization to an immunotherapy arm. Elective surgical splenectomy was performed for 42 patients at the completion of 3 months of induction therapy. Final analysis of the study revealed statistically significant survival advantages were correlated with age, splenectomy, the absence of hepatic leukemic infiltrate at the time of splenectomy, and race.

  20. Informed consent in oncology clinical trials: A Brown University Oncology Research Group prospective cross-sectional pilot study

    Science.gov (United States)

    Schumacher, Andrew; Sikov, William M.; Quesenberry, Matthew I.; Safran, Howard; Khurshid, Humera; Mitchell, Kristen M.

    2017-01-01

    Background Informed consent forms (ICFs) for oncology clinical trials have grown increasingly longer and more complex. We evaluated objective understanding of critical components of informed consent among patients enrolling in contemporary trials of conventional or novel biologic/targeted therapies. Methods We evaluated ICFs for cancer clinical trials for length and readability, and patients registered on those studies were asked to complete a validated 14-question survey assessing their understanding of key characteristics of the trial. Mean scores were compared in groups defined by trial and patient characteristics. Results Fifty patients, of whom half participated in trials of immunotherapy or biologic/targeted agents and half in trials of conventional therapy, completed the survey. On average, ICFs for industry-originated trials (N = 9 trials) were significantly longer (P < .0001) and had lower Flesch ease-of-reading scores (P = .003) than investigator-initiated trials (N = 11). At least 80% of patients incorrectly responded to three key questions which addressed the experimental nature of their trial therapy, its purported efficacy and potential risks relative to alternative treatments. The mean objective understanding score was 76.9±8.8, but it was statistically significantly lower for patients who had not completed high school (P = .011). The scores did not differ significantly by type of cancer therapy (P = .12) or trial sponsor (P = .38). Conclusions Many participants enrolled on cancer trials had poor understanding of essential elements of their trial. In order to ensure true informed consent, innovative approaches, such as expanded in-person counseling adapted to the patient’s education level or cultural characteristics should be evaluated across socio-demographic groups. Trial registration Clinicaltrials.gov NCT01772511 PMID:28235011

  1. Spontaneous adverse drug reaction monitoring in oncology: Our experience

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    K Kaur

    2015-01-01

    Full Text Available Background: Adverse drug reaction (ADR monitoring is slowly developing as an important aspect of healthcare. The aim of the study was to study the pattern of adverse drug reactions in the Oncology department of a tertiary care hospital. Materials And Methods: This was a prospective study conducted in the Oncology department of a tertiary care hospital in which ADRs were reported spontaneously. The ADRs were noted from 1st January, 2007 to 30th June, 2011. Following were noted: demographics, premedication (if any, diagnosis, chemotherapy (regimen, cycles, medication history, and alteration in the treatment or co morbidities, ADRs (severity and management. Adverse drug reactions were noted by patient interview, collaborating with information on file, recording changes in the prescribing chart and investigations, consulting the doctor on duty. Results: During this study period, there were total of 14,475 visits of patients from which 2500 ADRs were recorded. Maximum number of ADRs were noted with platinum compounds (25.52% followed by pyrimidine antagonists (19.88%. The most common malignancy reported in our hospital was Carcinoma breast (20% followed by leukemia (12% and Ca ovary (12%. Alopecia (27.76% was the most common ADR followed by anemia (7.48%, thrombocytopenia (6.96% and constipation (6.16%. Conclusion: Alopecia is the most common ADR and platinum compounds were responsible for the maximum number of ADRs. The most common carcinoma reported during this period was carcinoma breast.

  2. Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

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    Yimei Li

    Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

  3. [Breaking bad news in oncology: the Belgian experience].

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    Delevallez, F; Lienard, A; Gibon, A-S; Razavi, D

    2014-10-01

    Breaking bad news is a complex and frequent clinical task for physicians working in oncology. It can have a negative impact on patients and their relatives who are often present during breaking bad news consultations. Many factors influence how the delivery of bad news will be experienced especially the communication skills used by physicians. A three-phase process (post-delivery phase, delivery phase, pre-delivery phase) has been developed to help physician to handle this task more effectively. Communication skills and specific breaking bad news training programs are both necessary and effective. A recent study conducted in Belgium has shown their impact on the time allocated to each of the three phases of this process, on the communication skills used, on the inclusion of the relative in the consultation and on physicians' physiological arousal. These results underscore the importance of promoting intensive communication skills and breaking bad news training programs for health care professionals.

  4. Special aspects of social support: Qualitative analysis of oncologic rehabilitation through a belly dancing peer support group.

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    Szalai, M; Szirmai, A; Füge, K; Makai, A; Erdélyi, G; Prémusz, V; Bódis, J

    2017-02-13

    Tumour-related peer support groups (PSGs) show long-term development in quality of life and coping, and decrease distress in cancer care. To clarify channels of social support in oncologic rehabilitation by combined exercise and psychosocial therapy, individual semi-structured interviews were conducted after 1 year additional belly dance rehabilitation in a closed PSG among 51 patients with malignant tumour diagnosis in Budapest, Hungary. Interview data were transcribed and analysed using qualitative content analysis (ATLAS.ti 6 Win). Results suggest that group experience provides emotional-, practical- and informational support. We could point out specific social effects of "role model" function and extend the coping model. The group dispose all the features of effective suggestion and may be effectively applied as additional therapy for patients with malignancies. The extended coping model and the introduction of "role model" function could be useful for PSGs' efficacy assessment. © 2017 John Wiley & Sons Ltd.

  5. Phase 2 trial design in neuro-oncology revisited: a report from the RANO group.

    Science.gov (United States)

    Galanis, Evanthia; Wu, Wenting; Cloughesy, Timothy; Lamborn, Kathleen; Mann, Bhupinder; Wen, Patrick Y; Reardon, David A; Wick, Wolfgang; Macdonald, David; Armstrong, Terri S; Weller, Michael; Vogelbaum, Michael; Colman, Howard; Sargent, Daniel J; van den Bent, Martin J; Gilbert, Mark; Chang, Susan

    2012-05-01

    Advances in the management of gliomas, including the approval of agents such as temozolomide and bevacizumab, have created an evolving therapeutic landscape in glioma treatment, thus affecting our ability to reliably use historical controls to comparatively assess the activity of new therapies. Furthermore, the increasing availability of novel, targeted agents--which are competing for a small patient population, in view of the low incidence of primary brain tumours--draws attention to the need to improve the efficiency of phase 2 clinical testing in neuro-oncology to expeditiously transition the most promising of these drugs or combinations to potentially practice-changing phase 3 trials. In this report from the Response Assessment in Neurooncology (RANO) group, we review phase 2 trial designs that can address these challenges and capitalise on scientific and clinical advances in brain tumour treatment in neuro-oncology to accelerate and optimise the selection of drugs deserving further testing in phase 3 trials. Although there is still a small role for single-arm and non-comparative phase 2 designs, emphasis is placed on the potential role that comparative randomised phase 2 designs--such as screening designs, selection designs, discontinuation designs, and adaptive designs, including seamless phase 2/3 designs--can have. The rational incorporation of these designs, as determined by the specific clinical setting and the trial's endpoints or goals, has the potential to substantially advance new drug development in neuro-oncology.

  6. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

    Directory of Open Access Journals (Sweden)

    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  7. Obturator prostheses in post-oncological maxillofacial patients: our experience

    Directory of Open Access Journals (Sweden)

    Edoardo Brauner

    2014-12-01

    Full Text Available Background: Surgical procedures for tumors of the paranasal sinus, palatal epithelium, minor salivary glands or osteosarcoma of the upper jaw require a partial or total maxillectomy of the upper jaw. When the surgical procedure and/or radiation therapy result in a communication, the solution is necessarily prosthetical, through a palatal obturator that recreates a partition between the oral and nasal cavities. Methods: Authors selected 32 post-oncological patients with the upper maxilla completely edentulous prosthetically rehabilitated with a palatal obturator. Results: No serious complications or adverse reactions were reported during the fabrication of surgical or definitive obturators. All patients stated to benefit the palatal obturator in terms of quality of life. Conclusion: Prosthetic rehabilitation of edentulous maxillectomy with oral communication is a demanding challenge for the prosthodontist. The goals of prosthetic rehabilitation include separation of oral and nasal cavities to allow adequate deglutition and articulation of teeth, restore midfacial soft tissue contour and a satisfactory esthetic outcome. When, for any reason, the patient is not a suitable candidate for an implant-retained overdenture, a total removable prosthesis should ensure the most comfort in terms of swallowing, phonation and aesthetics.

  8. Imatinib resistance mutation analysis: experience from a tertiary oncology center

    Directory of Open Access Journals (Sweden)

    Mallekavu Suresh Babu

    2015-01-01

    Full Text Available Purpose: BCR-ABL kinase domain (KD mutations account for 50-90% of the imatinib resistance observed in patients of CML-chronic phase. In CML-CP patients receiving imatinib first-line, mutation analysis is recommended in case of failure or suboptimal response using European LeukemiaNet (ELN criteria. The present study was carried out at a tertiary oncology centre in south India to assess which mutations accounted for resistance to imatinib among patients of chronic phase CML being treated with imatinib.Methods: This was a retrospective observational study. We analyzed patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure. Direct sequencing of the BCR-ABL transcript by the Sanger method was used for IRMA testing.Results: Out of 120 tested for IRMA, 36 (30% had detectable mutations. We observed a higher frequency of mutations at amino acids T315, F359 and M351T.Conclusions: Among the patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure, 30% had IRMA +ve mutations. The high incidence of imatinib resistance in present study may be attributed to the fact that our patients were given higher dose of imatinib (600 mg, if they failed to achieve CCyR at 12 months or CHR at 3 months as they could not afford second generation TKIs.

  9. Past and present achievements, and future direction of the Gastrointestinal Oncology Study Group (GIOSG), a Division of Japan Clinical Oncology Group (JCOG).

    Science.gov (United States)

    Boku, Narikazu

    2011-12-01

    Initially, Gastrointestinal Study Group in Japan Clinical Oncology Group (GIOSG/JCOG) focused on gastric cancer. In 1980s, fluoropyrimidine, cisplatin and mitomycin C were key drugs. A randomized Phase II trial (JCOG8501) comparing futrafur plus mitomycin C and uracil plus futrafur and mitomycin C showed a higher response rate of uracil plus futrafur and mitomycin C than futrafur plus mitomycin C. From the results of two Phase II trials of etoposide, adriamycin and cisplatin, and cisplatin plus 5-fluorouracil, uracil plus futrafur and mitomycin C and cisplatin plus 5-fluorouracil were adopted for the test arms of the Phase III trial (JCOG9205) comparing with continuous infusion of 5-fluorouracil as a control arm. Neither cisplatin plus 5-fluorouracil nor uracil plus futrafur and mitomycin C showed a survival benefit over continuous infusion of 5-fluorouracil. In late 1990s, new agents, irinotecan and S-1, were developed for gastric cancer in Japan. GIOSG conducted a Phase III trial (JCOG9912) investigating superiority of irinotecan plus cisplatin and non-inferiority of monotherapy with S-1 compared with continuous infusion of 5-fluorouracil, and S-1 succeeded in showing non-inferiority. Then, SPIRITS trial showed a survival benefit of S-1 plus cisplatin over S-1, resulting in the establishment of a standard care for advanced gastric cancer in Japan. GIOSG have merged with Gastric Cancer Study Group as the Stomach Cancer Study Group (SCSG) from 2011. Recent progress in the development of new drugs has been remarkable. From the point of the roles shared with many other study groups for clinical trials, including registration trials of new drugs conducted by pharmaceutical companies, SCSG should recognize its role and conduct clinical trials with high quality for establishing new standard treatment.

  10. Lutetium-177 Labeled Peptides: The European Institute of Oncology Experience.

    Science.gov (United States)

    Carollo, Angela; Papi, Stefano; Chinol, Marco

    2016-01-01

    Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogues has shown encouraging results in various somatostatin receptor positive tumors. Partial remission rates up to 30% have been documented as well as significant improvements in quality of life and survival. This treatment takes advantage of the high specific binding of the radiolabeled peptide to somatostatin receptors overexpressed by the tumors thus being more effective on the tumor cells with less systemic side-effects. The development of macrocyclic chelators conjugated to peptides made possible the stable binding with various radionuclides. In particular 177Lu features favourable physical characteristics with a half-life of 6.7 days, emission of β- with energy of 0.5 MeV for treatment and γ-emissions suitable for imaging. The present contribution describes the learning process achieved at the European Institute of Oncology (IEO) since the first application of 90Y labeled peptides to the therapy of neuroendocrine tumors back in 1997. Continuous improvements led to the preparation of a safe 177Lu labeled peptide for human use. Our learning curve began with the identification of the optimal characteristics of the isotope paying attention to its chemical purity and specific activity along with the optimization of the parameters involved in the radiolabeling procedure. Also the radiation protection issues have been improved along the years and recently more and more attention has been devoted to the pharmaceutical aspects involved in the preparation. The overall issue of the quality has now been completed by drafting an extensive documentation with the goal to deliver a safe and reliable product to our patients.

  11. Response evaluation criteria for solid tumours in dogs (v1.0): a Veterinary Cooperative Oncology Group (VCOG) consensus document.

    Science.gov (United States)

    Nguyen, S M; Thamm, D H; Vail, D M; London, C A

    2015-09-01

    In veterinary medical oncology, there is currently no standardized protocol for assessing response to therapy in solid tumours. The lack of such a formalized guideline makes it challenging to critically compare outcome measures across various treatment protocols. The Veterinary Cooperative Oncology Group (VCOG) membership consensus document presented here is based on the recommendations of a subcommittee of American College of Veterinary Internal Medicine (ACVIM) board-certified veterinary oncologists. This consensus paper has used the human response evaluation criteria in solid tumours (RECIST v1.1) as a framework to establish standard procedures for response assessment in canine solid tumours that is meant to be easy to use, repeatable and applicable across a variety of clinical trial structures in veterinary oncology. It is hoped that this new canine RECIST (cRECIST v1.0) will be adopted within the veterinary oncology community and thereby facilitate the comparison of current and future treatment protocols used for companion animals with cancer.

  12. Nurse perceptions and experiences of patient health assets in oncology care: a qualitative study.

    Science.gov (United States)

    Rotegård, Ann Kristin; Ruland, Cornelia M; Fagermoen, May Solveig

    2011-01-01

    Health assets, a term that refers to patients' strengths and potentials, has emerged as an important aspect of health care. A conceptual analysis of health assets revealed five core dimensions: mobilization, motivational, relational, volitional, and protective strengths. How nurses experience and use patients' health assets, however, is unknown. In this qualitative study, 26 expert nurses in cancer care participated in focus group interviews. The nurses had a large repertoire of experiences with cancer patients' health assets. When the data were subjected to thematic analysis, three new core dimensions were revealed: cognitive, emotional, and physical strengths. Balancing processes within and among health assets--identified as an overriding theme--appeared to be affected by individual and contextual variations. The nurses realized that patients' health assets could be better used and voiced a need for the clinical and organizational support to do so. New issues about health assets raised in this study may be caused by its novel context (e.g., expert nurses in oncology care). More research is needed on health assets in other contexts, such as patients with different health problems, and of possible strategies to support nurses' use of health assets.

  13. Emotional intelligence: A unique group training in a hematology-oncology unit.

    Science.gov (United States)

    Tadmor, Tamar; Dolev, Niva; Attias, Dina; Lelong, Ayalla Reuven; Rofe, Amnon

    2016-01-01

    Emotional intelligence (EI) is increasingly viewed as one of the important skills required for a successful career and personal life. Consequently, efforts have been made to improve personal and group performance in EI, mostly in commercial organizations. However, these programs have not been widely applied in the health field. The aim of this study is to assess the impact of a unique special EI interventional process within the framework of an active hematology-oncology unit in a general hospital. This investigation employed a pre- and post-training design using the Bar-On Emotional Quotient Inventory (EQ-i) measure of EI, both before and after completion of training 10 months later. The training included personal and group EI assessments and 10 EI workshops, each 2 weeks apart and each lasting approximately 2 h. Results were compared to a control group of medical staff who did not undergo any EI training program during the same time period. Average total Bar-On EQ-i level at baseline for the group was 97.9, which increased significantly after the interventional process to a score of 105.6 (P = 0.001). There were also significant increases in all five main EQ-i scales, as well as for 12 of the 15 subscales. In contrast, the control group showed no significant differences in general EI level, in any of the five main scales or 15 EI subscale areas. This pilot study demonstrated the capability of a group intervention to improve EI of medical staff working in a hematology-oncological unit. The results are encouraging and suggest that the model program could be successfully applied in a large-scale interventional program.

  14. [An art education programme for groups in the psycho-oncological after-care].

    Science.gov (United States)

    Geue, Kristina; Buttstädt, Marianne; Richter, Robert; Böhler, Ursula; Singer, Susanne

    2011-03-01

    In this paper the formal and contentual structure of the outpatient art education programme for oncological patients is presented. The group intervention was comprised of 22 separate sessions. The course consisted of 3 phases. The first unit helped to foster mutual understanding and to learn various experimental drawing techniques using a given topic. The second unit merged into the shaping of personal thoughts and feelings with the aim of encouraging self-perception and reflection. The aim in the third phase is to create a personal book. The effects of the intervention for the participants were examined in studies. The art therapist as well as the supervisor sees development of better coping strategies, contact with other patients and enhancement of scope of action through the regular activities as main effects. Participants reported the enlargement of means of expression, emotional stabilization, coping with illness, personal growth and contacts with other patients as meanings. This art education course enlarges the field of psycho-oncological interventions in outpatient care with a low-treshhold and resource-oriented creative programme.

  15. Online focus groups as a tool to collect data in hard-to-include populations : examples from paediatric oncology

    NARCIS (Netherlands)

    Tates, Kiek; Zwaanswijk, Marieke; Otten, Roel; van Dulmen, Sandra; Hoogerbrugge, Peter M.; Kamps, Willem A.; Bensing, Jozien M.

    2009-01-01

    Background: The purpose of this article is to describe and evaluate the methodology of online focus group discussions within the setting of paediatric oncology. Methods: Qualitative study consisting of separate moderated asynchronous online discussion groups with 7 paediatric cancer patients (aged 8

  16. Experiences and preferences of patients visiting a head and neck oncology outpatient clinic: a qualitative study.

    Science.gov (United States)

    Bisschop, Jeroen A S; Kloosterman, Fabienne R; van Leijen-Zeelenberg, Janneke E; Huismans, Geert Willem; Kremer, Bernd; Kross, Kenneth W

    2017-05-01

    The objective of this study is to report on an in-depth evaluation of patient experiences and preferences at a Head and Neck Oncology outpatient clinic. A qualitative research design was used to determine the experiences and preferences of Head and Neck Cancer patients in an Oncology Outpatient Clinic, Maastricht University Medical Center, The Netherlands. Head and Neck Cancer Patients, treated for at least 6 months at the Oncology Clinic, were included. A qualitative research design with patient interviews was used. All interviews were recorded and transcribed verbatim to increase validity. Analysis was done with use of the template approach and qualitative data analysis software. Three of the six dimensions predominated in the interview: (1) respect for patients' values, preferences and expressed need, (2) information, communication and education and (3) involvement of family and friends. The dimensions physical comfort; emotional support; coordination and integration of care were considered to be of less significance. The findings from this study resulted in a deeper understanding of patients' experiences and preferences and can be useful in the transition towards a more patient-centered approach of health care.

  17. Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Cataldo Janine K

    2013-01-01

    Full Text Available Abstract Background Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger ( Methods Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms. Results Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were  Conclusions This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment that explain the differences in symptom experience identified in this study.

  18. Adolescents with Cancer in Italy: Improving Access to National Cooperative Pediatric Oncology Group (AIEOP) Centers.

    Science.gov (United States)

    Ferrari, Andrea; Rondelli, Roberto; Pession, Andrea; Mascarin, Maurizio; Buzzoni, Carlotta; Mosso, Maria Luisa; Maule, Milena; Barisone, Elena; Bertolotti, Marina; Clerici, Carlo Alfredo; Jankovic, Momcilo; Fagioli, Franca; Biondi, Andrea

    2016-06-01

    This analysis compared the numbers of patients treated at Italian pediatric oncology group (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]) centers with the numbers of cases predicted according to the population-based registry. It considered 32,431 patients registered in the AIEOP database (1989-2012). The ratio of observed (O) to expected (E) cases was 0.79 for children (0-14 years old) and 0.15 for adolescents (15-19 years old). The proportion of adolescents increased significantly over the years, however, from 0.05 in the earliest period to 0.10, 0.18, and then 0.28 in the latest period of observation, suggesting a greater efficacy of local/national programs dedicated to adolescents.

  19. Developing a decision-making model based on an interdisciplinary oncological care group for the management of colorectal cancer.

    Science.gov (United States)

    Genovesi, Domenico; Mazzilli, Lorenzo; Trignani, Marianna; DI Tommaso, Monica; Nuzzo, Antonio; Biondi, Edoardo; Tinari, Nicola; Martino, Maria Teresa; Innocenti, Paolo; DI Sebastiano, Pierluigi; Mazzola, Lorenzo; Lanci, Carmine; Neri, Matteo; Laterza, Francesco; Marino, Maria; Ferrini, Giovanni; Spadaccini, Antonio; Filippone, Antonella; DI Giandomenico, Enzo; Marulli, Antonio; Palombo, Giuseppe; Sparvieri, Antonio; Marchetti, Antonio; Pizzicannella, Giuseppe; Petrini, Flavia; DI Felice, Maria; Ottaviani, Floriana; Monteodorisio, Antonio; DI Nicola, Marta; Cefaro, Giampiero Ausili

    2014-05-01

    To report our experience on implementation and preliminary results of a decision-making model based on the recommendations of an Interdisciplinary Oncological Care Group developed for the management of colorectal cancer. The multidisciplinary team identified a reference guideline using appraisal of guidelines for research and evaluation (AGREE) tool based on a sequential assessment of the guideline quality. Thereafter, internal guidelines with diagnostic and therapeutic management for early, locally advanced and metastatic colonic and rectal cancer were drafted; organizational aspects, responsibility matrices, protocol actions for each area of specialty involved and indicators for performing audits were also defined. The National Institute for Health and Care Excellence (NICE) UK guideline was the reference for drafting the internal guideline document; from February to November 2013, 125 patients with colorectal cancer were discussed by and taken under the care of the Interdisciplinary Oncological Care Group. The first audit performed in December 2013 revealed optimal adherence to the internal guideline, mainly in terms of uniformity and accuracy of perioperative staging, coordination and timing of multi-modal therapies. To date, all patients under observation are within the diagnostic and therapeutic course, no patient came out from the multidisciplinary "path" and only in 14% of cases have the first recommendations proposed been changed. The selected indicators appear effective and reliable, while at the moment, it is not yet possible to assess the impact of the multidisciplinary team on clinical outcome. Although having a short observation period, our model seems capable of determining optimal uniformity of diagnostic and therapeutic management, to a high degree of patient satisfaction. A longer observation period is necessary in order to confirm these observations and for assessing the impact on clinical outcome.

  20. Gene expression profiles predictive of outcome and age in infant acute lymphoblastic leukemia: A Children's Oncology Group study

    NARCIS (Netherlands)

    H. Kang; C.S. Wilson (Carla); R. Harvey (R.); I.-M. Chen (I.-Ming); M.H. Murphy (Maurice); S.R. Atlas (Susan); E.J. Bedrick (Edward); M. Devidas (Meenakshi); A.J. Carroll; B.W. Robinson (Blaine); R.W. Stam (Ronald); M.G. Valsecchi (Maria Grazia); R. Pieters (Rob); N.A. Heerema (Nyla); J.M. Hilden (Joanne); C.A. Felix (Carolyn); G.H. Reaman (Gregory); B. Camitta (Bruce); N.J. Winick (Naomi); W.L. Carroll (William); S.D. Dreyer; S.P. Hunger (Stephen); S.F. Willman (Sami )

    2012-01-01

    textabstractGene expression profiling was performed on 97 cases of infant ALL from Children's Oncology Group Trial P9407. Statistical modeling of an outcome predictor revealed 3 genes highly predictive of event-free survival (EFS), beyond age and MLL status: FLT3, IRX2, and TACC2. Low FLT3 expressio

  1. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gay, Hiram A., E-mail: hgay@radonc.wustl.edu [Washington University School of Medicine, St Louis, MO (United States); Barthold, H. Joseph [Commonwealth Hematology and Oncology, Weymouth, MA (United States); Beth Israel Deaconess Medical Center, Boston, MA (Israel); O' Meara, Elizabeth [Radiation Therapy Oncology Group, Philadelphia, PA (United States); Bosch, Walter R. [Washington University School of Medicine, St Louis, MO (United States); El Naqa, Issam [Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec (Canada); Al-Lozi, Rawan [Washington University School of Medicine, St Louis, MO (United States); Rosenthal, Seth A. [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); Lawton, Colleen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Zietman, Anthony [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Myerson, Robert [Washington University School of Medicine, St Louis, MO (United States); Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Willett, Christopher [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Kachnic, Lisa A. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States); Jhingran, Anuja [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Portelance, Lorraine [University of Miami, Miami, FL (United States); Ryu, Janice [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); and others

    2012-07-01

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.

  2. Integrity of the National Resident Matching Program for Radiation Oncology: National Survey of Applicant Experiences

    Energy Technology Data Exchange (ETDEWEB)

    Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Thomas, Charles R., E-mail: thomasch@ohsu.edu [Department of Radiation Medicine, OHSU Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States); Kusano, Aaron S. [Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington (United States)

    2015-07-01

    Purpose: The aim of this study was to examine the experiences of radiation oncology applicants and to evaluate the prevalence of behaviors that may be in conflict with established ethical standards. Methods and Materials: An anonymous survey was sent to all 2013 applicants to a single domestic radiation oncology residency program through the National Resident Matching Program (NRMP). Questions included demographics, survey of observed behaviors, and opinions regarding the interview and matching process. Descriptive statistics were presented. Characteristics and experiences of respondents who matched were compared with those who did not match. Results: Questionnaires were returned by 87 of 171 applicants for a 51% response rate. Eighty-two questionnaires were complete and included for analysis. Seventy-eight respondents (95.1%) reported being asked at least 1 question in conflict with the NRMP code of conduct. When asked where else they were interviewing, 64% stated that this query made them uncomfortable. Forty-five respondents (54.9%) reported unsolicited post-interview contact by programs, and 31 (37.8%) felt pressured to give assurances. Fifteen respondents (18.3%) reported being told their rank position or that they were “ranked to match” prior to Match day, with 27% of those individuals indicating this information influenced how they ranked programs. Half of respondents felt applicants often made dishonest or misleading assurances, one-third reported that they believed their desired match outcome could be improved by deliberately misleading programs, and more than two-thirds felt their rank position could be improved by having faculty from their home institutions directly contact programs on their behalf. Conclusions: Radiation oncology applicants report a high prevalence of behaviors in conflict with written NRMP policies. Post-interview communication should be discouraged in order to enhance fairness and support the professional development of future

  3. Modern Radiation Therapy for Primary Cutaneous Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena, E-mail: lena.specht@regionh.dk [Departments of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Dabaja, Bouthaina [Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Stanford, California (United States)

    2015-05-01

    Primary cutaneous lymphomas are a heterogeneous group of diseases. They often remain localized, and they generally have a more indolent course and a better prognosis than lymphomas in other locations. They are highly radiosensitive, and radiation therapy is an important part of the treatment, either as the sole treatment or as part of a multimodality approach. Radiation therapy of primary cutaneous lymphomas requires the use of special techniques that form the focus of these guidelines. The International Lymphoma Radiation Oncology Group has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the International Lymphoma Radiation Oncology Group steering committee on the use of radiation therapy in primary cutaneous lymphomas in the modern era.

  4. Compassion and care at the end of life: oncology nurses' experiences in South-East Iran.

    Science.gov (United States)

    Ghaljeh, Mahnaz; Iranmanesh, Sedigheh; Nayeri, Nahid Dehghan; Tirgari, Batool; Kalantarri, Behjat

    2016-12-01

    End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life. The aim of this study was to explore nurses' experiences of caring for dying patients in Iran. A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons. Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives. Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.

  5. The use, publication and future directions of immunocytochemistry in veterinary medicine: a consensus of the Oncology-Pathology Working Group.

    Science.gov (United States)

    Priest, H L; Hume, K R; Killick, D; Kozicki, A; Rizzo, V L; Seelig, D; Snyder, L A; Springer, N L; Wright, Z M; Robat, C

    2016-03-22

    One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.

  6. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

    Energy Technology Data Exchange (ETDEWEB)

    Velde, Joris van de [Ghent University, Department of Anatomy, Ghent (Belgium); Ghent University, Department of Radiotherapy, Ghent (Belgium); Vercauteren, Tom; Gersem, Werner de; Vandecasteele, Katrien; Vuye, Philippe; Vanpachtenbeke, Frank; Neve, Wilfried de [Ghent University, Department of Radiotherapy, Ghent (Belgium); Wouters, Johan; Herde, Katharina d' ; Kerckaert, Ingrid; Hoof, Tom van [Ghent University, Department of Anatomy, Ghent (Belgium)

    2014-07-15

    The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.) [German] Ziel der Studie war

  7. Maternal Dietary Patterns During Early Pregnancy and the Odds of Childhood Germ Cell Tumors: A Children's Oncology Group Study

    OpenAIRE

    Musselman, Jessica R.B.; Anne M Jurek; Johnson, Kimberly J.; Linabery, Amy M.; Robison, Leslie L.; Shu, Xiao-Ou; Ross, Julie A

    2010-01-01

    Maternal diet during pregnancy may be associated with cancer in offspring. Intake of individual foods, as well as dietary patterns, can be used when examining these relations. Here, the authors examined associations between maternal dietary intake patterns and pediatric germ cell tumors (GCTs) using principal components analysis and logistic regression. Mothers of 222 GCT cases aged less than 15 years who were diagnosed at a Children's Oncology Group institution between 1993 and 2001 and thos...

  8. A Decade in Banking Ewing Sarcoma: A Report from the Children's Oncology Group.

    Science.gov (United States)

    Borinstein, Scott C; Beeler, Natalie; Block, John J; Gorlick, Richard; Grohar, Patrick; Jedlicka, Paul; Krailo, Mark; Morris, Carol; Phillips, Sharon; Siegal, Gene P; Lawlor, Elizabeth R; Lessnick, Stephen L

    2013-01-01

    Outcomes for patients with metastatic and recurrent Ewing sarcoma remain poor and a better understanding of the biology of this malignancy is critical to the development of prognostic biomarkers and novel therapies. Therefore, the Children's Oncology Group (COG) has created tissue banking protocols designed to collect high quality, clinically annotated, tumor specimens that can be distributed to researchers to perform basic science and correlative investigation. Data from the COG Ewing sarcoma tissue banking protocols AEWS02B1 and its successor study AEWS07B1 were reviewed in this study. Six-hundred and thirty five patients were enrolled on AEWS02B1 and 396 patients have had tissue submitted to AEWS07B1. The average age of participation was 13.2 years. About 86% were less than 19 years old and only 6% were greater than 21 years of age at diagnosis. When compared to SEER data, approximately 18% of all cases and only 8% of all patients >20 years old diagnosed with Ewing sarcoma annually in the United States have had tumor banked. The majority of participants submitted formalin fixed, paraffin embedded, primary tumor and blood samples. In total, fresh frozen tissue was submitted for only 29% of cases. Only seven metastatic tumor samples have been collected. Although the COG has been successful in collecting tumor samples from patients newly diagnosed with Ewing sarcoma, fresh frozen tumor specimens from primary and metastatic disease are critically needed, especially from young adult patients, in order to conduct high quality basic science and translational research investigation with a goal of developing better treatments.

  9. A Decade in Banking Ewing Sarcoma: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Borinstein, Scott C.; Beeler, Natalie; Block, John J.; Gorlick, Richard; Grohar, Patrick; Jedlicka, Paul; Krailo, Mark; Morris, Carol; Phillips, Sharon; Siegal, Gene P.; Lawlor, Elizabeth R.; Lessnick, Stephen L.

    2013-01-01

    Outcomes for patients with metastatic and recurrent Ewing sarcoma remain poor and a better understanding of the biology of this malignancy is critical to the development of prognostic biomarkers and novel therapies. Therefore, the Children’s Oncology Group (COG) has created tissue banking protocols designed to collect high quality, clinically annotated, tumor specimens that can be distributed to researchers to perform basic science and correlative investigation. Data from the COG Ewing sarcoma tissue banking protocols AEWS02B1 and its successor study AEWS07B1 were reviewed in this study. Six-hundred and thirty five patients were enrolled on AEWS02B1 and 396 patients have had tissue submitted to AEWS07B1. The average age of participation was 13.2 years. About 86% were less than 19 years old and only 6% were greater than 21 years of age at diagnosis. When compared to SEER data, approximately 18% of all cases and only 8% of all patients >20 years old diagnosed with Ewing sarcoma annually in the United States have had tumor banked. The majority of participants submitted formalin fixed, paraffin embedded, primary tumor and blood samples. In total, fresh frozen tissue was submitted for only 29% of cases. Only seven metastatic tumor samples have been collected. Although the COG has been successful in collecting tumor samples from patients newly diagnosed with Ewing sarcoma, fresh frozen tumor specimens from primary and metastatic disease are critically needed, especially from young adult patients, in order to conduct high quality basic science and translational research investigation with a goal of developing better treatments. PMID:23519678

  10. Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report.

    Science.gov (United States)

    Chow, Eric J; Anderson, Lynnette; Baker, K Scott; Bhatia, Smita; Guilcher, Gregory M T; Huang, Jennifer T; Pelletier, Wendy; Perkins, Joanna L; Rivard, Linda S; Schechter, Tal; Shah, Ami J; Wilson, Karla D; Wong, Kenneth; Grewal, Satkiran S; Armenian, Saro H; Meacham, Lillian R; Mulrooney, Daniel A; Castellino, Sharon M

    2016-05-01

    Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies, solid tumors, and, increasingly, nonmalignant diseases. Given improvements in care, there are a growing number of long-term survivors of pediatric HCT. Compared with childhood cancer survivors who did not undergo transplantation, HCT survivors have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pretransplantation treatment exposures and organ dysfunction, the transplantation conditioning regimen, and any post-transplantation graft-versus-host disease (GVHD). In response, the Children's Oncology Group (COG) has created long-term follow-up guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those who were treated with HCT. Guideline task forces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other health care professionals, and patient advocates systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided herein is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those who underwent transplantation for nonmalignant diseases, and those with a history of chronic GVHD.

  11. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  12. Young patients', parents', and survivors' communication preferences in paediatric oncology: using online focus groups.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Tates, K.; Dulmen, S. van; Hoogerbrugge, M.; Kamps, W.A.; Bensing, J.M.

    2007-01-01

    BACKGROUND: Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated

  13. Implementation of Remote 3-Dimensional Image Guided Radiation Therapy Quality Assurance for Radiation Therapy Oncology Group Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Cui Yunfeng [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Galvin, James M. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Radiation Therapy Oncology Group, American College of Radiology, Philadelphia, Pennsylvania (United States); Parker, William [Department of Medical Physics, McGill University Health Center, Montreal, QC (Canada); Breen, Stephen [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Yin Fangfang; Cai Jing [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Papiez, Lech S. [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Bednarz, Greg [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Chen Wenzhou [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Xiao Ying, E-mail: ying.xiao@jefferson.edu [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Radiation Therapy Oncology Group, American College of Radiology, Philadelphia, Pennsylvania (United States)

    2013-01-01

    Purpose: To report the process and initial experience of remote credentialing of three-dimensional (3D) image guided radiation therapy (IGRT) as part of the quality assurance (QA) of submitted data for Radiation Therapy Oncology Group (RTOG) clinical trials; and to identify major issues resulting from this process and analyze the review results on patient positioning shifts. Methods and Materials: Image guided radiation therapy datasets including in-room positioning CT scans and daily shifts applied were submitted through the Image Guided Therapy QA Center from institutions for the IGRT credentialing process, as required by various RTOG trials. A centralized virtual environment is established at the RTOG Core Laboratory, containing analysis tools and database infrastructure for remote review by the Physics Principal Investigators of each protocol. The appropriateness of IGRT technique and volumetric image registration accuracy were evaluated. Registration accuracy was verified by repeat registration with a third-party registration software system. With the accumulated review results, registration differences between those obtained by the Physics Principal Investigators and from the institutions were analyzed for different imaging sites, shift directions, and imaging modalities. Results: The remote review process was successfully carried out for 87 3D cases (out of 137 total cases, including 2-dimensional and 3D) during 2010. Frequent errors in submitted IGRT data and challenges in the review of image registration for some special cases were identified. Workarounds for these issues were developed. The average differences of registration results between reviewers and institutions ranged between 2 mm and 3 mm. Large discrepancies in the superior-inferior direction were found for megavoltage CT cases, owing to low spatial resolution in this direction for most megavoltage CT cases. Conclusion: This first experience indicated that remote review for 3D IGRT as part of QA

  14. Implementation of remote 3-dimensional image guided radiation therapy quality assurance for radiation therapy oncology group clinical trials.

    Science.gov (United States)

    Cui, Yunfeng; Galvin, James M; Parker, William; Breen, Stephen; Yin, Fang-Fang; Cai, Jing; Papiez, Lech S; Li, X Allen; Bednarz, Greg; Chen, Wenzhou; Xiao, Ying

    2013-01-01

    To report the process and initial experience of remote credentialing of three-dimensional (3D) image guided radiation therapy (IGRT) as part of the quality assurance (QA) of submitted data for Radiation Therapy Oncology Group (RTOG) clinical trials; and to identify major issues resulting from this process and analyze the review results on patient positioning shifts. Image guided radiation therapy datasets including in-room positioning CT scans and daily shifts applied were submitted through the Image Guided Therapy QA Center from institutions for the IGRT credentialing process, as required by various RTOG trials. A centralized virtual environment is established at the RTOG Core Laboratory, containing analysis tools and database infrastructure for remote review by the Physics Principal Investigators of each protocol. The appropriateness of IGRT technique and volumetric image registration accuracy were evaluated. Registration accuracy was verified by repeat registration with a third-party registration software system. With the accumulated review results, registration differences between those obtained by the Physics Principal Investigators and from the institutions were analyzed for different imaging sites, shift directions, and imaging modalities. The remote review process was successfully carried out for 87 3D cases (out of 137 total cases, including 2-dimensional and 3D) during 2010. Frequent errors in submitted IGRT data and challenges in the review of image registration for some special cases were identified. Workarounds for these issues were developed. The average differences of registration results between reviewers and institutions ranged between 2 mm and 3 mm. Large discrepancies in the superior-inferior direction were found for megavoltage CT cases, owing to low spatial resolution in this direction for most megavoltage CT cases. This first experience indicated that remote review for 3D IGRT as part of QA for RTOG clinical trials is feasible and effective

  15. Obstacles to transcultural caring relationships: experiences of health care staff in pediatric oncology.

    Science.gov (United States)

    Pergert, Pernilla; Ekblad, Solvig; Enskär, Karin; Björk, Olle

    2007-01-01

    This qualitative study explores the caring situation of families with an immigrant background within the context of pediatric oncology care from the perspective of health care staff. Five focus group interviews and 5 complementary individual interviews were conducted after purposive and theoretical sampling, respectively. Grounded theory methodology revealed that obstacles to transcultural caring relationships are a main concern of the health care staff. These obstacles are divided into 4 main categories: linguistic, cultural and religious, social, and organizational. When health care staff fail to recognize obstacles to transcultural caring relationships, the result is inequity in care of families with an immigrant background. Equity in care for all does not mean identical treatment but, rather, care adjusted to the needs of the individual family regardless of background.

  16. Discrete choice experiment to evaluate factors that influence preferences for antibiotic prophylaxis in pediatric oncology.

    Directory of Open Access Journals (Sweden)

    Dean A Regier

    Full Text Available BACKGROUND: Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality. The clinical utility of antimicrobial prophylaxis in children is uncertain and the personal utility of these agents is disputed. Objectives were to use a discrete choice experiment to: (1 describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis; and (2 estimate willingness-to-pay for prophylactic strategies. METHODS: Attributes were chances of infection, death and side effects, route of administration and cost of pharmacotherapy. Respondents were randomized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections. Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative (no prophylaxis. RESULTS: 102 parents and 60 healthcare providers participated. For the antibacterial discrete choice experiment, frequency of administration was significantly associated with utility for parents but not for healthcare providers. Increasing chances of infection, death, side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment. Parental willingness-to-pay was higher than healthcare providers for both strategies. CONCLUSION: Chances of infection, death, side effects and costs were all significantly associated with utility. Parents have higher willingness-to-pay for these strategies compared with healthcare providers. This knowledge can help to develop prophylaxis programs.

  17. Oncological results at 2 years after robotic radical prostatectomy – the Romanian experience

    Science.gov (United States)

    Andras, Iulia; Coman, Radu-Tudor; Logigan, Horia; Epure, Flavia; Stanca, Dan Vasile; Coman, Ioan

    2016-01-01

    Introduction To assess the oncological outcomes of robotic radical prostatectomy in a country where there are no on-going national screening programs for prostate cancer. Material and methods Between November 2009 and November 2014, 220 robotic radical prostatectomies were performed at our Robotic Surgery Center. We already have the complete data for the 2-year follow-up of the first 105 patients, who were therefore included in the study group. Pre-operative (age, prostate-specific antigen, body-mass index, prostate volume, clinical staging, biopsy characteristics), post-operative (surgical technique, surgical margin status, lymph node status, pathological stage, Gleason score) and follow-up parameters (biochemical recurrence) were assessed. Results The global rate of positive surgical margins was 34.3%, with rates of 17.2% in stage pT2 and 55.3% in stage pT3. The most frequent localization for positive surgical margins was at the base and apex of the prostate. The positive surgical margins rate was correlated with the pre-operative prostate-specific antigen, clinical and pathological Gleason score, lymph node status and the number of positive biopsy cores. The rate of biochemical recurrence at the 2-year follow-up was 11.8%. The most important predictors for the biochemical recurrence were the positive surgical margins, pathological staging and Gleason score on the prostatectomy specimen. Conclusions Robotic surgery is validated by the oncological results at medium follow-up (2 years) for localized and locally advanced prostate cancer, even in countries where there is no on-going national screening program. PMID:27123326

  18. The cancer and leukemia group B oncology nursing committee (1983-2006): a history of passion, commitment, challenge, and accomplishment.

    Science.gov (United States)

    Smith, Ellen Lavoie; Skosey, Consuelo; Armer, Jane; Berg, Deborah; Cirrincione, Constance; Henggeler, Mary

    2006-06-01

    The Cancer and Leukemia Group B (CALGB) Oncology Nursing Committee (ONC) was initially established in 1983 as a working group with the specific aim of promoting protocol compliance through collaboration, communication, and education to enhance the scientific goals of the Group. Due to the efforts of its members, the committee gained full committee status. ONC members now serve as principal investigators and coinvestigators on research studies, continue to sponsor biannual educational sessions individually and in concert with other CALGB committees, and continue to develop tools to enlighten patients about their disease and the clinical trial process. The ONC, an administrative group of 12 members, provides leadership within CALGB. Although ONC members have always acted as liaisons to the disease and modality committees, three positions have recently been designated specifically for doctorally prepared nurse scientists. Since its inception, general nurse membership within the group has more than doubled to a total of more than 500 members.

  19. Hepato-biliary late effects in survivors of childhood and adolescent cancer: a report from the Children's Oncology Group.

    Science.gov (United States)

    Castellino, Sharon; Muir, Andrew; Shah, Ami; Shope, Sheila; McMullen, Kevin; Ruble, Kathy; Barber, Ashley; Davidoff, Andrew; Hudson, Melissa M

    2010-05-01

    Curative therapy for childhood and adolescent cancer translates to 1 in 640 young adults being a survivor of cancer. Although acute hepato-biliary toxicity occurs commonly during pediatric cancer therapy, the impact of antineoplastic therapy on long-term liver health in childhood/adolescent cancer survivors is unknown. This article reviews the medical literature on late liver dysfunction following treatment for childhood/adolescent cancer. We also outline the Children's Oncology Group (COG) guidelines for screening and follow-up of hepato-biliary sequelae. As the population of survivors grow and age, vigilance for risks to hepatic health needs to continue based on specific exposures during curative cancer therapy.

  20. Histologic effects of medroxyprogesterone acetate on endometrioid endometrial adenocarcinoma: a Gynecologic Oncology Group study.

    Science.gov (United States)

    Zaino, Richard J; Brady, William E; Todd, William; Leslie, Kimberly; Fischer, Edgar G; Horowitz, Neil S; Mannel, Robert S; Walker, Joan L; Ivanovic, Marina; Duska, Linda R

    2014-11-01

    Progestins have been used in the treatment of recurrent endometrial adenocarcinoma for almost 50 yr. Some endometrial carcinomas respond to hormonal therapy, but the mechanism of action remains incompletely known. We wished to determine the efficacy of progestins to induce a histologic response in endometrioid carcinomas and explore its effects on histologic and immunohistochemical measures of growth and cell death. The Gynecologic Oncology Group initiated a study of 75 women with endometrioid endometrial adenocarcinoma, 59 of whom received the progestin, medroxyprogesterone acetate for 21 to 24 d immediately before hysterectomy and had available slides. Initial biopsies and hysterectomies were hematoxylin and eosin-stained and immunostained for estrogen receptor (ER) and progesterone receptor (PR), progesterone receptor-β (PRB), Bcl-2, Ki-67, and cleaved caspase-3 (Casp3). A histologic response was defined subjectively, following which specific histologic measurements and semiquantitative scores of immunohistologic variables of initial biopsies were compared with posttreatment slides. Only 1 complete histologic response was seen, but 37 tumors (63%) had a partial histologic response. Specific histologic changes included the following: a decrease in the nuclear grade, the number of mitotic figures, nucleoli, and mean gland cellularity, and acquisition of more abundant eosinophilic cytoplasm, squamous metaplasia, and secretion. The tumors that displayed a subjectively defined histologic response following treatment differed initially from those that did not only with respect to initial nuclear grade and the mitotic index. Statistically significant differences in the specific histologic features in carcinomas of responders versus nonresponders following treatment were found only with respect to acquisition of pale eosinophilic cytoplasm and luminal secretion. More than 90% of tumors were initially ER positive and 76% were PR positive. The initial presence of ER or

  1. An introduction to molecular imaging in radiation oncology: a report by the AAPM Working Group on Molecular Imaging in Radiation Oncology (WGMIR).

    Science.gov (United States)

    Munley, Michael T; Kagadis, George C; McGee, Kiaran P; Kirov, Assen S; Jang, Sunyoung; Mutic, Sasa; Jeraj, Robert; Xing, Lei; Bourland, J Daniel

    2013-10-01

    Molecular imaging is the direct or indirect noninvasive monitoring and recording of the spatial and temporal distribution of in vivo molecular, genetic, and/or cellular processes for biochemical, biological, diagnostic, or therapeutic applications. Molecular images that indicate the presence of malignancy can be acquired using optical, ultrasonic, radiologic, radionuclide, and magnetic resonance techniques. For the radiation oncology physicist in particular, these methods and their roles in molecular imaging of oncologic processes are reviewed with respect to their physical bases and imaging characteristics, including signal intensity, spatial scale, and spatial resolution. Relevant molecular terminology is defined as an educational assist. Current and future clinical applications in oncologic diagnosis and treatment are discussed. National initiatives for the development of basic science and clinical molecular imaging techniques and expertise are reviewed, illustrating research opportunities in as well as the importance of this growing field.

  2. Coping style and performance status in a group of oncological inpatients

    Directory of Open Access Journals (Sweden)

    Cecilia Chau Pérez-Aranibar

    2002-06-01

    Full Text Available The associations between coping styles, measured by COPE Test, dispositional version (Carver,Scheier and Weintraub, 1989, and Health Status inferred through a performance status, measured by Karnofsky's Index of Behavioral Performance are examined. The study focuses upon 28 oncological in patients. Positive moderate Pearson's correlations were found between these two variables in this correlational-descriptive study. These were interpreted in the following sense: the larger use of the style, the less health status among the scales suppression of competent activities, procrastination of coping, instrumental social support, focusing and releasing of emotions and behavioral disengagement. The active coping scale presented a negative correlationwith regard to Performance Status as a health measure.

  3. Clinical trends and outcomes of male breast cancer: Experience of a tertiary oncology centre in India

    Directory of Open Access Journals (Sweden)

    Anindya Mukherjee

    2014-08-01

    outcomes of Male Breast Cancer: experience of a tertiary oncology centre in India. Int J Cancer Ther Oncol 2014; 2(3:02035. DOI: 10.14319/ijcto.0203.5

  4. Inferior vena cava filter placement in the gynecologic oncology patient: A 15-year institutional experience.

    Science.gov (United States)

    Dewdney, Summer B; Benn, Teri; Rimel, B J; Gao, Feng; Saad, Nael; Vedantham, Suresh; Mutch, David G; Zighelboim, Israel

    2011-05-01

    Venous thrombosis is a frequent complication of gynecologic cancer. Data regarding the use of inferior vena cava (IVC) filters in this population is limited. The aim of this study was to review our experience with gynecologic oncology patients who received an IVC filter, specifically to evaluate indications for filter placement and survival outcomes. This was a retrospective, single-institution study of patients who had an IVC filter placed after a histologically confirmed gynecologic malignancy. Patients were identified from a prospectively collected interventional radiology (IR) database. Clinicopathologic characteristics, procedure details, and outcome data were obtained from outpatient and inpatient medical records. Survival after IVC filter placement was analyzed using the Kaplan-Meier product limit method and compared by log-rank test. A total of 128 patients were identified and 103 were found to be eligible for analysis. Most patients had ovarian cancer (52%), followed by cervical cancer (25%) and endometrial cancer (21%). Two-thirds had advanced stage disease (III/IV). The procedure complication rate was 2%. Median survival after IVC filter placement was 7.8months (95% CI, 4.1-13.6). The most common indication for IVC filter placement was contraindication to anticoagulation secondary to hemorrhage (44%), followed by perioperative indications (30%) and failed anticoagulation (14%). There was no difference in survival by IVC filter placement indication (p=0.18). The majority of the IVC filters placed were permanent (90.5%) and in an infrarenal position (95.8%). There was no difference in survival according to specific thromboembolic event (DVT vs. PE vs. both). Patients able to receive anticoagulation after IVC filter placement had improved survival (HR 0.45, 95%CI 0.45-0.27, p=0.003). We present the largest series of gynecologic oncology patients treated with IVC filters. Long-term survival after IVC filter placement is uncommon. Patients who receive

  5. [Radiotherapy for endometrial cancer: experience of the national institute of oncology with 52 cases].

    Science.gov (United States)

    Mezouri, Imane; Berhili, Soufiane; Mouhajir, Nawal; Bellefqih, Sara; Elkacemi, Hanan; Kebdani, Tayeb; Benjaafar, Noureddine

    2016-01-01

    Endometrial cancer is the most common gynecological cancer in the Western world. It affects mainly postmenopausal women. The aim of our study is to report the experience of the radiotherapy department of the National Oncology Institute (INO) in the treatment of endometrial cancer. We retrospectively analyzed 52 cases of endometrial cancer treated in the INO radiotherapy department between 2007-2009. Data obtained from the patient medical records were related to the epidemiologic, clinical, therapeutic and evolutionary aspects of this cancer. The median age of the patients was 57 years, 87% were postmenopausal. The median of consultation time was six months. The main symptom was metrorrhagia (51 patients). Histological diagnosis was based on biopsic curettage of uterine endometrium in 51% of the cases. Anatomo-pathological examination showed an endometrioid adenocarcinoma in 92% of the cases. After the assessment, 27% of the patients were stage I, 30% stage II, 20% stage III and 1% stage IVA, according to the International Federation of Gynecological and Obstetrics (FIGO) stage classification. After surgery, 51% of the patients received postoperative external radiotherapy. The delivered dose was 46 Gray (Gy). All patients received internal vaginal brachytherapy. From an evolutionary perspective, 83% of the patients had no recurrences during the follow-up period, 8% of patients had a local recurrence and 4% of patients had distant metastases. Therefore, surgery is the main treatment for endometrial cancer. Radiotherapy is the primary adjuvant treatment.

  6. Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Yahalom, Joachim, E-mail: yahalomj@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Specht, Lena [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Li, Ye-Xiong [Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Wirth, Andrew [Division of Radiation Oncology, Peter MacCallum Cancer Institute, St. Andrews Place, East Melbourne (Australia)

    2015-05-01

    Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL, involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements (ICRU), as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype, anatomy, the treatment intent, and other treatment modalities that may be have been used before RT.

  7. Impact of cytogenetics on the outcome of adult acute lymphoblastic leukemia: results of Southwest Oncology Group 9400 study.

    Science.gov (United States)

    Pullarkat, Vinod; Slovak, Marilyn L; Kopecky, Kenneth J; Forman, Stephen J; Appelbaum, Frederick R

    2008-03-01

    We examined the prognostic impact of cytogenetics on the outcome of 200 acute lymphoblastic leukemia (ALL) patients 15 to 65 years of age enrolled in Southwest Oncology Group (SWOG)-9400 study. Evaluable cytogenetics or fluorescence in situ hybridization studies were available in 140 (70%) patients. Four karyotype categories (normal [n = 31, 22%], t(9;22)/BCR/ABL1 [n = 36, 26%], other unfavorable [-7, +8, or 11q23 rearrangement, n = 19, 13%], and miscellaneous [n = 54, 39%]) and the biologically and clinically relevant ALL ploidy subgroups were prospectively defined. Overall survival (OS) decreased significantly with increasing age (P = .009) and varied with karyotype category (P cytogenetics as the most important prognostic factor in adult ALL. This trial was registered at www.ClinicalTrials.gov as #NCT00002665.

  8. A phase II trial of CPT-11 in recurrent squamous carcinoma of the cervix: a gynecologic oncology group study.

    Science.gov (United States)

    Look, K Y; Blessing, J A; Levenback, C; Kohler, M; Chafe, W; Roman, L D

    1998-09-01

    To determine the response rate and associated toxicity of weekly CPT-11 in squamous carcinoma of the cervix. From October 1994 to May 1996, the Gynecologic Oncology Group (GOG) conducted a Phase II trial in patients with recurrent squamous cervix carcinoma. The schedule employed weekly x4 intravenous CPT-11 at 125 mg/m2 followed with a 2-week rest, to be repeated until disease progression or unacceptable toxicity. Eligibility criteria were a GOG performance status of 0-2, adequate bone marrow reserve, adequate liver function, and serum creatinine OFFis schedule of CPT-11 exhibits modest activity with moderate toxicity in patients with recurrent squamous carcinoma of the cervix. Copyright 1998 Academic Press.

  9. Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre

    Directory of Open Access Journals (Sweden)

    Arathi Srinivasan

    2015-01-01

    Full Text Available Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed treatment and those currently undergoing treatment, is comparable in both the groups. Abandonment of treatment after initiating therapy was not seen in the financially supported group whereas abandonment of treatment after initiation was seen in one child in the non-funded group. Conclusions: Besides intensive treatment with good supportive care, financial support also has an important impact on compliance and abandonment in all socioeconomic strata of society. Financial support from private cancer support groups also has its impact beyond the patient and family, in reducing the burden on government institutions by non-governmental funding in private sector. Improvement in the delivery of pediatric oncology care in developing countries could be done by financial support from the private sector.

  10. THE NATIONAL ONCOLOGICAL PROGRAM IMPLEMENTATION – EXPERIENCE IN THE VLADIMIR REGION (TO THE 70TH ANNIVERSARY OF THE REGIONAL CLINICAL ONCOLOGICAL DISPENSARY

    Directory of Open Access Journals (Sweden)

    A. G. Zirin

    2017-01-01

    Full Text Available By 2010, on the background of the steady increase in the incidence of malignant tumors in the Vladimir area, primary oncological care level worked inefficiently.Condition of material and technical base of the Vladimir Regional Clinical Oncological Dispensary was also unsatisfactory. All these problems required solution in the form of the National Oncology Program realization in the region. The National Oncological Program has begun to work in the Vladimir region since 2011. Target indicators of the oncological program implementation by 2015 were established. They are: Increase of 5-year survival value of patients with malignant tumors after diagnosis date to 51.4%; Increase the number of malignant tumors early detection cases at the I–II stages up to 51%; Decrease the mortality rate of working age population to 99 per 100 000; Decrease of mortality within one year from the first time of cancer diagnosis to 27%. The following main objectives such as radically improved the material and technical base of oncology dispensary; modern methods of prevention, diagnosis and patients treatment improvement and introduction; the system providing population cancer care focused on the cancer early detection and the specialized combined antitumor treatment provision are realized in order to achieve these goals. The implementation of the tasks allowed to achieve positive dynamics of Vladimir region population cancer care indicators. All the main targets of the National Oncology Program for the Vladimir region were achieved successfully. Implementation of the National Oncology Program has had an extremely positive effect on the cancer services development of, as well as for the health of the entire population of the Vladimir region.

  11. Control Group Design, Contamination and Drop-Out in Exercise Oncology Trials : A Systematic Review

    NARCIS (Netherlands)

    Bisschop, Charlotte N. Steins; Courneya, Kerry S.; Velthuis, Miranda J.; Monninkhof, Evelyn M.; Jones, Lee W.; Friedenreich, Christine; van der Wall, Elsken; Peeters, Petra H. M.; May, Anne M.

    2015-01-01

    Purpose Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of

  12. The use of failure mode and effect analysis in a radiation oncology setting: the Cancer Treatment Centers of America experience.

    Science.gov (United States)

    Denny, Diane S; Allen, Debra K; Worthington, Nicole; Gupta, Digant

    2014-01-01

    Delivering radiation therapy in an oncology setting is a high-risk process where system failures are more likely to occur because of increasing utilization, complexity, and sophistication of the equipment and related processes. Healthcare failure mode and effect analysis (FMEA) is a method used to proactively detect risks to the patient in a particular healthcare process and correct potential errors before adverse events occur. FMEA is a systematic, multidisciplinary team-based approach to error prevention and enhancing patient safety. We describe our experience of using FMEA as a prospective risk-management technique in radiation oncology at a national network of oncology hospitals in the United States, capitalizing not only on the use of a team-based tool but also creating momentum across a network of collaborative facilities seeking to learn from and share best practices with each other. The major steps of our analysis across 4 sites and collectively were: choosing the process and subprocesses to be studied, assembling a multidisciplinary team at each site responsible for conducting the hazard analysis, and developing and implementing actions related to our findings. We identified 5 areas of performance improvement for which risk-reducing actions were successfully implemented across our enterprise.

  13. Recommendations for the Return of Research Results to Study Participants and Guardians: A Report From the Children's Oncology Group

    Science.gov (United States)

    Fernandez, Conrad V.; Ruccione, Kathleen; Wells, Robert J.; Long, Jay B.; Pelletier, Wendy; Hooke, Mary C.; Pentz, Rebecca D.; Noll, Robert B.; Baker, Justin N.; O'Leary, Maura; Reaman, Gregory; Adamson, Peter C.; Joffe, Steven

    2012-01-01

    Purpose The Children's Oncology Group (COG) strongly supports the widely recognized principle that research participants should be offered a summary of study results. The mechanism by which to do so in a cooperative research group setting has not been previously described. Methods On the basis of a review of the available empirical and theoretic literature and on iterative, multidisciplinary discussion, a COG Return of Results Task Force (RRTF) offered detailed recommendations for the return of results to research study participants. Results The RRTF established guidelines for the notification of research participants and/or their parents/guardians about the availability of research results, a mechanism for and timing of sharing results via registration on the COG public Web site, the scope of the research to be shared, the target audience, and a process for creating and vetting lay summaries of study results. The RRTF recognized the challenges in adequately conveying complex scientific results to audiences with varying levels of health literacy and recommended that particularly sensitive or complex results be returned using direct personal contact. The RRTF also recommended evaluation of the cost, effectiveness, and impact of sharing results. Conclusion These recommendations provide a framework for the offering and returning of results to participants. They can be used by individual investigators, multi-investigator research collaboratives, and large cooperative groups. PMID:23109703

  14. Salivary gland carcinoma : Independent prognostic factors for locoregional control, distant metastases, and overall survival: Results of the Dutch Head and Neck Oncology Cooperative Group

    NARCIS (Netherlands)

    Terhaard, CHJ; Lubsen, H; Van der Tweel, [No Value; Hilgers, FJM; Eijkenboom, WMH; Marres, HAM; Tjho-Heslinga, RE; de Jong, JMA; Roodenburg, JLN

    2004-01-01

    Background. We analyzed the records of patients with malignant salivary gland tumors, as diagnosed in centers of the Dutch Head and Neck Oncology Cooperative Group, in search of independent prognostic factors for locoregional control, distant metastases, and overall survival. Methods. In 565 patient

  15. E-learning programs in oncology: a nationwide experience from 2005 to 2014.

    Science.gov (United States)

    Degerfält, Jan; Sjöstedt, Staffan; Fransson, Per; Kjellén, Elisabeth; Werner, Mads U

    2017-01-13

    E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008-2014. The total number of trainees were 4693, allocated to 3889 individuals. The trainees included medical doctors (MDs; n = 759), registered nurses (RNs; n = 2359), radiation therapy technologists (n = 642), and, social and health care assistants (SHCAs; n = 933). The E-learning covered 29 different program classifications, comprising 731 recorded presentations, and covering 438 themes. A total of 490 programs were completed by the trainees. The European Credit Transfer and Accumulation System (ECTS; 1 ECTS point equals 0.60 US College Credit Hours) points varied across the educational programs from 0.7 to 30.0, corresponding to a duration of full-time studies ranging between 15 to 900 h (0.4-24 weeks) per program. The total number of ECTS points for the trainee cohort, was 20,000 corresponding to 530,000 full-time academic hours or 324.0 standard academic working years. The overall drop-out rate, across professions and programs, was 10.6% (499/4693). The lowest drop-out rate was seen for RNs (4.3%; P categorical scale (5 = excellent; 1 = very inferior), as excellent by 68.6% (MDs: 64.9%; RNs: 66.8%; SHCAs: 77.7%) and as good by 30.6% (MDs: 34.5%; RNs: 32.4%; SHCAs: 21.5%) of the responders. This descriptive study, performed in a lengthy timeframe, presents high-volume data from multi-professional, oncological E-learning programs. While the E-learning paradigm, across professions, seems to have been

  16. Control Group Design, Contamination and Drop-Out in Exercise Oncology Trials : A Systematic Review

    NARCIS (Netherlands)

    Bisschop, Charlotte N. Steins; Courneya, Kerry S.; Velthuis, Miranda J.; Monninkhof, Evelyn M.; Jones, Lee W.; Friedenreich, Christine; van der Wall, Elsken; Peeters, Petra H. M.; May, Anne M.

    2015-01-01

    Purpose Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of exercise-

  17. Experience of wireless local area network in a radiation oncology department

    Directory of Open Access Journals (Sweden)

    Mandal Abhijit

    2010-01-01

    Full Text Available 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.

  18. Barriers to a Career Focus in Cancer Prevention: A Report and Initial Recommendations From the American Society of Clinical Oncology Cancer Prevention Workforce Pipeline Work Group

    Science.gov (United States)

    Meyskens, Frank L.; Bajorin, Dean F.; George, Thomas J.; Jeter, Joanne M.; Khan, Shakila; Tyne, Courtney A.; William, William N.

    2016-01-01

    Purpose To assist in determining barriers to an oncology career incorporating cancer prevention, the American Society of Clinical Oncology (ASCO) Cancer Prevention Workforce Pipeline Work Group sponsored surveys of training program directors and oncology fellows. Methods Separate surveys with parallel questions were administered to training program directors at their fall 2013 retreat and to oncology fellows as part of their February 2014 in-training examination survey. Forty-seven (67%) of 70 training directors and 1,306 (80%) of 1,634 oncology fellows taking the in-training examination survey answered questions. Results Training directors estimated that ≤ 10% of fellows starting an academic career or entering private practice would have a career focus in cancer prevention. Only 15% of fellows indicated they would likely be interested in cancer prevention as a career focus, although only 12% thought prevention was unimportant relative to treatment. Top fellow-listed barriers to an academic career were difficulty in obtaining funding and lower compensation. Additional barriers to an academic career with a prevention focus included unclear career model, lack of clinical mentors, lack of clinical training opportunities, and concerns about reimbursement. Conclusion Reluctance to incorporate cancer prevention into an oncology career seems to stem from lack of mentors and exposure during training, unclear career path, and uncertainty regarding reimbursement. Suggested approaches to begin to remedy this problem include: 1) more ASCO-led and other prevention educational resources for fellows, training directors, and practicing oncologists; 2) an increase in funded training and clinical research opportunities, including reintroduction of the R25T award; 3) an increase in the prevention content of accrediting examinations for clinical oncologists; and 4) interaction with policymakers to broaden the scope and depth of reimbursement for prevention counseling and

  19. Reconsidering Physical Activity Restrictions for Mononephric Survivors of Childhood Cancer: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Okada, Maki; Hockenberry, Marilyn J; Koh, Chester J; Meeske, Kathleen A; Rangan, Kasey E; Rodgers, Cheryl; Rosenthal, Yael; Ruccione, Kathleen S; Freyer, David R

    2016-07-01

    Although traditional recommendations for mononephric childhood cancer survivors are to avoid contact sports in order to protect the remaining kidney, review of available evidence suggests that the majority of renal loss is caused by accidents not involving sports. An interdisciplinary team performed a review of the English literature published from 1999 to 2012 within the PubMed, Cochrane, Google Scholar, and National Guidelines Clearinghouse databases. The level of evidence and proposed recommendations were graded according to an established rubric and GRADE criteria. Our review found that kidney loss is most commonly caused by nonsports activities such as motor vehicle accidents and falls, implying that restrictions on sports-related activity in mononephric pediatric survivors are not well supported. This favors encouraging ordinary sports and related activities without restriction in mononephric childhood cancer survivors because the known benefits of exercise outweigh the exceedingly low risk of renal loss. Accordingly, activity recommendations for mononephric patients have been revised in the most current version of the Children's Oncology Group Long-term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers. This has important implications for this and similar populations who may now undertake individual and organized sports without undue regard for their mononephric status.

  20. Testing different brain metastasis grading systems in stereotactic radiosurgery: Radiation Therapy Oncology Group's RPA, SIR, BSBM, GPA, and modified RPA.

    Science.gov (United States)

    Serizawa, Toru; Higuchi, Yoshinori; Nagano, Osamu; Hirai, Tatsuo; Ono, Junichi; Saeki, Naokatsu; Miyakawa, Akifumi

    2012-12-01

    The authors conducted validity testing of the 5 major reported indices for radiosurgically treated brain metastases- the original Radiation Therapy Oncology Group's Recursive Partitioning Analysis (RPA), the Score Index for Radiosurgery in Brain Metastases (SIR), the Basic Score for Brain Metastases (BSBM), the Graded Prognostic Assessment (GPA), and the subclassification of RPA Class II proposed by Yamamoto-in nearly 2500 cases treated with Gamma Knife surgery (GKS), focusing on the preservation of neurological function as well as the traditional endpoint of overall survival. The authors analyzed data from 2445 cases treated with GKS by the first author (T.S.), the primary surgeon. The patient group consisted of 1716 patients treated between January 1998 and March 2008 (the Chiba series) and 729 patients treated between April 2008 and December 2011 (the Tokyo series). The interval from the date of GKS until the date of the patient's death (overall survival) and impaired activities of daily living (qualitative survival) were calculated using the Kaplan-Meier method, while the absolute risk for two adjacent classes of each grading system and both hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model. For overall survival, there were highly statistically significant differences between each two adjacent patient groups characterized by class or score (all p values GPA Scores 3.5-4.0 and 3.0. The SIR showed the best statistical results for predicting preservation of neurological function. Although no other grading systems yielded statistically significant differences in qualitative survival, the BSBM and the modified RPA appeared to be better than the original RPA and GPA. The modified RPA subclassification, proposed by Yamamoto, is well balanced in scoring simplicity with respect to case number distribution and statistical results for overall survival. However, a new or revised grading system is necessary for predicting

  1. Long-term results in the treatment of acute nonlymphocytic leukemia: a Pediatric Oncology Group Study.

    Science.gov (United States)

    Krischer, J P; Steuber, C P; Vietti, T J; Culbert, S J; Ragab, A H; Morgan, S K; Berry, D H; Hvizdala, E; Thomas, P J; Land, V J

    1989-01-01

    Complete remission (CR), 5-year remission duration (RD), and overall 5-year survival rates are 74%, 28% and 25%, respectively, for previously untreated children with acute nonlymphocytic leukemia diagnosed between 1977 and 1981, following induction therapy with vincristine, doxorubicin and prednisone (VAP), consolidation therapy with 6-thioguanine, cytosine arabinoside (TA) and cyclophosphamide/vincristine/cytosine arabinoside/prednisone (COAP), and maintenance therapy of alternating TA and COAP with or without VAP pulses. Approximately 20% are free of their disease for more than 5 years. High white blood cell counts (WBC) at diagnosis and M3 and M6 morphology were associated with lower CR rates, while M5 morphology was associated with higher CR rates. Patients with M1 morphology had shorter remission duration as compared to those with M4 or M5 morphology. Low WBC and age between 2 and 10 years at diagnosis were associated with longer remission durations and survival. Patients with M4 morphology also survived longer. The observed CR rates are comparable to other studies initiated at the same time as this study but survival is less than those reported more recently. Low WBC at diagnosis and M4/M5 morphology may identify relatively favorable prognostic groups.

  2. Canine digital tumors: a veterinary cooperative oncology group retrospective study of 64 dogs.

    Science.gov (United States)

    Henry, Carolyn J; Brewer, William G; Whitley, Elizabeth M; Tyler, Jeff W; Ogilvie, Gregory K; Norris, Alan; Fox, Leslie E; Morrison, Wallace B; Hammer, Alan; Vail, David M; Berg, John

    2005-01-01

    We compared clinical characteristics and outcomes for dogs with various digital tumors. Medical records and histology specimens of affected dogs from 9 veterinary institutions were reviewed. Risk factors examined included age, weight, sex, tumor site (hindlimb or forelimb), local tumor (T) stage, metastases, tumor type, and treatment modality. The Kaplan-Meier product limit method was used to determine the effect of postulated risk factors on local disease-free interval (LDFI), metastasis-free interval (MFI), and survival time (ST). Outcomes were thought to differ significantly between groups when P dogs were included. Squamous cell carcinoma (SCC) accounted for 33 (51.6%) of the tumors. Three dogs presented with or developed multiple digital SCC. Other diagnoses included malignant melanoma (MM) (n = 10; 15.6%), osteosarcoma (OSA) (n = 4; 6.3%), hemangiopericytoma (n = 3; 4.7%), benign soft tissue tumors (n = 5; 7.8%), and malignant soft tissue tumors (n = 9; 14%). Fourteen dogs with malignancies had black hair coats, including 5 of the 10 dogs with MM. Surgery was the most common treatment and, regardless of the procedure, had a positive impact on survival. None of the patient variables assessed, including age, sex, tumor type, site, and stage, had a significant impact on ST. Both LDFI and MFI were negatively affected by higher T stage, but not by type of malignancy. Although metastasis at diagnosis correlated with a shorter LDFI, it did not have a significant impact on ST. On the basis of these findings, early surgical intervention is advised for the treatment of dogs with digital tumors, regardless of tumor type or the presence of metastatic disease.

  3. Recommendations for the use of long-term central venous catheter (CVC) in children with hemato-oncological disorders: management of CVC-related occlusion and CVC-related thrombosis. On behalf of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology (AIEOP).

    Science.gov (United States)

    Giordano, Paola; Saracco, Paola; Grassi, Massimo; Luciani, Matteo; Banov, Laura; Carraro, Francesca; Crocoli, Alessandro; Cesaro, Simone; Zanazzo, Giulio Andrea; Molinari, Angelo Claudio

    2015-11-01

    Central venous catheters (CVC), used for the management of children with hemato-oncological disorders, are burdened by a significant incidence of mechanical, infective, or thrombotic complications. These complications favor an increasing risk in prolongation of hospitalization, extra costs of care, and sometimes severe life-threatening events. No guidelines for the management of CVC-related occlusion and CVC-related thrombosis are available for children. To this aim, members of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) reviewed the pediatric and adult literature to propose the first recommendations for the management of CVC-related occlusion and CVC-related thrombosis in children with hemato-oncological disorders.

  4. Combination goserelin and tamoxifen therapy in premenopausal advanced breast cancer: a multicentre study by the ITMO group. Italian Trials in Medical Oncology.

    Science.gov (United States)

    Buzzoni, R.; Biganzoli, L.; Bajetta, E.; Celio, L.; Fornasiero, A.; Mariani, L.; Zilembo, N.; Di Bartolomeo, M.; Di Leo, A.; Arcangeli, G.

    1995-01-01

    It has been suggested that tamoxifen may improve the efficacy of medical castration with luteinising hormone-releasing hormone analogues, but very few data have so far been published concerning the clinical and endocrinological activity of this therapeutic modality. In this phase II multicentre trial conducted by the Italian Trials in Medical Oncology group (ITMO), 64 premenopausal patients with hormone receptor-positive or unknown breast cancer were treated with monthly s.c. injections of goserelin 3.6 mg, in association with a tamoxifen daily dose of 20 mg, as first-line therapy for their advanced disease. All of the patients were evaluable for efficacy and there was an overall response rate of 41% (95% confidence interval 28-52%), with 7 of the 26 responders achieving complete remission. The median time to response was 4 months (range 2-17), and the median response duration was 13 months (range 6-37 +). Better responses were observed in soft tissues (51%); the response in visceral and bone metastases was respectively 19% and 37%. Serum concentrations of gonadotrophins and oestradiol were significantly decreased by the treatment, oestrogen levels being constantly suppressed to within the range observed in post-menopausal women. No significant change was detected in serum testosterone levels. In our experience, although it was not associated with any increased clinical efficacy, the concurrent use of goserelin and tamoxifen proved to be a feasible approach in the management of premenopausal advanced breast cancer. PMID:7734310

  5. Familiarity, opinions, experiences and knowledge about scalp cooling: a Dutch survey among breast cancer patients and oncological professionals

    Directory of Open Access Journals (Sweden)

    Mijke Peerbooms

    2015-01-01

    Full Text Available Objective: Scalp cooling (SC is applied to reduce chemotherapy-induced alopecia (CIA. The aim of this study was to investigate patients′ familiarity and opinions and oncological professionals′ attitude and knowledge about SC in the Netherlands. Methods: Ex breast cancer patients, nurses and medical oncologists (MDs from SC and non-SC hospitals filled out questionnaires. Results: The majority of MDs and nurses were satisfied with the results of SC, as were SC patients. Over 33% of MDs and nurses perceived their knowledge level insufficient to inform patients about effectiveness, which was over 43% for information about safety. MDs main reason to not apply SC was doubt about effectiveness and safety. Nurses generally offered SC to a minority of eligible patients. Patients were frequently unfamiliar with SC before diagnosis. Seventy percent of SC patients with insufficient results (20/52 reported to mind it very much. With expected success rates of 35% and 50%, respectively, 36% and 54% of patients would use SC again. Conclusion: Room for improvement has been shown for both patients′ familiarity and oncological professionals′ knowledge about SC. Sharing knowledge about results, safety and patients′ experiences will improve patient counseling and SC availability. The results of this survey led to the development of a national standard on CIA and SC.

  6. [From empowerment to customer satisfaction: experience of a medical oncology unit].

    Science.gov (United States)

    Cifaldi, L; Gareri, R; Cristina, G; Felicetti, V; Gremigni, U

    2009-01-01

    The purpose of the study was the objective assessment of the outpatients satisfaction of the Medical Oncology Unit in Colleferro (USL Roma G), Italy. A retrospective survey conducted on 584 patients using a closed questionnaire focusing on nine items assess the degree of satisfaction expressed by patients relating to the different aspects of the service. The main aspects object of analysis were the accommodation, the relationship with the staff, the comfort of the structure and the health assistance received. The survey showed a high percentage of overall satisfaction for each of the nine parameters evaluated. There were no significant differences appreciated on a personal variables. The evaluation of customer satisfaction is a useful tool to measure patients approval and to meet their needs.

  7. A summary of the osteosarcoma banking efforts: a report from the Children's Oncology Group and the QuadW Foundation.

    Science.gov (United States)

    Glover, Jason; Krailo, Mark; Tello, Tanya; Marina, Neyssa; Janeway, Katherine; Barkauskas, Don; Fan, Timothy M; Gorlick, Richard; Khanna, Chand

    2015-03-01

    Survival rates of patients with osteosarcoma have remained stagnant over the last thirty years. Better understanding of biology, new therapeutics, and improved biomarkers are needed. The Children's Oncology Group (COG) addressed this need by developing one of the largest osteosarcoma biorepositories ever, containing over 15,000 tumor and tissue samples from over 1,500 patients. The biology study P9851 and the banking study AOST06B1 has enrolled 1,787 patients (as of September, 2013). Clinical information was lacking on 510 patients on P9851, who were not enrolled on a concurrent therapeutic trial. The value of these specimens was diminished. The lack of statistical support available for biology projects slowed the analysis of several critical studies. The QuadW Foundation, CureSearch, and the COG formed the Childhood Sarcoma Biostatistics and Annotation Office (CSBAO) to provide the infrastructure and address these needs by linking clinically annotated patient data to archived tissue samples and to develop biostatistical support for childhood sarcoma research. Originally 5.3% of samples from the 510 patients on P9851 not enrolled on a therapeutic study had full clinical annotation. The efforts of the CSBAO have linked clinical annotation to 90.8% of those specimens and provided statistical analyses to several studies that had used COG samples. As a result, 24 biology studies in osteosarcoma have been completed and published in peer-reviewed journals. These samples and in-silico data are available to the research community for basic and translational science projects to improve the biological understanding and treatment of patients affected by osteosarcoma. © 2014 Wiley Periodicals, Inc.

  8. Male reproductive health after childhood, adolescent, and young adult cancers: a report from the Children's Oncology Group.

    Science.gov (United States)

    Kenney, Lisa B; Cohen, Laurie E; Shnorhavorian, Margarett; Metzger, Monika L; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

    2012-09-20

    The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors.

  9. Intensifying the Group Member's Experience Using the Group Log.

    Science.gov (United States)

    Valine, Warren J.

    1983-01-01

    Presents the use of a group log in which members analyze the content and process of each session using a suggested format. The log promotes dialogue between the leader and each group member and involves members more fully in the group process. Feedback indicates the log is valuable. (JAC)

  10. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Science.gov (United States)

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  11. Oncology outside hospital: a new experience for the benefit of longer survivors.

    Science.gov (United States)

    Camps, Carlos; Iranzo, Vega; Caballero, Cristina; Blasco, Ana; Godes, María José; Safont, María José; Blasco, Sergio; Mengual, Gloria; Berrocal, Alfonso; Sirera, Rafael

    2011-04-01

    In May 2007, the Consorcio Hospital General Universitario de Valencia created the position of "Liaison Oncologist". The holder of this position is responsible for coordinating specialised and primary hospital care in the geographic area of Valencia known as Health Care Department 9 to reduce the waiting time between cancer diagnosis and treatment. In this article we describe the implementation of the innovative proposal of the Liaison Oncologist's Consultation Clinic, which, apart from speeding up and directing diagnostic processes, facilitates access to treatment, prevents duplication of consultations and exploratory procedures by establishing therapeutic plans (preferential channels), gives continuity to diagnostic and therapeutic mechanisms, and permits active follow-up of patients who have finished treatment. An analysis of the results obtained shows that the clinic has allowed us to integrate the various aspects of medical oncology into one system and make it available to patients and primary and specialised care professionals. This system provides the patient with the highest quality of integrated health care, ensures the availability of continued health care to long-term survivors and establishes preferential channels between primary care and specialised cancer care to achieve a quick diagnosis.

  12. Magnetic resonance imaging appearance of soft-tissue metastases: our experience at an orthopedic oncology center

    Energy Technology Data Exchange (ETDEWEB)

    Sammon, Jennifer; Jain, Abhishek; Bleakney, Robert; Mohankumar, Rakesh [Mount Sinai Hospital and University of Toronto, Division of Musculoskeletal Imaging, Joint Department of Medical Imaging, Toronto, Ontario (Canada)

    2017-04-15

    To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass. A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed. Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old. Most (80%) of the masses were located deep to the deep fascia. In our cohort of patients, melanoma was the most common primary malignancy contributing to soft-tissue metastasis (21.8%). Among soft-tissue metastasis from solid organs, breast and lung were the most frequent (9.1% each). Five patients had soft-tissue metastases from an unknown primary. Imaging diagnosis of soft-tissue metastases is challenging as it can demonstrate imaging appearances similar to primary soft-tissue sarcoma. The presence of a known malignancy may not be evident in everyone, and even if available, histopathology will be necessary for diagnosis if this is the only site of recurrence/metastasis to differentiate from a primary soft-tissue sarcoma. Moreover, soft-tissue metastasis may be the initial presentation of a malignancy. Primary malignancies with soft-tissue metastasis carry a poor prognosis; hence, prompt diagnosis and management in essential. (orig.)

  13. Psycho-oncology: Searching for practical wisdom?

    Science.gov (United States)

    Butlin, Helen

    2015-10-01

    The debate is vigorous in psycho-oncology about whether spiritual, existential, and psychosocial are the most comprehensive terms for academic research discourses investigating meaning and purpose. A call-to-action email from the International Society of Psycho-Oncology included the term soul. The current essay highlights the historical and contemporary uses of "soul" to suggest that the re-emergent soul signifies a tacit quest for an "intangible" that seems missing in current constructs of clinical domains reflected in the vigor of the debates. It is suggested that the re-emergence of the pre-Medieval meaning(s) of the notion of soul affirms a growing need for integrative paradigms on "being human" to guide psycho-oncology practitioners and their research. As a paradigmatic example, a clinical support group entitled Soul Medicine is described as employing the term soul to open up the more marginal discourses about experiences of illness arising from philosophical reflection, arts, humanities, and spirituality within a clinical oncology context. A link between soul and wisdom is suggested for further exploration with the view that phronesis ("the virtue of practical wisdom"), an emerging concept in health professional education research, is of ultimate value to the people psycho-oncology seeks to serve. This group holds that garnering wisdom from the expertise of those living with cancer should be a central aim of our field.

  14. Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

    Energy Technology Data Exchange (ETDEWEB)

    Specht, Lena, E-mail: lena.specht@regionh.dk [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Illidge, Tim [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Christie Hospital NHS Trust, Manchester (United Kingdom); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen (Denmark); Constine, Louis S. [Department of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Eich, Hans Theodor [Department of Radiation Oncology, University of Münster (Germany); Girinsky, Theodore [Department of Radiation Oncology, Institut Gustave-Roussy, Villejuif (France); Hoppe, Richard T. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Mauch, Peter [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Mikhaeel, N. George [Department of Clinical Oncology and Radiotherapy, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States)

    2014-07-15

    use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines.

  15. Detection of Preoperative Wilms Tumor Rupture with CT: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Naranjo, Arlene; Hoffer, Fredric; Mullen, Elizabeth; Geller, James; Gratias, Eric J.; Ehrlich, Peter F.; Perlman, Elizabeth J.; Rosen, Nancy; Grundy, Paul; Dome, Jeffrey S.

    2013-01-01

    Purpose: To retrospectively determine the diagnostic performance of computed tomography (CT) in identifying the presence or absence of preoperative Wilms tumor rupture. Materials and Methods: The cohort was derived from the AREN03B2 study of the Children’s Oncology Group. The study was approved by the institutional review board and was compliant with HIPAA. Written informed consent was obtained before enrollment. The diagnosis of Wilms tumor rupture was established by central review of notes from surgery and/or pathologic examination. Seventy Wilms tumor cases with rupture were matched to 70 Wilms tumor controls without rupture according to age and tumor weight (within 6 months and 50 g, respectively). CT scans were independently reviewed by two radiologists, and the following CT findings were assessed: poorly circumscribed mass, perinephric fat stranding, peritumoral fat planes obscured, retroperitoneal fluid (subcapsular vs extracapsular), ascites beyond the cul-de-sac, peritoneal implants, ipsilateral pleural effusion, and intratumoral hemorrhage. All fluids were classified as hemorrhagic or nonhemorrhagic by using a cutoff of 30 HU. The relationship between CT findings and rupture was assessed with logistic regression models. Results: The sensitivity and specificity for detecting Wilms tumor rupture were 54% (36 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 1 and 70% (47 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 2. Interobserver agreement was substantial (ĸ = 0.76). All imaging signs tested, except peritoneal implants, intratumoral hemorrhage, and subcapsular fluid, showed a significant association with rupture (P ≤ .02). The attenuation of ascitic fluid did not have a significant correlation with rupture (P = .9990). Ascites beyond the cul-de-sac was the single best indicator of rupture for both reviewers, followed by perinephric fat stranding and retroperitoneal fluid for reviewers 1 and 2, respectively (P cul

  16. Adoption of an integrated radiology reading room within a urologic oncology clinic: initial experience in facilitating clinician consultations.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Lepor, Herbert; Taneja, Samir S; Recht, Michael P

    2014-05-01

    The authors describe their initial experience in implementing an integrated radiology reading room within a urologic oncology clinic, including the frequency and nature of clinician consultations and the perceived impact on patient management by clinicians. A radiology reading room was established within an office-based urologic oncology clinic in proximity to the surgeon's work area. A radiologist was present in this reading room for a 3-hour shift each day. The frequency and nature of consultations during these shifts were recorded. Also, the clinic's staff completed a survey assessing perceptions of the impact of the integrated reading room on patient management. One hundred two consultations occurred during 57 included dates (average, 1.8 consultations per shift): 52% for review of external cases brought in by patients on discs, 43% for review of internal cases, and 5% for direct review by the radiologist of imaging with patients. The maximum number of consultations during a single shift was 8. All of the clinic's urologists indicated that >90% of consultations benefited patient care. The clinicians indicated tendencies to view consultations as affecting management in the majority of cases, to be more likely to seek consultation for outside imaging when the radiologist was on site, and to be less likely to repeat outside imaging when the radiologist was on site. The integrated reading room within the clinic has potential to improve the quality of care, for instance by facilitating increased review of outside imaging studies and thereby potentially reducing duplicate ordering and by enabling occasional direct image review with patients by radiologists. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada.

    Science.gov (United States)

    Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob

    2012-01-05

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.

  18. Computational oncology.

    Science.gov (United States)

    Lefor, Alan T

    2011-08-01

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

  19. Ki-67 Is an Independent Predictor of Metastasis and Cause-Specific Mortality for Prostate Cancer Patients Treated on Radiation Therapy Oncology Group (RTOG) 94-08

    Energy Technology Data Exchange (ETDEWEB)

    Verhoven, Bret [University of Wisconsin Carbone Cancer Center, Madison, Wisconsin (United States); Yan, Yan [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Ritter, Mark, E-mail: ritter@humonc.wisc.edu [University of Wisconsin Carbone Cancer Center, Madison, Wisconsin (United States); Khor, Li-Yan [Case Medical Center, Cleveland, Ohio (United States); Hammond, Elizabeth [LDS Hospital, Salt Lake City, Utah (United States); Jones, Christopher [Radiological Associates of Sacramento, Sacramento, California (United States); Amin, Mahul [Cedars-Sinai Medical Center, Los Angeles, California (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Ontario (Canada); Zeitzer, Kenneth [Albert Einstein Medical Center, Philadelphia, Pennsylvania (United States); Pollack, Alan [University of Miami Miller School of Medicine, Miami, Florida (United States)

    2013-06-01

    Purpose: The association of Ki-67 staining index (Ki67-SI) with overall survival (OS), disease-specific mortality (DSM), distant metastasis (DM), and biochemical failure (BF) was examined in men with favorable- to intermediate-risk prostate cancer receiving radiation therapy (RT) alone or with short-term androgen deprivation (ADT) in Radiation Therapy Oncology Group (RTOG) 94-08. Methods and Materials: 468 patients (23.6%) on RTOG 94-08 had sufficient tissue for Ki67-SI analysis. The median follow-up time was 7.9 years. Ki67-SI was determined by immunohistochemistry and quantified manually and by image analysis. Correlative analysis versus clinical outcome was performed using the third quartile (≥Q3) cutpoint. A proportional hazards multivariable analysis (MVA) dichotomized covariates in accordance with trial stratification and randomization criteria. Results: In MVAs adjusted for all treatment covariates, high Ki67-SI (≥Q3) was correlated with increased DSM (hazard ratio [HR] 2.48, P=.03), DM (HR 3.5, P=.002), and BF (HR 3.55, P<.0001). MVA revealed similar Ki67-associated hazard ratios in each separate treatment arm for DSM, DM, and BF; these reached significance only for DM in the RT-alone arm and for BF in both arms. Ki67-SI was not a significant predictor of intraprostatic recurrence assessed by repeated biopsy 2 years after treatment. Patients with a high or low Ki67-SI seemed to experience a similar relative benefit from the addition of ADT to radiation. Conclusions: High Ki67-SI independently predicts for increased DSM, DM, and protocol BF in primarily intermediate-risk prostate cancer patients treated with RT with or without ADT on RTOG 94-08 but does not predict for local recurrence or for increased relative benefit from ADT. This and prior studies lend support for the use of Ki67-SI as a stratification factor in future trials.

  20. Interaktiver Kleingruppenunterricht für Medizinstudenten der Klinischen Semester in einer onkologischen Gemeinschaftspraxis [Interactive medical education for medical students in an oncology group practice

    Directory of Open Access Journals (Sweden)

    Weide, Rudolf

    2007-02-01

    Full Text Available [english] Background: The education of medical students to become qualified medical doctors should be improved in Germany. Reasons for this are medical teachers not properly trained in education, a lack of quality control and low esteem of medical education, too large groups, no intensive relationship between students and academic teachers and the triad for medical teachers at university hospitals to qualify in their discipline, to perform science and lecture medical students. At the same time experienced associate professors who left university are not integrated optimally in medical education programs. Pilotproject: Since 1998 we are performing weekend seminars for advanced medical students. 3 students are educated by 1 teacher. The topics of the training are differential diagnosis of anaemia, polyglobulinaemia, leukocytopenia, leukocytosis, thrombocytopenia, thrombocytosis, training in morphology, diagnosis and treatment of leukaemia and lymphoma and principles of communication skills. Patient cases are presented in a problem oriented learning manner using patient files, a video microscope and a computer based learning programme for interactive purposes.Results: So far 320 students have participated in our seminars. Systematic quality evaluation of the teaching reveals excellent marks for practical relevance, learning atmosphere, didactics and effectiveness. Impressions of the routine work in an oncology group practice widens the experience of the students.Conclusion: Academical training for medical students is feasable and successful in an oncology group practice. This teaching model enables external associate professors to give their education in the environment where they are working and may relieve the University personally and financially.[german] Hintergrund: Die Ausbildung von Medizinstudenten zu guten Ärzten ist in Deutschland verbesserungsbedürftig. Die Gründe für ein suboptimales Studium sind die häufig fehlende Vernetzung von

  1. Integrating mHealth in Oncology: Experience in the Province of Trento.

    Science.gov (United States)

    Galligioni, Enzo; Piras, Enrico Maria; Galvagni, Michele; Eccher, Claudio; Caramatti, Silvia; Zanolli, Daniela; Santi, Jonni; Berloffa, Flavio; Dianti, Marco; Maines, Francesca; Sannicolò, Mirella; Sandri, Marco; Bragantini, Lara; Ferro, Antonella; Forti, Stefano

    2015-05-13

    The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system. Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home. The STM system is fully integrated with the electronic oncological patient record. After the prescription of chemotherapy, specific barcodes are automatically associated with the patient and each drug, and a bedside barcode reader checks the patient, nurse, infusion bag, and drug sequence in order to trace the entire administration process, which is then entered in the patient's record. The usability and acceptability of the system was investigated by means of a modified questionnaire administered to nurses. The home monitoring system consists of a mobile phone or tablet diary app, which allows patients to record their state of health, the medications taken, their side effects, and a Web dashboard that allows health professionals to check the patient data and monitor toxicity and treatment adherence. A built-in rule-based alarm module notifies health care professionals of critical conditions. Initially developed for chronic patients, the system has been subsequently customized in order to monitor home treatments with capecitabine or sunitinib in cancer patients (Onco-TreC). The STM system never failed to match the patient/nurse/drug sequence association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied and had a positive perception of the system's usefulness and ease of use, and the quality of their working lives. The

  2. Geriatric Oncology

    National Research Council Canada - National Science Library

    Helen Hughes; Vikram Swaminathan; Alice Pellegrini; Riccardo Audisio

    2014-01-01

    .... In this article, we review the current field of geriatric oncology. We highlight that age is not a contradiction to cancer treatment but geriatric assessment is needed to identify which treatment a patient may tolerate and benefit from.

  3. Mastering group leadership. An active learning experience.

    Science.gov (United States)

    Scheick, Dawn M

    2002-09-01

    Leading therapeutic groups is an underused but viable treatment role for nurses in all specialty areas. A dynamic psychoeducational group model provides structure as nurses invest and collaboratively participate to actively learn the group leader role. this article highlights the sequencing of instruction of group theory and skills with examples from a baccalaureate nursing curriculum. Samples from student journals reveal their growing assimilation of the group leader role as learners actively participated in groups, collaborated, and reflected on their learning. Examples of creatively adapted group exercises, as well as selected nursing group leader interventions, demonstrate group leadership as a skill that can increase nurses' repertoire of therapeutic responses. Therapeutic groups are both exciting and cost-effective treatment strategies for use with mentally ill clients. The skills of an accomplished group leader are transferable from within the psychiatric population to working with families, bereavement groups, and other client populations, ranging from people with diabetes to survivors of catastrophic crises. Group leadership ability complements the management and negotiation skills needed in professional nursing roles. When students and staff nurses grow in group leadership expertise, clients in various settings will be better served with this currently underused treatment option.

  4. Quality Indicators in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-15

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts.

  5. Looking at Gestalt Group Impact: An Experiment.

    Science.gov (United States)

    Serok, Shraga; Bar, Ruth

    1984-01-01

    Tested the impact of gestalt group therapy on aspects of self-concept in graduate students (N=33). Results showed a significant rise in decisiveness, general adaptation and self-criticism in the gestalt group as compared to the control groups and showed no significant changes in the self-identification and self-acceptance parameters. (LLL)

  6. Neuro-Oncology Branch patient experience and expertise | Center for Cancer Research

    Science.gov (United States)

    Experience and Expertise We have more than 20 years of experience working with patients and their physicians to offer a comprehensive approach to patient care. Patients travel from all over the world to be evaluated and treated by our clinical team. The Brain Tumor Clinic sees hundreds of new patients and 2,000–3,000 follow-up patients each year. 

  7. Iron chelation with deferasirox for the treatment of secondary hemosiderosis in pediatric oncology patients: a single-center experience.

    Science.gov (United States)

    Ktena, Yiouli P; Athanasiadou, Anastasia; Lambrou, George; Adamaki, Maria; Moschovi, Maria

    2013-08-01

    Pediatric oncology patients are often iron overloaded, due to the multiple blood transfusions necessary during the course of chemotherapy. Our aim is to report the efficacy and safety of deferasirox, an oral iron chelator, in this patient group. Deferasirox was administered to 13 children with malignancies in remission and iron overload. Ferritin, blood urea nitrogen, creatinine, transaminases, and bilirubin were recorded at 4- to 8-week intervals, and hepatic and cardiac iron overload were assessed with magnetic resonance imaging before initiation of treatment. Deferasirox was administered for an average of 6 months (SD=4.5; range, 0.3 to 18.2). Two children presented with skin rash, 1 with gastrointestinal disturbances, and 1 with fully reversible acute renal failure. The mean monthly rate of change in ferritin levels was -10.8 μg/L before initiation of treatment (95% confidence interval [CI], -19.8 to -1.8; P=0.02) and -93.6 μg/L during deferasirox treatment (95% CI, -118.1 to -69.1; PDeferasirox was effective in reducing the iron burden. The adverse effects were easily monitored and managed. Further studies are warranted to investigate the effect of deferasirox on mortality and morbidity in this population.

  8. The Experiences of Expert Group Work Supervisors: An Exploratory Study

    Science.gov (United States)

    Atieno Okech, Jane E.; Rubel, Deborah

    2009-01-01

    Evaluation of group work supervision literature suggests that description of expert group work supervisors' experiences could be useful for expanding existing group work supervision practices and models. This study provided a systematic exploration of the experiences of expert group work supervisors during the supervision process. Results indicate…

  9. SU-F-E-15: Initial Experience Implementing a Case Method Teaching Approach to Radiation Oncology Physics Residents, Graduate Students and Doctorate of Medical Physics Students

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, A [University of Texas Health Science Center San Antonio, San Antonio, TX (United States)

    2016-06-15

    Purpose: Case Method Teaching approach is a teaching tool used commonly in business school to challenge students with real-world situations—i.e. cases. The students are placed in the role of the decision maker and have to provide a solution based on the multitude of information provided. Specifically, students must develop an ability to quickly make sense of a complex problem, provide a solution incorporating all of the objectives (at time conflicting) and constraints, and communicate that solution in a succinct, professional and effective manner. The validity of the solution is highly dependent on the auxiliary information provided in the case and the basic didactic knowledge of the student. A Case Method Teaching approach was developed and implemented into an on-going course focused on AAPM Task Group reports at UTHSCSA. Methods: A current course at UTHSCSA reviews and discusses 15 AAPM Task Group reports per semester. The course is structured into three topic modules: Imaging QA, Stereotactic Radiotherapy, and Special Patient Measurements—i.e. pacemakers, fetal dose. After a topic module is complete, the students are divided into groups (2–3 people) and are asked to review a case study related to the module topic. Students then provide a solution presented in an executive summary and class presentation. Results: Case studies were created to address each module topic. Through team work and whole-class discussion, a collaborative learning environment was established. Students additionally learned concepts such vendor relations, financial negotiations, capital project management, and competitive strategy. Conclusion: Case Method Teaching approach is an effective teaching tool to further enhance the learning experience of radiation oncology physics students by presenting them with though-provoking dilemmas that require students to distinguish pertinent from peripheral information, formulate strategies and recommendations for action, and confront obstacles to

  10. Pain control: mastery through group experience.

    Science.gov (United States)

    Herman, E; Baptiste, S

    1981-02-01

    This paper describes a group program which is part of the therapeutic management of out-patients with chronic pain at the multidisciplinary Pain Clinic in Hamilton, Ontario (McMaster Division, Chedoke-McMaster Hospital). The programme seeks to assist chronic pain sufferers in developing more adaptive coping styles. Groups of 12--14 patients meet for 9 weeks, 3 h/week, under the co-leadership of a physiotherapist and an occupational therapist with backgrounds in psychology and psychiatry. Seventy-five patients with diverse aetiologies of chronic pain have completed these "pain control classes". Outcome was assessed on the basis of several parameters. Results indicate a considerable reduction in depression, pain perception and analgesic intake. Conversely, employment figures increased from 20 to 48% after completion of the program. 21% were considered failures. Significant variables differentiating successes from failures were sex, marital status, work incentive, employment and absence of litigation or Workmen's Compensation claims.

  11. Phase II trial of the combination of bryostatin-1 and cisplatin in advanced or recurrent carcinoma of the cervix: a New York Gynecologic Oncology Group study.

    Science.gov (United States)

    Nezhat, Farr; Wadler, Scott; Muggia, Franco; Mandeli, John; Goldberg, Gary; Rahaman, Jamal; Runowicz, Carolyn; Murgo, Anthony J; Gardner, Ginger J

    2004-04-01

    Bryostatin-1 is a macrocyclic lactone that has been shown to regulate protein kinase C (PKC) activity and thereby potentially inhibit tumor invasion, angiogenesis, cell adhesion, and multidrug resistance. In preclinical experiments, bryostatin-1 induces tumor growth inhibition and enhances cytotoxicity when combined with other agents including cisplatin in cervical cancer cells. It was therefore anticipated that combination bryostatin-1-cisplatin therapy would be effective in patients with cervical cancer. The current study was conducted to evaluate this therapeutic approach in patients with recurrent or advanced-stage cervical carcinoma. An IRB-approved New York Gynecologic Oncology Group (NYGOG) trial was activated for patients with a histological diagnosis of metastatic cervical cancer or in patients with recurrent disease not eligible for surgery or radiation. Enrolled patients received bryostatin-1 (50-65 microg/m(2)) as a 1-h infusion followed by cisplatin (50 mg/m(2)). The combined treatment was administered every 21 days. Fourteen patients were enrolled. The majority of patients had squamous cell carcinoma. Ten out of fourteen patients had recurrent disease. Fifty percent of the patients received bryostatin at 50 microg/m(2) and 50% received bryostatin at 65 microg/m(2). Seventy-one percent completed two cycles of treatment. The most common grade II-III toxicities were myalgia, anemia, and nausea or vomiting. One patient developed a hypersensitivity reaction and one developed grade III nephrotoxicity. Seventy-one percent (10/14) of patients were evaluated for tumor response. Eight out of ten (80%) of patients had progressive disease and 2/10 (20%) had stable disease. There were no treatment responses. Despite promising preclinical data, this clinical trial indicates that the combination of cisplatin and bryostatin-1 at the doses and schedule used is not effective in patients with advanced-stage or recurrent cervical cancer. There is even the possibility of

  12. A phase II study of amifostine in children with myelodysplastic syndrome: a report from the Children's Oncology Group study (AAML0121).

    Science.gov (United States)

    Mathew, Prasad; Gerbing, Robert; Alonzo, Todd A; Wallas, Tanya; Gong, Jerald Z; Jasty, Rama; Jorstad, Dean T; Raimondi, Susana C; Chavez, Cathy M; Eisenberg, Nancy L; Hirsch, Betsy; Gamis, Alan; Smith, Franklin O; Arceci, Robert J

    2011-12-15

    Based on its potential role in adult myelodysplastic syndrome (MDS), the Children's Oncology Group (COG) embarked on a phase II study using amifostine in pediatric MDS (WHO 2001 criteria) patients. Responses were evaluated after two cycles. Ten patients were enrolled; five were deemed ineligible, and four withdrew after the first course. Only one patient completed two courses, and was found to be in complete remission. The study was closed after being open for 2 years due to slow accrual. Studying a rare disease like MDS may pose insurmountable obstacles even in a large clinical trials group such as COG, in part because of the changing definitions of MDS and the rarity of adult type MDS in children. The role of amifostine in pediatric MDS was not known at the time of study.

  13. Phenotype in combination with genotype improves outcome prediction in acute myeloid leukemia: a report from Children's Oncology Group protocol AAML0531.

    Science.gov (United States)

    Voigt, Andrew P; Eidenschink Brodersen, Lisa; Alonzo, Todd A; Gerbing, Robert B; Menssen, Andrew J; Wilson, Elisabeth R; Kahwash, Samir; Raimondi, Susana C; Hirsch, Betsy A; Gamis, Alan S; Meshinchi, Soheil; Wells, Denise A; Loken, Michael R

    2017-09-07

    Diagnostic biomarkers can be used to determine relapse risk in acute myeloid leukemia, and certain genetic aberrancies have prognostic relevance. A diagnostic immunophenotypic expression profile, which quantifies the amounts of distinct gene products, not just their presence or absence, was established to improve outcome prediction for patients with acute myeloid leukemia. The immunophenotypic expression profile, which defines each patient's leukemia as a location in 15-dimensional space, was generated for 769 patients enrolled in the Children's Oncology Group AAML0531 protocol. Unsupervised hierarchical clustering grouped patients with similar immunophenotypic expression profiles into eleven patient cohorts, demonstrating high associations among phenotype, genotype, morphology, and outcome. Of 95 patients with inv(16), 79% segregated in Cluster A. Of 109 patients with t(8;21), 92% segregated in Clusters A and B. Of 152 patients with 11q23 alterations, 78% segregated in Clusters D, E, F, G, or H. For both inv(16) and 11q23 abnormalities, differential phenotypic expression identified patient groups with different survival characteristics (P<0.05). Clinical outcome analysis revealed that Cluster B (predominantly t(8;21)) was associated with favorable outcome (P<0.001) and Clusters E, G, H, and K were associated with adverse outcomes (P<0.05). Multivariable regression analysis revealed that Clusters E, G, H, and K were independently associated with worse survival (P range <0.001 to 0.008). The Children's Oncology Group AAML0531 trial is registered at www.clinicaltrials.gov as NCT00372593. Copyright © 2017, Ferrata Storti Foundation.

  14. Experience with an online helpdesk for equipment fault reporting in a radiation oncology department.

    Science.gov (United States)

    McNamara, Joanne; Williams, Matthew; Carolan, Martin

    2013-11-04

    The safe and accurate delivery of radiotherapy requires that the various items of equipment used in the treatment process are in proper working order. Unusual equipment behavior, interlocks, and faults need to be communicated promptly to the appropriate personnel, the issue investigated, and information regarding the nature of faults and any subsequent reparative measures recorded in a readily accessible location. At the Illawarra Cancer Care Centre, an online help desk was introduced for the purposes of reporting and tracking equipment faults. In the three years since its introduction, there have been in excess of 1,300 entries made, and it has proven to be a suitable alternative to the use of a physical logbook. Key benefits identified were improved accessibility, automated fault notification, and the ability to search, review and update entries for particular equipment faults. It has been a useful tool for assessing the long-term performance of each piece of equipment, identifying specific servicing needs, and for substantiating the effectiveness of the service performed. The online help desk has not replaced the need for direct methods of verbal communication between the various professional groups involved with monitoring equipment performance. However, it is a very useful tool for supporting that communication.

  15. Psychosocial Demands of Speech Therapy with Head-and-Neck Cancer Patients: Clinical Experiences, Communicative Skills and Need for Training of Speech Therapists in Oncology

    Directory of Open Access Journals (Sweden)

    Peter Ullrich

    2010-01-01

    Full Text Available Head and neck cancer patients suffer from high levels of psychological comorbidity and often do not receive adequate psychological assistance. Therefore, speech therapists are frequently confronted with specific psychosocial challenges beyond the scope of their standard professional education. The following aspects were examined via a mixed-methods approach to explore their own perceptions of these challenges and their skills to deal with them: 1 The experiences and problems of speech therapists working with head and neck cancer patients; 2 the self-assessment of speech therapists' skills in cancer patient care; 3 the experiences and observations of psychologists supervising case discussions in oncology with speech therapists; 4 the communication skills of speech therapists working with emotionally distressed patients in oncology Our results show that therapists are acutely aware of their patients' distress. They agree that there is a need for patients to receive psychosocial counseling and that a significant portion of their speech therapy sessions is often dedicated to talking about personal problems. This difficult situation leads to: 1 deficiencies in speech therapists' ability to address patients' demands and deficiencies in distancing themselves from their patients; 2 speech therapists feeling overwhelmed with excessive demands and experiencing mental distress themselves. The psycho-oncological knowledge and communication skills among speech therapists were often deficient in light of such demands. There is a need for further training in psychological and social skills for speech therapists working with head and neck cancer patients. URN: urn:nbn:de:0114-fqs1001220

  16. Initial clinical experience with a radiation oncology dedicated open 1.0T MR-simulation.

    Science.gov (United States)

    Glide-Hurst, Carri K; Wen, Ning; Hearshen, David; Kim, Joshua; Pantelic, Milan; Zhao, Bo; Mancell, Tina; Levin, Kenneth; Movsas, Benjamin; Chetty, Indrin J; Siddiqui, M Salim

    2015-03-08

    The purpose of this study was to describe our experience with 1.0T MR-SIM including characterization, quality assurance (QA) program, and features necessary for treatment planning. Staffing, safety, and patient screening procedures were developed. Utilization of an external laser positioning system (ELPS) and MR-compatible couchtop were illustrated. Spatial and volumetric analyses were conducted between CT-SIM and MR-SIM using a stereotactic QA phantom with known landmarks and volumes. Magnetic field inhomogeneity was determined using phase difference analysis. System-related, in-plane distortion was evaluated and temporal changes were assessed. 3D distortion was characterized for regions of interest (ROIs) 5-20 cm away from isocenter. American College of Radiology (ACR) recommended tests and impact of ELPS on image quality were analyzed. Combined ultrashort echotime Dixon (UTE/Dixon) sequence was evaluated. Amplitude-triggered 4D MRI was implemented using a motion phantom (2-10 phases, ~ 2 cm excursion, 3-5 s periods) and a liver cancer patient. Duty cycle, acquisition time, and excursion were evaluated between maximum intensity projection (MIP) datasets. Less than 2% difference from expected was obtained between CT-SIM and MR-SIM volumes, with a mean distance of 3D geometric distortion was 0.59 ± 0.32 mm (maximum = 1.65 mm) and increased 10-15 cm from isocenter (mean = 1.57 ± 1.06 mm, maximum = 6.26 mm). ELPS interference was within the operating frequency of the scanner and was characterized by line patterns and a reduction in signal-to-noise ratio (4.6-12.6% for TE = 50-150 ms). Image quality checks were within ACR recommendations. UTE/Dixon sequences yielded detectability between bone and air. For 4D MRI, faster breathing periods had higher duty cycles than slow (50.4% (3 s) and 39.4% (5 s), p < 0.001) and ~fourfold acquisition time increase was measured for ten-phase versus two-phase. Superior-inferior object extent was underestimated 8% (6 mm) for two

  17. Exploring Group Cohesion in a Higher Education Field Experience

    Science.gov (United States)

    Malcarne, Brian Keith

    2012-01-01

    The purpose of this study was to gain understanding into the experience of group cohesion for university students participating in an academic field experience. A mixed methods approach was used following a two-phase, sequential research design to help provide a more complete explanation of how group cohesion was impacted by the field experience.…

  18. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    DEFF Research Database (Denmark)

    Illidge, Tim; Specht, Lena; Yahalom, Joachim

    2014-01-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning...... tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles...... of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT...

  19. Insufficiency Fractures After Pelvic Radiation Therapy for Uterine Cervical Cancer: An Analysis of Subjects in a Prospective Multi-institutional Trial, and Cooperative Study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)

    Energy Technology Data Exchange (ETDEWEB)

    Tokumaru, Sunao, E-mail: tokumaru@cc.saga-u.ac.jp [Department of Heavy Particle Therapy and Radiation Oncology, Saga University, Saga (Japan); Toita, Takafumi [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa (Japan); Oguchi, Masahiko [Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kato, Shingo [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Matsuyama (Japan); Shikama, Naoto [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tuskuba (Japan); Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita (Japan); Kagami, Yoshikazu [Department of Radiology, Showa University School of Medicine, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); and others

    2012-10-01

    Purpose: To investigate pelvic insufficiency fractures (IF) after definitive pelvic radiation therapy for early-stage uterine cervical cancer, by analyzing subjects of a prospective, multi-institutional study. Materials and Methods: Between September 2004 and July 2007, 59 eligible patients were analyzed. The median age was 73 years (range, 37-84 years). The International Federation of Gynecologic Oncology and Obstetrics stages were Ib1 in 35, IIa in 12, and IIb in 12 patients. Patients were treated with the constant method, which consisted of whole-pelvic external-beam radiation therapy of 50 Gy/25 fractions and high-dose-rate intracavitary brachytherapy of 24 Gy/4 fractions without chemotherapy. After radiation therapy the patients were evaluated by both pelvic CT and pelvic MRI at 3, 6, 12, 18, and 24 months. Diagnosis of IF was made when the patients had both CT and MRI findings, neither recurrent tumor lesions nor traumatic histories. The CT findings of IF were defined as fracture lines or sclerotic linear changes in the bones, and MRI findings of IF were defined as signal intensity changes in the bones, both on T1- and T2-weighted images. Results: The median follow-up was 24 months. The 2-year pelvic IF cumulative occurrence rate was 36.9% (21 patients). Using Common Terminology Criteria for Adverse Events version 3.0, grade 1, 2, and 3 IF were seen in 12 (21%), 6 (10%), and 3 patients (5%), respectively. Sixteen patients had multiple fractures, so IF were identified at 44 sites. The pelvic IF were frequently seen at the sacroileal joints (32 sites, 72%). Nine patients complained of pain. All patients' pains were palliated by rest or non-narcotic analgesic drugs. Higher age (>70 years) and low body weight (<50 kg) were thought to be risk factors for pelvic IF (P=.007 and P=.013, Cox hazard test). Conclusions: Cervical cancer patients with higher age and low body weight may be at some risk for the development of pelvic IF after pelvic radiation therapy.

  20. Prognostic relevance of DNA flow cytometry in breast cancer revisited: The 25-year experience of the Portuguese Institute of Oncology of Lisbon

    Science.gov (United States)

    Pinto, António E.; Pereira, Teresa; Silva, Giovani L.; André, Saudade

    2017-01-01

    The potential prognostic significance of DNA flow cytometric measurements (DNA ploidy and S-phase fraction) in breast cancer remains in dispute. Inconclusive data, primarily due to the lack of consistent standardization and quality control programs, have limited its translation into clinical practice. The aim of the present review, based on the 25-year experience of the Portuguese Institute of Oncology of Lisbon, is to assess the clinical relevance and application of DNA flow cytometry for the prognosis of breast cancer. Overall, data from Portuguese Institute of Oncology of Lisbon indicate that DNA flow cytometry provides significant prognostic information that is biologically relevant and clinically useful for the management of patients with breast cancer. Furthermore, this data has demonstrated the independent value of DNA aneuploidy as a prognostic indicator of poor clinical outcome in various subgroups of patients with early or locally advanced breast cancer at short- and long-term follow-up. Notably, aneuploidy identifies subsets of patients with grade (G)1 or G2 tumours who exhibit a poor clinical outcome. These patients may benefit from adjuvant chemotherapy, particularly those with luminal A and luminal B/human epidermal growth factor-2-negative endocrine-responsive breast cancer. In conclusion, data from Portuguese Institute of Oncology of Lisbon reinforces the clinical importance and utility of DNA flow cytometric analysis, particularly DNA ploidy, in the prognostic assessment and therapeutic planning for patients with breast cancer. PMID:28454358

  1. Evaluation of the prevalence of burnout and psychological morbidity among radiation oncologist members of the Kyoto Radiation Oncology Study Group (KROSG).

    Science.gov (United States)

    Mampuya, Wambaka Ange; Matsuo, Yukinori; Nakamura, Akira; Hiraoka, Masahiro

    2017-03-01

    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 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. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  2. The experiences of undergraduate nursing students and self-reflective accounts of first clinical rotation in pediatric oncology.

    Science.gov (United States)

    Mirlashari, Jila; Warnock, Fay; Jahanbani, Jahanfar

    2017-07-01

    The clinical practicum is one of the most anticipated components of the nursing program for nursing students. However, the practicum can be anxiety producing for students, especially when it is their first placement in an emotional demanding setting like pediatric oncology unit. Taking care of children with cancer and who are facing the death trajectory is complex and demanding not only for students but also for the experienced nurse. In this qualitative research, the purpose was to explore senior student perceptions and self-reflective accounts of what it was like to care for children with cancer and their family throughout the course of their first practicum on a pediatric oncology unit that also provided children palliative care as needed. Data from the self-reflective journals and interviews were analyzed together using conventional content analysis. The three resultant categories that emerged: state of shock and getting lost, walking in to a mind shaking world and finding the way provided in-depth novel insight on the perceptions of senior undergraduate nursing students as they journey through their first time practicum on a pediatric oncology unit. The findings also confirmed the importance and benefit of reflective journaling to student integrated learning and adjustment in nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Supervisees' and supervisors' experiences of group climate in group supervision in psychotherapy. Effects of admission procedure

    OpenAIRE

    Sundin, EC; Ogren, M

    2006-01-01

    The purpose of this study was to evaluate the effects of two different admission procedures (high school grades/scholastic aptitude test (SAT) versus high school grades/SAT + interview) to a program in professional psychology on students' and supervisors' experiences of the group climate in psychotherapy supervision groups during an eighteen-month clinical practicum. A self-rating scale constructed to measure experiences of group climate in group supervision in psychotherapy was used. The res...

  4. Perceived roles of oncology nursing.

    Science.gov (United States)

    Lemonde, Manon; Payman, Naghmeh

    2015-01-01

    The Canadian Association of Nurses in Oncology (CANO) Standards of Care (2001) provides a framework that delineates oncology nursing roles and responsibilities. The purpose of this study was to explore how oncology nurses perceive their roles and responsibilities compared to the CANO Standards of Care. Six focus groups were conducted and 21 registered nurses (RNs) from a community-based hospital participated in this study. Transcripts were analyzed using qualitative inductive content analysis. Three themes were identified: (1) Oncology nurses perceive a gap between their defined roles and the reality of daily practice, as cancer care becomes more complex and as they provide advanced oncology care to more patients while there is no parallel adaptation to the health care system to support them, such as safe staffing; (2) Oncology nursing, as a specialty, requires sustained professional development and leadership roles; and (3) Oncology nurses are committed to providing continuous care as a reference point in the health care team by fostering interdisciplinary collaboration andfacilitating patient's navigation through the system. Organizational support through commitment to appropriate staffing and matching scope ofpractice to patient needs may lead to maximize the health and well-being of nurses, quality of patient care and organizational performance.

  5. Body mass index and its association with clinical outcomes for advanced non-small-cell lung cancer patients enrolled on Eastern Cooperative Oncology Group clinical trials.

    Science.gov (United States)

    Dahlberg, Suzanne E; Schiller, Joan H; Bonomi, Philip B; Sandler, Alan B; Brahmer, Julie R; Ramalingam, Suresh S; Johnson, David H

    2013-09-01

    Obesity increases the risk of death from many adverse health outcomes and has also been linked with cancer outcomes. The impact of obesity on outcomes of advanced non-small-cell lung cancer patients is unclear. The authors evaluated the association of body mass index (BMI) and outcomes in 2585 eligible patients enrolled in three consecutive first-line trials conducted by the Eastern Cooperative Oncology Group. BMI was categorized as underweight (BMI obese (BMI ≥ 30 kg/m). In addition to analyzing overall and progression-free survival, reasons for treatment discontinuation were also assessed by BMI group. Of the patients enrolled, 4.6% were underweight, 44.1% were normal weight, 34.3% of patients were classified as overweight, and 16.9% were obese. Nonproportional hazards existed for obese patients relative to the other three groups of patients, with a change in overall survival hazard occurring at approximately 16 months. In multivariable Cox models, obese patients had superior outcomes earlier on study compared with normal/overweight patients 0.86 (HR=0.86, p=0.04; 95% CI: 0.75-0.99), but later experienced increased hazard (HR=1.54, p< 0.001; 95% CI: 1.22-1.94), indicating a time effect while undergoing treatment. Data from these three trials suggest differential outcomes associated with BMI, and additional studies of the mechanisms underlying this observation, as well as dietary and lifestyle interventions, are warranted to help optimize therapy.

  6. Physician groups' use of data from patient experience surveys.

    NARCIS (Netherlands)

    Friedberg, M.W.; SteelFisher, G.K.; Karp, M.; Schneider, E.C.

    2011-01-01

    BACKGROUND: In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. OBJECTIVE: To e

  7. Physician groups' use of data from patient experience surveys.

    NARCIS (Netherlands)

    Friedberg, M.W.; SteelFisher, G.K.; Karp, M.; Schneider, E.C.

    2011-01-01

    BACKGROUND: In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. OBJECTIVE: To

  8. Local Control With Reduced-Dose Radiotherapy for Low-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group D9602 Study

    Energy Technology Data Exchange (ETDEWEB)

    Breneman, John, E-mail: john.breneman@uchealth.com [Department of Radiation Oncology, University of Cincinnati and Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Meza, Jane [Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, NE (United States); Donaldson, Sarah S. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Raney, R. Beverly [Children' s Cancer Hospital and Division of Pediatrics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Children' s Ambulatory Blood and Cancer Center, Dell Children' s Medical Center of Central Texas, Austin, TX (United States); Wolden, Suzanne [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, RI (United States); Rodeberg, David A. [Department of Surgery, East Carolina University, Greenville, NC (United States); Meyer, William [Section of Pediatric Hematology/Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Walterhouse, David [Division of Hematology/Oncology, Children' s Memorial Medical Center, Chicago, IL (United States); Hawkins, Douglas S. [Department of Pediatrics, Seattle Children' s Hospital, University of Washington, Seattle, WA (United States)

    2012-06-01

    Purpose: To analyze the effect of reduced-dose radiotherapy on local control in children with low-risk rhabdomyosarcoma (RMS) treated in the Children's Oncology Group D9602 study. Methods and Materials: Patients with low-risk RMS were nonrandomly assigned to receive radiotherapy doses dependent on the completeness of surgical resection of the primary tumor (clinical group) and the presence of involved regional lymph nodes. After resection, most patients with microscopic residual and uninvolved nodes received 36 Gy, those with involved nodes received 41.4 to 50.4 Gy, and those with orbital primary tumors received 45 Gy. All patients received vincristine and dactinomycin, with cyclophosphamide added for patient subsets with a higher risk of relapse in Intergroup Rhabdomyosarcoma Study Group III and IV studies. Results: Three hundred forty-two patients were eligible for analysis; 172 received radiotherapy as part of their treatment. The cumulative incidence of local/regional failure was 15% in patients with microscopic involved margins when cyclophosphamide was not part of the treatment regimen and 0% when cyclophosphamide was included. The cumulative incidence of local/regional failure was 14% in patients with orbital tumors. Protocol-specified omission of radiotherapy in girls with Group IIA vaginal tumors (n = 5) resulted in three failures for this group. Conclusions: In comparison with Intergroup Rhabdomyosarcoma Study Group III and IV results, reduced-dose radiotherapy does not compromise local control for patients with microscopic tumor after surgical resection or with orbital primary tumors when cyclophosphamide is added to the treatment program. Girls with unresected nonbladder genitourinary tumors require radiotherapy for postsurgical residual tumor for optimal local control to be achieved.

  9. Physician groups' use of data from patient experience surveys.

    Science.gov (United States)

    Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

    2011-05-01

    In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

  10. Predictors of mother and child DNA yields in buccal cell samples collected in pediatric cancer epidemiologic studies: a report from the Children's Oncology group.

    Science.gov (United States)

    Poynter, Jenny N; Ross, Julie A; Hooten, Anthony J; Langer, Erica; Blommer, Crystal; Spector, Logan G

    2013-08-12

    Collection of high-quality DNA is essential for molecular epidemiology studies. Methods have been evaluated for optimal DNA collection in studies of adults; however, DNA collection in young children poses additional challenges. Here, we have evaluated predictors of DNA quantity in buccal cells collected for population-based studies of infant leukemia (N = 489 mothers and 392 children) and hepatoblastoma (HB; N = 446 mothers and 412 children) conducted through the Children's Oncology Group. DNA samples were collected by mail using mouthwash (for mothers and some children) and buccal brush (for children) collection kits and quantified using quantitative real-time PCR. Multivariable linear regression models were used to identify predictors of DNA yield. Median DNA yield was higher for mothers in both studies compared with their children (14 μg vs. mothers or children in this analysis. The association with seasonality suggests that conditions during transport may influence DNA yield. The low yields observed in most children in these studies highlight the importance of developing alternative methods for DNA collection in younger age groups.

  11. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences

    Directory of Open Access Journals (Sweden)

    de Vries Martine C

    2011-09-01

    Full Text Available Abstract Background Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences of the unprecedented integration of research and care in pediatric oncology from the perspective of parents and physicians. Methodology An empirical ethical approach, combining (1 a narrative review of (primarily qualitative studies on parents' and physicians' experiences of the pediatric oncology research practice, and (2 comparison of these experiences with existing theoretical ethical concepts about (pediatric research. The use of empirical evidence enriches these concepts by taking into account the peculiarities that ethical challenges pose in practice. Results Analysis of the 22 studies reviewed revealed that the integration of research and care has consequences for the informed consent process, the promotion of the child's best interests, and the role of the physician (doctor vs. scientist. True consent to research is difficult to achieve due to the complexity of research protocols, emotional stress and parents' dependency on their child's physician. Parents' role is to promote their child's best interests, also when they are asked to consider enrolling their child in a trial. Parents are almost never in equipoise on trial participation, which leaves them with the agonizing situation of wanting to do what is best for their child, while being fearful of making the wrong decision. Furthermore, a therapeutic misconception endangers correct assessment of participation, making parents inaccurately attribute therapeutic intent to research procedures. Physicians prefer the perspective of a therapist over a researcher. Consequently they may truly believe that in the research setting they promote the child's best interests, which maintains the

  12. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  13. Intensive cisplatin/oral etoposide for epithelial ovarian cancer: the Cambridge Gynae-Oncology Centre experience: too toxic for relapse?

    Science.gov (United States)

    Gounaris, Ioannis; Iddawela, Mahesh; Parkinson, Christine; Pratt, Jennie; Hatcher, Helen; Basu, Bristi; Tan, Li Tee; Brenton, James D; Earl, Helena M

    2016-03-01

    Intensive cisplatin and oral etoposide for relapsed epithelial ovarian cancer (EOC), commonly known as the van der Burg (VDB) protocol, has been reported to improve response rates and progression-free survival. We report on all patients with relapsed EOC treated on the VDB protocol at the Cambridge Gynae-Oncology Centre. From the institutional databases, we identified all patients treated since 2001. We extracted demographic, clinical, treatment, and toxicity data and outcomes. We used Cox regression to identify predictors of survival. A total of 35 patients were treated on the VDB protocol. Toxicity was significant, with grade 3/4 fatigue, nausea and vomiting affecting 46, 46 and 29% of patients, respectively. Six patients had grade 3/4 infection and four (11%) deaths occurred on treatment. Efficacy was encouraging, with a radiological response rate of 43%, a median progression-free survival of 5.8 months and a median overall survival of 14.1 months. No significant difference in efficacy was seen between platinum-resistant and sensitive patients. We report significant activity of the VDB protocol in a routine clinical setting. However, the high rates of serious toxicity and treatment-related deaths among patients treated with palliative intent proved unacceptable. The Cambridge Gynae-Oncology Centre no longer uses this regimen in women with relapsed EOC.

  14. Family Reconstruction: The Family within-a Group Experience.

    Science.gov (United States)

    Satir, Virginia; And Others

    1988-01-01

    Presents Virginia Satir's Family Reconstruction, a group therapy experience that blends and extends her 1982 process therapy and 1983 conjoint family therapy approaches. Describes the family reconstruction process, the review of family reconstruction data in the pregroup interview, the family reconstruction process in the counseling group, and the…

  15. Teachers' Leadership and Students' Experience of Group Work

    Science.gov (United States)

    Hammar Chiriac, Eva; Granstrom, Kjell

    2012-01-01

    Group work is used as a means of learning at all levels of most educational systems. However, teachers often use group work without considering its "pros and cons." Such a mode of non-reflected application may sometimes end up in positive experiences and learning, but the likelihood is that the outcome will be the opposite. The aim of this…

  16. Family Reconstruction: The Family within-a Group Experience.

    Science.gov (United States)

    Satir, Virginia; And Others

    1988-01-01

    Presents Virginia Satir's Family Reconstruction, a group therapy experience that blends and extends her 1982 process therapy and 1983 conjoint family therapy approaches. Describes the family reconstruction process, the review of family reconstruction data in the pregroup interview, the family reconstruction process in the counseling group, and the…

  17. Teachers' Leadership and Students' Experience of Group Work

    Science.gov (United States)

    Hammar Chiriac, Eva; Granstrom, Kjell

    2012-01-01

    Group work is used as a means of learning at all levels of most educational systems. However, teachers often use group work without considering its "pros and cons." Such a mode of non-reflected application may sometimes end up in positive experiences and learning, but the likelihood is that the outcome will be the opposite. The aim of…

  18. Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Illidge, Tim, E-mail: Tim.Illidge@ics.manchester.ac.uk [Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester (United Kingdom); Specht, Lena [Department of Oncology and Hematology, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Yahalom, Joachim [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Aleman, Berthe [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Berthelsen, Anne Kiil [Department of Radiation Oncology and PET Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Constine, Louis [Departments of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York (United States); Dabaja, Bouthaina [Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dharmarajan, Kavita [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ng, Andrea [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard University, Boston, Massachusetts (United States); Ricardi, Umberto [Radiation Oncology Unit, Department of Oncology, University of Torino, Torino (Italy); Wirth, Andrew [Division of Radiation Oncology, Peter MacCallum Cancer Institute, St. Andrews Place, East Melbourne (Australia)

    2014-05-01

    Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.

  19. Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the Postoperative Treatment of Pancreatic Head Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, Karyn A., E-mail: goodmank@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Regine, William F. [University of Maryland School of Medicine, Baltimore, Maryland (United States); Dawson, Laura A. [Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Ben-Josef, Edgar [University of Michigan Medical School, Ann Arbor, Michigan (United States); Haustermans, Karin [University Hospital Leuven, Leuven (Belgium); Bosch, Walter R. [Image-Guided Therapy QA Center, Washington University, St. Louis, Missouri (United States); Turian, Julius; Abrams, Ross A. [Rush University Medical College, Chicago, Illinois (United States)

    2012-07-01

    Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

  20. Introduction of online adaptive radiotherapy for bladder cancer through a multicentre clinical trial (Trans-Tasman Radiation Oncology Group 10.01: Lessons learned

    Directory of Open Access Journals (Sweden)

    Daniel Pham

    2013-01-01

    Full Text Available Online adaptive radiotherapy for bladder cancer is a novel radiotherapy technique that was found feasible in a pilot study at a single academic institution. In September 2010 this technique was opened as a multicenter study through the Trans-Tasman Radiation Oncology Group (TROG 10.01 bladder online adaptive radiotherapy treatment. Twelve centers across Australia and New-Zealand registered interest into the trial. A multidisciplinary team of radiation oncologists, radiation therapists and medical physicists represented the trial credentialing and technical support team. To provide timely activation and proper implementation of the adaptive technique the following key areas were addressed at each site: Staff education/training; Practical image guided radiotherapy assessment; provision of help desk and feedback. The trial credentialing process involved face-to-face training and technical problem solving via full day site visits. A dedicated "help-desk" team was developed to provide support for the clinical trial. 26% of the workload occurred at the credentialing period while the remaining 74% came post-center activation. The workload was made up of the following key areas; protocol clarification (36%, technical problems (46% while staff training was less than 10%. Clinical trial credentialing is important to minimizing trial deviations. It should not only focus on site activation quality assurance but also provide ongoing education and technical support.

  1. Randomized use of cyclosporin A (CsA) to modulate P-glycoprotein in children with AML in remission: Pediatric Oncology Group Study 9421

    Science.gov (United States)

    Becton, David; Dahl, Gary V.; Ravindranath, Yaddanapudi; Chang, Myron N.; Behm, Fred G.; Raimondi, Susana C.; Head, David R.; Stine, Kimo C.; Lacayo, Norman J.; Sikic, Branimir Ivan; Arceci, Robert J.; Weinstein, Howard

    2006-01-01

    Relapse is a major obstacle in the cure of acute myeloid leukemia (AML). The Pediatric Oncology Group AML Study 9421 tested 2 different strategies to improve event-free survival (EFS) and overall survival (OS). Patients were randomized to receive standard-dose DAT (daunorubicin, cytarabine, and thioguanine) or high-dose DAT during induction. To interfere with P-glycoprotein (P-gp)-dependent drug efflux, the second randomization tested the benefit of cyclosporine (CsA) added to consolidation chemotherapy. Of the 282 children randomly assigned to receive standard DAT induction, 248 (87.9%) achieved remission compared to 253 (91%) of the 278 receiving high-dose DAT (P = ns). Children with HLA-identical sibling donors who achieved a complete remission received an allogeneic bone marrow transplant as consolidation. For the 83 patients receiving a matched related donor bone marrow transplantation (BMT), the 3-year disease-free survival (DFS) is 67%. Of the 418 children who achieved remission and went on to consolidation with and without CsA, the DFS was 40.6% and 33.9%, respectively (P = .24). Overexpression of P-gp was infrequent (14%) in this pediatric population. In this study, intensifying induction with high-dose DAT and the addition of CsA to consolidation chemotherapy did not prolong the durations of remission or improve overall survival for children with AML. PMID:16254147

  2. Treatment of children with early pre-B and pre-B acute lymphocytic leukemia with antimetabolite-based intensification regimens: a Pediatric Oncology Group Study.

    Science.gov (United States)

    Harris, M B; Shuster, J J; Pullen, J; Borowitz, M J; Carroll, A J; Behm, F G; Camitta, B; Land, V J

    2000-09-01

    Between May 1987 and January 1991, 1354 patients, 1-21 years old, with standard or poor prognosis B-lineage acute lymphocytic leukemia were treated on the Pediatric Oncology Group Study 8602. One thousand three hundred and twenty-three patients entered remission and 1051 patients were randomized on day 43 to an intensification regimen containing L-asparaginase and intermediate-dose methotrexate (regimen B) or cytarabine and intermediate dose methotrexate (regimen C). After completion of intensification at week 25, all patients received the same maintenance therapy until 3 years from diagnosis. Overall 5-year continuous complete remission (CCR) for regimen B was 72+/-2% (s.e.) and for regimen C, 73+/-2% (P = 0.72 by log-rank analysis). Significant differences between treatments for CCR, testicular, CNS relapses overall or with regard to phenotype (pre-B vs early pre-B), gender, or race were not detected. During intensification, regimen C had significantly more bacterial infections (P = 0.05) and days spent in the hospital (P intensification phase of therapy in children with B-lineage acute lymphocytic leukemia.

  3. Presurgical chemotherapy compared with immediate surgery and adjuvant chemotherapy for nonmetastatic osteosarcoma: Pediatric Oncology Group Study POG-8651.

    Science.gov (United States)

    Goorin, Allen M; Schwartzentruber, Douglas J; Devidas, Meenakshi; Gebhardt, Mark C; Ayala, Alberto G; Harris, Michael B; Helman, Lee J; Grier, Holcombe E; Link, Michael P

    2003-04-15

    Successful therapeutic interventions to prevent disease progression in patients with nonmetastatic osteosarcoma have included surgery with adjuvant chemotherapy. Presurgical chemotherapy has been advocated for these patients because of putative improvement in event-free survival (EFS). The advantages of presurgical chemotherapy include early administration of systemic chemotherapy, shrinkage of primary tumor, and pathologic identification of risk groups. The theoretic disadvantage is that it exposes a large tumor burden to marginally effective chemotherapy. The contribution of chemotherapy and surgery timing has not been tested rigorously. Between 1986 and 1993, we conducted a prospective trial in patients with nonmetastatic osteosarcoma who were assigned randomly to immediate surgery or presurgical chemotherapy. Except for the timing of surgery (week 0 or 10), patients received 44 weeks of identical combination chemotherapy that included high-dose methotrexate with leucovorin rescue, doxorubicin, cisplatin, bleomycin, cyclophosphamide, and dactinomycin. One hundred six patients were enrolled onto this study. Six were excluded from analysis. Of the remaining 100 patients, 45 were randomly assigned to immediate chemotherapy, and 55 were randomly assigned to immediate surgery. Sixty-seven patients remain disease-free. At 5 years, the projected EFS +/- SE is 65% +/- 6% (69% +/- 8% for immediate surgery and 61% +/- 8% for presurgical chemotherapy; P =.8). The treatment arms had similar incidence of limb salvage (55% for immediate surgery and 50% for presurgical chemotherapy). Chemotherapy was effective in both treatment groups. There was no advantage in EFS for patients given presurgical chemotherapy.

  4. Intensified Chemotherapy With Dexrazoxane Cardioprotection in Newly Diagnosed Nonmetastatic Osteosarcoma: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Schwartz, Cindy L; Wexler, Leonard H; Krailo, Mark D; Teot, Lisa A; Devidas, Meenakshi; Steinherz, Laurel J; Goorin, Allen M; Gebhardt, Mark C; Healey, John H; Sato, Judith K; Meyers, Paul A; Grier, Holcombe E; Bernstein, Mark L; Lipshultz, Steven E

    2016-01-01

    Although chemotherapy has improved outcome of osteosarcoma, 30-40% of patients succumb to this disease. Survivors experience substantial morbidity and mortality from anthracycline-induced cardiotoxicity. We hypothesized that the cardioprotectant dexrazoxane would (i) support escalation of the cumulative doxorubicin dose (600 mg/m(2)) and (ii) not interfere with the cytotoxicity of chemotherapy measured by necrosis grading in comparison to historical control data. Children and adolescents with nonmetastatic osteosarcoma were treated with MAP (methotrexate, doxorubicin, cisplatin) or MAPI (MAP/ifosfamide). Dexrazoxane was administered with all doxorubicin doses. Cardioprotection was assessed by measuring left ventricular fractional shortening. Interference with chemotherapy-induced cytotoxicity was determined by measuring tumor necrosis after induction chemotherapy. Feasibility of intensifying therapy with either high cumulative-dose doxorubicin or high-dose ifosfamide/etoposide was evaluated for "standard responders" (SR, osteosarcoma. © 2015 Wiley Periodicals, Inc.

  5. The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Rusch, V.W.; Griffin, B.R.; Livingston, R.B. (Univ. of Washington, Seattle (USA))

    1989-10-01

    Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

  6. Talking therapy groups on acute psychiatric wards: patients' experience of two structured group formats

    Science.gov (United States)

    Radcliffe, Jonathan; Bird, Laura

    2016-01-01

    Aims and method We report the results of a clinical audit of patients' reactions to two types of talking therapy groups facilitated by assistant psychologists and psychology graduates on three acute wards. Patients' experiences of problem-solving and interpersonal group formats were explored via focus groups and structured interviews with 29 group participants. Results Both group formats generated high satisfaction ratings, with benefits related mostly to generic factors. Clinical implications Adequately trained and supported assistant psychologists and psychology graduates can provide supportive talking groups that patients find helpful. PMID:27512586

  7. Group work as an incentive for learning - students' experiences of group work.

    Science.gov (United States)

    Hammar Chiriac, Eva

    2014-01-01

    Group work is used as a means for learning at all levels in educational systems. There is strong scientific support for the benefits of having students learning and working in groups. Nevertheless, studies about what occurs in groups during group work and which factors actually influence the students' ability to learn is still lacking. Similarly, the question of why some group work is successful and other group work results in the opposite is still unsolved. The aim of this article is to add to the current level of knowledge and understandings regarding the essence behind successful group work in higher education. This research is focused on the students' experiences of group work and learning in groups, which is an almost non-existing aspect of research on group work prior to the beginning of the 21st century. A primary aim is to give university students a voice in the matter by elucidating the students' positive and negative points of view and how the students assess learning when working in groups. Furthermore, the students' explanations of why some group work ends up being a positive experience resulting in successful learning, while in other cases, the result is the reverse, are of interest. Data were collected through a study-specific questionnaire, with multiple choice and open-ended questions. The questionnaires were distributed to students in different study programs at two universities in Sweden. The present result is based on a reanalysis and qualitative analysis formed a key part of the study. The results indicate that most of the students' experiences involved group work that facilitated learning, especially in the area of academic knowledge. Three important prerequisites (learning, study-social function, and organization) for group work that served as an effective pedagogy and as an incentive for learning were identified and discussed. All three abstractions facilitate or hamper students' learning, as well as impact their experiences with group work.

  8. Age, Tumor Characteristics, and Treatment Regimen as Event Predictors in Ewing: A Children’s Oncology Group Report

    Directory of Open Access Journals (Sweden)

    Neyssa Marina

    2015-01-01

    Full Text Available Purpose. To associate baseline patient characteristics and relapse across consecutive COG studies. Methods. We analyzed risk factors for LESFT patients in three randomized COG trials. We evaluated age at enrollment, primary site, gender, tumor size, and treatment (as randomized. We estimated event-free survival (EFS, Kaplan-Meier and compared risk across groups (log-rank test. Characteristics were assessed by proportional hazards regression with the characteristic of interest as the only component. Confidence intervals (CI for RR were derived. Factors related to outcome at level 0.05 were included in a multivariate regression model. Results. Between 12/1988 and 8/2005, 1444 patients were enrolled and data current to 2001, 2004, or 2008 were used. Patients were with a median age of 12 years (0–45, 55% male and 88% Caucasian. The 5-year EFS was 68.3% ± 1.3%. In univariate analysis age, treatment, and tumor location were identified for inclusion in the multivariate model, and all remained significant (p 18 years, pelvic tumor, size > 8 cms, and chemotherapy without ifosfamide/etoposide significantly predict worse outcome. AEWS0031 is NCT00006734, INT0091 and INT0054 designed before 1993 (unregistered.

  9. Group work as an incentive for learning – students’ experiences of group work

    Directory of Open Access Journals (Sweden)

    Eva eHammar Chiriac

    2014-06-01

    Full Text Available Group work is used as a means for learning at all levels in educational systems. There is strong scientific support for the benefits of having students learning and working in groups. Nevertheless, studies about what occurs in groups during group work and which factors actually influence the students’ ability to learn is still lacking. Likewise, the question of why some group work is successful and other work results in the opposite is still unsolved. The aim of this article is to add to the current level of knowledge and understandings regarding the essence behind successful group work in higher education. This research is focused on the students’ experiences of group work and learning in groups, which is an almost non-existing aspect of research on group work prior to the beginning of the 21st century. A primary aim is to give university students a voice in the matter by elucidating the students’ positive and negative points of view and how the students assess learning when working in groups. Furthermore, the students’ explanations of why some group work ends up being a positive experience resulting in successful learning, while in other cases, the result is the reverse, are of interest. Data were collected through a study-specific questionnaire, with multiple choice and open-ended questions. The questionnaires were distributed to students in different study programs at two universities in Sweden. The present result is based on a reanalysis and qualitative analysis formed a key part of the study. The results indicate that most of the students’ experiences involved group work that facilitated learning, especially in the area of academic knowledge. Three important prerequisites (learning, study-social function and organization for group work that served as an effective pedagogy and as an incentive for learning were identified and discussed. All three abstractions facilitate or hamper students’ learning, as well as impact their

  10. Group counseling for medical students with drop-out experiences.

    Science.gov (United States)

    Kim, Eun Kyung; Baek, Sunyong; Woo, Jae Seok; Im, Sun Ju; Lee, Sun Hee; Kam, Beesung; Lee, Sang Yeoup; Yun, So Jung

    2013-03-01

    The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

  11. Validation of a multi-modal treatment protocol for Ewing sarcoma--a report from the polish pediatric oncology group.

    Science.gov (United States)

    Raciborska, Anna; Bilska, Katarzyna; Drabko, Katarzyna; Chaber, Radosław; Sobol, Grażyna; Pogorzała, Monika; Wyrobek, Elżbieta; Połczyńska, Katarzyna; Rogowska, Elżbieta; Rodriguez-Galindo, Carlos; Wożniak, Wojciech

    2014-12-01

    Ewing sarcoma (ES) is the second most common paediatric malignant bone tumor. Advances in multi-disciplinary care have resulted in significant improvement in cure rates over the last decades. However, the generalization of those results in countries traditionally excluded from large cooperative trials has yet to be demonstrated. We report the results of modern multi-disciplinary care for patients with ES in Poland. One hundred and thirty-two patients with ES were treated using modern multi-modal therapy during the period 2000-2009. Overall survival was estimated by Kaplan-Meier methods and compared using long-rank test and Cox models. Factors predictive of outcome in our setting were analyzed to identify distinct risk groups that could help identify areas for improvement. The median age at the time of diagnosis was 12.3 years. With a median follow-up of 5.0 years, the 5-year event-free survival (EFS) and OS estimates for localized disease were 54.88% and 68.29%, respectively. For patients with metastatic disease, 5-year EFS and OS estimates were 36% and 42%, respectively. There was no correlation between age and stage or site. Patients with localized, non-pelvic disease had better outcome than patients with axial tumors (71% vs. 44%, respectively, P = 0.00073). Treatment failure was associated with stage, pelvic primary, poor histological response, and type of local control. Successful treatment of ES requires optimal systemic and local therapy. We were able to replicate the results of modern multi-modal protocols. Validation of current treatment protocols in countries with more limited cancer treatment resources is required. © 2014 Wiley Periodicals, Inc.

  12. Impact of treatment in long-term survival patients with follicular lymphoma: A Spanish Lymphoma Oncology Group registry

    Science.gov (United States)

    Provencio, Mariano; Sabín, Pilar; Gomez-Codina, Jose; Calvo, Virginia; Llanos, Marta; Gumá, Josep; Quero, Cristina; Blasco, Ana; Cruz, Miguel Angel; Aguiar, David; García-Arroyo, Francisco; Lavernia, Javier; Martinez, Natividad; Morales, Manuel; Saez-Cusi, Alvaro; Rodriguez, Delvys; de la Cruz, Luis; Sanchez, Jose Javier; Rueda, Antonio

    2017-01-01

    Background Follicular lymphoma is the second most common non-Hodgkin lymphoma in the United States and Europe. However, most of the prospective randomized studies have very little follow-up compared to the long natural history of the disease. The primary aim of this study was to investigate the long-term survival of our series of patients with follicular lymphoma. Patients and methods A total of 1074 patients with newly diagnosed FL were enrolled. Patients diagnosed were prospectively enrolled from 1980 to 2013. Results Median follow-up was 54.9 months and median overall survival is over 20 years in our series. We analyzed the patients who are still alive beyond 10 years from diagnosis in order to fully assess the prognostic factors that condition this group. Out of 166 patients who are still alive after more than 10 years of follow-up, 118 of them (73%) are free of evident clinical disease. Variables significantly associated with survival at 10 years were stage < II (p <0.03), age < 60 years (p <0.0001), low FLIPI (p <0.002), normal β2 microglobulin (p <0.005), no B symptoms upon diagnosis (p <0.02), Performance Status 0–1 (p <0.03) and treatment with anthracyclines and rituximab (p <0.001), or rituximab (p <0.0001). Conclusions A longer follow-up and a large series demonstrated a substantial population of patients with follicular lymphoma free of disease for more than 10 years. PMID:28493986

  13. Collaborative Pediatric Bone Tumor Program to Improve Access to Specialized Care: An Initiative by the Lebanese Children's Oncology Group.

    Science.gov (United States)

    Saab, Raya; Merabi, Zeina; Abboud, Miguel R; Muwakkit, Samar; Noun, Peter; Gemayel, Gladys; Bechara, Elie; Khalifeh, Hassan; Farah, Roula; Kabbara, Nabil; El-Khoury, Tarek; Al-Yousef, Rasha; Haidar, Rachid; Saghieh, Said; Eid, Toufic; Akel, Samir; Khoury, Nabil; Bayram, Layal; Krasin, Matthew J; Jeha, Sima; El-Solh, Hassan

    2017-02-01

    Children with malignant bone tumors have average 5-year survival rates of 60% to 70% with current multimodality therapy. Local control modalities aimed at preserving function greatly influence the quality of life of long-term survivors. In developing countries, the limited availability of multidisciplinary care and limited expertise in specialized surgery and pediatric radiation therapy, as well as financial cost, all form barriers to achieving optimal outcomes in this population. We describe the establishment of a collaborative pediatric bone tumor program among a group of pediatric oncologists in Lebanon and Syria. This program provides access to specialized local control at a tertiary children's cancer center to pediatric patients with newly diagnosed bone tumors at participating sites. Central review of pathology, staging, and treatment planning is performed in a multidisciplinary tumor board setting. Patients receive chemotherapy at their respective centers on a unified treatment plan. Surgery and/or radiation therapy are performed centrally by specialized staff at the children's cancer center. Cost barriers were resolved through a program development initiative led by St Jude Children's Research Hospital. Once program feasibility was achieved, the Children's Cancer Center of Lebanon Foundation, via fundraising efforts, provided continuation of program-directed funding. Findings over a 3-year period showed the feasibility of this project, with timely local control and protocol adherence at eight collaborating centers. We report success in providing standard-of-care multidisciplinary therapy to this patient population with complex needs and financially challenging surgical procedures. This initiative can serve as a model, noting that facilitating access to specialized multidisciplinary care, resolution of financial barriers, and close administrative coordination all greatly contributed to the success of the program.

  14. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Theodore S., E-mail: tshong1@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Bosch, Walter R. [Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri (United States); Krishnan, Sunil [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kim, Tae K. [Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women' s College Hospital, University of Toronto, Toronto, Ontario (Canada); Mamon, Harvey J. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Shyn, Paul [Department of Radiology, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (United States); Seong, Jinsil [Department of Radiation Oncology, Yonsei University Medical College, Seoul (Korea, Republic of); Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Cheng, Jason C. [Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Feng, Mary U. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States); Stephans, Kevin L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Roberge, David [Department of Radiation Oncology, Montreal General Hospital/McGill University Health Centre, Montreal, Quebec (Canada); Crane, Christopher [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); and others

    2014-07-15

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment

  15. Quality assurance standards drive improvements in the profile of radiation therapy departments participating in trials of the EORTC Radiation Oncology Group.

    Science.gov (United States)

    Grant, Warren; Hurkmans, Coen W; Poortmans, Philip M; Maingon, Philippe; Monti, Angelo F; van Os, Marjolein J H; Weber, Damien C

    2014-09-01

    The Facility Questionnaire (FQ) of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group (EORTC-ROG) evaluates the human, technical and organizational resources at each EORTC member institution. The purpose of this study is to use the FQ database to assess the improvement of radiation therapy (RT) structures and resources within the EORTC compared to the previous surveys performed by our group. We report the content of the current FQ database, completed online by 156 EORTC candidate member institutions from 22 countries between February 2011 and February 2013. Results are compared to FQ-published data from 1992 and 2007. The average number of patients per year per EORTC institution is 2381 (range 350-12,000) an 18.2% increase compared to the 2007 figures. From 2007 to 2013 the average number of radiation oncologists, physicists and radiation technologists per EORTC institution has increased by 27% (from 8.5 to 10.8), 41% (from 5.2 to 7.4) and 38% (from 26.1 to 36.1) respectively. Consequently the number of patients per year per radiation oncologist has decreased from 258 to 243, for physicists from 426 to 354 and for radiation technologists from 107 to 86. One hundred and forty-six (94%) and 101 (65%) institutions can now deliver IMRT and SBRT, compared to 77 (79%) and 53 (54%) in 2007. The standards set by the EORTC-ROG are met by a continually improving number of institutions, helping to safeguard use of advanced technologies in EORTC-ROG clinical trials. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Metabolic Tumor Volume as a Prognostic Imaging-Based Biomarker for Head-and-Neck Cancer: Pilot Results From Radiation Therapy Oncology Group Protocol 0522

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, David L., E-mail: david.schwartz@utsw.edu [Department of Radiation Oncology, University of Texas Southwestern School of Medicine, Dallas, Texas (United States); Harris, Jonathan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Yao, Min [Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Opanowski, Adam; Levering, Anthony [American College of Radiology Imaging Network, Philadelphia, Pennsylvania (United States); Ang, K. Kian [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Trotti, Andy M. [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida (United States); Garden, Adam S. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Christopher U. [Sutter Medical Group, Sacramento, California (United States); Harari, Paul [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Foote, Robert [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Holland, John [Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon (United States); Zhang, Qiang [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California (United States)

    2015-03-15

    Purpose: To evaluate candidate fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging biomarkers for head-and-neck chemoradiotherapy outcomes in the cooperative group trial setting. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0522 patients consenting to a secondary FDG-PET/CT substudy were serially imaged at baseline and 8 weeks after radiation. Maximum standardized uptake value (SUVmax), SUV peak (mean SUV within a 1-cm sphere centered on SUVmax), and metabolic tumor volume (MTV) using 40% of SUVmax as threshold were obtained from primary tumor and involved nodes. Results: Of 940 patients entered onto RTOG 0522, 74 were analyzable for this substudy. Neither high baseline SUVmax nor SUVpeak from primary or nodal disease were associated with poor treatment outcomes. However, primary tumor MTV above the cohort median was associated with worse local-regional control (hazard ratio 4.01, 95% confidence interval 1.28-12.52, P=.02) and progression-free survival (hazard ratio 2.34, 95% confidence interval 1.02-5.37, P=.05). Although MTV and T stage seemed to correlate (mean MTV 6.4, 13.2, and 26.8 for T2, T3, and T4 tumors, respectively), MTV remained a strong independent prognostic factor for progression-free survival in bivariate analysis that included T stage. Primary MTV remained prognostic in p16-associated oropharyngeal cancer cases, although sample size was limited. Conclusion: High baseline primary tumor MTV was associated with worse treatment outcomes in this limited patient subset of RTOG 0522. Additional confirmatory work will be required to validate primary tumor MTV as a prognostic imaging biomarker for patient stratification in future trials.

  17. Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies—Assessment of Nodal Distribution in Gynecological Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kabolizadeh, Peyman; Fulay, Suyash; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2013-09-01

    Purpose: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. Methods and Materials: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. Results: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. Conclusions: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to

  18. Art Therapy with an Oncology Care Team

    Science.gov (United States)

    Nainis, Nancy A.

    2005-01-01

    Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients.…

  19. Group dynamics challenges: Insights from Biosphere 2 experiments.

    Science.gov (United States)

    Nelson, Mark; Gray, Kathelin; Allen, John P

    2015-07-01

    Successfully managing group dynamics of small, physically isolated groups is vital for long duration space exploration/habitation and for terrestrial CELSS (Controlled Environmental Life Support System) facilities with human participants. Biosphere 2 had important differences and shares some key commonalities with both Antarctic and space environments. There were a multitude of stress factors during the first two year closure experiment as well as mitigating factors. A helpful tool used at Biosphere 2 was the work of W.R. Bion who identified two competing modalities of behavior in small groups. Task-oriented groups are governed by conscious acceptance of goals, reality-thinking in relation to time and resources, and intelligent management of challenges. The opposing unconscious mode, the "basic-assumption" ("group animal") group, manifests through Dependency/Kill the Leader, Fight/Flight and Pairing. These unconscious dynamics undermine and can defeat the task group's goal. The biospherians experienced some dynamics seen in other isolated teams: factions developing reflecting personal chemistry and disagreements on overall mission procedures. These conflicts were exacerbated by external power struggles which enlisted support of those inside. Nevertheless, the crew evolved a coherent, creative life style to deal with some of the deprivations of isolation. The experience of the first two year closure of Biosphere 2 vividly illustrates both vicissitudes and management of group dynamics. The crew overrode inevitable frictions to creatively manage both operational and research demands and opportunities of the facility, thus staying 'on task' in Bion's group dynamics terminology. The understanding that Biosphere 2 was their life support system may also have helped the mission to succeed. Insights from the Biosphere 2 experience can help space and remote missions cope successfully with the inherent challenges of small, isolated crews.

  20. Group dynamics challenges: Insights from Biosphere 2 experiments

    Science.gov (United States)

    Nelson, Mark; Gray, Kathelin; Allen, John P.

    2015-07-01

    Successfully managing group dynamics of small, physically isolated groups is vital for long duration space exploration/habitation and for terrestrial CELSS (Controlled Environmental Life Support System) facilities with human participants. Biosphere 2 had important differences and shares some key commonalities with both Antarctic and space environments. There were a multitude of stress factors during the first two year closure experiment as well as mitigating factors. A helpful tool used at Biosphere 2 was the work of W.R. Bion who identified two competing modalities of behavior in small groups. Task-oriented groups are governed by conscious acceptance of goals, reality-thinking in relation to time and resources, and intelligent management of challenges. The opposing unconscious mode, the "basic-assumption" ("group animal") group, manifests through Dependency/Kill the Leader, Fight/Flight and Pairing. These unconscious dynamics undermine and can defeat the task group's goal. The biospherians experienced some dynamics seen in other isolated teams: factions developing reflecting personal chemistry and disagreements on overall mission procedures. These conflicts were exacerbated by external power struggles which enlisted support of those inside. Nevertheless, the crew evolved a coherent, creative life style to deal with some of the deprivations of isolation. The experience of the first two year closure of Biosphere 2 vividly illustrates both vicissitudes and management of group dynamics. The crew overrode inevitable frictions to creatively manage both operational and research demands and opportunities of the facility, thus staying 'on task' in Bion's group dynamics terminology. The understanding that Biosphere 2 was their life support system may also have helped the mission to succeed. Insights from the Biosphere 2 experience can help space and remote missions cope successfully with the inherent challenges of small, isolated crews.

  1. Medicinal cannabis in oncology.

    Science.gov (United States)

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

    2007-12-01

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

  2. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Servaes, Sabah [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Khanna, Geetika [Washington University School of Medicine, Pediatric Radiology, St. Louis Children' s Hospital, Mallinckrodt Institute for Radiology, 510 S. Kingshighway, Campus Box 8131-MIR, St. Louis, MO (United States); Naranjo, Arlene [University of Florida, Department of Biostatistics, Gainesville, FL (United States); Geller, James I. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cincinnati, OH (United States); Ehrlich, Peter F. [University of Michigan, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Gow, Kenneth W. [Seattle Children' s Hospital, Pediatric Surgery, Seattle, WA (United States); Perlman, Elizabeth J. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Pathology, Chicago, IL (United States); Dome, Jeffrey S. [Children' s National Medical Center, Center for Cancer and Blood Disorders, Washington, DC (United States); Gratias, Eric; Mullen, Elizabeth A. [Harvard University, Dana Farber Cancer Institute and Boston Children' s Hospital, Boston, MA (United States)

    2014-08-19

    CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P = 0.73), while specificity was 86.5% and 83.8% (P = 1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P = 0.22), and specificity was 90.4% and 92.3% (P = 1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco-regional staging of pediatric renal tumors. (orig.)

  3. Do Intermediate Radiation Doses Contribute to Late Rectal Toxicity? An Analysis of Data From Radiation Therapy Oncology Group Protocol 94-06

    Energy Technology Data Exchange (ETDEWEB)

    Tucker, Susan L., E-mail: sltucker@mdanderson.org [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Dong, Lei [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Michalski, Jeff M. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Bosch, Walter R. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Image-Guided Therapy QA Center, Washington University, St. Louis, MO (United States); Winter, Kathryn [American College of Radiology, Philadelphia, PA (United States); Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Purdy, James A. [Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, CA (United States); Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2012-10-01

    Purpose: To investigate whether the volumes of rectum exposed to intermediate doses, from 30 to 50 Gy, contribute to the risk of Grade {>=}2 late rectal toxicity among patients with prostate cancer receiving radiotherapy. Methods and Materials: Data from 1009 patients treated on Radiation Therapy Oncology Group protocol 94-06 were analyzed using three approaches. First, the contribution of intermediate doses to a previously published fit of the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model was determined. Next, the extent to which intermediate doses provide additional risk information, after taking the LKB model into account, was investigated. Third, the proportion of rectum receiving doses higher than a threshold, VDose, was computed for doses ranging from 5 to 85 Gy, and a multivariate Cox proportional hazards model was used to determine which of these parameters were significantly associated with time to Grade {>=}2 late rectal toxicity. Results: Doses <60 Gy had no detectable impact on the fit of the LKB model, as expected on the basis of the small estimate of the volume parameter (n = 0.077). Furthermore, there was no detectable difference in late rectal toxicity among cohorts with similar risk estimates from the LKB model but with different volumes of rectum exposed to intermediate doses. The multivariate Cox proportional hazards model selected V75 as the only value of VDose significantly associated with late rectal toxicity. Conclusions: There is no evidence from these data that intermediate doses influence the risk of Grade {>=}2 late rectal toxicity. Instead, the critical doses for this endpoint seem to be {>=}75 Gy. It is hypothesized that cases of Grade {>=}2 late rectal toxicity occurring among patients with V75 less than approximately 12% may be due to a 'background' level of risk, likely due mainly to biological factors.

  4. Marginal prescription equivalent to the isocenter prescription in lung stereotactic body radiotherapy: preliminary study for Japan Clinical Oncology Group trial (JCOG1408)

    Science.gov (United States)

    Kawahara, Daisuke; Ozawa, Shuichi; Kimura, Tomoki; Saito, Akito; Nishio, Teiji; Nakashima, Takeo; Ohno, Yoshimi; Murakami, Yuji; Nagata, Yasushi

    2017-01-01

    A new randomized Phase III trial, the Japan Clinical Oncology Group (JCOG) 1408, which compares two dose fractionations (JCOG 0403 and JCOG 0702) for medically inoperable Stage IA NSCLC or small lung lesions clinically diagnosed as primary lung cancer, involves the introduction of a prescribed dose to the D95% of the planning target volume (PTV) using a superposition/convolution algorithm. Therefore, we must determine the prescribed dose in the D95% prescribing method to begin JCOG1408. JCOG 0702 uses density correction and the D95% prescribing method. However, JCOG 0403 uses no density correction and isocenter- prescribing method. The purpose of this study was to evaluate the prescribed dose to the D95% of the PTV equivalent to a dose of 48 Gy to the isocenter (JCOG 0403) using a superposition algorithm. The peripheral isodose line, which has the highest conformity index, and the D95% of the PTV were analyzed by considering the weighting factor, i.e. the inverse of the difference between the doses obtained using the superposition and Clarkson algorithms. The average dose at the isodose line of the highest conformity index and the D95% of the PTV were 41.5 ± 0.3 and 42.0 ± 0.3 Gy, respectively. The D95% of the PTV had a small correlation with the target volume (r2 = 0.0022) and with the distance between the scatterer and tumor volumes (r2 = 0.19). Thus, the prescribed dose of 48 Gy using the Clarkson algorithm (JCOG0403) was found to be equivalent to the prescribed dose of 42 Gy to the D95% of the PTV using the superposition algorithm. PMID:28115532

  5. Childhood Hodgkin International Prognostic Score (CHIPS) Predicts event-free survival in Hodgkin Lymphoma: A Report from the Children's Oncology Group.

    Science.gov (United States)

    Schwartz, Cindy L; Chen, Lu; McCarten, Kathleen; Wolden, Suzanne; Constine, Louis S; Hutchison, Robert E; de Alarcon, Pedro A; Keller, Frank G; Kelly, Kara M; Trippet, Tanya A; Voss, Stephan D; Friedman, Debra L

    2017-04-01

    Early response to initial chemotherapy in Hodgkin lymphoma (HL) measured by computed tomography (CT) and/or positron emission tomography (PET) after two to three cycles of chemotherapy may inform therapeutic decisions. Risk stratification at diagnosis could, however, allow earlier and potentially more efficacious treatment modifications. We developed a predictive model for event-free survival (EFS) in pediatric/adolescent HL using clinical data known at diagnosis from 1103 intermediate-risk HL patients treated on Children's Oncology Group protocol AHOD0031 with doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide (ABVE-PC) chemotherapy and radiation. Independent predictors of EFS were identified and used to develop and validate a prognostic score (Childhood Hodgkin International Prognostic Score [CHIPS]). A training cohort was randomly selected to include approximately half of the overall cohort, with the remainder forming the validation cohort. Stage 4 disease, large mediastinal mass, albumin (<3.5), and fever were independent predictors of EFS that were each assigned one point in the CHIPS.  Four-year EFS was 93.1% for patients with CHIPS = 0, 88.5% for patients with CHIPS = 1, 77.6% for patients with CHIPS = 2, and 69.2% for patients with CHIPS = 3. CHIPS was highly predictive of EFS, identifying a subset (with CHIPS 2 or 3) that comprises 27% of intermediate-risk patients who have a 4-year EFS of <80% and who may benefit from early therapeutic augmentation.  Furthermore, CHIPS identified higher risk patients who were not identified by early PET or CT response. CHIPS is a robust and inexpensive approach to predicting risk in patients with intermediate-risk HL that may improve ability to tailor therapy to risk factors known at diagnosis. © 2016 Wiley Periodicals, Inc.

  6. Healthcare Costs Reduced After Incorporating the Results of the American College of Surgeons Oncology Group Z0011 Trial into Clinical Practice.

    Science.gov (United States)

    Fillion, Michelle M; Glass, Katherine E; Hayek, Joe; Wehr, Allison; Phillips, Gary; Terando, Alicia; Agnese, Doreen M

    2016-11-30

    The purpose of our study was to quantitate the changes in axillary lymph node dissection (ALND), frozen section (FS), and the impact on costs after the publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial. We compared axillary nodal management and cost data in breast cancer patients who met Z0011 criteria and were treated with lumpectomy and sentinel lymph nodes (SLN) biopsy from 2007 to July 2013. Of 800 patients, 67 (13.5%) and 34 (12.5%) patients in the pre- and post-Z0011 era had 1-2 positive SLN. ALND decreased from 78% to 21% (p < 0.001) after publication of Z0011. The mean overall cost of SLN biopsy was $41,059 per patient, while SLN biopsy with completion ALND was $50,999 (p < 0.001). Intraoperative FS use decreased from 95% to 66% (p = 0.015). Omitting the FS decreased mean costs from $4,319 to $2,036. The application of Z0011 resulted in an overall mean cost savings of $571,653 from 2011 to July 2013. ACOSOG Z0011 significantly impacted axillary management resulting in a 20% reduction in the mean overall cost per patient by omitting ALND. In these patients, intraoperative FS analysis had poor sensitivity (56%) and doubled the cost of pathologic examination. Fewer ALND and intraoperative FS were performed after the publication of ACOSOG Z0011. Eliminating FS and ALND in patients who met Z0011 criteria, results in significant cost savings.

  7. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study.

    Science.gov (United States)

    Rose, Peter G; Ali, Shamshad; Whitney, Charles W; Lanciano, Rachelle; Stehman, Frederick B

    2011-06-01

    To evaluate the outcome of stage IVA cervical cancer treated with radiation and concurrent cisplatin-based chemotherapy. We conducted a retrospective study of stage IVA cervical cancer patients from four trials (Gynecologic Oncology Group protocols 56, 85, 120, and 165) treated with radiotherapy with or without concurrent cisplatin-based chemotherapy. Patient records were reviewed for demographic and tumor features, treatment, and progression-free survival (PFS) and overall survival (OS). Stage IVA patients were compared to stage IIIB patients from these same studies. Among the 51 stage IVA patients studied, 92% were stage IVA on the basis of bladder involvement. The median PFS was 10.1 months (95% CI=6.3-14.5 months) and median OS was 21.2 months (95% CI=13.3-30.5 months). The 3 year survival was 32%. On univariate analysis, only advanced age was associated with OS (p=0.0115) but age had only marginal effect on PFS (p=0.083). Pathologic proven pelvic nodal metastasis was of marginal significance for both PFS and OS, p=0.059 and 0.064, respectively. Despite similar patient characteristics, the use of cisplatin-based chemotherapy had no impact on PFS or OS but was underpowered to address this question. When compared to stage IIIB patients, stage IVA patients had a poorer performance status (p=0.0231), larger tumor size (p=0.0302), and more frequent bilateral parametrial involvement (0.0063). Patients with stage IVA disease had poor median survival of only 21 months with only 32% 3 year survival. Stage IVA patients have larger tumor size, more bilateral parametrial involvement, and poorer survival when compared to stage IIIB patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Phase 2 Study of Temozolomide-Based Chemoradiation Therapy for High-Risk Low-Grade Gliomas: Preliminary Results of Radiation Therapy Oncology Group 0424

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Barbara J., E-mail: barbara.fisher@lhsc.on.ca [London Regional Cancer Program, London, Ontario (Canada); Hu, Chen [Radiation Therapy Oncology Group-Statistical Center, Philadelphia, Pennsylvania (United States); Macdonald, David R. [London Regional Cancer Program, London, Ontario (Canada); Lesser, Glenn J. [Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina (United States); Coons, Stephen W. [Barrow Neurological Institute, Phoenix, Arizona (United States); Brachman, David G. [Arizona Oncology Services Foundation, Phoenix, Arizona (United States); Ryu, Samuel [Henry Ford Hospital, Detroit, Michigan (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Liu, Junfeng [GCE Solutions, Inc., Bloomington, Illinois (United States); Chakravarti, Arnab [The Ohio State University, The James, Columbus, Ohio (United States); Mehta, Minesh [University of Maryland Medical Systems, Baltimore, Maryland (United States)

    2015-03-01

    Purpose: Radiation Therapy Oncology Group (RTOG) 0424 was a phase 2 study of a high-risk low-grade glioma (LGG) population who were treated with temozolomide (TMZ) and radiation therapy (RT), and outcomes were compared to those of historical controls. This study was designed to detect a 43% increase in median survival time (MST) from 40.5 to 57.9 months and a 20% improvement in 3-year overall survival (OS) rate from 54% to 65% at a 10% significance level (1-sided) and 96% power. Methods and Materials: Patients with LGGs with 3 or more risk factors for recurrence (age ≥40 years, astrocytoma histology, bihemispherical tumor, preoperative tumor diameter of ≥6 cm, or a preoperative neurological function status of >1) were treated with RT (54 Gy in 30 fractions) and concurrent and adjuvant TMZ. Results: From 2005 to 2009, 129 evaluable patients (75 males and 54 females) were accrued. Median age was 49 years; 91% had a Zubrod score of 0 or 1; and 69%, 25%, and 6% of patients had 3, 4, and 5 risk factors, respectively. Patients had median and minimum follow-up examinations of 4.1 years and 3 years, respectively. The 3-year OS rate was 73.1% (95% confidence interval: 65.3%-80.8%), which was significantly improved compared to that of prespecified historical control values (P<.001). Median survival time has not yet been reached. Three-year progression-free survival was 59.2%. Grades 3 and 4 adverse events occurred in 43% and 10% of patients, respectively. One patient died of herpes encephalitis. Conclusions: The 3-year OS rate of 73.1% for RTOG 0424 high-risk LGG patients is higher than that reported for historical controls (P<.001) and the study-hypothesized rate of 65%.

  9. GROUP OF HEARING MOTHERS OF DEAF CHILDREN: INTERNSHIP EXPERIENCE REPORT

    Directory of Open Access Journals (Sweden)

    Rafaela Fava de Quevedo

    2017-03-01

    Full Text Available This experience report describes a group phenomenon, based upon a case study of a group of hearing mothers of deaf children. The weekly group, in operation for over three years, provides support for families with deaf children. At first, observations were made in the group for a subsequent analysis of the data and act on interventions. Categories containing the main features that emerged in the group were created in order to discuss the content found. The categories addressed by mothers included: independence/autonomy of the child; adolescence and sexuality; discovery of deafness and reorganization of family dynamics; and matters beyond the group goal. As for the categories related to the group process there are: resistance; containing function of the coordinator; transfer; interventions in the group field. The results lead to understanding the group as a facilitator and as a necessary support for the participants. Before that, interventions were carried out to expand the space for reflection offered by the group, which provides adaptations to the different situations experienced by the participants.

  10. Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India

    Directory of Open Access Journals (Sweden)

    K N Lokesh

    2017-01-01

    Full Text Available Introduction: Diffuse large B-cell lymphoma (DLBCL is the most frequent non-Hodgkins lymphoma in the elderly. With the rising proportion of older persons in India, it is important to study current patterns and management of this disease, given that data in this regard are scarce in Indian settings. The aim of this study was to document the clinical features of DLBCL among elderly patients and their outcome over 7 years at a tertiary care oncology center. Materials and Methods: This was a retrospective records review of 119 DLBCL cases between January 2007 and January 2015 aged 60 years and above done at Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India. Clinical staging was done according to Ann Arbor staging as modified by Cotswold's and International Prognostic Index (IPI calculated. Results: The mean age was 69.54 years (±5.44 with male: female ratio of 1.52:1. B symptoms were seen in 33% of patients. Thirty-six percent of the patients had stage II disease. The advanced stage was seen in 12% and bulky disease in 9.5%. Bone marrow was involved in 12%. The most common extranodal site was the head and neck region. The distribution according to the IPI was as follows: Low risk 38 (31.93%, low-intermediate risk 53 (44.54%, high-intermediate risk 20 (16.80%, and high risk 8 (6.72%. Among 119 patients, 98 (64.7% received treatment with either combination of rituximab, cyclophosphamide, adriamycin, vincristine, epirubicin, and prednisolone. Overall response rate was 63.26% with a complete response rate of 38.77%. The overall survival ranged from 2 to 123 months with the median being 9.5 months. Conclusion: In elderly, DLBCL is common in seventh decade and most of them present in an early stage and low IPI. The incorporation of rituximab to anthracycline based chemotherapy shows a significant improvement in survival in elderly DLBCL.

  11. Decisions from Experience: How Groups and Individuals Adapt to Change

    Science.gov (United States)

    2014-01-01

    Experience: How Groups and Individuals Adapt to Change Every morning, Ferran Adrià receives fresh products from his suppliers on Spain‘s Costa Brava. High...involved in this decision? Perhaps. Only a few kilometers from El Bulli, Joan , Josep, and Jordi Roca manage El Celler de Can Roca, currently

  12. Language Experience Affects Grouping of Musical Instrument Sounds

    Science.gov (United States)

    Bhatara, Anjali; Boll-Avetisyan, Natalie; Agus, Trevor; Höhle, Barbara; Nazzi, Thierry

    2016-01-01

    Language experience clearly affects the perception of speech, but little is known about whether these differences in perception extend to non-speech sounds. In this study, we investigated rhythmic perception of non-linguistic sounds in speakers of French and German using a grouping task, in which complexity (variability in sounds, presence of…

  13. Group Performance Under Experienced and Inexperienced Leaders; A Validation Experiment.

    Science.gov (United States)

    Fiedler, Fred E.; Chemers, Martin M.

    This study investigated the effect of experience and training on the performance of Belgian naval officers in an experimental leadership situation. As in a previous study conducted with Belgian naval personnel, group performance under trained and experienced officers was not significantly better than performance under untrained recruits. Moreover,…

  14. Language Experience Affects Grouping of Musical Instrument Sounds

    Science.gov (United States)

    Bhatara, Anjali; Boll-Avetisyan, Natalie; Agus, Trevor; Höhle, Barbara; Nazzi, Thierry

    2016-01-01

    Language experience clearly affects the perception of speech, but little is known about whether these differences in perception extend to non-speech sounds. In this study, we investigated rhythmic perception of non-linguistic sounds in speakers of French and German using a grouping task, in which complexity (variability in sounds, presence of…

  15. Testing for difference between two groups of functional neuroimaging experiments

    DEFF Research Database (Denmark)

    Nielsen, Finn Årup; Chen, Andrew C. N.; Hansen, Lars Kai

    2004-01-01

    We describe a meta-analytic method that tests for the difference between two groups of functional neuroimaging experiments. We use kernel density estimation in three-dimensional brain space to convert points representing focal brain activations into a voxel-based representation. We find the maximum...

  16. Breast cancer patients' narrative experiences about communication during the oncology care process: a qualitative study.

    Science.gov (United States)

    Abt Sacks, A; Perestelo-Perez, L; Rodriguez-Martin, B; Cuellar-Pompa, L; Algara López, M; González Hernández, N; Serrano-Aguilar, P

    2016-09-01

    To analyse the perception about the information and communication received to evaluate oncologic care of breast cancer patients in Spain. Qualitative study based on conducting in-depth interviews. An inductive thematic analysis of the illness narratives was performed. Intentional theoretical sampling of 41 people diagnosed with breast cancer. The information provided during care process is assessed as appropriate, as it includes personalised skills focused on communication and considers organisational and contextual issues. In some cases, the information was considered partial, heterogeneous and at times contradictory, which revealed a lack of continuity. To provide and adequately cover information needs from the patient perspective, it is necessary to ensure access, both in its physical (material) and intellectual (comprehension) dimension, keeping in mind elements of social capital (social networks) and cultural capital (values, beliefs, non-verbal language) that facilitate or hinder access. The current state of transition to a horizontal model in the doctor-patient relationship, could account for the difficulties, deficits and contradictions in communication and information that breast cancer patients perceive in many contexts. © 2015 John Wiley & Sons Ltd.

  17. Group-Wide, Prospective Study of Ototoxicity Assessment in Children Receiving Cisplatin Chemotherapy (ACCL05C1): A Report From the Children's Oncology Group.

    Science.gov (United States)

    Knight, Kristin R; Chen, Lu; Freyer, David; Aplenc, Richard; Bancroft, Mary; Bliss, Bonnie; Dang, Ha; Gillmeister, Biljana; Hendershot, Eleanor; Kraemer, Dale F; Lindenfeld, Lanie; Meza, Jane; Neuwelt, Edward A; Pollock, Brad H; Sung, Lillian

    2017-02-01

    Purpose Optimal assessment methods and criteria for reporting hearing outcomes in children who receive treatment with cisplatin are uncertain. The objectives of our study were to compare different ototoxicity classification systems, to evaluate the feasibility of including otoacoustic emissions and extended high frequency audiometry, and to evaluate a central review mechanism for audiologic results for cisplatin-treated children in the cooperative group setting. Patients and Methods Eligible participants were 1 to 30 years, with planned cisplatin-containing treatment. Hearing evaluations were conducted at baseline, before each cisplatin cycle, and at the end of therapy. Audiologic results were assessed and graded by the testing audiologist and by two central review audiologists using the American Speech-Language-Hearing Association Ototoxicity Criteria (ASHA), Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE), and Brock Ototoxicity Grades (Brock). One central reviewer also used the Society for Industrial and Organizational Psychology Ototoxicity Scale (SIOP). Results At the end of treatment, the prevalence of any degree of ototoxicity ranged from 40% to 56%, and severe ototoxicity ranged from 7% to 22%. Compared with CTCAE, SIOP detected significantly more ototoxicity ( P = .004), whereas Brock criteria detected significantly fewer patients with any or severe ototoxicity ( P ototoxicity earlier than did the other scales. Agreement between the central reviewers and the institutional audiologist was almost perfect for ASHA and Brock, whereas the poorest agreement occurred with CTCAE. Conclusion The SIOP scale may be superior to ASHA, Brock, and CTCAE scales for classifying ototoxicity in pediatric patients who were treated with cisplatin. Future studies should evaluate inter-rater reliability of the SIOP scale.

  18. Nanotechnology in radiation oncology.

    Science.gov (United States)

    Wang, Andrew Z; Tepper, Joel E

    2014-09-10

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

  19. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239

    Energy Technology Data Exchange (ETDEWEB)

    Komaki, Ritsuko, E-mail: rkomaki@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Ettinger, David S. [Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States); Videtic, Gregory M.M. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Bradley, Jeffrey D. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Langer, Corey J. [Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sause, William T. [Radiation Center, LDS Hospital, Salt Lake City, Utah (United States); Curran, Walter J. [Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pennsylvania (United States); Choy, Hak [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)

    2012-07-15

    Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m{sup 2} IV) was given on day 1 and etoposide (120 mg/m{sup 2} IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CI 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538

  20. Oocyte cryopreservation in oncological patients.

    Science.gov (United States)

    Porcu, Eleonora; Fabbri, Raffaella; Damiano, Giuseppe; Fratto, Rosita; Giunchi, Susanna; Venturoli, Stefano

    2004-04-05

    The use of chemotherapy and radiotherapy in oncological patients may reduce their reproductive potential. Sperm cryopreservation has been already used in men affected by neoplastic disease. Oocyte cryopreservation might be an important solution for these patients at risk of losing ovarian function. A program of oocyte cryopreservation for oncological patients is also present in our center. From June 1996 to January 2000, 18 patients awaiting chemotherapy and radiotherapy for neoplastic disease were included in our oocyte cryopreservation program. Our experience documents that oocyte storage may be a concrete and pragmatic alternative for oncological patients. The duration of oocyte storage does not seem to interfere with oocyte survival as pregnancies occurred even after several years of gamete cryopreservation in liquid nitrogen.

  1. Constructing maturity through alcohol experience - Focus group interviews with teenagers

    DEFF Research Database (Denmark)

    Demant, Jakob Johan; Järvinen, Margaretha

    2006-01-01

    alcohol experience and positive attitudes towards drinking are related to popularity and influence in the peer group. The function of alcohol in teenagers’ struggle for recognition is so strong that the participants who drink very little or not at all are put under considerable pressure. With alcohol......Danish 14- and 15-year-olds are at the top of the European list when it comes to drinking and drunkenness. The aim of this article is to demonstrate how the struggle for social recognition–with alcohol as the central marker–transpires in groups of teenagers in Denmark. This article shows how...... as a central marker of maturity–and the drinking teenagers’ parents described as supporters of this view–non-drinking teenagers come out as the potential losers in the negotiation of status in the groups. The data are drawn from a large qualitative study in which 28 focus group interviews were conducted...

  2. Educating medical students about radiation oncology: initial results of the oncology education initiative.

    Science.gov (United States)

    Hirsch, Ariel E; Singh, Deeptej; Ozonoff, Al; Slanetz, Priscilla J

    2007-10-01

    Multidisciplinary cancer care requires the integration of teaching across established educational boundaries. Because exposure to oncology and radiation oncology is limited in the undergraduate medical curriculum, the authors introduced an oncology education initiative at their institution. They report on the addition of structured multidisciplinary oncology education to the required radiology core clerkship. An institutional-based cohort study of fourth-year medical students rotating through a required clerkship in radiology at Boston University School of Medicine was conducted, beginning with the class of 2007. An educational questionnaire measuring the perceived quality of oncology education before and after exposure to a structured didactic program was administered. Of the 149 fourth-year students, 121 (81%) have completed the didactics of the initiative. Although 68 of 121 (56%) students reported having limited exposure to cancer care in the clinical years, 107 of 121 (88%) were motivated to learn more about the subject, and 100 of 121 (83%) reported a better understanding of the multidisciplinary nature of cancer care after this oncology education initiative. One hundred ten of 121 (91%) felt that the radiology clerkship was an opportune time to receive oncology and radiation oncology teaching. As a result of the initiative, 32% of the students pursued advanced training in radiation oncology. Of students who before the initiative were not planning on taking oncology electives, 70 of 99 (71%) agreed or strongly agreed that the lecture motivated them to learn more about the subject, and 43 of 99 (43%) agreed or strongly agreed that the lecture motivated them to take oncology electives. Systematic exposure to multidisciplinary oncology education as part of a radiology core clerkship provides an excellent opportunity for the integrated teaching of oncologic principles and patient management. This type of experience addresses an important yet underrepresented

  3. Cleaners' experiences with group-based workplace physical training

    DEFF Research Database (Denmark)

    Kirkelund, Lasse; Mortensen, Ole Steen; Holtermann, Andreas

    2012-01-01

    This study investigates how work-site health promotion intervention, by involving group-based physical coordination training, may increase participants’ social awareness of new ways to use the body. Purpose: We investigated cleaners’ experiences with a one-year health promotion intervention...... involving group-based physical coordination training (PCT) during working hours. Design: We conducted a qualitative evaluation using method triangulation; continuous unfocused participant observation during the whole intervention, semi-structured focus group interview, and individual written evaluations one...... for implementation seem to be important for sustained effects of health-promotion interventions in the workplace. Originality: The social character of the physical training facilitated a community of practice, which potentially supported the learning of new competencies, and how to improve the organization...

  4. Engineering students' experiences from physics group work in learning labs

    Science.gov (United States)

    Strøm Mellingsæter, Magnus

    2014-01-01

    Background: This paper presents a case study from a physics course at a Norwegian university college, investigating key aspects of a group-work project, so-called learning labs, from the participating students' perspective. Purpose: In order to develop these learning labs further, the students' perspective is important. Which aspects are essential for how the students experience the learning labs, and how do these aspects relate to the emergence of occurrences termed joint workspace, i.e. the maintenance of content-related dialogues within the group? Programme description: First year mechanical engineering students attended the learning labs as a compulsory part of the physics course. The student groups were instructed to solve physics problems using the interactive whiteboard and then submit their work as whiteboard files. Sample: One group of five male students was followed during their work in these learning labs through one term. Design and methods: Data were collected as video recordings and fieldwork observation. In this paper, a focus group interview with the students was the main source of analysis. The interpretations of the interview data were compared with the video material and the fieldwork observations. Results: The results show that the students' overall experience with the learning labs was positive. They did, however, point to internal aspects of conflicting common and personal goals, which led to a group-work dynamics that seemed to inhibit elaborate discussions and collaboration. The students also pointed to external aspects, such as a close temporal proximity between lectures and exercises, which also seemed to inhibit occurrences termed joint workspace. Conclusions: In order to increase the likelihood of a joint workspace throughout the term in the learning labs, careful considerations have to be made with regard to timing between lectures and exercises, but also with regard to raising the students' awareness about shared and personal goals.

  5. The Cuban Institute of Oncology and Radiobiology experience on the beliefs and opinions about digital rectal exam in urological patients

    Directory of Open Access Journals (Sweden)

    Isabel García Figueredo

    2016-07-01

    Full Text Available Resumen OBJETIVO Describir las creencias, los conocimientos y opiniones sobre el examen dígito rectal en un grupo de pacientes urológicos. MÉTODOS Se desarrolló un estudio descriptivo transversal donde se evaluó un cuestionario anónimo con 15 preguntas, dividido en tres bloques: 1 variables socio-demográficas; 2 retraso en ir a la consulta de urología y su inconformidad con la práctica del examen dígito rectal; 3 percepción de dolor y malestar durante el examen dígito rectal. El cuestionario fue aplicado a una muestra de conveniencia. RESULTADOS Se analizaron 84 encuestas aplicadas en el Instituto de Oncología y Radiobiología de Cuba. Los resultados mostraron que 70,24% de los participantes conocían en cierta medida sobre el cáncer de próstata y 64,29%, sobre el uso del antígeno prostático específico. Sólo 27% encontró útil realizarse el examen digito rectal. Los mayores impedimentos para asistir a la consulta del urólogo fueron: no someterse a una biopsia (79,76% y evadir la práctica del examen dígito rectal (66,66%. Además, se observó que 52,39% y 36,90% de los hombres se quejaron de dolor moderado y severo respectivamente, siendo traumático el examen dígito rectal en 61,9%. Sin embargo, 88,09% de los pacientes respondió que repetirían el examen al siguiente año y el 94,05% animaría a un amigo para someterse al él. CONCLUSIONES En la muestra de individuos estudiados, más de la mitad afirmó conocer sobre el cáncer de próstata y el antígeno prostático específico, sin embargo, no consideró provechoso someterse a un examen dígito rectal. Evitar someterse a una biopsia o al examen dígito rectal fueron los principales impedimentos para su asistencia al urólogo. A pesar de que en la mayoría de los pacientes, realizarse el examen dígito rectal fue traumático, estos consintieron en repetírselo en el futuro.

  6. Contribution of the pivot nurse in oncology to the experience of receiving a diagnosis of cancer by the patient and their loved ones.

    Science.gov (United States)

    Leboeuf, Irène; Lachapelle, Dominique; Dubois, Sylvie; Genest, Catherine

    2014-01-01

    The announcement of a cancer diagnosis represents a difficult situation for the patient, their loved ones and professionals (Reich, Vennin & Belkacémie, 2008). Until now, few studies have described nurses' contribution to this critical moment along the care trajectory (Tobin, 2012) and even fewer, the contribution of the pivot nurse in oncology (OPN) or infirmière pivot en oncologie (PNO) as this specialist is called in Quebec. This study aims to document the OPN's contribution to the cancer experience of the patient and their loved ones, from the time the diagnosis is communicated to the period immediately following (four to six weeks). Fourteen PNOs from a Montreal university health centre took part in two individual interviews. Results show that PNOs offer personalized support which draws on their expertise to better understand the experience lived by patients and their loved ones, and adapt their interventions according to their needs and the timing of these interventions. These results support issuing three recommendations for nursing practice in the areas of PNOs; development of expertise, interprofessional collaboration and environment.

  7. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn

    2016-01-01

    AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has...... advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. CONCLUSION: The establishment of DNOR has optimized the quality...

  8. Intention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures: Single-Institutional Experience in Hungary.

    Science.gov (United States)

    Póka, Robert; Molnár, Szabolcs; Daragó, Péter; Lukács, János; Lampé, Rudolf; Krasznai, Zoárd; Hernádi, Zoltán

    2017-09-01

    The aim of our study was to evaluate clinical and pathological data in order to draw eligibility criteria for oncologically sufficient radical trachelectomy (RT) in early-stage cervical cancer. Reviewing all cases of attempted RT performed at our unit, we focused attention on prognostic indicators of the need for additional oncologic treatment following RT. The analysis was extended by extensive literature review to include previously published cases of oncologic failures. The authors retrospectively analyzed data of patients who underwent RT at the Department of Obstetrics and Gynecology, University of Debrecen. Electronic records and case notes of RT cases were reviewed to determine the incidence of abdominal and vaginal route, distribution of clinicopathologic data, and follow-up results of individual cases. Individual procedures were categorized as oncologically insufficient if additional oncologic treatment was necessary following RT. Theoretical eligibility criteria for RT in early-stage cervical cancer were determined retrospectively by selecting prognostic features that were associated with oncologic insufficiency from clinicopathologic indicators of the complete series. Twenty-four cases of RT were performed by the authors, 15 vaginal RTs with laparoscopic pelvic lymphadenectomy and 9 abdominal RTs with open pelvic lymphadenectomy. Fifteen of 24 cases proved oncologically sufficient. Three cases required immediate conversion to radical hysterectomy because of positive sentinel nodes and/or positive isthmic disc on frozen section. In further 5 cases, final pathology results indicated additional oncologic treatment, that is, radical hysterectomy (n = 2), chemoradiotherapy (n = 2), or chemotherapy (n = 1). One patient among immediately converted cases and another 3 among those who required additional oncologic treatment died of their disease later. There were no other cases of recurrences over a median follow-up of 34 months (range, 12-188 months). Factors

  9. Making music in a group: synchronization and shared experience.

    Science.gov (United States)

    Overy, Katie

    2012-04-01

    To consider the full impact of musical learning on the brain, it is important to study the nature of everyday, non-expert forms of musical behavior alongside expert instrumental training. Such informal forms of music making tend to include social interaction, synchronization, body movements, and positive shared experiences. Here, I propose that when designing music intervention programs for scientific purposes, such features may have advantages over instrumental training, depending on the specific research aims, contexts, and measures. With reference to a selection of classroom approaches to music education and to the shared affective motion experience (SAME) model of emotional responses to music, I conclude that group learning may be particularly valuable in music pedagogy.

  10. Complementary and alternative medicine in oncology nursing.

    Science.gov (United States)

    Somani, Salima; Ali, Fauziya; Saeed Ali, Tazeen; Sulaiman Lalani, Nasreen

    Use of complementary and alternative medicine (CAM) has increased globally, particularly among oncology patients. This study investigated the knowledge, experience and attitudes of oncology nurses towards CAM. A quantitative study was conducted in tertiary care hospitals in Karachi, Pakistan, where 132 oncology nurses were surveyed. The survey revealed that more than 50% of nurses had never heard about many of the CAM therapies used in Pakistan. Approximately 65% of the nurses had knowledge about prayer and less than 30% had experience of CAM education or training. In addition, the majority of nurses had seen patients using CAM and felt that their health status could be enhanced with the use of CAM. This study showed that oncology nurses had a positive experience of and attitude towards CAM, although they needed to enhance their knowledge of it to maximise patient satisfaction and quality of care.

  11. Working Group 5: Measurements technology and active experiments

    Science.gov (United States)

    Whipple, E.; Barfield, J. N.; Faelthammar, C.-G.; Feynman, J.; Quinn, J. N.; Roberts, W.; Stone, N.; Taylor, W. L.

    1986-01-01

    Technology issues identified by working groups 5 are listed. (1) New instruments are needed to upgrade the ability to measure plasma properties in space. (2) Facilities should be developed for conducting a broad range of plasma experiments in space. (3) The ability to predict plasma weather within magnetospheres should be improved and a capability to modify plasma weather developed. (4) Methods of control of plasma spacecraft and spacecraft plasma interference should be upgraded. (5) The space station laboratory facilities should be designed with attention to problems of flexibility to allow for future growth. These issues are discussed.

  12. Global Manufacturing Research: Experience Exchange Group (EEG) contributions

    DEFF Research Database (Denmark)

    Bruun, Peter

    1998-01-01

    The intention of this paper is to clarify if and how an ExperienceExchange Group (EEG) can be involved in a research process in the areaof industrial management. For exemplification of the topic an ongoingresearch in global manufacturing is referred to. In this research itwas after a series...... activities aredescribed and a tentative coupling to the phases in a research processis proposed. Following this is a discussion of methodological andquality requirements. It is considered how EEG activities couldpossible contribute to an industrial rooted research. The paper endsup looking at future research...

  13. [Leadership Experience of Clinical Nurses: Applying Focus Group Interviews].

    Science.gov (United States)

    Lee, Byoung Sook; Eo, Yong Sook; Lee, Mi Aie

    2015-10-01

    The purpose of this study was to understand and describe the leadership experience of clinical nurses. During 2014, data were collected using focus group interviews. Three focus group interviews were held with a total of 20 clinical nurses participating. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Fifteen categories emerged from the five main themes. 1) Thoughts on the leadership category: to lead others, to cope with problem situations adequately and to serve as a shield against difficulties. 2) Situations requiring leadership: situation that requires correct judgement, coping and situations that need coordination and cooperation. 3-1) Leadership behaviors: other-oriented approach and self-oriented approach. 3-2) Leadership behavior consequences: relevant compensation and unfair termination. 4-1) Facilitators of leadership: confidence and passion for nursing and external support and resources. 4-2) Barriers to leadership: non-supportive organization culture and deficiency in own leadership competencies. 5) Strategies of leadership development: strengthen leadership through self-development and organizational leadership development. In conclusion, the results indicate that it is necessary to enhance clinical nurses' leadership role in healthcare. Enhancement can be achieved through leadership programs focused on enlarging leadership experience, constant self-development, leadership training, and development of leadership competencies suited to the nursing environment.

  14. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences

    OpenAIRE

    de Vries Martine C; Houtlosser Mirjam; Wit Jan M; Engberts Dirk P; Bresters Dorine; Kaspers Gertjan JL; van Leeuwen Evert

    2011-01-01

    Abstract Background Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences of the unprecedented integration of research and care in pediatric oncology from the perspective of parents and physicians. Methodology An empirical ethical approach, combining (1) a narrati...

  15. Outcomes of Robotic Radical Prostatectomy in High-risk Prostate Cancer Patients: Experience in 60 Patients with Oncological and Functional Outcomes

    Directory of Open Access Journals (Sweden)

    Abdullah Erdem Canda

    2015-06-01

    Full Text Available Introduction: In this retrospective study, we report outcomes of robot-assisted laparoscopic radical prostatectomy (RARP in high-risk prostate cancer (HRPC, classified according to the D’Amico risk criteria and with a minimum follow-up of 1 year. Methods: A total of 60 patients who had at least one preoperative HRPC feature and underwent RARP were included. Mean patient age and preoperative serum prostate-specific antigen level were 66.4±7.5 years and 13.4±11.0 ng/ml, respectively. Preoperatively, 3 (5.0%, 4 (6.7%, 17 (28.3%, 3 (5.0%, and 33 (55.0% patients had prostate biopsy-proven Gleason scores of 5+4, 4+5, 4+4, 3+5, and 2 pads/day. Of the 27 patients with no preoperative erectile dysfunction (ED, 17 (63.0% had no ED at a mean follow-up of 1 year. Trifecta and pentafecta rates were 43.2% and 28.7%, respectively. Conclusion: Based on our experience, RARP in HRPC is a relatively safe procedure with satisfactory oncological and functional outcomes.

  16. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    OpenAIRE

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background. Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to sur...

  17. Cultural immersion through ethnography: the lived experience and group process.

    Science.gov (United States)

    Brennan, Sandra J; Schulze, Mary W

    2004-06-01

    A baccalaureate nursing class studying community/public health is a rich setting in which to initiate change in ethnocentric perspectives and foster an understanding of diverse cultures. This teaching strategy requires students to randomly select one of seven ethnographies to read, and then to write an analysis based on required guidelines. The results of the ethnographic analyses show that students immerse themselves within the culture of their respective texts. Ultimately, in-class learning groups are formed for each ethnography, and participants discuss their respective analyses. After exploring their commonalities and differences, students present the results to the entire class. This activity affords everyone a multicultural experience by sharing the different ethnographies and each student's perspective. This critical thinking activity serves to awaken one's ethnocentricity and paves the way to insightful changes and beliefs about diverse cultures.

  18. Men's Experiences of Living With Osteoporosis: Focus Group Interviews

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Brixen, Kim; Huniche, Lotte

    2011-01-01

    that resonated with the social construction of hegemonic masculinity as displayed through the men's fear of weakness and endurance through physical activity, as well as identity construction through active decision making in relation to health. Understanding and implementation of these issues is necessary......Osteoporotic fractures in men are an increasing public health problem. Male osteoporosis is often a low-prioritized issue, however. To examine men's experiences with osteoporosis and how they handle osteoporosis in their everyday lives, the authors collected data from four focus groups with a total...... of 16 men aged 51 to 82 years diagnosed with osteoporosis. Critical psychology was used as a theoretical framework for the data analysis, which aimed to elicit information about the men's daily lives. The men handled osteoporosis in different ways using different strategies. The authors found patterns...

  19. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

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

  20. Group Work Experiences: Domestic MBA Student Experiences and Outcomes when Working with International Students

    Science.gov (United States)

    Rafferty, Patricia D.

    2013-01-01

    This article forms part of an exploration into the results of a single-case, embedded study that was conducted to explore how domestic part-time graduate business students in the United States experience group work for summative assessment. Multiple information collection methods were utilised, including open-ended and semi-structured interviews,…

  1. Creating beauty: the experience of a fashion collection prepared by adolescent patients at a pediatric oncology unit.

    Science.gov (United States)

    Veneroni, Laura; Clerici, Carlo Alfredo; Proserpio, Tullio; Magni, Chiara; Sironi, Giovanna; Chiaravalli, Stefano; Roncari, Luisa; Casanova, Michela; Gandola, Lorenza; Massimino, Maura; Ferrari, Andrea

    2015-01-01

    Adolescent patients with cancer need psychological support in order to face the traumatic event of cancer diagnosis and to preserve continuity with their normal lives. Creative projects or laboratories may help young patients express their thoughts and feelings. The Youth Project developed activities dedicated to adolescents to give them a chance to vent their creative spirit and express themselves freely. In the first project, the teenagers designed their own fashion collection in all its various stages under the artistic direction of a well-known fashion designer, creating their own brand name (B.Live), and organized a fashion show. In all, 24 patients from 15 to 20 years old took part in the project. The fashion project proved a fundamental resource in helping the young patients involved to regain a positive self-image and the feeling that they could take action, both on themselves and in their relations with others. Facilitating the experience of beauty may enable hope to withstand the anguish caused by disease. This experience integrated the usual forms of psychological support to offer patients a form of expression and support during the course of their treatment.

  2. Implantable port devices are catheters of choice for administration of chemotherapy in pediatric oncology patients-a clinical experience in Pakistan.

    Science.gov (United States)

    Hooda, Barkat; Lalani, Gulrose; Fadoo, Zehra; Billoo, Ghaffar

    2008-09-01

    Phlebitis and cellulitis are commonly encountered problems in oncology patients receiving chemotherapy through peripherally inserted intravenous catheters. Use of central venous access devices (CVAD) is desirable. We have seen a steady increase in the use of CVADs in our oncology service with frequent use of indwelling ports, particularly during the last 2 years. In this study we have attempted to elucidate advantages of CVAD and compared them to peripheral catheters. This is a retrospective study with chart review of all oncology patients admitted in our oncology service at the Aga Khan University Hospital from March 2003 to March 2005. A survey was also conducted from a randomly selected sample of parents of children with cancer to elicit parental views regarding their choice of a particular catheter. Catheter-related infections were quite common (over 50%) in patients with peripheral lines, resulting in increased costs and prolonged hospitalization. Externalized CVADs were found difficult to care for, carried a risk of being accidentally pulled out or punctured, and were deemed undesirable for older female patients for cosmetic reasons. We found that the internalized CVADs (portacath) were superior to the externalized or peripheral lines and resulted in better patient and family satisfaction. Use of peripheral lines must be gradually phased out of pediatric oncology practice in Pakistan. Indwelling CVADs have become the standard of care internationally and should be considered for most patients in developing countries whenever resources are available.

  3. Glycemic modulation in neuro-oncology: experience and future directions using a modified Atkins diet for high-grade brain tumors.

    Science.gov (United States)

    Strowd, Roy E; Cervenka, Mackenzie C; Henry, Bobbie J; Kossoff, Eric H; Hartman, Adam L; Blakeley, Jaishri O

    2015-09-01

    Dietary glycemic modulation through high-fat, low-carbohydrate diets, which induce a state of systemic ketosis and alter systemic metabolic signaling, have been incorporated into the clinical management of patients with neurological disease for more than a century. Mounting preclinical evidence supports the antitumor, proapoptotic, and antiangiogenic effects of disrupting glycolytic metabolism through dietary intervention. In recent years, interest in incorporating such novel therapeutic strategies in neuro-oncology has increased. To date, 3 published studies incorporating novel dietary therapies in oncology have been reported, including one phase I study in neuro-oncology, and have set the stage for further study in this field. In this article, we review the biochemical pathways, preclinical data, and early clinical translation of dietary interventions that modulate systemic glycolytic metabolism in the management of primary malignant brain tumors. We introduce the modified Atkins diet (MAD), a novel dietary alternative to the classic ketogenic diet, and discuss the critical issues facing future study.

  4. Glycemic modulation in neuro-oncology: experience and future directions using a modified Atkins diet for high-grade brain tumors

    Science.gov (United States)

    Strowd, Roy E.; Cervenka, Mackenzie C.; Henry, Bobbie J.; Kossoff, Eric H.; Hartman, Adam L.; Blakeley, Jaishri O.

    2015-01-01

    Dietary glycemic modulation through high-fat, low-carbohydrate diets, which induce a state of systemic ketosis and alter systemic metabolic signaling, have been incorporated into the clinical management of patients with neurological disease for more than a century. Mounting preclinical evidence supports the antitumor, proapoptotic, and antiangiogenic effects of disrupting glycolytic metabolism through dietary intervention. In recent years, interest in incorporating such novel therapeutic strategies in neuro-oncology has increased. To date, 3 published studies incorporating novel dietary therapies in oncology have been reported, including one phase I study in neuro-oncology, and have set the stage for further study in this field. In this article, we review the biochemical pathways, preclinical data, and early clinical translation of dietary interventions that modulate systemic glycolytic metabolism in the management of primary malignant brain tumors. We introduce the modified Atkins diet (MAD), a novel dietary alternative to the classic ketogenic diet, and discuss the critical issues facing future study. PMID:26649186

  5. Predictive and Prognostic Implications of Variant Philadelphia Translocations in CML: Experience From a Tertiary Oncology Center in Southern India.

    Science.gov (United States)

    Kanakasetty, Govind Babu; Kuntejowdahalli, Lakshmaiah; Thanky, Aditi Harsh; Dasappa, Lokanatha; Jacob, Linu Abraham; Mallekavu, Suresh Babu; Kumari, Prasanna

    2017-01-01

    Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by Philadelphia (Ph) chromosome with classical t(9;22)(q34;q11) seen in up to 90% of cases. However 5% to 10% of patients who present with variant Ph translocations (vPh) have been an area of research for their significance in predicting response to various therapies including tyrosine kinase inhibitors as well as prognosticating survival outcomes for many years involving varied patient populations, with conflicting results. We retrospectively analyzed our data from January 2002 to December 2014. Patients with vPh in chronic phase of CML (CML-CP) were analyzed with respect to their demographic parameters, response to imatinib therapy, and survival and their data were compared with data of patients with classical Ph translocation (cPh). Of 615 patients diagnosed with CML-CP, 72 patients (11.7%) showed vPh. Most common chromosomes involved in these translocations were 14 (13.9%), 11 (12.5%), 19 (9.7%), and 7 (8.3%). Rates of complete hematological response, complete cytogenetic response, and major molecular response were not statistically different between the groups. At 5 years, event-free survival, failure-free survival, progression-free survival, and overall survival were 60% versus 67.9%, 62.7% versus 69.7%, 84.7% versus 92.1%, and 87.5% versus 92.4%, respectively, in vPh and cPh. The differences in survival were statistically not significant. To our knowledge, this is the largest series of variant translocations in CML-CP, pertaining to the Indian population. Our data suggest that the presence of vPh in CML has no significant effect in predicting response to imatinib as well as in prognosticating survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Pregnancy and Parenthood in Radiation Oncology, Views and Experiences Survey (PROVES): Results of a Blinded Prospective Trainee Parenting and Career Development Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ahmed, Awad A. [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Stentz, Natalie Clark [Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Woodward, Wendy A.; Fuller, Clifton D. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Thomas, Charles R., E-mail: thomasch@ohsu.edu [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)

    2015-07-01

    Purpose: Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. Methods and Materials: An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. Results: A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; P<.001), had a PhD (33% vs 19.3%, respectively; P=.033), were married (99% vs 43%, respectively; P<.001), and had a partner who did not work (24.7% vs 1.9%, respectively; <.001). There were no differences in the number of manuscripts published or the number of residents who expressed likelihood of pursing an academic career by parental status. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; P<.001) and reported that their partner performed a greater percentage of childcare duties (70% [IQR: 60%-80%] vs 35% [IQR: 20%-50%], respectively; P<.001). Conclusions: Pregnancy and parenthood are common during residency. Female residents are frequently responsible for more childcare duties than males

  7. The "Common Solutions" Strategy of the Experiment Support group at CERN for the LHC Experiments

    CERN Document Server

    Girone, M; Barreiro Megino, F H; Campana, S; Cinquilli, M; Di Girolamo, A; Dimou, M; Giordano, D; Karavakis, E; Kenyon, M J; Kokozkiewicz, L; Lanciotti, E; Litmaath, M; Magini, N; Negri, G; Roiser, S; Saiz, P; Saiz Santos, M D; Schovancova, J; Sciabà, A; Spiga, D; Trentadue, R; Tuckett, D; Valassi, A; Van der Ster, D C; Shiers, J D

    2012-01-01

    After two years of LHC data taking, processing and analysis and with numerous changes in computing technology, a number of aspects of the experiments' computing, as well as WLCG deployment and operations, need to evolve. As part of the activities of the Experiment Support group in CERN's IT department, and reinforced by effort from the EGI-InSPIRE project, we present work aimed at common solutions across all LHC experiments. Such solutions allow us not only to optimize development manpower but also offer lower long-term maintenance and support costs. The main areas cover Distributed Data Management, Data Analysis, Monitoring and the LCG Persistency Framework. Specific tools have been developed including the HammerCloud framework, automated services for data placement, data cleaning and data integrity (such as the data popularity service for CMS, the common Victor cleaning agent for ATLAS and CMS and tools for catalogue/storage consistency), the Dashboard Monitoring framework (job monitoring, data management m...

  8. Exploring resilience in paediatric oncology nursing staff.

    Science.gov (United States)

    Zander, Melissa; Hutton, Alison; King, Lindy

    2013-01-01

    Resilience has been suggested as an important coping strategy for nurses working in demanding settings, such as paediatric oncology. This qualitative study explored paediatric oncology nurses' perceptions of their development of resilience and how this resilience underpinned their ability to deal with work-related stressors. Five paediatric oncology nurses were interviewed about their understanding of the concept of resilience, their preferred coping mechanisms, and their day-today work in paediatric oncology. Using thematic analysis, the interviews were subsequently grouped together into seventeen initial themes. These themes were then grouped into seven major aspects that described how the participants perceived resilience underpinned their work. These "seven aspects of forming resilience" contributed to an initial understanding of how paediatric oncology nurses develop resilience in the face of their personal and professional challenges. Several key strategies derived from the findings, such as improved rostering, support to a nurse's friend and family, and a clinical support nursing role, could be implemented at an organizational level to support resilience development within the paediatric oncology setting.

  9. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    Science.gov (United States)

    Vogel, Wendy H

    2016-01-01

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

  10. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences.

    NARCIS (Netherlands)

    Vries, M.C. de; Houtlosser, M.; Wit, J.M.; Engberts, D.P.; Bresters, D.; Kaspers, G.J.L.; Leeuwen, E. van

    2011-01-01

    BACKGROUND: Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences o

  11. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences.

    NARCIS (Netherlands)

    Vries, M.C. de; Houtlosser, M.; Wit, J.M.; Engberts, D.P.; Bresters, D.; Kaspers, G.J.L.; Leeuwen, E. van

    2011-01-01

    BACKGROUND: Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences

  12. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences.

    NARCIS (Netherlands)

    Vries, M.C. de; Houtlosser, M.; Wit, J.M.; Engberts, D.P.; Bresters, D.; Kaspers, G.J.L.; Leeuwen, E. van

    2011-01-01

    BACKGROUND: Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences o

  13. Why Do Militant Groups Experience Intra-organizational Conflict

    Science.gov (United States)

    2016-12-01

    makers supporting a counterinsurgency effort may find it advantageous to increase such internal conflict to make groups less effective.1 A group...of divided leadership. Some advantages could include the ability of the divided group to target and attract different segments of the population, to...that identifies itself as a movement to fight against unfair oppression of a minority group might have a difficult time justifying its own autocratic

  14. Facilitating Group Cohesion among Adolescents through Challenge Course Experiences.

    Science.gov (United States)

    Glass, J. Scott; Benshoff, James M.

    2002-01-01

    A study examined the effects of participation in a low-element challenge course on younger adolescents' perceptions of group cohesion. Pre- and post-tests of group cohesion were administered to 167 North Carolina adolescents aged 11-14. Participants perceived an increase in group cohesion after the daylong program, regardless of their age, race,…

  15. Helen Hudson Lecture. Positive practice change using appreciative inquiry in oncology primary care nursing.

    Science.gov (United States)

    Campbell, Colleen P

    2013-01-01

    Ambulatory oncology nurses struggle to meet the increasing demands placed on them. Increased volume of patients, more complex treatments and symptom management, an older population with multiple co-morbidities combined with fiscal and human resource restraints has created job dissatisfaction and the feeling of powerlessness in the current environment. The Appreciative Inquiry process enables nurses to become engaged in planning and creating positive change based on their knowledge, experiences and clinical expertise, as oncology professionals. Through surveys and group work, nurses in this project were able to turn theory into positive practice change, inspiring a new paradigm of primary oncology nursing. Through the promotion of innovation, we have inspired hope while advocating for our profession.

  16. Group work as an incentive for learning – students’ experiences of group work

    OpenAIRE

    Hammar Chiriac, Eva

    2014-01-01

    Group work is used as a means for learning at all levels in educational systems. There is strong scientific support for the benefits of having students learning and working in groups. Nevertheless, studies about what occurs in groups during group work and which factors actually influence the students’ ability to learn is still lacking. Similarly, the question of why some group work is successful and other group work results in the opposite is still unsolved. The aim of this article is to add ...

  17. Identifying oncological emergencies.

    Science.gov (United States)

    Guddati, Achuta K; Kumar, Nilay; Segon, Ankur; Joy, Parijat S; Marak, Creticus P; Kumar, Gagan

    2013-01-01

    Prompt identification and treatment of life-threatening oncological conditions is of utmost importance and should always be included in the differential diagnosis. Oncological emergencies can have a myriad of presentations ranging from mechanical obstruction due to tumor growth to metabolic conditions due to abnormal secretions from the tumor. Notably, hematologic and infectious conditions may complicate the presentation of oncological emergencies. Advanced testing and imaging is generally required to recognize these serious presentations of common malignancies. Early diagnosis and treatment of these conditions can significantly affect the patient's clinical outcome.

  18. Current experiments in particle physics - particle data group

    Energy Technology Data Exchange (ETDEWEB)

    Galic, H. [Stanford Univ., CA (United States). Stanford Linear Accelerator Center; Lehar, F. [Centre d`Etudes Nucleaires de Saclay, Gif-sur-Yvette (France); Kettle, P.R. [Paul Scherrer Institute, Villigen (Switzerland)] [and others

    1996-09-01

    This report contains summaries of current and recent experiments in Particle Physics. Included are experiments at BEPC (Beijing), BNL, CEBAF, CERN, CESR, DESY, FNAL, Frascati, ITEP (Moscow), JINR (Dubna), KEK, LAMPF, Novosibirsk, PNPI (St. Petersburg), PSI, Saclay, Serpukhov, SLAC, and TRIUMF, and also several proton decay and solar neutrino experiments. Excluded are experiments that finished taking data before 1991. Instructions are given for the World Wide Web (WWW) searching of the computer database (maintained under the SLAC-SPIRES system) that contains the summaries.

  19. Orthodontic treatment in oncological patients.

    Science.gov (United States)

    Mituś-Kenig, Maria; Łoboda, Magdalena; Marcinkowska-Mituś, Agata; Durka-Zajac, Magdalena; Pawłowska, Elzbieta

    2015-01-01

    The progress in oncological treatment has led to the current increase of childhood cancer survival rate to 80%. That is why orthodontists more and more frequently consult patients who had completed a successful anti-cancer therapy in childhood. Oncological treatments such as chemotherapy, radiotherapy or supportive immunosuppressive therapy cause numerous side effects in growing patients, connected i.a. with growth, the development of teeth or the viscerocranium. This is a special group of patients that needs an optimised plan of orthodontic treatment and often has to accept a compromise result. The purpose of the current work is to discuss the results of orthodontic treatment in patients after an anti-cancer therapy. Time of treatment was 12,5 months. In 6 patients (from 40 undergoing orthodontic therapy) we haven't reached a normocclusion, in 9 patients we should have stopped the therapy because of the recurrence. In 11 patients we found mucosa inflammation and in 1 patient the therapy stopped before the end because of very low oral hygiene level. Bearing in mind the limited number of original works on the above topic in Polish medical literature, the study has been carried out in order to make Polish orthodontists more acquainted with the topic and the standards of dealing with an oncological patient.

  20. Une experience d'auto-enseignement de groupe (An Experiment in Group Self-Instruction). Melanges pedagogiques.

    Science.gov (United States)

    Riley, P.; Sicre, M.

    The principles and organization of a group learning scheme involving 100 members of the Universite du Troisieme Age are described. The particular group of interest here was involved in a conversational course in English. The average age of the group was 59 and generally the educational level was the baccalaureate. In this form of learning, the…

  1. Diagnosis and management of acquired aplastic anemia in childhood. Guidelines from the Marrow Failure Study Group of the Pediatric Haemato-Oncology Italian Association (AIEOP).

    Science.gov (United States)

    Barone, Angelica; Lucarelli, Annunziata; Onofrillo, Daniela; Verzegnassi, Federico; Bonanomi, Sonia; Cesaro, Simone; Fioredda, Francesca; Iori, Anna Paola; Ladogana, Saverio; Locasciulli, Anna; Longoni, Daniela; Lanciotti, Marina; Macaluso, Alessandra; Mandaglio, Rosalba; Marra, Nicoletta; Martire, Baldo; Maruzzi, Matteo; Menna, Giuseppe; Notarangelo, Lucia Dora; Palazzi, Giovanni; Pillon, Marta; Ramenghi, Ugo; Russo, Giovanna; Svahn, Johanna; Timeus, Fabio; Tucci, Fabio; Cugno, Chiara; Zecca, Marco; Farruggia, Piero; Dufour, Carlo; Saracco, Paola

    2015-06-01

    Acquired aplastic anemia (AA) is a rare heterogeneous disease characterized by pancytopenia and hypoplastic bone marrow. The incidence is 2-3/million inhabitants/year, in Europe, but higher in East Asia. Survival in severe aplastic anemia (SAA) has markedly improved in the past 2 decades because of advances in hematopoietic stem cell transplantation, immunosuppressive and biologic drugs, and supportive care. In SAA hematopoietic stem cell transplant (HSCT) from a matched sibling donor (MSD) is the treatment of choice. If a MSD is not available, the options include immunosuppressive therapy (IST) or unrelated donor HSCT. The objective of this guideline is to provide healthcare professionals with clear guidance on the diagnosis and management of pediatric patients with AA. A preliminary, evidence-based document issued by a group of pediatric hematologists was discussed, modified and approved during a series of "Consensus Conferences" according to procedures previously validated by the AIEOP Board. The guidelines highlight the importance of referring pediatric patients with AA to pediatric centers with long experience in diagnosis, differential diagnosis, management, supportive care and follow-up of AA.

  2. Republication of "Why Some Groups Fail: A Survey of Students' Experiences with Learning Groups"

    Science.gov (United States)

    Fiechtner, Susan Brown; Davis, Elaine Actis

    2016-01-01

    The issue of group learning has become an even greater concern in recent years as more college and university professors have begun to incorporate specific group assignments (i.e., assignments which require that students meet as a group and equally contribute to a final product) into their class requirements. The purpose of the present descriptive…

  3. Exercise-Based Oncology Rehabilitation: Leveraging the Cardiac Rehabilitation Model

    Science.gov (United States)

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

    2014-01-01

    PURPOSE The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose is to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a cardiac rehabilitation model. METHODS We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. RESULTS Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current cardiac rehabilitation models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. CONCLUSIONS Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors. PMID:25407596

  4. Decreasing the Inattentive Behavior of Jordanian Children: A Group Experiment

    Science.gov (United States)

    Zaghlawan, Hasan Y.; Ostrosky, Michaelene M.; Al-Khateeb, Jamal M.

    2007-01-01

    The present study investigated the efficacy of using response cost paired with Differential Reinforcement of Incompatible Behavior (DRI) to manage the inattentive behavior of 30 students attending third and fourth grade in Jordan. A pretest-posttest control group design was employed to evaluate the efficacy of response cost and DRI. Results showed…

  5. A Group of Nurses Experience Open Learning: Exploring the Impact.

    Science.gov (United States)

    Dearnley, Chris; Matthew, Bob

    2000-01-01

    This exploration of an open learning course in the United Kingdom, and its impact on a group of nurses seeking to update their education, identifies motivation as a key factor. Discusses outcomes including changing attitudes, further study intentions, and general life events and compares them to characteristics of lifelong learners. (Contains 37…

  6. Engineering Students' Experiences from Physics Group Work in Learning Labs

    Science.gov (United States)

    Mellingsaeter, Magnus Strøm

    2014-01-01

    Background: This paper presents a case study from a physics course at a Norwegian university college, investigating key aspects of a group-work project, so-called learning labs, from the participating students' perspective. Purpose: In order to develop these learning labs further, the students' perspective is important. Which aspects are essential…

  7. Cleaners' experiences with group-based workplace physical training

    DEFF Research Database (Denmark)

    Kirkelund, Lasse; Mortensen, Ole Steen; Holtermann, Andreas

    2012-01-01

    month post-intervention. We analyzed interview data using Systematic Text Condensation. Findings: Participants learned to use their bodies in new ways. Group training permitted social breaks from work, enforcing colleague unity. Participants did not perceive training as stressful, although working...... for implementation seem to be important for sustained effects of health-promotion interventions in the workplace. Originality: The social character of the physical training facilitated a community of practice, which potentially supported the learning of new competencies, and how to improve the organization...

  8. Late xerostomia after intensity-modulated conformational radiotherapy of upper aero-digestive tract cancers: study 2004-03 by the head and neck oncology and radiotherapy Group (Gortec); Xerostomie tardive apres radiotherapie conformationnelle avec modulation d'intensite des cancers des voies aero-digestives superieures: etude 2004-03 du Groupe oncologie et radiotherapie de la tete et du cou (Gortec)

    Energy Technology Data Exchange (ETDEWEB)

    Toledano, I.; Lapeyre, M. [Centre Jean-Perrin, 63 - Clermont-Ferrand (France); Graff, P. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Serre, C. [Centre Val d' Aurelle, 34 - Montpellier (France); Bensadoun, R.J. [CHU La Miletrie, 86 - Poitiers (France); Bensadoun, R.J.; Ortholan, C. [Centre Antoine-Lacassagne, 06 - Nice (France); Calais, G. [CHU Bretonneau, 37 - Tours (France); Alfonsi, M. [Institut Sainte-Catherine, 84 - Avignon (France); Giraud, P. [Institut Curie, 75 - Paris (France); Hopital europeen Georges-Pompidou, 75 - Paris (France); Racadot, S. [Centre Leon-Berrard, 69 - Lyon (France)

    2010-10-15

    The authors report a retrospective assessment of late xerostomia according to the RTOG (Radiation Therapy Oncology Group) classification of the European Organization for Research and Treatment of Cancer (EORTC) among patients treated by intensity-modulated conformational radiotherapy (IMRT) and suffering from upper aero-digestive tract carcinomas of different stages. Some of these patients have bee operated, and some have been treated by chemotherapy. It appears that the IMRT results in a reduction of late xerostomia, and even in an absence of salivary toxicity. Short communication

  9. Instruction in medical ethics during clinical training for medical students. Report on experience in radio-oncology; Unterricht in Medizinethik im Rahmen der klinischen Ausbildung von Medizinstudenten. Ein Erfahrungsbericht aus der Radioonkologie

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, C. [Universitaet Regensburg (Germany). Klinik und Poliklinik fuer Strahlentherapie; Universitaetsklinikum, Klinik und Poliklinik fuer Strahlentherapie, Regensburg (Germany); Lenk, C. [Universitaet Goettingen (Germany). Abt. Ethik und Geschichte der Medizin; Koelbl, O. [Universitaet Regensburg (Germany). Klinik und Poliklinik fuer Strahlentherapie

    2006-12-15

    The article gives a review of the current state of education in medical ethics in Germany. The issue is considered from the viewpoint of radio-oncology. Both the pertinent literature and our own experience in teaching medical ethics are presented. In October 2003, medical ethics was integrated into the curriculum of medicine. The aim was to train competence in the field of personal attitudes and to intensify skills of moral reasoning. Our own experiences are positive, which is in accordance with the reports of other working groups. Most of the students were interested in education in medical ethics and looked upon ethical training as being an important part of their studies. Medical students are interested in ethical education during the clinical period of their studies, which has been taken into account since the actual change of the curriculum. Radio-oncologists as specialists in other clinical fields can offer important contributions when they discuss clinical cases from the viewpoint of medical ethics. The long-term effect of such an education will become the subject of future research. (orig.) Dieser Beitrag gibt aus dem Blickwinkel der Radioonkologie eine Uebersicht ueber den gegenwaertigen Stand der medizinethischen Ausbildung von Medizinstudenten in Deutschland. Es wird die Literatur zum Thema vorgestellt und eigene Erfahrungen aus dem Studentenunterricht auf der radioonkologischen Bettenstation beschrieben. Mit der Aenderung der Approbationsordnung vom Oktober 2003 wurde die Medizinethik als Fachgebiet erstmals in das Medizinstudium integriert. Damit sollen Kompetenzen im Bereich der eigenen Haltungen geschult und das Argumentieren auf der Grundlage analytisch gewonnener Ueberzeugungen vermittelt werden. Studenten sollen lernen, moegliche ethische Konflikte rational zu loesen. Die eigenen Erfahrungen mit der medizinethischen Ausbildung sind ueberwiegend positiv, was mit den Mitteilungen anderer Arbeitsgruppen uebereinstimmt. So stuften die meisten

  10. American Society for Radiation Oncology

    Science.gov (United States)

    ... for other cancer types View videos on radiation oncology Please Select an Action Read a news release ... This online career board is the premier radiation oncology recruitment tool, offering employers and job seekers an ...

  11. Present experiment of BASJE group at Mt. Chacaltaya

    Energy Technology Data Exchange (ETDEWEB)

    Yoshii, H.; Morizawa, A. [Ehime University, Dept. of Physics, Matsuyama, Ehime (Japan); Kakimoto, F.; Ogio, S.; Tsunesada, Y.; Tokunou, H.; Harada, D.; Burgoa, O. [Tokyo Institute of Technology, Dept. of Physics, Meguro, Tokyo (Japan); Tajima, N.; Yamada, Y.; Shimoda, S.; Nishi, K.; Nakatani, H.; Gotoh, E. [The Institute of Physics and Chemistry Research, Wako, Saitama (Japan); Shirasaki, Y. [National Space Development Agency of Japan, Tsukuba, Ibaraki (Japan); Miranda, P.; Velarde, A. [Instituto de Investigaciones en Informatica, Universidad Mayor de San Andres, La Paz (Bolivia); Kaneko, T. [Oayama University, Dept. of Physics, Okayama (Japan); Murakami, K. [Nagoya University of Foreign Studies, Nissin, Aichi (Japan); Toyoda, Y. [Fukui University of Technology, Faculty of General Education, Fukui (Japan); Matsubara, Y. [Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya, Aichi (Japan); Mizumoto, Y. [National Astronomical Observatory, Mitaka, Tokyo (Japan)

    2001-10-01

    A compact air shower array to observe primary cosmic rays above a few TeV has been installed at Mt. Chacaltaya in Bolivia since 1996. This array is available to observe the air showers above 6 TeV and the longitudinal development curves above 50 TeV. The purpose of the observations is to study the chemical composition and the energy spectrum of cosmic rays in the energy region including the knee of the energy spectrum. First, the consistency between direct measurements (balloon-borne experiments) and air shower observations in the energy region from 50 TeV to 80 TeV is examined and confirmed. Next, the chemical composition and the energy spectrum are derived from the air shower observations. In the study, the longitudinal developments of shower particles are calculated by Monte Carlo simulations, assuming different chemical compositions above 80 TeV. The characteristics of the present air shower array and the comparison of the preliminary observed results with that of the simulations are presented.

  12. Comparative oncology today.

    Science.gov (United States)

    Paoloni, Melissa C; Khanna, Chand

    2007-11-01

    The value of comparative oncology has been increasingly recognized in the field of cancer research, including the identification of cancer-associated genes; the study of environmental risk factors, tumor biology, and progression; and, perhaps most importantly, the evaluation of novel cancer therapeutics. The fruits of this effort are expected to be the creation of better and more specific drugs to benefit veterinary and human patients who have cancer. The state of the comparative oncology field is outlined in this article, with an emphasis on cancer in dogs.

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

    Science.gov (United States)

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

    2017-05-01

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

  14. A Phase 3 Trial of 2 Years of Androgen Suppression and Radiation Therapy With or Without Adjuvant Chemotherapy for High-Risk Prostate Cancer: Final Results of Radiation Therapy Oncology Group Phase 3 Randomized Trial NRG Oncology RTOG 9902

    Energy Technology Data Exchange (ETDEWEB)

    Rosenthal, Seth A., E-mail: rosents@sutterhealth.org [Radiation Oncology, Sutter Cancer Centers, Roseville, California (United States); Hunt, Daniel [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Sartor, A. Oliver [Tulane University Medical Center, New Orleans, Louisiana (United States); Pienta, Kenneth J. [Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Gomella, Leonard [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Grignon, David [Indiana University, Bloomington, Indiana (United States); Rajan, Raghu [McGill University, Montreal, Quebec (Canada); Kerlin, Kevin J. [Community Clinical Oncology Program, Southeast Cancer Control Consortium, Inc, Winston-Salem, North Carolina (United States); Jones, Christopher U. [Radiation Oncology, Sutter Cancer Centers, Roseville, California (United States); Radiological Associates of Sacramento, Sacramento, California (United States); Dobelbower, Michael [University of Alabama at Birmingham Medical Center, Birmingham, Alabama (United States); Shipley, William U. [Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Zeitzer, Kenneth [Albert Einstein Medical Center, Bronx, New York (United States); Hamstra, Daniel A. [University of Michigan Medical Center, Ann Arbor, Michigan (United States); Donavanik, Viroon [Christiana Care Health Services, Inc, Wilmington, Delaware (United States); Rotman, Marvin [State University of New York Health Science Center–Brooklyn, Brooklyn, New York (United States); Hartford, Alan C. [Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (United States); Michalski, Jeffrey [Washington University, St. Louis, Missouri (United States); Seider, Michael [Akron City Hospital, Akron, Ohio (United States); Kim, Harold [Wayne State University, Detroit, Michigan (United States); and others

    2015-10-01

    Purpose: Long-term (LT) androgen suppression (AS) with radiation therapy (RT) is a standard treatment of high-risk, localized prostate cancer (PCa). Radiation Therapy Oncology Group 9902 was a randomized trial testing the hypothesis that adjuvant combination chemotherapy (CT) with paclitaxel, estramustine, and oral etoposide plus LT AS plus RT would improve overall survival (OS). Methods and Materials: Patients with high-risk PCa (prostate-specific antigen 20-100 ng/mL and Gleason score [GS] ≥7 or clinical stage ≥T2 and GS ≥8) were randomized to RT and AS (AS + RT) alone or with adjuvant CT (AS + RT + CT). CT was given as four 21-day cycles, delivered beginning 28 days after 70.2 Gy of RT. AS was given as luteinizing hormone-releasing hormone for 24 months, beginning 2 months before RT plus an oral antiandrogen for 4 months before and during RT. The study was designed based on a 6% improvement in OS from 79% to 85% at 5 years, with 90% power and a 2-sided alpha of 0.05. Results: A total of 397 patients (380 eligible) were randomized. The patients had high-risk PCa, 68% with GS 8 to 10 and 34% T3 to T4 tumors, and median prostate-specific antigen of 22.6 ng/mL. The median follow-up period was 9.2 years. The trial closed early because of excess thromboembolic toxicity in the CT arm. The 10-year results for all randomized patients revealed no significant difference between the AS + RT and AS + RT + CT arms in OS (65% vs 63%; P=.81), biochemical failure (58% vs 54%; P=.82), local progression (11% vs 7%; P=.09), distant metastases (16% vs 14%; P=.42), or disease-free survival (22% vs 26%; P=.61). Conclusions: NRG Oncology RTOG 9902 showed no significant differences in OS, biochemical failure, local progression, distant metastases, or disease-free survival with the addition of adjuvant CT to LT AS + RT. The trial results provide valuable data regarding the natural history of high-risk PCa treated with LT AS + RT and have implications for

  15. A Brief Encounter Group Experience and Social Relationships in a Dormitory

    Science.gov (United States)

    Dies, Robert R.; Sadowsky, Richard

    1974-01-01

    The investigation examined the effects of a brief encounter group experience upon residents in a university dormitory. Women living on three separate floors were designated experimental subjects and provided with a group experience designed to encourage personal interaction, while women on two other floors were assigned to a control group. (Author)

  16. Anti-CD13 Abs in children with extensive chronic GVHD and their relation to soluble CD13 after allogeneic blood and marrow transplantation from a Children's Oncology Groups Study, ASCT0031.

    Science.gov (United States)

    Cuvelier, G D E; Kariminia, A; Fujii, H; Aslanian, S; Wall, D; Goldman, F; Grupp, S A; Dunn, S E; Krailo, M; Shapiro, L H; Gilman, A; Schultz, K R

    2010-11-01

    Our group previously demonstrated a strong association between elevated plasma soluble CD13 enzyme activity and newly diagnosed extensive chronic GVHD (cGVHD) in children. As cytotoxic anti-CD13 Abs have been documented after blood and marrow transplant (BMT) in association with CMV infection and cGVHD, we hypothesized that soluble CD13 contributes to cGVHD pathogenesis by induction of CD13 reactive Abs and that anti-CD13 Abs could be additional biomarkers for newly diagnosed pediatric extensive cGVHD. Using prospectively collected plasma samples from pediatric allogeneic BMT (allo-BMT) subjects with cGVHD and controls without cGVHD enrolled in a large multi-institution Children's Oncology Group cGVHD therapeutic trial, we evaluated whether soluble CD13 correlates with induction of anti-CD13 Abs. We found that CD13 reactive Abs are present in a proportion of patients after allo-BMT, but did not seem to correlate with the presence of soluble CD13. Anti-CD13 Abs also did not meet our criteria as a diagnostic biomarker for cGVHD. These data do not confirm that induction of CD13 reactive Abs is a mechanism for cGVHD in children nor are part of the pathogenesis of cGVHD associated with elevated soluble CD13. The exact role of CD13 in cGVHD remains to be determined.

  17. Tobacco control policies of oncology nursing organizations.

    Science.gov (United States)

    Sarna, Linda; Bialous, Stella Aguinaga

    2004-05-01

    Nurses, the largest group of health care professionals, and the policies of nursing organizations, have tremendous potential to promote health and tobacco control. Policies addressing tobacco use have been implemented by a variety of national and international nursing organizations. This article reviews existing tobacco control policies in oncology nursing organizations.

  18. Dummy Run of Quality Assurance Program in a Phase 3 Randomized Trial Investigating the Role of Internal Mammary Lymph Node Irradiation in Breast Cancer Patients: Korean Radiation Oncology Group 08-06 Study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yoonsun [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jun Won [Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan [Department of Radiation Oncology, Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Su Ssan [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Ahn, Sung-Ja [Department of Radiation Oncology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Hyung-Sik [Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan (Korea, Republic of); Kim, Dong Won [Department of Radiation Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Lee, Kyu Chan [Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Suh, Hyun Suk [Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Seoul (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Shin, Hyun Soo [Department of Radiation Oncology, Bundang CHA Hospital, School of Medicine, CHA University, Seongnam (Korea, Republic of); Kim, Yong Bae, E-mail: ybkim3@yuhs.ac [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Suh, Chang-Ok [Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-02-01

    Purpose: The Korean Radiation Oncology Group (KROG) 08-06 study protocol allowed radiation therapy (RT) technique to include or exclude breast cancer patients from receiving radiation therapy to the internal mammary lymph node (IMN). The purpose of this study was to assess dosimetric differences between the 2 groups and potential influence on clinical outcome by a dummy run procedure. Methods and Materials: All participating institutions were asked to produce RT plans without irradiation (Arm 1) and with irradiation to the IMN (Arm 2) for 1 breast-conservation treatment case (breast-conserving surgery [BCS]) and 1 mastectomy case (modified radical mastectomy [MRM]) whose computed tomography images were provided. We assessed interinstitutional variations in IMN delineation and evaluated the dose-volume histograms of the IMN and normal organs. A reference IMN was delineated by an expert panel group based on the study guidelines. Also, we analyzed the potential influence of actual dose variation observed in this study on patient survival. Results: Although physicians intended to exclude the IMN within the RT field, the data showed almost 59.0% of the prescribed dose was delivered to the IMN in Arm 1. However, the mean doses covering the IMN in Arm 1 and Arm 2 were significantly different for both cases (P<.001). Due to the probability of overdose in Arm 1, the estimated gain in 7-year disease-free survival rate would be reduced from 10% to 7.9% for BCS cases and 7.1% for MRM cases. The radiation doses to the ipsilateral lung, heart, and coronary artery were lower in Arm 1 than in Arm 2. Conclusions: Although this dummy run study indicated that a substantial dose was delivered to the IMN, even in the nonirradiation group, the dose differences between the 2 groups were statistically significant. However, this dosimetric profile should be studied further with actual patient samples and be taken into consideration when analyzing clinical outcomes according to IMN

  19. Preliminary Toxicity Analysis of 3-Dimensional Conformal Radiation Therapy Versus Intensity Modulated Radiation Therapy on the High-Dose Arm of the Radiation Therapy Oncology Group 0126 Prostate Cancer Trial

    Energy Technology Data Exchange (ETDEWEB)

    Michalski, Jeff M., E-mail: jmichalski@radonc.wustl.edu [Department of Radiation Oncology Washington University Medical Center, St. Louis, Missouri (United States); Yan, Yan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Watkins-Bruner, Deborah [Emory University School of Nursing, Atlanta, Georgia (United States); Bosch, Walter R. [Department of Radiation Oncology Washington University Medical Center, St. Louis, Missouri (United States); Winter, Kathryn [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Galvin, James M. [Department of Radiation Oncology Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Department of Radiation Oncology Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, QC (Canada); Morton, Gerard C. [Department of Radiation Oncology Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON (Canada); Parliament, Matthew B. [Department of Oncology Cross Cancer Institute, Edmonton, AB (Canada); Sandler, Howard M. [Department of Radiation Oncology Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California (United States)

    2013-12-01

    Purpose: To give a preliminary report of clinical and treatment factors associated with toxicity in men receiving high-dose radiation therapy (RT) on a phase 3 dose-escalation trial. Methods and Materials: The trial was initiated with 3-dimensional conformal RT (3D-CRT) and amended after 1 year to allow intensity modulated RT (IMRT). Patients treated with 3D-CRT received 55.8 Gy to a planning target volume that included the prostate and seminal vesicles, then 23.4 Gy to prostate only. The IMRT patients were treated to the prostate and proximal seminal vesicles to 79.2 Gy. Common Toxicity Criteria, version 2.0, and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late morbidity scores were used for acute and late effects. Results: Of 763 patients randomized to the 79.2-Gy arm of Radiation Therapy Oncology Group 0126 protocol, 748 were eligible and evaluable: 491 and 257 were treated with 3D-CRT and IMRT, respectively. For both bladder and rectum, the volumes receiving 65, 70, and 75 Gy were significantly lower with IMRT (all P<.0001). For grade (G) 2+ acute gastrointestinal/genitourinary (GI/GU) toxicity, both univariate and multivariate analyses showed a statistically significant decrease in G2+ acute collective GI/GU toxicity for IMRT. There were no significant differences with 3D-CRT or IMRT for acute or late G2+ or 3+ GU toxicities. Univariate analysis showed a statistically significant decrease in late G2+ GI toxicity for IMRT (P=.039). On multivariate analysis, IMRT showed a 26% reduction in G2+ late GI toxicity (P=.099). Acute G2+ toxicity was associated with late G3+ toxicity (P=.005). With dose–volume histogram data in the multivariate analysis, RT modality was not significant, whereas white race (P=.001) and rectal V70 ≥15% were associated with G2+ rectal toxicity (P=.034). Conclusions: Intensity modulated RT is associated with a significant reduction in acute G2+ GI/GU toxicity. There is a trend for a

  20. Medical Student Knowledge of Oncology and Related Disciplines: a Targeted Needs Assessment.

    Science.gov (United States)

    Oskvarek, Jonathan; Braunstein, Steve; Farnan, Jeanne; Ferguson, Mark K; Hahn, Olwen; Henderson, Tara; Hong, Susan; Levine, Stacie; Rosenberg, Carol A; Golden, Daniel W

    2016-09-01

    Despite increasing numbers of cancer survivors, non-oncology physicians report discomfort and little training regarding oncologic and survivorship care. This pilot study assesses medical student comfort with medical oncology, surgical oncology, radiation oncology, hospice/palliative medicine, and survivorship care. A survey was developed with input from specialists in various fields of oncologic care at a National Cancer Institute-designated comprehensive cancer center. The survey included respondent demographics, reports of experience with oncology, comfort ratings with oncologic care, and five clinical vignettes. Responses were yes/no, multiple choice, Likert scale, or free response. The survey was distributed via email to medical students (MS1-4) at two US medical schools. The 105 respondents were 34 MS1s (32 %), 15 MS2s and MD/PhDs (14 %), 26 MS3s (25 %), and 30 MS4s (29 %). Medical oncology, surgical oncology, and hospice/palliative medicine demonstrated a significant trend for increased comfort from MS1 to MS4, but radiation oncology and survivorship care did not. MS3s and MS4s reported the least experience with survivorship care and radiation oncology. In the clinical vignettes, students performed the worst on the long-term chemotherapy toxicity and hospice/palliative medicine questions. Medical students report learning about components of oncologic care, but lack overall comfort with oncologic care. Medical students also fail to develop an increased self-assessed level of comfort with radiation oncology and survivorship care. These pilot results support development of a formalized multidisciplinary medical school oncology curriculum at these two institutions. An expanded national survey is being developed to confirm these preliminary findings.

  1. The oncologic radiotherapy experience for patients: a poison-drug La experiencia de los pacientes sometidos a radioterapia oncológica: una medicina-veneno A experiência da radioterapia oncológica para os pacientes: um remédio-veneno

    OpenAIRE

    Rosani Manfrin Muniz; Marcia Maria Fontão Zago

    2008-01-01

    The study aimed at understanding the patients' experience with oncologic radiotherapy. The anthropological interpretative approach and the ethnographic method guided the investigation. Ten patients took part in the study. They were of both genders, within the age range from 34 to 80 years old and monitored during radiotherapy treatment. Data were collected through semi-structured interviews, participative observation and medical records. The analysis of the respondents' statements allowed for...

  2. Quality Assessment in Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    The movement to improve healthcare quality has led to a need for carefully designed quality indicators that accurately reflect the quality of care. Many different measures have been proposed and continue to be developed by governmental agencies and accrediting bodies. However, given the inherent differences in the delivery of care among medical specialties, the same indicators will not be valid across all of them. Specifically, oncology is a field in which it can be difficult to develop quality indicators, because the effectiveness of an oncologic intervention is often not immediately apparent, and the multidisciplinary nature of the field necessarily involves many different specialties. Existing and emerging comparative effectiveness data are helping to guide evidence-based practice, and the increasing availability of these data provides the opportunity to identify key structure and process measures that predict for quality outcomes. The increasing emphasis on quality and efficiency will continue to compel the medical profession to identify appropriate quality measures to facilitate quality improvement efforts and to guide accreditation, credentialing, and reimbursement. Given the wide-reaching implications of quality metrics, it is essential that they be developed and implemented with scientific rigor. The aims of the present report were to review the current state of quality assessment in oncology, identify existing indicators with the best evidence to support their implementation, and propose a framework for identifying and refining measures most indicative of true quality in oncologic care.

  3. Nanomedicine in veterinary oncology.

    Science.gov (United States)

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

    2015-08-01

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

  4. Active surveillance: Oncologic outcome

    NARCIS (Netherlands)

    L.D.F. Venderbos (Lionne); L.P. Bokhorst (Leonard); C.H. Bangma (Chris); M.J. Roobol-Bouts (Monique)

    2013-01-01

    textabstractPURPOSE OF REVIEW: To give insight into recent literature (during the past 12-18 months) reporting on oncologic outcomes of men on active surveillance. RECENT FINDINGS: From recent published trials comparing radical prostatectomy vs. watchful waiting, we learn that radical treatment only

  5. Molecular imaging in oncology

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-01

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

  6. Modernizing Clinical Trial Eligibility Criteria: Recommendations of the American Society of Clinical Oncology-Friends of Cancer Research Brain Metastases Working Group.

    Science.gov (United States)

    Lin, Nancy U; Prowell, Tatiana; Tan, Antoinette R; Kozak, Marina; Rosen, Oliver; Amiri-Kordestani, Laleh; White, Julia; Sul, Joohee; Perkins, Louise; Beal, Katherine; Gaynor, Richard; Kim, Edward S

    2017-10-02

    Purpose Broadening trial eligibility to improve accrual and access and to better reflect intended-to-treat populations has been recognized as a priority. Historically, patients with brain metastases have been understudied, because of restrictive eligibility across all phases of clinical trials. Methods In 2016, after a literature search and series of teleconferences, a multistakeholder workshop was convened. Our working group focused on developing consensus recommendations regarding the inclusion of patients with brain metastases in clinical trials, as part of a broader effort that encompassed minimum age, HIV status, and organ dysfunction. The working group attempted to balance the needs of protecting patient safety, facilitating access to investigational therapies, and ensuring trial integrity. On the basis of input at the workshop, guidelines were further refined and finalized. Results The working group identified three key populations: those with treated/stable brain metastases, defined as patients who have received prior therapy for their brain metastases and whose CNS disease is radiographically stable at study entry; those with active brain metastases, defined as new and/or progressive brain metastases at the time of study entry; and those with leptomeningeal disease. In most circumstances, the working group encourages the inclusion of patients with treated/stable brain metastases in clinical trials. A framework of key considerations for patients with active brain metastases was developed. For patients with leptomeningeal disease, inclusion of a separate cohort in both early-phase and later-phase trials is recommended, if CNS activity is anticipated and when relevant to the specific disease type. Conclusion Expanding eligibility to be more inclusive of patients with brain metastasis is justified in many cases and may speed the development of effective therapies in this area of high clinical need.

  7. Women's experiences of participation in a pregnancy and postnatal group incorporating yoga and facilitated group discussion: a qualitative evaluation.

    Science.gov (United States)

    Doran, Frances; Hornibrook, Julie

    2013-03-01

    This paper reports on a small qualitative research study which explored women's experiences of participation in a pregnancy and postnatal group that incorporated yoga and facilitated discussion. The group is offered through a community based feminist non-government women's health Centre in Northern NSW Australia. The purpose of the research was to explore women's experiences of attending this pregnancy and postnatal group. An exploratory qualitative approach was used to explore women's experiences of attending the group. Fifteen women participated in individual, in-depth face-to-face interviews. Interviews were recorded and transcribed verbatim. Thematic analysis was undertaken to analyse the qualitative data. Six themes were developed, one with 3 subthemes. One theme was labelled as: 'the pregnancy and motherhood journey' and included 3 sub-themes which were labelled: 'preparation for birth', 'connecting with the baby' and 'sharing birth stories.' The other five themes were: 'feminine nurturing safe space', 'watching and learning the mothering', 'building mental health, well-being and connections', the "group like a rock and a seed' and 'different from mainstream'. This research adds to the overall body of knowledge about the value of yoga in pre and postnatal care. It demonstrates the value of sharing birth stories and the strong capacity women have to support one another, bringing benefits of emotional and social well-being, information, resources and support derived from group based models of care. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  8. Some observations on the subjective experience of neophyte group therapy trainees.

    Science.gov (United States)

    Murphy, L; Leszcz, M; Collings, A K; Salvendy, J

    1996-10-01

    Neophyte group therapy trainees often encounter significant difficulties in their initial experiences as group therapists. In this article, we report and discuss the results of a semistructured interview conducted with each of 16 neophyte group therapy trainees in an academic training program. The interview focused on the trainees' subjective experiences related to their initial training and group therapy clinical practice, with particular emphasis on their satisfaction with their training, and the role and impact of supervision. All trainees reported strong emotional reactions to their group experience and numerous technical concerns. However, trainees reported a broad range of degrees of satisfaction with their training Overall satisfaction with training strongly paralleled satisfaction with supervision and the supervisory relationship. Recommendations for improving the group therapy training experience that emerge from the evaluation of the trainees' subjective experiences are suggested.

  9. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hanbyoul [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, Byung-Ho [Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Cho, Chi-Heum [Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Byoung Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Ryu, Hee-Sug [Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, Soon Beom [Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul (Korea, Republic of); Kim, Jae-Hoon, E-mail: jaehoonkim@yuhs.ac [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-01

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m{sup 2} was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study.

  10. Report of a Phase I Evaluation of Dose and Schedule of Interleukin-1 Alpha and Cyclophosphamide in Patients with Advanced Tumors: An Eastern Cooperative Oncology Group Study (PX990) and Review of IL-1-Based Studies of Hematopoietic Reconstitution

    Science.gov (United States)

    Neuberg, Donna; Atkins, Michael B.; Tester, William J.; Wadler, Scott; Stewart, James A.; Chachoua, Abraham; Schuchter, Lynn M.

    2014-01-01

    Interleukin-1 (IL-1) is a cytokine critical to inflammation, immunological activation, response to infection, and bone marrow hematopoiesis. Cyclophosphamide downmodulates immune suppressor cells and is cytotoxic to a variety of tumors. A phase I trial of IL-1 and cyclophosphamide was conducted by the Eastern Cooperative Oncology Group. This study evaluated 3 dose levels and 3 schedules in patients with solid tumors. The goal was to evaluate the hematopoietic supportive care effect and possible antitumor effect. Toxicity was fever, chills, hypotension, nausea/emesis, hepatic, and neutropenia. Toxicity increased with dose increases of interleukin-1. Treatment at all dose levels resulted in significant increases in total white blood cell (WBC) counts above baseline. Nadir WBC and nadir absolute neutrophil counts were not significantly different by dose level of IL-1 or schedule of IL-1. Toxicity due to IL-1 at higher doses prohibited further evaluation of this agent for hematopoietic support, particularly in view of the activity and tolerability of more lineage-specific hematopoietic cytokines. Therapeutic interventions in the role of IL-1 in inflammatory conditions and cancer may be further informed by our definition of its clinical and biological effects in this evaluation of dose and schedule. PMID:24433038

  11. Modernizing Clinical Trial Eligibility Criteria: Recommendations of the American Society of Clinical Oncology-Friends of Cancer Research Organ Dysfunction, Prior or Concurrent Malignancy, and Comorbidities Working Group.

    Science.gov (United States)

    Lichtman, Stuart M; Harvey, R Donald; Damiette Smit, Marie-Anne; Rahman, Atiqur; Thompson, Michael A; Roach, Nancy; Schenkel, Caroline; Bruinooge, Suanna S; Cortazar, Patricia; Walker, Dana; Fehrenbacher, Louis

    2017-10-02

    Purpose Patients with organ dysfunction, prior or concurrent malignancies, and comorbidities are often excluded from clinical trials. Excluding patients on the basis of these factors results in clinical trial participants who are healthier and younger than the overall population of patients with cancer. Methods ASCO and Friends of Cancer Research established a multidisciplinary working group that included experts in trial design and conduct to examine how eligibility criteria could be more inclusive. The group analyzed current eligibility criteria; conducted original data analysis; considered safety concerns, potential benefits, research, and potential hurdles of this approach through discussion; and reached consensus on recommendations regarding updated eligibility criteria that prioritize inclusiveness without compromising patient safety. Results If renal toxicity and clearance are not of direct treatment-related concern, then patients with lower creatinine clearance values of > 30 mL/min should be included in trials. Inclusion of patients with mild to moderate hepatic dysfunction may be possible when the totality of the available nonclinical and clinical data indicates that inclusion is safe. Ejection fraction values should be used with investigator assessment of a patient's risk for heart failure to determine eligibility. Patients with laboratory parameters out of normal range as a result of hematologic disease should be included in trials. Measures of patient functional status should be included in trials to better assess fit versus frail patients. Conclusion Expanding inclusion of these patients will increase the number and diversity of patients in clinical trials and result in a more appropriate population of patients.

  12. Intensified Chemotherapy with Dexrazoxane Cardioprotection in Newly Diagnosed Non-Metastatic Osteosarcoma: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Schwartz, CL; Wexler, LH; Krailo, MD; Teot, LA; Devidas, M; Steinherz, LJ; Goorin, AM; Gebhardt, MC; Healey, JH; Sato, JK; Meyers, PA; Grier, HE; Bernstein, ML; Lipshultz, SE

    2016-01-01

    Background Although chemotherapy has improved outcome of osteosarcoma, 30–40% of patients succumb to this disease. Survivors experience substantial morbidity and mortality from anthracycline-induced cardiotoxicity. We hypothesized that the cardioprotectant dexrazoxane would 1) support escalation of the cumulative doxorubicin dose (600 mg/m2) and 2) not interfere with the cytotoxicity of chemotherapy measured by necrosis grading in comparison to historical control data.9 Procedure Children and adolescents with non-metastatic osteosarcoma were treated with MAP (methotrexate, doxorubicin, cisplatin) or MAPI (MAP/ifosfamide). Dexrazoxane was administered with all doxorubicin doses. Cardioprotection was assessed by measuring left ventricular fractional shortening. Interference with chemotherapy-induced cytotoxicity was determined by measuring tumor necrosis after induction chemotherapy. Feasibility of intensifying therapy with either high cumulative-dose doxorubicin or high-dose ifosfamide/etoposide was evaluated for ‘standard responders’ (SR, osteosarcoma. PMID:26398490

  13. The experiential world of the Oncology nurse

    Directory of Open Access Journals (Sweden)

    Laetitia le Roux

    2008-03-01

    Full Text Available In her experiential world, the oncology nurse experiences unique, challenging and rewarding relationships in a multidimensional, dynamic way. The aim of this study was to describe, from her viewpoint and perspective, how she experiences and reacts to this world. Through this study the researcher wants the oncology nurse’s voice to be heard, the richness of her story acknowledged and the derived data to be applied to the benefit of the field of oncology. In-depth, unstructured phenomenological interviews provided the saturated data from which the uniqueness of the world of the oncology nurse unfolded as the uniqueness of the oncology patients and their world emerged clearly. Findings show that the oncology nurse, attending to the cancer patients and their family, experiences many different relationships. The uniqueness of the oncology nurse-patient relationship is described as unlike any other nurse-patient relationship. The challenging interpersonal relationships with management and other members of the multiprofessional team, as experienced from the perspective of the oncology nurse, are also highlighted. Furthermore, a unifying intrapersonal relationship with the self was identified. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment she works in, explaining, at least partly, the high job satisfaction that permeated the interviews in this study. Recommendations for nursing practice, education and research were formulated. Opsomming In haar leefwêreld ondervind onkologieverpleegkundige unieke, uitdagende en belonende verhoudinge op ‘n multidimensionele en dinamiese wyse. Die doel van hierdie studie was om ‘n beskrywing van die onkologieverpleegkundige se ervarings van en reaksie op haar leefwêreld vanuit haar oogpunt en perspektief. Deur middel van hierdie studie wil die navorser die stem van die onkologieverpleegkundige gehoor laat word, die rykdom van haar verhaal

  14. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute's Comprehensive Research Needs Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Bekelman, Justin E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Brawley, Otis W. [Department of Hematology and Oncology, Emory University, and American Cancer Society, Atlanta, Georgia (United States); Deasy, Joseph O. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Michalski, Jeff M. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Thomas, Charles R. [Department of Radiation Oncology, Oregon Health and Sciences University, Portland, OR (United States); Lawton, Colleen A. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2012-10-01

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  15. Therapists in Oncology Settings

    Science.gov (United States)

    Hendrick, Susan S.

    2013-01-01

    This article describes the author's experiences of working with cancer patients/survivors both individually and in support groups for many years, across several settings. It also documents current best-practice guidelines for the psychosocial treatment of cancer patients/survivors and their families. The author's view of the important qualities…

  16. Validation of Lysyl Oxidase As a Prognostic Marker for Metastasis and Survival in Head and Neck Squamous Cell Carcinoma: Radiation Therapy Oncology Group Trial 90-03

    Science.gov (United States)

    Le, Quynh-Thu; Harris, Jonathan; Magliocco, Anthony M.; Kong, Christina S.; Diaz, Roman; Shin, Brian; Cao, Hongbin; Trotti, Andy; Erler, Janine T.; Chung, Christine H.; Dicker, Adam; Pajak, Thomas F.; Giaccia, Amato J.; Ang, K. Kian

    2009-01-01

    Purpose To validate lysyl oxidase (LOX), a hypoxia-related protein, as a marker for metastasis in an independent head and neck cancer (HNC) patient group enrolled onto a prospective trial. Patients and Methods We performed traditional immunohistochemical (IHC) staining and automated quantitative analysis (AQUA) for LOX expression in 66 HNC patients from one institution. We also performed AQUA staining for LOX in 306 of 1,113 patients treated on a phase III trial comparing four radiation fractionation schedules in locally advanced HNC (RTOG 90-03). Pretreatment characteristics and outcome were similar between patients with and without LOX assessment. We correlated AQUA LOX expression with time to metastasis (TTM), time to progression (TTP), and overall survival (OS). Results LOX expression from both staining methods predicted for TTM in the first 66 patients. Multivariate analysis, controlling for significant parameters including nodal stage and performance status, revealed tumor LOX expression, as a continuous variable, was an independent predictor for TTM (hazard ratio [HR], 1.21; 95% CI, 1.10 to 1.33; P = .0001), TTP (HR, 1.06; 95% CI, 1.02 to 1.10; P = .0069), and OS (HR, 1.04; 95% CI, 1.00 to 1.07; P = .0311) in RTOG 90-03 patients. This translates into a 259% increase in metastatic risk for a patient at the 75th percentile of LOX compared with one at the 25th percentile. Conclusion AQUA LOX expression was strongly associated with increased metastasis, progression, and death in RTOG 90-03 patients. This study validates that LOX is a marker for metastasis and survival in HNC. PMID:19667273

  17. Vesicular monoamine transporter protein expression correlates with clinical features, tumor biology, and MIBG avidity in neuroblastoma: a report from the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Temple, William; Mendelsohn, Lori; Nekritz, Erin; Gustafson, W.C.; Matthay, Katherine K. [UCSF School of Medicine, Department of Pediatrics, San Francisco, CA (United States); UCSF Benioff Children' s Hospital, San Francisco, CA (United States); Kim, Grace E. [UCSF School of Medicine, Department of Pathology, San Francisco, CA (United States); Lin, Lawrence; Giacomini, Kathy [UCSF School of Pharmacy, Department of Bioengineering and Therapeutic Sciences, San Francisco, CA (United States); Naranjo, Arlene; Van Ryn, Collin [University of Florida, Children' s Oncology Group Statistics and Data Center, Gainesville, FL (United States); Yanik, Gregory A. [University of Michigan, CS Mott Children' s Hospital, Ann Arbor, MI (United States); Kreissman, Susan G. [Duke University Medical Center, Durham, NC (United States); Hogarty, Michael [University of Pennsylvania, Children' s Hospital of Philadelphia and Perelman School of Medicine, Philadelphia, PA (United States); DuBois, Steven G. [UCSF School of Medicine, Department of Pediatrics, San Francisco, CA (United States); UCSF Benioff Children' s Hospital, San Francisco, CA (United States); UCSF School of Medicine, San Francisco, CA (United States)

    2016-03-15

    Vesicular monoamine transporters 1 and 2 (VMAT1 and VMAT2) are thought to mediate MIBG uptake in adult neuroendocrine tumors. In neuroblastoma, the norepinephrine transporter (NET) has been investigated as the principal MIBG uptake protein, though some tumors without NET expression concentrate MIBG. We investigated VMAT expression in neuroblastoma and correlated expression with MIBG uptake and clinical features. We evaluated VMAT1 and VMAT2 expression by immunohistochemistry (IHC) in neuroblastoma tumors from 76 patients with high-risk metastatic disease treated in a uniform cooperative group trial (COG A3973). All patients had baseline MIBG diagnostic scans centrally reviewed. IHC results were scored as the product of intensity grading (0 - 3+) and percent of tumor cells expressing the protein of interest. The association between VMAT1 and VMAT2 scores and clinical and biological features was tested using Wilcoxon rank-sum tests. Patient characteristics were typical of high-risk neuroblastoma, though the cohort was intentionally enriched in patients with MIBG-nonavid tumors (n = 20). VMAT1 and VMAT2 were expressed in 62 % and 75 % of neuroblastoma tumors, respectively. VMAT1 and VMAT2 scores were both significantly lower in MYCN amplified tumors and in tumors with high mitotic karyorrhectic index. MIBG-avid tumors had significantly higher VMAT2 scores than MIBG-nonavid tumors (median 216 vs. 45; p = 0.04). VMAT1 expression did not correlate with MIBG avidity. VMAT1 and VMAT2 are expressed in the majority of neuroblastomas. Expression correlates with other biological features. The expression level of VMAT2 but not that of VMAT1 correlates with avidity for MIBG. (orig.)

  18. Prevalence of BRCA1 mutations among 403 women with triple-negative breast cancer: implications for genetic screening selection criteria: a Hellenic Cooperative Oncology Group Study.

    Science.gov (United States)

    Fostira, Florentia; Tsitlaidou, Marianthi; Papadimitriou, Christos; Pertesi, Maroulio; Timotheadou, Eleni; Stavropoulou, Alexandra V; Glentis, Stavros; Bournakis, Evangelos; Bobos, Mattheos; Pectasides, Dimitrios; Papakostas, Pavlos; Pentheroudakis, George; Gogas, Helen; Skarlos, Pantelis; Samantas, Epaminontas; Bafaloukos, Dimitrios; Kosmidis, Paris A; Koutras, Angelos; Yannoukakos, Drakoulis; Konstantopoulou, Irene; Fountzilas, George

    2012-07-01

    In spite the close association of the triple-negative breast cancer immunophenotype with hereditary breast cancers and the BRCA1 pathway, there is a lack of population studies that determine the frequency of BRCA1 mutations among triple-negative breast cancer patients. To address this, we have screened a large sample of 403 women diagnosed with triple-negative invasive breast cancer, independently of their age or family history, for germline BRCA1 mutations. Median age at diagnosis was 50 years (range 20-83). The overall prevalence of triple-negative cases among the initial patient group with invasive breast cancer was 8%. BRCA1 was screened by direct DNA sequencing in all patients, including all exons where a mutation was previously found in the Greek population (exons 5, 11, 12, 16, 20, 21, 22, 23, 24-77% of the BRCA1 coding region), including diagnostic PCRs to detect the three Greek founder large genomic rearrangements. Sixty-five deleterious BRCA1 mutations were identified among the 403 triple-negative breast cancer patients (16%). Median age of onset for mutation carriers was 39 years. Among a total of 106 women with early-onset triple-negative breast cancer (<40 years), 38 (36%) had a BRCA1 mutation, while 27% of women with triple-negative breast cancer diagnosed before 50 years (56/208) had a BRCA1 mutation. A mutation was found in 48% (50/105) of the triple-negative breast cancer patients with family history of breast or ovarian cancer. It is noteworthy, however, that of the 65 carriers, 15 (23%) had no reported family history of related cancers. All but one of the carriers had grade III tumors (98%). These results indicate that women with early-onset triple-negative breast cancer, and ideally all triple-negative breast cancer patients, are candidates for BRCA1 genetic testing even in the absence of a family history of breast or ovarian cancer.

  19. What, why, and when we image: considerations for diagnostic imaging and clinical research in the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Reaman, Gregory H. [The George Washington University, School of Medicine and Health Sciences, Division of Hematology Oncology, Children' s National Medical Center, Washington, DC (United States)

    2009-02-15

    Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach will mandate the continued dependence on advances in diagnostic imaging for improvements in staging methodologies to best define risk groups for risk-adjusted therapy. In addition, anatomic and functional assessment of response and surveillance for disease recurrence will require improved understanding of the biology as well as natural history of individual diseases, which one hopes will better inform investigators in designing trials. Clinical and research expertise is urgently needed in the selection of specific imaging studies and frequencies that best assess a response as well as to define disease-free intervals. Despite limited resources to develop sufficient infrastructure, emphasis on enabling early assessment of new technology to minimize risks associated with treatment advances and with those critical diagnostic and staging procedures must continue to be a focus of pediatric cancer clinical research. (orig.)

  20. Integrative oncology: an overview.

    Science.gov (United States)

    Deng, Gary; Cassileth, Barrie

    2014-01-01

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

  1. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  2. Significance of PIK3CA Mutations in Patients with Early Breast Cancer Treated with Adjuvant Chemotherapy: A Hellenic Cooperative Oncology Group (HeCOG Study.

    Directory of Open Access Journals (Sweden)

    George Papaxoinis

    Full Text Available The PI3K-AKT pathway is frequently activated in breast cancer. PIK3CA mutations are most frequently found in the helical (exon 9 and kinase (exon 20 domains of this protein. The aim of the present study was to examine the role of different types of PIK3CA mutations in combination with molecular biomarkers related to PI3K-AKT signaling in patients with early breast cancer.Tumor tissue samples from 1008 early breast cancer patients treated with adjuvant chemotherapy in two similar randomized trials of HeCOG were examined. Tumors were subtyped with immunohistochemistry (IHC and FISH for ER, PgR, Ki67, HER2 and androgen receptor (AR. PIK3CA mutations were analyzed by Sanger sequencing (exon 20 and qPCR (exon 9 (Sanger/qPCR mutations. In 610 cases, next generation sequencing (NGS PIK3CA mutation data were also available. PIK3CA mutations and PTEN protein expression (IHC were analyzed in luminal tumors (ER and/or PgR positive, molecular apocrine carcinomas (MAC; ER/PgR negative / AR positive and hormone receptor (ER/PgR/AR negative tumors.PIK3CA mutations were detected in 235/1008 tumors (23% with Sanger/qPCR and in 149/610 tumors (24% with NGS. Concordance between the two methods was good with a Kappa coefficient of 0.76 (95% CI 0.69-0.82. Lobular histology, low tumor grade and luminal A tumors were associated with helical domain mutations (PIK3CAhel, while luminal B with kinase domain mutations (PIK3CAkin. The overall incidence of PIK3CA mutations was higher in luminal as compared to MAC and hormone receptor negative tumors (p = 0.004. Disease-free and overall survival did not significantly differ with respect to PIK3CA mutation presence and type. However, a statistically significant interaction between PIK3CA mutation status and PTEN low protein expression with regard to prognosis was identified.The present study did not show any prognostic significance of specific PIK3CA mutations in a large group of predominantly lymph-node positive breast cancer

  3. Exploring oncology nurses' grief: A self-study

    Directory of Open Access Journals (Sweden)

    Lisa C Barbour

    2016-01-01

    Full Text Available Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release.

  4. Nasopharyngeal carcinoma in a low incidence European area. A prospective observational analysis from the Head and Neck Study Group of the Italian Society of Radiation Oncology (AIRO)

    Energy Technology Data Exchange (ETDEWEB)

    Tonoli, S.; Bruschieri, L. [Brescia University, Istituto del Radio, Brescia (Italy); Alterio, D. [European Institute of Oncology, Milan (Italy); Caspiani, O. [Isola Tiberina Hospital, Rome (Italy); Bacigalupo, A. [IRCCS A.O.U. San Martino IST Genoa, Genoa (Italy); Bunkheila, F. [S. Orsola Hospital, Bologna (Italy); Cianciulli, M. [S. Camillo Hospital, Rome (Italy); Merlotti, A. [Busto Arsizio Hospital, Busto Arsizio (Italy); Podhradska, A. [Milan University - Monza S. Gerardo Hospital, Milan (Italy); Rampino, M. [Turin University, Turin (Italy); Cante, D. [Treviglio Hospital, Treviglio (Italy); Gatta, R. [Brescia University, Istituto del Radio, Brescia (Italy); Prato Hospital, Prato (Italy); Magrini, S.M.

    2016-12-15

    To evaluate the outcomes with respect to long-term survival and toxicity in patients with nasopharyngeal carcinoma (NPC) treated in a European country with low incidence. A prospective observational study carried out by the AIRO Head and Neck group in 12 Italian institutions included 136 consecutive patients treated with radiotherapy (RT) ± chemotherapy (CHT) for NPC (without distant metastasis) between January 1, 2008 and December 31, 2010. The disease-specific survival (DSS), overall survival (OS), and disease-free survival (DFS) at 5 years were 92 (±2), 91 (±3), and 69 % (±5 %), respectively. Distant failure was the most frequent modality of relapse. The local, regional, and locoregional control at 5 years were 89 (±3), 93 (±3), and 84 % (±4 %), respectively. The incidence of acute and late toxicity and the correlations with different clinical/technical variables were analyzed. Neoadjuvant CHT prolongs radiotherapy overall treatment time (OTT) and decreases treatment adherence during concomitant chemoradiotherapy. An adequate minimum dose coverage to PTV(T) is a predictive variable well related to outcome. Our data do not substantially differ in terms of survival and toxicity outcomes from those reported in larger series of patients treated in countries with higher incidences of NPC. The T stage (TNM 2002 UICC classification) is predictive of DSS and OS. The GTV volume (T ± N) and an adequate minimum PTV(T) coverage dose (D95 %) were also identified as potential predictive variables. Sophisticated technologies of dose delivery (IMRT) with image-guided radiotherapy could help to obtain better minimum PTV(T) coverage dose with increased DFS; distant metastasis after treatment still remains an unresolved issue. (orig.) [German] Bewertung von langfristigem Ueberleben und Toxizitaet bei Patienten mit Nasopharynxkarzinom (NPC), die in einem europaeischen Land mit geringer Inzidenz behandelt wurden. Die prospektive Beobachtungsanalyse, durchgefuehrt von der

  5. Hospital Experiences of Older People with Intellectual Disability: Responses of Group Home Staff and Family Members

    Science.gov (United States)

    Webber, Ruth; Bowers, Barbara; Bigby, Christine

    2010-01-01

    Background: This study reports on the hospitalisation experiences of older adults with intellectual disability living in group homes. Methods: Grounded dimensional analysis was used to guide data collection and analysis. Group home residents were tracked prospectively over a 3-year period. Interviews were conducted with family, group home, and…

  6. Hospital Experiences of Older People with Intellectual Disability: Responses of Group Home Staff and Family Members

    Science.gov (United States)

    Webber, Ruth; Bowers, Barbara; Bigby, Christine

    2010-01-01

    Background: This study reports on the hospitalisation experiences of older adults with intellectual disability living in group homes. Methods: Grounded dimensional analysis was used to guide data collection and analysis. Group home residents were tracked prospectively over a 3-year period. Interviews were conducted with family, group home, and…

  7. With or without the group: Swedish midwives' and child healthcare nurses' experiences in leading parent education groups.

    Science.gov (United States)

    Forslund Frykedal, Karin; Rosander, Michael; Berlin, Anita; Barimani, Mia

    2016-12-01

    The aim of the study was to describe and to understand midwives' and child healthcare nurses' experiences of working with parent education groups through their descriptions of the role and what they find rewarding and challenging in that work. Data were collected through three open-ended questions from a web survey: 'How do you refer to your role when working in parent education?', 'What is the biggest challenge or difficulty for you when working in parent education?' and 'What is most rewarding when working in parent education?' The answers were analysed by using qualitative content analysis and correlation analysis. The results show that the midwives and child healthcare nurses either included or excluded the group when describing their role as leaders and their influence on parents. The same applies to what they found rewarding and what was difficult and challenging for them in working with the groups. Primarily, the leaders who excluded the group expressed a lack of competence on a professional level in managing groups and using the right teaching methods to process the knowledge content. One important question to deal with is how to best support midwives and nurses in child healthcare to be prepared for working with parent education groups. One obvious thing is to provide specialized training in an educational sense. An important aspect could also be providing supervision, individually or in groups. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Future vision for the quality assurance of oncology clinical trials

    Directory of Open Access Journals (Sweden)

    Thomas eFitzGerald, MD

    2013-03-01

    Full Text Available The National Cancer Institute clinical cooperative groups have been instrumental over the past 50 years in developing clinical trials and evidence based process improvements for clinical oncology patient care. The cooperative groups are undergoing a transformation process as we further integrate molecular biology into personalized patient care and move to incorporate international partners in clinical trials. To support this vision, data acquisition and data management informatics tools must become both nimble and robust to support transformational research at an enterprise level. Information, including imaging, pathology, molecular biology, radiation oncology, surgery, systemic therapy and patient outcome data needs to be integrated into the clinical trial charter using adaptive clinical trial mechanisms for design of the trial. This information needs to be made available to investigators using digital processes for real time data analysis. Future clinical trials will need to be designed and completed in a timely manner facilitated by nimble informatics processes for data management. This paper discusses both past experience and future vision for clinical trials as we move to develop data management and quality assurance processes to meet the needs of the modern trial.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-01

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

  11. "It's not like a fat camp" - A focus group study of adolescents' experiences on group-based obesity treatment.

    Science.gov (United States)

    Engström, Anna; Abildsnes, Eirik; Mildestvedt, Thomas

    2016-01-01

    The health burden related to obesity is rising among children and adolescents along with the general population worldwide. For the individual as well as the society this trend is alarming. Several factors are driving the trend, and the solution seems to be multifaceted because long-lasting treatment alternatives are lacking. This study aims to explore adolescents' and young adults' motivation for attending group-based obesity treatment and social and environmental factors that can facilitate or hinder lifestyle change. In this study, we arranged three focus groups with 17 participants from different obesity treatment programs in the west and south of Norway. The content in these programs differed, but they all used Motivational Interviewing as a teaching method. We conducted a data-driven analysis using systematic text condensation. Self-determination theory has been used as an explanatory framework. We identified four major themes: 1) motivation, 2) body experience and self-image, 3) relationships and sense of belonging, and 4) the road ahead. Many of the participants expressed external motivation to participate but experienced increasing inner motivation and enjoyment during the treatment. Several participants reported negative experiences related to being obese and appreciated group affiliation and sharing experiences with other participants. Motivation may shift during a lifestyle course. Facilitating factors include achieving and experiencing positive outcomes as well as gaining autonomy support from other course participants and friends. Obstacles to change were a widespread obesogenic environment as well as feelings of guilt, little trust in personal achievements and non-supporting friends.

  12. [Which approach of therapeutic education (TE) for adolescents and young adults with cancer? Experience from the TE working group of "Go-AJA"].

    Science.gov (United States)

    Corradini, Nadège; Dagorne, Loïc; Retailleau, Marielle; Rédini, Françoise; Sudour-Bonnange, Hélène; Gofti-Laroche, Leila; Le Rhun, Anne; Gaspar, Nathalie

    2016-12-01

    Therapeutic education (TE) is a practice developed over 40 years at an international level to give people with chronic illness the skills necessary to help them better manage their disease. The lengthening survival time of cancer patients as well as changes in the patient-caregiver relationship have contributed to the development of TE in oncologic diseases. Every year in France, about 1900 adolescents and young adults (15-25 years old) are diagnosed with cancer which is the second leading cause of death in this age group. The observed survival rates for these patients are lower when compared with children's. Some of the hypotheses put forward to explain this difference include a lack of constancy in care and a non-following treatment, as failure to adhere to therapies is common in this age group. "Go-AJA", an interdisciplinary national organization established in 2012, aims to improve the quality of care and treatment results for AYA living with cancer. Therapeutic education for AYA in oncology is an active working group of "Go-AJA" and intends to draw recommendations and to improve adapted communication on different education topics. Elaboration and preparation of TE programs by skilled multidisciplinary teams engaged in interactive educational actions is the first and most crucial step. The TE "Go-AJA" working group has federated pediatric and adult oncologists, nurses, psychologists, TE professionals, and resource patients, thanks to the commitment of professionals from the 8 national teams supported by the National Cancer Institute. Physical meetings and conference calls were organized from 2012 to 2015 to construct TE tools and programs for AYA with cancer. A competence referential was built and adapted to AYA population with cancer, after focused groups organized in 2 main oncology centers with on-therapy sarcoma patients and members of the multidisciplinary TE working group. Tools were validated and adapted to adolescents or young adults with cancer, to

  13. Natural Interactions in Artifical Situations: Focus Groups as an Active Social Experiment

    DEFF Research Database (Denmark)

    Demant, Jakob

    2012-01-01

    the interactions going on in the group can be described as natural occurring data (cf. Silverman, 2007). Thus this approach comes to terms with some of the problems addressed within both positivistic as well as constructivist uses of focus group methods. Secondly, framing focus groups as social experiments also......This chapter discuss the question of how the validity of focus group data can be reframed when approaching focus groups as social experiments in a science and technology approach. By using this frame we first of all comes to perceive the focus group discussion as an artificial situation, while...... highlights possibilities of a more active use of groups (by intervention) that resembles the interviewing situations as an active ethnomethodological breaching. It is within this framework of “stimulated or irritated” natural occurring data that focus groups will be discussed....

  14. The Shared Experience Help the Bereavement to Flow: A Family Support Group Evaluation.

    Science.gov (United States)

    Henoch, Ingela; Berg, Christina; Benkel, Inger

    2016-12-01

    When a family member dies, a bereavement period is taking place for all family members. The death of a parent during childhood is a highly stressful event. This study evaluates families' experiences of family support groups when a parent has died. Families were participate in groups for children, teenagers, young adults, and parents in seven sessions. The same topic which was discussed in all groups. The support groups were evaluated qualitatively and quantitatively. The participants were satisfied with the groups and experienced that the shared experience facilitated bereavement to proceed. The results indicate that families' experiences is being more open about feelings in their own family. A support group can be one possibility to help the whole family in the bereavement. © The Author(s) 2015.

  15. Overall survival and local recurrence of 406 completely resected stage IIIa-N2 non-small cell lung cancer patients: questionnaire survey of the Japan Clinical Oncology Group to plan for clinical trials.

    Science.gov (United States)

    Ichinose, Y; Kato, H; Koike, T; Tsuchiya, R; Fujisawa, T; Shimizu, N; Watanabe, Y; Mitsudomi, T; Yoshimura, M

    2001-10-01

    the group of completely resected stage IIIA-N2 non-small cell lung cancer patients (NSCLC) is considered to be heterogeneous in various aspects including survival and the recurrent pattern. In the present study, we attempted to clarify the factors which separate these patients into high and low risk groups based on the survival and local recurrence. a questionnaire survey on the survival and local recurrence of non-small cell lung cancer patients with pathological stage IIIA-N2 disease who underwent a complete resection from January 1992 to December 1993 was performed by the Japan Clinical Oncology Group as of July 1999. The information on the survival of 406 patients and that of local recurrence in 332 of them was available. the 5-year survival of the 406 patients was 31.0%. In a univariate analysis, the age, clinical and pathological T status, number of N2 stations, pathological N1 disease, operative modality and postoperative radiotherapy were all found to be important prognostic factors. Clinical N2 disease marginally influenced the survival (P=0.07). In a multivariate analysis of these variables including clinical N2 disease, the survival was significantly worse in the case of multiple N2 stations (hazard ratio=1.741), the presence of pathological N1 disease (1.403), pathological T2 or 3 disease (1.399) and an age older than 65 (1.327). The rate of freedom from any local recurrence at the bronchial stump, or in the hilar, mediastinal or supraclavicular lymph nodes at 5 years was 64%. In a univariate analysis of the freedom from local recurrence, the clinical N status, pathological T status, pathological N1 disease and number of N2 stations were all found to be important prognostic factors. A multivariate analysis revealed the freedom from local recurrence to be adversely influenced by multiple N2 stations (hazard ratio=2.05), and the presence of either clinical N1 or 2 (1.733) disease. The 5-year survival and the rate of freedom from local recurrence at 5

  16. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    Energy Technology Data Exchange (ETDEWEB)

    Gaze, Mark N., E-mail: mark.gaze@uclh.nhs.uk [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Boterberg, Tom [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Dieckmann, Karin; Hoermann, Marcus [General Hospital Vienna, Medical University Vienna (Austria); Gains, Jennifer E.; Sullivan, Kevin P. [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Ladenstein, Ruth [Children' s Cancer Research Institute, St. Anna Children' s Hospital, Vienna (Austria)

    2013-01-01

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  17. A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

    Energy Technology Data Exchange (ETDEWEB)

    Sperduto, Paul W., E-mail: psperduto@mropa.com [Metro MN CCOP, Minneapolis, Minnesota (United States); Wang, Meihua [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Robins, H. Ian [University of Wisconsin Medical School Cancer Center, Madison, Wisconsin (United States); Schell, Michael C. [Wilmot Cancer Center, University of Rochester, Rochester, New York (United States); Werner-Wasik, Maria [Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Komaki, Ritsuko [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Buyyounouski, Mark K. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Khuntia, Deepak [University of Wisconsin Hospital, Madison, Wisconsin (United States); Demas, William [Akron City Hospital, Akron, Ohio (United States); Shah, Sunjay A. [Christiana Care Health Services, Inc, CCOP, Newark, Delaware (United States); Nedzi, Lucien A. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Perry, Gad [The Ottawa Hospital Cancer Centre, Ottawa, Ontario (Canada); Suh, John H. [Cleveland Clinic Foundation, Cleveland, Ohio (United States); Mehta, Minesh P. [Northwestern Memorial Hospital, Chicago, Illinois (United States)

    2013-04-01

    Background: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials: NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m{sup 2}/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m{sup 2}/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. Results: After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion: The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms.

  18. Prognostic significance of the S-phase fraction of light-chain-restricted cytoplasmic immunoglobulin (cIg) positive plasma cells in patients with newly diagnosed multiple myeloma enrolled on Eastern Cooperative Oncology Group treatment trial E9486.

    Science.gov (United States)

    Trendle, M C; Leong, T; Kyle, R A; Katzmann, J A; Oken, M M; Kay, N E; Van Ness, B G; Greipp, P R

    1999-08-01

    The bone marrow plasma cell labeling index (PCLI) as measured by bromodeoxyuridine uptake is a well-established independent prognostic factor for patients with newly diagnosed multiple myeloma, but the test is not easily done in most laboratories. The purpose of this study was to determine if the proliferative activity (% S-phase) as determined by two-color flow cytometry for cytoplasmic immunoglobulin (cIg) light chain and DNA content also had prognostic significance. As part of Eastern Cooperative Oncology Group clinical trial E9486, 500 patients had successful performance of the bone marrow PCLI. Of 349 patients who had flow cIg and DNA content cytometry, 210 had adequate data to reliably calculate S-phase %. Patients with low % S-phase fraction (/=2%), median survivals 4.1 vs. 2.9 years (P = 0.032). Measurement of the S-phase % by flow cytometry gives significant prognostic information in patients with newly diagnosed myeloma. However, in multivariate analysis, S-phase % did not add prognostic information when PCLI was in the model. S-phase % added prognostic information only when all cases with flow measurement of S-phase % were included, and when PCLI was excluded from the model. Discriminating a population of only cIg positive cells proved difficult in patients with a low percentage of bone marrow plasma cells. Methodology to measure S-phase % in patients with a low percent plasma cells is needed before this technique can be used for diagnosis and prognosis in myeloma. Copyright 1999 Wiley-Liss, Inc.

  19. A Paired, Double-Blind, Randomized Comparison of a Moisturizing Durable Barrier Cream to 10% Glycerine Cream in the Prophylactic Management of Postmastectomy Irradiation Skin Care: Trans Tasman Radiation Oncology Group (TROG) 04.01

    Energy Technology Data Exchange (ETDEWEB)

    Graham, Peter H., E-mail: peter.graham@sesiahs.health.nsw.gov.au [Cancer Care Centre, St. George Hospital, Kogarah, New South Wales (Australia); Plant, Natalie; Graham, Jennifer L.; Browne, Lois [Cancer Care Centre, St. George Hospital, Kogarah, New South Wales (Australia); Borg, Martin [Department of Radiation Oncology, Royal Adelaide Hospital (Australia); Capp, Anne [Department of Radiation Oncology, Mater Hospital, Newcastle, New South Wales (Australia); Delaney, Geoff P. [Cancer Care Centre, Liverpool Hospital, Liverpool, New South Wales (Australia); Harvey, Jennifer [Mater Hospital, South Brisbane, Queensland (Australia); Kenny, Lisbeth [Royal Brisbane Hospital, Herston, Queensland (Australia); Francis, Michael [Andrew Love Cancer Centre, Geelong (Australia); Zissiadis, Yvonne [Department of Radiation Oncology, Royal Perth Hospital, Perth (Australia)

    2013-05-01

    Purpose: A previous, unblinded study demonstrated that an alcohol-free barrier film containing an acrylate terpolymer (ATP) was effective in reducing skin reactions compared with a 10% glycerine cream (sorbolene). The different appearances of these products precluded a blinded comparison. To test the acrylate terpolymer principle in a double-blinded manner required the use of an alternative cream formulation, a moisturizing durable barrier cream (MDBC); the study was conducted by the Trans Tasman Radiation Oncology Group (TROG) as protocol 04.01. Methods and Materials: A total of 333 patients were randomized; 1 patient was ineligible and 14 patients withdrew or had less than 7 weeks' observations, leaving 318 for analysis. The chest wall was divided into medial and lateral compartments, and patients were randomized to have MDBC applied daily to the medial or lateral compartment and sorbolene to the other compartment. Weekly observations, photographs, and symptom scores (pain and pruritus) were collected to week 12 or resolution of skin reactions if earlier. Skin dose was confirmed by centrally calibrated thermoluminescent dosimeters. Results: Rates of medial and lateral compartment Common Toxicity Criteria (CTC), version 3, greater than or equal to grade 3 skin reactions were 23% and 41%, but rates by skin care product were identical at 32%. There was no significant difference between MDBC and sorbolene in the primary endpoint of peak skin reactions or secondary endpoints of area-under-the-curve skin reaction scores. Conclusions: The MDBC did not reduce the peak skin reaction compared to sorbolene. It is possible that this is related to the difference in the formulation of the cream compared with the film formulation. Skin dosimetry verification and double blinding are essential for radiation skin care comparative studies.

  20. Standardizing Naming Conventions in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Santanam, Lakshmi [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Hurkmans, Coen [Department of Radiation Oncology, Catharina Hospital, Eindhoven (Netherlands); Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Vliet-Vroegindeweij, Corine van [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Brame, Scott; Straube, William [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Galvin, James [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Tripuraneni, Prabhakar [Department of Radiation Oncology, Scripps Clinic, LaJolla, CA (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Bosch, Walter, E-mail: wbosch@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Advanced Technology Consortium, Image-guided Therapy QA Center, St. Louis, MO (United States)

    2012-07-15

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  1. Evaluación del riesgo nutricional e instauración de soporte nutricional en pacientes oncológicos, según el protocolo del grupo español de Nutrición y Cáncer Nutritional risk evalution and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group

    Directory of Open Access Journals (Sweden)

    M. M. Marín Caro

    2008-10-01

    porcentaje de pérdida de peso es del 6,64% ± 0,87 (min 0, máx 33%. El 32% de la población presenta cifras de albúmina entre 3 y 3,5 g/dl, existiendo una correlación negativa entre ésta y las dificultades con la alimentación p = 0,001. El IMC no mostró ser un parámetro significativo para detectar malnutrición (sólo un 10% se encontraba por debajo de 19,9 kg/m², pero tiene una tendencia lineal significativa con las dificultades en la alimentación, de forma tal que a medida que disminuye el IMC aumentan las dificultades p = 0,001. Más de la mitad de la población, requirió recomendaciones dietéticas específicas para el control de los síntomas que dificultaban la ingesta y una tercera parte de la población necesitó la indicación de suplementos nutricionales. Tras la intervención nutricional más de la mitad (60% mantuvo su peso y una sexta parte lo aumentó. Conclusión: La aplicación de este protocolo es útil, sencillo y podría facilitar la detección de malnutrición en los pacientes oncológicos. Seleccionando a los pacientes que realmente se podrían beneficiar de una intervención nutricional específica, pero debería aplicarse al inicio coincidiendo si fuera posible con el diagnóstico de la enfermedad. El soporte nutricional resulta eficaz en la mayoría de los pacientes.Introduction: Cancer and its oncological treatment cause symptoms which increase the patients risk to suffer from malnutrition. This affects the patients health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patients quality of life. Motivated by this, a group of health professionals from several spanish regions met with the backing of the Sociedad Española de Nutrición Básica y Aplicada (SENBA to address strategies to improve the quality of nutritional intervention in cancer patients. Methods: This multidisciplinary group developed a protocol describing nutritional assessment and

  2. Brief Group Psychotherpay for Women after Divorce: Planning a Focused Experience.

    Science.gov (United States)

    Coche, Judith; Goldman, Janice

    1979-01-01

    A model for a brief, focused group psychotherapy experience for women, led by women therapists, is suggested as an effective means to ease the transition from marriage and to allow a redefinition of the self as a single individual. (Author)

  3. Grade Inflation in Medical Student Radiation Oncology Clerkships: Missed Opportunities for Feedback?

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Surbhi, E-mail: surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Swisher-McClure, Samuel [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sosnowicz, Stasha [University of Pennsylvania, Philadelphia, Pennsylvania (United States); Li, Jiaqi; Mitra, Nandita [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Berman, Abigail T.; Baffic, Cordelia; Vapiwala, Neha; Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2015-07-15

    Purpose: To test the hypothesis that medical student radiation oncology elective rotation grades are inflated and cannot be used to distinguish residency applicants. Methods and Materials: The records of 196 applicants to a single radiation oncology residency program in 2011 and 2012 were retrospectively reviewed. The grades for each rotation in radiation oncology were collected and converted to a standardized 4-point grading scale (honors, high pass, pass, fail). Pass/fail grades were scored as not applicable. The primary study endpoint was to compare the distribution of applicants' grades in radiation oncology with their grades in medicine, surgery, pediatrics, and obstetrics/gynecology core clerkships. Results: The mean United States Medical Licensing Examination Step 1 score of the applicants was 237 (range, 188-269), 43% had additional Masters or PhD degrees, and 74% had at least 1 publication. Twenty-nine applicants were graded for radiation oncology rotations on a pass/fail basis and were excluded from the final analysis. Of the remaining applicants (n=167), 80% received the highest possible grade for their radiation oncology rotations. Grades in radiation oncology were significantly higher than each of the other 4 clerkships studied (P<.001). Of all applicants, 195 of 196 matched into a radiation oncology residency. Higher grades in radiation oncology were associated with significantly higher grades in the pediatrics core clerkship (P=.002). However, other medical school performance metrics were not significantly associated with higher grades in radiation oncology. Conclusions: Although our study group consists of a selected group of radiation oncology applicants, their grades in radiation oncology clerkships were highly skewed toward the highest grades when compared with grades in other core clerkships. Student grading in radiation oncology clerkships should be re-evaluated to incorporate more objective and detailed performance metrics to allow for

  4. Nord-Cotentin radioecology group: an innovative experiment in pluralist expertise; Le groupe Radioecologie Nord-Cotentin: une experience originale d'expertise pluraliste

    Energy Technology Data Exchange (ETDEWEB)

    Lochard, J.; Schneider, T.; Crouail, P. [Centre d' Etude sur l' Evaluation de la Protection dans le Domaine Nucleaire, 92 - Fontenay-aux-Roses (France); Heriard-Dubreuil, G.; Gadbois, S. [Mutadis, 92 - Fontenay aux Roses (France); Oudiz, A. [CEA Fontenay-aux-Roses, 92 (France). Inst. de Protection et de Surete Nucleaire

    2000-11-01

    This report gives a synthetic overview of the procedure and the main results of the GRNC (Nord-Cotentin Radioecology Group), and lessons that can be drawn from it. In particular, it is intended to demonstrate the innovation of the pluralist approach adopted by summarizing its historic context and differences with the similar experiment carried out in the United Kingdom for the Sellafield nuclear site 1. It also presents the different steps in the evaluation of exposures and risks associated with ionising radiation. Finally, it emphasizes prospects opened as a result of the Group's experiment on the involvement of stakeholders in the evaluation and management of radiological risk. This final aspect could open up new means of ''preventively'' dealing with questions related to risks to health and the environment inherent to industrial activities. (A.L.B.)

  5. Group of experience with the elderly: psychosocial support in health promotion

    Directory of Open Access Journals (Sweden)

    Laudicéia Noronha Xavier

    2015-09-01

    Full Text Available Objective: to analyze the perception of the elderly on the importance of a group of experience. Methods: iIt is an exploratory, descriptive research with qualitative approach, developed at a Basic Health Unit in a county of the Brazilian northeast, with 13 elderly people attending the Group. Data were collected through semi-structured interviews and analysis by the thematic analysis technique. Results: three empirical categories were identified: motivation to seek the group of experience, perspective concerning this group and changes perceived through participation. Conclusion: the group of experience can represent a therapeutic moment for the elderly, serving as support and strengthening the elderly in the social context, making the improvement and development of abilities as well as the obtaining more knowledge for health promotion possible.

  6. Qualitative analysis of experiences of members of a psychoeducational assertiveness group.

    Science.gov (United States)

    Argyrakouli, Effi; Zafiropoulou, Maria

    2007-04-01

    This study describes qualitatively a psychoeducational assertiveness intervention for 20 women's perceptions of positive and negative experiences, undertaken to identify whether therapeutic mechanisms operating in group therapy as described by Yalom might be inferred. There were 14 90-min. weekly sessions organized around educational material. Two groups were conducted with 10 university women each (M= 20.9 yr., SD= 1.9). Qualitative analysis of the 20 interviews identified five of Yalom's therapeutic mechanisms, namely, self-understanding, universality, acceptance, catharsis, and self-disclosure. The positive experiences were group cohesiveness, self-understanding, self-disclosure, positive views about the self and learning, and cognitive benefits. Self-disclosing at the early stages of group development was the most frequently reported negative experience or difficulty in the group. Although participants stated they improved interpersonal communication skills, analysis suggested the cultural context was an important mediator of assertive behavior.

  7. A quality of experience testbed for video-mediated group communication

    NARCIS (Netherlands)

    Schmitt, M.R.; Gunkel, S.; Cesar Garcia, P.S.

    2013-01-01

    Video-Mediated group communication is quickly moving from the office to the home, where network conditions might fluctuate. If we are to provide a software component that can, in real-time, monitor the Quality of Experience (QoE), we would have to carry out extensive experiments under different vary

  8. Compassion Fatigue: Exploring Early-Career Oncology Nurses' Experiences
.

    Science.gov (United States)

    Finley, Brooke A; Sheppard, Kate G

    2017-06-01

    Oncology nurses have a higher risk and rate of compassion fatigue (CF) compared to professionals in other specialties. CF exhibits tangible negative outcomes, affecting nurses' health and professional practice.
. Early-career oncology nurses' unique CF experiences lack thorough scientific exploration. This secondary analysis seeks to qualitatively augment this paucity and illuminate targeted interventions.
. Open-ended interviews were conducted with five early-career inpatient oncology nurses. Subsequent transcripts were explored for CF themes secondarily using thematic analysis.
. Themes indicate that early-career oncology nurses enjoy connecting with patients and families, but over-relating, long patient stays, and high patient mortality rates trigger CF. Symptoms include internalizing patients' and families' pains and fears, being haunted by specific patient deaths, feeling emotionally depleted, assuming that all patients will die, and experiencing burnout, physical exhaustion, and hypervigilance protecting loved ones.

  9. Laparoscopic versus open nephroureterectomy: perioperative and oncologic outcomes from a randomised prospective study.

    Science.gov (United States)

    Simone, Giuseppe; Papalia, Rocco; Guaglianone, Salvatore; Ferriero, Mariaconsiglia; Leonardo, Costantino; Forastiere, Ester; Gallucci, Michele

    2009-09-01

    Laparoscopic nephroureterectomy (LNU) is increasingly being used instead of open nephroureterectomy (ONU) for the treatment of urothelial carcinoma (UC) of the upper urinary tract (UUT), but the evidence of equal oncologic effectiveness is still lacking. To present perioperative and oncologic results from a prospective randomised study comparing ONU and LNU. Eighty patients with nonmetastatic UUT UC and without previous history of UC were enrolled. Of those, 40 patients (group A) randomly received ONU and 40 patients (group B) randomly received LNU. ONU was performed through a flank incision with a lower quadrant incision to allow excision of a bladder cuff. Transperitoneal LNU was performed with a four-trocar technique, and bladder cuff was detached with a 10-mm LigaSure device. Perioperative data were compared with the student t test. Bladder tumour-free survival (BTFS), metastasis-free survival (MFS), and cancer-specific survival (CSS) curves for both groups were compared with the log-rank test before and after stratifying patients for pT category and tumour grade. Operative times were comparable, while mean blood loss and mean time to discharge were significantly lower in group B (both p values ONU (p=0.039 and p=0.004, respectively, for pT3 tumours; p=0.078 and p=0.014, respectively, for high-grade tumours). The limitations of our study include the small sample size, the single-centre experience, the personal choice of laparoscopic technique, and not performing lymphadenectomies. Perioperative data and preliminary oncologic results were presented at 22nd Congress of the European Association of Urology, Berlin, Germany. In patients with organ-confined UUT UCs, LNU has the advantages of minimal invasiveness and oncologic outcomes comparable to those of ONU, while its effectiveness in patients with advanced stage diseases remains to be proven.

  10. Oncology in Cambodia.

    Science.gov (United States)

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

    2012-01-01

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

  11. Molecular radio-oncology

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-01

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

  12. Quantitative FDG PET/CT in the community: experience from interpretation of outside oncologic PET/CT exams in referred cancer patients.

    Science.gov (United States)

    Tahari, Abdel K; Wahl, Richard L

    2014-04-01

    oncologic PET/CT studies among different centres must still be pursued. © 2013 The Royal Australian and New Zealand College of Radiologists.

  13. Patients' experiences and expectations of general practice: a questionnaire study of differences by ethnic group

    Science.gov (United States)

    Ogden, Jane; Jain, Asha

    2005-01-01

    Background Research has highlighted variations in morbidity, mortality and health needs by ethnic group, and suggests that some ethnic groups may receive a poorer service. Aim To explore the impact of ethnic group on patients' experiences and expectations of their general practice consultation. Design of study Cross-sectional survey. Setting One general practice in a multicultural area of London. Method A total of 604 consecutive patients attending their general practice (response rate = 60.4%) who described their ethnic group as white British, black African, black African Caribbean or Vietnamese completed a measure relating to their experiences and their expectations of the general practice consultation in terms of treatment, communication, patients' agenda, patients' choice and doctor consistency. Results No differences were found for the black African or black African Caribbean patients. The Vietnamese patients reported better experiences of communication, more focus on their agenda and more attention to their choices than the white British patients. However, they also reported expecting lower levels of communication, less focus on their own agenda and reported wanting less GP consistency than the other ethnic groups. Conclusion Vietnamese patients state that they are receiving better standards of care in general practice than other ethnic groups. However, they also state that they expect less. This may illustrate a problem with assessing experiences of primary care. Higher scores of experience may not illustrate better consultations as such, but only better when compared with a lower level of initial expectation. A lower expectation is easier to fulfil. PMID:15904553

  14. Two replications of "Hierarchical encoding makes individuals in a group seem more attractive (2014; Experiment 4".

    Directory of Open Access Journals (Sweden)

    Yuko Ojiro

    2015-06-01

    Full Text Available The cheerleader effect implies that a person in a group look like more attractive than in isolation. Walker and Vul (2014 reported results supporting the existence of the cheerleader effect. We replicated Walker and Vul’s Experiment 4, which manipulated group size. Their participants were asked to rate attractiveness of each female face image in a group (one of 4, 9, or 16 members and in isolation and revealed that attractiveness ratings significantly increased in all the group conditions. We performed two direct replications of this experiment using Japanese participants. As a result, at least one experiment yielded a pattern of results similar to those of the previous study, although the effect was not significant and the effect size was small.

  15. Great Expectations: How Role Expectations and Role Experiences Relate to Perceptions of Group Cohesion.

    Science.gov (United States)

    Benson, Alex J; Eys, Mark A; Irving, P Gregory

    2016-04-01

    Many athletes experience a discrepancy between the roles they expect to fulfill and the roles they eventually occupy. Drawing from met expectations theory, we applied response surface methodology to examine how role expectations, in relation to role experiences, influence perceptions of group cohesion among Canadian Interuniversity Sport athletes (N = 153). On the basis of data from two time points, as athletes approached and exceeded their role contribution expectations, they reported higher perceptions of task cohesion. Furthermore, as athletes approached and exceeded their social involvement expectations, they reported higher perceptions of social cohesion. These response surface patterns-pertaining to task and social cohesion-were driven by the positive influence of role experiences. On the basis of the interplay between athletes' role experiences and their perception of the group environment, efforts to improve team dynamics may benefit from focusing on improving the quality of role experiences, in conjunction with developing realistic role expectations.

  16. Radiation oncology a physicist's-eye view

    CERN Document Server

    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...

  17. Resilience and family of oncological patients

    Directory of Open Access Journals (Sweden)

    María Elena Garassi

    2015-09-01

    Full Text Available Resilience like ability to overcome adversity and even learn and get out “strengthened” them has become, in the last decade, the focus of many studies throughout the life cycle and in different cultures. On the other hand, oncological disease was introduced globally in a high percentage of the population requiring labor and health team including psychologists for coping on the part of the patient and their family members. The authors cited in the course of this article refer to the importance of developing resilience at the personal, family and cultural level, started with the presence of trust relationships, cultivating positive emotions, the acceptance of different cycles of life and belief in a just world. These promoting resilience factors are the springs that allow the experience of oncological disease and even death and mourning as opportunities to generate personal and familiar learning. 

  18. [Strategies for improving care of oncologic patients: SHARE Project results].

    Science.gov (United States)

    Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

    2016-01-01

    Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients.

  19. Evaluating Experiential Learning in Organizational Behavior: Taking Measure of Student Perception Regarding Group Experience

    Directory of Open Access Journals (Sweden)

    Roxanne Helm-Stevens

    2009-01-01

    Full Text Available Problem statement: The purpose of this study was to determine undergraduate student perceptions in the areas of group experience within the context of an undergraduate organizational behavior business class community service assignment. College students, as part of an in-class service-learning project, were assigned to teach business related curriculum to at-risk high school students. Approach: Students, enrolled in the required senior level business course, were then assessed in the following areas: service learning experience and group experience. A multiple-choice questionnaire was administered to undergraduate students in an organizational and administrative behavior class and analyzed for correlations and relationships. The survey was administered in week eleven of a traditional semester and in the last week of the community service project. The survey was comprised of seven questions relating to group experience and one based on the impact of the community service project itself. Results: Significant findings revealed a positive correlation between the group experience and the feelings toward the project. In addition, multiple linear regressions suggested a positive and significant prediction. Conclusion: From the findings, implications for the development of experiential learning projects for use in the college classroom will be discussed. When paired with the results of previous research, the findings of this research can be very useful in developing group based service learning projects at the undergraduate level. Based upon the importance of service learning as an experiential teaching style, it is critical to understand how to better use this vehicle for discovery.

  20. Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

    Energy Technology Data Exchange (ETDEWEB)

    Gondi, Vinai, E-mail: vgondi@chicagocancer.org [Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Bruner, Deborah W. [Nell Hodgson Woodfull School of Nursing, Emory University, Atlanta, Georgia (United States); Meyers, Christina A. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wolfson, Aaron [University of Miami School of Medicine, Miami, Florida (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Sun, Alexander Y. [Princess Margaret Hospital, Toronto, ON (Canada); Choy, Hak [University of Texas Southwestern Moncreif Cancer Center, Fort Worth, Texas (United States); Movsas, Benjamin [Henry Ford Health System, Detroit, Michigan (United States)

    2013-07-15

    Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum.

  1. Low Interrater Reliability in Grading of Rectal Bleeding Using National Cancer Institute Common Toxicity Criteria and Radiation Therapy Oncology Group Toxicity Scales: A Survey of Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Huynh-Le, Minh-Phuong [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Zhang, Zhe [Department of Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Tran, Phuoc T.; DeWeese, Theodore L. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Song, Daniel Y., E-mail: dsong2@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

    2014-12-01

    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

  2. Higher Biologically Effective Dose of Radiotherapy Is Associated With Improved Outcomes for Locally Advanced Non-Small Cell Lung Carcinoma Treated With Chemoradiation: An Analysis of the Radiation Therapy Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Machtay, Mitchell, E-mail: Mitchell.machtay@uhhospitals.org [University Hospitals/Case Western Reserve University, Cleveland, OH (United States); Bae, Kyounghwa [Radiation Therapy Oncology Group (RTOG) Department of Statistics, Philadelphia, PA (United States); Movsas, Benjamin [Henry Ford Hospital, Detroit, MI (United States); Paulus, Rebecca [Radiation Therapy Oncology Group (RTOG) Department of Statistics, Philadelphia, PA (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, WI (United States); Komaki, Ritsuko [M.D. Anderson Cancer Center, Houston, TX (United States); Albain, Kathy [Loyola University Chicago Stritch School of Medicine, Maywood, IL (United States); Sause, William T. [LDS Hospital, Salt Lake City, UT (United States); Curran, Walter J. [Emory University, Atlanta, GA (United States)

    2012-01-01

    Purpose: Patients treated with chemoradiotherapy for locally advanced non-small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity. Methods and Materials: This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA-NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10, and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with chi-squared statistics, and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray's proportional hazard models were used for OS and LRF, respectively, to test the associations between BED and tBED adjusted for other covariates. Results: A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%, respectively. The 2-year and 5-year LRF rates were 46% and 52%, respectively. The BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p < 0.0001). A 1-Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival; this is another way of expressing the finding that the pool-adjusted hazard ratio for survival as a function of BED was 0.96. Similarly, a 1-Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control; this is another way of expressing the finding that the pool-adjusted hazard ratio as a function of tBED was 0.97. Conclusions: Higher radiotherapy dose intensity is associated with improved local-regional control

  3. Historical time to disease progression and progression-free survival in patients with recurrent/refractory neuroblastoma treated in the modern era on Children's Oncology Group early-phase trials.

    Science.gov (United States)

    London, Wendy B; Bagatell, Rochelle; Weigel, Brenda J; Fox, Elizabeth; Guo, Dongjing; Van Ryn, Collin; Naranjo, Arlene; Park, Julie R

    2017-09-08

    Early-phase trials in patients with recurrent neuroblastoma historically used an objective "response" of measureable disease (Response Evaluation Criteria In Solid Tumors [RECIST], without bone/bone marrow assessment) to select agents for further study. Historical cohorts may be small and potentially biased; to the authors' knowledge, disease recurrence studies from international registries are outdated. Using a large recent cohort of patients with recurrent/refractory neuroblastoma from Children's Oncology Group (COG) modern-era early-phase trials, the authors determined outcome and quantified parameters for designing future studies. The first early-phase COG trial enrollment (sequential) of 383 distinct patients with recurrent/refractory neuroblastoma on 23 phase 1, 3 phase 1/2, and 9 phase 2 trials (August 2002 to January 2014) was analyzed for progression-free survival (PFS), overall survival (OS), and time to disease progression (TTP). Planned frontline therapy for patients with high-risk neuroblastoma included hematopoietic stem cell transplantation (approximately two-thirds of patients underwent ≥1 hematopoietic stem cell transplantation); 13.2% of patients received dinutuximab. From the time of the patient's first early-phase trial enrollment (383 patients), the 1-year and 4-year PFS rates ( ± standard error) were 21% ± 2% and 6% ± 1%, respectively, whereas the 1-year and 4-year OS rates were 57% ± 3% and 20% ± 2%, respectively. The median TTP was 58 days (interquartile range, 31-183 days [350 patients]); the median follow-up was 25.3 months (33 patients were found to be without disease recurrence/progression). The median time from diagnosis to first disease recurrence/progression was 18.7 months (range, 1.4-64.8 months) (176 patients). MYCN amplification and 11q loss of heterozygosity were prognostic of worse PFS and OS (P = .003 and Pphase trial enrollment. This recent COG cohort of patients with recurrent

  4. Assessment of the Prognostic Value of Two Common Variants of BRCA1 and BRCA2 Genes in Ovarian Cancer Patients Treated with Cisplatin and Paclitaxel: A Gynecologic Oncology Group Study

    Directory of Open Access Journals (Sweden)

    Chunqiao eTian

    2013-08-01

    Full Text Available Purpose: BRCA1/BRCA2 germline mutations appear to enhance the platinum-sensitivity, but little is known about the prognostic relevance of polymorphisms in BRCA1/BRCA2 in epithelial ovarian cancer (EOC. This study evaluated whether common variants of BRCA1/BRCA2 are associated with progression-free survival (PFS and overall survival (OS in patients with advanced stage sporadic EOC.Experimental Design: The allelic frequency of BRCA1 (2612C>T, P871L-rs799917 and BRCA2 (114A>C, N372H-rs144848 were determined in normal blood DNA from women in Gynecologic Oncology Group (GOG protocol #172 phase III trial with optimally-resected stage III EOC treated with intraperitoneal or intravenous cisplatin and paclitaxel (C+P. Associations between polymorphisms and PFS or OS were assessed. Results: 232 women were included for analyses. African Americans (AA had different distributions for the two polymorphisms from Caucasians and others. For non-AA patients, the genotype for BRCA1 P871L was distributed as 38% for CC, 49% for CT and 13% for TT. Median PFS was estimated to be 31, 21 and 21 months, respectively. After adjusting for cell type, residual disease and chemotherapy regimen, CT/TT genotypes were associated with a 1.40-fold increased risk of disease progression (95% confidence interval [CI]=1.00-1.95, p=0.049. After removing 7 patients with known BRCA1 germline mutations, the hazard ratio (HR was 1.36 (95% CI=0.97-1.91, p=0.073. The association between BRCA1 P871L and OS was not significant (HR =1.25, 95% CI=0.88-1.76, p=0.212. Genotype distribution of BRCA2 N372H among non-AA patients was 50%, 44% and 6% for AA, AC and CC, respectively and there is no evidence that this BRCA2 polymorphism was related to PFS or OS. Conclusion: Polymorphisms in BRCA1 P871L or in BRCA2 N372H were not associated with either PFS or OS in women with optimally-resected, stage III EOC treated with cisplatin and paclitaxel.

  5. Transpersonal experiences in childhood: an exploratory empirical study of selected adult groups.

    Science.gov (United States)

    Hunt, H T; Gervais, A; Shearing-Johns, S; Travis, F

    1992-12-01

    A questionnaire was developed to assess adult recall for a range of transpersonal experiences throughout childhood and adolescence (mystical experience, out-of-body experience, lucid dreams, archetypal dreams, ESP), as well as nightmares and night terrors as indicators of more conflicted, negative states. In two exploratory studies this questionnaire was administered to subjects with high estimated levels of early transpersonal experiences and practising meditators, with respective undergraduate controls. A cognitive skills/precocity model of early transpersonal experience was contrasted with a vulnerability of self model by comparisons of these groups on questionnaire categories, imaginative absorption, neuroticism, and visual-spatial skills, with some support found for both models depending on experience type, age of estimated recall, and adult meditative practice.

  6. Mathematical oncology 2013

    CERN Document Server

    Gandolfi, Alberto

    2014-01-01

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

  7. [Dermato-oncological rehabilitation].

    Science.gov (United States)

    Buhles, N; Sander, C

    2005-07-01

    National insurance companies in Germany support health cures for patients with malignant tumors (malignant melanoma, squamous cell carcinoma, Merkel cell tumor, malignant cutaneous lymphoma). The clinical requirements are an invasively growing tumor, problems of self-assurance, and dis-integration of the patient regarding his social and/or professional environment. The decision for a health cure is made by the treating dermatologist in the hospital. In this context, the following sociomedical criteria should be applied: impairment, disability, and handicap. Usually, rehabilitation starts after the patient is discharged from the hospital. The inpatient rehabilitation program should be performed at an institution capable of providing dermatological and psychological treatment. The dermatologist acts as a manager for the members of the rehabilitation team (psychologists, physiotherapists, social workers, and ergo-therapists). In conclusion, dermato-oncologic rehabilitation plays an important role in re-integrating the patient into his professional life to avoid retirement.

  8. NCCN Oncology Risk Evaluation and Mitigation Strategies White Paper: Recommendations for Stakeholders.

    Science.gov (United States)

    Johnson, Philip E; Dahlman, George; Eng, Kirby; Garg, Rekha; Gottlieb, Scott; Hoffman, James M; Howell, Peyton; Jahanzeb, Mohammad; Johnson, Shirley; Mackler, Emily; Rubino, Mark; Sarokhan, Brenda; Marc Stewart, F; Tyler, Tim; Vose, Julie M; Weinstein, Sharon; Li, Edward C; Demartino, Jessica

    2010-09-01

    REMS are a particularly important issue for oncology and the National Comprehensive Cancer Network (NCCN). A disproportionate number of drugs with complex REMS are used in patients with cancer or hematologic disorders. REMS policies and processes within oncology may act as a model for other clinical areas. A breadth of experience and access to a wide knowledge base exists within oncology that will ensure appropriate development and consideration of the practical implications of REMS. NCCN is uniquely positioned to assume a leadership role in this process given its status as the arbiter of high-quality cancer care based on its world-leading institutions and clinicians. Notwithstanding the potential benefits, the successful design, implementation, and analysis of the FDA's recent requirement for REMS for some high-risk drugs and biologics will present significant challenges for stakeholders, including patients, providers, cancer centers, manufacturers, payors, health information technology vendors, and regulatory agencies. To provide guidance to these stakeholders regarding REMS challenges, the NCCN assembled a work group comprised of thought leaders from NCCN Member Institutions and other outside experts. The Work Group identified challenges across the REMS spectrum, including the areas of standardization, development and assessment of REMS programs, medication guides, provider knowledge and impact on prescribing, provider burden and compensation, and incorporation of REMS into clinical practice.

  9. Selective incivility: immigrant groups experience subtle workplace discrimination at different rates.

    Science.gov (United States)

    Krings, Franciska; Johnston, Claire; Binggeli, Steve; Maggiori, Christian

    2014-10-01

    Immigrants play an increasingly important role in local labor markets. Not only do they grow steadily in number but also in cultural, educational, and skill diversity, underlining the necessity to distinguish between immigrant groups when studying discrimination against immigrants. We examined immigrant employees' subtle discrimination experiences in a representative sample in Switzerland, controlling for dispositional influences. Results showed that mainly members of highly competitive immigrant groups, from immediate neighbor countries, experienced workplace incivility and that these incivility experiences were related to higher likelihoods of perceived discrimination at work. This research confirms recent accounts that successful but disliked groups are particularly likely to experience subtle interpersonal discrimination. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  10. Quasi-Experiments in Schools: The Case for Historical Cohort Control Groups

    Directory of Open Access Journals (Sweden)

    Tamara M. Walser

    2014-06-01

    Full Text Available There is increased emphasis on using experimental and quasi-experimental methods to evaluate educational programs; however, educational evaluators and school leaders are often faced with challenges when implementing such designs in educational settings. Use of a historical cohort control group design provides a viable option for conducting quasi-experiments in school-based outcome evaluation. A cohort is a successive group that goes through some experience together, such as a grade level or a training program. A historical cohort comparison group is a cohort group selected from pre-treatment archival data and matched to a subsequent cohort currently receiving a treatment. Although prone to the same threats to study validity as any quasi-experiment, issues related to selection, history, and maturation can be particularly challenging. However, use of a historical cohort control group can reduce noncomparability of treatment and control conditions through local, focal matching. In addition, a historical cohort control group design can alleviate concerns about denying program access to students in order to form a control group, minimize resource requirements and disruption to school routines, and make use of archival data schools and school districts collect and find meaningful.

  11. Experiences of older adults in a group physiotherapy program at a rehabilitation hospital: A qualitative study.

    Science.gov (United States)

    Raymond, Melissa J; Burge, Angela T; Soh, Sze-Ee; Jeffs, Kimberley J; Winter, Adele; Holland, Anne E

    2016-05-01

    Physiotherapy delivered in a group setting has been shown to be effective in a variety of populations. However, little is known about the attitudes of older adults toward participating in group physiotherapy. The objectives of this study were to explore older inpatients' perceptions and experiences of group physiotherapy using qualitative methods. Twelve hospitalized adults aged ≥65 years who were involved in a larger randomized controlled trial undertook individual semistructured interviews regarding their experiences in group physiotherapy. Interviews were transcribed verbatim, and line by line, iterative thematic analysis was undertaken. Descriptive codes were developed, compared, and grouped together to create themes. Analysis revealed 6 major themes and 10 subthemes. All participants reported feeling happy to attend group sessions, a satisfactory alternative to individual physiotherapy. Participants described physical benefits that increased their motivation, and comparisons with their peers either motivated them or made them feel gratitude for their own health. Perceived attentiveness of group instructors contributed to participants reporting that treatment was individualized and similar to individual physiotherapy. Motivation and camaraderie with peers contributed to their enjoyment of group physiotherapy. Hospitalized older adults enjoyed exercising with their peers and valued the physical and social benefits of group physiotherapy. Journal of Hospital Medicine 2016;11:358-362. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  12. Corrective interpersonal experience in psychodrama group therapy: a comprehensive process analysis of significant therapeutic events.

    Science.gov (United States)

    McVea, Charmaine S; Gow, Kathryn; Lowe, Roger

    2011-07-01

    This study investigated the process of resolving painful emotional experience during psychodrama group therapy, by examining significant therapeutic events within seven psychodrama enactments. A comprehensive process analysis of four resolved and three not-resolved cases identified five meta-processes which were linked to in-session resolution. One was a readiness to engage in the therapeutic process, which was influenced by client characteristics and the client's experience of the group; and four were therapeutic events: (1) re-experiencing with insight; (2) activating resourcefulness; (3) social atom repair with emotional release; and (4) integration. A corrective interpersonal experience (social atom repair) healed the sense of fragmentation and interpersonal disconnection associated with unresolved emotional pain, and emotional release was therapeutically helpful when located within the enactment of this new role relationship. Protagonists who experienced resolution reported important improvements in interpersonal functioning and sense of self which they attributed to this experience.

  13. An Innovative Sequential Focus Group Method for Investigating Diabetes Care Experiences With Indigenous Peoples in Canada

    Directory of Open Access Journals (Sweden)

    Kristen Jacklin

    2016-10-01

    Full Text Available This article describes the innovative use of sequential focus groups (SFGs with Indigenous adults living with type 2 diabetes. This use of SFGs has not been previously described in the literature. In our project, SFGs were used to explore Indigenous people’s experiences in managing their diabetes. Our research objective has been to elucidate deep understandings of these experiences in order to inform the development of continuing medical education curriculum with the aim of improving approaches to diabetes care for Indigenous people. Working in partnerships with Indigenous health organizations, we recruited four groups comprising participants from diverse Indigenous communities (two urban, two rural in three provinces of Canada. We conducted a series of five focus groups (SFGs with the same participants (6–8 participants at each site for a total of 20 focus groups and 29 participants. Indigenous people living with type 2 diabetes were asked open-ended questions concerning their experiences with diabetes and diabetes care in primary health-care settings. Our findings concerning the use of SFGs for Indigenous health research draw on team member and participants’ reflections captured in facilitator field notes, memos from debriefing sessions, and focus group transcripts. The SFG approach enabled in-depth exploration of the complex, and at times sensitive, issues related to Indigenous people’s views on diabetes and their experiences of diabetes care. The repeated sessions facilitated comfort and camaraderie among participants, which led to insightful sessions filled with personal and emotional stories of living with diabetes, the impacts of colonization, and health-care experiences. Overall, the method fostered a deeper level of engagement, exploration, and reflection than a single-session focus group typically would. We suggest this adaptation of the traditional single-session focus groups would be applicable to a wide variety of research

  14. Dutch Cyberbullying Victims’ Experiences, Perceptions, Attitudes and Motivations Related to (Coping with) Cyberbullying: Focus Group Interviews

    OpenAIRE

    Niels C.L. Jacobs; Linda Goossens; Francine Dehue; Trijntje Völlink; Lilian Lechner

    2015-01-01

    Because of the negative effects of cyberbullying; and because of its unique characteristics; interventions to stop cyberbullying are needed. For this purpose, more insightful information is needed about cyberbullying victims’ ( i.e., the target group) experiences, perceptions, attitudes and motivations related to (coping with) cyberbullying. Five schools with 66 low-educated Dutch adolescents between 12 and 15 (53% female) participated in 10 focus group interviews. Results show that victims d...

  15. An Approach for Group, Undergraduate Research Experiences in Courses Across the Geology Curriculum

    Science.gov (United States)

    Lord, M.; Kinner, D. A.

    2013-12-01

    At Western Carolina University, a past NSF CCLI grant helped embed project-based learning throughout the geology curriculum, including a senior capstone seminar in which groups of students conduct authentic undergraduate research (UR). These curricular changes showed many high-level educational benefits to the group senior capstone research and the benefits of complex, technical projects at all levels of the curriculum if project goals and guidance for students is appropriate for their level, skills, and experiences. A current NSF TUES grant, now in its 3rd year, is formally assessing the impact of students participating in group UR experiences embedded in traditional courses at all curricular levels to determine if they have similar benefits to students conducting individually-mentored research. An ancillary goal is to develop a transferable, sustainable model for this approach, so UR experiences can formally broaden to more students at more levels. At this time, we have taught about 100 students in five research-based courses at all levels of the curriculum. Student's perceived strong benefits of their UR experience, and have been evaluated with quantitative (URSSA) and qualitative (focus groups) data. Benefits of their experiences are high related to personal growth and the scientific process and relatively low in research skills. Qualitative data shows students value 1) the open-ended nature of the authentic research questions, 2) group collaboration, and 3) hands-on learning. Similarity of student results across different courses reflect a now stable approach we have developed for courses with group UR experiences. Key elements to our approach are 1) an ongoing, broad research program (in our case, an on-campus hydrologic research station), 2) strategically assigned student groups (no. 3-6), group responsibilities that include a mix of individual and group assignments, and peer assessments, 3) student research fellows that help run the research station and

  16. Dissecting the journey: nursing student experiences with collaboration during the group work process.

    Science.gov (United States)

    Gagnon, Lissa L; Roberge, Ginette D

    2012-11-01

    Since the outset of nursing care, group work processes have evolved into essential components of a nurse's role and responsibilities within the health care system. To reflect this trend, group work is often utilized as a medium to promote professional socialization in undergraduate nursing curricula. The purpose of this qualitative study was to explore the ways undergraduate nursing students experience collaboration during group work activities. Braun and Clarke's (2006) theoretical thematic analysis combined with Pollio et al.'s (2006) interpretive framework was utilized to capture the students' lived experiences regarding group work. The participants of this study consisted of 96 undergraduate students enrolled in a nursing program in Canada. Written descriptions of their perceptions of their group work practices were analyzed to determine the extent to which these adhere to the collaborative practice essential elements (Jones and Way, 2006). Analysis of the results revealed an unexpected element of collaboration that of the psychosocial element in group work. The results from this study expose advantages and disadvantages of group work processes during group work in nursing education. This type of insight is valuable for educators to prepare nursing students for the complex demands of working with interdisciplinary teams.

  17. Experience of dysmenorrhea among a group of physical therapy students from Cairo University: an exploratory study

    Directory of Open Access Journals (Sweden)

    Kamel DM

    2017-05-01

    Full Text Available Dalia M Kamel,1,2 Sayed A Tantawy,2,3 Gehan A Abdelsamea1 1Department of Physical Therapy for Obstetrics & Gynecology, Faculty of Physical Therapy, Cairo University, Giza, Egypt; 2Physiotherapy Department, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain; 3Department of Physiotherapy, Centre of Radiation, Oncology and Nuclear Medicine, Cairo University, Giza, Egypt Introduction: Dysmenorrhea is a condition describing the painful cramps that women feel before or during the menstrual period. While dysmenorrhea is the most common gynecologic complaint affecting adolescent and young women and there has been significant progress in understanding its pathophysiology and managing the symptoms, many young women do not seek medical consultation and remain untreated.Aim of the study: The aim of the study was to explore the prevalence of dysmenorrhea, its physical impact, and associated coping behaviors among university students.Methods: A total of 269 female college students volunteered to participate in the study. Data regarding the students’ experience with dysmenorrhea were collected via self-reported questionnaire developed based on relevant literature. Pain was scored on visual analog scale (VAS.Results: Most respondents (84.01% reported feeling pain in the abdomen and back (VAS score, 5.00. Mood swings (84.8% and dizziness (48.2% were, respectively, the most common affective and somatic symptoms related to menstruation. There was a significant difference in the amount of menstrual flow (p=0.004 and incidence of dysmenorrhea (p=0.03 according to menstrual regularity. Most students (91.2% did not seek medical consultation for dysmenorrhea, and 62.4% used analgesics. However, no significant correlation (p=0.25 was found between analgesic intake and pain relief. While most students (90.7% did not miss exams, 48.7% reported poor satisfaction with their academic performance because of dysmenorrhea

  18. Compassion Fatigue, Burnout, and Compassion Satisfaction Among Oncology Nurses in the United States and Canada.

    Science.gov (United States)

    Wu, Stacey; Singh-Carlson, Savitri; Odell, Annie; Reynolds, Grace; Su, Yuhua

    2016-07-01

    To examine the experiences of compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada. 
. Quantitative, descriptive, nonexperimental.
. Online survey with members from the Canadian Association of Nursing Oncology and the Oncology Nursing Society.
. 486 American and 63 Canadian practicing oncology nurses.
. The Professional Quality of Life (ProQOL) scale, version 5, and modified Abendroth Demographic Questionnaire were administered through FluidSurveys™, an online data collection instrument. Chi-square tests of independence were used to investigate associations between demographic characteristics, health, personal stressors, and work-related characteristics to experiences of compassion fatigue, burnout, and compassion satisfaction. Compassion fatigue was measured using the subscales of secondary traumatic stress and burnout. 
. Compassion fatigue, burnout, and compassion satisfaction.
. Demographic characteristics were similar in American and Canadian participants, and both cohorts reported comparable levels of compassion fatigue, burnout, and compassion satisfaction. Perception of team cohesiveness within the workplace environment was found to be significant for both groups, as indicated by significant relationships in all three subscales of secondary traumatic stress, burnout, and compassion satisfaction in the ProQOL.
. Healthy and supportive work environments are imperative to nurses' health, well-being, and satisfaction. Improvements in the workplace can help prevent negative sequelae, as well as improve health outcomes for patients and nurses, decrease nurse turnover, and reduce healthcare expenditures. 
. Findings can be used to implement institutional changes, such as creating policies and guidelines for the development of preventive interventions and psychosocial support for nurses.

  19. Systemic treatment with capecitabine as maintenance therapy in patients with recurring or metastatic breast cancer: experience in the Oncology Hospital, National Medical Center Siglo XXI, Mexican Social Security Institute.

    Science.gov (United States)

    Segura-González, Manuel; Quintana-Quintana, Miguel

    2015-04-01

    Metastatic breast cancer as initial onset represents between 20 and 30 % of cases and is considered an incurable disease. The goal of its treatment is palliative, looking for increasing the survival while reducing the symptoms. Maintenance chemotherapy studies for metastatic breast cancer have demonstrated to prolong the progression-free survival, with unclear results in terms of overall survival. The main objectives of our study were the progression-free survival and overall survival in patients with recurring or metastatic breast cancer treated with capecitabine in the maintenance chemotherapy setting compared with patients not receiving maintenance chemotherapy. As secondary objectives, the frequency of dose-limiting toxicities and response rate were determined. A non-probabilistic sampling was used, through expert selection of patients from the recurring/metastatic breast cancer survey cared within the period from January 1, 2007, to December 21, 2012. A total of 77 patients were included. Clinical data of advanced/recurrent breast cancer patients that were treated with capecitabine were recorded. The study achieved its primary objective, since the progression-free survival was prolonged for the maintenance therapy group: 6.6 versus 18.1 months, p Siglo XXI Oncology Hospital extends the overall survival and progression-free survival with a good toxicity profile.

  20. [Oncologic gynecology and the Internet].

    Science.gov (United States)

    Gizler, Robert; Bielanów, Tomasz; Kulikiewicz, Krzysztof

    2002-11-01

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

  1. American Society of Clinical Oncology

    Science.gov (United States)

    ... of Interest Mobile App Privacy Policy Privacy Policy Social Media Policy Sponsor Policy Terms of Use American Society of Clinical Oncology ASCO Annual Meeting Register and Reserve Your Hotel June 2-6, 2017 | Chicago, Illinois Hotel Reservation & ...

  2. Personalizing medicine in geriatric oncology

    National Research Council Canada - National Science Library

    Walko, Christine M; McLeod, Howard L

    2014-01-01

    Minimizing toxicity while maximizing efficacy is a common goal in the treatment of any condition but its importance is underscored in the discipline of oncology because of the serious nature of many...

  3. A Study of Layered Learning in Oncology.

    Science.gov (United States)

    Bates, Jill S; Buie, Larry W; Lyons, Kayley; Rao, Kamakshi; Pinelli, Nicole R; McLaughlin, Jacqueline E; Roth, Mary T

    2016-05-25

    Objective. To explore use of pharmacy learners as a means to expand pharmacy services in a layered learning practice model (LLPM), to examine whether an LLPM environment precludes achievement of knowledge-based learning objectives, and to explore learner perception of the experience. Design. An acute care oncology pharmacy practice experience was redesigned to support the LLPM. Specifically, the redesign focused on micro discussion, standardized feedback (eg, rubrics), and cooperative learning to enhance educational gain through performing clinical activities. Assessment. Posttest scores evaluating knowledge-based learning objectives increased in mean percentage compared to pretest values. Learners viewed the newly designed practice experience positively with respect to perceived knowledge attainment, improved clinical time management skills, contributions to patient care, and development of clinical and self-management skills. A fifth theme among students, comfort with learning, was also noted. Conclusion. Layered learning in an oncology practice experience was well-received by pharmacy learners. Data suggest a practice experience in the LLPM environment does not preclude achieving knowledge-based learning objectives and supports further studies of the LLPM.

  4. Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience.

    Science.gov (United States)

    Boyle, Michael P

    2013-12-01

    To compare adults who stutter with and without support group experience on measures of self-esteem, self-efficacy, life satisfaction, self-stigma, perceived stuttering severity, perceived origin and future course of stuttering, and importance of fluency. Participants were 279 adults who stutter recruited from the National Stuttering Association and Board Recognized Specialists in Fluency Disorders. Participants completed a Web-based survey comprised of various measures of well-being including the Rosenberg Self-Esteem Scale, Generalized Self-Efficacy Scale, Satisfaction with Life Scale, a measure of perceived stuttering severity, the Self-Stigma of Stuttering Scale, and other stuttering-related questions. Participants with support group experience as a whole demonstrated lower internalized stigma, were more likely to believe that they would stutter for the rest of their lives, and less likely to perceive production of fluent speech as being highly or moderately important when talking to other people, compared to participants with no support group experience. Individuals who joined support groups to help others feel better about themselves reported higher self-esteem, self-efficacy, and life satisfaction, and lower internalized stigma and perceived stuttering severity, compared to participants with no support group experience. Participants who stutter as an overall group demonstrated similar levels of self-esteem, higher self-efficacy, and lower life satisfaction compared to averages from normative data for adults who do not stutter. Findings support the notion that self-help support groups limit internalization of negative attitudes about the self, and that focusing on helping others feel better in a support group context is linked to higher levels of psychological well-being. At the end of this activity the reader will be able to: (a) describe the potential psychological benefits of stuttering self-help support groups for people who stutter, (b) contrast between

  5. Older Adults with Visual Impairment: Lived Experiences and a Walking Group

    Science.gov (United States)

    Green, Clare; Miyahara, Motohide

    2007-01-01

    The authors investigated past and present physical activities of 6 older individuals with diverse types of visual impairment who participated in a walking group. The authors identified the participants' lived experiences of visual impairment and physical activity through interviews and assessed their current activity levels by using pedometers.…

  6. Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

    Science.gov (United States)

    Martínez García, José Manuel; Martín López, María Jesús

    2015-10-30

    Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support.

  7. A Qualitative Study of the Experience of Parents Attending a Psychoanalytically Informed Parent-Toddler Group

    Science.gov (United States)

    Barros, Maria; Kitson, Annabel; Midgley, Nick

    2008-01-01

    The paper presents the findings of a qualitative study into the experience of seven parents attending a psychoanalytically informed parent-toddler group. Semi-structured interviews were carried out with each parent, and analysed using Interpretative Phenomenological Analysis. Analysis of the interviews led us to three "superordinate…

  8. The Effect of Group Works and Demonstrative Experiments Based on Conceptual Change Approach: Photosynthesis and Respiration

    Science.gov (United States)

    Cibik, Ayse Sert; Diken, Emine Hatun; Darcin, Emine Selcen

    2008-01-01

    The purpose of this study is to investigate the effect of the use of group works and demonstration experiments based on conceptual change approach in the elimination of misconception about the subject of photosynthesis and respiration in plants in pre-service science teachers. This study was conducted with 78 pre-service science teachers including…

  9. Fostering Undergraduate Research Experiences in Management Information Systems through the "Research Group" Framework

    Science.gov (United States)

    Bartkus, Ken; Mills, Robert; Olsen, David

    2010-01-01

    The purpose of this paper is to propose an innovative approach to engaged learning. Founded on the principles of a scholarly think-tank and administered along the lines of a consulting organization, the proposed "Research Group" framework is designed to facilitate effective and efficient undergraduate research experiences in Management…

  10. Experience Exchange Group (EEG) Approach as a Means for Research to be rooted in Industry

    DEFF Research Database (Denmark)

    Bruun, Peter

    1997-01-01

    The intention of this paper is to clarify if and how an Experience Exchange Group(EEG) can be involved in a research process in the area of industrial management. For exemplification of the topic an ongoing research in global manufacturing is referred to. In this research it was after a series...

  11. The Effect of Group Works and Demonstrative Experiments Based on Conceptual Change Approach: Photosynthesis and Respiration

    Science.gov (United States)

    Cibik, Ayse Sert; Diken, Emine Hatun; Darcin, Emine Selcen

    2008-01-01

    The purpose of this study is to investigate the effect of the use of group works and demonstration experiments based on conceptual change approach in the elimination of misconception about the subject of photosynthesis and respiration in plants in pre-service science teachers. This study was conducted with 78 pre-service science teachers including…

  12. How to survive (and enjoy) doing a thesis: the experiences of a methodological working group.

    Science.gov (United States)

    Giddings, Lynne S; Wood, Pamela J

    2006-03-01

    'Doing a thesis', whether for Masters or PhD, can be a lonely and tortuous journey. This article offers a complementary process to the traditional apprenticeship supervision model. It describes the experiences of students who during their thesis research met monthly in a grounded theory working group. They reflected on their experiences during a focus group interview. After describing the background to how the group started in 1999 and exploring some of the ideas in the literature concerning the thesis experience, the article presents the interview. To focus the presentation, specific questions are used as category headings. Overall, the participants found attending the group was a "life-line" that gave them "hope" and was complementary to the supervision process. Through the support of peers, guidance from those ahead in the process, and consultancy with teachers and visiting methodological scholars, these students not only successfully completed their theses, but reported that they had some enjoyment along the way. This is the fifteenth in a series of articles which have been based on interviews with nursing and midwifery researchers, and were primarily designed to offer the beginning researcher a first-hand account of the experience of using particular methodologies.

  13. Investigating the Impact of Mediated Learning Experiences on Cooperative Peer Communication during Group Initiatives

    Science.gov (United States)

    White, Robert; Dinos, Sokratis

    2010-01-01

    This study investigates how structured Mediated Learning Experiences may improve peer-cooperative communication within problem-solving task exercises. Two groups (n = 22) of Year 8 students (mean age 13 +/- 5 months) were randomly selected to participate in this study. The study began with two one-hour sessions of activity-based problem-solving…

  14. Family Experiences, the Motivation for Science Learning and Science Achievement of Different Learner Groups

    Science.gov (United States)

    Schulze, Salomé; Lemmer, Eleanor

    2017-01-01

    Science education is particularly important for both developed and developing countries to promote technological development, global economic competition and economic growth. This study explored the relationship between family experiences, the motivation for science learning, and the science achievement of a group of Grade Nine learners in South…

  15. Effects of Professional Experience and Group Interaction on Information Requested in Analyzing IT Cases

    Science.gov (United States)

    Lehmann, Constance M.; Heagy, Cynthia D.

    2008-01-01

    The authors investigated the effects of professional experience and group interaction on the information that information technology professionals and graduate accounting information system (AIS) students request when analyzing business cases related to information systems design and implementation. Understanding these effects can contribute to…

  16. International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

    Energy Technology Data Exchange (ETDEWEB)

    Mayr, Nina A., E-mail: ninamayr@uw.edu [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Hu, Kenneth S. [Department of Radiation Oncology, Beth Israel Medical Center, New York, New York (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Wall, Terry J. [St. Luke' s Cancer Institute, Kansas City, Missouri (United States); Amendola, Beatriz E. [Innovative Cancer Institute, Miami, Florida (United States); Calaguas, Miriam J. [Department of Radiation Oncology, St. Luke' s Medical Center, Quezon City (Philippines); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Yue, Ning J. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Rengan, Ramesh [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Williams, Timothy R. [Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, Florida (United States)

    2014-07-01

    In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups.

  17. Permanent education and co-management: experience of a health managing group

    Directory of Open Access Journals (Sweden)

    Diogo Faria Corrêa da Costa

    2015-08-01

    Full Text Available This paper presents the experience lived by a group of workers of the Regional Center for Action on Health of the 4th. Regional Health State Department of Health of Rio Grande do Sul in Santa Maria. The paper presents an experience of reorganization of the work process in order to tackle the historical fragmentation of activities in the field of health management, and trigger a learning process for institutional support to carry thirty-two municipalities in the area of administrative scope of this coordinating body . To do so, it relies upon the co-management strategies and continuing health education as tools to trigger processes of change and inventing other ways of designing and conducting health work. With this experience, we can dislodge established places, inventing new forms of teamwork and interdisciplinary manner in order to strengthen this group of workers and their practices.

  18. Health science students' experiences of group supervision of the bachelor's thesis.

    Science.gov (United States)

    Utriainen, Kati; Ahonen, Sanna-Mari; Kangasniemi, Mari; Liikanen, Eeva

    2011-04-01

    This study aimed to describe health science university students' experiences of group supervision of the bachelor's thesis. Sixty-one students responded to questions on an open data collection form, and the data were analyzed by using qualitative inductive content analysis. According to the students, group supervision is supportive in terms of joint learning as well as commitment-enhancing and participative learning, but it also can be useless from the viewpoint of an individual student's own thesis. Teachers' role as experts and active directors of the group, students' commitment to learn together, and workable practical organization of the group were promoting factors, whereas students' timetable problems, mismatch between received and needed supervision, and difficulties in supervising other students were restraining factors. The results can be used for developing group supervision in higher health education.

  19. Gynecologic oncology training systems in europe: a report from the European network of young gynaecological oncologists

    DEFF Research Database (Denmark)

    Gultekin, Murat; Dursun, Polat; Vranes, Boris

    2011-01-01

    The objectives of the study were to highlight some of the differences in training systems and opportunities for training in gynecologic oncology across Europe and to draw attention to steps that can be taken to improve training prospects and experiences of European trainees in gynecologic oncology....

  20. Life-course events and experiences: association with fruit and vegetable consumption in 3 ethnic groups.

    Science.gov (United States)

    Devine, C M; Wolfe, W S; Frongillo, E A; Bisogni, C A

    1999-03-01

    To examine how life-course experiences and events are associated with current fruit and vegetable consumption in 3 ethnic groups. A theoretic model developed from previous qualitative research guided the development of a telephone survey. Data were collected on fruit and vegetable consumption, sociodemographic characteristics, ethnic identity, and life-course events and experiences, including food upbringing, social roles, food skills, dietary changes for health, and practice of food traditions. Low- to moderate-income adults living in a northeastern US city were selected randomly from 3 ethnic groups: black (n = 201), Hispanic (n = 191), and white (n = 200). Bivariate and multiple linear regression analysis of associations between life-course variables and fruit and vegetable consumption. Black, Hispanic, and white respondents differed significantly in life-course experiences, family roles, socio-demographic characteristics, and place of birth. Explanatory models for fruit and vegetable consumption differed among ethnic groups and between fruits and vegetables. Among black respondents, a college education was positively associated with fruit consumption; education and family roles contributed most to differences in fruit (R2 = .16) and vegetable (R2 = .09) consumption. Among Hispanic respondents, life-course experiences such as liking fruits and vegetables in youth, making dietary changes for health, and food skills were positively associated with fruit (R2 = .25) and vegetable (R2 = .35) consumption. Among white respondents, socio-demographic characteristics, such as being married with a young child or single with no child and having a garden as an adult, were positively associated with fruit (R2 = .20) and vegetable (R2 = .22) consumption. An understanding of the determinants of food choice in different subcultural groups can be used to design effective nutrition interventions to increase fruit and vegetable consumption. Experiences such as eating fresh

  1. The “Common Solutions" Strategy of the Experiment Support group at CERN for the LHC Experiments

    CERN Document Server

    CERN. Geneva

    2012-01-01

    After two years of LHC data taking, processing and analysis and with numerous changes in computing technology, a number of aspects of the experiments’ computing as well as WLCG deployment and operations need to evolve. As part of the activities of the Experiment Support group in CERN’s IT department, and reinforced by effort from the EGI-InSPIRE project, we present work aimed at common solutions across all LHC experiments. Such solutions allow us not only to optimize development manpower but also offer lower long-term maintenance and support costs. The main areas cover Distributed Data Management, Data Analysis, Monitoring and the LCG Persistency Framework. Specific tools have been developed including the HammerCloud framework, automated services for data placement, data cleaning and data integrity (such as the data popularity service for CMS, the common Victor cleaning agent for ATLAS and CMS and tools for catalogue/storage consistency), the Dashboard Monitoring framework (job monitoring, data management...

  2. [Unproven methods in oncology].

    Science.gov (United States)

    Jallut, O; Guex, P; Barrelet, L

    1984-09-08

    As in some other chronic diseases (rheumatism, multiple sclerosis, etc.), unproven methods of diagnosis and treatment have long been current in cancer. Since 1960 the American Cancer Society has published an abundant literature on these "unproven methods", which serves as a basis for a historical review: some substances (Krebiozen, Laetrile) have enjoyed tremendous if shortlived success. The present trend is back to nature and "mild medicine". The proponents of this so-called natural medicine are often disciples of a pseudoscientific religion using irrational arguments. Direct attacks on these erroneous theories and their public refutation fail to convince the adepts, who trust in these methods and are not amenable to a scientific approach. Study of their psychological motivations reveals that in fact they seek something more reassuring than plain medical explanation which is aware of its limits. They feel reassured by theories which often bear some resemblance to the old popular medicine. To protect patients against these dangerous methods and all the disillusionment they entail, the Swiss Society of Oncology and the Swiss Cancer League have decided to gather information and draw up a descriptive list of the commonest unproven methods in Switzerland (our File No. 2, "Total anti-cancer cure", is given as an example). The files are published in French, German and English and are available to physicians, nursing teams, and also patients who wish to have more objective information on these methods.

  3. [Economic limits in oncology].

    Science.gov (United States)

    Hellriegel, K P

    2000-12-01

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

  4. Micronutrients in Oncological Intervention

    Directory of Open Access Journals (Sweden)

    Uwe Gröber

    2016-03-01

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

  5. Four cycles of paclitaxel and carboplatin as adjuvant treatment in early-stage ovarian cancer: a six-year experience of the Hellenic Cooperative Oncology Group

    Directory of Open Access Journals (Sweden)

    Fountzilas Georgios

    2006-09-01

    Full Text Available Abstract Background Surgery can cure a significant percentage of ovarian carcinoma confined to the pelvis. Nevertheless, there is still a 10–50% recurrence rate. We administered paclitaxel/carboplatin as adjuvant treatment in early-stage ovarian carcinoma. Methods Patients with stages Ia or Ib, Grade 2 or 3 and Ic to IIb (any grade were included. Patients were treated with 4 cycles of Paclitaxel 175 mg/m2 and Carboplatin [area under the curve (AUC 6 (Calvert Formula] every 3 weeks. Results Sixty-nine patients with no residual disease following cytoreductive surgery and minimal or modified surgical staging were included in this analysis. Grade 3 or 4 neutropenia occured in 29.9% of patients, while neutropenic fever was reported in 4.5%. Neurotoxicity (all Grade 1 or 2 was reported in 50% of cases. Median follow-up was 62 months. 5-year overall survival (OS and relapse-free survival (RFS were: 87% (95% confidence intervals [CI]: 78–96 and 79% (95% CI: 69–89, respectively. Significantly fewer patients with stages Ic-IIb and tumor grade 2 or 3 achieved a 5-year RFS than patients with only one of these two factors (73% vs 92%, p = 0.03. Conclusion Paclitaxel/Carboplatin chemotherapy is a safe and effective adjuvant treatment in early-stage ovarian carcinoma. Patients with stages Ic-IIb and tumor grade 2 or 3 may benefit from more extensive treatment.

  6. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2017-04-18

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  7. Moving on in life after intensive care--partners' experience of group communication.

    Science.gov (United States)

    Ahlberg, Mona; Bäckman, Carl; Jones, Christina; Walther, Sten; Hollman Frisman, Gunilla

    2015-09-01

    Partners have a burdensome time during and after their partners' intensive care period. They may appear to be coping well outwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited. The aim of this study was to describe the experience of participating in group communication with other partners of former intensive care patients. The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive care unit (ICU) patients was evaluated. A strategic selection was made of adult partners to former adult intensive care patients (n = 15), 5 men and 10 women, aged 37-89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote, in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six of the partners were interviewed. Content analysis was used to analyse the notebooks and the interviews. Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2) Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participate in group communication. Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategies to ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is one way for partners to be able to move forward in life. Group communication with other patients' partners eases the process of going through the burden of being a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus and evidence for the best practice. © 2015 British Association of Critical Care Nurses.

  8. [Donatori di Musica: when oncology meets music].

    Science.gov (United States)

    Graiff, Claudio

    2014-10-01

    Donatori di Musica is a network of musicians - both physicians and volunteers - that was initially founded in 2009 with the aim to set up and coordinate classical music concerts in hospitals. This activity was initially started and led by the Oncology Departments at Carrara and Bolzano Hospitals, where high profile professional musicians make themselves available for concerts in support of Oncological in/out-patients of that specific Hospital. A live classical music performance is a deeply touching experience - particularly for those who live a critical condition like cancer. Main characteristics of Donatori di Musica concerts are: continuity (concerts are part of a regular and non-stopping music season); quality (concerts are held by well-established professional musicians); philanthropic attitude (musicians do not wear a suit and usually chat with patients; they also select an easy-to-listen program; a convivial event is usually organized after the performance with the aim of overcoming distinctions and barriers between physician and patient); no profit: musicians perform for free - travel expenses and/or overnight staying only can be claimed; concerts have free access for patients, their families and hospital staff.Patients and musicians therefore do get in close contact and music is able to merge each other experiences - with patients being treated by the beauty of music and musicians being treated theirselves by patients daily-life feedback. The Donatori di Musica experience is therefore able to help Medicine to retrieve its very first significance - the medical act regain that human and cultural dimension that seems to be abandoned in the last decades in favour of a mere technicism. This is the spirit and the deep significance of Donatori di Musica - «[…] the hope that Music can become a key support to medical treatments in every Oncology department» (by Gian Andrea Lodovici).

  9. Mental maps in chacma baboons (Papio ursinus): using inter-group encounters as a natural experiment.

    Science.gov (United States)

    Noser, Rahel; Byrne, Richard W

    2007-07-01

    Encounters between groups of wild chacma baboons (Papio ursinus) can be viewed as a natural experiment to investigate the nature of these primates' mental representations of large-scale space. During a 16-month field study in a high population density habitat we recorded the foraging routes and the most important resources of a group of 25 individuals. Also, we estimated the locations of additional baboon groups relative to the study group. Routes were less linear, travel speed was higher, and inter-resource distances were larger when other groups were present within 500 m of the focal group; thus, the study group avoided others by taking detours. We predicted that evasive manoeuvres would be characteristic of different possible orientation mechanisms, and compared them with our observations. We analysed 34 evasive manoeuvres in detail. In an area that lacked prominent landmarks, detours were small; larger detours occurred when resources were directly visible, or in the vicinity of a hill offering conspicuous landmarks. In areas without prominent landmarks, detours were along familiar routes and waiting bouts of up to 60 min occurred; on one occasion the study group aborted their entire day's journey. We discuss these findings in the light of time and energy costs and suggest that the baboons lack the ability to compute Euclidean relations among locations, but use network maps to find their way to out-of-sight locations.

  10. Menstruation experiences of South African women belonging to the ama-Xhosa ethnic group.

    Science.gov (United States)

    Padmanabhanunni, Anita; Jaffer, Labeeqah; Steenkamp, Jeanette

    2017-09-15

    A growing body of research has emphasised the salience of cultural beliefs and traditional practices to women's experiences of menstruation. Relatively less research has, however, been undertaken in South Africa. This study explored the experience of menstruation among women from the ama-Xhosa ethnic group, one of the largest ethnic groups in the country. Among the ama-Xhosa, there are distinct cultural practices associated with menstruation, including the female rite of passage (intonjane) and virginity testing (inkciyo). However, few studies have explored the experience of menstruation for women from this cultural group. This study involved the synthesis of data from individual interviews and focus group discussions conducted among a sample of ama-Xhosa women. The data were analysed using thematic analysis. Distinctive findings included women's participation in traditional cultural practices of intonjane and inkciyo and the presence of cultural taboos associated with menstruation. Women's narratives revealed strong ambivalence regarding these practices. On the one hand, they wanted to adhere to traditional practices but experienced these customs as evoking discomfort and shame. The study confirmed the prevalence of negative constructions of menstruation. Positive appraisals of menstruation as evoking joy and happiness were also encountered.

  11. A focus group study of chiropractic students following international service learning experiences.

    Science.gov (United States)

    Boysen, James C; Salsbury, Stacie A; Derby, Dustin; Lawrence, Dana J

    2016-10-01

    One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor-patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices.

  12. A focus group study of chiropractic students following international service learning experiences

    Science.gov (United States)

    Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.

    2016-01-01

    Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817

  13. Experiences of women with bulimia nervosa in a mindfulness-based eating disorder treatment group.

    Science.gov (United States)

    Proulx, Kathryn

    2008-01-01

    The experience of 6 college-age women with bulimia nervosa was examined after they participated in an 8-week mindfulness-based eating disorder treatment group. This phenomenological study used individual interview and pre- and post-treatment self-portraits. Participants described their experience of transformation from emotional and behavioral extremes, disembodiment, and self-loathing to the cultivation of an inner connection with themselves resulting in greater self-awareness, acceptance, and compassion. They reported less emotional distress and improved abilities to manage stress. This treatment may help the 40% of women who do not improve with current therapies and might be useful to prevent symptoms in younger women.

  14. Trajectories of Change in University Students' General Views of Group Work Following One Single Group Assignment: Significance of Instructional Context and Multidimensional Aspects of Experience

    Science.gov (United States)

    Wosnitza, Marold; Volet, Simone

    2014-01-01

    This paper examines how distinct trajectories of change in students' general views of group work over the duration of one single group assignment could be explained by multidimensional aspects of their experience and the overall instructional context. Science (336) and Education (377) students involved in a semester-long group assignment…

  15. Modulation of systemic and intestinal immune response by interleukin-2 therapy in gastrointestinal surgical oncology. Personal experience in the context of current knowledge and future perspectives.

    Science.gov (United States)

    Nespoli, Luca; Uggeri, Fabio; Romano, Fabrizio; Nespoli, Angelo; Brivo, Fernando; Fumagalli, Luca; Sargenti, Manuela; Uggeri, Franco; Gianotti, Luca

    2012-03-01

    Interactions between host and malignant tumor is currently under intensive investigation. The immune system seems to have a key role in cancer development and spread. Novel strategies to actively modulate the immune system have been proposed to improve the outcome of disease in patients with neoplasms. Our experience with systemic immunomodulation by interleukin-2 (IL-2) focused on both systemic and local immunity in surgical gastrointestinal cancer. Preoperative IL-2 subcutaneous injection was effective in counteracting postoperative immunosuppression, with a reduction of serum levels of IL-6 and the maintenance of preoperative levels of IL-12, a higher number of circulating total lymphocytes, and CD3(+) and CD4(+) T-cells, and a smaller decrease in circulating mature and immature dendritic cells (DCs), as well as a reduction in postoperative serum levels of vascular endothelial growth factor. At the intestinal level, in patients with colorectal cancer, preoperative administration of IL-2 affected both phenotype and function of resident dendritic cells and T-cells, skewing local immunity toward a more immunogenic one. Our data showed that immunomodulation by IL-2 was effective in counteracting the systemic postoperative immune suppression related to surgical stress. IL-2 was also active at a local level on intestinal immunity, affecting both phenotype and function of resident T-cells and DCs. Future studies will encompass the possibility of reaching more adequate intratumoral IL-2 concentrations by direct intralesional injection to maximize immunostimulatory effects and minimize adverse effects.

  16. Stress Levels of Nurses in Oncology Outpatient Units.

    Science.gov (United States)

    Ko, Woonhwa; Kiser-Larson, Norma

    2016-04-01

    Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

  17. The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups.

    Science.gov (United States)

    Pound, Carole; Greenwood, Nan

    2016-10-01

    Very little is known about how older people from black and minority ethnic (BME) groups caring for someone after a stroke access and engage with social care services. This paper explores both the experiences of carers whose relative was receiving social care services in their own home and the value of a theory of humanising care to understand and explain these experiences. Semi-structured interviews were undertaken with 50 carers from five different ethnic groups: Asian Indian, Asian Pakistani, Black African, Black Caribbean and White British. Data were thematically analysed within a phenomenological framework. Five interacting themes emerged: communication and bureaucracy; time and timing; communication and rapport building; trust and safety; humanity and the human dimensions of care. Many of the experiences could be interpreted within a conceptual framework of humanising care underpinned by eight interacting dimensions of what it means to be treated as an individual and a human. Carers from BME and White British groups share many experiences of homecare although language and cultural difference may exacerbate common pressures and stresses. The framework for humanising care is a useful tool to evaluate aspects of homecare that are responsive to dignity and diversity. Implications for Rehabilitation Explicitly identifying, describing and valuing the human dimensions of care may support services in responding appropriately to homecare users from black minority ethnic communities as well as those from white majority groups. Unresponsive services and poor communication may lead to loss of trust with care agencies and undermine BME carers' sense of entitlement and competence in engaging with homecare services. Care worker continuity investing time in building relationships and care worker familiarity is important to many families who access social care services.

  18. Critical experiments analyses by using 70 energy group library based on ENDF/B-VI

    Energy Technology Data Exchange (ETDEWEB)

    Tahara, Yoshihisa; Matsumoto, Hideki [Mitsubishi Heavy Industries Ltd., Yokohama (Japan). Nuclear Energy Systems Engineering Center; Huria, H.C.; Ouisloumen, M.

    1998-03-01

    The newly developed 70-group library has been validated by comparing kinf from a continuous energy Monte-Carlo code MCNP and two dimensional spectrum calculation code PHOENIX-CP. The code employs Discrete Angular Flux Method based on Collision Probability. The library has been also validated against a large number of critical experiments and numerical benchmarks for assemblies with MOX and Gd fuels. (author)

  19. Nuture groups in secondary schools: An exploration of young people's lived experiences

    OpenAIRE

    Hibberd, Benjamin

    2015-01-01

    \\ud Children with emotional difficulties often experience problems at school in terms of their academic progress and within peer relationships. This can create a particular challenge to teachers in terms of managing their behaviour and meeting their needs (Bennathan, 2000). Nurture groups (NGs) were developed by educational psychologist Marjorie Boxall in the 1960’s with an aim to improve the emotional wellbeing of children with Social, Emotional and Behavioural Difficulties (SEBD). This chap...

  20. Anatomy by whole body dissection: a focus group study of students' learning experience.

    Science.gov (United States)

    Burgess, Annette; Ramsey-Stewart, George

    2015-01-01

    The social construction of knowledge within medical education is essential for learning. Students' interactions within groups and associated learning artifacts can meaningfully impact learning. Situated cognition theory poses that knowledge, thinking, and learning are located in experience. In recent years, there has been a reported decline in time spent on anatomy by whole body dissection (AWBD) within medical programs. However, teaching by surgeons in AWBD provides unique opportunities for students, promoting a deeper engagement in learning. In this study, we apply situated cognition theory as a conceptual framework to explore students' perceptions of their learning experience within the 2014 iteration of an 8-week elective AWBD course. At the end of the course, all students (n=24) were invited to attend one of three focus groups. Framework analysis was used to code and categorize data into themes. In total, 20/24 (83%) students participated in focus groups. Utilizing situated cognition theory as a conceptual framework, we illustrate students' learning experiences within the AWBD course. Students highlighted opportunities to create and reinforce their own knowledge through active participation in authentic dissection tasks; guidance and clinical context provided by surgeons as supervisors; and the provision of an inclusive learning community. Situated cognition theory offers a valuable lens through which to view students' learning experience in the anatomy dissection course. By doing so, the importance of providing clinical relevance to medical teaching is highlighted. Additionally, the value of having surgeons teach AWBD and the experience they share is illustrated. The team learning course design, with varying teaching methods and frequent assessments, prompting student-student and student-teacher interaction, was also beneficial for student learning.

  1. Anatomy by whole body dissection: a focus group study of students’ learning experience

    Directory of Open Access Journals (Sweden)

    Burgess A

    2015-08-01

    Full Text Available Annette Burgess,1 George Ramsey-Stewart2 1Central Clinical School, Sydney Medical School, The University of Sydney, 2Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Background: The social construction of knowledge within medical education is essential for learning. Students’ interactions within groups and associated learning artifacts can meaningfully impact learning. Situated cognition theory poses that knowledge, thinking, and learning are located in experience. In recent years, there has been a reported decline in time spent on anatomy by whole body dissection (AWBD within medical programs. However, teaching by surgeons in AWBD provides unique opportunities for students, promoting a deeper engagement in learning. In this study, we apply situated cognition theory as a conceptual framework to explore students’ perceptions of their learning experience within the 2014 iteration of an 8-week elective AWBD course. Methods: At the end of the course, all students (n=24 were invited to attend one of three focus groups. Framework analysis was used to code and categorize data into themes. Results: In total, 20/24 (83% students participated in focus groups. Utilizing situated cognition theory as a conceptual framework, we illustrate students’ learning experiences within the AWBD course. Students highlighted opportunities to create and reinforce their own knowledge through active participation in authentic dissection tasks; guidance and clinical context provided by surgeons as supervisors; and the provision of an inclusive learning community. Conclusion: Situated cognition theory offers a valuable lens through which to view students’ learning experience in the anatomy dissection course. By doing so, the importance of providing clinical relevance to medical teaching is highlighted. Additionally, the value of having surgeons teach AWBD and the experience they share is illustrated. The team learning course design, with varying

  2. Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

    2017-01-01

    The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs. Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation. The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others. The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.

  3. Report of the Plasma Physics and Environmental Perturbation Laboratory (PPEPL) working groups. Volume 2: Wave experiments working group

    Science.gov (United States)

    1974-01-01

    The area of wave experiments for the PPEPL is considered in broad terms. It was found that most experiments in this area can be classified typically by a few generalized experiments. These experiment possibilities are discussed in terms of advantages, disadvantages, and probable areas for future investigation. It was concluded that the areas where wave experiments have the most promise are wave sources, wave propagation, and nonlinear interactions and should be implemented in that order. It was recommended that the PPEPL facility remain sufficiently flexible to handle new ideas as they appear, and a continuing effort should be made to solicit new ideas and approaches. It was also felt that detailed investigations should begin as soon as possible in the areas of antennas, both conventional and particle types, and wave-particle interaction experiments. For Vol. 1, see N74-28169; for Vol. 3, see N74-28171.

  4. Adjustment to cancer: exploring patients' experiences of participating in a psychodramatic group intervention.

    Science.gov (United States)

    Menichetti, J; Giusti, L; Fossati, I; Vegni, E

    2016-09-01

    The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In-depth interviews using an interpretative-phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it.

  5. [Epidemiology of invasive group A streptococcal infections in developed countries : the Canadian experience with necrotizing fasciitis].

    Science.gov (United States)

    Ovetchkine, Ph; Bidet, Ph; Minodier, Ph; Frère, J; Bingen, E

    2014-11-01

    In industrialized countries, group A streptococcal infections were a source of concern, mainly due to the occurrence of rheumatic fever and its cardiac complications. At present, the incidence of rheumatic fever is decreasing in these countries, giving way to an increasing occurrence of invasive streptococcal group A infections with high level of morbidity and mortality. Streptococcal necrotizing fasciitis, a specific entity, emerged these last decades, often in association with chickenpox. The introduction of the varicella vaccine in the province of Quebec routine immunization program, was followed by a significant decrease in the number of necrotizing fasciitis or other skin and soft-tissues infections in our pediatric population. However, in our experience at the CHU Sainte-Justine, this immunization program has not been helpful to reduce the overall incidence of invasive group A streptococcal infections. Conversely, an increase in the number of pleuro-pulmonary and osteo-articular infections was observed.

  6. Experiences with recruitment of marginalized groups in a Danish health promotion program

    DEFF Research Database (Denmark)

    Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen

    2016-01-01

    to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees' presence...... in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. CONCLUSION: This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods...... as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to increase participation among marginalized groups....

  7. Social Groups and Pedestrian Crowds: Experiment on Dyads in a Counter Flow Scenario

    CERN Document Server

    Gorrini, Andrea; Feliciani, Claudio; Zhao, Pengfei; Nishinari, Katsuhiro; Bandini, Stefania

    2016-01-01

    The calibration and validation of pedestrian simulations require the acquisition of empirical evidences of human behaviour. The current work presents the results of an experiment focused on the potentially combined effect of counter flow and grouping on pedestrian dynamics. In particular, we focused on: (i) four different configurations of flow ratio (the rate between the minor flow and the total flow in bidirectional scenarios); (ii) dyads, as the most frequently observed and basic social groups of crowds. Results showed that the increase of flow ratio negatively impacted the speed of pedestrians. Dyads walked significantly slower than singletons, due to the difficulty in movement coordination among group members (proxemics) in case of counter flow. The collected results represent an useful contribution towards the validation of pedestrian simulations.

  8. Continuing Education Needs of the Office Oncology Nurse.

    Science.gov (United States)

    Rogers, Miriam P.

    1999-01-01

    A study determined the learning needs of office oncology nurses (n=290)as a critical first step in planning education programs. Participants ranked cancer-care topics similarly, regardless of age, background, or experience. The highest-ranked needs were clustered in the areas of cancer nursing practice, major cancers, and cancer treatment.…

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

    Science.gov (United States)

    Becker, Janet E.

    2004-01-01

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

  10. Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

    Science.gov (United States)

    Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

    2015-01-01

    Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients.

  11. Multidisciplinary care in pediatric oncology

    Directory of Open Access Journals (Sweden)

    Cantrell MA

    2011-05-01

    Full Text Available Mary Ann Cantrell1, Kathy Ruble21College of Nursing, Villanova University, Villanova, PA, USA; 2Department of Pediatric Oncology, Johns Hopkins University, School of Medicine, Baltimore, MD, USAAbstract: This paper describes the significant advances in the treatment of childhood cancer and supportive care that have occurred over the last several decades and details how these advances have led to improved survival and quality of life (QOL for children with cancer through a multidisciplinary approach to care. Advances in the basic sciences, general medicine, cooperative research protocols, and policy guidelines have influenced and guided the multidisciplinary approach in pediatric oncology care across the spectrum from diagnosis through long-term survival. Two case studies are provided to highlight the nature and scope of multidisciplinary care in pediatric oncology care.Keywords: childhood cancer, chemotherapy, leukemia

  12. Personality types of oncology nurses.

    Science.gov (United States)

    Bean, C A; Holcombe, J K

    1993-12-01

    Personality type influences the choice of occupation. The breadth of specialty areas within oncology nursing allows for divergent activities and relationships and, thus, the accommodation of different personality characteristics. This exploratory study examined personality types for a convenience sample of oncology nurses predominantly employed in hospitals. According to the personality typology defined by Carl Jung, a person demonstrates a preference among four dimensions, i.e., extraversion/introversion, sensory/intuition, thinking/feeling, and judging/perceiving. The type with the strongest self-selection for these oncology nurses was ISFJ, where feeling is introverted and perception is practical, so that helping others is both a responsibility and a pleasure. The discussion relates the personality types to Jung's theory and their impact in clinical practice. Strengths and weaknesses of each personality type are described.

  13. Palliative medicine and medical oncology.

    Science.gov (United States)

    Maltoni, M; Amadori, D

    2001-04-01

    Traditionally, medical oncology and palliative care have been considered two distinct and separate disciplines, both as regards treatment objectives and delivery times. Palliative care in terminal stages, aimed exclusively at evaluating and improving quality of life, followed antitumor therapies, which concentrated solely on quantitative results (cure, prolongation of life, tumoral mass shrinkage). Over the years, more modern concepts have developed on the subject. Medical oncology, dealing with the skills and strategic co-ordination of oncologic interventions from primary prevention to terminal phases, should also include assessment and treatment of patients' subjective needs. Anticancer therapies should be evaluated in terms of both the quantitative and qualititative impact on patients' lives. Hence, the traditional view of palliative care has to be modified: it constitutes a philosophical and methodological approach to be adopted from the early phases of illness. It is not the evident cultural necessity of integrating medical oncology with palliative medicine that may be a matter of argument, but rather the organizational models needed to put this combined care into practice: should continuous care be guaranteed by a single figure, the medical oncologist, or rather by an interdisciplinary providers' team, including full-time doctors well-equipped for palliative care? In this paper the needs of cancer patients and the part that a complete oncologist should play to deal with such difficult and far-reaching problems are firstly described. Then, as mild provocation, data and critical considerations on the ever increasing needs of palliative care, the present shortcomings in quality of life and pain assessment and management by medical oncologists, and the uncertain efficacy of interventional programmes to change clinical practice are described. Finally, a model of therapeutic continuity is presented. which in our view is realistic and feasible: an Oncologic

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

    Science.gov (United States)

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

    2014-11-01

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

  15. 77 FR 57095 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-09-17

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

  16. 75 FR 66773 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-10-29

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

  17. 78 FR 63222 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-10-23

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... ] (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... relevance and potential use of such measures in the pediatric development plans of oncology products....

  18. 78 FR 63224 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-10-23

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... late stage development for various adult oncology indications. The subcommittee will consider...

  19. 76 FR 61713 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-10-05

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

  20. PET/MR in oncology

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  1. Global Health in Radiation Oncology

    DEFF Research Database (Denmark)

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

    2017-01-01

    The massive global shortfall in radiotherapy equipment and human resources in developing countries is an enormous challenge for international efforts in cancer control. This lack of access to treatment has been long-standing, but there is now a growing consensus about the urgent need to prioritize...... programs. However, formalized training and career promotion tracks in global health within radiation oncology have been slow to emerge, thereby limiting the sustained involvement of students and faculty, and restricting opportunities for leadership in this space. We examine here potential structures...... and funding models might be used to further develop and expand radiation oncology services globally....

  2. PET/MR in oncology

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  3. Attitudes toward infection prophylaxis in pediatric oncology: a qualitative approach.

    Directory of Open Access Journals (Sweden)

    Caroline Diorio

    Full Text Available BACKGROUND: The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology. METHODS: THE STUDY WAS COMPLETED IN THREE PHASES: 1 An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2 A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3 In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach. RESULTS: A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration. CONCLUSION: Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments.

  4. Establishment of the Asia Oncology Nursing Society (AONS

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2014-01-01

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

  5. Establishment of the Asia Oncology Nursing Society (AONS

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2014-06-01

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

  6. The GPS Radio Occultation and Ultraviolet Photometry—Colocated (GROUP-C) Experiment on the ISS

    Science.gov (United States)

    Budzien, Scott A.; Powell, Steven P.; Psiaki, Mark; O'Hanlon, Brady; Stephan, Andrew W.; Bishop, Rebecca L.

    2015-04-01

    The GPS Radio Occultation and Ultraviolet Photometry—Colocated (GROUP-C) Experiment is an ionospheric remote sensing experiment manifested to fly on the International Space Station in early 2016. GROUP-C will operate aboard the Space Test Program Houston 5 (STP-H5) experiment pallet and provide ionospheric measurements in real-time. GROUP-C includes two sensors: the Fast Orbital TEC, Observables, and Navigation (FOTON) L1/L2 GPS receiver, which provides vertical electron density profiles and scintillation; and the Tiny Ionospheric Photometer (TIP), a far-ultraviolet photometer for measuring horizontal ionosphere gradients. The FOTON receiver includes a capability for multipath mitigation using a multi-antenna array. The TIP photometer is similar to the photometers aboard the COSMIC satellites with minor improvements in optical performance.Ionospheric irregularities, also known as ionospheric bubbles, are transient features of the low and middle latitude ionosphere with important implications for operational systems. Understanding irregularity formation, development, and evolution is vital for efforts within NASA and DoD to forecast scintillation. Irregularity structures have been studied primarily using ground-based systems, though some spaced-based remote and in-situ sensing has been performed. In combination with GROUP-C, the Limb-imaging Ionospheric and Thermospheric Extreme-ultraviolet Spectrograph (LITES) experiment on STP-H5 will serve as an interactive ionospheric observatory on the ISS. These experiments would provide new capability to study low- and mid-latitude ionospheric structures on a global scale. By combining for the first time high-sensitivity in-track photometry with vertical ionospheric airglow spectrographic imagery, and simultaneous GPS TEC and scintillation measurements, high-fidelity optical tomographic reconstruction of bubbles can be performed from the ISS. Ground-based imagery can supplement the tomography by providing all-sky images of

  7. Obesity in general practice: a focus group study on patient experiences.

    Science.gov (United States)

    Malterud, Kirsti; Ulriksen, Kjersti

    2010-12-01

    To explore obese patients' experiences with GPs' management of their weight problems. Focus-group study with a purposive sample of 13 participants (eight women and five men), aged 30-55 years, with BMI above 40, or BMI above 35 with additional weight-related problems. Two focus-group interviews were conducted, inviting the participants to speak about their health care experiences from general practice. Analysis applied Systematic Text Condensation inspired by Giorgi's approach, searching for issues describing or discussing participants' experiences of GPs' obesity management. Obese patients want their GPs to put their weight problems on the agenda. When the patient appears reluctant, it may be a sign of embarrassment rather than rejection of the issue. However, restricted attention to obesity could lead to neglect of patients' problems. Participants complained that GPs often demonstrated insufficient engagement and knowledge regarding service resources for obesity treatment, leaving the responsibility for information on available referral resources to the patient. Finally, considerate attitudes in the GPs are needed for follow-up to be experienced as helpful by the patients. Vulnerable feelings of failure could be reinforced by well-intended advice. Degrading attitudes were perceived as especially subversive when they came from doctors. The challenge for the GP is to increase his or her competence in individualized and evidence-based counselling, while acknowledging the efforts needed by the patient to achieve permanent change, and shifting attention from shame to coping.

  8. Dutch Cyberbullying Victims’ Experiences, Perceptions, Attitudes and Motivations Related to (Coping with Cyberbullying: Focus Group Interviews

    Directory of Open Access Journals (Sweden)

    Niels C.L. Jacobs

    2015-01-01

    Full Text Available Because of the negative effects of cyberbullying; and because of its unique characteristics; interventions to stop cyberbullying are needed. For this purpose, more insightful information is needed about cyberbullying victims’ (i.e., the target group experiences, perceptions, attitudes and motivations related to (coping with cyberbullying. Five schools with 66 low-educated Dutch adolescents between 12 and 15 (53% female participated in 10 focus group interviews. Results show that victims do not perceive all behaviors as cyberbullying and traditional bullying is generally perceived as worse than cyberbullying. Cyberbullies are perceived as sad, cowards and embarrassing themselves. Victims are perceived as easy targets; they wear strange clothes, act in a provocative manner and have a bad appearance. These perceptions often depend on context, the level of anonymity, being in a fight or not, the person sending the message and his/her behavior. Further, victims reacted to cyberbullying by acting nonchalant, by not actually saying anything and seeking help from others (i.e., parents are not often asked for help because they do not want to bother them; fear of restricted Internet privileges. It can be concluded that asking cyberbullying victims about their experiences in an open manner, and allowing them to discuss these experiences, likely results in new and insightful information compared to using self-reports. In this questioning the perception of adolescents is key to see what is perceived as cyberbullying.

  9. Medellin youth experiences before, during and after belonging to an illegal armed group, 2005.

    Science.gov (United States)

    Hernández-Holguín, Dora María; Alzate-Gutiérrez, Eliana María

    2016-08-01

    A better understanding of the experiences of young people before, during and after belonging to an illegal armed group (IAG) can provide information to promote their reintegration into urban settings in Colombia and to help prevent violence. A qualitative study with a hermeneutic historical approach was performed to examine these experiences from the perspective of direct or indirect participants in the armed conflict. Fifty individuals aged 14-24 years (7 women and 43 men) with low socioeconomic status from Medellín were interviewed; 26 of them had a history of direct experience with IAGs. What stands out in their stories are descriptions of obstacles to progress in their lives; lives marked by stigma, poverty, violence and inequality; the differences of opinion among these young people regarding whether to belong to these illegal groups; how becoming an active member of an IAG creates both an opportunity for the present and an additional obstacle for the future, which adds complexity to the risk behaviors they assume; and how the reintegration process offers new expectations regarding access to educational and employment opportunities and social recognition. All of these factors point to the need for not only a comprehensive reintegration process but for more inclusive and equitable social policies, in this case for children and young people.

  10. Intervention group as a resource of Occupational Therapy: an experience with menopausal women

    Directory of Open Access Journals (Sweden)

    Soraya Diniz Rosa

    2013-08-01

    Full Text Available Intervention group as a resource of Occupational Therapy is the main theme of this study. Herein we present an experience carried out in two universities in the areas of occupational therapy, pharmacy and medicine, more specifically in the field of gynecology regarding the care of climacteric woman. The first intervention occurred in 2004 with trainees of the occupational therapy course and medical school residents. However, the study was restarted in 2010 with expansion to the human resources and knowledge areas. The methodology was based on the transcripts of the remarks made after each group meeting, which was coordinated by the Occupational Therapy. Results showed that the intervention group process has helped participants in the understanding of this stage of life and has interfered in the changing of habits and attitudes, with great improvement in daily life organization. We concluded that the use of intervention group as a resource of Occupational Therapy and the liaison with other areas are of great importance because they enable the construction of a unique treatment plan for the group, given the contribution from each clinical area.

  11. Patients' experience of home and hospital based cardiac rehabilitation: a focus group study.

    Science.gov (United States)

    Jones, Miren I; Greenfield, Sheila; Jolly, Kate

    2009-03-01

    New cardiac rehabilitation (CR) programmes, such as home programmes using the Heart Manual, are being introduced but little is known about patients' experiences of these. To compare the views of patients who had completed a home or hospital-based CR programme and explore the benefits and problems of each programme. 16 patients from 4 hospital programmes attended one of 3 focus groups; 10 home programme patients attended one of 2 focus groups. Some themes were common to all focus groups: loss of confidence; continuing to exercise and lifestyle changes; understanding of heart disease. Hospital programme patients particularly enjoyed exercising in a group and mixing with other people, and gained motivation and support from others. Home programme patients spoke very highly of the Heart Manual and valued the one-to-one support of the nurse facilitators. They described the home programme as a lifestyle change compared to the hospital programme which they suggested was more like a treatment. Patients in the hospital programme enjoyed the camaraderie of group exercise and patients in the home programme valued the wealth of information and advice in the Heart Manual and this gave them a feeling of being in control of their health.

  12. Exploring the Experience of Nursing Home Residents Participation in a Hope-Focused Group

    Directory of Open Access Journals (Sweden)

    Sharon L. Moore

    2014-01-01

    Full Text Available A qualitative intervention was used to explore how older adults living in a long-term care environment (nursing home understand hope and experience being participants in a group in which a hope intervention was carried out. A group project in which each session focused intentionally on a hope strategy was carried out with a convenience sample of 10 women (ages 75–99 who were members of an existing group. Data were analyzed using thematic analysis of the interviews (conducted before the group intervention was carried out and again at the end, field notes, and collaborative conversations regarding emerging themes. Findings from this study suggest that hope is not static and that it can change over time in response to one’s situations and circumstances. Also evident in this study is the potential for using a group process in long-term care to foster hope in an intentional way to make it more visible in the lives of the residents and their environment suggesting that one is “never too old for hope.”

  13. Exploring the Experience of Nursing Home Residents Participation in a Hope-Focused Group

    Science.gov (United States)

    Moore, Sharon L.; Hall, Susan E.

    2014-01-01

    A qualitative intervention was used to explore how older adults living in a long-term care environment (nursing home) understand hope and experience being participants in a group in which a hope intervention was carried out. A group project in which each session focused intentionally on a hope strategy was carried out with a convenience sample of 10 women (ages 75–99) who were members of an existing group. Data were analyzed using thematic analysis of the interviews (conducted before the group intervention was carried out and again at the end), field notes, and collaborative conversations regarding emerging themes. Findings from this study suggest that hope is not static and that it can change over time in response to one's situations and circumstances. Also evident in this study is the potential for using a group process in long-term care to foster hope in an intentional way to make it more visible in the lives of the residents and their environment suggesting that one is “never too old for hope.” PMID:24551450

  14. Lecturers' experiences of facilitating guided group reflection with pre-registration BSc Nursing students.

    Science.gov (United States)

    Mc Carthy, Jane; Cassidy, Irene; Tuohy, Dympna

    2013-01-01

    The development of reflective practitioners is integral to undergraduate nursing degree programmes. This study reports on lecturers' experiences of facilitating guided group reflection with pre-registration BSc Nursing students.The research purposively sampled lecturers (n=7) working in a department of nursing and midwifery at a third level institute in Ireland, all of whom were registered nurses. Using a qualitative research approach, data was collected through audio-taped semi-structured individual interviews. The data were thematically analysed using guidelines developed by Braun and Clarke (2006). Tripartite researcher discussion and further analysis of these initial individual analyses led to consensus regarding the three themes arising from the study. These were: Being a facilitator; Facilitating reflective learning and Creating structure. The discussion centred on: having knowledge and experience to effectively facilitate guided group reflection; the influence of the facilitator's personal philosophy on reflection and adult learning on group facilitation; and finally concerns regarding professional responsibility in response to students' reflective practice accounts.

  15. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study

    Science.gov (United States)

    Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Background Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Method Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. Results The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees’ presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. Conclusion This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are

  16. 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.

  17. Training oncology practitioners in communication skills.

    Science.gov (United States)

    Baile, Walter F

    2011-10-01

    Many practitioners in oncology receive no or little training in how to effectively communicate with patients and families who are dealing with cancer. Moreover medical teachers are not always aware of the pedagogy of teaching communication skills in a way that results in performance improvement in this area. In this paper a method of small group teaching that was used to instruct medical oncology fellows in the essentials of communication using a retreat format that lasted three days is described. The paper covers the theoretical basis for the teaching format as well as the specific components of the workshops. It describes the process of facilitation using a "learner-centered" approach using standardized patients who take on the role of cancer patients along the trajectory of the illness. It discuss the use of small group process to facilitate skills acquisition and other strategies that facilitate learning such as reflective exercises, open role play and parallel process. It concludes with a consideration of the various ways that such workshops can be evaluated.

  18. Apps for Radiation Oncology. A Comprehensive Review.

    Science.gov (United States)

    Calero, J J; Oton, L F; Oton, C A

    2017-02-01

    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. 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. 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. 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. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  19. The Effects of Two Group Approaches on Counseling Students' Empathy Development, Group Leader Self-Efficacy Development, and Experience of the Therapeutic Factors

    Science.gov (United States)

    Ohrt, Jonathan H.

    2010-01-01

    Counselor education programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) require their students to participate in a group experience as a member for 10 clock hours over the course of an academic term (CACREP, 2009). In addition, the Association for Specialists in Group Work (ASGW) recommends…

  20. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically......PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...

  1. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael

    2010-01-01

    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  2. A functional renormalization group application to the scanning tunneling microscopy experiment

    Directory of Open Access Journals (Sweden)

    José Juan Ramos Cárdenas

    2015-12-01

    Full Text Available We present a study of a system composed of a scanning tunneling microscope (STM tip coupled to an absorbed impurity on a host surface using the functional renormalization group (FRG. We include the effect of the STM tip as a correction to the self-energy in addition to the usual contribution of the host surface in the wide band limit. We calculate the differential conductance curves at two different lateral distances from the quantum impurity and find good qualitative agreement with STM experiments where the differential conductance curves evolve from an antiresonance to a Lorentzian shape.

  3. Exploring Experiences and Perceptions of Aging and Cognitive Decline Across Diverse Racial and Ethnic Groups

    Directory of Open Access Journals (Sweden)

    Lisa R. Roberts DrPH, MSN, FNP-BC

    2015-07-01

    Full Text Available Objective: To explore how older adults from three prominent ethnoracial groups experience cognitive decline and aging. Method: Semistructured key informant interviews (KIIs and focus groups (FGs were conducted with caregivers, experts, and older adults. Results: ( N = 75. Fifteen KIIs regarding cognitive aging issues were conducted among health care professionals and community-based agencies serving older adults. Eight FGs included family caregivers and physicians, and six FGs with Latino, African American, and White older adult community members. Major themes included (a personal expectations about aging, (b societal value of older adults, (c model of care preferred, and (d community concerns. An overarching theme was a sense of loss associated with aging; however, how this loss was experienced and dealt with varied. Discussion: Distinct patterns of concerns and views are important to understand for the development of programs aimed at meeting the needs of diverse older adult community members to improve health outcomes.

  4. Exploring Experiences and Perceptions of Aging and Cognitive Decline Across Diverse Racial and Ethnic Groups

    Directory of Open Access Journals (Sweden)

    Lisa R. Roberts DrPH, MSN, FNP-BC

    2015-07-01

    Full Text Available Objective: To explore how older adults from three prominent ethnoracial groups experience cognitive decline and aging. Method: Semistructured key informant interviews (KIIs and focus groups (FGs were conducted with caregivers, experts, and older adults. Results: (N = 75. Fifteen KIIs regarding cognitive aging issues were conducted among health care professionals and community-based agencies serving older adults. Eight FGs included family caregivers and physicians, and six FGs with Latino, African American, and White older adult community members. Major themes included (a personal expectations about aging, (b societal value of older adults, (c model of care preferred, and (d community concerns. An overarching theme was a sense of loss associated with aging; however, how this loss was experienced and dealt with varied. Discussion: Distinct patterns of concerns and views are important to understand for the development of programs aimed at meeting the needs of diverse older adult community members to improve health outcomes.

  5. Oncological emergencies for the internist

    Directory of Open Access Journals (Sweden)

    Umesh Das

    2015-01-01

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

  6. Exploring targeted therapies in oncology

    NARCIS (Netherlands)

    Mom, Constantijne Helene

    2007-01-01

    Targeted therapy in oncology is treatment directed at specific biological pathways and processes that play a critical role in carcinogenesis. Increased knowledge regarding the molecular changes underlying tumor progression and metastatis has resulted in the development of agents that are designed to

  7. [What's new in geriatric oncology?].

    Science.gov (United States)

    Terret, Catherine; Albrand, Gilles; Jeanton, Martine; Courpron, Philippe; Droz, Jean-Pierre

    2006-01-01

    Remarkably, although 60% of new cancer cases and over 70% of cancer deaths occur in patients aged 65 years and older in Europe, standard treatment strategies have been mostly validated in younger adults. This demographic trend has led to the emergence of a new medical discipline, geriatric oncology and the development worldwide of geriatric oncology programs for the individualized management of elderly cancer patients. Elderly cancer patients represent an increasing share of the population and strategies for treating cancer must evolve to face this ineluctable reality. Treatment should take into account the highly heterogeneous physiological age of the elderly, their individual life expectancy, functional reserves, social support and preferences. French geriatric oncology programs have been mostly based on the interdependence of geriatricians, oncologists and auxiliary nursing people. This approach represent the best way to offer patients optimal management; oncologists and geriatricians collaborate to assess both global health status by means of Comprehensive Geriatric Assessment (CGA) and tumor stage by means of Comprehensive Tumor Assessment (CTA) and to initiate individualized care plans, involving comprehensive management and follow-up of all identified problems. This paper focuses on progress observed in the field of geriatric oncology both in France and worldwide.

  8. [History of Oncology in Slovakia].

    Science.gov (United States)

    Ondruš, D; Kaušitz, J

    2016-01-01

    The history of oncology in Slovakia is closely linked to the history of St. Elizabeth Hospital, which was set up in the mid-18th century by nuns of the St. Elizabeth Order in Bratislava. In the first half of the 20th century, a unit was set up in the hospital dedicated to diagnosis and treatment of cancer. Shortly after World War II, the unit was turned into the Institute for Cancer Research and Treatment. In 1950, St. Elizabeth Hospital was nationalized, and the Cancer Research Institute of the Slovak Academy of Science and the Institute of Clinical Oncology were located there as centers for oncological diagnosis and treatment. After the restitution of church property in the early 1990s, the hospital was returned to the Order of St. Elizabeth, which set up the St. Elisabeth Cancer Institute in the hospital premises in January of 1996. This year marks the 20th anniversary of this institute in its new premises and the 85th anniversary of the Institute of Radiumtherapy founded in Bratislava, and thus the establishment of institutional healthcare for cancer patients in Slovakia is the reason for balancing. We present a view of the consecutive changes in the organization, space and staff of the Institute and evaluate the impact of celebrities on medicine who developed oncology as a clinical, scientific and educational discipline in Bratislava and in other cities and regions of Slovakia.

  9. The academic writing experiences of a group of student nurses: a phenomenological study.

    Science.gov (United States)

    Whitehead, Dean

    2002-06-01

    To investigate the academic writing experiences of a group of preregistration nursing students. To explore issues surrounding how academic writing skills were developed, integrated and received into the student's educational programme and how these skills impacted on various aspects of their educational and clinical experience. The development of an academic writing style is seen to be an integral skill that the student must be willing to learn and undertake within higher education settings. Academic styles of writing have been imported into nursing education as a consequence of its integration into higher education. I wanted to investigate the experiences of learning an academic style of writing for students early on in their nursing career. There is little, if any, research that seeks to investigate or measure these experiences of nursing students. A phenomenological approach to investigate the academic writing experiences of a group of preregistration students. There is an expectation that preregistration students will quickly acquire academic writing skills when most will have had little or no prior experience. There appeared to have been little emphasis placed on facilitating the development of these skills in the educational programme. The lack of emphasis and support proved to be problematical for these nursing students. The emergence of a theory-practice divide also figured strongly. Students were, however, able to appreciate the need and place for academic writing skills and most were able to identify the structural processes that were integral to acquiring such skills. A plethora of anecdotal evidence, supported by the findings in this study, suggests that most nursing students' struggle with the demands placed upon them when writing academic assignments. The need for greater emphasis and support throughout the whole period of training are highlighted in the findings of this study. It is known that nursing loses large numbers of its students to the

  10. Extractive industries and sustainable development: an evaluation of World Bank Group experience

    Energy Technology Data Exchange (ETDEWEB)

    Andres Liebenthal; Roland Michelitsch; Ethel Tarazona

    2005-07-01

    How effectively has the World Bank Group assisted its clients in enhancing the contribution of the extractive industries to sustainable development? (Extractive industries include oil, gas, and mining of minerals including coals and metals.) This evaluation finds that with its global mandate and experience, comprehensive country development focus, and overarching mission to fight poverty, the World Bank Group is well positioned to help countries overcome the policy, institutional, and technical challenges that prevent them from transforming resource endowments into sustainable benefits. Furthermore, the World Bank Group's achievements are many. On the whole, its extractive industries projects have produced positive economic and financial results, though compliance with its environmental and social safeguards remains a challenge. Its research has broadened and deepened understanding of the causes for the disappointing performance of resource-rich countries. Its guidelines for the mitigation of adverse environmental and social impacts have been widely used and appreciated. More recently, it has begun to address the challenge of country governance with a variety of instruments. The World Bank Group can, however, do much to improve its performance in enhancing the extractive industry sector's contribution to sustainable development and poverty reduction. The report identifies three main areas for improvement - formulating an integrated strategy, strengthening implementation and engagement of stakeholders. 5 annexes.

  11. Sample-size calculations for multi-group comparison in population pharmacokinetic experiments.

    Science.gov (United States)

    Ogungbenro, Kayode; Aarons, Leon

    2010-01-01

    This paper describes an approach for calculating sample size for population pharmacokinetic experiments that involve hypothesis testing based on multi-group comparison detecting the difference in parameters between groups under mixed-effects modelling. This approach extends what has been described for generalized linear models and nonlinear population pharmacokinetic models that involve only binary covariates to more complex nonlinear population pharmacokinetic models. The structural nonlinear model is linearized around the random effects to obtain the marginal model and the hypothesis testing involving model parameters is based on Wald's test. This approach provides an efficient and fast method for calculating sample size for hypothesis testing in population pharmacokinetic models. The approach can also handle different design problems such as unequal allocation of subjects to groups and unbalanced sampling times between and within groups. The results obtained following application to a one compartment intravenous bolus dose model that involved three different hypotheses under different scenarios showed good agreement between the power obtained from NONMEM simulations and nominal power.

  12. A common control group - optimising the experiment design to maximise sensitivity.

    Directory of Open Access Journals (Sweden)

    Simon Bate

    Full Text Available Methods for choosing an appropriate sample size in animal experiments have received much attention in the statistical and biological literature. Due to ethical constraints the number of animals used is always reduced where possible. However, as the number of animals decreases so the risk of obtaining inconclusive results increases. By using a more efficient experimental design we can, for a given number of animals, reduce this risk. In this paper two popular cases are considered, where planned comparisons are made to compare treatments back to control and when researchers plan to make all pairwise comparisons. By using theoretical and empirical techniques we show that for studies where all pairwise comparisons are made the traditional balanced design, as suggested in the literature, maximises sensitivity. For studies that involve planned comparisons of the treatment groups back to the control group, which are inherently more sensitive due to the reduced multiple testing burden, the sensitivity is maximised by increasing the number of animals in the control group while decreasing the number in the treated groups.

  13. Malevolent Governance, Intra-Group Conflict and the Paradox of the Plenty: An Experiment

    Directory of Open Access Journals (Sweden)

    Klarizze Anne Puzon

    2015-12-01

    Full Text Available Using a laboratory experiment, we behaviourally study the impact of a sudden increase in the common-pool size on within-group conflict, i.e., the paradox of the plenty. We also consider the potential role of governance in avoiding this paradox. In the first stage, a randomly-chosen leader of the group determines how much of the common-pool resource to protect from second-stage conflict. In the next stage, each group member allocates his private endowment between working or fighting for a share of the unprotected resource. We consider two treatments: anarchy (consisting of the second stage only and with a leader deciding in the first stage. We find that the existence of institutions is not always better than anarchy. This is aggravated when the resource size is higher. Group conflict (income decreases (increases only when leaders chose the strongest resource protection. When leaders are malevolent, i.e., they chose weak resource protection, outcomes are worse than when institutions are absent.

  14. The effect of short term neo-adjuvant androgen deprivation on erectile function in patients treated with external beam radiotherapy for localised prostate cancer: an analysis of the 4- versus 8-month randomised trial (Irish Clinical Oncology Research Group 97-01).

    LENUS (Irish Health Repository)

    Daly, Patricia E

    2012-07-01

    Erectile dysfunction is a common consequence of external beam radiotherapy (EBRT) for prostate cancer. The addition of neo-adjuvant androgen deprivation (NAD) has an indeterminate additive effect. We examined the long-term effect on erectile function (EF) of two durations (4 months: arm 1 and 8 months: arm 2) of NAD prior to radiation (RT) for patients with localised prostate cancer from the Irish Clinical Oncology Research Group (ICORG 97-01) 4- versus 8-month trial. In this study we aimed to (1) analyse the overall effect on EF of NAD in an EBRT population, (2) compare the probability of retained EF over time in an EBRT population treated with either 4 or 8 months of NAD and (3) identify any variables such as risk group and age which may have an additive detrimental effect. This analysis provides unique long term follow up data.

  15. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    The objective of this review is to synthesize the best available evidence on palliative care experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliative care experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients with cancer from diverse ethnocultural groups assign to their experiences with palliative care? Globally, over 20.4 million people need palliative care services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliative care is expected to rise. Furthermore, how palliative care is offered and received continues to be shaped by culture and ethnicity. Likewise, culture and ethnicity influence how palliative care patients experience diseases like cancer, and seek and utilize palliative care services. Also, healthcare providers sometimes find it challenging to address the palliative care needs of patients from different ethnocultural groups. Sometimes these challenges are believed to be due to cultural incompetence of the care provider. When palliative care patients and their providers differ in their perception of care needs and how to address them, negative palliative care experiences are likely to ensue. Therefore, as the demand for palliative care increases, and ethnocultural factors continue to affect palliation, it is important to gain a better understanding of palliative care experiences of patients from different ethnocultural groups.The terms culture and ethnicity have been defined and used differently in literature which sometimes lead to confusion. Ethnicity has been defined as distinctive shared origins or social backgrounds and traditions of a group of people that are maintained between generations and

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

    Directory of Open Access Journals (Sweden)

    Aprile G

    2015-05-01

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

  17. Clinical experiences in treating PTSD patients by combining individual and group psychotherapy.

    Science.gov (United States)

    Bilić, Vedran; Nemcić-Moro, Iva; Karsić, Vana; Grgić, Vesna; Stojanović-Spehar, Stanislava; Marcinko, Darko

    2010-06-01

    PTSD is a complex psychobiological disorder that causes disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychological Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychotherapy, psychopharmacotherapy and group psychotherapeutic techniques introduced within repeated day-hospital treatments. In this paper the efficiency of the above mentioned model has been explored. Three PTSD patients have been presented. We assessed changes in psychological functioning of our subjects on the basis of clinical observation and analysis of the session protocols. The model of combined and long-term treatment of PTSD in which the approach to traumatized patients has been mostly supportive, including supportive psychotherapeutic interventions and psychopharmacotherapy, has proved to be efficient in achieving integration of traumatic experiences and consolidation of the traumatised Self. Combination of individual and group approach facilitates the analysis of traumatic transference, whereas more mature defence patterns become stronger and integration of traumatic experiences improved. Consolidation of the Self leads to better socialization.

  18. Friendship group identification, multidimensional self-concept, and experience of developmental tasks in adolescence.

    Science.gov (United States)

    Tarrant, Mark; MacKenzie, Liam; Hewitt, Lisa A

    2006-08-01

    This study applied a social identity perspective to the study of adolescent self-concept and social development. British adolescents aged 14-15 years (N=114) completed a questionnaire which asked them to: (i) rate their degree of identification with a school-based friendship group; (ii) complete a measure of multi-dimensional self-concept; and (iii) report their experiences of a variety of personal, relational and socio-institutional (e.g., achieving economic independence) developmental tasks. Compared to low identifiers, participants who were highly identified with a friendship group reported highest levels of self-esteem; and these differences were most marked in non-academic domains of self. High identifiers also displayed higher levels of general self-esteem and reported more positive experiences of personal and relational developmental tasks. The discussion focuses on the potential benefits to understanding of social developmental processes that can be derived from a consideration of adolescents' subjective appraisals of their peer relations.

  19. Inspired by Fieldwork: A Teacher Research Experience Energizes and Ignites a Group of Elementary Students

    Science.gov (United States)

    Munroe, C. H.

    2010-12-01

    Through involvement in authentic research experiences teachers improve their content knowledge, deepen their understanding of the research process, and rejuvenate their interest in science. These positive results of fieldwork transfer into the classroom, directly benefiting students. The ARMADA project provided me with a three week research experience aboard the Amundsen (Canadian Coast Guard science vessel) which enriched and strengthened me professionally. Guided by master and early career scientists, I took part in specific research techniques and deep scientific discourse. My immersion in ocean science was so stimulating that I was inspired to share that excitement with my students. The fascination my students showed for basic experiments and ocean related activities fueled my interest further and I began to research more deeply which led to Climate Literacy and Polar Studies as essentials in my science curriculum. Over the following years I continued to expand and refine the workshops and activities students take part in. Three years after the research experience students still love the science explorations we embark upon together. This past year a group of students became so excited about Polar Science and Climate that they authored a 36 page non fiction book for upper elementary and middle school students entitled, "Changing Poles, Changing Planet: Climate Change vs. The Earth". Seven of the authors decided to continue their science outreach work by creating an educational video focusing on the basics of climate science and what children can do to lower carbon emissions. The book and video were distributed to educators as well as scientists at the International Polar Year Science Conference in June, 2010. In August some of these students presented their work at a Sustainability festival that was organized by M-CAN a local climate action group. Two of these students (who have left my class and started 6th grade at the middle school)recently decided to form a

  20. Focus Groups Reveal Differences in Career Experiences Between Male and Female Geoscientists

    Science.gov (United States)

    Oconnell, S.; Frey, C. D.; Holmes, M.

    2003-12-01

    We conducted twelve telephone focus groups of geoscientists to discover what motivates geoscientists to enter our field and stay in our field. There were separate male and female groups from six different professional categories: administrators, full and associate professors, non-tenure track personnel, assistant professors, post-docs and PhD candidates, Bachelor's and Master's candidates. A total of 96 geoscientists participated. Specifically, respondents were asked what initially brought them into the geosciences. Three dominant themes emerged: the subject matter itself, undergraduate experiences, and relationships. A total of 51 responses to this question related to the subject matter itself. Approximately 61 percent (31) of those responses were given by male focus group participants. Across all focus groups, participants brought up issues such as a general appreciation of the outdoors, weather, rocks, and dinosaurs. Following closely behind the general subject matter is undergraduate events. Fifty-one responses mentioned something about undergraduate experiences such as an introductory class, a laboratory experience, or field experiences. While both female and male participants discussed the role of interpersonal relationships in their decision to become a geoscientist, females were slightly more likely to bring up relevant relationships (26 times for females compared to 21 for males). These relationships varied in both groups from a parent or grandparents influence to camping trips with professors. When respondents were asked whether they had ever considered leaving the geosciences and under what circumstances, there was a striking difference between males and females: males were far less likely to have ever considered leaving. Younger males were more likely to consider leaving than older geoscientists. They feel challenged by the financial constraints of graduate school and the time constraints of academic vs. family life. Many females considered leaving at

  1. Report of the Plasma Physics and Environmental Perturbation Laboratory (PPEPL) working groups. Volume 3: Magnetospheric experiments working group

    Science.gov (United States)

    1974-01-01

    A number of general studies that were proposed for the PPEPL-SHUTTLE program are considered in qualitative detail from both the theoretical and practical points of view. The selection of experimental programs was restricted to those which may be considered active as opposed to refinements of the passive observational programs done previously. It is concluded that, while these new studies were scientifically worthwhile and could be performed in principle, in most cases insufficient attention was paid to the practical details of the experiments. Several specific areas of study, stressing in particular the practical feasibility of the proposed experiments, are recommended. In addition, recommendations are made for further theoretical study, where appropriate. For Vol. 1, see N74-28169; for Vol. 2, see N74-28170.

  2. Target Group Segmentation in the Horse Buyers' Market against the Background of Equestrian Experience.

    Science.gov (United States)

    Gille, Claudia; Kayser, Maike; Spiller, Achim

    2010-01-01

    Whereas in former times horses were reserved primarily for people involved in agriculture, elite equestrians or the military, nowadays equestrian sport has become an activity for people with a wide variety of backgrounds. However, as more and more people become involved with equestrian sport today, the knowledge concerning animal husbandry in general is diminishing due to an alienation from agricultural themes in modern societies. As a consequence, this development affects both riding ability and the appraisal of horses, especially with respect to the purchase of horses. In order to analyse which factors influence purchase decisions in the horse market in conjunction with equestrian experience, 739 horse riders were surveyed on their purchase behaviour in this study. Using cluster analysis, a typology was generated that provides a differentiated picture of the preferences of the various rider groups. Three clusters were distinguished: the "amateurs", the "experienced" and the "experts". Taking personal horse riding proficiency into account, it could be concluded that especially the "amateur" group required objective criteria for the evaluation of a horse they are considering purchasing. Alongside "measureable" qualities, such as previous showing success or the level of training of the horse, also other attributes such as the simple handling of the horse should be taken into consideration. As particularly the "amateur" group in equestrian sport is increasing in numbers, it is therefore advisable when preparing a horse for sale to align oneself to the needs of this customer segment in order to ensure an effective and targeted marketing of horses.

  3. [Helpful Factors of Ambulant Art Therapy in the Group and Changes of Experiences in Psychosomatic Patients].

    Science.gov (United States)

    Oster, Jörg; Moser, Anna Sophie; Danner-Weinberger, Alexandra; von Wietersheim, Jörn

    2016-02-01

    The aim of this study was to analyze the experiences of patients suffering from mostly chronic psychosomatic disorders in an ambulant art therapy in the group. Especially, the focus was on the experienced changes, helpful factors and specifics of the therapy as well as on the experienced benefit. For this, 30 patients were interviewed in a semi-standardized way. Additionally, the symptom-based strain was psychometrically recorded in a part of the patients (21) at the beginning of the therapy and after at least 6 months of participation. The evaluation of those interviews with the qualitative analysis of the therapy subjects surrendered an improvement of the health state in most of the participants. Especially group factors, art as a mean of communication, becoming aware of feelings but also diversion and fun were proved to be beneficial. The art therapy also serves for structuring the week as well as a contact point and a resource in the interpersonal communication of everyday life. Nearly all of the patients referred to some important turning point pictures. Mostly, the benefit was valued as being high. But, in contrast, the psychometric measure did not show any significant change. The results emphasize the stabilizing function of art therapy in the examined patients, whereat the classification of the psychometric result is complicated by the absence of a control group. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Initial experience with a group presentation of study results to research participants

    Directory of Open Access Journals (Sweden)

    Bent Stephen

    2008-03-01

    Full Text Available Abstract Background Despite ethical imperatives, informing research participants about the results of the studies in which they take part is not often performed. This is due, in part, to the costs and burdens of communicating with each participant after publication of the results. Methods Following the closeout and publication of a randomized clinical trial of saw palmetto for treatment of symptoms of benign prostatic hyperplasia, patients were invited back to the research center to participate in a group presentation of the study results. Results Approximately 10% of participants attended one of two presentation sessions. Reaction to the experience of the group presentation was very positive among the attendees. Conclusion A group presentation to research participants is an efficient method of communicating study results to those who desire to be informed and was highly valued by those who attended. Prospectively planning for such presentations and greater scheduling flexibility may result in higher attendance rates. Trial Registration Number Clinicaltrials.gov #NCT00037154

  5. Toward a consensus on radiobiology teaching to radiation oncology residents.

    Science.gov (United States)

    Dynlacht, Joseph R; Dewhirst, Mark W; Hall, Eric J; Rosenstein, Barry S; Zeman, Elaine M

    2002-05-01

    There are approximately 82 radiation oncology residency programs in the United States, which provide training opportunities for about 400 residents. All accredited radiation oncology residency programs must have at least one basic scientist on the faculty, and it is these individuals who often assume, wholly or in part, the responsibility of teaching radiation and cancer biology to radiation oncology residents in preparation for the American College of Radiology (ACR) In-Training Examination in Radiation Oncology and the American Board of Radiology (ABR) written examinations. In response to a perceived lack of uniformity in radiation and cancer biology curricula currently being taught to residents and a perceived lack of guidance for instructors in formulating course content for this population, a special session was presented at the Forty-eighth Annual Radiation Research Society meeting on April 23, 2001. The session, entitled "Toward a Consensus on Radiobiology Teaching to Radiation Oncology Residents", was focused on issues related to teaching radiobiology to radiation oncology residents and targeted for individuals who actively teach radiation and cancer biology as well as coordinators of residency training programs. The speakers addressed current challenges and future problems facing instructors and programs. Among these were lack of feedback on resident performance on ABR and ACR written examinations and on course content, uncertainty about what topics residents must know to pass the ABR examination, and, in the near future, a reduction (due to retirement) of instructors qualified to teach radiobiology. This article provides a synopsis of the information that was presented during that session, offers a glimpse into how the ABR and ACR examinations are prepared and details of the content of past and future examinations, and summarizes the activities of the Joint Working Group on Radiobiology Teaching which was formed to educate instructors, to establish a

  6. A physician team's experiences in community-based participatory research: insights into effective group collaborations.

    Science.gov (United States)

    Dalal, Mehul; Skeete, Rachel; Yeo, Heather L; Lucas, Georgina I; Rosenthal, Marjorie S

    2009-12-01

    Postdoctoral fellows from the Robert Wood Johnson Clinical Scholars Program are among a growing number of physician-researchers training in community-based participatory research (CBPR). These fellows are uniquely positioned to observe and evaluate CBPR training needs and the experience of collaboratively conducting a CBPR project. To describe, from the perspective of physician-researchers, experiences in intragroup and intergroup collaborations while conducting CBPR. During a 2-year fellowship, a group of seven fellows received 6 months of didactic training and then spent 18 months conducting a mentored CBPR project. The CBPR project was complemented by a 2-year facilitated leadership seminar, which allowed for reflection on intragroup (among fellows) and intergroup (fellows/community members) relationships throughout the CBPR process. Seven core principles of CBPR were found to apply to not only intergroup but also intragroup relationships: (1) building trust, (2) finding a shared interest, (3) power-sharing, (4) fostering co-learning and capacity building among partners, (5) building on existing strengths, (6) employing an iterative process, and (7) finding a balance between research and action for the mutual benefit of all partners. Establishing and maintaining relationships is at the core of CBPR. The development of intragroup relationships paralleled the development of intergroup relationships with community members. Applying the core principles of CBPR to the development of intragroup relationships provided experience that may have enhanced relationships with community partners. An a priori acknowledgement of the importance of relationships and the time needed to develop and manage those relationships may add to the CBPR training experience and assist in successfully executing collaborative projects.

  7. Evolution of health technology assessment: best practices of the pan-Canadian Oncology Drug Review

    Directory of Open Access Journals (Sweden)

    Rocchi A

    2015-06-01

    Full Text Available Angela Rocchi,1 Isabelle Chabot,2 Judith Glennie3 1Athena Research Inc., Burlington, ON, 2EvAccess Inc., Vaudreuil-Dorion, QC, 3JL Glennie Consulting Inc., Aurora, ON, Canada Background: In 2007, Canada chose to develop a separate and distinct path for oncology drug health technology assessment (HTA. In 2013, the decision was made to transfer the pan-Canadian Oncology Drug Review (pCODR to the Canadian Agency for Drugs and Technologies in Health (CADTH, to align the pCODR and CADTH Common Drug Review processes while building on the best practices of both. The objective of this research was to conduct an examination of the best practices established by the pCODR. Methods: A qualitative research approach was taken to assess the policies, processes, and practices of the pCODR, based on internationally accepted best practice “principles” in HTA, with a particular focus on stakeholder engagement. Publicly available information regarding the approach of the pCODR was used to gauge the agency's performance against these principles. In addition, stakeholder observations and real-world experiences were gathered through key informant interviews to be inclusive of perspectives from patient advocacy groups, provincial and/or cancer agency decision-makers, community and academic oncologists, industry, expert committee members, and health economists. Results: This analysis indicated that, through the pCODR, oncology stakeholders have had a voice in and have come to trust the quality and relevance of oncology HTA as a vital tool to ensure the best decisions for Canadians with cancer and their health care system. It could be expected that adoption of the principles and processes of the pCODR would bring a similar level of engagement and trust to other HTA organizations in Canada and elsewhere. Conclusion: The results of this research led to recommendations for improvement and potential extrapolation of these best practices to other HTA organizations

  8. Paying physician group practices for quality: A statewide quasi-experiment.

    Science.gov (United States)

    Conrad, Douglas A; Grembowski, David; Perry, Lisa; Maynard, Charles; Rodriguez, Hector; Martin, Diane

    2013-12-01

    This article presents the results of a unique quasi-experiment of the effects of a large-scale pay-for-performance (P4P) program implemented by a leading health insurer in Washington state during 2001-2007. The authors received external funding to provide an objective impact evaluation of the program. The program was unique in several respects: (1) It was designed dynamically, with two discrete intervention periods-one in which payment incentives were based on relative performance (the "contest" period) and a second in which payment incentives were based on absolute performance compared to achievable benchmarks. (2) The program was designed in collaboration with large multispecialty group practices, with an explicit run-in period to test the quality metrics. Public reporting of the quality scorecard for all participating medical groups was introduced 1 year before the quality incentive payment program's inception, and continued throughout 2002-2007. (3) The program was implemented in stages with distinct medical groups. A control group of comparable group practices also was assembled, and difference-in-differences methodology was applied to estimate program effects. Case mix measures were included in all multivariate analyses. The regression design permitted a contrast of intervention effects between the "contest" approach in the sub-period of 2003-2004 and the absolute standard, "achievable benchmarks of care" approach in sub-period 2005-2007. Most of the statistically significant quality incentive program coefficients were small and negative (opposite to program intent). A consistent pattern of differential intervention impact in the sub-periods did not emerge. Cumulatively, the probit regression estimates indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. Based on key informant interviews with medical leaders, practicing physicians, and administrators of the

  9. Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand.

    Science.gov (United States)

    Ratanakaaew, A; Khemapech, N; Laurujisawat, P

    2015-01-01

    The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9% of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this

  10. Genetics in neuro-oncology.

    Science.gov (United States)

    Martuza, R L

    1983-01-01

    This review provides a framework for the neurosurgeon in understanding the increasingly important role of genetics in the study of nervous system tumors. The three tumors discussed (retinoblastoma, meningioma, and neurofibroma) are neither the most common nor the most clinically devastating tumors faced by neurosurgeons. Rather, the studies on these tumors are presented because of the important lessons each provides. Studies of retinoblastoma demonstrate the ability of a gene which is recessive at the cellular level to require a second mutation for tumorigenesis and therein to appear as a dominantly inherited disorder at the level of the organism. This "multi-hit" theory could easily be applied to other nervous system tumors which have both sporadic solitary tumors and familial multiple tumors. In this group we should include acoustic neuromas, meningiomas, gliomas, neurofibromas, paragangliomas (glomus and carotid body tumors), and the pituitary tumors (and others) associated with the multiple endocrine neoplasia syndromes. The limits of this review do not allow a separate discussion of the neurosurgical aspect of these lesions; for this, the reader is referred elsewhere (18, 19). Meningiomas are discussed because it appears that two separate lines of inquiry may eventually be related at a cellular level. These directions of study are the demonstration that a common karyotypic abnormality (monosomy 22) is associated with a female preponderance of meningiomas and the demonstration of sex hormone binding in meningiomas. Future studies should be aimed at showing an in vitro biologic response of these tumors to exogenously added hormones or to their blocking agents. Moreover, one would hope that this response would correlate with a specific chromosomal abnormality. It is possible that some portion of the DNA which has been deleted or altered in these tumors plays an essential role in the regulation of the sex steroid regulatory system. If this segment of the genome

  11. Experience Exchange Group (EEG) Approach as a Means for Research to be rooted in Industry

    DEFF Research Database (Denmark)

    Bruun, Peter

    1997-01-01

    The intention of this paper is to clarify if and how an Experience Exchange Group(EEG) can be involved in a research process in the area of industrial management. For exemplification of the topic an ongoing research in global manufacturing is referred to. In this research it was after a series...... of preliminary studies found interesting to set up an EEG composed of representatives from industry and a researcher. In the paper some general research methods pertinent to the area industrial management are discussed. The EEG concept is introduced and characterised in comparison with the other methods. EEG...... activities are described and a tentative coupling to the phases in a research process is proposed. Following this is a discussion of methodological and quality requirements. It is considered how EEG activities could possibly contribute to an industrial rooted research. The paper ends up looking at future...

  12. How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group.

    Science.gov (United States)

    Verrier, J-F; Paget, C; Perlier, F; Demesmay, F

    2016-12-01

    The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction. These will ultimately assess adaptation of structures within these new organizations. In this article, we share our insights based on experience gained over the past six years by surgical teams of the CAPIO group.

  13. Experimenting clinical pathways in general practice: a focus group investigation with Italian general practitioners

    Directory of Open Access Journals (Sweden)

    Lucia Zannini

    2012-07-01

    Full Text Available Background. Clinical governance is considered crucial in primary care. Since 2005, clinical pathways have been experimentally implemented at the Local Health Authority of Monza Brianza (ASLMB, Italy, to develop general practitioners’ (GPs care of patients affected by some chronic diseases. The experimentation was aimed at introducing clinical governance in primary care, increasing GPs’ involvement in the care of their patients, and improving both patients’ and professionals’ satisfaction. In the period 2005-2006, 12% of the 763 employed GPs in the ASLMB were involved in the experiment, while this percentage increased to 15-20% in 2007-2008. Design and Methods. Twenty-four GPs were purposively sampled, randomly divided into two groups and asked to participate in focus groups (FGs held in 2008, aimed at evaluating their perception of the experiment. The FGs were audio-recorded, dialogues were typed out and undergone to a thematic analysis, according to the Interpretative Phenomenological Approach. Results. Four major themes emerged: i clinical pathways can result in GPs working in a more efficient and effective fashion; ii they can assure higher levels of both patient and professional satisfaction, since they sustain a caring approach and strengthen the GPs’ role; iii nevertheless, clinical pathways increase the bureaucratic workload and problems can arise in relationships among GPs and the LHA; iv the implementation of clinical pathways can be improved, especially by reducing bureaucracy and by assuring their continuity. Conclusions. Managerial aspects should be considered with care in order to experimentally introduce clinical pathways in general practice, and continuity of the experimentation should be guaranteed to improve GPs’ adherence and commitment.

  14. [Shared web-based data center for multi-institutional clinical trials: evaluation of UMIN-INDICE (university hospital medical information network-internet data and information center for medical research)in clinical trials of JIVROSG (Japan interventional radiology in oncology study group)].

    Science.gov (United States)

    Sone, Miyuki; Arai, Yasuaki; Kiuchi, Takahiro; Ishikawa, Hirono; Aoki, Noriaki; Inaba, Yoshitaka; Yoshioka, Tetsuya; Aramaki, Takeshi; Kobayashi, Takeshi; Matsuoka, Toshiyuki; Anai, Hiroshi; Tanigawa, Noboru; Osuga, Keigo; Takeuchi, Yoshito; Okusaka, Takushi; Kanazawa, Susumu; Matsui, Osamu; Endo, Keigo

    2012-04-01

    A patient registration system is mandatory for establishing the scientific credibility of the multi-center clinical trials. The Japan Interventional Radiology in Oncology Study Group (JIVROSG) was organized in 2002 to establish evidence supporting the procedures used in interventional radiology. The Internet Data and Information Center for Medical Research (INDICE), provided by the University Hospital Medical Information Network(UMIN), has been utilized for patient registration in the clinical trials of JIVROSG. In this study, the safety and efficacy of UMIN-INDICE were evaluated. From 2002 to 2010, 18 clinical trials, including one international trial, were conducted. A total of 736 patients were enrolled from 51 institutions. No significant trouble was encountered during this period. A questionnaire survey demonstrated that 90% of participating researchers could use this system without difficulties. UMIN-INDICE may contribute to promoting clinical trials as an infrastructure of multicenter studies.

  15. Raman Spectroscopy for Clinical Oncology

    Directory of Open Access Journals (Sweden)

    Michael B. Fenn

    2011-01-01

    Full Text Available Cancer is one of the leading causes of death throughout the world. Advancements in early and improved diagnosis could help prevent a significant number of these deaths. Raman spectroscopy is a vibrational spectroscopic technique which has received considerable attention recently with regards to applications in clinical oncology. Raman spectroscopy has the potential not only to improve diagnosis of cancer but also to advance the treatment of cancer. A number of studies have investigated Raman spectroscopy for its potential to improve diagnosis and treatment of a wide variety of cancers. In this paper the most recent advances in dispersive Raman spectroscopy, which have demonstrated promising leads to real world application for clinical oncology are reviewed. The application of Raman spectroscopy to breast, brain, skin, cervical, gastrointestinal, oral, and lung cancers is reviewed as well as a special focus on the data analysis techniques, which have been employed in the studies.

  16. Working group report on beam plasmas, electronic propulsion, and active experiments using beams

    Science.gov (United States)

    Dawson, J. M.; Eastman, T.; Gabriel, S.; Hawkins, J.; Matossian, J.; Raitt, J.; Reeves, G.; Sasaki, S.; Szuszczewicz, E.; Winkler, J. R.

    1986-01-01

    The JPL Workshop addressed a number of plasma issues that bear on advanced spaceborne technology for the years 2000 and beyond. Primary interest was on the permanently manned space station with a focus on identifying environmentally related issues requiring early clarification by spaceborne plasma experimentation. The Beams Working Group focused on environmentally related threats that platform operations could have on the conduct and integrity of spaceborne beam experiments and vice versa. Considerations were to include particle beams and plumes. For purposes of definition it was agreed that the term particle beams described a directed flow of charged or neutral particles allowing single-particle trajectories to represent the characteristics of the beam and its propagation. On the other hand, the word plume was adopted to describe a multidimensional flow (or expansion) of a plasma or neutral gas cloud. Within the framework of these definitions, experiment categories included: (1) Neutral- and charged-particle beam propagation, with considerations extending to high powers and currents. (2) Evolution and dynamics of naturally occurring and man-made plasma and neutral gas clouds. In both categories, scientific interest focused on interactions with the ambient geoplasma and the evolution of particle densities, energy distribution functions, waves, and fields.

  17. Managing a work-life balance: the experiences of midwives working in a group practice setting.

    Science.gov (United States)

    Fereday, Jennifer; Oster, Candice

    2010-06-01

    To explore how a group of midwives achieved a work-life balance working within a caseload model of care with flexible work hours and on-call work. in-depth interviews were conducted and the data were analysed using a data-driven thematic analysis technique. Children, Youth and Women's Health Service (CYWHS) (previously Women's and Children's Hospital), Adelaide, where a midwifery service known as Midwifery Group Practice (MGP) offers a caseload model of care to women within a midwife-managed unit. 17 midwives who were currently working, or had previously worked, in MGP. analysis of the midwives' individual experiences provided insight into how midwives managed the flexible hours and on-call work to achieve a sustainable work-life balance within a caseload model of care. it is important for midwives working in MGP to actively manage the flexibility of their role with time on call. Organisational, team and individual structure influenced how flexibility of hours was managed; however, a period of adjustment was required to achieve this balance. the study findings offer a description of effective, sustainable strategies to manage flexible hours and on-call work that may assist other midwives working in a similar role or considering this type of work setting. Copyright 2008 Elsevier Ltd. All rights reserved.

  18. DEGRO 2009. Radiation oncology - medical physics - radiation biology. Abstracts; DEGRO 2009. Radioonkologie - Medizinische Physik - Strahlenbiologie. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-06-15

    The special volume of the journal covers the abstracts of the DEGRO 2009 meeting on radiation oncology, medical physics, and radiation biology, covering the following topics: seldom diseases, gastrointestinal tumors, radiation reactions and radiation protection, medical care and science, central nervous system, medical physics, the non-parvicellular lung carcinomas, ear-nose-and throat, target-oriented radiotherapy plus ''X'', radio-oncology - young academics, lymphomas, mammary glands, modern radiotherapy, life quality and palliative radiotherapy, radiotherapy of the prostate carcinoma, imaging for planning and therapy, the digital documentation in clinics and practical experiences, NMR imaging and tomography, hadrons - actual status in Germany, urinal tract oncology, radiotoxicity.

  19. Report on the International Colloquium on Cardio-Oncology (Rome, 12–14 March 2014)

    Science.gov (United States)

    Ewer, Michael; Gianni, Luca; Pane, Fabrizio; Sandri, Maria Teresa; Steiner, Rudolf K; Wojnowski, Leszek; Yeh, Edward T; Carver, Joseph R; Lipshultz, Steven E; Minotti, Giorgio; Armstrong, Gregory T; Cardinale, Daniela; Colan, Steven D; Darby, Sarah C; Force, Thomas L; Kremer, Leontien CM; Lenihan, Daniel J; Sallan, Stephen E; Sawyer, Douglas B; Suter, Thomas M; Swain, Sandra M; van Leeuwen, Flora E

    2014-01-01

    Cardio-oncology is a relatively new discipline that focuses on the cardiovascular sequelae of anti-tumour drugs. As any other young adolescent discipline, cardio-oncology struggles to define its scientific boundaries and to identify best standards of care for cancer patients or survivors at risk of cardiovascular events. The International Colloquium on Cardio-Oncology was held in Rome, Italy, 12–14 March 2014, with the aim of illuminating controversial issues and unmet needs in modern cardio-oncology. This colloquium embraced contributions from different kind of disciplines (oncology and cardiology but also paediatrics, geriatrics, genetics, and translational research); in fact, cardio-oncology goes way beyond the merging of cardiology with oncology. Moreover, the colloquium programme did not review cardiovascular toxicity from one drug or the other, rather it looked at patients as we see them in their fight against cancer and eventually returning to everyday life. This represents the melting pot in which anti-cancer therapies, genetic backgrounds, and risk factors conspire in producing cardiovascular sequelae, and this calls for screening programmes and well-designed platforms of collaboration between one key professional figure and another. The International Colloquium on Cardio-Oncology was promoted by the Menarini International Foundation and co-chaired by Giorgio Minotti (Rome), Joseph R Carver (Philadelphia, Pennsylvania, United States), and Steven E Lipshultz (Detroit, Michigan, United States). The programme was split into five sessions of broad investigational and clinical relevance (what is cardiotoxicity?, cardiotoxicity in children, adolescents, and young adults, cardiotoxicity in adults, cardiotoxicity in special populations, and the future of cardio-oncology). Here, the colloquium chairs and all the session chairs briefly summarised what was said at the colloquium. Topics and controversies were reported on behalf of all members of the working group

  20. Phase III Randomized Study of 4 Weeks of High-Dose Interferon-α-2b in Stage T2bNO, T3a-bNO, T4a-bNO, and T1-4N1a-2a (microscopic) Melanoma: A Trial of the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Cancer Research Group (E1697).

    Science.gov (United States)

    Agarwala, Sanjiv S; Lee, Sandra J; Yip, Waiki; Rao, Uma N; Tarhini, Ahmad A; Cohen, Gary I; Reintgen, Douglas S; Evans, Terry L; Brell, Joanna M; Albertini, Mark R; Atkins, Michael B; Dakhil, Shaker R; Conry, Robert M; Sosman, Jeffrey A; Flaherty, Lawrence E; Sondak, Vernon K; Carson, William E; Smylie, Michael G; Pappo, Alberto S; Kefford, Richard F; Kirkwood, John M

    2017-03-10

    Purpose To test the efficacy of 4 weeks of intravenous (IV) induction with high-dose interferon (IFN) as part of the Eastern Cooperative Oncology Group regimen compared with observation (OBS) in patients with surgically resected intermediate-risk melanoma. Patients and Methods In this intergroup international trial, eligible patients had surgically resected cutaneous melanoma in the following categories: (1) T2bN0, (2) T3a-bN0, (3) T4a-bN0, and (4) T1-4N1a-2a (microscopic). Patients were randomly assigned to receive IFN α-2b at 20 MU/m(2)/d IV for 5 days (Monday to Friday) every week for 4 weeks (IFN) or OBS. Stratification factors were pathologic lymph node status, lymph node staging procedure, Breslow depth, ulceration of the primary lesion, and disease stage. The primary end point was relapse-free survival. Secondary end points included overall survival, toxicity, and quality of life. Results A total of 1,150 patients were randomly assigned. At a median follow-up of 7 years, the 5-year relapse-free survival rate was 0.70 (95% CI, 0.66 to 0.74) for OBS and 0.70, (95% CI, 0.66 to 0.74) for IFN ( P = .964). The 5-year overall survival rate was 0.83 (95% CI, 0.79 to 0.86) for OBS and 0.83 (95% CI, 0.80 to 0.86) for IFN ( P = .558). Treatment-related grade 3 and higher toxicity was 4.6% versus 57.9% for OBS and IFN, respectively ( P weeks of IV induction as part of the Eastern Cooperative Oncology Group high-dose IFN regimen is not better than OBS alone for patients with intermediate-risk melanoma as defined in this trial.

  1. Phase II Trial Assessing the Ability of Neoadjuvant Chemotherapy With or Without Second-Look Surgery to Eliminate Measurable Disease for Nongerminomatous Germ Cell Tumors: A Children's Oncology Group Study.

    Science.gov (United States)

    Goldman, Stewart; Bouffet, Eric; Fisher, Paul G; Allen, Jeffrey C; Robertson, Patricia L; Chuba, Paul J; Donahue, Bernadine; Kretschmar, Cynthia S; Zhou, Tianni; Buxton, Allen B; Pollack, Ian F

    2015-08-01

    Oncology.

  2. Generalities of the oncological pain

    Directory of Open Access Journals (Sweden)

    Sarah María Regueira Betancourt

    2015-09-01

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

  3. Recent benchmarking experience of the OECD/Nea expert group on three-dimensional radiation transport

    Energy Technology Data Exchange (ETDEWEB)

    Smith, M.A. [Argonne National Laboratory, Illinois (United States); Lewis, E.E. [Northwestern Univ., Department of Mechanical Engineering, Evanston, Illinois (United States); Byung-Chan, Na [OECD/NEA, 92 - Issy-les-Moulineaux (France)

    2003-07-01

    Experience of the OECD/NEA Expert Group on three-dimensional radiation transport pertaining to the C5 MOX fuel problem is examined, and the group's activity since the project's initiation in the fall of 1999 is reviewed. Twenty groups from seven nations submitted solutions to the two- and/or three-dimensional forms of the problem. Their solution methods are compared and their results analyzed. Observations are drawn from the benchmarking experience to assess the strengths and weaknesses of current methods and to better understand the challenges encountered by those who seek to obtain accurate solutions to large-scale multidimensional neutron transport problems. Drawing on the tabulated results, our e-mail correspondence and telephone conversations with participants, and on our own parametric studies, we are able to share some insights concerning space-angle transport approximations. For light water reactor physics problems without spatial homogenization like this one, refinement of angular approximations proved to be a greater challenge than refinement of the spatial approximation. Either a stair-step representation of the fuel-coolant interface or a polygonal representation was sufficient to describe the pin cell geometry, but only if great care was take to preserve the fuel volume exactly. The use of a high order angular approximation, such as S32 or P31, was required to obtain an accurate pin power and eigenvalue solution. The dangers of employing just one level of space-angle approximation became apparent to a number of participants during the course of this benchmark exercise. Frequently, eigenvalue errors resulting from coarse angular and spatial approximations have opposing effects on the eigenvalue. Thus, by cancellation of error, an accurate eigenvalue can be obtained using a coarse space-angle approximation while the flux solution is quite inaccurate. As a result, refinement of the spatial or angular approximation in such situations can cause

  4. Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators.

    Science.gov (United States)

    Siller, Heidi; Tauber, Gloria; Komlenac, Nikola; Hochleitner, Margarethe

    2017-08-14

    Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed. In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment. The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men. Mistreatment of female and

  5. Clinical Trials and the Role of the Oncology Clinical Trials Nurse.

    Science.gov (United States)

    Ness, Elizabeth A; Royce, Cheryl

    2017-03-01

    Clinical trials are paramount to improving human health. New trial designs and informed consent issues are emerging as a result of genomic profiling and the development of molecularly targeted agents. Many groups and individuals are responsible for ensuring the protection of research participants and the quality of the data produced. The specialty role of the clinical trials nurse (CTN) is critical to clinical trials. Oncology CTNs have competencies that can help guide their practice; however, not all oncology clinical trials are supervised by a nurse. Using the process of engagement, one organization has restructured oncology CTNs under a nurse-supervised model.

  6. Intervention patterns of pivot nurses in oncology.

    Science.gov (United States)

    Skrutkowski, Myriam; Saucier, Andréanne; Ritchie, Judith A; Tran, Ngoc; Smith, Kevin

    2011-01-01

    The Pivot Nurse in Oncology (PNO) is a health care professional dedicated to providing patients with cancer and their families with continuing and consistent supportive care throughout the care trajectory. The purpose of this paper is to describe the variation and frequency of nursing interventions delivered by 12 PNOs at our health centre. An administrative analysis over a three-year period revealed a total of 43,906 interventions that were grouped into 10 categories. This analysis provided a description of the intervention frequency and these interventions were further collapsed into the four role functions of the PNO. Coordination/continuity of care and the assessment of needs and symptoms were identified as the dominant practice domains of the PNO in the professional cancer navigator role.

  7. Community assessment workshops: a group method for gathering client experiences of health services.

    Science.gov (United States)

    Freeman, Toby; Jolley, Gwyn; Baum, Fran; Lawless, Angela; Javanparast, Sara; Labonté, Ronald

    2014-01-01

    Community assessment workshops were developed to gather client experiences of primary health care services in Australia. Primary health care services are particularly concerned with working with disadvantaged populations, for whom traditional client survey methods such as written surveys may not be inclusive and accessible. Service staff at six Australian primary health care services, including two Aboriginal-specific services, invited participants to attend workshops in 2011-2012. Participants were offered transport, childcare and an interpreter, and provided with reimbursement for their time. Ten workshops were run with a total of 65 participants who accessed a variety of services and programmes. A mix of age and gender was achieved. The workshops yielded detailed qualitative data and quantitative rankings for nine service qualities: holistic, effective, efficient, culturally respectful, used by those most in need, responsive to the local community, increasing individual control, supports and empowers the community, and mix of treatment, prevention and promotion. Discussions were audio recorded and transcribed for qualitative analysis. The workshop approach succeeded in being (i) inclusive, reaching users from disadvantaged sections of the community; (ii) comprehensive, providing ratings and discussion that took account of the whole service; (iii) richly descriptive, with researchers able to generate detailed feedback; and (iv) more empowering than traditional client survey methods, by allowing more control to participants and greater benefits than surveys of individuals. The community assessment workshops are a method that could be widely applied to health service evaluation research where the goal is to reach disadvantaged communities and provide ratings and detailed analysis of the experience of users. The participants and the research benefited from the group approach, and the workshops provided valuable, actionable information to the health services

  8. Experiences of employees with arm, neck or shoulder complaints: a focus group study

    Science.gov (United States)

    2014-01-01

    Background Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. Methods A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Results Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Conclusions Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be

  9. Joking Culture: The Role of Repeated Humorous Interactions on Group Processes during Challenge Course Experiences

    Science.gov (United States)

    Rothwell, Erin; Siharath, Kassidy; Bell, Steven; Nguyen, Kim; Baker, Carla

    2011-01-01

    When groups form, they develop their own culture from the shared meaning created from their interactions. Humor is part of every social group, and when repeatedly referenced, it forms a joking culture. The joking culture of small groups influences group processes by smoothing group interaction, forming a collective identity, separating the group…

  10. We are on the same boat, but still I am from another culture: the lived experiences of learning in groups

    Directory of Open Access Journals (Sweden)

    Sandra Kaire

    2017-06-01

    Full Text Available What does it mean to learn in a group of people from different cultures? How does one encounter people from different cultures when there is no clear ‘quantitative’ domination of any culture? By asking these questions the paper represents a hermeneutic phenomenological study that explores the phenomenon of learning in a culturally diverse group. A phenomenological study is undertaken with young people (18-30 years from different EU countries who participated in learning mobility project European Voluntary Service and had long-term volunteering experience abroad. The research concentrates on the lived moments of vis-à-vis intercultural encounters during learning process in groups. Specifically, through the descriptions of lived experience and phenomenological reflection the paper describes how young people experience self and others while they are learning in culturally diverse groups. Lived experiences of young people lead them into ‘no-man’s land’ (Waldenfels, 2011 where connection and separation simultaneously exist.

  11. Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview

    Directory of Open Access Journals (Sweden)

    Kidd Jane

    2006-02-01

    Full Text Available Abstract Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview Background Communication programmes are well established in nurse education. The focus of programmes is most often on communicating with patients with less attention paid to inter-professional communication or skills essential for working in specialised settings. Although there are many anecdotal reports of communication within the operating theatre, there are few empirical studies. This paper explores communication behaviours for effective practice in the operating theatre as perceived by nurses and serves as a basis for developing training. Methods A focus group interview was conducted with seven experienced theatre nurses from a large London teaching hospital. The interview explored their perceptions of the key as well as unique features of effective communication skills in the operating theatre. Data was transcribed and thematically analysed until agreement was achieved by the two authors. Results There was largely consensus on the skills deemed necessary for effective practice including listening, clarity of speech and being polite. Significant influences on the nature of communication included conflict in role perception and organisational issues. Nurses were often expected to work outside of their role which either directly or indirectly created barriers for effective communication. Perceptions of a lack of collaborative team effort also influenced communication. Conclusion Although fundamental communication skills were identified for effective practice in the operating theatre, there were significant barriers to their use because of confusion over clarity of roles (especially nurses' roles and the implications for teamwork. Nurses were dissatisfied with several aspects of communication. Future studies should explore the breadth and depth of this dissatisfaction in other operating theatres, its impact on morale and importantly

  12. Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview

    Science.gov (United States)

    Nestel, Debra; Kidd, Jane

    2006-01-01

    Abstract Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview Background Communication programmes are well established in nurse education. The focus of programmes is most often on communicating with patients with less attention paid to inter-professional communication or skills essential for working in specialised settings. Although there are many anecdotal reports of communication within the operating theatre, there are few empirical studies. This paper explores communication behaviours for effective practice in the operating theatre as perceived by nurses and serves as a basis for developing training. Methods A focus group interview was conducted with seven experienced theatre nurses from a large London teaching hospital. The interview explored their perceptions of the key as well as unique features of effective communication skills in the operating theatre. Data was transcribed and thematically analysed until agreement was achieved by the two authors. Results There was largely consensus on the skills deemed necessary for effective practice including listening, clarity of speech and being polite. Significant influences on the nature of communication included conflict in role perception and organisational issues. Nurses were often expected to work outside of their role which either directly or indirectly created barriers for effective communication. Perceptions of a lack of collaborative team effort also influenced communication. Conclusion Although fundamental communication skills were identified for effective practice in the operating theatre, there were significant barriers to their use because of confusion over clarity of roles (especially nurses' roles) and the implications for teamwork. Nurses were dissatisfied with several aspects of communication. Future studies should explore the breadth and depth of this dissatisfaction in other operating theatres, its impact on morale and importantly on patient safety

  13. Organisational design for an integrated oncological department

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    Ch.L. Meiss-de Haas

    2001-09-01

    Full Text Available Objective: The outcomes of a Strength, Weakness, Opportunities and Threat (SWOT analysis of three Integrated Oncological Departments were compared with their present situation three years later to define factors that can influence a successful implementation and development of an Integrated Oncological Department in- and outside (i.e. home care the hospital. Research design: Comparative Qualitative Case Study. Methods: Auditing based on care-as-usual norms by an external, experienced auditing committee. Research setting: Integrated Oncological Departments of three hospitals. Results: Successful multidisciplinary care in an integrated, oncological department needs broad support inside the hospital and a well-defined organisational plan.

  14. Randomized Trial Comparing Conventional-Dose With High-Dose Conformal Radiation Therapy in Early-Stage Adenocarcinoma of the Prostate: Long-Term Results From Proton Radiation Oncology Group/American College of Radiology 95-09

    Science.gov (United States)

    Zietman, Anthony L.; Bae, Kyounghwa; Slater, Jerry D.; Shipley, William U.; Efstathiou, Jason A.; Coen, John J.; Bush, David A.; Lunt, Margie; Spiegel, Daphna Y.; Skowronski, Rafi; Jabola, B. Rodney; Rossi, Carl J.

    2010-01-01

    Purpose To test the hypothesis that increasing radiation dose delivered to men with early-stage prostate cancer improves clinical outcomes. Patients and Methods Men with T1b-T2b prostate cancer and prostate-specific antigen ≤ 15 ng/mL were randomly assigned to a total dose of either 70.2 Gray equivalents (GyE; conventional) or 79.2 GyE (high). No patient received androgen suppression therapy with radiation. Local failure (LF), biochemical failure (BF), and overall survival (OS) were outcomes. Results A total of 393 men were randomly assigned, and median follow-up was 8.9 years. Men receiving high-dose radiation therapy were significantly less likely to have LF, with a hazard ratio of 0.57. The 10-year American Society for Therapeutic Radiology and Oncology BF rates were 32.4% for conventional-dose and 16.7% for high-dose radiation therapy (P < .0001). This difference held when only those with low-risk disease (n = 227; 58% of total) were examined: 28.2% for conventional and 7.1% for high dose (P < .0001). There was a strong trend in the same direction for the intermediate-risk patients (n = 144; 37% of total; 42.1% v 30.4%, P = .06). Eleven percent of patients subsequently required androgen deprivation for recurrence after conventional dose compared with 6% after high dose (P = .047). There remains no difference in OS rates between the treatment arms (78.4% v 83.4%; P = .41). Two percent of patients in both arms experienced late grade ≥ 3 genitourinary toxicity, and 1% of patients in the high-dose arm experienced late grade ≥ 3 GI toxicity. Conclusion This randomized controlled trial shows superior long-term cancer control for men with localized prostate cancer receiving high-dose versus conventional-dose radiation. This was achieved without an increase in grade ≥ 3 late urinary or rectal morbidity. PMID:20124169

  15. 78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

    Science.gov (United States)

    2013-04-30

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

  16. 76 FR 58520 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-21

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

  17. Adoption of web-based group decision support systems: experiences from the field and future developments

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    Jos van Hillegersberg

    2016-01-01

    Full Text Available While organizations have massively adopted enterprise information systems to support business processes, business meetings in which key decisions are made about products, services and processes, are usually held without much support of information systems. This is remarkable as group decision support systems (GDSS seems to fit for this purpose. They have existed for decades and modern versions benefit of web-based technologies, enabling low cost any-place, any time and device independent meeting support. In this exploratory case research, we study nine organizations in four different adoption categories to learn more about the reasons for the relatively slow adoption of web-based GDSS. Using the Fit-Viability adoption framework we conduct interviews with organizations that have experience with using GDSS. We conclude that adopting GDSS requires considerable and carefully planned change of processes that are deeply grounded in the organization. Existing meeting routines need to be adapted. Introduction needs to be carefully planned and room for face-to-face meetings and creativity sessions away from the keyboard need to be built in depending on the type of meeting. Not all companies find the cost level affordable. Clear and convincing business cases are lacking. Still the added value is ranked highly and there are frequent and enthusiastic user organizations that may lead the way for others. Their success stories show others how to mitigate problems.

  18. Management of Overweight during Childhood: A Focus Group Study on Health Professionals’ Experiences in General Practice

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    Lone Marie Larsen

    2015-01-01

    Full Text Available Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs and practice nurses participating in a randomised controlled trial (RCT comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health professionals considered it their responsibility to offer a management programme to overweight children. They recognised that management of overweight during childhood was a complex task that required an evidence-based strategy w