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Sample records for predictive oncology multidisciplinary

  1. Multidisciplinary care in pediatric oncology

    PubMed Central

    Cantrell, Mary Ann; Ruble, Kathy

    2011-01-01

    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. PMID:21811384

  2. Predictive oncology: multidisciplinary, multi-scale in-silico modeling linking phenotype, morphology and growth

    PubMed Central

    Sanga, Sandeep; Frieboes, Hermann B.; Zheng, Xiaoming; Gatenby, Robert; Bearer, Elaine L.; Cristini, Vittorio

    2007-01-01

    Empirical evidence and theoretical studies suggest that the phenotype, i.e., cellular- and molecular-scale dynamics, including proliferation rate and adhesiveness due to microenvironmental factors and gene expression that govern tumor growth and invasiveness, also determine gross tumor-scale morphology. It has been difficult to quantify the relative effect of these links on disease progression and prognosis using conventional clinical and experimental methods and observables. As a result, successful individualized treatment of highly malignant and invasive cancers, such as glioblastoma, via surgical resection and chemotherapy cannot be offered and outcomes are generally poor. What is needed is a deterministic, quantifiable method to enable understanding of the connections between phenotype and tumor morphology. Here, we critically review advantages and disadvantages of recent computational modeling efforts (e.g., continuum, discrete, and cellular automata models) that have pursued this understanding. Based on this assessment, we propose and discuss a multi-scale, i.e., from the molecular to the gross tumor scale, mathematical and computational “first-principle” approach based on mass conservation and other physical laws, such as employed in reaction-diffusion systems. Model variables describe known characteristics of tumor behavior, and parameters and functional relationships across scales are informed from in vitro, in vivo and ex vivo biology. We demonstrate that this methodology, once coupled to tumor imaging and tumor biopsy or cell culture data, should enable prediction of tumor growth and therapy outcome through quantification of the relation between the underlying dynamics and morphological characteristics. In particular, morphologic stability analysis of this mathematical model reveals that tumor cell patterning at the tumor-host interface is regulated by cell proliferation, adhesion and other phenotypic characteristics: histopathology information of

  3. [Multidisciplinary oncology teams: beware of endless discussions].

    PubMed

    Giard, Raimond W M

    2010-01-01

    The continual and increasing complexity of diagnostic and treatment options in oncology demands careful communication, coordination and decision making. Cancer care could be improved by multidisciplinary teamwork. Although this sort of teamwork has many advantages in theory, we know very little about its effectiveness in practice. We have to answer questions such as how teams can accomplish their task most effectively and how we must manage organizations in such a way that team-based working contributes optimally to organizational effectiveness. PMID:20619056

  4. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs

    PubMed Central

    Freeman, Richard K.; Krasna, Mark J.

    2015-01-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

  5. Development of an Integrated Subspecialist Multidisciplinary Neuro-oncology Service.

    PubMed

    Price, Stephen J; Guilfoyle, Mathew; J Jefferies, Sarah; Harris, Fiona; Oberg, Ingela; G Burnet, Neil; Santarius, Thomas; Watts, Colin

    2013-01-01

    Traditionally, the poor outcome for patients with malignant brain tumours led to therapeutic nihilism. In turn, this resulted in lack of interest in neurosurgical oncology subspecialisation, and less than ideal patient pathways. One problem of concern was the low rate of tumour resection. Between 1997 and 2006, 685 treated glioblastomas were identified. In the first four years only 40% of patients underwent tumour resection, rising to 55% in the last four years. Before revision of the pathway, the median length of hospital stay was 8 days, and 35% of patients received the results of their histology outside of a clinic setting. A pathway of care was established, in which all patients were discussed pre-operatively in an MDT meeting and then directed into a new surgical neuro-oncology clinic providing first point of contact. This limited the number of surgeons operating on adult glioma patients and aided recruitment into research studies. Now, three consultant neurosurgeons run this service, easily fulfilling IOG requirement to spend >50% of programmed activities in neuro-oncology. Nursing support has been critical to provide an integrated service. This model has allowed increased recruitment to clinical trials. The introduction of this service led to an increase in patients discussed pre-operatively in an MDT (66% rising to 87%; P=0.027), an increase in the rate of surgical resection (from 40% to 80%) and more patients being admitted electively (from 25% to 80%; P<0.001). There was a reduction in the median length of stay (8 days reduced to 4.5 days; P<0.001). For the cohort of GBM patients that went on to have chemoradiotherapy we improved median survival to 18 months, with 35% of patients alive at two years, comparable to international outcomes. Implementing a specialist neurosurgical oncology service begins with understanding the patient care pathway. Our patients have benefitted from the culture of subspecialisation and the excellent inter-disciplinary working

  6. Life prediction: A case for multidisciplinary research

    SciTech Connect

    Wei, R.P.

    1997-12-01

    Concerns with aging infrastructure worldwide and with the life-cycle costs and management of engineered systems have placed increased emphasis on the development of methods for life prediction. To be effective as true predictors of future performance (i.e., to provide accurate estimates beyond the range employed in the development of supporting data), such methods must be built upon mechanistic models that capture the functional dependence on all of the key external and internal variables. The development of these methods argues strongly for multidisciplinary research that integrates mechanistic understanding with probability analysis. In this paper, a mechanistically based probability approach to life prediction (versus the more traditional statistically based parametric approach) and the processes for model development are outlined to provide a framework for discussion. The use of a coordinated, multidisciplinary approach to develop mechanistic understanding and to model material response is illustrated through examples on crack growth in a high-strength steel. The need for multidisciplinary research that broadens the perspective from testing to testing and materials is discussed.

  7. [Minimally-invasive surgery: even less invasive? Oncological surgery: multidisciplinary first].

    PubMed

    Zingg, T; Demartines, N

    2010-01-27

    Despite advertising for NOTES in 2009, single trocart laparoscopic surgery is about to become a new standard in selected indications. As other important topics, the limits of oncological surgery are extended due to a systematic multidisciplinary approach. To discuss every publication would be difficult and our review will focus on a selected number of papers of importance for daily practice. As examples, the management of acute calculous cholecystitis, gastro-esophageal reflux, inguinal and incisional hernia repair as well as colorectal surgery are presented. PMID:20214193

  8. OECI accreditation at Veneto Institute of Oncology IOV - IRCCS, general framework and multidisciplinary approach.

    PubMed

    Chiusole, Daniela; Cioffredi, Piero; Basso, Umberto; Bortolami, Alberto; Crivellari, Gino; Gennaro, Gisella; Spina, Romina; Opocher, Giuseppe

    2015-01-01

    The aim of this article is to describe the accreditation process of the Veneto Institute of Oncology (IOV-IRCCS) according to the Organisation of European Cancer Institutes (OECI) model, with particular reference to the standards for the multidisciplinary approach. Through the analysis of the process and the activities of each multidisciplinary team (MDT) and the development, at a regional level, of diagnostic, therapeutic, and care pathways (PDTA), all the necessary steps to meet the OECI standards have been determined. Adjustment is ongoing. We are working on the inclusion of the MDT registration forms in the electronic medical records and on the possibility to extend the OECI model to the MDT not based at IOV, but participated in by IOV professionals. The sarcoma MDT has achieved results demonstrating that the OECI framework has allowed the professionals involved in the multidisciplinary meeting to systematically share the clinical information of the patient, who can benefit from better continuity of care. The model has also provided greater clarity in the management of patients who are enrolled in clinical trials and deviate from Guide Lines (GL)/PDTA. The accreditation process according to the OECI model has added value to the IOV's already well-developed multidisciplinary activities. PMID:27096271

  9. General surgeons' views on Oncologic Multidisciplinary Group meetings as part of colorectal cancer care.

    PubMed

    Feroci, Francesco; Lenzi, Elisa; Baraghini, Maddalena; Cantafio, Stefano; Scatizzi, Marco

    2012-12-01

    This study aimed to assess the current effectiveness of Oncologic Multidisciplinary Groups (OMGs) meetings across central Tuscany through surgeons' reports and their individual perceived benefits on colorectal cancer management. One hundred and sixty-seven general surgeons received a questionnaire with 21 questions covering organizational characteristics of OMGs and the individual perceived benefits of OMGs. The responses were analyzed by hospital setting (teaching vs. community hospital). The reply rate was 62.8 %, and 82 respondent surgeons (49.1 %) were involved in the treatment of colorectal cancer patients. At community hospitals, there was a more frequent participation of medical oncologists, radiation oncologists and pathologists; a less selection of discussed cases was performed; and almost all decisions were inserted into official patient charts (p < 0.05). Community hospital surgeons perceived more of a benefit than academic surgeons: OMGs ensure that all treatment options are considered and improve timeliness of care, patient outcomes, patient satisfaction and communication with patients (p < 0.05). The surveyed surgeons reported that OMGs offer a modest degree of protection from malpractice but improve communications between colleagues and are an opportunity for personal professional development. Professionals regularly participating in well-conducted and well-organized OMGs for colorectal cancer felt that the multidisciplinary strategy may be advantageous to both patients and caregivers. PMID:22987014

  10. The Cardio-oncology Program: A Multidisciplinary Approach to the Care of Cancer Patients With Cardiovascular Disease.

    PubMed

    Parent, Sarah; Pituskin, Edith; Paterson, D Ian

    2016-07-01

    Improved cancer survivorship has resulted in a growing number of Canadians affected by cancer and cardiovascular disease. As a consequence, cardio-oncology programs are rapidly emerging to treat cancer patients with de novo and preexisting cardiovascular disease. The primary goal of a cardio-oncology program is to preserve cardiovascular health to allow the timely delivery of cancer therapy and achieve disease-free remission. Multidisciplinary programs in oncology and cardiology have been associated with enhanced patient well-being and improved clinical outcomes. Because of the complex needs of these multisystem patients, a similar model of care is gaining acceptance. The optimal composition of the cardio-oncology team will typically involve support from cardiology, oncology, and nursing. Depending on the clinical scenario, additional consultation from dietetics, pharmacy, and social services might be required. Timely access to consultation and testing is another prerequisite for cardio-oncology programs because delays in treating cardiac complications and nonadherence to prescribed cancer therapy are each associated with poor outcomes. Recommended reasons for referral to cardio-oncology programs include primary prevention for those at high risk for cardiotoxicity and the secondary treatment of new or worsening cardiovascular disease in cancer patients and survivors. Management is multifaceted and can involve lifestyle education, pharmacotherapy, enhanced cardiovascular surveillance, and support services, such as exercise training. The lack of evidence to guide clinical decisions and recommendations in cardio-oncology is a major challenge and opportunity for health care professionals. Large multicentre prospective registries are needed to adequately power risk model calculations and generate hypotheses for novel interventions. PMID:27343743

  11. Oncology Teaching: A Multidisciplinary Approach for Second-Year Medical Students

    ERIC Educational Resources Information Center

    Elkort, Richard; Mozden, Peter J.

    1975-01-01

    A Boston University School of Medicine course in oncology is described which covers basic science correlates, diagnostic approaches, treatment modalities, and psycho-social aspects. Based on five years experience, the course is considered a successful means of correlating basic and clinical information for second- and third-year medical students.…

  12. Multidisciplinary lung cancer meetings: improving the practice of radiation oncology and facing future challenges.

    PubMed

    Campbell, Belinda A; Ball, David; Mornex, Françoise

    2015-02-01

    Clinical guidelines widely recognize the importance of multidisciplinary meetings (MDM) in the optimal care of lung cancer patients. The published literature suggest that dedicated Lung Cancer MDM lead to increased treatment utilization rates and improved survival outcomes for patients with lung cancer. For radiation oncologists, Lung Cancer MDM have been proven to support evidence-based practice and improve the utilization of radiotherapy. Lung Cancer MDM also allow for education and promotion of specialty radiotherapy services. The fast pace of modern medicine is also presenting new challenges for the multidisciplinary lung cancer team, and technological advances are likely to lead to new changes in the structure of traditional Lung Cancer MDM. PMID:25581058

  13. [Which is the place of the human being inside the recommendations, multidisciplinary oncological meetings, and treatment plan?].

    PubMed

    Barthelemy, N; Herman, M; Boga, D; Princen, F; Thirion, C; Damas, F; Brichant, J-F; Coucke, P

    2014-01-01

    Nowadays, the cancer patient has access to a highly technical, more and more targeted and increasingly individualized medicine. And the human being in that matter ? Numerous tools have been developed to help physicians and caregivers to reconcile contemporary medicine and the rights of the patient. Among these are multidisciplinary oncology meetings and treatment guidelines published by national and international scientific societies. The patients care must be cross-disciplinary and evidence-based. This shared decision-making process should at the end be in accordance with the wishes of the patient. This approach should allow him/her to maintain autonomy and be the main actor in the decision-making process. PMID:24822298

  14. Repression predicts outcome following multidisciplinary treatment of chronic pain.

    PubMed

    Burns, J W

    2000-01-01

    This study examined whether repression predicts outcome following multidisciplinary treatment for chronic pain and whether links between anxiety and outcome are obscured by repressors. Ninety-three chronic pain patients completed a 4-week pain program. Lifting capacity, walking endurance, depression, pain severity, and activity were measured at pre- and posttreatment. Low-anxious, repressor, high-anxious, and defensive/high-anxious groups were formed from median splits of Anxiety Content (ACS) and Lie scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Significant ACS x Lie interactions were found for lifting capacity, depression, and pain severity changes. Planned comparisons showed that both repressors and high-anxious patients performed poorly on lifting capacity; repressors alone recovered poorly on depression and pain severity. Results imply that repression may interfere with the process and outcome of pain programs. PMID:10711590

  15. Imaging in thoracic oncology: case studies from Multidisciplinary Thoracic Tumor Board

    PubMed Central

    Reddy, Rishindra M.; Lin, Jules; Arenberg, Douglas A.; Speers, Corey; Hayman, James A.; Kong, Fengming P.; Orringer, Mark B.; Kalemkerian, Gregory P.

    2013-01-01

    Abstract Multidisciplinary tumor board conferences foster collaboration among health care providers from a variety of specialties and help to facilitate optimal patient care. Generally, the clinical questions revolve around the best options for establishing a diagnosis, staging the disease and directing treatment. This article describes and illustrates the clinical scenarios of three patients who were presented at our thoracic Tumor Board, focusing on management issues and the role of imaging. These patients had invasive thymoma; concurrent small cell lung cancer and non-small cell lung cancer; and esophageal cancer with celiac lymph node metastases, respectively. PMID:24325879

  16. Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge

    PubMed Central

    Berry, Jonathan; Nisbet, Angus; Bloomfield, David; Burkill, Guy

    2013-01-01

    Abstract The purpose of this article is to familiarize the reader with the anatomy of the major pelvic nerves and the clinical features of associated lumbosacral plexopathies. To demonstrate this we illustrate several cases of malignant lumbosacral plexopathy on computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography. A new lumbosacral plexopathy in a patient with a prior history of abdominal or pelvic malignancy is usually of malignant etiology. Biopsies may be required to definitively differentiate tumour from posttreatment fibrosis, and in cases of inconclusive sampling or where biopsies are not possible, follow-up imaging may be necessary. In view of the complexity of clinical findings often confounded by a history of prior surgery and/or radiotherapy, a multidisciplinary approach between oncologists, neurologists, and radiologists is often required for what can be a diagnostic challenge. PMID:24433993

  17. Does Cancer Literature Reflect Multidisciplinary Practice? A Systematic Review of Oncology Studies in the Medical Literature Over a 20-Year Period

    SciTech Connect

    Holliday, Emma B.; Ahmed, Awad A.; Yoo, Stella K.; Jagsi, Reshma; Hoffman, Karen E.

    2015-07-15

    Purpose: Quality cancer care is best delivered through a multidisciplinary approach requiring awareness of current evidence for all oncologic specialties. The highest impact journals often disseminate such information, so the distribution and characteristics of oncology studies by primary intervention (local therapies, systemic therapies, and targeted agents) were evaluated in 10 high-impact journals over a 20-year period. Methods and Materials: Articles published in 1994, 2004, and 2014 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, Lancet Oncology, Journal of Clinical Oncology, Annals of Oncology, Radiotherapy and Oncology, International Journal of Radiation Oncology, Biology, Physics, Annals of Surgical Oncology, and European Journal of Surgical Oncology were identified. Included studies were prospectively conducted and evaluated a therapeutic intervention. Results: A total of 960 studies were included: 240 (25%) investigated local therapies, 551 (57.4%) investigated systemic therapies, and 169 (17.6%) investigated targeted therapies. More local therapy trials (n=185 [77.1%]) evaluated definitive, primary treatment than systemic (n=178 [32.3%]) or targeted therapy trials (n=38 [22.5%]; P<.001). Local therapy trials (n=16 [6.7%]) also had significantly lower rates of industry funding than systemic (n=207 [37.6%]) and targeted therapy trials (n=129 [76.3%]; P<.001). Targeted therapy trials represented 5 (2%), 38 (10.2%), and 126 (38%) of those published in 1994, 2004, and 2014, respectively (P<.001), and industry-funded 48 (18.9%), 122 (32.6%), and 182 (54.8%) trials, respectively (P<.001). Compared to publication of systemic therapy trial articles, articles investigating local therapy (odds ratio: 0.025 [95% confidence interval: 0.012-0.048]; P<.001) were less likely to be found in high-impact general medical journals. Conclusions: Fewer studies evaluating local therapies, such as surgery and radiation, are published in

  18. Cardio-Oncology Training: A Proposal From the International Cardioncology Society and Canadian Cardiac Oncology Network for a New Multidisciplinary Specialty.

    PubMed

    Lenihan, Daniel J; Hartlage, Gregory; DeCara, Jeanne; Blaes, Anne; Finet, J Emanuel; Lyon, Alexander R; Cornell, Robert F; Moslehi, Javid; Oliveira, Guilherme H; Murtagh, Gillian; Fisch, Michael; Zeevi, Gary; Iakobishvili, Zaza; Witteles, Ron; Patel, Aarti; Harrison, Eric; Fradley, Michael; Curigliano, Giuseppe; Lenneman, Carrie Geisberg; Magalhaes, Andreia; Krone, Ron; Porter, Charles; Parasher, Susmita; Dent, Susan; Douglas, Pamela; Carver, Joseph

    2016-06-01

    There is an increasing awareness and clinical interest in cardiac safety during cancer therapy as well as in optimally addressing cardiac issues in cancer survivors. Although there is an emerging expertise in this area, known as cardio-oncology, there is a lack of organization in the essential components of contemporary training. This proposal, an international consensus statement organized by the International Cardioncology Society and the Canadian Cardiac Oncology Network, attempts to marshal the important ongoing efforts for training the next generation of cardio-oncologists. The necessary elements are outlined, including the expectations for exposure necessary to develop adequate training. There should also be a commitment to local, regional, and international education and research in cardio-oncology as a requirement for advancement in the field. PMID:27038642

  19. Brain Tumor Epidemiology - A Hub within Multidisciplinary Neuro-oncology. Report on the 15th Brain Tumor Epidemiology Consortium (BTEC) Annual Meeting, Vienna, 2014.

    PubMed

    Woehrer, Adelheid; Lau, Ching C; Prayer, Daniela; Bauchet, Luc; Rosenfeld, Myrna; Capper, David; Fisher, Paul G; Kool, Marcel; Müller, Martin; Kros, Johan M; Kruchko, Carol; Wiemels, Joseph; Wrensch, Margaret; Danysh, Heather E; Zouaoui, Sonia; Heck, Julia E; Johnson, Kimberly J; Qi, Xiaoyang; O'Neill, Brian P; Afzal, Samina; Scheurer, Michael E; Bainbridge, Matthew N; Nousome, Darryl; Bahassi, El Mustapha; Hainfellner, Johannes A; Barnholtz-Sloan, Jill S

    2015-01-01

    The Brain Tumor Epidemiology Consortium (BTEC) is an open scientific forum, which fosters the development of multi-center, international and inter-disciplinary collaborations. BTEC aims to develop a better understanding of the etiology, outcomes, and prevention of brain tumors (http://epi.grants.cancer.gov/btec/). The 15th annual Brain Tumor Epidemiology Consortium Meeting, hosted by the Austrian Societies of Neuropathology and Neuro-oncology, was held on September 9 - 11, 2014 in Vienna, Austria. The meeting focused on the central role of brain tumor epidemiology within multidisciplinary neuro-oncology. Knowledge of disease incidence, outcomes, as well as risk factors is fundamental to all fields involved in research and treatment of patients with brain tumors; thus, epidemiology constitutes an important link between disciplines, indeed the very hub. This was reflected by the scientific program, which included various sessions linking brain tumor epidemiology with clinical neuro-oncology, tissue-based research, and cancer registration. Renowned experts from Europe and the United States contributed their personal perspectives stimulating further group discussions. Several concrete action plans evolved for the group to move forward until next year's meeting, which will be held at the Mayo Clinic at Rochester, MN, USA. PMID:25518914

  20. [The indications for medical rehabilitation of certain oncological patients presenting with the complications of the radical treatment under the conditions of a multi-disciplinary hospital].

    PubMed

    Grushina, T I

    2015-01-01

    This article was designed to help the practitioners by proposing the recommendations for diagnostics and evaluation of the severity of complications of the radical treatment of the patients presenting with breast cancer, stomach cancer, endometrial cancer, cervical cancer, bone sarcoma (osteosarcoma, chondrosarcoma, periosteal sarcoma, et al.). The indications for medical rehabilitation of the patients with these problems are described with special reference to their treatment under the conditions of a multidisciplinary hospital depending on the type and severity of complications of the radical treatment. The results of the long-term investigations and analysis of a large number of observations were used to substantiate the application of the available physiotherapeutic technologies for the medical rehabilitation of the oncological patients belonging to clinical group III. PMID:26285336

  1. Integrating Anatomy Training into Radiation Oncology Residency: Considerations for Developing a Multidisciplinary, Interactive Learning Module for Adult Learners

    ERIC Educational Resources Information Center

    Labranche, Leah; Johnson, Marjorie; Palma, David; D'Souza, Leah; Jaswal, Jasbir

    2015-01-01

    Radiation oncologists require an in-depth understanding of anatomical relationships for modern clinical practice, although most do not receive formal anatomy training during residency. To fulfill the need for instruction in relevant anatomy, a series of four multidisciplinary, interactive learning modules were developed for a cohort of radiation…

  2. Multidisciplinary Care.

    PubMed

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

    Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients. PMID:27535399

  3. Interaction Prediction Optimization in Multidisciplinary Design Optimization Problems

    PubMed Central

    Zhang, Xiaoling; Huang, Hong-Zhong; Wang, Zhonglai; Xu, Huanwei

    2014-01-01

    The distributed strategy of Collaborative Optimization (CO) is suitable for large-scale engineering systems. However, it is hard for CO to converge when there is a high level coupled dimension. Furthermore, the discipline objectives cannot be considered in each discipline optimization problem. In this paper, one large-scale systems control strategy, the interaction prediction method (IPM), is introduced to enhance CO. IPM is utilized for controlling subsystems and coordinating the produce process in large-scale systems originally. We combine the strategy of IPM with CO and propose the Interaction Prediction Optimization (IPO) method to solve MDO problems. As a hierarchical strategy, there are a system level and a subsystem level in IPO. The interaction design variables (including shared design variables and linking design variables) are operated at the system level and assigned to the subsystem level as design parameters. Each discipline objective is considered and optimized at the subsystem level simultaneously. The values of design variables are transported between system level and subsystem level. The compatibility constraints are replaced with the enhanced compatibility constraints to reduce the dimension of design variables in compatibility constraints. Two examples are presented to show the potential application of IPO for MDO. PMID:24744685

  4. Evaluating the impact of an integrated multidisciplinary head & neck competency-based anatomy & radiology teaching approach in radiation oncology: a prospective cohort study

    PubMed Central

    2014-01-01

    Background Modern radiation oncology demands a thorough understanding of gross and cross-sectional anatomy for diagnostic and therapeutic applications. Complex anatomic sites present challenges for learners and are not well-addressed in traditional postgraduate curricula. A multidisciplinary team (MDT) based head-and-neck gross and radiologic anatomy program for radiation oncology trainees was developed, piloted, and empirically assessed for efficacy and learning outcomes. Methods Four site-specific MDT head-and-neck seminars were implemented, each involving a MDT delivering didactic and case-based instruction, supplemented by cadaveric presentations. There was no dedicated contouring instruction. Pre- and post-testing were performed to assess knowledge, and ability to apply knowledge to the clinical setting as defined by accuracy of contouring. Paired analyses of knowledge pretests and posttests were performed by Wilcoxon matched-pair signed-rank test. Results Fifteen post-graduate trainees participated. A statistically significant (p < 0.001) mean absolute improvement of 4.6 points (17.03%) was observed between knowledge pretest and posttest scores. Contouring accuracy was analyzed quantitatively by comparing spatial overlap of participants’ pretest and posttest contours with a gold standard through the dice similarity coefficient. A statistically significant improvement in contouring accuracy was observed for 3 out of 20 anatomical structures. Qualitative and quantitative feedback revealed that participants were more confident at contouring and were enthusiastic towards the seminars. Conclusions MDT seminars were associated with improved knowledge scores and resident satisfaction; however, increased gross and cross-sectional anatomic knowledge did not translate into improvements in contouring accuracy. Further research should evaluate the impact of hands-on contouring sessions in addition to dedicated instructional sessions to develop competencies. PMID

  5. Quality Assessment in Oncology

    SciTech Connect

    Albert, Jeffrey M.; Das, Prajnan

    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.

  6. Development and Validation of a Multidisciplinary Tool for Accurate and Efficient Rotorcraft Noise Prediction (MUTE)

    NASA Technical Reports Server (NTRS)

    Liu, Yi; Anusonti-Inthra, Phuriwat; Diskin, Boris

    2011-01-01

    A physics-based, systematically coupled, multidisciplinary prediction tool (MUTE) for rotorcraft noise was developed and validated with a wide range of flight configurations and conditions. MUTE is an aggregation of multidisciplinary computational tools that accurately and efficiently model the physics of the source of rotorcraft noise, and predict the noise at far-field observer locations. It uses systematic coupling approaches among multiple disciplines including Computational Fluid Dynamics (CFD), Computational Structural Dynamics (CSD), and high fidelity acoustics. Within MUTE, advanced high-order CFD tools are used around the rotor blade to predict the transonic flow (shock wave) effects, which generate the high-speed impulsive noise. Predictions of the blade-vortex interaction noise in low speed flight are also improved by using the Particle Vortex Transport Method (PVTM), which preserves the wake flow details required for blade/wake and fuselage/wake interactions. The accuracy of the source noise prediction is further improved by utilizing a coupling approach between CFD and CSD, so that the effects of key structural dynamics, elastic blade deformations, and trim solutions are correctly represented in the analysis. The blade loading information and/or the flow field parameters around the rotor blade predicted by the CFD/CSD coupling approach are used to predict the acoustic signatures at far-field observer locations with a high-fidelity noise propagation code (WOPWOP3). The predicted results from the MUTE tool for rotor blade aerodynamic loading and far-field acoustic signatures are compared and validated with a variation of experimental data sets, such as UH60-A data, DNW test data and HART II test data.

  7. Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings

    PubMed Central

    Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

    2016-01-01

    Background The contribution of patients’ non-medical characteristics to individual physicians’ decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients’ non-medical characteristics are presented at MDT meetings and how this information may affect the team’s final medical decisions. Design Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians’ verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. Results In the final sample of patients’ records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient’s age and his/her “likeability” were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients’ non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. Limitations The design of the study made it difficult to draw definite cause-and-effect conclusions. Conclusion The Social Representations approach suggests that patients’ non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians

  8. Neuro-oncological patients admitted in intensive-care unit: predictive factors and functional outcome.

    PubMed

    Tabouret, E; Boucard, C; Devillier, R; Barrie, M; Boussen, S; Autran, D; Chinot, O; Bruder, N

    2016-03-01

    The prognosis of oncology patients admitted to the intensive care unit (ICU) is considered poor. Our objective was to analyze the characteristics and predictive factors of death in the ICU and functional outcome following ICU treatment for neuro-oncology patients. A retrospective study was conducted on all patients with primary brain tumor admitted to our institutional ICU for medical indications. Predictive impact on the risk of death in the ICU was analyzed as well as the functional status was evaluated prior and following ICU discharge. Seventy-one patients were admitted to the ICU. ICU admission indications were refractory seizures (41 %) and septic shock (17 %). On admission, 16 % had multi-organ failure. Ventilation was necessary for 41 % and catecholamines for 13 %. Twenty-two percent of patients died in the ICU. By multivariate analysis, predictive factors associated with an increased risk of ICU death were: non-neurological cause of admission [p = 0.045; odds ratio (OR) 5.405], multiple organ failure (p = 0.021; OR 8.027), respiratory failure (p = 0.006; OR 9.615), and hemodynamic failure (p = 0.008; OR 10.111). In contrast, tumor type (p = 0.678) and disease control status (p = 0.380) were not associated with an increased risk of ICU death. Among the 35 evaluable patients, 77 % presented with a stable or improved Karnofsky performance status following ICU hospitalization compared with the ongoing status before discharge. In patients with primary brain tumor admitted to the ICU, predictive factors of death appear to be similar to those described in non-oncology patients. ICU hospitalization is generally not associated with a subsequent decrease in the functional status. PMID:26608523

  9. Population pharmacokinetic–pharmacodynamic modelling in oncology: a tool for predicting clinical response

    PubMed Central

    Bender, Brendan C; Schindler, Emilie; Friberg, Lena E

    2015-01-01

    In oncology trials, overall survival (OS) is considered the most reliable and preferred endpoint to evaluate the benefit of drug treatment. Other relevant variables are also collected from patients for a given drug and its indication, and it is important to characterize the dynamic effects and links between these variables in order to improve the speed and efficiency of clinical oncology drug development. However, the drug-induced effects and causal relationships are often difficult to interpret because of temporal differences. To address this, population pharmacokinetic–pharmacodynamic (PKPD) modelling and parametric time-to-event (TTE) models are becoming more frequently applied. Population PKPD and TTE models allow for exploration towards describing the data, understanding the disease and drug action over time, investigating relevance of biomarkers, quantifying patient variability and in designing successful trials. In addition, development of models characterizing both desired and adverse effects in a modelling framework support exploration of risk-benefit of different dosing schedules. In this review, we have summarized population PKPD modelling analyses describing tumour, tumour marker and biomarker responses, as well as adverse effects, from anticancer drug treatment data. Various model-based metrics used to drive PD response and predict OS for oncology drugs and their indications are also discussed. PMID:24134068

  10. Predictive factors for the outcome of multidisciplinary treatments in chronic low back pain at the first multidisciplinary pain center of Japan

    PubMed Central

    Hayashi, Kazuhiro; Arai, Young-Chang P.; Ikemoto, Tatsunori; Nishihara, Makoto; Suzuki, Shigeyuki; Hirakawa, Tomoe; Matsuo, Shingo; Kobayashi, Mami; Haruta, Midori; Kawabata, Yuka; Togo, Hiroki; Noguchi, Taiji; Hase, Toshiyuki; Hatano, Genki; Ushida, Takahiro

    2015-01-01

    [Purpose] Multidisciplinary treatments are recommended for treatment of chronic low back pain. The aim of this study was to show the associations among multidisciplinary treatment outcomes, pretreatment psychological factors, self-reported pain levels, and history of pain in chronic low back pain patients. [Subjects and Methods] A total of 221 chronic low back pain patients were chosen for the study. The pretreatment scores for the 10-cm Visual Analogue Scale, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Short-Form McGill Pain Questionnaire, Pain Disability Assessment Scale, pain drawings, and history of pain were collected. The patients were divided into two treatment outcome groups a year later: a good outcome group and a poor outcome group. [Results] One-hundred eighteen patients were allocated to the good outcome group. The scores for the Visual Analogue Scale, Pain Disability Assessment Scale, and affective subscale of the Short-Form McGill Pain Questionnaire and number of nonorganic pain drawings in the good outcome group were significantly lower than those in the poor outcome group. Duration of pain in the good outcome group was significantly shorter than in the poor outcome group. [Conclusion] These findings help better predict the efficacy of multidisciplinary treatments in chronic low back pain patients. PMID:26504321

  11. Predictive factors for the outcome of multidisciplinary treatments in chronic low back pain at the first multidisciplinary pain center of Japan.

    PubMed

    Hayashi, Kazuhiro; Arai, Young-Chang P; Ikemoto, Tatsunori; Nishihara, Makoto; Suzuki, Shigeyuki; Hirakawa, Tomoe; Matsuo, Shingo; Kobayashi, Mami; Haruta, Midori; Kawabata, Yuka; Togo, Hiroki; Noguchi, Taiji; Hase, Toshiyuki; Hatano, Genki; Ushida, Takahiro

    2015-09-01

    [Purpose] Multidisciplinary treatments are recommended for treatment of chronic low back pain. The aim of this study was to show the associations among multidisciplinary treatment outcomes, pretreatment psychological factors, self-reported pain levels, and history of pain in chronic low back pain patients. [Subjects and Methods] A total of 221 chronic low back pain patients were chosen for the study. The pretreatment scores for the 10-cm Visual Analogue Scale, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Short-Form McGill Pain Questionnaire, Pain Disability Assessment Scale, pain drawings, and history of pain were collected. The patients were divided into two treatment outcome groups a year later: a good outcome group and a poor outcome group. [Results] One-hundred eighteen patients were allocated to the good outcome group. The scores for the Visual Analogue Scale, Pain Disability Assessment Scale, and affective subscale of the Short-Form McGill Pain Questionnaire and number of nonorganic pain drawings in the good outcome group were significantly lower than those in the poor outcome group. Duration of pain in the good outcome group was significantly shorter than in the poor outcome group. [Conclusion] These findings help better predict the efficacy of multidisciplinary treatments in chronic low back pain patients. PMID:26504321

  12. A Tool for Predicting Regulatory Approval After Phase II Testing of New Oncology Compounds.

    PubMed

    DiMasi, J A; Hermann, J C; Twyman, K; Kondru, R K; Stergiopoulos, S; Getz, K A; Rackoff, W

    2015-11-01

    We developed an algorithm (ANDI) for predicting regulatory marketing approval for new cancer drugs after phase II testing has been conducted, with the objective of providing a tool to improve drug portfolio decision-making. We examined 98 oncology drugs from the top 50 pharmaceutical companies (2006 sales) that first entered clinical development from 1999 to 2007, had been taken to at least phase II development, and had a known final outcome (research abandonment or regulatory marketing approval). Data on safety, efficacy, operational, market, and company characteristics were obtained from public sources. Logistic regression and machine-learning methods were used to provide an unbiased approach to assess overall predictability and to identify the most important individual predictors. We found that a simple four-factor model (activity, number of patients in the pivotal phase II trial, phase II duration, and a prevalence-related measure) had high sensitivity and specificity for predicting regulatory marketing approval. PMID:26239772

  13. Standardized data collection to build prediction models in oncology: a prototype for rectal cancer.

    PubMed

    Meldolesi, Elisa; van Soest, Johan; Damiani, Andrea; Dekker, Andre; Alitto, Anna Rita; Campitelli, Maura; Dinapoli, Nicola; Gatta, Roberto; Gambacorta, Maria Antonietta; Lanzotti, Vito; Lambin, Philippe; Valentini, Vincenzo

    2016-01-01

    The advances in diagnostic and treatment technology are responsible for a remarkable transformation in the internal medicine concept with the establishment of a new idea of personalized medicine. Inter- and intra-patient tumor heterogeneity and the clinical outcome and/or treatment's toxicity's complexity, justify the effort to develop predictive models from decision support systems. However, the number of evaluated variables coming from multiple disciplines: oncology, computer science, bioinformatics, statistics, genomics, imaging, among others could be very large thus making traditional statistical analysis difficult to exploit. Automated data-mining processes and machine learning approaches can be a solution to organize the massive amount of data, trying to unravel important interaction. The purpose of this paper is to describe the strategy to collect and analyze data properly for decision support and introduce the concept of an 'umbrella protocol' within the framework of 'rapid learning healthcare'. PMID:26674745

  14. Precision Oncology: Identifying Predictive Biomarkers for the Treatment of Metastatic Renal Cell Carcinoma

    PubMed Central

    Modi, Parth K.; Farber, Nicholas J.; Singer, Eric A.

    2016-01-01

    The recent FDA approval of multiple new pharmaceutical agents for metastatic renal cell carcinoma (RCC) has left physicians with several options for first- and second- line therapy. With limited head-to-head comparisons, however, there is a paucity of evidence to recommend the use of one agent over another. To address this knowledge gap, Voss et al. identified serum biomarkers from specimens collected during the RECORD-3 trial, a comparative study of first-line sunitinib versus first-line everolimus. Of the biomarkers identified, the 5 most strongly associated with first-line everolimus progression-free survival (PFS1L) were combined to form a composite biomarker score (CBS). The CBS was significantly associated with everolimus PFS1L in multivariate regression analysis. This study is an example of the additional value offered by a randomized trial with prospective biospecimen collection and a significant step towards identifying predictive biomarkers for the treatment of metastatic RCC. As further comparative trials are performed, it will be essential that biomarkers are appropriately identified and validated in order to further the goal of precision oncology.

  15. Factors Predicting Oncology Care Providers' Behavioral Intention to Adopt Clinical Decision Support Systems

    ERIC Educational Resources Information Center

    Wolfenden, Andrew

    2012-01-01

    The purpose of this quantitative correlation study was to examine the predictors of user behavioral intention on the decision of oncology care providers to adopt or reject the clinical decision support system. The Unified Theory of Acceptance and Use of Technology (UTAUT) formed the foundation of the research model and survey instrument. The…

  16. Predicting ectotherm disease vector spread—benefits from multidisciplinary approaches and directions forward

    NASA Astrophysics Data System (ADS)

    Thomas, Stephanie Margarete; Beierkuhnlein, Carl

    2013-05-01

    The occurrence of ectotherm disease vectors outside of their previous distribution area and the emergence of vector-borne diseases can be increasingly observed at a global scale and are accompanied by a growing number of studies which investigate the vast range of determining factors and their causal links. Consequently, a broad span of scientific disciplines is involved in tackling these complex phenomena. First, we evaluate the citation behaviour of relevant scientific literature in order to clarify the question "do scientists consider results of other disciplines to extend their expertise?" We then highlight emerging tools and concepts useful for risk assessment. Correlative models (regression-based, machine-learning and profile techniques), mechanistic models (basic reproduction number R 0) and methods of spatial regression, interaction and interpolation are described. We discuss further steps towards multidisciplinary approaches regarding new tools and emerging concepts to combine existing approaches such as Bayesian geostatistical modelling, mechanistic models which avoid the need for parameter fitting, joined correlative and mechanistic models, multi-criteria decision analysis and geographic profiling. We take the quality of both occurrence data for vector, host and disease cases, and data of the predictor variables into consideration as both determine the accuracy of risk area identification. Finally, we underline the importance of multidisciplinary research approaches. Even if the establishment of communication networks between scientific disciplines and the share of specific methods is time consuming, it promises new insights for the surveillance and control of vector-borne diseases worldwide.

  17. Models of Care in Geriatric Oncology

    PubMed Central

    Magnuson, A.; Dale, W.; Mohile, S.

    2014-01-01

    Cancer is common in older adults and the approach to cancer treatment and supportive measures in this age group is continuously evolving. Incorporating geriatric assessment (GA) into the care of the older patient with cancer has been shown to be feasible and predictive of outcomes, and there are unique aspects of the traditional geriatric domains that can be considered in this population. Geriatric assessment-guided interventions can also be developed to support patients during their treatment course. There are several existing models of incorporating geriatrics into oncology care, including a consultative geriatric assessment, geriatrician “embedded” within an oncology clinic and primary management by a dual-trained geriatric oncologist. Although a geriatrician or geriatric oncologist leads the geriatric assessment, is it truly a multidisciplinary assessment, and often includes evaluation by a physical therapist, occupational therapist, pharmacist, social worker and nutritionist. PMID:25587518

  18. Quality Indicators in Radiation Oncology

    SciTech Connect

    Albert, Jeffrey M.; Das, Prajnan

    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.

  19. [Analysis of the medical activity related to cancer in a network of multidisciplinary hospitals using claims databases, the reseau Concorde Oncology Network].

    PubMed

    Schott, Anne-Marie; Hajri, Touria; Gelas-Dore, Bénédicte; Couris, Chantal Marie; Couray-Targe, Sandrine; Trillet-Lenoir, Véronique; Dumeril, Bernard; Grandjean, Jean Paul; Lledo, Gérard; Poncet, Jean Luc; Colin, Cyrille; Cautela, Nicola; Gilly, François Noël

    2005-02-01

    Recently, to answer patients, caregivers and professionals needs, the "Plan Cancer" has been presented by the French Government. This plan is intended to improve quality of care in cancer patients and finally, patients' survival and quality of life. This planned strategy stresses the importance of organized interactions between hospitals and between the various health professionals. Measuring the number of patients with cancer and the activity related to cancer in large networks of multidisciplinary hospitals has became a real challenge in France for organizational, quality of care and economic reasons. Many University Hospitals in France have chosen to face this question by using the French DRG based information system called PMSI. It allows estimating the proportion of hospital stays concerned by cancers that are identified with algorithms based on ICD 10. However, French databases of hospital discharges do not allow patients identification. We collected data on hospital stays and patients in a subset of an organized network focused on cancer care and composed of 55 public or private hospitals in the Rhone-Alpes area. We used these data to estimate the number of patients who had been hospitalized within the network in 2000. Approximately 110,000 hospital stays were related with a diagnostic of cancer, corresponding to a number of patients within a range of 30345 to 35700. In absence of communicating files between hospitals, claims databases are an interesting source of information for cancer burden. The recent implementation of a procedure allowing the linkage of data concerning each patient should permit better estimates in the future. The main limitation will remain the possibility of a hospital to participate to more than one network. PMID:15749646

  20. Identification of an N staging system that predicts oncologic outcome in resected left-sided pancreatic cancer

    PubMed Central

    Kim, Sung Hyun; Hwang, Ho Kyoung; Lee, Woo Jung; Kang, Chang Moo

    2016-01-01

    Abstract In this study, we investigated which N staging system was the most accurate at predicting survival in pancreatic cancer patients. Lymph node (LN) metastasis is known to be one of the important prognostic factors in resected pancreatic cancer. There are several LN evaluation systems to predict oncologic impact. From January 1992 to December 2014, 77 medical records of patients who underwent radical pancreatectomy for left-sided pancreatic cancer were reviewed retrospectively. Clinicopathologic variables including pN stage, total number of retrieved LNs (N-RLN), lymph node ratio (LNR), and absolute number of LN metastases (N-LNmet) were evaluated. Disease-free survival (DFS) and disease-specific survival (DSS) were analyzed according to these 4 LN staging systems. In univariate analysis, pN stage (pN0 vs pN1: 17.5 months vs 7.9 months, P = 0.001), LNR (<0.08 vs ≥0.08: 17.5 months vs 4.4 months, P < 0.001), and N-LNmet (#N = 0 vs #N = 1 vs #N≥2: 17.5 months vs 11.0 months vs 6.4 months, P = 0.002) had a significant effect on DFS, whereas the pN stage (pN0 vs pN1: 35.3 months vs 16.7 months, P = 0.001), LNR (<0.08 vs ≥0.08: 37.1 months vs 15.0 months, P < 0.001), and N-LNmet (#N = 0 vs #N = 1 vs #N≥2: 35.3 months vs 18.4 months vs 16.4 months, P = 0.001) had a significant effect on DSS. In multivariate analysis, N-LNmet (#N≥2) was identified as an independent prognostic factor of oncologic outcome (DFS and DSS: Exp (β) = 2.83, P = 0.001, and Exp (β) = 3.17, P = 0.001, respectively). Absolute number of lymph node metastases predicted oncologic outcome in resected left-sided pancreatic cancer patients. PMID:27368029

  1. Oncologic imaging

    SciTech Connect

    Bragg, D.G.; Rubin, P.; Youker, J.E.

    1985-01-01

    This book presents papers on nuclear medicine. Topics considered include the classification of cancers, oncologic diagnosis, brain and spinal cord neoplasms, lymph node metastases, the larynx and hypopharynx, thyroid cancer, breast cancer, esophageal cancer, bladder cancer, tumors of the skeletal system, pediatric oncology, computed tomography and radiation therapy treatment planning, and the impact of future technology on oncologic diagnosis.

  2. Organisational design for an integrated oncological department

    PubMed Central

    Meiss-de Haas, Ch.L.; Falkmann, H.; Douma, J.; van Gassel, J.G.; Peters, W.G.; van Mierlo, R.; van Turnhout, J.M.; Verhagen, C.A.H.H.V.M.; Schrijvers, A.J.P.

    2001-01-01

    Abstract 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. PMID:16896411

  3. Prediction of function in daily life following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain; a prospective study

    PubMed Central

    Lillefjell, Monica; Krokstad, Steinar; Espnes, Geir Arild

    2007-01-01

    Background The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. It is therefore important to find ways to predict the outcome of rehabilitation programmes in terms of function in daily life. The aims of this study were to investigate the improvements over time from multidisciplinary rehabilitation in terms of pain and function, and analyse the relative impact of individual and psychosocial factors as predictors of function in daily life in individuals with chronic musculoskeletal pain. Methods A prospective study was conducted among one hundred and forty three (N = 143) musculoskeletal pain patients. Measures of pain, function, and functional health status were obtained at baseline, after 5 weeks of intensive training, at the end of the 57-week rehabilitation programme, and at a 1 year follow-up, using validated self-administrated measures. Linear regression analysis was applied to investigate the relative impact of musculoskeletal pain, individual-, and psychosocial factors in function. Results The participants studied showed a significant increase in function during the 57 weeks rehabilitation period. There was also a significant increase in function from the end of the rehabilitation period (57th week) to the one year follow-up measures. Pain intensity associated significantly with pain experience over all measurement periods. High levels of pain intensity (β = .42**) and pain experience (β = .37*), and poor psychological capacity (β = -.68*) at baseline, as well as poor physiological capacity (β = -.44**) and high levels of anxiety (β = .48**) and depression (β = .58***) at the end of the rehabilitation program were the most important prognostic factors of variance in functioning over the 4 measurement periods. Conclusion The data suggest that physical capacity, emotional distress and coping skills should be priority areas in rehabilitation programmes to

  4. Pretreatment Quality of Life Predicts for Locoregional Control in Head and Neck Cancer Patients: A Radiation Therapy Oncology Group Analysis

    SciTech Connect

    Siddiqui, Farzan; Pajak, Thomas F.; Watkins-Bruner, Deborah; Konski, Andre A.; Coyne, James C.; Gwede, Clement K.; Garden, Adam S.; Spencer, Sharon A.; Jones, Christopher; Movsas, Benjamin

    2008-02-01

    Purpose: To analyze the prospectively collected health-related quality-of-life (HRQOL) data from patients enrolled in two Radiation Therapy Oncology Group randomized Phase III head and neck cancer trials (90-03 and 91-11) to assess their value as an independent prognostic factor for locoregional control (LRC) and/or overall survival (OS). Methods and Materials: HRQOL questionnaires, using a validated instrument, the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H and N), version 2, were completed by patients before the start of treatment. OS and LRC were the outcome measures analyzed using a multivariate Cox proportional hazard model. Results: Baseline FACT-H and N data were available for 1,093 patients and missing for 417 patients. No significant difference in outcome was found between the patients with and without baseline FACT-H and N data (p = 0.58). The median follow-up time was 27.2 months for all patients and 49 months for surviving patients. Multivariate analyses were performed for both OS and LRC. Beyond tumor and nodal stage, Karnofsky performance status, primary site, cigarette use, use of concurrent chemotherapy, and altered fractionation schedules, the FACT-H and N score was independently predictive of LRC (but not OS), with p = 0.0038. The functional well-being component of the FACT-H and N predicted most significantly for LRC (p = 0.0004). Conclusions: This study represents, to our knowledge, the largest analysis of HRQOL as a prognostic factor in locally advanced head and neck cancer patients. The results of this study have demonstrated the importance of baseline HRQOL as a significant and independent predictor of LRC in patients with locally advanced head and neck cancer.

  5. Imaging Opportunities in Radiation Oncology

    SciTech Connect

    Balter, James M.; Haffty, Bruce G.; Dunnick, N. Reed; Siegel, Eliot L.

    2011-02-01

    Interdisciplinary efforts may significantly affect the way that clinical knowledge and scientific research related to imaging impact the field of Radiation Oncology. This report summarizes the findings of an intersociety workshop held in October 2008, with the express purpose of exploring 'Imaging Opportunities in Radiation Oncology.' Participants from the American Society for Radiation Oncology (ASTRO), National Institutes of Health (NIH), Radiological Society of North America (RSNA), American Association of physicists in Medicine (AAPM), American Board of Radiology (ABR), Radiation Therapy Oncology Group (RTOG), European Society for Therapeutic Radiology and Oncology (ESTRO), and Society of Nuclear Medicine (SNM) discussed areas of education, clinical practice, and research that bridge disciplines and potentially would lead to improved clinical practice. Findings from this workshop include recommendations for cross-training opportunities within the allowed structured of Radiology and Radiation Oncology residency programs, expanded representation of ASTRO in imaging related multidisciplinary groups (and reciprocal representation within ASTRO committees), increased attention to imaging validation and credentialing for clinical trials (e.g., through the American College of Radiology Imaging Network (ACRIN)), and building ties through collaborative research as well as smaller joint workshops and symposia.

  6. Predictive model of San Andreas fault system paleogeography, Late Cretaceous to early Miocene, derived from detailed multidisciplinary conglomerate correlations

    NASA Astrophysics Data System (ADS)

    Burnham, Kathleen

    2009-01-01

    Paleogeographic reconstruction of the region of the San Andreas fault system in western California, USA, was hampered for more than two decades by the apparent incompatibility of authoritative lithologic correlations. These led to disparate estimates of dextral strike-slip offsets across the San Andreas fault, notably 315 km between Pinnacles and Neenach Volcanics, versus 563 km offset between Anchor Bay and Eagle Rest peak. Furthermore, one section of the San Andreas fault between Pinnacles and Point Reyes had been reported to have six pairs of features showing only ~ 30 km offset, while several younger features in that same area were reported consistent with ~ 315 km offset. Estimates of total dextral slip on the adjoining San Gregorio fault have ranged from 5 km to 185 km. Sixteen Upper Cretaceous and Paleogene conglomerates of the California Coast Ranges, from Anchor Bay to Simi Valley, were included in a multidisciplinary study centered on identification of matching unique clast varieties, rather than on simply counting general clast types. Detailed analysis verified the prior correlation of the Upper Cretaceous strata of Anchor Bay at Anchor Bay with a then-unnamed conglomerate at Highway 92 and Skyline Road (south of San Francisco); and verified that the Paleocene or Eocene Point Reyes Conglomerate at Point Reyes is a tectonically displaced segment of the Carmelo Formation of Point Lobos (near Monterey). The work also led to three new correlations: Point Reyes Conglomerate with granitic source rock at Point Lobos; a magnetic anomaly at Black Point (near Sea Ranch) with a magnetic anomaly near San Gregorio; and strata of Anchor Bay with previously established source rock, the potassium-poor Logan Gabbro of Eagle Rest peak, at a more recently recognized subsurface location just east of the San Gregorio fault, south of San Gregorio. From these correlations, a Late Cretaceous to early Oligocene paleogeography was constructed which was unique in utilizing modern

  7. [Surgical oncology: historical development and current status].

    PubMed

    Granados García, Martín; Beltrán Ortega, Arturo; Soto Sánchez, Beatriz Lucero; León Takahashi, Alberto Mitsuo

    2011-01-01

    The surgical oncology remains an essential part in the multidisciplinary management for patients with cancer, even though the current progress in field of radiotherapy, chemotherapy, systemic therapies, including therapies directed to molecular targets. Their role impact in several moments during the management of an oncological patient: prevention, diagnosis, assessment of the spread of the disease, curative treatment, management of the sequels, complications by the treatment and not less important, the palliation. The current state of the surgical oncology as a result of a constant development, inspired by skillful hands with creative and restless minds, have achieved to mark the history of the medicine in an area which currently has a great transcendence and an accelerated growth in a short period of time. Under this argument, we have decided to present an updated overview about the role of the surgical oncology, from the evolution through the history until all their applications in the different areas of the oncology. PMID:22116189

  8. Limb Salvage Surgery for Musculoskeletal Oncology

    PubMed Central

    Wan Ismail, Wan Faisham Nu’man Bin

    2015-01-01

    The management of musculoskeletal tumours has progressed tremendously over the past few decades. Limb salvage surgery has become a standard practise without compromising the oncological outcome. Patients generally will benefit with superior function and a better quality of life compared with definitive amputation. The multidisciplinary approach and advancement of surgeries are important to achieve patient survival and optimum function. PMID:26715902

  9. Introduction to veterinary clinical oncology

    SciTech Connect

    Weller, R.E.

    1991-10-01

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

  10. Current Management of Surgical Oncologic Emergencies

    PubMed Central

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    Objectives For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. Method A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. Results In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. Conclusion In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy. PMID:25933135

  11. Gene Expression Signatures Predictive of Early Response and Outcome in High-Risk Childhood Acute Lymphoblastic Leukemia: A Children's Oncology Group Study

    PubMed Central

    Bhojwani, Deepa; Kang, Huining; Menezes, Renee X.; Yang, Wenjian; Sather, Harland; Moskowitz, Naomi P.; Min, Dong-Joon; Potter, Jeffrey W.; Harvey, Richard; Hunger, Stephen P.; Seibel, Nita; Raetz, Elizabeth A.; Pieters, Rob; Horstmann, Martin A.; Relling, Mary V.; den Boer, Monique L.; Willman, Cheryl L.; Carroll, William L.

    2008-01-01

    Purpose To identify children with acute lymphoblastic leukemia (ALL) at initial diagnosis who are at risk for inferior response to therapy by using molecular signatures. Patients and Methods Gene expression profiles were generated from bone marrow blasts at initial diagnosis from a cohort of 99 children with National Cancer Institute–defined high-risk ALL who were treated uniformly on the Children's Oncology Group (COG) 1961 study. For prediction of early response, genes that correlated to marrow status on day 7 were identified on a training set and were validated on a test set. An additional signature was correlated with long-term outcome, and the predictive models were validated on three large, independent patient cohorts. Results We identified a 24–probe set signature that was highly predictive of day 7 marrow status on the test set (P = .0061). Pathways were identified that may play a role in early blast regression. We have also identified a 47–probe set signature (which represents 41 unique genes) that was predictive of long-term outcome in our data set as well as three large independent data sets of patients with childhood ALL who were treated on different protocols. However, we did not find sufficient evidence for the added significance of these genes and the derived predictive models when other known prognostic features, such as age, WBC, and karyotype, were included in a multivariate analysis. Conclusion Genes and pathways that play a role in early blast regression may identify patients who may be at risk for inferior responses to treatment. A fully validated predictive gene expression signature was defined for high-risk ALL that provided insight into the biologic mechanisms of treatment failure. PMID:18802149

  12. SeaRISE: A Multidisciplinary Research Initiative to Predict Rapid Changes in Global Sea Level Caused by Collapse of Marine Ice Sheets

    NASA Technical Reports Server (NTRS)

    Bindschadler, Robert A. (Editor)

    1990-01-01

    The results of a workshop held to discuss the role of the polar ice sheets in global climate change are reported. The participants agreed that the most important aspect of the ice sheets' involvement in climate change is the potential of marine ice sheets to cause a rapid change in global sea level. To address this concern, a research initiative is called for that considers the full complexity of the coupled atmosphere-ocean-cryosphere-lithosphere system. This initiative, called SeaRISE (Sea-level Response to Ice Sheet Evolution) has the goal of predicting the contribution of marine ice sheets to rapid changes in global sea level in the next decade to few centuries. To attain this goal, a coordinated program of multidisciplinary investigations must be launched with the linked objectives of understanding the current state, internal dynamics, interactions, and history of this environmental system. The key questions needed to satisfy these objectives are presented and discussed along with a plan of action to make the SeaRISE project a reality.

  13. The 1998 PNG tsunami: multidisciplinary evidence on its architecture and run-up effects - pathways to prediction?

    NASA Astrophysics Data System (ADS)

    Tappin, D. R.; Watts, P.; Grilli, S. T.; Matsumoto, T.

    2002-12-01

    To address the threat of tsunami prediction from local slumps is problematic. To generate realistic models of tsunami generation and runup, an essential requirement is for the models to be validated by direct evidence provided from offshore surveying. Case studies are therefore required and a seminal example is the Papua New Guinea tsunami of 1998. After considerable controversy over the origin of the 1998 PNG tsunami, there is now a body of evidence that supports a cause by sediment slumping offshore of the devastated area. In association with onshore run-up measurements, five surveys carried out between 1999 and 2000 offshore of the most affected area have resulted in a composite suite of data that locates and images the slump and also allows appraisal of its geotechnical properties. An original dataset of multibeam bathymetry, high resolution 3.5kHz data, multichannel seismic, and piston cores in association with ROV and submersible images and direct seabed observation has now been improved with the acquisition in 2001 of a closely spaced grid of single channel seismic data. Better definition of the slump is now possible for use in modelling. The slump geometry in the context of the regional tectonic setting, suggests a novel type of stability analysis performed with a 1D-consolidation code. The simulation results help constrain slump motion following failure. The geologic, bathymetric and soil mechanic data are now all used in new simulations of fully 3D tsunami generation by the slump as newly defined. The result is a more definite assessment of the susceptibility to slumping of the area offshore of northern PNG. The interpretations and analyses employed in this work may contribute to the identification of other regions susceptible to comparable offshore slumping and tsunami generation.

  14. The 1998 PNG tsunami: multidisciplinary evidence on its architecture and run-up effects - pathways to prediction?

    NASA Astrophysics Data System (ADS)

    Tappin, D.; Watts, P.; Grilli, S.; Biscontin, G.; Pestana, J.; Matsumoto, T.

    2003-04-01

    To address the threat of tsunami prediction from local slumps is problematic. To generate realistic models of tsunami generation and runup an essential requirement is for the models to be validated by direct evidence provided from offshore surveying. Case studies are therefore required and a seminal example is the Papua New Guinea tsunami of 1998. After considerable controversy over the origin of the 1998 PNG tsunami, there is now a body of evidence that supports a cause by sediment slumping offshore of the devastated area. In association with onshore run-up measurements, four surveys carried out between 1999 and 2001 offshore of the most affected area have resulted in a composite suite of data that locates and images the slump and also allows appraisal of its geotechnical properties. An original dataset of multibeam bathymetry, high resolution 3.5kHz data, multichannel seismic, and piston cores in association with ROV and submersible images and direct seabed observation has now been improved with the acquisition in 2001 of a closely spaced set of single channel seismic data. Better definition of the slump is now possible for use in modelling. The regional tectonic setting, combined with the slump geometry, suggests a novel type of stability analysis performed with a 1D-consolidation code. The simulation results help constrain slump motion following failure. The geologic, bathymetric and soil mechanic data are now all used in new simulations of fully 3D tsunami generation by the slump as newly defined. The result is a more definite assessment of the susceptibility to slumping of the area offshore of northern PNG. The interpretations and analyses employed in this work may contribute to the identification of other regions susceptible to comparable offshore slumping and tsunami generation.

  15. High Expression of Suppressor of Cytokine Signaling-2 Predicts Poor Outcome in Pediatric Acute Myeloid Leukemia: A Report from the Children's Oncology Group

    PubMed Central

    Laszlo, George S.; Ries, Rhonda E.; Gudgeon, Chelsea J.; Harrington, Kimberly H.; Alonzo, Todd A.; Gerbing, Robert B.; Raimondi, Susana C.; Hirsch, Betsy A.; Gamis, Alan S.; Meshinchi, Soheil; Walter, Roland B.

    2015-01-01

    Deregulated cytokine signaling is a characteristic feature of acute myeloid leukemia (AML), and expression signatures of cytokines and chemokines have been identified as significant prognostic factor in this disease. Given this aberrant signaling, we hypothesized that expression of Suppressor of Cytokine Signaling-2 (SOCS2), a negative regulator of cytokine signaling, might be altered in AML and could provide predictive information. Among 188 participants of the Children's Oncology Group AAML03P1 trial, SOCS2 mRNA levels varied >6,000-fold. Higher (>median) SOCS2 expression was associated with inferior overall (60±10% vs. 75±9%, p=0.026) and event-free (44±10% vs. 59±10%, p=0.031) survival. However, these differences were accounted for by higher prevalence of high-risk and lower prevalence of low-risk disease among patients with higher SOCS2 expression, limiting the clinical utility of SOCS2 as predictive marker. It remains untested whether high SOCS2 expression identifies a subset of leukemias with deregulated cytokine signaling that could be amenable to therapeutic intervention. PMID:24559289

  16. Early Prediction of Disease Progression in Small Cell Lung Cancer: Toward Model-Based Personalized Medicine in Oncology.

    PubMed

    Buil-Bruna, Núria; Sahota, Tarjinder; López-Picazo, José-María; Moreno-Jiménez, Marta; Martín-Algarra, Salvador; Ribba, Benjamin; Trocóniz, Iñaki F

    2015-06-15

    Predictive biomarkers can play a key role in individualized disease monitoring. Unfortunately, the use of biomarkers in clinical settings has thus far been limited. We have previously shown that mechanism-based pharmacokinetic/pharmacodynamic modeling enables integration of nonvalidated biomarker data to provide predictive model-based biomarkers for response classification. The biomarker model we developed incorporates an underlying latent variable (disease) representing (unobserved) tumor size dynamics, which is assumed to drive biomarker production and to be influenced by exposure to treatment. Here, we show that by integrating CT scan data, the population model can be expanded to include patient outcome. Moreover, we show that in conjunction with routine medical monitoring data, the population model can support accurate individual predictions of outcome. Our combined model predicts that a change in disease of 29.2% (relative standard error 20%) between two consecutive CT scans (i.e., 6-8 weeks) gives a probability of disease progression of 50%. We apply this framework to an external dataset containing biomarker data from 22 small cell lung cancer patients (four patients progressing during follow-up). Using only data up until the end of treatment (a total of 137 lactate dehydrogenase and 77 neuron-specific enolase observations), the statistical framework prospectively identified 75% of the individuals as having a predictable outcome in follow-up visits. This included two of the four patients who eventually progressed. In all identified individuals, the model-predicted outcomes matched the observed outcomes. This framework allows at risk patients to be identified early and therapeutic intervention/monitoring to be adjusted individually, which may improve overall patient survival. PMID:25939602

  17. Multidisciplinary Prognostication Using the Palliative Prognostic Score in an Australian Cancer Center

    PubMed Central

    Mendis, Ruwani; Soo, Wee-Kheng; Zannino, Diana; Michael, Natasha; Spruyt, Odette

    2015-01-01

    CONTEXT Accurate prognostication is important in oncology and palliative care. A multidisciplinary approach to prognostication provides a novel approach, but its accuracy and application is poorly researched. In this study, we describe and analyze our experience of multidisciplinary prognostication in palliative care patients with cancer. OBJECTIVES To assess our accuracy of prognostication using multidisciplinary team prediction of survival (MTPS) alone and within the Palliative Prognostic (PaP) Score. METHODS This retrospective study included all new patients referred to a palliative care consultation service in a tertiary cancer center between January 2010 and December 2011. Initial assessment data for 421 inpatients and 223 outpatients were analyzed according to inpatient and outpatient groups to evaluate the accuracy of prognostication using MTPS alone and within the PaP score (MTPS-PaP) and their correlation with overall survival. RESULTS Inpatients with MTPS-PaP group A, B, and C had a median survival of 10.9, 3.4, and 0.7 weeks, respectively, and a 30-day survival probability of 81%, 40%, and 10%, respectively. Outpatients with MTPS-PaP group A and B had a median survival of 17.3 and 5.1 weeks, respectively, and a 30-day survival probability of 94% and 50%, respectively. MTPS overestimated survival by a factor of 1.5 for inpatients and 1.2 for outpatients. The MTPS-PaP score correlated better than MTPS alone with overall survival. CONCLUSION This study suggests that a multidisciplinary team approach to prognostication within routine clinical practice is possible and may substitute for single clinician prediction of survival within the PaP score without detracting from its accuracy. Multidisciplinary team prognostication can assist treating teams to recognize and articulate prognosis, facilitate treatment decisions, and plan end-of-life care appropriately. PaP was less useful in the outpatient setting, given the longer survival interval of the outpatient

  18. The GCIP/GAPP NOAA Partnership of NCEP, OHD, and NESDIS in Multi-disciplinary, Coupled Land/Atmosphere Modeling, Prediction and Data Assimilation

    NASA Astrophysics Data System (ADS)

    Mitchell, K. E.

    2001-12-01

    In this year 2001, which marks the transition of the GCIP Project to its next-generation follow-on project known as GAPP, it is fitting in this special session to review and honor the visionary GCIP role of John Schaake of the National Weather Service's Office of Hydrologic Development (OHD, formerly OH). In the early 1990's, John put into motion a strongly held personal scientific vision. This vision was to spur more rapid advancements in both hydrology and meteorology by forging working-level, everyday, multi-disciplinary partnerships between hydrologists, meteorologists, and land-surface remote sensing experts in coupled land/atmosphere modeling, prediction, and data assimilation. This vision, shared by a few like-minded colleagues, took concrete form in the now widely regarded GCIP Project, under key sponsorship from the NOAA Office of Global Programs (OGP). Fueled by his career stints in both academic research and federal operations, a pillar component of John's vision and actions was to first form a GCIP partnership between the NOAA operational components of OHD, NCEP, and NESDIS -- for the purpose of acting as both a 1) direct operational target and 2) test and evaluation test-bed for the technology infusion of coupled land/atmosphere advancements from the federal and academic research components of GCIP (and related programs in GEWEX, IGBP, EOS, etc.). This presentation will present examples, taken from the past seven years of this GCIP partnership, of coupled land/atmosphere modeling advancements and operational implementation in coupled land/atmosphere prediction models at NCEP. These examples will span the range of improvements in 1) land/biosphere/snowpack physics, 2) land-state initialization, 3) parameter optimization, 4) specification of land-surface characteristics, 4) surface forcing and 5) validation tools on large regional scales. The advancements include improvements in the treatment of canopy resistance, annual cycle of greenness, surface

  19. Radiation Oncology in Undergraduate Medical Education: A Literature Review

    SciTech Connect

    Dennis, Kristopher E.B.; Duncan, Graeme

    2010-03-01

    Purpose: To review the published literature pertaining to radiation oncology in undergraduate medical education. Methods and Materials: Ovid MEDLINE, Ovid MEDLINE Daily Update and EMBASE databases were searched for the 11-year period of January 1, 1998, through the last week of March 2009. A medical librarian used an extensive list of indexed subject headings and text words. Results: The search returned 640 article references, but only seven contained significant information pertaining to teaching radiation oncology to medical undergraduates. One article described a comprehensive oncology curriculum including recommended radiation oncology teaching objectives and sample student evaluations, two described integrating radiation oncology teaching into a radiology rotation, two described multidisciplinary anatomy-based courses intended to reinforce principles of tumor biology and radiotherapy planning, one described an exercise designed to test clinical reasoning skills within radiation oncology cases, and one described a Web-based curriculum involving oncologic physics. Conclusions: To the authors' knowledge, this is the first review of the literature pertaining to teaching radiation oncology to medical undergraduates, and it demonstrates the paucity of published work in this area of medical education. Teaching radiation oncology should begin early in the undergraduate process, should be mandatory for all students, and should impart knowledge relevant to future general practitioners rather than detailed information relevant only to oncologists. Educators should make use of available model curricula and should integrate radiation oncology teaching into existing curricula or construct stand-alone oncology rotations where the principles of radiation oncology can be conveyed. Assessments of student knowledge and curriculum effectiveness are critical.

  20. Decision making in surgical oncology.

    PubMed

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients. PMID:20719499

  1. Older Age Predicts Decreased Metastasis and Prostate Cancer-Specific Death for Men Treated With Radiation Therapy: Meta-Analysis of Radiation Therapy Oncology Group Trials

    SciTech Connect

    Hamstra, Daniel A.; Bae, Kyounghwa; Pilepich, Miljenko V.; Hanks, Gerald E.; Grignon, David J.; McGowan, David G.; Roach, Mack; Lawton, Colleen; Lee, R. Jeffrey; Sandler, Howard

    2011-12-01

    Purpose: The impact of age on prostate cancer (PCa) outcome has been controversial; therefore, we analyzed the effect of age on overall survival (OS), distant metastasis, prostate cancer-specific death (PCSD), and nonprostate cancer death (NPCD) on patients with locally advanced PCa. Methods and Materials: Patients who participated in four Radiation Therapy Oncology Group (RTOG) phase III trials, 8531, 8610, 9202, and 9413, were studied. Cox proportional hazards regression was used for OS analysis, and cumulative events analysis with Fine and Gray's regression was used for analyses of metastasis, PCSD, and NPCD. Results: Median follow-up of 4,128 patients with median age of 70 (range, 43-88 years) was 7.3 years. Most patients had high-risk disease: cT3 to cT4 (54%) and Gleason scores (GS) of 7 (45%) and 8 to 10 (27%). Older age ({<=}70 vs. >70 years) predicted for decreased OS (10-year rate, 55% vs. 41%, respectively; p < 0.0001) and increased NPCD (10-year rate, 28% vs. 46%, respectively; p < 0.0001) but decreased metastasis (10-year rate, 27% vs. 20%, respectively; p < 0.0001) and PCSD (10-year rate, 18% vs. 14%, respectively; p < 0.0001). To account for competing risks, outcomes were analyzed in 2-year intervals, and age-dependent differences in metastasis and PCSD persisted, even in the earliest time periods. When adjusted for other covariates, an age of >70 years remained associated with decreased OS (hazard ratio [HR], 1.56 [95% confidence interval [CI], 1.43-1.70] p < 0.0001) but with decreased metastasis (HR, 0.72 [95% CI, 0.63-0.83] p < 0.0001) and PCSD (HR, 0.78 [95% CI, 0.66-0.92] p < 0.0001). Finally, the impact of the duration of androgen deprivation therapy as a function of age was evaluated. Conclusions: These data support less aggressive PCa in older men, independent of other clinical features. While the biological underpinning of this finding remains unknown, stratification by age in future trials appears to be warranted.

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

    PubMed

    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. PMID:26153490

  3. Teams: communication in multidisciplinary care.

    PubMed

    Penson, Richard T; Kyriakou, Helena; Zuckerman, Dan; Chabner, Bruce A; Lynch, Thomas J

    2006-05-01

    Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery that provides hope to the patient and support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. The evolving field of oncology increasingly requires a team of medical specialists working in unison to deliver optimal medical care. While this coordination may maximize the technical synergy of care, it can challenge interprofessional and interdisciplinary connections. Poor and miscommunication and conflicts between staff and between the family and providers adversely affect patient care and quality of life. Furthermore, lack of communication leaves a vacuum that sucks in fear. A recent Newsweek article highlighted the challenges of practicing in the age of high-tech medicine. The author had to beg for a prognosis for her critically ill and dying husband, with unhelpful subspecialists failing to communicate the bigger picture. This article explores the tough issue of how teams handle uncertainty and bad news and how patients and families can be better supported in the multifaceted paradigm of modern care. PMID:16720852

  4. American Society for Radiation Oncology

    MedlinePlus

    ... PAC Become an Advocate Log In SNIPEND American Society for Radiation Oncology Plan your time at the ... oncology practices. RO-ILS The only medical specialty society-sponsored incident learning system for radiation oncology. RO ...

  5. Guidelines for treatment naming in radiation oncology.

    PubMed

    Denton, Travis R; Shields, Lisa B E; Hahl, Michael; Maudlin, Casey; Bassett, Mark; Spalding, Aaron C

    2015-01-01

    Safety concerns may arise from a lack of standardization and ambiguity during the treatment planning and delivery process in radiation therapy. A standardized target and organ-at-risk naming convention in radiation therapy was developed by a task force comprised of several Radiation Oncology Societies. We present a nested-survey approach in a community setting to determine the methodology for radiation oncology departments to standardize their practice. Our Institution's continuous quality improvement (CQI) committee recognized that, due to growth from one to three centers, significant variability existed within plan parameters specific to patients' treatment. A multidiscipline, multiclinical site consortium was established to create a guideline for standard naming. Input was gathered using anonymous, electronic surveys from physicians, physicists, dosimetrists, chief therapists, and nurse managers. Surveys consisted of several primary areas of interest: anatomical sites, course naming, treatment plan naming, and treatment field naming. Additional concepts included capitalization, specification of later-ality, course naming in the event of multiple sites being treated within the same course of treatment, primary versus boost planning, the use of bolus, revisions for plans, image-guidance field naming, forbidden characters, and standard units for commonly used physical quantities in radiation oncology practice. Guidelines for standard treatment naming were developed that could be readily adopted. This multidisciplinary study provides a clear, straightforward, and easily implemented protocol for the radiotherapy treatment process. Standard nomenclature facilitates the safe means of communication between team members in radiation oncology. The guidelines presented in this work serve as a model for radiation oncology clinics to standardize their practices. PMID:27074449

  6. [1st National Meeting of Multidisciplinary Work in Oncogeriatrics: expert consensus document].

    PubMed

    Antonio, Maite; Saldaña, Juana; Formiga, Francesc; Lozano, Alicia; González-Barboteo, Jesús; Fernández, Paz; Arias, Fernando; Arribas, Lorena; Barbero, Elisabeth; Bescós, María del Mar; Boya, Maria Jesús; Bueso, Pilar; Casas, Ana; Dotor, Emma; Fort, Eduard; García-Alfonso, Pilar; Herruzo, Ismael; Llonch, Mireia; Morlans, Germà; Murillo, Maria Teresa; Ossola, Gustavo; Peiró, Inma; Saiz, Fabiola; Sanz, Javier; Serra, José Antonio; Trelis, Jordi; Yuste, Antonio

    2012-01-01

    On 2nd of June 2011 the Institut Català d' Oncologia l'Hospitalet--Hospital Duran i Reynals hosted the first Meeting of Multidisciplinary Work in Oncogeriatrics. The reason for the meeting, which follows on from an initiative of the Medical Societies of Radiotherapy, Oncology, Geriatrics and Gerontology and Palliative Care and Medical Oncology, was to initiate a joint line of work among the different specialties that generally take part in the handling of the elderly patient suffering from oncologic pathologies. This document summarises the different subjects covered during the Meeting. PMID:23044361

  7. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    PubMed

    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. PMID:27249776

  8. Global radiation oncology waybill

    PubMed Central

    Muñoz-Garzón, Victor; Rovirosa, Ángeles; Ramos, Alfredo

    2013-01-01

    Background/aim Radiation oncology covers many different fields of knowledge and skills. Indeed, this medical specialty links physics, biology, research, and formation as well as surgical and clinical procedures and even rehabilitation and aesthetics. The current socio-economic situation and professional competences affect the development and future or this specialty. The aim of this article was to analyze and highlight the underlying pillars and foundations of radiation oncology, indicating the steps implicated in the future developments or competences of each. Methods This study has collected data from the literature and includes highlights from discussions carried out during the XVII Congress of the Spanish Society of Radiation Oncology (SEOR) held in Vigo in June, 2013. Most of the aspects and domains of radiation oncology were analyzed, achieving recommendations for the many skills and knowledge related to physics, biology, research, and formation as well as surgical and clinical procedures and even supportive care and management. Results Considering the data from the literature and the discussions of the XVII SEOR Meeting, the “waybill” for the forthcoming years has been described in this article including all the aspects related to the needs of radiation oncology. Conclusions Professional competences affect the development and future of this specialty. All the types of radio-modulation are competences of radiation oncologists. On the other hand, the pillars of Radiation Oncology are based on experience and research in every area of Radiation Oncology. PMID:24416572

  9. Identifying oncological emergencies.

    PubMed

    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. PMID:23873016

  10. Soft Tissue Coverage of the Lower Limb following Oncological Surgery

    PubMed Central

    Radtke, Christine; Panzica, Martin; Dastagir, Khaled; Krettek, Christian; Vogt, Peter M.

    2016-01-01

    The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases. PMID:26793620

  11. Length of Stay in Ambulatory Surgical Oncology Patients at High Risk for Sleep Apnea as Predicted by STOP-BANG Questionnaire

    PubMed Central

    Faiz, Saadia A.; Hernandez, Mike; Bashoura, Lara; Cherian, Sujith V.; French, Katy E.

    2016-01-01

    Background. The STOP-BANG questionnaire has been used to identify surgical patients at risk for undiagnosed obstructive sleep apnea (OSA) by classifying patients as low risk (LR) if STOP-BANG score < 3 or high risk (HR) if STOP-BANG score ≥ 3. Few studies have examined whether postoperative complications are increased in HR patients and none have been described in oncologic patients. Objective. This retrospective study examined if HR patients experience increased complications evidenced by an increased length of stay (LOS) in the postanesthesia care unit (PACU). Methods. We retrospectively measured LOS and the frequency of oxygen desaturation (<93%) in cancer patients who were given the STOP-BANG questionnaire prior to cystoscopy for urologic disease in an ambulatory surgery center. Results. The majority of patients in our study were men (77.7%), over the age of 50 (90.1%), and had BMI < 30 kg/m2 (88.4%). STOP-BANG results were obtained on 404 patients. Cumulative incidence of the time to discharge between HR and the LR groups was plotted. By 8 hours, LR patients showed a higher cumulative probability of being discharged early (80% versus 74%, P = 0.008). Conclusions. Urologic oncology patients at HR for OSA based on the STOP-BANG questionnaire were less likely to be discharged early from the PACU compared to LR patients. PMID:27610133

  12. Length of Stay in Ambulatory Surgical Oncology Patients at High Risk for Sleep Apnea as Predicted by STOP-BANG Questionnaire.

    PubMed

    Balachandran, Diwakar D; Faiz, Saadia A; Hernandez, Mike; Kowalski, Alicia M; Bashoura, Lara; Goravanchi, Farzin; Cherian, Sujith V; Rebello, Elizabeth; Kee, Spencer S; French, Katy E

    2016-01-01

    Background. The STOP-BANG questionnaire has been used to identify surgical patients at risk for undiagnosed obstructive sleep apnea (OSA) by classifying patients as low risk (LR) if STOP-BANG score < 3 or high risk (HR) if STOP-BANG score ≥ 3. Few studies have examined whether postoperative complications are increased in HR patients and none have been described in oncologic patients. Objective. This retrospective study examined if HR patients experience increased complications evidenced by an increased length of stay (LOS) in the postanesthesia care unit (PACU). Methods. We retrospectively measured LOS and the frequency of oxygen desaturation (<93%) in cancer patients who were given the STOP-BANG questionnaire prior to cystoscopy for urologic disease in an ambulatory surgery center. Results. The majority of patients in our study were men (77.7%), over the age of 50 (90.1%), and had BMI < 30 kg/m(2) (88.4%). STOP-BANG results were obtained on 404 patients. Cumulative incidence of the time to discharge between HR and the LR groups was plotted. By 8 hours, LR patients showed a higher cumulative probability of being discharged early (80% versus 74%, P = 0.008). Conclusions. Urologic oncology patients at HR for OSA based on the STOP-BANG questionnaire were less likely to be discharged early from the PACU compared to LR patients. PMID:27610133

  13. Clinical radiation oncology

    SciTech Connect

    Wang, C.C.

    1988-01-01

    This book presents current concepts of radiation oncology in the management of various malignant diseases. Recent advances such as the use of linear accelerators and recently increased knowledge concerning radiation biology have been incorporated into the text.

  14. Gaps in Oncology

    Cancer.gov

    The first plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study Original Version provides background for the curriculum and identifies gaps in current and desired comprehensive cancer care.

  15. Basic Principles in Oncology

    NASA Astrophysics Data System (ADS)

    Vogl, Thomas J.

    The evolving field of interventional oncology can only be considered as a small integrative part in the complex area of oncology. The new field of interventional oncology needs a standardization of the procedures, the terminology, and criteria to facilitate the effective communication of ideas and appropriate comparison between treatments and new integrative technology. In principle, ablative therapy is a part of locoregional oncological therapy and is defined either as chemical ablation using ethanol or acetic acid, or thermotherapies such as radiofrequency, laser, microwave, and cryoablation. All these new evolving therapies have to be exactly evaluated and an adequate terminology has to be used to define imaging findings and pathology. All the different technologies and evaluated therapies have to be compared, and the results have to be analyzed in order to improve the patient outcome.

  16. Integrating Multidisciplinary Engineering Knowledge

    ERIC Educational Resources Information Center

    Wolff, Karin; Luckett, Kathy

    2013-01-01

    In order to design two distinct engineering qualification levels for an existing University of Technology programme, empirical evidence based on the current diploma is necessary to illuminate the nature of and the relationship between the "contextual" and "conceptual" elements underpinning a multidisciplinary engineering…

  17. Multidisciplinary management: why me?

    PubMed

    Wetenkamp, Vicki

    2002-01-01

    Laboratory professionals are being asked more and more frequently to spread their wings and take on additional responsibilities in the form of multidisciplinary management. Multidisciplinary management can be described as the management of multiple departments with one or more being outside of the traditional laboratory department, such as respiratory care, pharmacy, radiology, or cardiodiagnostics. Reasons behind the trend in multidisciplinary management and why laboratory professionals often are asked to assume these roles will be explored. This column will cover how laboratory managers can prepare for the challenges of multidisciplinary management, what skills are necessary for these new roles, and how to prepare yourself to be the candidate of choice for these positions when they develop. Challenges often encountered will be discussed, including suggestions on how to turn potential difficulties into positive growth experiences. Hopefully, at the conclusion, you will be able to answer the question "Why me?"--either in the form of "Why have I been asked to take on this role?" or "Why might I want to pursue such a role with enthusiasm?" PMID:12046275

  18. Hyperthermia in Oncology

    NASA Astrophysics Data System (ADS)

    Mocna, Marta

    2007-11-01

    The aim of hyperthermia in oncology is destroy the cancer tissues by heat (so called non-ionizing form of the therapy). The cancer tissues is influenced by the temperature in the range of 40-44 °C. The article presents the most important facts connected with using hyperthermia in oncology and gives an overview of the current clinical investigation of this kind of thermotherapy in the treatment of cancer in Poznan.

  19. Possibly Impossible Patients: Management of Difficult Behavior in Oncology Outpatients

    PubMed Central

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

    2011-01-01

    Angry, threatening, or otherwise disruptive behavior by patients can interfere with necessary oncologic treatment, sometimes to the point of rendering continued care impossible. We offer oncology clinicians guidance in dealing with difficult outpatients by discussing the differential diagnosis and multidisciplinary management of treatment-disrupting behavior in the ambulatory oncology setting. We review the existing literature on dealing with difficult patients and present clinical experience at a comprehensive cancer center where a formalized, institutional process for responding to disruptive outpatients has been developed. A structured, multidisciplinary approach to deal with difficult behavior in oncology outpatients can improve care and staff morale. Staff using this approach can identify causes of treatment-disrupting behavior, develop and implement appropriate behavior plans, facilitate communication, address mental health issues, and ensure that decisions to terminate a relationship with a patient are ethical, clinically justified, and supported by due process. In the future, clinical recommendations and institutional guidelines for dealing with difficult patients should be evaluated with more structured, quantitative research. PMID:22043189

  20. Multidisciplinary computational aerosciences

    NASA Technical Reports Server (NTRS)

    Kutler, Paul

    1992-01-01

    As the challenges of single disciplinary computational physics are met, such as computational fluid dynamics, computational structural mechanics, computational propulsion, computational aeroacoustics, computational electromagnetics, etc., scientists have begun investigating the combination of these single disciplines into what is being called multidisciplinary computational aerosciences (MCAS). The combination of several disciplines not only offers simulation realism but also formidable computational challenges. The solution of such problems will require computers orders of magnitude larger than those currently available. Such computer power can only be supplied by massively parallel machines because of the current speed-of-light limitation of conventional serial systems. Even with such machines, MCAS problems will require hundreds of hours for their solution. To efficiently utilize such a machine, research is required in three areas that include parallel architectures, systems software, and applications software. The main emphasis of this paper is the applications software element. Examples that demonstrate application software for multidisciplinary problems currently being solved at NASA Ames Research Center are presented. Pacing items for MCAS are discussed such as solution methodology, physical modeling, computer power, and multidisciplinary validation experiments.

  1. Pediatric oncology in Pakistan.

    PubMed

    Ashraf, Muhammad Shamvil

    2012-03-01

    Pediatric oncology in Pakistan has developed over last decade with substantial increase in the facility for treatment and number of expertise. Though large numbers of children still do not reach treatment center more children have now access to quality cancer treatment. There has been gradual improvement in Pediatric oncology nursing and allied services. Pediatric Palliative care in Pakistan is in initial phase of development. Pediatric Oncology services are largely supported by philanthropists. Children Cancer Hospital a project of Children Cancer Foundation Pakistan Trust is not only providing quality treatment to every child regardless of paying ability but also playing a pivotal role in capacity building and creating awareness about childhood cancer in Pakistan. PMID:22357147

  2. Use of Geriatric Assessment for Older Adults in the Oncology Setting: A Systematic Review

    PubMed Central

    2012-01-01

    Background Geriatric assessment is a multidisciplinary diagnostic process that evaluates the older adult’s medical, psychological, social, and functional capacity. No systematic review of the use of geriatric assessment in oncology has been conducted. The goals of this systematic review were: 1) to provide an overview of all geriatric assessment instruments used in the oncology setting; 2) to examine the feasibility and psychometric properties of those instruments; and 3) to systematically evaluate the effectiveness of geriatric assessment in predicting or modifying outcomes (including the impact on treatment decision making, toxicity of treatment, and mortality). Methods We searched Medline, Embase, Psychinfo, Cinahl, and the Cochrane Library for articles published in English, French, Dutch, or German between January 1, 1996, and November 16, 2010, reporting on cross-sectional, longitudinal, interventional, or observational studies that assessed the feasibility or effectiveness of geriatric assessment instruments. The quality of articles was evaluated using relevant quality assessment frameworks. Results We identified 83 articles that reported on 73 studies. The quality of most studies was poor to moderate. Eleven studies examined psychometric properties or diagnostic accuracy of the geriatric assessment instruments used. The assessment generally took 10–45min. Geriatric assessment was most often completed to describe a patient’s health and functional status. Specific domains of geriatric assessment were associated with treatment toxicity in 6 of 9 studies and with mortality in 8 of 16 studies. Of the four studies that examined the impact of geriatric assessment on the cancer treatment decision, two found that geriatric assessment impacted 40%–50% of treatment decisions. Conclusion Geriatric assessment in the oncology setting is feasible, and some domains are associated with adverse outcomes. However, there is limited evidence that geriatric assessment

  3. Expression of Estrogen Receptor Beta Predicts Oncologic Outcome of pT3 Upper Urinary Tract Urothelial Carcinoma Better Than Aggressive Pathological Features

    PubMed Central

    Luo, Hao Lun; Sung, Ming Tse; Tsai, Eing Mei; Lin, Chang Shen; Lee, Nai Lun; Chung, Yueh-Hua; Chiang, Po Hui

    2016-01-01

    Upper urinary tract urothelial carcinoma (UT-UC) is rare and treatment options or prognostic markers are limited. There is increasing evidence indicating that urothelial carcinoma may be an endocrine-related cancer. The aim of this study was to analyze the prognostic effect of estrogen receptor beta (ERβ) on the outcome of UT-UC. From 2005 to 2012, this study included 105 patients with pT3 UT-UC. Perioperative factors, pathological features, and ERβ immunostaining were reviewed and prognostic effects were examined by multivariate analysis. This study divided patients into either the ERβ-high (n = 52) or ERβ-low (n = 53) group and analyzed their oncologic outcomes. All pathological features except infiltrating tumor architecture (significantly higher incidence in ERβ-low group, p = 0.004) are symmetric in both groups. Low ERβ expression was significantly correlated with local recurrence and distant metastasis in univariate analysis (p = 0.035 and 0.004, respectively) and multivariate analysis (p = 0.05 and 0.008, respectively). Cell line study also proved that knock down of ERβ cause less UTUC proliferation and migration. In addition, ERβ agonist also enhanced the cytotoxic and migration inhibition effect of cisplatin and ERβ antagonist cause the UTUC cell more resistant to cisplatin. This result may help identify patients in need of adjuvant therapy or develop potential targeted therapy. PMID:27052470

  4. Integration of tobacco cessation services into multidisciplinary lung cancer care: rationale, state of the art, and future directions

    PubMed Central

    Warren, Graham W.

    2015-01-01

    Tobacco use is the largest risk factor for lung cancer and many lung cancer patients still smoke at the time of diagnosis. Although clinical practice guidelines recommend that all patients receive evidence-based tobacco treatment, implementation of these services in oncology practices is inconsistent and inadequate. Multidisciplinary lung cancer treatment programs offer an ideal environment to optimally deliver effective smoking cessation services. This article reviews best practice recommendations and current status of tobacco treatment for oncology patients, and provides recommendations to optimize delivery of tobacco treatment in multidisciplinary practice. PMID:26380175

  5. Nonclinical Evaluations of Small-Molecule Oncology Drugs: Integration into Clinical Dose Optimization and Toxicity Management.

    PubMed

    Dambach, Donna M; Simpson, Natalie E; Jones, Thomas W; Brennan, Richard J; Pazdur, Richard; Palmby, Todd R

    2016-06-01

    Multidisciplinary approaches that incorporate nonclinical pharmacologic and toxicologic characterization of small-molecule oncology drugs into clinical development programs may facilitate improved benefit-risk profiles and clinical toxicity management in patients. The performance of the current nonclinical safety-testing scheme was discussed, highlighting current strengths and areas for improvement. While current nonclinical testing appears to predict the clinical outcome where the prevalence of specific adverse effects are high, nonclinical testing becomes less reliable for predicting clinical adverse effects that occur infrequently, as with some kinase inhibitors. Although adverse effects associated with kinase inhibitors can often be predicted on the basis of target biology, drugs can be promiscuous and inhibit targets with poorly defined function and associated risks. Improvements in adverse effect databases and better characterization of the biologic activities of drug targets may enable better use of computational modeling approaches in predicting adverse effects with kinase inhibitors. Assessing safety of a lead candidate in parallel with other drug properties enables incorporation of a molecule's best features during chemical design, eliminates the worst molecules early, and permits timely investigation/characterization of toxicity mechanisms for identified liabilities. A safety lead optimization and candidate identification strategy that reduces intrinsic toxicity and metabolic risk and enhances selectivity can deliver selective kinase inhibitors that demonstrate on-target adverse effects identified nonclinically. Integrating clinical and nonclinical data during drug development can facilitate better identification and management of oncology drugs. Follow-up nonclinical studies may be used to better understand the risks in a given patient population and minimize or manage these risks more appropriately. Clin Cancer Res; 22(11); 2618-22. ©2016 AACR SEE ALL

  6. High-performance GPU-based rendering for real-time, rigid 2D/3D-image registration and motion prediction in radiation oncology

    PubMed Central

    Spoerk, Jakob; Gendrin, Christelle; Weber, Christoph; Figl, Michael; Pawiro, Supriyanto Ardjo; Furtado, Hugo; Fabri, Daniella; Bloch, Christoph; Bergmann, Helmar; Gröller, Eduard; Birkfellner, Wolfgang

    2012-01-01

    A common problem in image-guided radiation therapy (IGRT) of lung cancer as well as other malignant diseases is the compensation of periodic and aperiodic motion during dose delivery. Modern systems for image-guided radiation oncology allow for the acquisition of cone-beam computed tomography data in the treatment room as well as the acquisition of planar radiographs during the treatment. A mid-term research goal is the compensation of tumor target volume motion by 2D/3D registration. In 2D/3D registration, spatial information on organ location is derived by an iterative comparison of perspective volume renderings, so-called digitally rendered radiographs (DRR) from computed tomography volume data, and planar reference x-rays. Currently, this rendering process is very time consuming, and real-time registration, which should at least provide data on organ position in less than a second, has not come into existence. We present two GPU-based rendering algorithms which generate a DRR of 512 × 512 pixels size from a CT dataset of 53 MB size at a pace of almost 100 Hz. This rendering rate is feasible by applying a number of algorithmic simplifications which range from alternative volume-driven rendering approaches – namely so-called wobbled splatting – to sub-sampling of the DRR-image by means of specialized raycasting techniques. Furthermore, general purpose graphics processing unit (GPGPU) programming paradigms were consequently utilized. Rendering quality and performance as well as the influence on the quality and performance of the overall registration process were measured and analyzed in detail. The results show that both methods are competitive and pave the way for fast motion compensation by rigid and possibly even non-rigid 2D/3D registration and, beyond that, adaptive filtering of motion models in IGRT. PMID:21782399

  7. [Thoracic oncology: annual review].

    PubMed

    Sculier, J-P; Berghmans, T; Meert, A-P

    2013-01-01

    The objective of this paper is to review the literature published in 2011-12 in the field of thoracic oncology. Are discussed because of new original publications: epidemiology, screening, pulmonary nodule, diagnosis and assessment, treatment of lung cancer non-small cell, small cell lung cancer, prognosis, palliative care and end of life, organization of care, mesothelioma. PMID:23755717

  8. Updates in oncology.

    PubMed

    Sculier, Jean-Paul; Meert, Anne-Pascale; Berghmans, Thierry

    2014-03-01

    The objective of this review is to report the Clinical Year in Review proceedings in the field of thoracic oncology that were presented at the 2013 European Respiratory Society Annual Congress in Barcelona, Spain. Various topics were reviewed, including: epidemiology, screening, histology, and treatment of nonsmall cell lung cancer and small cell lung cancer. PMID:24591664

  9. [Curative treatment for esophageal cancer: results of a multidisciplinary consensus].

    PubMed

    Allemann, Pierre; Mantziari, Styliani; Wagner, Dorothea; Digklia, Antonia; Ozsahin, Esat; De Bari, Berardino; Dorta, Gian; Godat, Sébastien; Montserrat, Fraga; Sempoux, Christine; Brunel, Christophe; Demartines, Nicolas; Schäfer, Markus

    2016-06-15

    The management of patients with resectable cancer of the esophagus or gastroesophageal junction is currently not standardized. A multi- disciplinary regional consensus has been developed and is presented in this article. The standard workup includes an upper endoscopy, ultrasonography and a CT-scan. For locally advanced tumors, surgery should be associated with either preoperative radiochemotherapy orperioperative chemotherapy after discussion in multidisciplinary tumor board. Before the operation, smoking and alcohol cessation is imperative and nutritional status should be optimized. Nowadays, surgery is well standardized and generally performed minimally invasive accesses. After surgery, clinical and oncological follow-up is necessary. PMID:27487620

  10. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology.

    PubMed

    Apte, Sachin M; Patel, Kavita

    2016-01-01

    With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

  11. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

    PubMed Central

    Apte, Sachin M.; Patel, Kavita

    2016-01-01

    With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

  12. Halitosis: the multidisciplinary approach

    PubMed Central

    Bollen, Curd ML; Beikler, Thomas

    2012-01-01

    Halitosis, bad breath or oral malodour are all synonyms for the same pathology. Halitosis has a large social and economic impact. For the majority of patients suffering from bad breath, it causes embarrassment and affects their social communication and life. Moreover, halitosis can be indicative of underlying diseases. Only a limited number of scientific publications were presented in this field until 1995. Ever since, a large amount of research is published, often with lack of evidence. In general, intraoral conditions, like insufficient dental hygiene, periodontitis or tongue coating are considered to be the most important cause (85%) for halitosis. Therefore, dentists and periodontologists are the first-line professionals to be confronted with this problem. They should be well aware of the origin, the detection and especially of the treatment of this pathology. In addition, ear–nose–throat-associated (10%) or gastrointestinal/endocrinological (5%) disorders may contribute to the problem. In the case of halitophobia, psychiatrical or psychological problems may be present. Bad breath needs a multidisciplinary team approach: dentists, periodontologists, specialists in family medicine, ear–nose–throat surgeons, internal medicine and psychiatry need to be updated in this field, which still is surrounded by a large taboo. Multidisciplinary bad breath clinics offer the best environment to examine and treat this pathology that affects around 25% of the whole population. This article describes the origin, detection and treatment of halitosis, regarded from the different etiological origins. PMID:22722640

  13. GRC RBCC Concept Multidisciplinary Analysis

    NASA Technical Reports Server (NTRS)

    Suresh, Ambady

    2001-01-01

    This report outlines the GRC RBCC Concept for Multidisciplinary Analysis. The multidisciplinary coupling procedure is presented, along with technique validations and axisymmetric multidisciplinary inlet and structural results. The NPSS (Numerical Propulsion System Simulation) test bed developments and code parallelization are also presented. These include milestones and accomplishments, a discussion of running R4 fan application on the PII cluster as compared to other platforms, and the National Combustor Code speedup.

  14. Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)

    SciTech Connect

    Lee, Hyun Jin; Han, Seungbong; Kim, Young Seok; Nam, Joo-Hyun; Kim, Hak Jae; Kim, Jae Weon; Park, Won; Kim, Byoung-Gie; Kim, Jin Hee; Cha, Soon Do; Kim, Juree; Lee, Ki-Heon; Yoon, Mee Sun; and others

    2013-11-15

    Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.

  15. The Edinburgh Malawi Cancer Partnership: helping to establish multidisciplinary cancer care in Blantyre, Malawi.

    PubMed

    Brown, E; Gorman, D; Knowles, G; Taylor, F; Jere, Y; Bates, J; Masamba, L

    2016-12-01

    In response to the growing incidence of cancer in Malawi, a new oncology unit was established at the Queen Elizabeth Central Hospital, Blantyre. The unit opened in 2010, the first in the country, and is led by a single consultant oncologist. In 2012, a healthcare partnership was formed between the oncology and palliative care unit at Queen Elizabeth Central Hospital and the Edinburgh Cancer Centre, UK. The principal objective of the partnership is to help develop high quality multidisciplinary cancer care in Malawi. Methods A needs assessment identified three priority areas for further improvement of cancer services: nurse-led treatment delivery; management of clinical data; and multidisciplinary working. The partnership received grant funding from the Scottish Government Malawi Development Programme in 2013 and a three year project plan was implemented. This has been conducted through a series of reciprocal training visits. Results Key achievements have been completion of a programme of oncology nursing education attended by 32 oncology nurses and other healthcare professionals, which has resulted in increased experience in cancer practice and standardisation of chemotherapy delivery procedures; development of a clinical database that enables prospective collection of data of all new patients with cancer and which links to the Malawi Cancer Registry; development of weekly multidisciplinary meetings involving oncology, gynaecology and surgery that has enabled a cross-specialty approach to patient care. Conclusion The Edinburgh Malawi Cancer Partnership is supporting nursing education, data use and cross-specialty collaboration that we are confident will improve cancer care in Malawi. Future work will focus on the further development of multidisciplinary breast cancer care and the development of a radiotherapy service for patients in Malawi. PMID:27092363

  16. Multidisciplinary mental health teams.

    PubMed

    Slade, M; Rosen, A; Shankar, R

    1995-01-01

    This study surveyed current practice amongst 91 Indian and Australian staff working within multidisciplinary mental health teams, looking at leadership skills, conflict resolution and therapeutic abilities. Length of training was associated with management skills, though these skill were more developed by psychiatric nurses and occupational therapists working in community settings. Hospital settings involved less consensual decision-making than community teams. Psychiatric nurses spent most time in clinical work, and occupational therapists were rated as less skilled in the therapeutic activities assessed than any other profession. Psychiatrists and clinical psychologists undertook most research. The activities assessed in this study could be undertaken by a team comprising psychiatrists, psychiatric nurses and social workers, with clinical psychologists employed where possible, especially for research or service evaluation. PMID:8847199

  17. [Oncology PET imaging].

    PubMed

    Inubushi, Masayuki

    2014-01-01

    At the beginning of this article, likening medical images to "Where is Waldo?" I indicate the concept of diagnostic process of PET/CT imaging, so that medical physics specialists could understand the role of each imaging modality and infer our distress for image diagnosis. Then, I state the present situation of PET imaging and the basics (e.g. health insurance coverage, clinical significance, principle, protocol, and pitfall) of oncology FDG-PET imaging which accounts for more than 99% of all clinical PET examinations in Japan. Finally, I would like to give a wishful prospect of oncology PET that will expand to be more cancer-specific in order to assess therapeutic effects of emerging molecular targeted drugs targeting the "hallmarks of cancer". PMID:25199271

  18. Oncology nurse navigator.

    PubMed

    Case, Mary Ann B

    2011-02-01

    The purpose of this integrative review is to explore the presence of the oncology nurse as navigator on measurable patient outcomes. Eighteen primary nursing research studies were found using combinations of the following key words: advocate, cancer, case manager, coach, certification, guide, navigator, nurse, oncology, patient navigator, pivot nurse, and continuity of care. Nurse researchers identified nursing-sensitive patient outcomes related to the time to diagnosis and appropriate treatment, effect on mood states, satisfaction, support, continuity of care, and cost outcomes. Navigator roles are expanding globally, and nurses should continue to embrace opportunities to ensure the safe passage of patients with cancer along the entire trajectory of illness and to evaluate the implications for educational preparation, research, and practice of navigators of all kinds. PMID:21278039

  19. Introduction to pediatric oncology

    SciTech Connect

    McWhirter, W.R.; Masel, J.P.

    1987-01-01

    This book covers the varied and complex aspects of management in pediatric oncology. Emphasis is placed on a team approach and on establishing and maintaining an individualized, humanistic relationships with the patient. Numerous illustrations show modern imaging techniques that are proving most valuable in the investigation of suspected or confirmed childhood cancer. Physical and psychological side effects of short-term and long-term treatment are also discussed.

  20. [Factitious diseases in oncology].

    PubMed

    Reich, Michel; Clermont, Amélie; Amela, Éric; Kotecki, Nuria

    2015-12-01

    Factitious diseases and pathomimias and particularly Munchausen's syndrome, due to their rarity, are poorly diagnosed by medical teams working in oncology. Consequences can be serious and result in unadapted surgery or non justified implementation of chemotherapy and radiotherapy regimens. These patients simulate diseases in order to attract medical attention. They might become belligerent and are likely to promptly discharge themselves from hospital if they do not get the desired attention or are unmasked. With two following case reports and literature review, we would like to alert clinicians about difficulties encountered in diagnosis and management of factitious disorders. When faced with this diagnosis, the patient will tend to deny reality and break contact with the medical team who exposed him. Medical peregrinating behavior surrounded by conflicts with medical team, past psychiatric illness, history of working in the medical and paramedical field and social isolation can guide the diagnosis. Somaticians and especially surgeons working in the oncologic field must remain vigilant about this diagnosis and collaborate with either the psycho-oncologic team or the consultation-liaison psychiatric team. Some recommendations for medical professionals how to cope with these patients will be suggested. PMID:26597474

  1. Hybrid Imaging in Oncology.

    PubMed

    Fatima, Nosheen; Zaman, Maseeh uz; Gnanasegaran, Gopinath; Zaman, Unaiza; Shahid, Wajeeha; Zaman, Areeba; Tahseen, Rabia

    2015-01-01

    In oncology various imaging modalities play a crucial role in diagnosis, staging, restaging, treatment monitoring and follow up of various cancers. Stand-alone morphological imaging like computerized tomography (CT) and magnetic resonance imaging (MRI) provide a high magnitude of anatomical details about the tumor but are relatively dumb about tumor physiology. Stand-alone functional imaging like positron emission tomography (PET) and single photon emission tomography (SPECT) are rich in functional information but provide little insight into tumor morphology. Introduction of first hybrid modality PET/CT is the one of the most successful stories of current century which has revolutionized patient care in oncology due to its high diagnostic accuracy. Spurred on by this success, more hybrid imaging modalities like SPECT/CT and PET/MR were introduced. It is the time to explore the potential applications of the existing hybrid modalities, developing and implementing standardized imaging protocols and train users in nuclear medicine and radiology. In this review we discuss three existing hybrid modalities with emphasis on their technical aspects and clinical applications in oncology. PMID:26320423

  2. The importance of pharmacist providing patient education in oncology.

    PubMed

    Avery, Mia; Williams, Felecia

    2015-02-01

    The world's increasing diversity requires health care professionals to adjust delivery methods of teaching to accommodate different cultural values and beliefs. The ability to communicate effectively across languages and various cultural practices directly affects patient education outcomes. Pharmacist should be aware of varying modalities and considerations when counseling a patient diagnosed with cancer and undergoing chemotherapy. In more recent years, the medical profession has seen an increase in patient outcomes due to using the multidisciplinary team approach and has benefited by implementing Medication Therapy Management (MTM) programs at various institutions. For the clinical pharmacist, this would mean documentation for these services should be precise and accurate based on the specific patients needs. There are several factors involved in the care and therapy of the patient with cancer. Clinical oncology pharmacist should be aware of the ever-changing role in oncology and be able to implement new practices at their facility for better patient outcomes. PMID:25540194

  3. Comparison of 123I-Metaiodobenzylguanidine (MIBG) and 131I-MIBG Semi-Quantitative Scores in Predicting Survival in Patients With Stage 4 Neuroblastoma: A Report From the Children’s Oncology Group

    PubMed Central

    Naranjo, Arlene; Parisi, Marguerite T.; Shulkin, Barry L.; London, Wendy B.; Matthay, Katherine K.; Kreissman, Susan G.; Yanik, Gregory A.

    2015-01-01

    Background 123I-metaiodobenzylguanidine (MIBG) scans are preferable to 131I-MIBG for neuroblastoma imaging as they deliver less patient radiation yet have greater sensitivity in disease detection. Both 123I-MIBG and 131I-MIBG scans were used for disease assessments of neuroblastoma patients enrolled on Children’s Oncology Group (COG) high-risk study A3973. The hypothesis was that 123I-MIBG and 131I-MIBG scans were sufficiently similar for clinical purposes in terms of ability to predict survival. Procedure Patients enrolled on COG A3973 with stage 4 disease who completed 123I-MIBG or 131I-MIBG scans at diagnosis, post-induction, post-transplant, or post-biotherapy were analyzed. The performance of the Curie score for each MIBG scan type in predicting survival was evaluated. At each time point, survival curves for 123I-MIBG versus 131I-MIBG were compared using the log-rank test. Results Of the 413 patients on A3973 with at least one MIBG scan, 350 were stage 4. The 5-year event-free survival (EFS) and overall survival (OS) rates were 33.4 ± 3.6% and 45.6 ± 4.0% (N = 350). At post-induction, EFS (P = 0.3501) and OS (P = 0.5337) for 123I-MIBG versus 131I-MIBG were not significantly different. Similarly, comparisons at the three other time points were non-significant. Conclusions We found no evidence of a statistically significant difference in outcome by type of scan. For future survival analyses of MIBG Curie scores, 123I-MIBG and 131I-MIBG results may be combined and analyzed overall, without adjustment for scan type. PMID:21328522

  4. Multidisciplinary System Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Mahadevan, Sankaran; Han, Song; Chamis, Christos C. (Technical Monitor)

    2001-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code, developed under the leadership of NASA Glenn Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multidisciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  5. Breakfast: a multidisciplinary approach

    PubMed Central

    2013-01-01

    Background The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. Discussion Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. Summary The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being. PMID:23842429

  6. Music therapy: a valuable adjunct in the oncology setting.

    PubMed

    Mahon, Emily M; Mahon, Suzanne M

    2011-08-01

    Music therapy is the supervised and therapeutic use of music by a credentialed therapist to promote positive clinical outcomes. It can be a valuable form of complementary medicine in the oncology setting to decrease patient stress and anxiety, relieve pain and nausea, provide distraction, alleviate depression, and promote the expression of feelings. The music therapist assesses the patient and consults other members of the multidisciplinary team to create a therapeutic treatment plan. Music therapists design music sessions based on patients' needs and their intended therapeutic goals. Patients can participate actively or passively in individual or group sessions. Only a credentialed music therapist can provide safe and beneficial music therapy interventions. PMID:21810567

  7. Imaging of complications of oncological therapy in the gastrointestinal system

    PubMed Central

    Viswanathan, Chitra; Bhosale, Priya; Moorthy Ganeshan, Dhakshin; Truong, Myelene T.; Silverman, Paul

    2012-01-01

    Abstract Treatment of cancer involves a multidisciplinary approach consisting of surgery, chemotherapy, molecular targeted therapy and radiation therapy. These therapies work on the tumor cells to result in cell stasis or cell death. The same mechanism can result in toxicity to the normal gastrointestinal tract. Radiation therapy can cause acute and chronic injury. The chronic injury results from involvement of the vascular supply of the gastrointestinal tract and by causing fibrosis. The purpose of this article is to describe the imaging of complications resulting from oncologic treatment in the gastrointestinal system. PMID:22571819

  8. [Dignity therapy in oncology].

    PubMed

    Ripamonti, Carla Ida

    2016-04-01

    In oncology, little is known about dignity, dignity-related distress and the issues that influence the sense of dignity for patients. Dignity is personal, subject to changes depending on the experience and the path of life. In oncology some patients feel that their dignity is directly related to the disease, to physical and emotional symptoms, to the highest level of physical and cognitive autonomy and to the continuity of the self. Patient dignity inventory (PDI) is a validate tool designed to measure various sources of dignity-related distress among patients nearing the end of life and serve as a screening tool to assess a broad range of issues that influence the sense of dignity. Dignity therapy is a novel focused psychotherapy consisting in a brief semi-structured interview, audio-recorded and transcribed in order to obtain the "generativity document". The patients are invited to tell about their life history, and to leave words of guidance and offer instructions to pass along to their son, daughters, husband, wife, parents, others. The generativity document is the result of process of emotional and existential care for the patients and a gift for everybody will receive it. PMID:27093325

  9. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    SciTech Connect

    Kron, Tomas; Willis, David; Link, Emma; Lehman, Margot; Campbell, Gillian; O'Brien, Peter; Chua, Boon

    2013-11-15

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI.

  10. The Clinical Usefulness of 18F-Fluorodeoxyglucose Positron Emission Tomography (PET) to Predict Oncologic Outcomes and PET-Based Radiotherapeutic Considerations in Locally Advanced Nasopharyngeal Carcinoma

    PubMed Central

    Yoon, Hong In; Kim, Kyung Hwan; Lee, Jeongshim; Roh, Yun Ho; Yun, Mijin; Cho, Byoung Chul; Lee, Chang Geol; Keum, Ki Chang

    2016-01-01

    Purpose We investigated 18F-fluorodeoxyglucose positron emission tomography (PET)-derived parameters as prognostic indices for disease progression and survival in locally advanced nasopharyngeal carcinoma (NPC) and the effect of high-dose radiotherapy for a subpopulation with PET-based poor prognoses. Materials and Methods Ninety-seven stage III and Iva-b NPC patients who underwent definitive treatment and PET were reviewed. For each primary, nodal, and whole tumor, maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) were evaluated. Results Based on the C-index (0.666) and incremental area under the curve (0.669), the whole tumor TLGwas the most useful predictorfor progression-free survival (PFS); thewhole tumor TLG cut-off value showing the best predictive performance was 322.7. In multivariate analysis, whole tumor TLG was a significant prognostic factor for PFS (hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.14 to 0.65; p=0.002) and OS (HR, 0.29; 95% CI, 0.11 to 0.79; p=0.02). Patients with low whole tumor TLG showed the higher 5-year PFS in the subgroup for only patients receiving intensity modulated radiotherapy (77.4% vs. 53.0%, p=0.01). In the subgroup of patients with high whole tumor TLG, patients receiving an EQD2 ≥ 70 Gy showed significantly greater complete remission rates (71.4% vs. 33.3%, p=0.03) and higher 5-year OS (74.7% vs. 19.6%, p=0.02). Conclusion Our findings demonstrated that whole tumor TLG could be an independent prognostic factor and high-dose radiotherapy could improve outcomes for NPC showing high whole tumor TLG. PMID:26693913

  11. [Therapeutic consequences of molecular biology advances in oncology].

    PubMed

    Bauvet, F; Awada, A; Gil, T; Hendlisz, A

    2009-01-01

    This review article presents the improvements made in the field of molecular biology in oncology and their diagnostic and therapeutic consequences. As an illustration, three types of tumors for which these projections strongly modified the management will be used as a basis in this article: breast cancer, kidney cancer and colorectal cancer. Indeed, the last years, new prognostic factors (natural evolution of a specific patient's tumor) and predictive factors (prediction of the responsiveness to anticancer therapies) have emerged for these tumors. In addition, a better comprehension of the mechanisms implied in the development of cancers allowed the advent of many molecular-targeted therapies, which constitute a true revolution in oncology. PMID:19211361

  12. Psychiatric considerations in the oncology setting.

    PubMed

    Mehta, Reema D; Roth, Andrew J

    2015-01-01

    An aging population and advances in diagnostics and treatment have resulted in a rapidly growing population of people impacted by cancer. People live longer after a cancer diagnosis and tolerate more aggressive treatments than in the past. Younger patients struggle with diversions from the normal developmental milestones in career and relationships, while older patients deal with the dual challenges of aging and cancer. Cancer's transition from likely death to survival has increased interest in its impact on psychosocial issues and quality of life, rather than just longevity. In this article, the authors review the psychiatric diagnosis and management of the mental health issues most often encountered in oncology. Oncology treatment teams, including oncologists, nurses, social workers, and other ancillary staff, are often on the front lines of addressing psychiatric distress and clinical syndromes when psychiatrists are not easily available. The purpose of this review article is to highlight opportunities for nonpsychiatrists to improve identification and treatment of psychosocial distress and psychiatric syndromes and to request formal psychiatric consultation in appropriate situations. Psychotherapeutic, psychopharmacologic, cognitive, and behavioral-oriented interventions, as well as supportive interventions, are discussed for treating patients who are facing challenges during active cancer treatment, survivorship, and at the end of life. This review is not exhaustive but highlights the more common psychosomatic medicine and palliative care scenarios that impact cancer patient care. The importance of recognizing and addressing burnout and compassion fatigue in multidisciplinary professionals who care for those treated for cancer is also discussed given the secondary impact this can have on patient care. PMID:26012508

  13. Multicriteria decision analysis in oncology

    PubMed Central

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

    2015-01-01

    Background There has been a growing interest in the development and application of alternative decision-making frameworks within health care, including multicriteria decision analysis (MCDA). Even though the literature includes several reviews on MCDA methods, applications of MCDA in oncology are lacking. Aim The aim of this paper is to discuss a rationale for the use of MCDA in oncology. In this context, the following research question emerged: How can MCDA be used to develop a clinical decision support tool in oncology? Methods In this paper, a brief background on decision making is presented, followed by an overview of MCDA methods and process. The paper discusses some applications of MCDA, proposes research opportunities in the context of oncology and presents an illustrative example of how MCDA can be applied to oncology. Findings Decisions in oncology involve trade-offs between possible benefits and harms. MCDA can help analyse trade-off preferences. A wide range of MCDA methods exist. Each method has its strengths and weaknesses. Choosing the appropriate method varies depending on the source and nature of information used to inform decision making. The literature review identified eight studies. The analytical hierarchy process (AHP) was the most often used method in the identified studies. Conclusion Overall, MCDA appears to be a promising tool that can be used to assist clinical decision making in oncology. Nonetheless, field testing is desirable before MCDA becomes an established decision-making tool in this field. PMID:24635949

  14. Perceived roles of oncology nursing.

    PubMed

    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. PMID:26897865

  15. [Biosimilar drugs in oncology].

    PubMed

    Levêque, Dominique

    2016-03-01

    Biosimilar drugs are biologic drugs clinically similar to the reference products. They correspond to a generic approach applied to biologic agents. Biosimilars are aimed to provide cheaper drugs by enhancing the concurrency. The approval of biosimilars is abbreviated when compared to that of the reference biologics but includes clinical trials (distinguishing them from the generics). Current available biosimilars in oncology are filgrastim and epoietin alpha. In the next future, will be launched rituximab and trastuzumab. In France, the development of biosimilars is faced with many hurdles that necessitates a better information of physicians and a greater price discount in the out-patient setting. More globally, harmonisation of recommendations particularly concerning extrapolation of indications and nomenclature are needed for a better acceptance. PMID:26832422

  16. Nuclear medicine in oncology

    SciTech Connect

    Murphy, J.

    1996-12-31

    Radioactivity was discovered in the late 1890s, and as early as 1903, Alexander Graham Bell advocated that radioactivity be used to treat tumors. In 1913, the first paper describing therapeutic uses of radium was published; in 1936, {sup 24}Na was administered as a therapy to a leukemia patient. Three years later, uptake of {sup 89}Sr was noted in bone metastases. During the 1940s, there was increasing use of iodine therapy for thyroid diseases, including thyroid cancer. Diagnostic {open_quotes}imaging{close_quotes} with radioisotopes was increasingly employed in the 1930s and 40s using probes and grew in importance and utility with the development of scintillation detectors with photorecording systems. Although coincidence counting to detect positron emissions was developed in 1953, the first medical center cyclotron was not installed until 1961. The 1960s saw the development of {sup 99m}Tc-labeled radiopharmaceuticals, emission reconstruction tomography [giving rise to single photon emission computed tomography (SPECT) and positron emission tomography (PET)], and {sup 64}Ga tumor imaging. Nuclear medicine was recognized as a medical specialty in 1971. Radiolabeled antibodies targeting human tumors in animals was reported in 1973; antibody tumor imaging in humans was reported in 1978. Technology has continued to advance, including the development of SPECT cameras with coincidence detection able to perform FDG/PET imaging. With this overview as as backdrop, this paper focuses on the role of nuclear medicine in oncology from three perspectives: nonspecific tumor imaging agents, specific tumor imaging agents, and radioisotopes for tumor therapy. In summary, while tumor diagnosis and treatment were among the first uses explored for radioactivity, these areas have yet to reach their full potential. Development of new radioisotopes and new radiopharmaceuticals, coupled with improvements in technology, make nuclear oncology an area of growth for nuclear medicine.

  17. Computed Tomography Imaging in Oncology.

    PubMed

    Forrest, Lisa J

    2016-05-01

    Computed tomography (CT) imaging has become the mainstay of oncology, providing accurate tumor staging and follow-up imaging to monitor treatment response. Presurgical evaluation of tumors is becoming commonplace and guides surgeons as to the extent and whether complete tumor resection is possible. CT imaging plays a crucial role in radiotherapy treatment planning. CT imaging in oncology has become ubiquitous in veterinary medicine because of increased availability of this imaging modality. This article focuses on CT cancer staging in veterinary oncology, CT imaging for surgical planning, and advances in CT simulation for radiation therapy planning. PMID:26851976

  18. [Operational Management of Multidisciplinary Organ-Based Tumor Units in Our Cancer Center].

    PubMed

    Kato, Hiroaki; Tsujie, Masanori; Ichimura, Noriko; Yukawa, Masao; Inoue, Masatoshi

    2016-05-01

    Owing to the advances in diagnosis and treatment, it is imperative to develop a multidisciplinary approach for the management of cancer patients. In our cancer center, multidisciplinary organ-based tumor units have been organized for team medical care. These units consist of cancer specialists from multiple departments including medical oncology, surgery, radiology, histopathology, and nursing. Members of each unit regularly conduct meetings to discuss diagnostic and therapeutic aspects, as well as to report the progress of cancer patients. Co-operation with the counseling and support center, utilization of the computerized medical record system, and using brochures for advertisement, all play important roles in adequate management of multidisciplinary organ-based tumor units. PMID:27210090

  19. Targeted molecular imaging in oncology.

    PubMed

    Yang, David J; Kim, E Edmund; Inoue, Tomio

    2006-01-01

    Improvement of scintigraphic tumor imaging is extensively determined by the development of more tumor specific radiopharmaceuticals. Thus, to improve the differential diagnosis, prognosis, planning and monitoring of cancer treatment, several functional pharmaceuticals have been developed. Application of molecular targets for cancer imaging, therapy and prevention using generator-produced isotopes is the major focus of ongoing research projects. Radionuclide imaging modalities (positron emission tomography, PET; single photon emission computed tomography, SPECT) are diagnostic cross-sectional imaging techniques that map the location and concentration of radionuclide-labeled radiotracers. 99mTc- and 68Ga-labeled agents using ethylenedicysteine (EC) as a chelator were synthesized and their potential uses to assess tumor targets were evaluated. 99mTc (t1/2 = 6 hr, 140 keV) is used for SPECT and 68Ga (t1/2 = 68 min, 511 keV) for PET. Molecular targets labeled with Tc-99m and Ga-68 can be utilized for prediction of therapeutic response, monitoring tumor response to treatment and differential diagnosis. Molecular targets for oncological research in (1) cell apoptosis, (2) gene and nucleic acid-based approach, (3) angiogenesis (4) tumor hypoxia, and (5) metabolic imaging are discussed. Numerous imaging ligands in these categories have been developed and evaluated in animals and humans. Molecular targets were imaged and their potential to redirect optimal cancer diagnosis and therapeutics were demonstrated. PMID:16485568

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

    PubMed Central

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

    2014-01-01

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

  1. Effectiveness of a thoracic multidisciplinary clinic in the treatment of stage III non-small-cell lung cancer

    PubMed Central

    Friedman, Eliot L; Kruklitis, Robert J; Patson, Brian J; Sopka, Dennis M; Weiss, Michael J

    2016-01-01

    Introduction The Institute of Medicine, the American Society of Clinical Oncology, and the European Society of Medical Oncology promote a multidisciplinary approach for the treatment of cancer. Stage III non-small-cell lung cancer (NSCLC) represents a heterogeneous group of diseases necessitating coordination of care among medical, radiation, and surgical oncology. The optimal care of stage III NSCLC underscores the need for a multidisciplinary approach. Methods From tumor registry data, we identified all cases of stage III NSCLC seen at Lehigh Valley Health Network between March 2010 and March 2013. The care received by patients when seen in the thoracic multidisciplinary clinic (MDC) was compared with the care received when not seen in the thoracic MDC. Results All patients seen in the MDC, compared to <50% of patients seen outside the MDC, were evaluated by more than one physician prior to beginning the treatment. Time to initiate treatment was shorter in MDC patients than in non-MDC patients. Patients seen in the MDC had a greater concordance with clinical pathways. A greater percentage of patients seen in the thoracic MDC had pathologic staging of their mediastinum. Patients seen in the MDC were more likely to receive all of their care at Lehigh Valley Health Network. Conclusion Multidisciplinary care is essential in the treatment of patients with stage III NSCLC. Greater utilization of MDCs for this complex group of patients will result in more efficient coordination of care, pretreatment evaluation, and therapy, which in turn should translate to improve patients’ outcomes. PMID:27358568

  2. Exercise Promotion in Geriatric Oncology.

    PubMed

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

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals. PMID:27484061

  3. Oral Health Status of Patients Undergoing Treatment for Head and Neck Oncology in Northern Ireland.

    PubMed

    Moore, Ciaran; Killough, Simon; Markey, Neill; Winning, Lewis; McKenna, Gerald

    2016-06-01

    This study aimed to collect data on the oral health status of patients undergoing treatment for head and neck oncology across Northern Ireland. Data were collected on all patients referred to the Northern Ireland Multidisciplinary Head and Neck Oncology Team for discussion and treatment planning. Each patient underwent pre-treatment dental assessment in the Centre for Dentistry, Queen's University Belfast, between June 2013 and November 2014. Data were collected from clinical oral examinations supplemented with intra-oral radiographs. During the course of the study 96 patients were assessed and the levels of dental disease observed in this cohort were high. On clinical examination 43% were diagnosed with caries and 46% with periodontal disease. Ten patients were completely edentate. The disease profile of this patient group presents significant challenges to dental services tasked with rendering patients dentally fit prior to undergoing oncology treatment. PMID:27424336

  4. Thyroid Disorders in the Oncology Patient

    PubMed Central

    Hartmann, Kari

    2015-01-01

    Thyroid disease and cancer diagnoses are common conditions likely to coexist. Optimal management requires appropriate diagnostic testing and consideration of a number of factors, including overall health status and prognosis. Hypothyroidism and hyperthyroidism can lead to a number of symptoms that may affect not only quality of life but can interfere with the patient’s ability to tolerate cancer treatment. Imaging studies performed for cancer staging can identify incidental structural abnormalities in the thyroid, which should be assessed with dedicated neck ultrasonography and possibly fine-needle aspiration. Incidental thyroid cancer is most often less urgent than the patient’s presenting malignancy and can be addressed surgically when appropriate in the context of other treatments (i.e., chemotherapy). Providers working in an oncology setting, as well as primary care providers, should be aware of medications that are associated with hormonal abnormalities. Any patient with a history of neck or brain radiation therapy is at risk of developing hypothyroidism and possibly other endocrinopathies. Complex or very ill patients may benefit from a multidisciplinary approach that utilizes the experience of a knowledgeable endocrinologist. PMID:26649243

  5. Thyroid Disorders in the Oncology Patient.

    PubMed

    Hartmann, Kari

    2015-01-01

    Thyroid disease and cancer diagnoses are common conditions likely to coexist. Optimal management requires appropriate diagnostic testing and consideration of a number of factors, including overall health status and prognosis. Hypothyroidism and hyperthyroidism can lead to a number of symptoms that may affect not only quality of life but can interfere with the patient's ability to tolerate cancer treatment. Imaging studies performed for cancer staging can identify incidental structural abnormalities in the thyroid, which should be assessed with dedicated neck ultrasonography and possibly fine-needle aspiration. Incidental thyroid cancer is most often less urgent than the patient's presenting malignancy and can be addressed surgically when appropriate in the context of other treatments (i.e., chemotherapy). Providers working in an oncology setting, as well as primary care providers, should be aware of medications that are associated with hormonal abnormalities. Any patient with a history of neck or brain radiation therapy is at risk of developing hypothyroidism and possibly other endocrinopathies. Complex or very ill patients may benefit from a multidisciplinary approach that utilizes the experience of a knowledgeable endocrinologist. PMID:26649243

  6. Traditional Roles in a Non-Traditional Setting: Genetic Counseling in Precision Oncology

    PubMed Central

    Gustafson, Shanna L.; Raymond, Victoria M.

    2014-01-01

    Next generation sequencing technology is increasingly utilized in oncology with the goal of targeting therapeutics to improve response and reduce side effects. Interpretation of tumor mutations requires sequencing of paired germline DNA, raising questions about incidental germline findings. We describe our experiences as part of a research team implementing a protocol for whole genome sequencing (WGS) of tumors and paired germline DNA known as the Michigan Oncology Sequencing project (MI-ONCOSEQ) that includes options for receiving incidental germline findings. Genetic counselors (GCs) discuss options for return of results with patients during the informed consent process and document family histories. GCs also review germline findings and actively participate in the multi-disciplinary Precision Medicine Tumor Board (PMTB), providing clinical context for interpretation of germline results and making recommendations about disclosure of germline findings. GCs have encountered ethical and counseling challenges with participants, described here. Although GCs have not been traditionally involved in molecular testing of tumors, our experiences with MI-ONCOSEQ demonstrate that GCs have important applicable skills to contribute to multi-disciplinary care teams implementing precision oncology. Broader use of WGS in oncology treatment decision making and American College of Medical Genetics and Genomics (ACMG) recommendations for active interrogation of germline tissue in tumor-normal dyads suggests that GCs will have future opportunities in this area outside of research settings. PMID:24578120

  7. Giant Serpentine Aneurysms: Multidisciplinary Management

    PubMed Central

    Anshun, W.; Feng, L.; Daming, W.

    2000-01-01

    Summary Sixty-five cases of intracranial giant serpentine aneurysms (GSΛs), including 61 cases reported in the literature and four additional cases presented in this study were reviewed. The clinical presentation, possible causes, natural history, and especially management of GSAs are discussed with emphasis on the need for aggressive intervention and multidisciplinary management. PMID:20667180

  8. Micronutrients in Oncological Intervention.

    PubMed

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

    2016-03-01

    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. PMID:26985904

  9. Micronutrients in Oncological Intervention

    PubMed Central

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

    2016-01-01

    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. PMID:26985904

  10. Managing Complexity in Multidisciplinary Visualization

    NASA Technical Reports Server (NTRS)

    Miceli, Kristina D.; Lasinski, T. A. (Technical Monitor)

    1995-01-01

    As high performance computing technology progresses, computational simulations are becoming more advanced in their capabilities. In the computational aerosciences domain, single discipline steady-state simulations computed on a single grid are far from the state-of-the-art. In their place are complex, time-dependent multidisciplinary simulations that attempt to model a given geometry more realistically. The product of these multidisciplinary simulations is a massive amount of data stored in different formats, grid topologies, units of measure, etc., as a result of the differences in the simulated physical domains. In addition to the challenges posed by setting up and performing the simulation, additional challenges exist in analyzing computational results. Visualization plays an important role in the advancement of multidisciplinary simulations. To date, visualization has been used to aid in the interpretation of large amounts of simulation data. Because the human visual system is effective in digesting a large amount of information presented graphically, visualization has helped simulation scientists to understand complex simulation results. As these simulations become even more complex, integrating several different physical domains, visualization will be critical to digest the massive amount of information. Another important role for visualization is to provide a common communication medium from which the domain scientists can use to develop, debug, and analyze their work. Multidisciplinary analyses are the next step in simulation technology, not only in computational aerosciences, but in many other areas such as global climate modeling. Visualization researchers must understand and work towards the challenges posed by multidisciplinary simulation scenarios. This paper addresses some of these challenges, describing technologies that must be investigated to create a useful visualization analysis tool for domain scientists.

  11. Translational value of mouse models in oncology drug development.

    PubMed

    Gould, Stephen E; Junttila, Melissa R; de Sauvage, Frederic J

    2015-05-01

    Much has been written about the advantages and disadvantages of various oncology model systems, with the overall finding that these models lack the predictive power required to translate preclinical efficacy into clinical activity. Despite assertions that some preclinical model systems are superior to others, no single model can suffice to inform preclinical target validation and molecule selection. This perspective provides a balanced albeit critical view of these claims of superiority and outlines a framework for the proper use of existing preclinical models for drug testing and discovery. We also highlight gaps in oncology mouse models and discuss general and pervasive model-independent shortcomings in preclinical oncology work, and we propose ways to address these issues. PMID:25951530

  12. Development of a Multidisciplinary, Multicampus Subspecialty Practice in Endocrine Cancers

    PubMed Central

    Bible, Keith C.; Smallridge, Robert C.; Morris, John C.; Molina, Julian R.; Suman, Vera J.; Copland, John A.; Rubin, Joseph; Menefee, Michael E.; Sideras, Kostandinos; Maples, William J.; McIver, Bryan; Fatourechi, Vahab; Hay, Ian; Foote, Robert L.; Garces, Yolanda I.; Kasperbauer, Jan L.; Thompson, Geoffrey B.; Grant, Clive S.; Richards, Melanie L.; Sebo, Thomas; Lloyd, Ricardo; Eberhardt, Norman L.; Reddi, Honey V.; Casler, John D.; Karlin, Nina J.; Westphal, Sydney A.; Richardson, Ronald L.; Buckner, Jan C.; Erlichman, Charles

    2012-01-01

    Purpose: Relative to more abundant neoplasms, endocrine cancers have been historically neglected, yet their incidence is increasing. We therefore sought to build interest in endocrine cancers, improve physician experience, and develop innovative approaches to treating patients with these neoplasms. Methods: Between 2005 and 2010, we developed a multidisciplinary Endocrine Malignancies Disease Oriented Group involving all three Mayo Clinic campuses (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ). In response to higher demand at the Rochester campus, we sought to develop a Subspecialty Tumor Group and an Endocrine Malignancies Tumor Clinic within the Division of Medical Oncology. Results: The intended groups were successfully formed. We experienced difficulty in integration of the Mayo Scottsdale campus resulting from local uncertainty as to whether patient volumes would be sufficient to sustain the effort at that campus and difficulty in developing enthusiasm among clinicians otherwise engaged in a busy clinical practice. But these obstacles were ultimately overcome. In addition, with respect to the newly formed medical oncology subspecialty endocrine malignancies group, appointment volumes quadrupled within the first year and increased seven times within two years. The number of active therapeutic endocrine malignancies clinical trials also increased from one in 2005 to five in 2009, with all three Mayo campuses participating. Conclusion: The development of subspecialty tumor groups for uncommon malignancies represents an effective approach to building experience, increasing patient volumes and referrals, and fostering development of increased therapeutic options and clinical trials for patients afflicted with otherwise historically neglected cancers. PMID:22942830

  13. Multidisciplinary management of heart failure just beginning in Japan.

    PubMed

    Sato, Yukihito

    2015-09-01

    The mortality associated with end-stage heart failure (HF) is high despite the development of new and increasingly effective drugs and non-pharmacological therapies. Repetitive hospitalizations predict fatal outcomes and each hospitalization should prompt individual conversations with the patient, the family, and the caregivers. A multidisciplinary disease management program promotes the education of patients and their families and modifies their behavior, with a view to ultimately improve the prognosis and quality of life. From the early to the late stages of HF, a multidisciplinary disease management program should be implemented. In Western societies this multidisciplinary management has long been debated and endorsed, in contrast to Japan, where it has just begun. In 2012, the Japanese Nursing Association launched a certification in chronic HF nursing. A Japanese version of HF disease management should soon be developed in its own social environment. PMID:25722045

  14. Recommending Research Profiles for Multidisciplinary Academic Collaboration

    ERIC Educational Resources Information Center

    Gunawardena, Sidath Deepal

    2013-01-01

    This research investigates how data on multidisciplinary collaborative experiences can be used to solve a novel problem: recommending research profiles of potential collaborators to academic researchers seeking to engage in multidisciplinary research collaboration. As the current domain theories of multidisciplinary collaboration are insufficient…

  15. Multidisciplinary perspective of hepatocellular carcinoma: A Pacific Northwest experience

    PubMed Central

    Yeh, Matthew M; Yeung, Raymond S; Apisarnthanarax, Smith; Bhattacharya, Renuka; Cuevas, Carlos; Harris, William P; Hon, Tony Lim Kiat; Padia, Siddharth A; Park, James O; Riggle, Kevin M; Daoud, Sayed S

    2015-01-01

    Hepatocellular carcinoma (HCC) is the most rapidly increasing type of cancer in the United States. HCC is a highly malignant cancer, accounting for at least 14000 deaths in the United States annually, and it ranks third as a cause of cancer mortality in men. One major difficulty is that most patients with HCC are diagnosed when the disease is already at an advanced stage, and the cancer cannot be surgically removed. Furthermore, because almost all patients have cirrhosis, neither chemotherapy nor major resections are well tolerated. Clearly there is need of a multidisciplinary approach for the management of HCC. For example, there is a need for better understanding of the fundamental etiologic mechanisms that are involved in hepatocarcinogenesis, which could lead to the development of successful preventive and therapeutic modalities. It is also essential to define the cellular and molecular bases for malignant transformation of hepatocytes. Such knowledge would: (1) greatly facilitate the identification of patients at risk; (2) prompt efforts to decrease risk factors; and (3) improve surveillance and early diagnosis through diagnostic imaging modalities. Possible benefits extend also to the clinical management of this disease. Because there are many factors involved in pathogenesis of HCC, this paper reviews a multidisciplinary perspective of recent advances in basic and clinical understanding of HCC that include: molecular hepatocarcinogenesis, non-invasive diagnostics modalities, diagnostic pathology, surgical modality, transplantation, local therapy and oncological/target therapeutics. PMID:26085907

  16. Personality types of oncology nurses.

    PubMed

    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. PMID:8111753

  17. Ethical issues in integrative oncology.

    PubMed

    Ben-Arye, Eran; Schiff, Elad; Golan, Ofra

    2008-08-01

    Integrative oncology relates to an emerging dialog between complementary and alternative medicine (CAM) scholars, oncologists, family practitioners, and other health care providers who envision an extended and holistic patient-centered approach to oncology care. The multiple commitments of integrative oncology to a medical humanistic approach and to a strong evidence-based foundation may impose considerable ethical concerns and dilemmas. The authors use narrative ethics to present a case study that exemplifies the ethical challenges confronting physicians and health care providers who wish to provide an integrative approach for their patients. An ethical analysis of the narrative is provided to help clarify the ethical issues and conflicts within it. Finally, a framework that may transform ethical constraints to a communication tool is proposed. PMID:18638699

  18. Tissue Microarrays in Clinical Oncology

    PubMed Central

    Voduc, David; Kenney, Challayne; Nielsen, Torsten O.

    2008-01-01

    The tissue microarray is a recently-implemented, high-throughput technology for the analysis of molecular markers in oncology. This research tool permits the rapid assessment of a biomarker in thousands of tumor samples, using commonly available laboratory assays such as immunohistochemistry and in-situ hybridization. Although introduced less than a decade ago, the TMA has proven to be invaluable in the study of tumor biology, the development of diagnostic tests, and the investigation of oncological biomarkers. This review describes the impact of TMA-based research in clinical oncology and its potential future applications. Technical aspects of TMA construction, and the advantages and disadvantages inherent to this technology are also discussed. PMID:18314063

  19. Pharmacological foundations of cardio-oncology.

    PubMed

    Minotti, Giorgio; Salvatorelli, Emanuela; Menna, Pierantonio

    2010-07-01

    Anthracyclines and many other antitumor drugs induce cardiotoxicity that occurs "on treatment" or long after completing chemotherapy. Dose reductions limit the incidence of early cardiac events but not that of delayed sequelae, possibly indicating that any dose level of antitumor drugs would prime the heart to damage from sequential stressors. Drugs targeted at tumor-specific moieties raised hope for improving the cardiovascular safety of antitumor therapies; unfortunately, however, many such drugs proved unable to spare the heart, aggravated cardiotoxicity induced by anthracyclines, or were safe in selected patients of clinical trials but not in the general population. Cardio-oncology is the discipline aimed at monitoring the cardiovascular safety of antitumor therapies. Although popularly perceived as a clinical discipline that brings oncologists and cardiologists working together, cardio-oncology is in fact a pharmacology-oriented translational discipline. The cardiovascular performance of survivors of cancer will only improve if clinicians joined pharmacologists in the search for new predictive models of cardiotoxicity or mechanistic approaches to explain how a given drug might switch from causing systolic failure to inducing ischemia. The lifetime risk of cardiotoxicity from antitumor drugs needs to be reconciled with the identification of long-lasting pharmacological signatures that overlap with comorbidities. Research on targeted drugs should be reshaped to appreciate that the terminal ballistics of new "magic bullets" might involve cardiomyocytes as innocent bystanders. Finally, the concepts of prevention and treatment need to be tailored to the notion that late-onset cardiotoxicity builds on early asymptomatic cardiotoxicity. The heart of cardio-oncology rests with such pharmacological foundations. PMID:20335321

  20. Comprehensive Oncologic Emergencies Research Network (CONCERN)

    Cancer.gov

    The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.

  1. 78 FR 63222 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    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....

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

  5. Establishing a framework for building multidisciplinary programs

    PubMed Central

    Meguid, Cheryl; Ryan, Carrie E; Edil, Barish H; Schulick, Richard D; Gajdos, Csaba; Boniface, Megan; Schefter, Tracey E; Purcell, W Thomas; McCarter, Martin

    2015-01-01

    While most providers support the concept of a multidisciplinary approach to patient care, challenges exist to the implementation of successful multidisciplinary clinical programs. As patients become more knowledgeable about their disease through research on the Internet, they seek hospital programs that offer multidisciplinary care. At the University of Colorado Hospital, we utilize a formal multidisciplinary approach across a variety of clinical settings, which has been beneficial to patients, providers, and the hospital. We present a reproducible framework to be used as a guide to develop a successful multidisciplinary program. PMID:26664132

  6. Computerized Provider Order Entry in Pediatric Oncology: Design, Implementation, and Outcomes

    PubMed Central

    Chen, Allen R.; Lehmann, Christoph U.

    2011-01-01

    Purpose: Pediatric oncology is a challenging environment for computerized provider order entry (CPOE). Our goal was to build on the proven safety features of CPOE and facilitate input of expert clinicians. Methods: A standard, commercially available CPOE system was implemented throughout the hospital. The design of the pediatric oncology implementation was a collaborative effort by a multidisciplinary team of clinicians and information technology experts. Results: During 9 months of configuration effort, 30 medical logic modules and 110 order sets were developed to support pediatric oncology. The proportion of chemotherapy orders submitted using specific research protocol or standard-of-care order sets increased from 57% to 84% as the number of active order sets grew to 200. The number of medication-related patient safety events decreased 39% after implementation of CPOE in pediatric oncology. Acceptance of the system is high in all clinical disciplines. Conclusion: Implementation of CPOE required extensive customization but improved patient safety in this highly complex pediatric oncology environment. PMID:22043183

  7. Advances in Statistical Approaches Oncology Drug Development

    PubMed Central

    Ivanova, Anastasia; Rosner, Gary L.; Marchenko, Olga; Parke, Tom; Perevozskaya, Inna; Wang, Yanping

    2014-01-01

    We describe some recent developments in statistical methodology and practice in oncology drug development from an academic and an industry perspective. Many adaptive designs were pioneered in oncology, and oncology is still at the forefront of novel methods to enable better and faster Go/No-Go decision making while controlling the cost. PMID:25949927

  8. Oncologic Outcomes After Transoral Robotic Surgery

    PubMed Central

    Magnuson, J. Scott; Smith, Richard V.; Moore, Eric; Lawson, Georges; Remacle, Marc; Ganly, Ian; Kraus, Dennis H.; Teng, Marita S.; Miles, Brett A.; White, Hilliary; Duvvuri, Umamaheswar; Ferris, Robert L.; Mehta, Vikas; Kiyosaki, Krista; Damrose, Edward J.; Wang, Steven J.; Kupferman, Michael E.; Koh, Yoon Woo; Genden, Eric M.; Holsinger, F. Christopher

    2016-01-01

    all-cause mortality (P = .01). Although advanced age and tobacco use were associated with locoregional recurrence and disease-specific survival, they, as well as tumor stage and other adverse histopathologic features, did not remain significant on multivariate analysis. CONCLUSIONS AND RELEVANCE This large, multi-institutional study supports the role of TORS within the multidisciplinary treatment paradigm for the treatment of head and neck cancer, especially for patients with oropharyngeal cancer. Favorable oncologic outcomes have been found across institutions. Ongoing comparative clinical trials funded by the National Cancer Institute will further evaluate the role of robotic surgery for patients with head and neck cancers. PMID:26402479

  9. Oncology Practice Trends From the National Practice Benchmark

    PubMed Central

    Barr, Thomas R.; Towle, Elaine L.

    2012-01-01

    In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey. PMID:23277766

  10. Patient education and pediatric oncology.

    PubMed

    Kramer, R F; Perin, G

    1985-03-01

    An overview is provided of important principles and content useful in planning educational programs for pediatric oncology patients and their families. Implementation considerations, such as assessment of the learner, selection of appropriate teaching methods, and problems with the selection process are addressed. PMID:2579366

  11. [Oncologic gynecology and the Internet].

    PubMed

    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. PMID:12722411

  12. [History of Oncology in Slovakia].

    PubMed

    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. PMID:27296401

  13. Supporting prostate cancer focal therapy: a multidisciplinary International Consensus of Experts ("ICE").

    PubMed

    Reis, Leonardo O; Billis, Athanase; Zequi, Stenio C; Tobias-Machado, Marcos; Viana, Publio; Cerqueira, Michael; Ward, John F

    2014-06-01

    Prostate cancer is a common malignancy among men, and the current screening, imaging and sampling approaches aim to detect early-stage, organ-confined disease. In such scenario, focal prostate cancer therapy currently relies on the index lesion concept as the dominant lesion that drives the disease natural history. Focal therapy demands the essential imaging and sampling techniques to strategically locate and qualify the disease, but, despite advances in technology, prostate imaging and biopsy have several limitations that need to be overcome if focal therapy is to be developed further. The I Prostate Cancer Focal Treatment International Symposium was convened to foster discussion on this topic that sits at the crossroads of multiple disciplines (Urology, Pathology, Radiology, Radiation Oncology and Medical Oncology) all of which were represented for this comprehensive multidisciplinary review of the current literature. PMID:24597940

  14. How Multidisciplinary Are the Multidisciplinary Journals Science and Nature?

    PubMed Central

    Solomon, Gregg E. A.; Carley, Stephen; Porter, Alan L.

    2016-01-01

    Interest in cross-disciplinary research knowledge interchange runs high. Review processes at funding agencies, such as the U.S. National Science Foundation, consider plans to disseminate research across disciplinary bounds. Publication in the leading multidisciplinary journals, Nature and Science, may signify the epitome of successful interdisciplinary integration of research knowledge and cross-disciplinary dissemination of findings. But how interdisciplinary are they? The journals are multidisciplinary, but do the individual articles themselves draw upon multiple fields of knowledge and does their influence span disciplines? This research compares articles in three fields (Cell Biology, Physical Chemistry, and Cognitive Science) published in a leading disciplinary journal in each field to those published in Nature and Science. We find comparable degrees of interdisciplinary integration and only modest differences in cross-disciplinary diffusion. That said, though the rate of out-of-field diffusion might be comparable, the sheer reach of Nature and Science, indicated by their potent Journal Impact Factors, means that the diffusion of knowledge therein can far exceed that of leading disciplinary journals in some fields (such as Physical Chemistry and Cognitive Science in our samples). PMID:27043924

  15. [Multidisciplinary approach to postpartum depression].

    PubMed

    Arranz Lara, Lilia Cristina; Aguirre Rivera, Wilfrido; Ruiz Ornelas, Jaime; Gaviño Ambriz, Salvador; Cervantes Chávez, José Francisco; Carsi Bocanegra, Eduardo; Camacho Díaz, Margarita; Ochoa Madrigal, Martha Georgina

    2008-06-01

    Postpartum depression is a multifactorial condition suffered by 15% of women after delivery. We report a clinical case of a 32 years old female admitted at Postpartum depression clinic of gyneco-obstetric coordination at Centro Médico Nacional 20 de Noviembre, ISSTE, Mexico City. Patient was evaluated by psychiatric and psychological service personnel and diagnosed as with postpartum depression. She was admitted with her child during two weeks to be studied and treated. Several evaluation tests were applied and specific interventions by multidisciplinary team were designed. PMID:18800591

  16. Multidisciplinary Care of Laryngeal Cancer.

    PubMed

    Salvador-Coloma, Carmen; Cohen, Ezra

    2016-08-01

    Treatment of larynx cancer has changed dramatically over the past several years. Novel modalities of treatment have been introduced as organ preservation has been developed. In addition, new targeted therapies have appeared, and improvements in radiotherapeutic and surgical techniques have been introduced. Thus, a large variety of treatment options is increasing local control rates and overall survival; however, selecting the most appropriate treatment remains a challenging decision. This article focuses on the multidisciplinary care of early-stage and locally advanced larynx cancer and attempts to sum up different approaches. Moreover, it reviews state-of-the-art treatment in larynx preservation, which has been consolidated in recent years. PMID:27511718

  17. The 100 most-cited articles in spinal oncology.

    PubMed

    De la Garza-Ramos, Rafael; Benvenutti-Regato, Mario; Caro-Osorio, Enrique

    2016-05-01

    spinal oncology. The studies highlighted the multidisciplinary and multimodal nature of spinal tumor management. Recognition of historical articles may guide future spinal oncology research. PMID:26771372

  18. Multidisciplinary Approach to Hepatic Metastases of Intracranial Hemangiopericytoma: A Case Report and Review of the Literature

    PubMed Central

    Manatakis, Dimitrios K.; Delis, Spiridon G.; Ptohis, Nikolaos; Korkolopoulou, Penelope; Dervenis, Christos

    2015-01-01

    Hemangiopericytoma is a rare primary tumor originating from Zimmerman's pericytes, with significant metastatic potential. Hepatic metastatic disease requires an aggressive approach by a multidisciplinary team of dedicated oncology specialists, to prolong survival in selected patients. We report on a patient with recurrent hepatic metastases of grade II intracranial hemangiopericytoma 5 years after initial treatment, managed by a stepwise combination of liver resection, radiofrequency ablation, and transarterial embolization. Although metastatic disease implies hematogenous dissemination, long-term survival after liver resection has been reported and major hepatectomies are justified in patients with adequate local control. Liver resections combined with transarterial embolization are highly recommended, due to hypervascularity of the tumor. PMID:26090247

  19. EMSO: European Multidisciplinary Seafloor Observatory

    NASA Astrophysics Data System (ADS)

    Favali, Paolo; Partnership, Emso

    2010-05-01

    EEMSO, an ESFRI Research Infrastructure, is the European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the scientific objective of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes through long time series appropriate to the scale of the phenomena, constituting the new frontier of studying Earth interior, deep-sea biology and chemistry and ocean processes. EMSO will reply also to the need expressed in the frame of GMES (Global Monitoring for Environment and Security) to develop a marine segment integrated in the in situ and satellite global monitoring system. The EMSO infrastructure will extend the coverage to the sea of the monitoring, integrating the land-based networks with multidisciplinary seafloor measurements. With this aim the two European research infrastructures EPOS (European Plate Observing System) and EMSO can operate in coordination in order to increase the mutual benefits. EMSO is presently at the stage of Preparatory Phase, funded in the EC FP7. The EMSO status, the perspectives and relations with other existing or incoming sensor networks and data infrastructures are outlined.

  20. Organization and implementation of a cardio-oncology program.

    PubMed

    Fiuza, Manuela; Ribeiro, Leonor; Magalhães, Andreia; Sousa, Ana Rita; Nobre Menezes, Miguel; Jorge, Marília; Costa, Luís; Pinto, Fausto José

    2016-09-01

    Considerable advances in cancer therapies in recent decades have reshaped the prognosis of cancer patients. There are now estimated to be over 20 million cancer survivors in the USA and Europe, numbers unimaginable a few years ago. However, this increase in survival, along with the aging of the patient population, has been accompanied by a rise in adverse cardiovascular effects, particularly when there is a previous history of heart disease. The incidence of cardiotoxicity continues to grow, which can compromise the effectiveness of cancer therapy. Cardiotoxicity associated with conventional therapies, especially anthracyclines and radiation, is well known, and usually leads to left ventricular dysfunction. However, heart failure represents only a fraction of the cardiotoxicity associated with newer therapies, which have diverse cardiovascular effects. There are few guidelines for early detection, prevention and treatment of cardiotoxicity of cancer treatments, and no well-established tools for screening these patients. Echocardiography is the method of choice for assessment of patients before, during and after cancer treatment. It therefore makes sense to adopt a multidisciplinary approach to these patients, involving cardiologists, oncologists and radiotherapists, collaborating in the development of new training modules, and performing clinical and translational research in a cardio-oncology program. Cardio-oncology is a new frontier in medicine and has emerged as a new medical subspecialty that concentrates knowledge, understanding, training and treatment of cardiovascular comorbidities, risks and complications in patients with cancer in a comprehensive approach to the patient rather than to the disease. PMID:27503589

  1. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    PubMed Central

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  2. A Model for Rural Oncology

    PubMed Central

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

    2011-01-01

    Small rural hospitals in the United States have had challenging issues developing sustainable oncology programs. This is a report on the development of a successful rural oncology program. In 2006, the Tahoe Forest Health System in Truckee, CA, a remote mountain resort town, started a cancer program that was focused on addressing patient and family fears that are common to all cancer patients but more frightening in the rural setting. Four years later, it is a thriving program with significant community support, a creative academic affiliation, and a central focus of the future of the hospital. The Tahoe Forest Cancer Center developed a sustainable model for high quality cancer care that overcomes geographic, cultural and financial barriers. This structure may serve as a model for national rural health care. PMID:21886498

  3. Major milestones in translational oncology.

    PubMed

    Dragani, Tommaso A; Castells, Antoni; Kulasingam, Vathany; Diamandis, Eleftherios P; Earl, Helena; Iams, Wade T; Lovly, Christine M; Sedelaar, J P Michiel; Schalken, Jack A

    2016-01-01

    Translational oncology represents a bridge between basic research and clinical practice in cancer medicine. Today, translational research in oncology benefits from an abundance of knowledge resulting from genome-scale studies regarding the molecular pathways involved in tumorigenesis. In this Forum article, we highlight the state of the art of translational oncology in five major cancer types. We illustrate the use of molecular profiling to subtype colorectal cancer for both diagnosis and treatment, and summarize the results of a nationwide screening program for ovarian cancer based on detection of a tumor biomarker in serum. Additionally, we discuss how circulating tumor DNA can be assayed to safely monitor breast cancer over the course of treatment, and report on how therapy with immune checkpoint inhibitors is proving effective in advanced lung cancer. Finally, we summarize efforts to use molecular profiling of prostate cancer biopsy specimens to support treatment decisions. Despite encouraging early successes, we cannot disregard the complex genetics of individual susceptibility to cancer nor the enormous complexity of the somatic changes observed in tumors, which urge particular attention to the development of personalized therapies. PMID:27469586

  4. A systematic evaluation of a multidisciplinary social work-lawyer elder mistreatment intervention model.

    PubMed

    Rizzo, Victoria M; Burnes, David; Chalfy, Amy

    2015-01-01

    This study introduces a conceptually based, systematic evaluation process employing multivariate techniques to evaluate a multidisciplinary social work-lawyer intervention model (JASA-LEAP). Logistic regression analyses were used with a random sample of case records (n = 250) from three intervention sites. Client retention, program fidelity, and exposure to multidisciplinary services were significantly related to reduction in mistreatment risk at case closure. Female gender, married status, and living with perpetrator significantly predicted unfavorable outcomes. This study extends the elder mistreatment program evaluation literature beyond descriptive/bivariate evaluation strategies. Findings suggest that a multidisciplinary social work-lawyer elder mistreatment intervention model is a successful approach. PMID:24965802

  5. [Anorexia nervosa: a multidisciplinary approach].

    PubMed

    Bastidas, A; Cantó, T; Font, E

    2000-06-01

    The childhood-adolescent psychiatrics field has, for various years, been confronted by a very significant increase in cases of nervous anorexia, a serious eating disorder characterized by a noticeable loss of weight. At the bottom of this situation lie complex biological, psychological and social-cultural problems, which demand an interdisciplinary approach to solve them. This article presents the predisposing factors, the initial factors, the factors which maintain this disorder...; what behaviors are considered to be normal; what the physical and psychological manifestations are; as well as what the medical evaluation carried out is ... to finalize with an explanation of the different functions to be performed by each member of a multidisciplinary team. PMID:10983149

  6. NPSS Multidisciplinary Integration and Analysis

    NASA Technical Reports Server (NTRS)

    Hall, Edward J.; Rasche, Joseph; Simons, Todd A.; Hoyniak, Daniel

    2006-01-01

    The objective of this task was to enhance the capability of the Numerical Propulsion System Simulation (NPSS) by expanding its reach into the high-fidelity multidisciplinary analysis area. This task investigated numerical techniques to convert between cold static to hot running geometry of compressor blades. Numerical calculations of blade deformations were iteratively done with high fidelity flow simulations together with high fidelity structural analysis of the compressor blade. The flow simulations were performed with the Advanced Ducted Propfan Analysis (ADPAC) code, while structural analyses were performed with the ANSYS code. High fidelity analyses were used to evaluate the effects on performance of: variations in tip clearance, uncertainty in manufacturing tolerance, variable inlet guide vane scheduling, and the effects of rotational speed on the hot running geometry of the compressor blades.

  7. Pediatric pain management: the multidisciplinary approach

    PubMed Central

    Odell, Shannon; Logan, Deirdre E

    2013-01-01

    Chronic pain in children and adolescents is a growing problem and one that is increasingly being addressed with multidisciplinary treatment teams. This review summarizes different multidisciplinary clinics, focusing specifically on intensive pediatric pain rehabilitation centers. This review offers a summary of the challenges faced by these programs and areas for future study. PMID:24250232

  8. Multi-Disciplinary Consumer Education Curriculum.

    ERIC Educational Resources Information Center

    Sie, Maureen A.; And Others

    Two activities are described in this report, both of which focus on the multi-disciplinary approach in the development of a consumer education curriculum for high school students. The first activity, which demonstrated the feasibility of a multi-disciplinary approach using local school personnel and resources and university faculty in curriculum…

  9. Oncology nurses' use of nondrug pain interventions in practice.

    PubMed

    Kwekkeboom, Kristine L; Bumpus, Molly; Wanta, Britt; Serlin, Ronald C

    2008-01-01

    Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses. PMID:17959348

  10. Report on the use of non-clinical studies in the regulatory evaluation of oncology drugs.

    PubMed

    Hayakawa, Yoshihiro; Kawada, Manabu; Nishikawa, Hiroyoshi; Ochiya, Takahiro; Saya, Hideyuki; Seimiya, Hiroyuki; Yao, Ryoji; Hayashi, Masahiro; Kai, Chieko; Matsuda, Akira; Naoe, Tomoki; Ohtsu, Atsushi; Okazaki, Taku; Saji, Hideo; Sata, Masataka; Sugimura, Haruhiko; Sugiyama, Yuichi; Toi, Masakazu; Irimura, Tatsuro

    2016-02-01

    Non-clinical studies are necessary at each stage of the development of oncology drugs. Many experimental cancer models have been developed to investigate carcinogenesis, cancer progression, metastasis, and other aspects in cancer biology and these models turned out to be useful in the efficacy evaluation and the safety prediction of oncology drugs. While the diversity and the degree of engagement in genetic changes in the initiation of cancer cell growth and progression are widely accepted, it has become increasingly clear that the roles of host cells, tissue microenvironment, and the immune system also play important roles in cancer. Therefore, the methods used to develop oncology drugs should continuously be revised based on the advances in our understanding of cancer. In this review, we extensively summarize the effective use of those models, their advantages and disadvantages, ranges to be evaluated and limitations of the models currently used for the development and for the evaluation of oncology drugs. PMID:26919617

  11. Technical aspects of quality assurance in radiation oncology

    PubMed Central

    Saw, CB; Ferenci, MS; Wanger, H

    2008-01-01

    The technical aspects of quality assurance (QA) in radiation oncology as practice in the United States will be reviewed and updated in the spirit of offering the experience to the radiation oncology communities in the Asia-Pacific region. The word “technical” is used to express the organisational components or processes and not the materials within the QA program. A comprehensive QA program in radiation oncology will have an official statement declaring the quality plan for effective patient care services it provides in a document. The QA program will include all aspects of patient care: physical, clinical, and medical aspects of the services. The document will describe the organisational structure, responsibilities, checks and procedures, and resources allocated to ensure the successful implementation of the quality of patient management. Regulatory guidelines and guidelines from accreditation agencies should be incorporated in the QA program to ensure compliance. The organisational structure will have a multidisciplinary QA committee that has the authority to evaluate continuously the effectiveness of the QA program to provide prompt corrective recommendations and to request feedback as needed to monitor the response. The continuous monitoring aspects require meetings to be held at regular intervals with the minutes of the meetings officially recorded and documented. To ensure that a QA program is effective, the program itself should be audited for quality at regular intervals at least annually. It has been recognised that the current QA program has not kept abreast with the rapid implementation of new and advanced radiation therapy technologies with the most recent in image-based radiation therapy technology. The societal bodies (ASTRO and AAPM) and federal agency (NCI) acknowledge this inadequacy and have held workshops to address this issue. The challenges for the societal bodies and federal agency are numerous that include (a) the prescriptive methodology

  12. Multidisciplinary research of geothermal modeling

    NASA Astrophysics Data System (ADS)

    -Ing. Ulvi Arslan, Univ., ., Dr. _., Prof.; Heiko Huber, Dipl.-Ing.

    2010-05-01

    KEYWORDS Geothermal sciences, geothermics, research, theory and application, numerical calculation, geothermal modeling, Technical University Darmstadt, Ministry of Economics and Technology (BMWi) INTRODUCTION In times of global warming renewable, green energies are getting more and more important. The development of application of geothermal energy as a part of renewable energies in Germany is a multidisciplinary process of fast growing research and improvements. Geothermal energy is the energy, which is stored below earth's surface. The word geothermal derives from the Greek words geo (earth) and thermos (heat), so geothermal is a synonym to earth heat. Geothermal energy is one of the auspicious renewable energies. In average the temperature increases 3°C every 100 m of depth, which is termed as geothermal gradient. Therefore 99 percent of our planet is hotter than 1.000°C, while 99 percent of that last percent is even hotter than 100°C. Already in a depth of about 1 kilometer temperatures of 35 - 40°C can be achieved. While other renewable energies arise less or more from the sun, geothermal energy sources its heat from the earth's interior, which is caused mostly by radioactive decay of persistent isotopes. This means a possibility of a base-loadable form of energy supply. Especially efficient is the use of deep geothermal energy of high-enthalpie reservoirs, which means a high energy potential in low depths. In Germany no high-enthalpie reservoirs are given. To use the given low-enthalpie potential and to generate geothermal power efficiently inventions and improvements need to be performed. An important part of geothermal progresses is performed by universities with multidisciplinary research of geothermal modeling. Especially in deep geothermal systems numerical calculations are essential for a correct dimensioning of the geothermal system. Therefore German universities and state aided organizations are developing numerical programs for a detailed use of

  13. Design Environment for Multifidelity and Multidisciplinary Components

    NASA Technical Reports Server (NTRS)

    Platt, Michael

    2014-01-01

    One of the greatest challenges when developing propulsion systems is predicting the interacting effects between the fluid loads, thermal loads, and structural deflection. The interactions between technical disciplines often are not fully analyzed, and the analysis in one discipline often uses a simplified representation of other disciplines as an input or boundary condition. For example, the fluid forces in an engine generate static and dynamic rotor deflection, but the forces themselves are dependent on the rotor position and its orbit. It is important to consider the interaction between the physical phenomena where the outcome of each analysis is heavily dependent on the inputs (e.g., changes in flow due to deflection, changes in deflection due to fluid forces). A rigid design process also lacks the flexibility to employ multiple levels of fidelity in the analysis of each of the components. This project developed and validated an innovative design environment that has the flexibility to simultaneously analyze multiple disciplines and multiple components with multiple levels of model fidelity. Using NASA's open-source multidisciplinary design analysis and optimization (OpenMDAO) framework, this multifaceted system will provide substantially superior capabilities to current design tools.

  14. New Technologies in Radiation Oncology

    NASA Astrophysics Data System (ADS)

    Schlegel, Wolfgang; Bortfeld, Thomas; Grosu, Anca-Ligia

    This book provides an overview of recent advances in radiation oncology, many of which have originated from physics and engineering sciences. After an introductory section on basic aspects of 3D medical imaging, the role of 3D imaging in the context of radiotherapy is explored in a series of chapters on the various modern imaging techniques. A further major section addresses 3D treatment planning for conformal radiotherapy, with consideration of both external radiotherapy and brachytherapy. Subsequently the modern techniques of 3D conformal radiotherapy are described, including stereotactic radiotherapy, intensity-modulated radiation therapy, image-guided and adaptive radiotherapy, and radiotherapy with charged particles.

  15. Temporomandibular joint multidisciplinary team clinic.

    PubMed

    Ahmed, Nabeela; Poate, Tim; Nacher-Garcia, Cristina; Pugh, Nicola; Cowgill, Helen; Page, Lisa; Matthews, N Shaun

    2014-11-01

    Patients with dysfunction of the temporomandibular joint (TMJ) commonly present to oral and maxillofacial departments and are increasingly being managed by a subspecialist group of surgeons. We review the outcomes of patients attending a specialist TMJ multidisciplinary team (MDT) clinic. All patients are simultaneously reviewed by a consultant oral and maxillofacial surgeon, consultant in oral medicine, specialist physiotherapist, and maxillofacial prosthetist, and they can also see a consultant liaison psychiatrist. They are referred from primary, secondary, and tertiary care when medical and surgical treatment in the routine TMJ clinic has failed, and are triaged by the attending maxillofacial surgeon. On discharge they are returned to the care of the referring practitioner. We review the outcomes of patients attending this clinic over a 2-year period and show improvements in pain scores and maximal incisal opening, as well as quality of life outcome measures. All units in the UK with an interest in the management of diseases of the TMJ should consider establishing this type of clinic and should use available resources and expertise to maximise outcomes. PMID:25179688

  16. Pineal lesions: a multidisciplinary challenge.

    PubMed

    Westphal, Manfred; Emami, Pedram

    2015-01-01

    The pineal region is a complex anatomical compartment, harbouring the pineal gland surrounded by the quadrigeminal plate and the confluents of the internal cerebral veins to form the vein of Galen. The complexity of lesions in that region, however, goes far beyond the pineal parenchyma proper. Originating in the pineal gland, there are not only benign cysts but also numerous different tumour types. In addition, lesions such as tectal gliomas, tentorial meningiomas and choroid plexus papillomas arise from the surrounding structures, occupying that regions. Furthermore, the area has an affinity for metastatic lesions. Vascular lesions complete the spectrum mainly as small tectal arteriovenous malformations or cavernous haemangiomas.Taken together, there is a wide spectrum of lesions, many unique to that region, which call for a multidisciplinary approach. The limited access and anatomical complexity have generated a spectrum of anatomical approaches and raised the interest for neuroendoscopic approaches. Equally complex is the spectrum of treatment modalities such as microsurgery as the main option but stereotactic radiosurgery as an alternative or adjuvant to surgery for selected cases, radiation as for germinoma (see below) and or combinatorial chemotherapy, which may need to precede any other ablative technique as constituents.In this context, we review the current literature and our own series to obtain a snapshot sentiment of how to approach pineal lesions, how to interrelate alternative/competing concepts and review the recent technological advances. PMID:25411146

  17. Multidisciplinary approaches to solar hydrogen

    PubMed Central

    Bren, Kara L.

    2015-01-01

    This review summarizes three different approaches to engineering systems for the solar-driven evolution of hydrogen fuel from water: molecular, nanomaterials and biomolecular. Molecular systems have the advantage of being highly amenable to modification and detailed study and have provided great insight into photophysics, electron transfer and catalytic mechanism. However, they tend to display poor stability. Systems based on nanomaterials are more robust but also are more difficult to synthesize in a controlled manner and to modify and study in detail. Biomolecular systems share many properties with molecular systems and have the advantage of displaying inherently high efficiencies for light absorption, electron–hole separation and catalysis. However, biological systems must be engineered to couple modules that capture and convert solar photons to modules that produce hydrogen fuel. Furthermore, biological systems are prone to degradation when employed in vitro. Advances that use combinations of these three tactics also are described. Multidisciplinary approaches to this problem allow scientists to take advantage of the best features of biological, molecular and nanomaterials systems provided that the components can be coupled for efficient function. PMID:26052425

  18. Multidisciplinary approaches to solar hydrogen.

    PubMed

    Bren, Kara L

    2015-06-01

    This review summarizes three different approaches to engineering systems for the solar-driven evolution of hydrogen fuel from water: molecular, nanomaterials and biomolecular. Molecular systems have the advantage of being highly amenable to modification and detailed study and have provided great insight into photophysics, electron transfer and catalytic mechanism. However, they tend to display poor stability. Systems based on nanomaterials are more robust but also are more difficult to synthesize in a controlled manner and to modify and study in detail. Biomolecular systems share many properties with molecular systems and have the advantage of displaying inherently high efficiencies for light absorption, electron-hole separation and catalysis. However, biological systems must be engineered to couple modules that capture and convert solar photons to modules that produce hydrogen fuel. Furthermore, biological systems are prone to degradation when employed in vitro. Advances that use combinations of these three tactics also are described. Multidisciplinary approaches to this problem allow scientists to take advantage of the best features of biological, molecular and nanomaterials systems provided that the components can be coupled for efficient function. PMID:26052425

  19. Multidisciplinary Management of Laryngeal Carcinoma

    SciTech Connect

    Mendenhall, William M. Mancuso, Anthony A.; Hinerman, Russell W.; Malyapa, Robert S.; Werning, John W.; Amdur, Robert J.; Villaret, Douglas B.

    2007-10-01

    The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.

  20. EMSO: European multidisciplinary seafloor observatory

    NASA Astrophysics Data System (ADS)

    Favali, Paolo; Beranzoli, Laura

    2009-04-01

    EMSO has been identified by the ESFRI Report 2006 as one of the Research Infrastructures that European members and associated states are asked to develop in the next decades. It will be based on a European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the aim of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes, providing long time series data for the different phenomenon scales which constitute the new frontier for study of Earth interior, deep-sea biology and chemistry, and ocean processes. The development of an underwater network is based on past EU projects and is supported by several EU initiatives, such as the on-going ESONET-NoE, aimed at strengthening the ocean observatories' scientific and technological community. The EMSO development relies on the synergy between the scientific community and industry to improve European competitiveness with respect to countries such as USA, Canada and Japan. Within the FP7 Programme launched in 2006, a call for Preparatory Phase (PP) was issued in order to support the foundation of the legal and organisational entity in charge of building up and managing the infrastructure, and coordinating the financial effort among the countries. The EMSO-PP project, coordinated by the Italian INGV with participation by 11 institutions from as many European countries, started in April 2008 and will last four years.

  1. Multidisciplinary cancer care in Spain, or when the function creates the organ: qualitative interview study

    PubMed Central

    2011-01-01

    Background The Spanish National Health System recognised multidisciplinary care as a health priority in 2006, when a national strategy for promoting quality in cancer care was first published. This institutional effort is being implemented on a co-operative basis within the context of Spain's decentralised health care system, so a high degree of variability is to be expected. This study was aimed to explore the views of professionals working with multidisciplinary cancer teams and identify which barriers to effective team work should be considered to ensure implementation of health policy. Methods Qualitative interview study with semi-structured, one-to-one interviews. Data were examined inductively, using content analysis to generate categories and an explanatory framework. 39 professionals performing their tasks, wholly or in part, in different multidisciplinary cancer teams were interviewed. The breakdown of participants' medical specialisations was as follows: medical oncologists (n = 10); radiation oncologists (n = 8); surgeons (n = 7); pathologists or radiologists (n = 6); oncology nurses (n = 5); and others (n = 3). Results Teams could be classified into three models of professional co-operation in multidisciplinary cancer care, namely, advisory committee, formal co-adaptation and integrated care process. The following barriers to implementation were posed: existence of different gateways for the same patient profile; variability in development and use of clinical protocols and guidelines; role of the hospital executive board; outcomes assessment; and the recording and documenting of clinical decisions in a multidisciplinary team setting. All these play a key role in the development of cancer teams and their ability to improve quality of care. Conclusion Cancer team development results from an specific adaptation to the hospital environment. Nevertheless, health policy plays an important role in promoting an organisational approach that changes the way in

  2. Oncology nurse navigator role delineation study: an oncology nursing society report.

    PubMed

    Brown, Carlton G; Cantril, Cynthia; McMullen, Lori; Barkley, Dana L; Dietz, Michele; Murphy, Cynthia Miller; Fabrey, Lawrence J

    2012-12-01

    The purpose of the Oncology Nursing Society (ONS) Oncology Nurse Navigator Role Delineation Study was to examine the job-function activities of the oncology nurse navigator, thus providing an understanding of this unique role. The Role Delineation Advisory Committee consisting mainly of oncology nurse navigators was formed to provide content expertise to Applied Measurement Professionals, which conducted the role delineation study. Three hundred and thirty nurses completed the survey. The study clearly defined tasks, knowledge areas, and skills that are very specific to the nurse navigator role; however, the overlap in knowledge with the general oncology nurse role needs to be explored. The ONS Board of Directors and the Oncology Nursing Certification Corporation Board of Directors currently are exploring the need for additional initiatives to help define the role and competencies of the oncology nurse navigator. PMID:23178350

  3. Report from the OECI Oncology Days 2014

    PubMed Central

    van Harten, WH; Stanta, G; Bussolati, G; Riegman, P; Hoefler, G; Becker, KF; Folprecht, G; Truini, M; Haybaeck, J; Buiga, R; Dono, M; Bagg, A; López Guerrero, JA; Zupo, S; Lemare, F; de Lorenzo, F; Goedbloed, N; Razavi, D; Lövey, J; Cadariu, PA; Rollandi, GA; Paparo, F; Pierotti, M; Ciuleanu, T; De Paoli, P; Weiner, G; Saghatchian, M; Lombardo, Claudio

    2014-01-01

    The 2014 OECI Oncology Days was held at the ‘Prof. Dr. Ion Chiricuta’ Oncology Institute in Cluj, Romania, from 12 to 13 June. The focus of this year’s gathering was on developments in personalised medicine and other treatment advances which have made the cost of cancer care too high for many regions throughout Europe. PMID:25624877

  4. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

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

  5. [Oncological intensive care: 2011 year's review].

    PubMed

    Sculier, J P; Berghmans, T; Meert, A P

    2012-01-01

    The objective of this paper is to review the literature published in 2011 in the field of intensive care and emergency related to oncology. Are discussed because of new original publications: prognosis, resuscitation techniques, oncologic emergencies, serious toxicities of cytotoxic chemotherapy and targeted therapies, complicated aplastic anemia, toxicity of bisphosphonates, respiratory complications, pulmonary embolism and neurological complications. PMID:23373125

  6. Art Therapy with an Oncology Care Team

    ERIC Educational Resources Information Center

    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. Attention to…

  7. Clinical Oncology Assistantship Program for Medical Students.

    ERIC Educational Resources Information Center

    Neilan, Barbara A.; And Others

    1985-01-01

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

  8. Perceptions of Oncology as a Medical Specialty.

    ERIC Educational Resources Information Center

    Cassileth, Barrie R.; And Others

    1980-01-01

    The characteristics and prestige associated with oncology and assessed shifts in medical students' perceptions as a result of participation in an oncology course are explored. Respondents were asked to rate the prestige of eight specialities and asked to select characteristics "that best describe each type of specialist." (MLW)

  9. [Consultations in oncological supportive care mono-, multi-, ou interdisciplinary: What should we favour?].

    PubMed

    Garnier, Stéphanie Ranque; Pelletti, Caroline; Quenard, Christelle; Vallet, Fabienne; Lemoine, Patrick; Guastella, Virginie; Rhondali, Wadih

    2015-09-01

    According to the point 7.6 and 7.7 of the Cancer Plan 2014, all cancer patients should have access to supportive care. Indeed, the supportive care consultation in oncology is an important tool for the symptom management of cancer patients at all times of treatment. This consultation can be mono-disciplinary or multi-disciplinary (with different professions: physician, nurse, psychologist, social service assistant…) with or without integration (multidisciplinary or interdisciplinary). There are few studies focusing on the types of consultations (mono- or multidisciplinary) to promote based on their expected outcomes. After describing the different types of consultations (initial, follow-up, unscheduled, discharge) and having highlighted the main issues of these consultations, we will present the possible configurations. Our discussion will concern then the advantages and disadvantages of monodisciplinarity and different types of multidisciplinary highlighting the possible improvements. At the end of this work, after a brief synthesis of the different outcomes associated with each type of consultation, we would like to discuss the type of consultation to choose according to the outcomes. PMID:26031300

  10. [The first 25 years of oncopsychology at the National Institute of Oncology: antecedents and events (1988-2013)].

    PubMed

    Riskó, Ágnes

    2015-09-01

    The first oncopsychological department was established in National Institute of Oncology by Sándor Eckhardt in 1988. At an early stage the specialists who were interested in mental hygiene made a united effort with Katalin Muszbek's oncopsychologic group. Ágnes Riskó was the first specialist who seceded from this group, and she became a permanent member of the onco-hematology group in 1992. Due to the universalized approach, the psyhcologist would become a permanent member of onco-team. The overhand and increasing multidisciplinary cooperation enable to use this accepted method in the daily medical treatment. When necessary, patients' relatives may come in for treatment and this method can help for medical stuff to avoid burnout. As a result of oncopsychology techniques and cooperation of oncologic teamwork the integration of psychosocial intervention into a complex oncologic treatment has already begun. The attendance of supervised onco-psychological specialists is being increased. Our activity contributes to improve our patients' psychosocial standard of living, their cooperation with the medical staff and the atmosphere of oncologic departments. The integration of the approach and methods of psychosocial rehabilitation into the new oncologic professional guideline has also begun. PMID:26339913

  11. Preparing for the future of radiation oncology.

    PubMed

    Buchholz, Thomas A; McBride, William H; Cox, James D

    2007-08-01

    The field of radiation oncology is currently attracting a high number of accomplished MD and PhD graduates who have aspirations of pursuing physician-scientist career paths. This good fortune comes at a time when radiation oncology is in need of professionals interested in contributing to the exciting advances in treatment technologies and molecular oncology and in helping translate advances in these areas into benefits for patients. Although the profession of radiation oncology has done an outstanding job of attracting excellent residents and providing appropriate environments for their continued academic development during residency training, the profession has not fully prepared an infrastructure for accepting these highly qualified individuals into physician-scientist faculty positions. It is very important that radiation oncology develop a more comprehensive strategy to address this need. Doing so will ensure the preservation and growth of the profession. PMID:17660121

  12. Expanding the role of the oncology nurse

    PubMed Central

    Quinn, A

    2008-01-01

    Oncology nursing continues to evolve in response to advances in cancer treatment, information and biotechnology. As new scientific and technological discoveries are integrated into cancer care, oncology nurses need to play a key role in the management of this patient population. The role of the oncology nurse has expanded significantly and can differ greatly across cultures. Sophisticated treatments and the growth of targeted therapies will create the challenge of ensuring that all nurses working in this arena are well-educated, independent thinkers. Thus the future success of oncology nurses will focus on enhancement of nursing practice through advanced education. The increased globalisation of healthcare offers exciting opportunities to accomplish this goal by allowing for collaborative relationships among oncology nurses across the globe. PMID:21611002

  13. Development of a Virtual Multidisciplinary Lung Cancer Tumor Board in a Community Setting

    PubMed Central

    Stevenson, Marvaretta M.; Irwin, Tonia; Lowry, Terry; Ahmed, Maleka Z.; Walden, Thomas L.; Watson, Melanie; Sutton, Linda

    2013-01-01

    Purpose: Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. Methods: Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Results: Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. Conclusion: The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan. PMID:23942505

  14. Localized Pancreatic Cancer: Multidisciplinary Management.

    PubMed

    Coveler, Andrew L; Herman, Joseph M; Simeone, Diane M; Chiorean, E Gabriela

    2016-01-01

    Pancreatic cancer is an aggressive cancer that continues to have single-digit 5-year mortality rates despite advancements in the field. Surgery remains the only curative treatment; however, most patients present with late-stage disease deemed unresectable, either due to extensive local vascular involvement or the presence of distant metastasis. Resection guidelines that include a borderline resectable group, as well as advancements in neoadjuvant chemotherapy and radiation that improve resectability of locally advanced disease, may improve outcomes for patients with more invasive disease. Multi-agent chemotherapy regimens fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) and nab-paclitaxel with gemcitabine improved response rates and survival in metastatic pancreatic cancer and are now being used in earlier stages for patients with localized potentially resectable and unresectable disease, with goals of downstaging tumors to allow margin-negative resection and reducing systemic recurrence. Chemoradiotherapy, although still controversial for both resectable and unresectable pancreatic cancer, is being used in the context of contemporary chemotherapy backbone regimens, and novel radiation techniques such as stereotactic body frame radiation therapy (SBRT) are studied on the premise of maintaining or improving efficacy and reducing treatment duration. Patient selection for optimal treatment designation is currently provided by multidisciplinary tumor boards, but biomarker discovery, in blood, tumors, or through novel imaging, is an area of intense research. Results to date suggest that some patients with unresectable disease at the outset have survival rates as good as those with initially resectable disease if able to undergo surgical resection. Long-term follow-up and improved clinical trials options are needed to determine optimal treatment modalities for patients with localized pancreatic cancer. PMID:27249726

  15. Multidisciplinary Design and Analysis for Commercial Aircraft

    NASA Technical Reports Server (NTRS)

    Cummings, Russell M.; Freeman, H. JoAnne

    1999-01-01

    Multidisciplinary design and analysis (MDA) has become the normal mode of operation within most aerospace companies, but the impact of these changes have largely not been reflected at many universities. On an effort to determine if the emergence of multidisciplinary design concepts should influence engineering curricula, NASA has asked several universities (Virginia Tech, Georgia Tech, Clemson, BYU, and Cal Poly) to investigate the practicality of introducing MDA concepts within their undergraduate curricula. A multidisciplinary team of faculty, students, and industry partners evaluated the aeronautical engineering curriculum at Cal Poly. A variety of ways were found to introduce MDA themes into the curriculum without adding courses or units to the existing program. Both analytic and educational tools for multidisciplinary design of aircraft have been developed and implemented.

  16. Integrating Genomics into Clinical Oncology: Ethical and Social Challenges from Proponents of Personalized Medicine

    PubMed Central

    Settersten, Richard A.; Juengst, Eric T.; Fishman, Jennifer R.

    2013-01-01

    Summary The use of molecular tools to individualize health care, predict appropriate therapies and prevent adverse health outcomes has gained significant traction in the field of oncology, under the banner of “personalized medicine.” Enthusiasm for personalized medicine in oncology has been fueled by success stories of targeted treatments for a variety of cancers based on their molecular profiles. Though these are clear indications of optimism for personalized medicine, little is known about the ethical and social implications of personalized approaches in clinical oncology. The objective of this study is to assess how a range of stakeholders engaged in promoting, monitoring, and providing personalized medicine understand the challenges of integrating genomic testing and targeted therapies into clinical oncology. The study involved the analysis of in-depth interviews with 117 basic scientists, clinician-researchers, clinicians in private practice, health professional educators, representatives of funding agencies, medical journal editors, entrepreneurs, and insurers whose experiences and perspectives on personalized medicine span a wide variety of institutional and professional settings. Despite considerable enthusiasm for this shift, promoters, monitors and providers of personalized medicine identified four domains which will still provoke heightened ethical and social concerns: (1) informed consent for cancer genomic testing, (2) privacy, confidentiality, and disclosure of genomic test results, (3) access to genomic testing and targeted therapies in oncology, and (4) the costs of scaling up pharmacogenomic testing and targeted cancer therapies. These specific concerns are not unique to oncology, or even genomics. However, those most invested in the success of personalized medicine view oncologists’ responses to these challenges as precedent-setting because oncology is farther along the path of clinical integration of genomic technologies than other fields

  17. Bridging Gaps in Multidisciplinary Head and Neck Cancer Care: Nursing Coordination and Case Management

    SciTech Connect

    Wiederholt, Peggy A. Connor, Nadine P.; Hartig, Gregory K.; Harari, Paul M.

    2007-10-01

    Patients with advanced head and neck cancer face not only a life-threatening malignancy, but also a remarkably complex treatment regimen that can affect their cosmetic appearance and ability to speak, breathe, and swallow. These patients benefit from the coordinated interaction of a multidisciplinary team of specialists and a comprehensive plan of care to address their physical and psychosocial concerns, manage treatment-related toxicities, and prevent or limit long-term morbidities affecting health-related quality of life. Although little has been published on patient-provider communication with a multidisciplinary team, evidence has suggested that gaps often occur in communication between patients and providers, as well as between specialists. These communication gaps can hinder the multidisciplinary group from working toward common patient-centered goals in a coordinated 'interdisciplinary' manner. We discuss the role of a head-and-neck oncology nurse coordinator at a single institution in bridging gaps across the continuum of care, promoting an interdisciplinary team approach, and enhancing the overall quality of patient-centered head-and-neck cancer care.

  18. A framework for prescription in exercise-oncology research†

    PubMed Central

    Sasso, John P; Eves, Neil D; Christensen, Jesper F; Koelwyn, Graeme J; Scott, Jessica; Jones, Lee W

    2015-01-01

    The field of exercise-oncology has increased dramatically over the past two decades, with close to 100 published studies investigating the efficacy of structured exercise training interventions in patients with cancer. Of interest, despite considerable differences in study population and primary study end point, the vast majority of studies have tested the efficacy of an exercise prescription that adhered to traditional guidelines consisting of either supervised or home-based endurance (aerobic) training or endurance training combined with resistance training, prescribed at a moderate intensity (50–75% of a predetermined physiological parameter, typically age-predicted heart rate maximum or reserve), for two to three sessions per week, for 10 to 60 min per exercise session, for 12 to 15 weeks. The use of generic exercise prescriptions may, however, be masking the full therapeutic potential of exercise treatment in the oncology setting. Against this background, this opinion paper provides an overview of the fundamental tenets of human exercise physiology known as the principles of training, with specific application of these principles in the design and conduct of clinical trials in exercise-oncology research. We contend that the application of these guidelines will ensure continued progress in the field while optimizing the safety and efficacy of exercise treatment following a cancer diagnosis. PMID:26136187

  19. EMSO: European Multidisciplinary Seafloor Observatory

    NASA Astrophysics Data System (ADS)

    Favali, Paolo

    2010-05-01

    EMSO, a Research Infrastructure listed within ESFRI (European Strategy Forum on Research Infrastructures) Roadmap (Report 2006, http://cordis.europa.eu/esfri/roadmap.htm), is the European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the scientific objective of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes through long time series appropriate to the scale of the phenomena, constituting the new frontier of studying Earth interior, deep-sea biology and chemistry and ocean processes. The development of an underwater network is based on previous EU-funded projects since early '90 and is being supported by several EU initiatives, as the on-going ESONET-NoE, coordinated by IFREMER (2007-2011, http://www.esonet-emso.org/esonet-noe/), and aims at gathering together the Research Community of the Ocean Observatories. In 2006 the FP7 Capacities Programme launched a call for Preparatory Phase (PP) projects, that will provide the support to create the legal and organisational entities in charge of managing the infrastructures, and coordinating the financial effort among the countries. Under this call the EMSO-PP project was approved in 2007 with the coordination of INGV and the participation of other 11 Institutions of 11 countries. The project has started in April 2008 and will last 4 years. The EMSO is a key-infrastructure both for Ocean Sciences and for Solid Earth Sciences. In this respect it will enhance and complement profitably the capabilities of other European research infrastructures such as EPOS, ERICON-Aurora Borealis, and SIOS. The perspective of the synergy among EMSO and other ESFRI Research Infrastructures will be outlined. EMSO Partners: IFREMER-Institut Français de Recherche pour l'exploitation de la mer (France, ref. Roland Person); KDM-Konsortium Deutsche Meeresforschung e.V. (Germany, ref. Christoph

  20. EMSO: European Multidisciplinary Seafloor Observatory

    NASA Astrophysics Data System (ADS)

    Favali, P.; Partnership, Emso

    2009-04-01

    EMSO, a Research Infrastructure listed within ESFRI (European Strategy Forum on Research Infrastructures) Roadmap), is the European-scale network of multidisciplinary seafloor observatories from the Arctic to the Black Sea with the scientific objective of long-term real-time monitoring of processes related to geosphere/biosphere/hydrosphere interactions. EMSO will enhance our understanding of processes through long time series appropriate to the scale of the phenomena, constituting the new frontier of studying Earth interior, deep-sea biology and chemistry and ocean processes. EMSO will reply also to the need expressed in the frame of GMES (Global Monitoring for Environment and Security) to develop a marine segment integrated in the in situ and satellite global monitoring system. The EMSO development relays upon the synergy between the scientific community and the industry to improve the European competitiveness with respect to countries like USA/Canada, NEPTUNE, VENUS and MARS projects, Taiwan, MACHO project, and Japan, DONET project. In Europe the development of an underwater network is based on previous EU-funded projects since early '90, and presently supported by EU initiatives. The EMSO infrastructure will constitute the extension to the sea of the land-based networks. Examples of data recorded by seafloor observatories will be presented. EMSO is presently at the stage of Preparatory Phase (PP), funded in the EC FP7 Capacities Programme. The project has started in April 2008 and will last 4 years with the participation of 12 Institutions representing 12 countries. EMSO potential will be significantly increased also with the interaction with other Research Infrastructures addressed to Earth Science. 2. IFREMER-Institut Français de Recherche pour l'exploitation de la mer (France, ref. Roland Person); KDM-Konsortium Deutsche Meeresforschung e.V. (Germany, ref. Christoph Waldmann); IMI-Irish Marine Institute (Ireland, ref. Michael Gillooly); UTM-CSIC-Unidad de

  1. WE-G-9A-01: Radiation Oncology Outcomes Informatics

    SciTech Connect

    Mayo, C; Miller, R; Sloan, J; Wu, Q; Howell, R

    2014-06-15

    The construction of databases and support software to enable routine and systematic aggregation, analysis and reporting of patient outcomes data is emerging as an important area. “How have results for our patients been affected by the improvements we have made in our practice and in the technologies we use?” To answer this type of fundamental question about the overall pattern of efficacy observed, it is necessary to systematically gather and analyze data on all patients treated within a clinic. Clinical trials answer, in great depth and detail, questions about outcomes for the subsets of patients enrolled in a given trial. However, routine aggregation and analysis of key treatment parameter data and outcomes information for all patients is necessary to recognize emergent patterns that would be of interest from a public health or practice perspective and could better inform design of clinical trials or the evolution of best practice principals. To address these questions, Radiation Oncology outcomes databases need to be constructed to enable combination essential data from a broad group of data types including: diagnosis and staging, dose volume histogram metrics, patient reported outcomes, toxicity metrics, performance status, treatment plan parameters, demographics, DICOM data and demographics. Developing viable solutions to automate aggregation and analysis of this data requires multidisciplinary efforts to define nomenclatures, modify clinical processes and develop software and database tools requires detailed understanding of both clinical and technical issues. This session will cover the developing area of Radiation Oncology Outcomes Informatics. Learning Objectives: Audience will be able to speak to the technical requirements (software, database, web services) which must be considered in designing an outcomes database. Audience will be able to understand the content and the role of patient reported outcomes as compared to traditional toxicity measures

  2. The radiation oncology workforce: a focus on medical dosimetry.

    PubMed

    Robinson, Gregg F; Mobile, Katherine; Yu, Yan

    2014-01-01

    The 2012 Radiation Oncology Workforce survey was conducted to assess the current state of the entire workforce, predict its future needs and concerns, and evaluate quality improvement and safety within the field. This article describes the dosimetrist segment results. The American Society for Radiation Oncology (ASTRO) Workforce Subcommittee, in conjunction with other specialty societies, conducted an online survey targeting all segments of the radiation oncology treatment team. The data from the dosimetrist respondents are presented in this article. Of the 2573 dosimetrists who were surveyed, 890 responded, which resulted in a 35% segment response rate. Most respondents were women (67%), whereas only a third were men (33%). More than half of the medical dosimetrists were older than 45 years (69.2%), whereas the 45 to 54 years age group represented the highest percentage of respondents (37%). Most medical dosimetrists stated that their workload was appropriate (52%), with respondents working a reported average of 41.7 ± 4 hours per week. Overall, 86% of medical dosimetrists indicated that they were satisfied with their career, and 69% were satisfied in their current position. Overall, 61% of respondents felt that there was an oversupply of medical dosimetrists in the field, 14% reported that supply and demand was balanced, and the remaining 25% felt that there was an undersupply. The medical dosimetrists׳ greatest concerns included documentation/paperwork (78%), uninsured patients (80%), and insufficient reimbursement rates (87%). This survey provided an insight into the dosimetrist perspective of the radiation oncology workforce. Though an overwhelming majority has conveyed satisfaction concerning their career, the study allowed a spotlight to be placed on the profession׳s current concerns, such as insufficient reimbursement rates and possible oversupply of dosimetrists within the field. PMID:24630911

  3. The radiation oncology workforce: A focus on medical dosimetry

    SciTech Connect

    Robinson, Gregg F.; Mobile, Katherine; Yu, Yan

    2014-07-01

    The 2012 Radiation Oncology Workforce survey was conducted to assess the current state of the entire workforce, predict its future needs and concerns, and evaluate quality improvement and safety within the field. This article describes the dosimetrist segment results. The American Society for Radiation Oncology (ASTRO) Workforce Subcommittee, in conjunction with other specialty societies, conducted an online survey targeting all segments of the radiation oncology treatment team. The data from the dosimetrist respondents are presented in this article. Of the 2573 dosimetrists who were surveyed, 890 responded, which resulted in a 35% segment response rate. Most respondents were women (67%), whereas only a third were men (33%). More than half of the medical dosimetrists were older than 45 years (69.2%), whereas the 45 to 54 years age group represented the highest percentage of respondents (37%). Most medical dosimetrists stated that their workload was appropriate (52%), with respondents working a reported average of 41.7 ± 4 hours per week. Overall, 86% of medical dosimetrists indicated that they were satisfied with their career, and 69% were satisfied in their current position. Overall, 61% of respondents felt that there was an oversupply of medical dosimetrists in the field, 14% reported that supply and demand was balanced, and the remaining 25% felt that there was an undersupply. The medical dosimetrists' greatest concerns included documentation/paperwork (78%), uninsured patients (80%), and insufficient reimbursement rates (87%). This survey provided an insight into the dosimetrist perspective of the radiation oncology workforce. Though an overwhelming majority has conveyed satisfaction concerning their career, the study allowed a spotlight to be placed on the profession's current concerns, such as insufficient reimbursement rates and possible oversupply of dosimetrists within the field.

  4. Nutrition support in surgical oncology.

    PubMed

    Huhmann, Maureen B; August, David A

    2009-01-01

    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies. PMID:19605805

  5. Pharmacy Instruction in Medical Oncology: Results of a National Survey.

    ERIC Educational Resources Information Center

    Cersosimo, Robert J.

    1989-01-01

    A survey concerning oncology instruction in pharmacy schools found it taught primarily as part of a course in medicinal chemistry/pharmacology or therapeutics. Twenty-one schools offer an oncology course, with others planning them. Oncology clerkships are currently available in 42 schools. Increased emphasis on oncology instruction is encouraged.…

  6. Application of multidisciplinary analysis to gene expression.

    SciTech Connect

    Wang, Xuefel; Kang, Huining; Fields, Chris; Cowie, Jim R.; Davidson, George S.; Haaland, David Michael; Sibirtsev, Valeriy; Mosquera-Caro, Monica P.; Xu, Yuexian; Martin, Shawn Bryan; Helman, Paul; Andries, Erik; Ar, Kerem; Potter, Jeffrey; Willman, Cheryl L.; Murphy, Maurice H.

    2004-01-01

    Molecular analysis of cancer, at the genomic level, could lead to individualized patient diagnostics and treatments. The developments to follow will signal a significant paradigm shift in the clinical management of human cancer. Despite our initial hopes, however, it seems that simple analysis of microarray data cannot elucidate clinically significant gene functions and mechanisms. Extracting biological information from microarray data requires a complicated path involving multidisciplinary teams of biomedical researchers, computer scientists, mathematicians, statisticians, and computational linguists. The integration of the diverse outputs of each team is the limiting factor in the progress to discover candidate genes and pathways associated with the molecular biology of cancer. Specifically, one must deal with sets of significant genes identified by each method and extract whatever useful information may be found by comparing these different gene lists. Here we present our experience with such comparisons, and share methods developed in the analysis of an infant leukemia cohort studied on Affymetrix HG-U95A arrays. In particular, spatial gene clustering, hyper-dimensional projections, and computational linguistics were used to compare different gene lists. In spatial gene clustering, different gene lists are grouped together and visualized on a three-dimensional expression map, where genes with similar expressions are co-located. In another approach, projections from gene expression space onto a sphere clarify how groups of genes can jointly have more predictive power than groups of individually selected genes. Finally, online literature is automatically rearranged to present information about genes common to multiple groups, or to contrast the differences between the lists. The combination of these methods has improved our understanding of infant leukemia. While the complicated reality of the biology dashed our initial, optimistic hopes for simple answers from

  7. Advances in Multi-disciplinary Interoperability

    NASA Astrophysics Data System (ADS)

    Pearlman, J.; Nativi, S.; Craglia, M.; Huerta, J.; Rubio-Iglesias, J. M.; Serrano, J. J.

    2012-04-01

    The challenge for addressing issues such as climate change, food security or ecosystem sustainability is that they require multi-disciplinary collaboration and the ability to integrate information across scientific domains. Multidisciplinary collaborations are difficult because each discipline has its own "language", protocols and formats for communicating within its community and handling data and information. EuroGEOSS demonstrates the added value to the scientific community and to society of making existing systems and applications interoperable and useful within the GEOSS and INSPIRE frameworks. In 2010, the project built an initial operating capacity of a multi-disciplinary Information System addressing three areas: drought, forestry and biodiversity. It is now furthering this development into an advanced operating capacity (http://www.eurogeoss.eu). The key to this capability is the creation of a broker that supports access to multiple resources through a common user interface and the automation of data search and access using state of the art information technology. EuroGEOSS hosted a conference on information systems and multi-disciplinary applications of science and technology. "EuroGEOSS: advancing the vision of GEOSS" provided a forum for developers, users and decision-makers working with advanced multi-disciplinary information systems to improve science and decisions for complex societal issues. In particular, the Conference addressed: Information systems for supporting multi-disciplinary research; Information systems and modeling for biodiversity, drought, forestry and related societal benefit areas; and Case studies of multi-disciplinary applications and outcomes. This paper will discuss the major finding of the conference and the directions for future development.

  8. The impact of a new acute oncology service in acute hospitals: experience from the Clatterbridge Cancer Centre and Merseyside and Cheshire Cancer Network.

    PubMed

    Neville-Webbe, H L; Carser, J E; Wong, H; Andrews, J; Poulter, T; Smith, R; Marshall, E

    2013-12-01

    The 2008 National Confidential Enquiry into Patient Outcomes and Death highlighted an urgent need to improve the quality, safety and efficiency of care for cancer patients following emergency presentation to acute general hospitals. A network-wide acute oncology service (AOS) was therefore commissioned and implemented on the basis of recommendations from the National Chemotherapy Advisory Group (NCAG). Through a continuous programme of raising awareness regarding both the role of the AOS and the necessity of early patient referral to acute oncology teams, we have been able to establish an AOS across all acute trusts in our cancer network. The network-wide AOS has improved communication across clinical teams, enabled rapid review of over 3,000 patients by oncology staff, reduced hospital stay, increased understanding of oncology emergencies and their treatment, and enhanced pathways for rapid diagnosis and appropriate referrals for patients presenting with malignancy of undefined origin (MUO). These achievements have been made by developing a network protocol book for managing common oncology emergencies, by introducing local pathways for managing MUO and by collaborating with palliative care teams to introduce local acute oncology (AO) multi-disciplinary team (MDT) meetings. PMID:24298102

  9. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    PubMed

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-02-20

    The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for

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

    PubMed

    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. PMID:22364244

  11. Current Views on Clinical Oncology Training from the 2015 Oncology Registrars' Forum Survey.

    PubMed

    Kosmin, M; Brown, S; Hague, C; Said, J; Wells, L; Wilson, C

    2016-09-01

    The major role of the Oncology Registrars' Forum (ORF) of the Royal College of Radiologists is to voice the opinions of the clinical oncology trainee body and work towards improving all aspects of clinical oncology training in the UK. In order to provide data to support these efforts, the ORF undertakes a biennial survey of all trainees. As with the previous surveys, this year's ORF survey produced data that highlight areas of good training as well as new and ongoing areas of concern. This summary highlights the key survey results and provides recommendations for improving the delivery of clinical oncology training in the UK. PMID:27184941

  12. American Society of Pediatric Hematology/Oncology

    MedlinePlus

    ... 2016 Engage with ASPHO and benefit from the Society’s professional development, education, and networking resources! Read More » ... Career Center Mentoring Funding Compensation Survey © The American Society of Pediatric Hematology/Oncology 8735 W. Higgins Road, ...

  13. Robot-Assisted Gynecologic Oncology Surgery

    MedlinePlus

    ROBOTIC-ASSISTED GYNECOLOGIC ONCOLOGY PROCEDURE HALIFAX HEALTH DAYTONA BEACH, FLORIDA April 24, 2008 00:00:11 KELLY ... You're just minutes away from seeing a robotic-assisted laparoscopic gynecological case live. This very progressive ...

  14. [Current problems in pediatric ophthalmologic oncology].

    PubMed

    Krásný, J; Koutecký, J; Mottl, H

    1991-09-01

    The authors give an account of contemporary problems of child ophthalmological oncology from the paediatrician's aspect. The most serious intraocular tumors are retinoblastomas, in the orbitopalpebral area rhabdomyosarcomas. The authors draw attention to the five main alarming symptoms typical for tumorous processes at these sites: red painful eye, leukokoria, acute visual failure, acute strabism and various rapidly developing protrusions of the bulbus. Subsequently they inform on possible ophthalmological complications of comprehensive oncological treatment. PMID:1751981

  15. Demystified … Molecular pathology in oncology

    PubMed Central

    Crocker, J

    2002-01-01

    In the past 10 years, molecular biology has found major applications in pathology, particularly in oncology. This has been a field of enormous expansion, where pure science has found a place in clinical practice and is now of everyday use in any academic unit. This demystified review will discuss the techniques used in molecular pathology and then provide examples of how these can be used in oncology. PMID:12456768

  16. Towards a Science of Tumor Forecast for Clinical Oncology

    DOE PAGESBeta

    Yankeelov, Tom; Quaranta, Vito; Evans, Katherine J; Rericha, Erin

    2015-01-01

    We propose that the quantitative cancer biology community make a concerted effort to apply the methods of weather forecasting to develop an analogous theory for predicting tumor growth and treatment response. Currently, the time course of response is not predicted, but rather assessed post hoc by physical exam or imaging methods. This fundamental limitation of clinical oncology makes it extraordinarily difficult to select an optimal treatment regimen for a particular tumor of an individual patient, as well as to determine in real time whether the choice was in fact appropriate. This is especially frustrating at a time when a panoplymore » of molecularly targeted therapies is available, and precision genetic or proteomic analyses of tumors are an established reality. By learning from the methods of weather and climate modeling, we submit that the forecasting power of biophysical and biomathematical modeling can be harnessed to hasten the arrival of a field of predictive oncology. With a successful theory of tumor forecasting, it should be possible to integrate large tumor specific datasets of varied types, and effectively defeat cancer one patient at a time.« less

  17. Toward a science of tumor forecasting for clinical oncology

    SciTech Connect

    Yankeelov, Thomas E.; Quaranta, Vito; Evans, Katherine J.; Rericha, Erin C.

    2015-03-15

    We propose that the quantitative cancer biology community makes a concerted effort to apply lessons from weather forecasting to develop an analogous methodology for predicting and evaluating tumor growth and treatment response. Currently, the time course of tumor response is not predicted; instead, response is only assessed post hoc by physical examination or imaging methods. This fundamental practice within clinical oncology limits optimization of a treatment regimen for an individual patient, as well as to determine in real time whether the choice was in fact appropriate. This is especially frustrating at a time when a panoply of molecularly targeted therapies is available, and precision genetic or proteomic analyses of tumors are an established reality. By learning from the methods of weather and climate modeling, we submit that the forecasting power of biophysical and biomathematical modeling can be harnessed to hasten the arrival of a field of predictive oncology. Furthermore, with a successful methodology toward tumor forecasting, it should be possible to integrate large tumor-specific datasets of varied types and effectively defeat one cancer patient at a time.

  18. Toward a science of tumor forecasting for clinical oncology

    DOE PAGESBeta

    Yankeelov, Thomas E.; Quaranta, Vito; Evans, Katherine J.; Rericha, Erin C.

    2015-03-15

    We propose that the quantitative cancer biology community makes a concerted effort to apply lessons from weather forecasting to develop an analogous methodology for predicting and evaluating tumor growth and treatment response. Currently, the time course of tumor response is not predicted; instead, response is only assessed post hoc by physical examination or imaging methods. This fundamental practice within clinical oncology limits optimization of a treatment regimen for an individual patient, as well as to determine in real time whether the choice was in fact appropriate. This is especially frustrating at a time when a panoply of molecularly targeted therapiesmore » is available, and precision genetic or proteomic analyses of tumors are an established reality. By learning from the methods of weather and climate modeling, we submit that the forecasting power of biophysical and biomathematical modeling can be harnessed to hasten the arrival of a field of predictive oncology. Furthermore, with a successful methodology toward tumor forecasting, it should be possible to integrate large tumor-specific datasets of varied types and effectively defeat one cancer patient at a time.« less

  19. Multidisciplinary Approach to Linear Aerospike Nozzle Optimization

    NASA Technical Reports Server (NTRS)

    Korte, J. J.; Salas, A. O.; Dunn, H. J.; Alexandrov, N. M.; Follett, W. W.; Orient, G. E.; Hadid, A. H.

    1997-01-01

    A model of a linear aerospike rocket nozzle that consists of coupled aerodynamic and structural analyses has been developed. A nonlinear computational fluid dynamics code is used to calculate the aerodynamic thrust, and a three-dimensional fink-element model is used to determine the structural response and weight. The model will be used to demonstrate multidisciplinary design optimization (MDO) capabilities for relevant engine concepts, assess performance of various MDO approaches, and provide a guide for future application development. In this study, the MDO problem is formulated using the multidisciplinary feasible (MDF) strategy. The results for the MDF formulation are presented with comparisons against sequential aerodynamic and structural optimized designs. Significant improvements are demonstrated by using a multidisciplinary approach in comparison with the single- discipline design strategy.

  20. Multidisciplinary management for esophageal and gastric cancer

    PubMed Central

    Boniface, Megan M; Wani, Sachin B; Schefter, Tracey E; Koo, Phillip J; Meguid, Cheryl; Leong, Stephen; Kaplan, Jeffrey B; Wingrove, Lisa J; McCarter, Martin D

    2016-01-01

    The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical), and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. PMID:27217796

  1. Multidisciplinary Concurrent Design Optimization via the Internet

    NASA Technical Reports Server (NTRS)

    Woodard, Stanley E.; Kelkar, Atul G.; Koganti, Gopichand

    2001-01-01

    A methodology is presented which uses commercial design and analysis software and the Internet to perform concurrent multidisciplinary optimization. The methodology provides a means to develop multidisciplinary designs without requiring that all software be accessible from the same local network. The procedures are amenable to design and development teams whose members, expertise and respective software are not geographically located together. This methodology facilitates multidisciplinary teams working concurrently on a design problem of common interest. Partition of design software to different machines allows each constituent software to be used on the machine that provides the most economy and efficiency. The methodology is demonstrated on the concurrent design of a spacecraft structure and attitude control system. Results are compared to those derived from performing the design with an autonomous FORTRAN program.

  2. Multidisciplinary Approach to Aerospike Nozzle Design

    NASA Technical Reports Server (NTRS)

    Korte, J. J.; Salas, A. O.; Dunn, H. J.; Alexandrov, N. M.; Follett, W. W.; Orient, G. E.; Hadid, A. H.

    1997-01-01

    A model of a linear aerospike rocket nozzle that consists of coupled aerodynamic and structural analyses has been developed. A nonlinear computational fluid dynamics code is used to calculate the aerodynamic thrust, and a three-dimensional finite-element model is used to determine the structural response and weight. The model will be used to demonstrate multidisciplinary design optimization (MDO) capabilities for relevant engine concepts, assess performance of various MDO approaches, and provide a guide for future application development. In this study, the MDO problem is formulated using the multidisciplinary feasible (MDF) strategy. The results for the MDF formulation are presented with comparisons against separate aerodynamic and structural optimized designs. Significant improvements are demonstrated by using a multidisciplinary approach in comparison with the single-discipline design strategy.

  3. ‘One-stop shop’: lung cancer patients’ and caregivers’ perceptions of multidisciplinary care in a community healthcare setting

    PubMed Central

    Kedia, Satish K.; Ward, Kenneth D.; Digney, Siri A.; Jackson, Bianca M.; Nellum, April L.; McHugh, Laura; Roark, Kristina S.; Osborne, Orion T.; Crossley, Fayre J.; Faris, Nicholas

    2015-01-01

    Background Multidisciplinary care is rarely practiced in community healthcare settings where the majority of patients receive lung cancer care in the US. We sought direct input from patients and their informal caregivers on their experience of lung cancer care delivery. Methods We conducted focus groups of patient and caregiver dyads. Patients had received care for lung cancer in or out of a multidisciplinary thoracic oncology clinic coordinated by a nurse navigator. Focus groups were audiotaped, transcribed, and analyzed using Creswell’s 7-step process. Recurring overlapping themes were developed using constant comparative methods within the Grounded Theory framework. Results A total of 46 participants were interviewed in focus groups of 5 patient-caregiver dyads. Overlapping themes were a perception that multidisciplinary care improved physician collaboration, patient-physician communication, and patient convenience, while reducing redundancy in testing. Improved coordination decreased confusion, stress, and anxiety. Negative experience of serial care included poor communication among physicians, insensitive communication about illness, delays in diagnosis and treatment, misdiagnosis, and mistreatment. Physician-to-physician communication and patient education were suggested areas for improvement in the multidisciplinary model. Conclusions Multidisciplinary care was perceived as more patient-centered, effective, safe, and efficient than standard serial care. It was also believed to improve the timeliness of care and equitable access to high quality care. Additional studies to compare these perspectives to those of other key stakeholders, including clinicians, hospital administrators and representatives of third party payers, will facilitate better understanding of the role of multidisciplinary care programs in lung cancer care delivery. PMID:26380187

  4. Addressing Low Literacy and Health Literacy in Clinical Oncology Practice

    PubMed Central

    Garcia, Sofia F.; Hahn, Elizabeth A.; Jacobs, Elizabeth A.

    2011-01-01

    Low functional literacy and low health literacy continue to be under-recognized and are associated with poorer patient health outcomes. Health literacy is a dynamic state influenced by how well a healthcare system delivers information and services that match patients’ abilities, needs and preferences. Oncology care poses considerable health literacy demands on patients who are expected to process high stakes information about complex multidisciplinary treatment over lengths of time. Much of the information provided to patients in clinical care and research is beyond their literacy levels. In this paper, we provide an overview of currently available guidelines and resources to improve how the needs of patients with diverse literacy skills are met by cancer care providers and clinics. We present recommendations for health literacy assessment in clinical practice and ways to enhance the usability of health information and services by improving written materials and verbal communication, incorporating multimedia and culturally appropriate approaches, and promoting health literacy in cancer care settings. The paper also includes a list of additional resources that can be used to develop and implement health literacy initiatives in cancer care clinics. PMID:20464884

  5. Development of inpatient oncology educational and support programs.

    PubMed

    Grassman, D

    1993-05-01

    Support programs are needed to help patients manage the overwhelming emotions they experience when diagnosed and treated for cancer. Although many cancer support groups exist, most programs are designed for outpatients. Support groups for hospitalized patients and their families are an excellent way to provide greatly needed education and support to those who otherwise might not be able or willing to attend outpatient programs. Inpatient programs also offer the opportunity to provide support to people at the onset of diagnosis and treatment--a time when these services are particularly needed. This paper describes special considerations regarding the establishment of inpatient educational and support programs. The evolution of the Oncology Health Management Program of the Bay Pines VA Medical Center in Bay Pines, FL, also is presented. This multidisciplinary program for inpatients includes classes in spiritual support, family support, patient support, symptom management, stress management, and laughter therapy. Evaluation of the program revealed that classes that related symptom management were most useful and that laughter therapy and emotional support were reported to be highly beneficial as well. Nursing staff also gained from their participation in leading the program and expressed greater self-awareness and self-esteem. This has resulted in improved job satisfaction and staff retention as well as in more sensitive and compassionate delivery of patient care. These findings show that providing inpatient educational and support programs is an effective means of meeting the physical, mental, emotional, and spiritual needs of patients with cancer and their families. PMID:7686668

  6. Assessing multi-disciplinary Earth observation impacts on societal benefits

    NASA Astrophysics Data System (ADS)

    Pearlman, J.

    2011-12-01

    Multi-disciplinary interactions are becoming more important as demands for science-driven information needed for decision-making are increasing. Further development of systems to improve the scientific understanding of Earth's system and its response to natural or human-induced changes are required to meet this need. These would facilitate modeling and analyses in many critical areas such as climate prediction, food security, water availability and ecosystem sustainability among others. It is intuitive that better information will have a positive impact on decision outcomes. Yet this is difficult to quantitate. The impacts of multi-disciplinary work are particularly difficult to assess, yet it is hard to predict climate change without considering oceans, land use and many other Earth system characteristics. There are several steps that are important to quantitate the benefits. Some of these have been discussed at IIASA, RFI and other centers of excellence in this area. The key is to establish a program with metrics, a community of practice to propagate the metrics and clear case studies that will demonstrate effectiveness. A workshop was held to set the foundations for this approach and recommendations from a team of global experts are evolving into a program. This presentation discusses the indicators and metrics, examines their efficacy and looks at a case study to assess and validate the development.

  7. Development and validation of a single-cell network profiling assay-based classifier to predict response to induction therapy in paediatric patients with de novo acute myeloid leukaemia: a report from the Children's Oncology Group.

    PubMed

    Lacayo, Norman J; Alonzo, Todd A; Gayko, Urte; Rosen, David B; Westfall, Matt; Purvis, Norman; Putta, Santosh; Louie, Brent; Hackett, James; Cohen, Aileen Cleary; Cesano, Alessandra; Gerbing, Robert; Ravindranath, Yaddanapudi; Dahl, Gary V; Gamis, Alan; Meshinchi, Soheil

    2013-07-01

    Single cell network profiling (SCNP) is a multi-parameter flow cytometry technique for simultaneous interrogation of intracellular signalling pathways. Diagnostic paediatric acute myeloid leukaemia (AML) bone marrow samples were used to develop a classifier for response to induction therapy in 53 samples and validated in an independent set of 68 samples. The area under the curve of a receiver operating characteristic curve (AUC(ROC)) was calculated to be 0·85 in the training set and after exclusion of induction deaths, the AUC(ROC) of the classifier was 0·70 (P = 0·02) and 0·67 (P = 0·04) in the validation set when induction deaths (intent to treat) were included. The highest predictive accuracy was noted in the cytogenetic intermediate risk patients (AUC(ROC) 0·88, P = 0·002), a subgroup that lacks prognostic/predictive biomarkers for induction response. Only white blood cell count and cytogenetic risk were associated with response to induction therapy in the validation set. After controlling for these variables, the SCNP classifier score was associated with complete remission (P = 0·017), indicating that the classifier provides information independent of other clinical variables that were jointly associated with response. This is the first validation of an SCNP classifier to predict response to induction chemotherapy. Herein we demonstrate the usefulness of quantitative SCNP under modulated conditions to provide independent information on AML disease biology and induction response. PMID:23682827

  8. Molecular oncology of lung cancer.

    PubMed

    Toyooka, Shinichi; Mitsudomi, Tetsuya; Soh, Junichi; Aokage, Keiju; Yamane, Masaomi; Oto, Takahiro; Kiura, Katsuyuki; Miyoshi, Shinichiro

    2011-08-01

    Progress in genetic engineering has made it possible to elucidate the molecular biological abnormalities in lung cancer. Mutations in KRAS and P53 genes, loss of specific alleles, and DNA methylation of the tumor suppressor genes were the major abnormalities investigated between 1980 and the 2000s. In 2004, mutations in the epidermal growth factor receptor (EGFR) gene that cause oncogene addiction were discovered in non-small-cell lung cancers (NSCLCs), especially in adenocarcinomas. Because they are strongly associated with sensitivity to EGFR-tyrosine kinase inhibitors (EGFR-TKIs), a great deal of knowledge has been acquired in regard to both EGFR and other genes in the EGFR family and their downstream genes. Moreover, in 2007 the existence of the echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene was discovered in NSCLC; and the same as EGFR-TKIs, ALK inhibitors are being found to be highly effective in lung cancers that have this translocation. These discoveries graphically illustrate that molecular biological findings are directly linked to the development of clinical oncology and to improving the survival rates of lung cancer patients. Here, we review the remarkable progress in molecular biological knowledge acquired thus far in regard to lung cancer, especially NSCLC, and the future possibilities. PMID:21850578

  9. Spirituality and religion in oncology.

    PubMed

    Peteet, John R; Balboni, Michael J

    2013-01-01

    Despite the difficulty in clearly defining and measuring spirituality, a growing literature describes its importance in oncology and survivorship. Religious/spiritual beliefs influence patients' decision-making with respect to both complementary therapies and aggressive care at the end of life. Measures of spirituality and spiritual well-being correlate with quality of life in cancer patients, cancer survivors, and caregivers. Spiritual needs, reflective of existential concerns in several domains, are a source of significant distress, and care for these needs has been correlated with better psychological and spiritual adjustment as well as with less aggressive care at the end of life. Studies show that while clinicians such as nurses and physicians regard some spiritual care as an appropriate aspect of their role, patients report that they provide it infrequently. Many clinicians report that their religious/spiritual beliefs influence their practice, and practices such as mindfulness have been shown to enhance clinician self-care and equanimity. Challenges remain in the areas of conceptualizing and measuring spirituality, developing and implementing training for spiritual care, and coordinating and partnering with chaplains and religious communities. PMID:23625473

  10. Emerging therapeutic aspects in oncology

    PubMed Central

    MacEwan, David J

    2013-01-01

    Cancer remains a peculiarly stubborn disease to treat. Some forms of cancer have seen tremendous advances in the effectiveness of their treatments, whereas other forms have remained resistant to pharmacological control. This lack of hope for success is in part due to the types of drugs that are used in the clinic, and the targeted biological system being based purely on cellular growth rates. However, recent drugs designed to affect specific signalling pathways or proteins have been showing much success. Thanks to the ingenuity of pharmacologists in understanding and targeting these processes, there have been real improvements in treatment. Here we are presented with some of the research into such critical systems that have to be understood, so that they can be conquered. We will also look at the challenges facing cancer pharmacologists and what the field may present to us all in the future. Linked Articles This article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-8 PMID:23889318

  11. Surgeons' views on multi-disciplinary breast meetings.

    PubMed

    Macaskill, E J; Thrush, S; Walker, E M; Dixon, J M

    2006-05-01

    The aim of this study was to assess surgeons' views and their current commitments to multi-disciplinary breast meetings (MDMs). Two hundred and fifty questionnaires were sent out to registered members of the British Association of Surgical Oncology. Hundred and fifty-three were returned (reply rate 61.2%), of which 136 were suitable for analysis. All those who replied were involved in MDMs. 80.9% held MDMs once a week. Only 28% of MDMs were held during a protected session. Over 95% of surgeons and breast care nurses were present for the whole meeting. Radiologists and pathologists were present for the whole meeting in 90-95% of cases. In contrast, clinical oncologists were present for the whole MDM in 70% of cases and medical oncologists attended the whole meeting in only 44.1% of cases. There was variability in which patients were discussed in MDMs, and in many centres not all patients with cancer were discussed before surgery. Suggestions for improvement of MDMs included more time on protected sessions (72.8% in favour), time to prepare for meetings (29% in favour), allocation of a designated co-ordinator (30.9% in favour) and attendance of oncologists for the whole meeting (over 35% in favour). The majority of Breast MDMs were held at breakfast, lunch or the evening. There was variable attendance with a significant percentage of both clinical and medical oncologists not being present for the whole meeting. A quarter of units did not discuss patients with breast cancer before operation. This study shows that there is a need to improve provision for MDMs and to produce guidelines for these meetings. PMID:16516461

  12. Inception of a national multidisciplinary registry for stereotactic radiosurgery.

    PubMed

    Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

    2016-01-01

    Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway. PMID

  13. 78 FR 63224 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... 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 Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

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

    SciTech Connect

    Jagsi, Reshma; Bekelman, Justin E.; Brawley, Otis W.; Deasy, Joseph O.; Le, Quynh-Thu; Michalski, Jeff M.; Movsas, Benjamin; Thomas, Charles R.; Lawton, Colleen A.; Lawrence, Theodore S.; Hahn, Stephen M.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    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 Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

  16. Virtual Oncological Networks--IT Support for an Evidence-based, Oncological Health Care Management.

    PubMed

    Heiden, Katja; Sinha, Monika; Böckmann, Britta

    2015-01-01

    An interdisciplinary and intersectoral coordinated therapy management along Clinical Practice Guidelines can ensure that all patients receive adequate diagnostic, treatment, and supportive services that lead most likely to optimal outcomes. Within the research project "Virtual Oncological Networks", guideline-compliant pathways are defined and enacted within a Health Care Management Platform to support treatment planning and ongoing care of oncological diseases. PMID:26262255

  17. Enhancing the role of case-oriented peer review to improve quality and safety in radiation oncology: Executive summary

    PubMed Central

    Marks, Lawrence B.; Adams, Robert D.; Pawlicki, Todd; Blumberg, Albert L.; Hoopes, David; Brundage, Michael D.; Fraass, Benedick A.

    2013-01-01

    This report is part of a series of white papers commissioned for the American Society for Radiation Oncology (ASTRO) Board of Directors as part of ASTRO's Target Safely Campaign, focusing on the role of peer review as an important component of a broad safety/quality assurance (QA) program. Peer review is one of the most effective means for assuring the quality of qualitative, and potentially controversial, patient-specific decisions in radiation oncology. This report summarizes many of the areas throughout radiation therapy that may benefit from the application of peer review. Each radiation oncology facility should evaluate the issues raised and develop improved ways to apply the concept of peer review to its individual process and workflow. This might consist of a daily multidisciplinary (eg, physicians, dosimetrists, physicists, therapists) meeting to review patients being considered for, or undergoing planning for, radiation therapy (eg, intention to treat and target delineation), as well as meetings to review patients already under treatment (eg, adequacy of image guidance). This report is intended to clarify and broaden the understanding of radiation oncology professionals regarding the meaning, roles, benefits, and targets for peer review as a routine quality assurance tool. It is hoped that this work will be a catalyst for further investigation, development, and study of the efficacy of peer review techniques and how these efforts can help improve the safety and quality of our treatments. PMID:24175002

  18. Next steps for adolescent and young adult oncology workshop: An update on progress and recommendations for the future.

    PubMed

    Smith, Ashley Wilder; Seibel, Nita L; Lewis, Denise R; Albritton, Karen H; Blair, Donald F; Blanke, Charles D; Bleyer, W Archie; Freyer, David R; Geiger, Ann M; Hayes-Lattin, Brandon; Tricoli, James V; Wagner, Lynne I; Zebrack, Bradley J

    2016-04-01

    Each year, 70,000 adolescents and young adults (AYAs) between ages 15 and 39 years in the United States are diagnosed with cancer. In 2006, a National Cancer Institute (NCI) Progress Review Group (PRG) examined the state of science associated with cancer among AYAs. To assess the impact of the PRG and examine the current state of AYA oncology research, the NCI, with support from the LIVESTRONG Foundation, sponsored a workshop entitled "Next Steps in Adolescent and Young Adult Oncology" on September 16 and 17, 2013, in Bethesda, Maryland. This report summarizes the findings from the workshop, opportunities to leverage existing data, and suggestions for future research priorities. Multidisciplinary teams that include basic scientists, epidemiologists, trialists, biostatisticians, clinicians, behavioral scientists, and health services researchers will be essential for future advances for AYAs with cancer. Cancer 2016;122:988-999. © 2016 American Cancer Society. PMID:26849003

  19. Using Baldrige Performance Excellence Program Approaches in the Pursuit of Radiation Oncology Quality Care, Patient Satisfaction, and Workforce Commitment

    PubMed Central

    Sternick, Edward S.

    2011-01-01

    The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance US business competitiveness and economic growth. Administered by the National Institute of Standards and Technology, the Act created the Baldrige National Quality Program, recently renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well-suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self-assessment approach is used for radiotherapy program evaluation and development in order to generate a fact-based, knowledge-driven system for improving quality of care, increasing patient satisfaction, enhancing leadership effectiveness, building employee engagement, and boosting organizational innovation. This methodology also provides a valuable framework for benchmarking an individual radiation oncology practice's operations and results against guidelines defined by accreditation and professional organizations and regulatory agencies. PMID:22655229

  20. Improving Care in Pediatric Neuro-oncology Patients: An Overview of the Unique Needs of Children With Brain Tumors.

    PubMed

    Fischer, Cheryl; Petriccione, Mary; Donzelli, Maria; Pottenger, Elaine

    2016-03-01

    Brain tumors represent the most common solid tumors in childhood, accounting for almost 25% of all childhood cancer, second only to leukemia. Pediatric central nervous system tumors encompass a wide variety of diagnoses, from benign to malignant. Any brain tumor can be associated with significant morbidity, even when low grade, and mortality from pediatric central nervous system tumors is disproportionately high compared to other childhood malignancies. Management of children with central nervous system tumors requires knowledge of the unique aspects of care associated with this particular patient population, beyond general oncology care. Pediatric brain tumor patients have unique needs during treatment, as cancer survivors, and at end of life. A multidisciplinary team approach, including advanced practice nurses with a specialty in neuro-oncology, allows for better supportive care. Knowledge of the unique aspects of care for children with brain tumors, and the appropriate interventions required, allows for improved quality of life. PMID:26245798

  1. The National Oncology Working Group (NOW) initiative: payer and provider collaborations in oncology benefits management.

    PubMed

    Soper, Aileen M; Reeder, C E; Brown, Loreen M; Stojanovska, Ana; Lennert, Barbara J

    2010-04-01

    Payers recognize the need to expand benefits management for oncology but struggle to find effective solutions amid the complexity of available therapies and skepticism from oncologists, who are facing their own set of economic pressures. An effort called the National Oncology Working Group (NOW) Initiative is trying to change the sometimes adversarial relationship between payers and oncologists through a collaborative model. The group, which is supported by pharmaceutical manufacturer sanofi-aventis, is developing patient-centered strategies for successful and sustainable oncology benefits management. The focus includes finding consensus between payers and providers and devising solutions for oncology management such as decreasing variability of cancer care and improving end-of-life care for patients with terminal illness. NOW is designing tools that will be tested in small-scale regional demonstration projects, which NOW participants anticipate will set an example for successful oncology benefits management that can be replicated and expanded. PMID:20370311

  2. American Society of Clinical Oncology Policy Statement on Clinical Pathways in Oncology.

    PubMed

    Zon, Robin T; Frame, James N; Neuss, Michael N; Page, Ray D; Wollins, Dana S; Stranne, Steven; Bosserman, Linda D

    2016-03-01

    The use of clinical pathways in oncology care is increasingly important to patients and oncology providers as a tool for enhancing both quality and value. However, with increasing adoption of pathways into oncology practice, concerns have been raised by ASCO members and other stakeholders. These include the process being used for pathway development, the administrative burdens on oncology practices of reporting on pathway adherence, and understanding the true impact of pathway use on patient health outcomes. To address these concerns, ASCO's Board of Directors established a Task Force on Clinical Pathways, charged with articulating a set of recommendations to improve the development of oncology pathways and processes, allowing the demonstration of pathway concordance in a manner that promotes evidence-based, high-value care respecting input from patients, payers, and providers. These recommendations have been approved and adopted by ASCO's Board of Directors on August 12, 2015, and are presented herein. PMID:26759491

  3. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    PubMed

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-01-01

    Answer questions and earn CME/CNE The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made. PMID:26641959

  4. How to use molecular markers when caring for a patient with brain cancer: 1P/19Q as a predictive and prognostic marker in the neuro-oncology clinic.

    PubMed

    van den Bent, M J

    2013-01-01

    Although the central role of 1p/19q codeletion in oligodendroglioma was established almost two decades ago, apart from clear prognostic significance the implications for clinical care have been less clear. This has changed with the long-term follow-up analysis of the EORTC and RTOG trials on procarbazine, lomustine, and vincristine (PCV) chemotherapy in anaplastic oligodendroglioma. These have shown that 1p/19q loss in these tumors is predictive of overall survival benefit of the addition of PCV chemotherapy to radiotherapy. PMID:23714473

  5. Single-Cell Sequencing Technology in Oncology: Applications for Clinical Therapies and Research

    PubMed Central

    Ye, Baixin; Gao, Qingping; Zeng, Zhi; Stary, Creed M.; Jian, Zhihong; Xiong, Xiaoxing; Gu, Lijuan

    2016-01-01

    Cellular heterogeneity is a fundamental characteristic of many cancers. A lack of cellular homogeneity contributes to difficulty in designing targeted oncological therapies. Therefore, the development of novel methods to determine and characterize oncologic cellular heterogeneity is a critical next step in the development of novel cancer therapies. Single-cell sequencing (SCS) technology has been recently employed for analyzing the genetic polymorphisms of individual cells at the genome-wide level. SCS requires (1) precise isolation of the single cell of interest; (2) isolation and amplification of genetic material; and (3) descriptive analysis of genomic, transcriptomic, and epigenomic data. In addition to targeted analysis of single cells isolated from tumor biopsies, SCS technology may be applied to circulating tumor cells, which may aid in predicting tumor progression and metastasis. In this paper, we provide an overview of SCS technology and review the current literature on the potential application of SCS to clinical oncology and research. PMID:27313981

  6. Thoughts about multidisciplinary, interdisciplinary, and transdisciplinary research.

    PubMed

    Fawcett, Jacqueline

    2013-10-01

    This essay focuses on multidisciplinary, interdisciplinary, and transdisciplinary research. The definitions and objectives for these three types of multiple discipline research are given. Discussion centers on the gains and losses that may be experienced by individual nurses who engage in such research, as well as gains and losses for the discipline of nursing. PMID:24085679

  7. The Taliesin Project: Multidisciplinary Education and Multimedia.

    ERIC Educational Resources Information Center

    Smith, Eric E.; Westhoff, Guy M.

    1992-01-01

    Describes the Taliesin Project, a current curriculum materials research and development effort whose main goals are (1) the development of a computer-aided classroom instructional tool for grades six through eight based on hypermedia technology, and (2) the development of a multidisciplinary curriculum to help develop stronger interests in…

  8. Stronger Disciplinary Identities in Multidisciplinary Research Schools

    ERIC Educational Resources Information Center

    Geschwind, Lars; Melin, Göran

    2016-01-01

    In this study, two multidisciplinary Social Sciences and Humanities research schools in Sweden have been investigated regarding disciplinary identity-making. This study investigates the meetings between different disciplines around a common thematic area of study for Ph.D. students. The Ph.D. students navigate through a complex social and…

  9. 34 CFR 303.17 - Multidisciplinary.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Multidisciplinary. 303.17 Section 303.17 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS...

  10. International Multidisciplinary Artificial Gravity (IMAG) Project

    NASA Technical Reports Server (NTRS)

    Laurini, Kathy

    2007-01-01

    This viewgraph presentation reviews the efforts of the International Multidisciplinary Artificial Gravity Project. Specifically it reviews the NASA Exploration Planning Status, NASA Exploration Roadmap, Status of Planning for the Moon, Mars Planning, Reference health maintenance scenario, and The Human Research Program.