78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

..., USA, Inc., Oncology Care Systems (Radiation Oncology), Including On-Site Leased Workers From Source... Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), including on- site leased... of February 2013, Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology...

Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey.

PubMed

Kamisli, S; Yuce, D; Karakilic, B; Kilickap, S; Hayran, M

2017-09-01

Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.

Distance learning in the Applied Sciences of Oncology.

PubMed

Barton, Michael B; Thode, Richard J

2010-04-01

The major impediment to the expansion of oncology services is a shortage of personnel. To develop a distance learning course for radiation oncology trainees. Under the sponsorship of the Asia Pacific Regional Cooperative Agreement administered by the International Atomic Energy Agency (IAEA), a CD ROM-based Applied Sciences of Oncology (ASOC) distance learning course of 71 modules was created. The course covers communications, critical appraisal, functional anatomy, molecular biology, pathology. The materials include interactive text and illustrations that require students to answer questions before they can progress. The course aims to supplement existing oncology curricula and does not provide a qualification. It aims to assist students in acquiring their own profession's qualification. The course was piloted in seven countries in Asia, Africa and Latin America during 2004. After feedback from the pilot course, a further nine modules were added to cover imaging physics (three modules), informed consent, burnout and coping with death and dying, Economic analysis and cancer care, Nutrition, cachexia and fatigue, radiation-induced second cancers and mathematical tools and background for radiation oncology. The course was widely distributed and can be downloaded from http://www.iaea.org/Publications/Training/Aso/register.html. ASOC has been downloaded over 1100 times in the first year after it was posted. There is a huge demand for educational materials but the interactive approach is labour-intensive and expensive to compile. The course must be maintained to remain relevant. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Nanotechnology in radiation oncology.

PubMed

Wang, Andrew Z; Tepper, Joel E

2014-09-10

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

Continuing Education Needs of the Office Oncology Nurse.

ERIC Educational Resources Information Center

Rogers, Miriam P.

1999-01-01

A study determined the learning needs of office oncology nurses (n=290)as a critical first step in planning education programs. Participants ranked cancer-care topics similarly, regardless of age, background, or experience. The highest-ranked needs were clustered in the areas of cancer nursing practice, major cancers, and cancer treatment.…

Package Design Affects Accuracy Recognition for Medications.

PubMed

Endestad, Tor; Wortinger, Laura A; Madsen, Steinar; Hortemo, Sigurd

2016-12-01

Our aim was to test if highlighting and placement of substance name on medication package have the potential to reduce patient errors. An unintentional overdose of medication is a large health issue that might be linked to medication package design. In two experiments, placement, background color, and the active ingredient of generic medication packages were manipulated according to best human factors guidelines to reduce causes of labeling-related patient errors. In two experiments, we compared the original packaging with packages where we varied placement of the name, dose, and background of the active ingredient. Age-relevant differences and the effect of color on medication recognition error were tested. In Experiment 1, 59 volunteers (30 elderly and 29 young students), participated. In Experiment 2, 25 volunteers participated. The most common error was the inability to identify that two different packages contained the same active ingredient (young, 41%, and elderly, 68%). This kind of error decreased with the redesigned packages (young, 8%, and elderly, 16%). Confusion errors related to color design were reduced by two thirds in the redesigned packages compared with original generic medications. Prominent placement of substance name and dose with a band of high-contrast color support recognition of the active substance in medications. A simple modification including highlighting and placing the name of the active ingredient in the upper right-hand corner of the package helps users realize that two different packages can contain the same active substance, thus reducing the risk of inadvertent medication overdose. © 2016, Human Factors and Ergonomics Society.

Cross-Cultural Communication in Oncology: Challenges and Training Interests.

PubMed

Weber, Orest; Sulstarova, Brikela; Singy, Pascal

2016-01-01

To survey oncology nurses and oncologists about difficulties in taking care of culturally and linguistically diverse patients and about interests in cross-cultural training.
. Descriptive, cross-sectional.
. Web-based survey.
. 108 oncology nurses and 44 oncologists. 
. 31-item questionnaire derived from preexisting surveys in the United States and Switzerland.
. Self-rated difficulties in taking care of culturally and linguistically diverse patients and self-rated interests in cross-cultural training.
. All respondents reported communication difficulties in encounters with culturally and linguistically diverse patients. Respondents considered the absence of written materials in other languages, absence of a shared common language with patients, and sensitive subjects (e.g., end of life, sexuality) to be particularly problematic. Respondents also expressed a high level of interest in all aspects of cross-cultural training (task-oriented skills, background knowledge, reflexivity, and attitudes). Nurses perceived several difficulties related to care of migrants as more problematic than physicians did and were more interested in all aspects of cross-cultural training. 
. The need for cross-cultural training is high among oncology clinicians, particularly among nurses.
. The results reported in the current study may help nurses in decision-making positions and educators in introducing elements of cross-cultural education into oncology curricula for nurses. Cross-cultural training should be offered to oncology nurses.

Intraarterial Liver-Directed Therapies: The Role of Interventional Oncology

PubMed Central

Ma, Jenson; Sandow, Tyler; Devun, Daniel; Kirsch, David; Gulotta, Paul; Gilbert, Patrick; Kay, Dennis

2017-01-01

Background: Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma. Methods: We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies. Results: Chemoembolization and radioembolization are considered a standard of care in treating, delaying progression of disease, and downstaging to bridge to liver transplantation. Progression-free survival and overall survival outcomes are promising in patients with colorectal cancer and neuroendocrine tumors with liver metastases. Applications in the treatment of hepatic metastases from cholangiocarcinoma, breast cancer, melanoma, and sarcoma also show potential. Conclusion: Interventional oncology and its image-guided intraarterial therapies continue to gain recognition as treatment options for primary and secondary liver cancers. Growing evidence supports their role as a standard of care alongside medical oncology, surgery, and radiation oncology. PMID:29230127

American Society for Radiation Oncology (ASTRO) Survey of Radiation Biology Educators in U.S. and Canadian Radiation Oncology Residency Programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosenstein, Barry S., E-mail: barry.rosenstein@mssm.ed; Department of Radiation Oncology, New York University School of Medicine, New York, NY; Held, Kathryn D.

2009-11-01

Purpose: To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada. Methods and Materials: In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada. Results: The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educatorsmore » whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs. Conclusions: A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.« less

Nanotechnology in Radiation Oncology

PubMed Central

Wang, Andrew Z.; Tepper, Joel E.

2014-01-01

Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology. PMID:25113769

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

...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... oncology indications. The subcommittee will consider and discuss issues relating to the development of each...

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

...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... adult oncology indication, or in late stage development in pediatric patients with cancer. The...

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

...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... or, are in late stage development for an adult oncology indication. The subcommittee will consider...

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

...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... that are in development for an adult oncology indication. The subcommittee will consider and discuss...

Content analysis of oncology-related pharmaceutical advertising in a peer-reviewed medical journal.

PubMed

Yonemori, Kan; Hirakawa, Akihiro; Ando, Masashi; Hirata, Taizo; Yunokawa, Mayu; Shimizu, Chikako; Tamura, Kenji; Fujiwara, Yasuhiro

2012-01-01

The oncology market represents one of the largest pharmaceutical markets in any medical field, and printed advertising in medical journals is an important channel by which pharmaceutical companies communicate with healthcare professionals. The aim of the present study was to analyze the volume and content of and trends and changes in oncology-related advertising intended for healthcare professionals in a peer-reviewed medical journal. Information that could be included in advertisements to promote drug development and improve treatment strategies for cancer patients is discussed on the basis of the results of the analysis. Overall, 6,720 advertisements covering 13,039 pages in a leading oncology medical journal published (by the American Society of Clinical Oncology) between January 2005 and December 2009 were analyzed. The advertisements targeting pharmaceuticals and clinical trials, in particular, were reviewed. A total of 6,720 advertisements covering 13,039 pages were included in the analysis. For the years 2005-2009, the percentages of total journal pages dedicated to advertising were 24.0%, 45.7%, 49.8%, 46.8%, and 49.8%, respectively. Package insert information and efficacy and safety explanations appeared in more than 80% of advertisements intended for pharmaceutical promotion. From 2005 to 2009, the overall quantity of drug advertisements decreased by approximately 13%, whereas advertisements calling for the enrollment of patients into registration trials increased by approximately 11%. Throughout the study period, oncology-related pharmaceutical advertisements occupied a considerable number of pages relative to other journal content. The proportion of advertisements on ongoing clinical trials increased progressively throughout the study period.

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

...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... the public. Name of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory... measures in the pediatric development plans of oncology products. The half-day session will provide an...

Breast Cancer Integrative Oncology Care and Its Costs

PubMed Central

Standish, Leanna J.; Dowd, Fred; Sweet, Erin; Dale, Linda; Weaver, Morgan; Osborne, Barbara; Andersen, M. Robyn

2016-01-01

Background. Naturopathic oncology in conjunction with conventional treatment is commonly referred to as integrative oncology (IO). Clinics directed by oncology board certified NDs (Fellows of the American Board of Naturopathic Oncology or FABNOs) provide high-quality data for describing IO therapies, their costs and measuring clinical outcomes. Purpose. To describe the types of IO therapies prescribed to breast cancer patients by ND FABNO physicians. Study participants (n = 324). Women who sought care at 1 of 6 naturopathic oncology clinics in Washington State were asked to enroll in a prospective 5 year observational outcomes study. Methods. Medical records were abstracted to collect treatment recommendations and cost data. Results. More than 72 oral or topical, nutritional, botanical, fungal and bacterial-based medicines were prescribed to the cohort during their first year of IO care. Trametes versicolor was prescribed to 63% of the women. Mind-body therapy was recommended to 45% of patients, and 49% received acupuncture. Also, 26% were prescribed injectable therapy, including mistletoe, vitamin B complex (12%), IV ascorbate (12%), IV artesunate (7%), and IV nutrition and hydration (4%). Costs ranged from $1594/year for early-stage breast cancer to $6200/year for stage 4 breast cancer patients. Of the total amount billed for IO care for 1 year for breast cancer patients, 21% was out-of-pocket. Conclusions. IO care for women with breast cancer consists of botanical and mushroom oral therapies, parenteral botanical and nutrient therapy, mind-body medicine and acupuncture. IO clinic visits and acupuncture are partially paid for by medical insurance companies. PMID:27230757

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

PubMed Central

Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

2016-01-01

Background: Early integration of palliative care in oncology practice (“simultaneous care”, SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. Patients and methods: A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Results: Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. Conclusion: SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field. PMID:27877212

The Future of Gero-Oncology Nursing.

PubMed

Kagan, Sarah H

2016-02-01

To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

Oncology Social Workers' Attitudes toward Hospice Care and Referral Behavior

ERIC Educational Resources Information Center

Becker, Janet E.

2004-01-01

Members of the Association of Oncology Social Workers completed a survey, which included the Hospice Philosophy Scale (HPS) assessing the likelihood of the worker referring a terminally ill patient to hospice, background and experience, and demographics. The respondents held overwhelmingly favorable attitudes toward hospice philosophy and care,…

Nursing Practice Environment and Outcomes for Oncology Nursing

PubMed Central

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

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

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General...

Medicinal cannabis in oncology.

PubMed

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

2007-12-01

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

Psychosocial Issues in Pediatric Oncology

PubMed Central

Marcus, Joel

2012-01-01

Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

Oncology Nurse Generalist Competencies: Oncology Nursing Society’s Initiative to Establish Best Practice

PubMed

Gaguski, Michele; George, Kim; Bruce, Susan; Brucker, Edie; Leija, Carol; LeFebvre, Kristine; Thompson Mackey, Heather

2017-09-25

A project team was formulated by the Oncology Nursing Society (ONS) to create evidence-based oncology nurse generalist (ONG) competencies to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses. This article aims to describe the process and the development of ONG competencies. This article describes how the ONG competencies were accomplished, and includes outcomes and suggestions for use in clinical practice. Institutions can use the ONG competencies to assess and develop competency programs, offer unique educational strategies to measure and appraise proficiency, and establish processes to foster a workplace environment committed to mentoring and teaching future oncology nurses. 2017 Oncology Nursing Society

American Society of Clinical Oncology policy for relationships with companies: background and rationale.

PubMed

2013-06-01

The American Society of Clinical Oncology's (ASCO's) new conflict of interest policy reflects a commitment to transparency and independence in the development and presentation of scientific and educational content. ASCO supports thorough and accessible disclosure of financial relationships with companies at institutional and individual levels and calls for rigorous evaluation of content in light of the information disclosed. For abstracts and articles presenting original research, ASCO holds first, last, and corresponding authors to a clear standard of independence. In imposing restrictions, the new policy focuses on the role of these authors rather than of the principal investigator(s) as in the previous policy. ASCO remains actively engaged with the broader scientific community in seeking and implementing efficient, effective approaches to conflict of interest management.

Precision medicine in oncology: New practice models and roles for oncology pharmacists.

PubMed

Walko, Christine; Kiel, Patrick J; Kolesar, Jill

2016-12-01

Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners. Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment. The University of Wisconsin, Indiana University, and Moffit Cancer Center have implemented precision medicine practice models developed and led by oncology pharmacists. Different practice models, including a clinic, a clinical consultation service, and a molecular tumor board (MTB), were adopted to enhance integration into health systems and payment structures. Although the practice models vary, commonalities of three models include leadership by the clinical pharmacist, specific therapeutic recommendations, procurement of medications for off-label use, and a research component. These three practice models function as interprofessional training sites for pharmacy and medical students and residents, providing an important training resource at these institutions. Key implementation strategies include interprofessional involvement, institutional support, integration into clinical workflow, and selection of model by payer mix. MTBs are a pathway for clinical implementation of genomic medicine in oncology and are an emerging practice model for oncology pharmacists. Because pharmacists must be prepared to participate fully in contemporary practice, oncology pharmacy residents must be trained in genomic oncology, schools of pharmacy should expand precision medicine and genomics education, and opportunities for continuing education in precision medicine should be made available to practicing pharmacists. Copyright © 2016 by the

Quality Indicators in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Albert, Jeffrey M.; Das, Prajnan, E-mail: prajdas@mdanderson.org

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 tomore » 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.« less

Report on the International Colloquium on Cardio-Oncology (Rome, 12–14 March 2014)

PubMed Central

Ewer, Michael; Gianni, Luca; Pane, Fabrizio; Sandri, Maria Teresa; Steiner, Rudolf K; Wojnowski, Leszek; Yeh, Edward T; Carver, Joseph R; Lipshultz, Steven E; Minotti, Giorgio; Armstrong, Gregory T; Cardinale, Daniela; Colan, Steven D; Darby, Sarah C; Force, Thomas L; Kremer, Leontien CM; Lenihan, Daniel J; Sallan, Stephen E; Sawyer, Douglas B; Suter, Thomas M; Swain, Sandra M; van Leeuwen, Flora E

2014-01-01

Cardio-oncology is a relatively new discipline that focuses on the cardiovascular sequelae of anti-tumour drugs. As any other young adolescent discipline, cardio-oncology struggles to define its scientific boundaries and to identify best standards of care for cancer patients or survivors at risk of cardiovascular events. The International Colloquium on Cardio-Oncology was held in Rome, Italy, 12–14 March 2014, with the aim of illuminating controversial issues and unmet needs in modern cardio-oncology. This colloquium embraced contributions from different kind of disciplines (oncology and cardiology but also paediatrics, geriatrics, genetics, and translational research); in fact, cardio-oncology goes way beyond the merging of cardiology with oncology. Moreover, the colloquium programme did not review cardiovascular toxicity from one drug or the other, rather it looked at patients as we see them in their fight against cancer and eventually returning to everyday life. This represents the melting pot in which anti-cancer therapies, genetic backgrounds, and risk factors conspire in producing cardiovascular sequelae, and this calls for screening programmes and well-designed platforms of collaboration between one key professional figure and another. The International Colloquium on Cardio-Oncology was promoted by the Menarini International Foundation and co-chaired by Giorgio Minotti (Rome), Joseph R Carver (Philadelphia, Pennsylvania, United States), and Steven E Lipshultz (Detroit, Michigan, United States). The programme was split into five sessions of broad investigational and clinical relevance (what is cardiotoxicity?, cardiotoxicity in children, adolescents, and young adults, cardiotoxicity in adults, cardiotoxicity in special populations, and the future of cardio-oncology). Here, the colloquium chairs and all the session chairs briefly summarised what was said at the colloquium. Topics and controversies were reported on behalf of all members of the working group

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

Reporting guidelines for oncology research: helping to maximise the impact of your research

PubMed Central

MacCarthy, Angela; Kirtley, Shona; de Beyer, Jennifer A; Altman, Douglas G; Simera, Iveta

2018-01-01

Many reports of health research omit important information needed to assess their methodological robustness and clinical relevance. Without clear and complete reporting, it is not possible to identify flaws or biases, reproduce successful interventions, or use the findings in systematic reviews or meta-analyses. The EQUATOR Network (http://www.equator-network.org/) promotes responsible reporting and the use of reporting guidelines to improve the accuracy, completeness, and transparency of health research. EQUATOR supports researchers by providing online resources and training. EQUATOR Oncology, a project funded by Cancer Research UK, aims to support cancer researchers reporting their research through the provision of online resources. In this article, our objective is to highlight reporting issues related to oncology research publications and to introduce reporting guidelines that are designed to aid high-quality reporting. We describe generic reporting guidelines for the main study types, and explain how these guidelines should and should not be used. We also describe 37 oncology-specific reporting guidelines, covering different clinical areas (e.g., haematology or urology) and sections of the report (e.g., methods or study characteristics); most of these are little-used. We also provide some background information on EQUATOR Oncology, which focuses on addressing the reporting needs of the oncology research community. PMID:29471308

Global Curriculum in Surgical Oncology.

PubMed

Are, Chandrakanth; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

2016-06-01

The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. © 2016 Society of Surgical Oncology and the European Society of Surgical Oncology. Published by SpringerNature. All rights reserved.

Global curriculum in surgical oncology.

PubMed

Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

2016-06-01

The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

PubMed

Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

2016-12-01

Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

Economics of new oncology drug development.

PubMed

DiMasi, Joseph A; Grabowski, Henry G

2007-01-10

Review existing studies and provide new results on the development, regulatory, and market aspects of new oncology drug development. We utilized data from the US Food and Drug Administration (FDA), company surveys, and publicly available commercial business intelligence databases on new oncology drugs approved in the United States and on investigational oncology drugs to estimate average development and regulatory approval times, clinical approval success rates, first-in-class status, and global market diffusion. We found that approved new oncology drugs to have a disproportionately high share of FDA priority review ratings, of orphan drug designations at approval, and of drugs that were granted inclusion in at least one of the FDA's expedited access programs. US regulatory approval times were shorter, on average, for oncology drugs (0.5 years), but US clinical development times were longer on average (1.5 years). Clinical approval success rates were similar for oncology and other drugs, but proportionately more of the oncology failures reached expensive late-stage clinical testing before being abandoned. In relation to other drugs, new oncology drug approvals were more often first-in-class and diffused more widely across important international markets. The market success of oncology drugs has induced a substantial amount of investment in oncology drug development in the last decade or so. However, given the great need for further progress, the extent to which efforts to develop new oncology drugs will grow depends on future public-sector investment in basic research, developments in translational medicine, and regulatory reforms that advance drug-development science.

Oncology education in Canadian undergraduate and postgraduate medical programs: a survey of educators and learners

PubMed Central

Tam, V.C.; Berry, S.; Hsu, T.; North, S.; Neville, A.; Chan, K.; Verma, S.

2014-01-01

Background The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer. Methods To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents. Results Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty–related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners. Conclusions Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners. PMID:24523624

The optimal organization of gynecologic oncology services: a systematic review

PubMed Central

Fung-Kee-Fung, M.; Kennedy, E.B.; Biagi, J.; Colgan, T.; D’Souza, D.; Elit, L.M.; Hunter, A.; Irish, J.; McLeod, R.; Rosen, B.

2015-01-01

Background A system-level organizational guideline for gynecologic oncology was identified by a provincial cancer agency as a key priority based on input from stakeholders, data showing more limited availability of multidisciplinary or specialist care in lower-volume than in higher-volume hospitals in the relevant jurisdiction, and variable rates of staging for ovarian and endometrial cancer patients. Methods A systematic review assessed the relationship of the organization of gynecologic oncology services with patient survival and surgical outcomes. The electronic databases medline and embase (ovid: 1996 through 9 January 2015) were searched using terms related to gynecologic malignancies combined with organization of services, patterns of care, and various facility and physician characteristics. Outcomes of interest included overall or disease-specific survival, short-term survival, adequate staging, and degree of cytoreduction or optimal cytoreduction (or both) for ovarian cancer patients by hospital or physician type, and rate of discrepancy in initial diagnoses and intraoperative consultation between non-specialist pathologists and gyne-oncology–specialist pathologists. Results One systematic review and sixteen additional primary studies met the inclusion criteria. The evidence base as a whole was judged to be of lower quality; however, a trend toward improved outcomes with centralization of gynecologic oncology was found, particularly with respect to the gynecologic oncology care of patients with advanced-stage ovarian cancer. Conclusions Improvements in outcomes with centralization of gynecologic oncology services can be attributed to a number of factors, including access to specialist care and multidisciplinary team management. Findings of this systematic review should be used with caution because of the limitations of the evidence base; however, an expert consensus process made it possible to create recommendations for implementation. PMID:26300679

The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria

PubMed Central

DeAngelis, Lisa M.; Brandes, Alba A.; Peereboom, David M.; Galanis, Evanthia; Lin, Nancy U.; Soffietti, Riccardo; Macdonald, David R.; Chamberlain, Marc; Perry, James; Jaeckle, Kurt; Mehta, Minesh; Stupp, Roger; Muzikansky, Alona; Pentsova, Elena; Cloughesy, Timothy; Iwamoto, Fabio M.; Tonn, Joerg-Christian; Vogelbaum, Michael A.; Wen, Patrick Y.; van den Bent, Martin J.; Reardon, David A.

2017-01-01

Abstract Background. The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology. Methods. An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility. Results. The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3–5). Conclusion. The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients. PMID:28453751

American Society of Clinical Oncology National Census of Oncology Practices: Preliminary Report

PubMed Central

Forte, Gaetano J.; Hanley, Amy; Hagerty, Karen; Kurup, Anupama; Neuss, Michael N.; Mulvey, Therese M.

2013-01-01

In response to reports of increasing financial and administrative burdens on oncology practices and a lack of systematic information related to these issues, American Society of Clinical Oncology (ASCO) leadership started an effort to collect key practice-level data from all oncology practices in the United States. The result of the effort is the ASCO National Census of Oncology Practices (Census) launched in June 2012. The initial Census work involved compiling an inventory of oncology practices from existing lists of oncology physicians in the United States. A comprehensive, online data collection instrument was developed, which covered a number of areas, including practice characteristics (staffing configuration, organizational structure, patient mix and volume, types of services offered); organizational, staffing, and service changes over the past 12 months; and an assessment of the likelihood that the practice would experience organizational, staffing, and service changes in the next 12 months. More than 600 practices participated in the Census by providing information. In this article, we present preliminary highlights from the data gathered to date. We found that practice size was related to having experienced practice mergers, hiring additional staff, and increasing staff pay in the past 12 months, that geographic location was related to having experienced hiring additional staff, and that practices in metropolitan areas were more likely to have experienced practice mergers in the past 12 months than those in nonmetropolitan areas. We also found that practice size and geographic location were related to higher likelihoods of anticipating practice mergers, sales, and purchases in the future. PMID:23633966

Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

PubMed

Ignoffo, Robert; Knapp, Katherine; Barnett, Mitchell; Barbour, Sally Yowell; D'Amato, Steve; Iacovelli, Lew; Knudsen, Jasen; Koontz, Susannah E; Mancini, Robert; McBride, Ali; McCauley, Dayna; Medina, Patrick; O'Bryant, Cindy L; Scarpace, Sarah; Stricker, Steve; Trovato, James A

2016-04-01

With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits. Copyright © 2016 by American Society of Clinical Oncology.

Oncology Nurse Generalist Competencies: Oncology Nursing Society's Initiative to Establish Best Practice.

PubMed

Gaguski, Michele E; George, Kim; Bruce, Susan D; Brucker, Edie; Leija, Carol; LeFebvre, Kristine B; Mackey, Heather

2017-12-01

A project team was formulated to create evidence-based oncology nurse generalist competencies (ONGCs) to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses.
. This article aims to describe the process and the development of ONGCs. 
. This article explains how the ONGCs were accomplished, and includes outcomes and suggestions for use in clinical practice. 
. Institutions can use the ONGCs to assess and develop competency programs, offer educational strategies to measure proficiency, and establish processes to foster a workplace committed to mentoring and teaching future oncology nurses.

Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

PubMed

Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

2017-09-01

This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jagsi, Reshma, E-mail: rjagsi@med.umich.edu; Bekelman, Justin E.; Brawley, Otis W.

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 patientsmore » 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.« less

Biosimilars: Considerations for Oncology Nurses
.

PubMed

Vizgirda, Vida; Jacobs, Ira

2017-04-01

Biosimilars are developed to be highly similar to and treat the same conditions as licensed biologics. As they are approved and their use becomes more widespread, oncology nurses should be aware of their development and unique considerations. This article reviews properties of biosimilars; their regulation and approval process; the ways in which their quality, safety, and efficacy are evaluated; their postmarketing safety monitoring; and their significance to oncology nurses and oncology nursing.
. A search of PubMed and regulatory agency websites was conducted for references related to the development and use of biosimilars in oncology. 
. Because biologics are large, structurally complex molecules, biosimilars cannot be considered generic equivalents to licensed biologic products. Consequently, regulatory approval for biosimilars is different from approval for small-molecule generics. Oncology nurses are in a unique position to educate themselves, other clinicians, and patients and their families about biosimilars to ensure accurate understanding, as well as optimal and safe use, of biosimilars.

Identification of the Key Fields and Their Key Technical Points of Oncology by Patent Analysis

PubMed Central

Zhang, Ting; Chen, Juan; Jia, Xiaofeng

2015-01-01

Background This paper aims to identify the key fields and their key technical points of oncology by patent analysis. Methodology/Principal Findings Patents of oncology applied from 2006 to 2012 were searched in the Thomson Innovation database. The key fields and their key technical points were determined by analyzing the Derwent Classification (DC) and the International Patent Classification (IPC), respectively. Patent applications in the top ten DC occupied 80% of all the patent applications of oncology, which were the ten fields of oncology to be analyzed. The number of patent applications in these ten fields of oncology was standardized based on patent applications of oncology from 2006 to 2012. For each field, standardization was conducted separately for each of the seven years (2006–2012) and the mean of the seven standardized values was calculated to reflect the relative amount of patent applications in that field; meanwhile, regression analysis using time (year) and the standardized values of patent applications in seven years (2006–2012) was conducted so as to evaluate the trend of patent applications in each field. Two-dimensional quadrant analysis, together with the professional knowledge of oncology, was taken into consideration in determining the key fields of oncology. The fields located in the quadrant with high relative amount or increasing trend of patent applications are identified as key ones. By using the same method, the key technical points in each key field were identified. Altogether 116,820 patents of oncology applied from 2006 to 2012 were retrieved, and four key fields with twenty-nine key technical points were identified, including “natural products and polymers” with nine key technical points, “fermentation industry” with twelve ones, “electrical medical equipment” with four ones, and “diagnosis, surgery” with four ones. Conclusions/Significance The results of this study could provide guidance on the development

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.

Exercise Promotion in Geriatric Oncology

PubMed Central

Leak Bryant, Ashley; Mustian, Karen M.

2018-01-01

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

Geriatric Oncology Program Development and Gero-Oncology Nursing.

PubMed

Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

2016-02-01

To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burmeister, Jay, E-mail: burmeist@karmanos.org; Chen, Zhe; Chetty, Indrin J.

Purpose: The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. Methods and Materials: The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. Results: The newmore » curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. Conclusions: The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents.

PubMed

Burmeister, Jay; Chen, Zhe; Chetty, Indrin J; Dieterich, Sonja; Doemer, Anthony; Dominello, Michael M; Howell, Rebecca M; McDermott, Patrick; Nalichowski, Adrian; Prisciandaro, Joann; Ritter, Tim; Smith, Chadd; Schreiber, Eric; Shafman, Timothy; Sutlief, Steven; Xiao, Ying

2016-07-15

The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. The new curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and

The changing face of clinical trials in the personalized medicine and immuno-oncology era: report from the international congress on clinical trials in Oncology & Hemato-Oncology (ICTO 2017).

PubMed

Golan, Talia; Milella, Michele; Ackerstein, Aliza; Berger, Ranaan

2017-12-28

In the past decade, the oncology community has witnessed major advances in the understanding of cancer biology and major breakthroughs in several different therapeutic areas, from solid tumors to hematological malignancies; moreover, the advent of effective immunotherapy approaches, such as immune-checkpoint blockade, is revolutionizing treatment algorithms in almost all oncology disease areas. As knowledge evolves and new weapons emerge in the "war against cancer", clinical and translational research need to adapt to a rapidly changing environment to effectively translate novel concepts into sustainable and accessible therapeutic options for cancer patients.With this in mind, translational cancer researchers, oncology professionals, treatment experts, CRO and industry leaders, as well as patient representatives gathered in London, 16-17 March 2017, for The International Congress on Clinical Trials in Oncology and Hemato-Oncology (ICTO2017), to discuss the changing face of oncology clinical trials in the new era of personalized medicine and immuno-oncology. A wide range of topics, including clinical trial design in immuno-oncology, biomarker-oriented drug development paths, statistical design and endpoint selection, challenges in the design and conduct of personalized medicine clinical trials, risk-based monitoring, financing and reimbursement, as well as best operational practices, were discussed in an open, highly interactive format, favoring networking among all relevant stakeholders. The most relevant data, approaches and issues emerged and discussed during the conference are summarized in this report.

Palliative Care: Delivering Comprehensive Oncology Nursing Care.

PubMed

Dahlin, Constance

2015-11-01

To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

Public health oncology: a framework for progress in low- and middle-income countries†

PubMed Central

Love, R. R.; Ginsburg, O. M.; Coleman, C. N.

2012-01-01

Background The problems of cancer are increasing in low- and middle-income countries (LMCs), which now have significant majorities of the global case and mortality burdens. The professional oncology community is being increasingly called upon to define pragmatic and realistic approaches to these problems. Patients and methods Focusing on mortality and case burden outcomes defines public health oncology or population-affecting cancer medicine. We use this focus to consider practical approaches. Results The greatest cancer burdens are in Asia. A public health oncology perspective mandates: first, addressing the major and social challenges of cancer medicine for populations: human rights, health systems, corruption, and our limited knowledge base for value-conscious interventions. Second, adoption of evolving concepts and models for sustainable development in LMCs. Third, clear and realistic statements of action and inaction affecting populations, grounded in our best cancer science, and attention to these. Finally, framing the goals and challenges for population-affecting cancer medicine requires a change in paradigm from historical top-down models of technology transfer, to one which is community-grounded and local-evidence based. Conclusion Public health oncology perspectives define clear focus for much needed research on country-specific practical approaches to cancer control. PMID:23087162

Relationship between physicians' perceived stigma toward depression and physician referral to psycho-oncology services on an oncology/hematology ward.

PubMed

Kim, Won-Hyoung; Bae, Jae-Nam; Lim, Joohan; Lee, Moon-Hee; Hahm, Bong-Jin; Yi, Hyeon Gyu

2018-03-01

This study was performed to identify relationships between physicians' perceived stigma toward depression and psycho-oncology service utilization on an oncology/hematology ward. The study participants were 235 patients in an oncology/hematology ward and 14 physicians undergoing an internal medicine residency training program in Inha University Hospital (Incheon, South Korea). Patients completed the Patient Health Questionnaire-9 (PHQ-9), and residents completed the Perceived Devaluation-Discrimination scale that evaluates perceived stigma toward depression. A total PHQ-9 score of ≥5 was defined as clinically significant depression. Physicians decided on referral on the basis of their opinions and those of their patients. The correlates of physicians' recommendation for referral to psycho-oncology services and real referrals psycho-oncology services were examined. Of the 235 patients, 143 had PHQ-9 determined depression, and of these 143 patients, 61 received psycho-oncology services. Physicians recommended that 87 patients consult psycho-oncology services. Multivariate analyses showed that lower physicians' perceived stigma regarding depression was significantly associated with physicians' recommendation for referral, and that real referral to psycho-oncology services was significantly associated with presence of a hematologic malignancy and lower physicians' perceived stigma toward depression. Physicians' perceived stigma toward depression was found to be associated with real referral to psycho-oncology services and with physician recommendation for referral to psycho-oncology services. Further investigations will be needed to examine how to reduce physicians' perceived stigma toward depression. Copyright © 2017 John Wiley & Sons, Ltd.

American Society of Clinical Oncology 2012 Annual Meeting: highlights from the gynecologic oncology track.

PubMed

Tewari, Krishnansu S

2012-11-01

The 2012 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago, June 1-5, 2011, and brought together more than 25,000 oncology professionals from a broad range of specialties to explore the theme, "Collaborating to Conquer Cancer". The Gynecologic Oncology Track had a strong international presence, with important clinical trials being presented from Japan, Germany, Norway, the United States, and others. This meeting report will highlight several phase 3 and phase 2 clinical trials as well as notable translational research endeavors and other selected abstracts.

A Comprehensive Definition for Integrative Oncology.

PubMed

Witt, Claudia M; Balneaves, Lynda G; Cardoso, Maria J; Cohen, Lorenzo; Greenlee, Heather; Johnstone, Peter; Kücük, Ömer; Mailman, Josh; Mao, Jun J

2017-11-01

Integrative oncology, which is generally understood to refer to the use of a combination of complementary medicine therapies in conjunction with conventional cancer treatments, has been defined in different ways, but there is no widely accepted definition. We sought to develop and establish a consensus for a comprehensive definition of the field of integrative oncology. We used a mixed-methods approach that included a literature analysis and a consensus procedure, including an interdisciplinary expert panel and surveys, to develop a comprehensive and acceptable definition for the term "integrative oncology." The themes identified in the literature and from the expert discussion were condensed into a two-sentence definition. Survey respondents had very positive views on the draft definition, and their comments helped to shape the final version. The final definition for integrative oncology is: "Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before,during, and beyond cancer treatment." This short and comprehensive definition for the term integrative oncology will facilitate a better understanding and communication of this emerging field. This definition will also drive focused and cohesive effort to advance the field of integrative oncology. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Optimizing patient education of oncology medications: A descriptive survey of pharmacist-provided patient education in Canada.

PubMed

Donald, Gillian; Scott, Samantha; Broadfield, Larry; Harding, Claudia; Meade, Andrea

2017-01-01

Background The incidence of cancer is increasing in Canada due to an aging and growing population. This frequently necessitates chemotherapy, which is a high-risk treatment, often given as a part of a complex regimen with serious side effects. A review of the evidence of pharmacy-provided patient education initiatives targeted to oncology patients revealed that minimal is known about this service. Objective The objective of this study was to determine the different models of patient education of oncology medications delivered by pharmacists to adult oncology patients in a hospital or cancer center in Canada. Methods The study design was a descriptive online survey developed by the investigation team and was distributed to pharmacists who provided patient education to adult oncology patients. The primary outcome of this research project was to describe self-reported pharmacist-provided patient education of oncology medications across Canada. The survey data was analyzed quantitatively with Opinio survey software. Results Sixty-four pharmacists completed the survey. Key findings of the study were that approximately 50% of pharmacists spend up to 25% of their time providing direct patient care and that not all adult oncology patients are receiving education by a pharmacist. Conclusions Pharmacists provide patient education at the first treatment, change in therapy, and on request of another healthcare professional. Most cover administration, side effects, their prevention and management, and drug-interactions. Frequently used teaching methods include structured patient education delivery process, customized teaching for each patient, and repetition of key educational points.

21 CFR 610.62 - Proper name; package label; legible type.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Labeling Standards § 610.62 Proper name; package... contrast in color value between the proper name and the background shall be at least as great as the color value between the trademark and trade name and the background. Typography, layout, contrast, and other...

Communication competencies of oncology nurses in Malaysia.

PubMed

Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

2013-01-01

This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

Labeling for Big Data in radiation oncology: The Radiation Oncology Structures ontology.

PubMed

Bibault, Jean-Emmanuel; Zapletal, Eric; Rance, Bastien; Giraud, Philippe; Burgun, Anita

2018-01-01

Leveraging Electronic Health Records (EHR) and Oncology Information Systems (OIS) has great potential to generate hypotheses for cancer treatment, since they directly provide medical data on a large scale. In order to gather a significant amount of patients with a high level of clinical details, multicenter studies are necessary. A challenge in creating high quality Big Data studies involving several treatment centers is the lack of semantic interoperability between data sources. We present the ontology we developed to address this issue. Radiation Oncology anatomical and target volumes were categorized in anatomical and treatment planning classes. International delineation guidelines specific to radiation oncology were used for lymph nodes areas and target volumes. Hierarchical classes were created to generate The Radiation Oncology Structures (ROS) Ontology. The ROS was then applied to the data from our institution. Four hundred and seventeen classes were created with a maximum of 14 children classes (average = 5). The ontology was then converted into a Web Ontology Language (.owl) format and made available online on Bioportal and GitHub under an Apache 2.0 License. We extracted all structures delineated in our department since the opening in 2001. 20,758 structures were exported from our "record-and-verify" system, demonstrating a significant heterogeneity within a single center. All structures were matched to the ROS ontology before integration into our clinical data warehouse (CDW). In this study we describe a new ontology, specific to radiation oncology, that reports all anatomical and treatment planning structures that can be delineated. This ontology will be used to integrate dosimetric data in the Assistance Publique-Hôpitaux de Paris CDW that stores data from 6.5 million patients (as of February 2017).

An Increase in Medical Student Knowledge of Radiation Oncology: A Pre-Post Examination Analysis of the Oncology Education Initiative

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirsch, Ariel E.; Department of Radiation Oncology, Boston University School of Medicine, Boston, MA; Department of Radiation Oncology, Harvard Medical School, Boston, MA

Purpose: The Oncology Education Initiative was created to advance oncology and radiation oncology education by integrating structured didactics into the existing core radiology clerkship. We set out to determine whether the addition of structured didactics could lead to a significant increase in overall medical student knowledge about radiation oncology. Methods and Materials: We conducted a pre- and posttest examining concepts in general radiation oncology, breast cancer, and prostate cancer. The 15-question, multiple-choice exam was administered before and after a 1.5-hour didactic lecture by an attending physician in radiation oncology. Individual question changes, overall student changes, and overall categorical changes weremore » analyzed. All hypothesis tests were two-tailed (significance level 0.05). Results: Of the 153 fourth-year students, 137 (90%) took the pre- and posttest and were present for the didactic lecture. The average test grade improved from 59% to 70% (p = 0.011). Improvement was seen in all questions except clinical vignettes involving correct identification of TNM staging. Statistically significant improvement (p {<=} 0.03) was seen in the questions regarding acute and late side effects of radiation, brachytherapy for prostate cancer, delivery of radiation treatment, and management of early-stage breast cancer. Conclusions: Addition of didactics in radiation oncology significantly improves medical students' knowledge of the topic. Despite perceived difficulty in teaching radiation oncology and the assumption that it is beyond the scope of reasonable knowledge for medical students, we have shown that even with one dedicated lecture, students can learn and absorb general principles regarding radiation oncology.« less

A national portfolio of bone oncology trials—The Canadian experience in 2012

PubMed Central

Kuchuk, I.; Simos, D.; Addison, C.L.; Clemons, M.

2012-01-01

Background The impact of both cancer and its treatment on bone is an essential component of oncological practice. Bone oncology not only affects patients with both early stage and metastatic disease but also covers the entire spectrum of tumour types. We therefore decided to review and summarise bone oncology-related trials that are currently being conducted in Canada. Method We assessed ongoing and recently completed trials in Canada. We used available North American and Canadian cancer trial websites and also contacted known investigators in this field for their input. Results Twenty seven clinical trials were identified. Seven pertained to local treatment of bone metastasis from any solid tumour type. Seven were systemic treatment trials, five focused on bone biology and predictive factors, three evaluated safety of bone-targeted agents, three were adjuvant trials and two trials investigated impact of cancer therapy on bone health. The majority of trials were related to systemic treatment and bone biology in breast cancer. Most were small, single centre, grant-funded studies. Not surprisingly the larger safety and adjuvant studies were pharmaceutical company driven. Discussion Despite the widespread interest in bone-targeted therapies our survey would suggest that most studies are single centre and breast cancer focused. If major advances in bone oncology are to be made then collaborative strategies are needed to not only increase current sample sizes but to also expand these studies into non-breast cancer populations. PMID:26909263

Isolation and identification of bacteria from paperboard food packaging

PubMed Central

Mashhadi Mohammadzadeh-Vazifeh, Mojtaba; Khajeh-Nasiri, Shamsolmoluk; Hashemi, Shabnam; Fakhari, Javad

2015-01-01

Background and Objectives: Paper and paperboard packaging play an important role in safety and quality of food products. Common bacteria of paper and paperboard food packaging could grow due to specific conditions included humidity, temperature and major nutrition to contaminate the food. The purpose of this research was to investigate numbers and the types of bacteria in the food packaging paperboard. Materials and Methods: The surface and the depth of the each paperboard sample were examined by the dimension of one cm2 and one gram. The paperboard samples were randomly collected from popular confectionaries and fast food restaurants in Tehran, Iran. Results: The results indicated the range of 0.2×103 to >1.0×105 cfu/1g bacterial contamination in paperboard food packaging. Also, most detected bacteria were from spore forming and family Bacillaceae. Conclusion: The bioburden paperboard used for food packaging showed high contamination rate more than standard acceptance level. PMID:26719786

American Society of Pediatric Hematology/Oncology

MedlinePlus

... Learn More Explore career opportunities in pediatric hematology/oncology Visit the ASPHO Career Center. Learn More Join ... Privacy Policy » © The American Society of Pediatric Hematology/Oncology

Labeling for Big Data in radiation oncology: The Radiation Oncology Structures ontology

PubMed Central

Zapletal, Eric; Rance, Bastien; Giraud, Philippe; Burgun, Anita

2018-01-01

Purpose Leveraging Electronic Health Records (EHR) and Oncology Information Systems (OIS) has great potential to generate hypotheses for cancer treatment, since they directly provide medical data on a large scale. In order to gather a significant amount of patients with a high level of clinical details, multicenter studies are necessary. A challenge in creating high quality Big Data studies involving several treatment centers is the lack of semantic interoperability between data sources. We present the ontology we developed to address this issue. Methods Radiation Oncology anatomical and target volumes were categorized in anatomical and treatment planning classes. International delineation guidelines specific to radiation oncology were used for lymph nodes areas and target volumes. Hierarchical classes were created to generate The Radiation Oncology Structures (ROS) Ontology. The ROS was then applied to the data from our institution. Results Four hundred and seventeen classes were created with a maximum of 14 children classes (average = 5). The ontology was then converted into a Web Ontology Language (.owl) format and made available online on Bioportal and GitHub under an Apache 2.0 License. We extracted all structures delineated in our department since the opening in 2001. 20,758 structures were exported from our “record-and-verify” system, demonstrating a significant heterogeneity within a single center. All structures were matched to the ROS ontology before integration into our clinical data warehouse (CDW). Conclusion In this study we describe a new ontology, specific to radiation oncology, that reports all anatomical and treatment planning structures that can be delineated. This ontology will be used to integrate dosimetric data in the Assistance Publique—Hôpitaux de Paris CDW that stores data from 6.5 million patients (as of February 2017). PMID:29351341

Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

PubMed

Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

2015-11-01

With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

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.

The differences in the assessments of side effects at an oncology outpatient clinic.

PubMed

Bayraktar-Ekincioglu, A; Kucuk, E

2018-04-01

Background There is a growing interest in the use of targeted and immunotherapies in oncology. However, the assessment of side effects can be different due to interpretation of patients' health status by healthcare professionals in oncology outpatient clinics. Objective To demonstrate the differences in the assessments of side effects conducted independently by a clinical pharmacist and nurses in patients who receive targeted therapies at an oncology outpatient clinic. Setting The study was conducted at the University Oncology Hospital in an outpatient clinic from October 2015 to March 2016. Method Patients receiving ipilimumab, nivolumab, pembrolizumab, bevacizumab, panitumumab or cetuximab during study period were included. The assessment of side effects was conducted by a pharmacist and nurse independently using the NCI-CTCAE version-2. Main outcome measure To compare the severity assessments of side effects between a clinical pharmacist and nurses in an outpatient clinic. Results During the study, 204 visits for 43 patients with a total of 5508 side effect assessments were recorded where 1137 (20.64%) assessments were graded differently. Out of 1137 assessments, 473 of them were graded higher by a clinical pharmacist whereas 664 were graded higher by nurses. Statistically significant differences were detected in the assessment of vomiting, taste changes, sense changes, alopecia, fatigue, mood changes, anxiety, hearing impairment, and allergic reactions. Conclusion An assessment of side effects by healthcare providers in patients with cancer may be challenging due to an increased workload in clinics and undistinguishable symptoms of side effects and cancer itself. Therefore, a new care model which increases an interprofessional communication may improve pharmaceutical care in oncology outpatient clinics.

Results of the Association of Directors of Radiation Oncology Programs (ADROP) Survey of Radiation Oncology Residency Program Directors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, Eleanor; Abdel-Wahab, May; Spangler, Ann E.

2009-06-01

Purpose: To survey the radiation oncology residency program directors on the topics of departmental and institutional support systems, residency program structure, Accreditation Council for Graduate Medical Education (ACGME) requirements, and challenges as program director. Methods: A survey was developed and distributed by the leadership of the Association of Directors of Radiation Oncology Programs to all radiation oncology program directors. Summary statistics, medians, and ranges were collated from responses. Results: Radiation oncology program directors had implemented all current required aspects of the ACGME Outcome Project into their training curriculum. Didactic curricula were similar across programs nationally, but research requirements and resourcesmore » varied widely. Program directors responded that implementation of the ACGME Outcome Project and the external review process were among their greatest challenges. Protected time was the top priority for program directors. Conclusions: The Association of Directors of Radiation Oncology Programs recommends that all radiation oncology program directors have protected time and an administrative stipend to support their important administrative and educational role. Departments and institutions should provide adequate and equitable resources to the program directors and residents to meet increasingly demanding training program requirements.« less

Hospitalization and other risk factors for depressive and anxious symptoms in oncological and non-oncological patients.

PubMed

De Fazio, Pasquale; Cerminara, Gregorio; Ruberto, Stefania; Caroleo, Mariarita; Puca, Maurizio; Rania, Ornella; Suffredini, Elina; Procopio, Leonardo; Segura-Garcìa, Cristina

2017-04-01

Depression and anxiety are common in hospitalized patients. In particular, oncological patients might be vulnerable to depression and anxiety. The aim of this study is to assess and compare different variables and the prevalence of anxiety and depression symptoms between oncological and medically ill inpatients and to identify variables that can influence depressive and anxious symptoms during hospitalization of patients. A total of 360 consecutive hospitalized patients completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Patients Health Questionnaire-9, General Health Questionnaire (GHQ-12), 12-Item Short-Form Survey: physical component summary (PCS), and mental component summary (MCS). Patients were divided into oncological patients and non-oncological patients: groups 1 and 2. Only two significant differences were evident between the groups: the PCS of 12-item Short-form Survey was higher in non-oncological patient (p < 0.000), and the GHQ total score was higher in oncological patients. Variables significantly associated with HADS-D ≥ 8 were lower MCS, higher GHQ-12 score, lower PCS, more numerous previous hospitalizations, longer duration of hospitalization, and positive psychiatric family history. Variables significantly associated with HADS-A ≥ 8 were lower MCS, higher GHQ-12 score, positive psychiatric family history, longer duration of hospitalization, and younger age. Anxiety and depression symptoms in concurrent general medical conditions were associated with a specific sociodemographic profile, and this association has implications for clinical care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The art of pediatric oncology nursing practice.

PubMed

Cantrell, Mary Ann

2007-01-01

Pediatric oncology nursing practice must incorporate both the science and the art of the discipline to foster positive physical and psychosocial treatment outcomes for pediatric oncology patients, especially those outcomes related to their health-related quality of life. In this article, the art of nursing care is described within the context of scientifically based care, and the art of nursing practice is evident in the implementation of the scientific principles and standards for pediatric oncology nursing practice. The author proposes that the art of pediatric oncology nursing practice ought to be evident in care activities that the nurse provides within a therapeutic relationship that is steeped in nursing presence. Although the art of nursing care and the nature of an effective therapeutic relationship is tacit, valued knowledge among pediatric oncology nurses, as well as children and adolescents with cancer and their families, it is difficult to describe and challenging to quantify its effect on patient care outcomes. This article discusses the art of pediatric oncology nursing practice and its influence on treatment outcomes.

Evaluating Patient Activation Measure (PAM) Scores and Readmission Rates Following Implementation of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality Improvement Project

DTIC Science & Technology

2016-06-30

5b. GRANT NUMBER N/A of a Nurse-Initiated Multi-Faceted Strategy for Patients on a U.S. Navy Inpatient Oncology Unit: A Quality...13. SUPPLEMENTARY NOTES N/A 14. ABSTRACT Background: Chronically ill patients often experience multiple hospitalizations. Oncology patients...have been shown to have more readmissions to the hospital than non- oncology patients. Recent reports estimate a $17.4 billion cost burden is

Personalized Oncology in Interventional Radiology

PubMed Central

Abi-Jaoudeh, Nadine; Duffy, Austin G.; Greten, Tim F.; Kohn, Elise C.; Clark, Timothy W.I.; Wood, Bradford J.

2013-01-01

As personalized medicine becomes more applicable to oncologic practice, image-guided biopsies will be integral for enabling predictive and pharmacodynamic molecular pathology. Interventional radiology has a key role in defining patient-specific management. Advances in diagnostic techniques, genomics, and proteomics enable a window into subcellular mechanisms driving hyperproliferation, metastatic capabilities, and tumor angiogenesis. A new era of personalized medicine has evolved whereby clinical decisions are adjusted according to a patient’s molecular profile. Several mutations and key markers already have been introduced into standard oncologic practice. A broader understanding of personalized oncology will help interventionalists play a greater role in therapy selection and discovery. PMID:23885909

Effectiveness of a psycho-oncology training program for oncology nurses: a randomized controlled trial.

PubMed

Kubota, Yosuke; Okuyama, Toru; Uchida, Megumi; Umezawa, Shino; Nakaguchi, Tomohiro; Sugano, Koji; Ito, Yoshinori; Katsuki, Fujika; Nakano, Yumi; Nishiyama, Takeshi; Katayama, Yoshiko; Akechi, Tatsuo

2016-06-01

Oncology nurses are expected to play an important role in psychosocial care for cancer patients. The aim of this study was to examine whether a novel training program aimed at enhancing oncology nurses' ability to assess and manage common psychological problems in cancer patients would improve participants' self-reported confidence, knowledge, and attitudes regarding care of patients with common psychological problems (trial register: UMIN000008559). Oncology nurses were assigned randomly to either the intervention group (N = 50) or the waiting list control group (N = 46). The intervention group received a 16-h program, the content of which focused on four psychological issues: normal reactions, clinically significant distress, suicidal thoughts, and delirium. Each session included a role-play exercise, group work, and didactic lecture regarding assessment and management of each problem. Primary outcomes were changes in self-reported confidence, knowledge, and attitudes toward the common psychological problems between pre-intervention and 3 months post-intervention. Secondary outcomes were job-related stress and burnout. Intervention acceptability to participants was also assessed. In the intervention group, confidence and knowledge but not attitudes were significantly improved relative to the control group. No significant intervention effects were found for job- related stress and burnout. A high percentage (98%) of participants considered the program useful in clinical practice. This psycho-oncology training program improved oncology nurses' confidence and knowledge regarding care for patients with psychological problems. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Oncology nursing in Cuba: report of the delegation.

PubMed

Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

2012-08-01

In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

[Development of analysis software package for the two kinds of Japanese fluoro-d-glucose-positron emission tomography guideline].

PubMed

Matsumoto, Keiichi; Endo, Keigo

2013-06-01

Two kinds of Japanese guidelines for the data acquisition protocol of oncology fluoro-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) scans were created by the joint task force of the Japanese Society of Nuclear Medicine Technology (JSNMT) and the Japanese Society of Nuclear Medicine (JSNM), and published in Kakuigaku-Gijutsu 27(5): 425-456, 2007 and 29(2): 195-235, 2009. These guidelines aim to standardize PET image quality among facilities and different PET/CT scanner models. The objective of this study was to develop a personal computer-based performance measurement and image quality processor for the two kinds of Japanese guidelines for oncology (18)F-FDG PET/CT scans. We call this software package the "PET quality control tool" (PETquact). Microsoft Corporation's Windows(™) is used as the operating system for PETquact, which requires 1070×720 image resolution and includes 12 different applications. The accuracy was examined for numerous applications of PETquact. For example, in the sensitivity application, the system sensitivity measurement results were equivalent when comparing two PET sinograms obtained from the PETquact and the report. PETquact is suited for analysis of the two kinds of Japanese guideline, and it shows excellent spec to performance measurements and image quality analysis. PETquact can be used at any facility if the software package is installed on a laptop computer.

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

Components of the Early Apollo Scientific Experiments Package (EASEP)

NASA Image and Video Library

1969-07-20

AS11-37-5551 (20 July 1969) --- Two components of the Early Apollo Scientific Experiments Package (EASEP) are seen deployed on the lunar surface in this view photographed from inside the Lunar Module (LM). In the far background is the Passive Seismic Experiment Package (PSEP); and to the right and closer to the camera is the Laser Ranging Retro-Reflector (LR-3). The footprints of Apollo 11 astronauts Neil A. Armstrong and Edwin E. Aldrin Jr. are very distinct in the lunar soil.

European Union centralised procedure for marketing authorisation of oncology drugs: an in-depth review of its efficiency.

PubMed

Netzer, Tilo

2006-03-01

In the European Union (EU) 20 anticancer agents have been successfully authorised via the Centralised Procedure since its implementation in 1995. Public information on these 20 agents has been reviewed in order to evaluate the effectiveness of the available regulatory mechanisms to facilitate the marketing authorisation of such drugs in the EU. These mechanisms include orphan drug legislation, exceptional circumstances provision and the accelerated evaluation procedure. Based on the fact that the EU orphan drug legislation was not implemented before the year 2000 no conclusions on its effectiveness to facilitate oncology drug development can be drawn today. Much more data are available on the effects of the exceptional circumstances provision, which was used in 6 out of 10 cases over the past four years. An analysis of the clinical data packages indicates that this provision allows authorisation of innovative oncology drugs based on smaller clinical data sets than required for full approval. The accelerated evaluation procedure was used in only one case and significantly reduced the scientific review time at the EU agencies. However, this mechanism does not influence the administrative time at the authorities, which accounted for almost one-third of the overall duration of the EU marketing authorisation procedures for oncology drugs. Revision of the EU drug legislation brings about some changes to the above-described provisions, with the potential for an improvement in the current situation. Thus, its implementation offers the chance to reduce the time that innovative oncology agents take to reach the market, although -- based on experience with the current procedures -- more effort is likely to be required to achieve this goal.

Surgical Oncology Nursing: Looking Back, Looking Forward.

PubMed

Crane, Patrick C; Selanders, Louise

2017-02-01

To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

Psycho-oncology in Korea: past, present and future.

PubMed

Lee, Hyun Jeong; Lee, Kwang-Min; Jung, Dooyoung; Shim, Eun-Jung; Hahm, Bong-Jin; Kim, Jong-Heun

2017-01-01

Psycho-oncology in Korea was introduced among the circle of consultation-liaison psychiatrists, in the 1990s. For almost 25 years, the field has been developing at a steady pace as the psychosocial needs of patients with cancer continue to increase. In this study, we review the history of psycho-oncology in Korea, in a chronological order, within the domains of clinical practice, research activity, training, and public policy. Before the 1990s, patients with cancer with psychiatric comorbidities were usually taken care of by consultation-liaison psychiatrists in general hospitals. In 1993, psycho-oncology was first introduced by psychiatrists. Psychologists, nurses, and social workers have also been increasingly involved in providing psychosocial care for patients with cancer. Professionals from various disciplines began to communicate, and agreed to found the Korean Psycho-Oncology Study Group (KPOSG) in 2006, the first academic society in this field. In 2009, National Cancer Center published the "Recommendations for Distress Management in Patients with Cancer", which are consensus-based guidelines for Korean patients. In 2014, the KPOSG was dissolved and absorbed into a new organization, the Korean Psycho-Oncology Society (KPOS). It functions as a center of development of psycho-oncology, publishing official journals, and hosting annual conferences. There are many challenges, including, low awareness of psycho-oncology, presence of undertreated psychiatric disorders in patients with cancer, shortage of well-trained psycho-oncologists, stigma, and suicide risk. It is important to improve the cancer care system to the extent that psycho-oncology is integrated with mainstream oncology. Considering the socio-cultural characteristics of Korean cancer care, a Korean model of distress management is being prepared by the KPOS. This article provides an overview of the development, current issues, and future challenges of psycho-oncology in Korea. Through its long journey

Radiation Oncology in Undergraduate Medical Education: A Literature Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dennis, Kristopher E.B., E-mail: kdennis@bccancer.bc.c; 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 oncologymore » 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.« less

18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and background tissues

PubMed Central

2014-01-01

Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a well-established imaging modality for a wide variety of solid malignancies. Currently, only limited data exists regarding the utility of PET/CT imaging at very extended injection-to-scan acquisition times. The current retrospective data analysis assessed the feasibility and quantification of diagnostic 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals. Methods 18F-FDG-avid lesions (not surgically manipulated or altered during 18F-FDG-directed surgery, and visualized both on preoperative and postoperative 18F-FDG PET/CT imaging) and corresponding background tissues were assessed for 18F-FDG accumulation on same-day preoperative and postoperative 18F-FDG PET/CT imaging. Multiple patient variables and 18F-FDG-avid lesion variables were examined. Results For the 32 18F-FDG-avid lesions making up the final 18F-FDG-avid lesion data set (from among 7 patients), the mean injection-to-scan times of the preoperative and postoperative 18F-FDG PET/CT scans were 73 (±3, 70-78) and 530 (±79, 413-739) minutes, respectively (P < 0.001). The preoperative and postoperative mean 18F-FDG-avid lesion SUVmax values were 7.7 (±4.0, 3.6-19.5) and 11.3 (±6.0, 4.1-29.2), respectively (P < 0.001). The preoperative and postoperative mean background SUVmax values were 2.3 (±0.6, 1.0-3.2) and 2.1 (±0.6, 1.0-3.3), respectively (P = 0.017). The preoperative and postoperative mean lesion-to-background SUVmax ratios were 3.7 (±2.3, 1.5-9.8) and 5.8 (±3.6, 1.6-16.2), respectively, (P < 0.001). Conclusions 18F-FDG PET/CT oncologic imaging can be successfully performed at extended injection-to-scan acquisition time intervals of up to approximately 5 half-lives for 18F-FDG while maintaining good/adequate diagnostic image quality. The resultant increase in the 18F-FDG-avid lesion SUVmax values, decreased background SUVmax values, and

Development and Validation of a Nutritional Education Pamphlet for Low-Literacy Pediatric Oncology Caregivers in Central America

PubMed Central

Garcia, Melissa; Chismark, Elisabeth A.; Mosby, Terezie; Day, Sara

2013-01-01

Background A culturally appropriate nutrition education pamphlet was developed and validated for low-literacy caregivers in Honduras, El Salvador, and Guatemala. Methods The pamphlet was developed after a preliminary survey of pediatric oncology nurses in the 3 countries to assess the need for education materials, caregiver literacy levels, and local eating habits. Experts in nutrition and low-literacy patient education and nurses validated the pamphlet’s content and design. Results and Conclusions Nurses expressed the need for nutrition-related pamphlets in developing countries. The pamphlet was validated positively by experts and nurses and has been circulated to pediatric oncology caregivers in Central America. PMID:20300913

The Evolution of Gero-Oncology Nursing.

PubMed

Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

2016-02-01

This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.

Actionable data analytics in oncology: are we there yet?

PubMed

Barkley, Ronald; Greenapple, Rhonda; Whang, John

2014-03-01

To operate under a new value-based paradigm, oncology providers must develop the capability to aggregate, analyze, measure, and report their value proposition--that is, their outcomes and associated costs. How are oncology providers positioned currently to perform these functions in a manner that is actionable? What is the current state of analytic capabilities in oncology? Are oncology providers prepared? This line of inquiry was the basis for the 2013 Cancer Center Business Summit annual industry research survey. This article reports on the key findings and implications of the 2013 research survey with regard to data analytic capabilities in the oncology sector. The essential finding from the study is that only a small number of oncology providers (7%) currently possess the analytic tools and capabilities necessary to satisfy internal and external demands for aggregating and reporting clinical outcome and economic data. However there is an expectation that a majority of oncology providers (60%) will have developed such capabilities within the next 2 years.

Current management of surgical oncologic emergencies.

PubMed

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

2015-01-01

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. 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. 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%. 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.

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

Inpatient Hematology-Oncology Rotation Is Associated With a Decreased Interest in Pursuing an Oncology Career Among Internal Medicine Residents.

PubMed

McFarland, Daniel C; Holland, Jimmie; Holcombe, Randall F

2015-07-01

The demand for hematologists and oncologists is not being met. We hypothesized that an inpatient hematology-oncology ward rotation would increase residents' interest. Potential reasons mitigating interest were explored and included differences in physician distress, empathy, resilience, and patient death experiences. Agreement with the statement "I am interested in pursuing a career/fellowship in hematology and oncology" was rated by residents before and after a hematology-oncology rotation, with 0 = not true at all, 1 = rarely true, 2 = sometimes true, 3 = often true, and 4 = true nearly all the time. House staff rotating on a hematology-oncology service from November 2013 to October 2014 also received questionnaires before and after their rotations containing the Connors-Davidson Resilience Scale, the Impact of Events Scale-Revised, the Interpersonal Reactivity Index, demographic information, and number of dying patients cared for and if a sense of meaning was derived from that experience. Fifty-six residents completed both before- and after-rotation questionnaires (response rate, 58%). The mean interest score was 1.43 initially and decreased to 1.24 after the rotation (P = .301). Female residents' mean score was 1.13 initially and dropped to 0.81 after the rotation (P = .04). Male residents' mean score was 1.71 initially and 1.81 after the rotation (P = .65). Decreased hematology-oncology interest correlated with decreased empathy; male interest decrease correlated with decreased resilience. An inpatient hematology-oncology ward rotation does not lead to increased interest and, for some residents, may lead to decreased interest in the field. Encouraging outpatient hematology-oncology rotations and the cultivation of resilience, empathy, and meaning regarding death experiences may increase resident interest. Copyright © 2015 by American Society of Clinical Oncology.

Comparative Effectiveness Research in Gynecologic Oncology

PubMed Central

Patankar, Sonali; Tergas, Ana I.

2015-01-01

The field of gynecologic oncology is faced with a number of challenges including how to incorporate new drugs and procedures into practice, how to balance therapeutic efficacy and toxicity of treatment, how to individualize therapy to particular patients or groups of patients, and how to contain the rapidly rising costs associated with oncologic care. In this chapter we examine three common and highly debated clinical scenarios in gynecologic oncology: the initial management of ovarian cancer, the role of lymphadenectomy in the treatment of endometrial cancer, and the choice of adjuvant therapy for ovarian cancer. PMID:25677027

Precision oncology: origins, optimism, and potential.

PubMed

Prasad, Vinay; Fojo, Tito; Brada, Michael

2016-02-01

Imatinib, the first and arguably the best targeted therapy, became the springboard for developing drugs aimed at molecular targets deemed crucial to tumours. As this development unfolded, a revolution in the speed and cost of genetic sequencing occurred. The result--an armamentarium of drugs and an array of molecular targets--set the stage for precision oncology, a hypothesis that cancer treatment could be markedly improved if therapies were guided by a tumour's genomic alterations. Drawing lessons from the biological basis of cancer and recent empirical investigations, we take a more measured view of precision oncology's promise. Ultimately, the promise is not our concern, but the threshold at which we declare success. We review reports of precision oncology alongside those of precision diagnostics and novel radiotherapy approaches. Although confirmatory evidence is scarce, these interventions have been widely endorsed. We conclude that the current path will probably not be successful or, at a minimum, will have to undergo substantive adjustments before it can be successful. For the sake of patients with cancer, we hope one form of precision oncology will deliver on its promise. However, until confirmatory studies are completed, precision oncology remains unproven, and as such, a hypothesis in need of rigorous testing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality Assessment in Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Albert, Jeffrey M.; Das, Prajnan, E-mail: prajdas@mdanderson.org

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 involvesmore » 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.« less

Emergencies in Hematology and Oncology.

PubMed

Halfdanarson, Thorvardur R; Hogan, William J; Madsen, Bo E

2017-04-01

The development of medical emergencies related to the underlying disease or as a result of complications of therapy are common in patients with hematologic or solid tumors. These oncological emergencies can occur as an initial presentation or in a patient with an established diagnosis and are encountered in all medical care settings, ranging from primary care to the emergency department and various subspecialty environments. Therefore, it is critically important that all physicians have a working knowledge of the potential oncological emergencies that may present in their practice and how to provide the most effective care without delay. This article reviews the most common oncological emergencies and provides practical guidance for initial management of these patients. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Modular vaccine packaging increases packing efficiency

PubMed Central

Norman, Bryan A.; Rajgopal, Jayant; Lim, Jung; Gorham, Katrin; Haidari, Leila; Brown, Shawn T.; Lee, Bruce Y.

2015-01-01

Background Within a typical vaccine supply chain, vaccines are packaged into individual cylindrical vials (each containing one or more doses) that are bundled together in rectangular “inner packs” for transport via even larger groupings such as cold boxes and vaccine carriers. The variability of vaccine inner pack and vial size may hinder efficient vaccine distribution because it constrains packing of cold boxes and vaccine carriers to quantities that are often inappropriate or suboptimal in the context of country-specific vaccination guidelines. Methods We developed in Microsoft Excel (Microsoft Corp., Redmond, WA) a spreadsheet model that evaluated the impact of different packing schemes for the Benin routine regimen plus the introduction of the Rotarix vaccine. Specifically, we used the model to compare the current packing scheme to that of a proposed modular packing scheme. Results Conventional packing of a Dometic RCW25 that aims to maximize fully-immunized children (FICs) results in 123 FICs and a packing efficiency of 81.93% compared to a maximum of 155 FICs and 94.1% efficiency for an alternative modular packaging system. Conclusions Our analysis suggests that modular packaging systems could offer significant advantages over conventional vaccine packaging systems with respect to space efficiency and potential FICs, when they are stored in standard vaccine carrying devices. This allows for more vaccines to be stored within the same volume while also simplifying the procedures used by field workers to pack storage devices. Ultimately, modular packaging systems could be a simple way to help increase vaccine coverage worldwide. PMID:25957666

Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration.

PubMed

Cox, Anna; Arber, Anne; Gallagher, Ann; MacKenzie, Mairead; Ream, Emma

2017-03-01

To obtain consensus on priorities for oncology nursing research in the United Kingdom.
. A three-round online Delphi survey.
. Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
. 50 oncology nurses and 18 patients.
. Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
. Research priorities for oncology nursing as reported by oncology nurses and patients. 
. Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed. Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
. Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

Wait Times Experienced by Lung Cancer Patients in the BC Southern Interior to Obtain Oncologic Care: Exploration of the Intervals from First Abnormal Imaging to Oncologic Treatment

PubMed Central

Chowdhury, Rezwan; Boyce, Andrew; Halperin, Ross

2015-01-01

Background: Lung cancer is associated with rapid disease progression, which can significantly progress over a duration of four to eight weeks. This study examines the time interval lung cancer patients from the interior of British Columbia (BC) experience while undergoing diagnostic evaluation, biopsy, staging, and preparation for treatment. Methods: A chart review of lung cancer patients (n=231) referred to the BC Cancer Agency Centre for the Southern Interior between January 1, 2010 and December 31, 2011 was performed. Time zero was defined as the date of the first abnormal chest imaging. Time intervals, expressed as median averages, to specialist consult, biopsy, oncologic referral, initial oncology consultation, and commencement of oncologic treatment were obtained. Results: The median time interval from first abnormal chest imaging to a specialist consultation was 18 days (interquartile range, IQR, 7-36). An additional nine days elapsed prior to biopsy in the form of bronchoscopy, CT-guided biopsy, or sputum cytology (median; IQR, 3-21); if lobectomy was required, 18 days elapsed (median; IQR, 9-28). Eight days were required for pathologic diagnosis and subsequent referral to the cancer centre (median; IQR, 3-16.5). Once referral was received, 10 days elapsed prior to consultation with either a medical or radiation oncologist (median, IQR 5-18). Finally, eight days was required for initiation of radiation and/or chemotherapy (median; IQR, 1-15). The median wait time from detection of lung cancer on imaging to oncologic treatment in the form of radiation and/or chemotherapy was 65.5 days (IQR, 41.5-104.3).  Interpretation: Patients in the BC Southern Interior experience considerable delays in accessing lung cancer care. During this time, the disease has the potential to significantly progress and it is possible that a subset of patients may lose their opportunity for curative intent treatment. PMID:26543688

Prevalence of Cryptosporidium species and subtypes in paediatric oncology and non-oncology patients with diarrhoea in Jordan.

PubMed

Hijjawi, Nawal; Zahedi, Alireza; Kazaleh, Mahmoud; Ryan, Una

2017-11-01

Cryptosporidiosis is a protozoan parasitic disease which affects human and animals worldwide. In adult immunocompetent individuals, cryptosporidiosis usually results in acute and self-limited diarrhoea; however, it can cause life threatening diarrhoea in children and immunocompromised individuals. In the present study, we compared the prevalence of Cryptosporidium species and gp60 subtypes amongst paediatric oncology patients with diarrhoea (n=160) from King Hussein Medical Centre for Cancer in Jordan, and non-oncology paediatric patients with diarrhoea (n=137) from Al-Mafraq paediatric hospital. Microscopy results using modified acid fast staining identified a significantly (p≤0.05) higher prevalence of Cryptosporidium in paediatric oncology patients with diarrhoea (14.4% - 23/160), compared to non-oncology paediatric patients with diarrhoea only (5.1% - 7/137). With the exception of one sample, all microscopy-positive samples (n=29) and an additional 3/30 microscopy-negative controls were typed to species and subtype level at the 18S and gp60 loci, respectively. All Cryptosporidium positives were typed as C. parvum. Of the 22 typed Cryptosporidium positives from the paediatric oncology patients, 21 were subtyped as IIaA17G2R1 and one as IIaA16G2R1 C. parvum subtypes. The 7 typed positives from the paediatric patients from Al-Mafraq hospital were subtyped as IIaA17G2R1 (n=5) and IIaA16G2R1 (n=2). The 3 additional positives from the 30 microscopy negative control samples were subtyped as IIaA17G2R1. The high prevalence of the IIaA17G2R1 subtype, particularly amongst oncology patients, suggests that an outbreak of cryptosporidiosis may have been occurring in oncology patients during the collection period (April to December, 2016). New therapies for cryptosporidiosis in immunocompromised patients are urgently required. Copyright © 2017 Elsevier B.V. All rights reserved.

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.…

Global geriatric oncology: Achievements and challenges.

PubMed

Soto-Perez-de-Celis, Enrique; de Glas, Nienke A; Hsu, Tina; Kanesvaran, Ravindran; Steer, Christopher; Navarrete-Reyes, Ana Patricia; Battisti, Nicolo Matteo Luca; Chavarri-Guerra, Yanin; O'Donovan, Anita; Avila-Funes, Jose Alberto; Hurria, Arti

2017-09-01

The aging of the population is a global challenge. The number of older adults is rapidly growing, leading to an increase in the prevalence of noncommunicable diseases associated with aging, such as cancer. Worldwide, older adults account for approximately half of all cancer cases, and this proportion is projected to increase globally. Furthermore, the majority of older adults live in less developed regions, where health systems are generally ill-equipped to provide care for complex chronic conditions. Worldwide, there is paucity of geriatric training, and most of the oncology workforce lacks the skills and knowledge to provide comprehensive care for older patients. Various initiatives aimed at providing adequate clinical care for older adults, increasing the geriatric skills and knowledge of healthcare professionals, and developing geriatric oncology research, have been successfully implemented. However, most developments in geriatric oncology have taken place in high-income countries, and there are still large inequalities in the availability of clinical, educational, and research initiatives across different regions of the world. This article provides an overview of geriatric oncology initiatives in Asia, Europe, Australia and New Zealand, Latin America, and the United States and Canada. Understanding the achievements and challenges of geriatric oncology around the world, and fostering international collaboration in research and training are essential for improving the care of all older adults with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

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

The script concordance test in radiation oncology: validation study of a new tool to assess clinical reasoning

PubMed Central

Lambert, Carole; Gagnon, Robert; Nguyen, David; Charlin, Bernard

2009-01-01

Background The Script Concordance test (SCT) is a reliable and valid tool to evaluate clinical reasoning in complex situations where experts' opinions may be divided. Scores reflect the degree of concordance between the performance of examinees and that of a reference panel of experienced physicians. The purpose of this study is to demonstrate SCT's usefulness in radiation oncology. Methods A 90 items radiation oncology SCT was administered to 155 participants. Three levels of experience were tested: medical students (n = 70), radiation oncology residents (n = 38) and radiation oncologists (n = 47). Statistical tests were performed to assess reliability and to document validity. Results After item optimization, the test comprised 30 cases and 70 questions. Cronbach alpha was 0.90. Mean scores were 51.62 (± 8.19) for students, 71.20 (± 9.45) for residents and 76.67 (± 6.14) for radiation oncologists. The difference between the three groups was statistically significant when compared by the Kruskall-Wallis test (p < 0.001). Conclusion The SCT is reliable and useful to discriminate among participants according to their level of experience in radiation oncology. It appears as a useful tool to document the progression of reasoning during residency training. PMID:19203358

Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015.

PubMed

Yoo, Stella K; Ahmed, Awad A; Ileto, Jan; Zaorsky, Nicholas G; Deville, Curtiland; Holliday, Emma B; Wilson, Lynn D; Jagsi, Reshma; Thomas, Charles R

2017-10-01

To quantify and determine the relationship between oncology departmental/division heads and private industry vis-à-vis potential financial conflict of interests (FCOIs) as publicly reported by the Centers for Medicare and Medicaid Services Open Payments database. We extracted the names of the chairs/chiefs in medical oncology (MO) and chairs of radiation oncology (RO) for 81 different institutions with both RO and MO training programs as reported by the Association of American Medical Colleges. For each leader, the amount of consulting fees and research payments received in 2015 was determined. Logistic modeling was used to assess associations between the 2 endpoints of receiving a consulting fee and receiving a research payment with various institution-specific and practitioner-specific variables included as covariates: specialty, sex, National Cancer Institute designation, PhD status, and geographic region. The majority of leaders in MO were reported to have received consulting fees or research payments (69.5%) compared with a minority of RO chairs (27.2%). Among those receiving payments, the average (range) consulting fee was $13,413 ($200-$70,423) for MO leaders and $6463 ($837-$16,205) for RO chairs; the average research payment for MO leaders receiving payments was $240,446 ($156-$1,234,762) and $295,089 ($160-$1,219,564) for RO chairs. On multivariable regression when the endpoint was receipt of a research payment, those receiving a consulting fee (odds ratio [OR]: 5.34; 95% confidence interval [CI]: 2.22-13.65) and MO leaders (OR: 5.54; 95% CI: 2.62-12.18) were more likely to receive research payments. Examination of the receipt of consulting fees as the endpoint showed that those receiving a research payment (OR: 5.41; 95% CI: 2.23-13.99) and MO leaders (OR: 3.06; 95% CI: 1.21-8.13) were more likely to receive a consulting fee. Leaders in academic oncology receive consulting or research payments from industry. Relationships between oncology leaders and

Pediatric oncologic endosurgery.

PubMed

Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

2017-08-01

Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

Understanding the role of physician assistants in oncology.

PubMed

Ross, Alicia C; Polansky, Maura N; Parker, Patricia A; Palmer, J Lynn

2010-01-01

To understand the deployment of physician assistants (PAs) in oncology. A recent analysis of the oncology workforce in the United States commissioned by ASCO predicted a significant shortage of providers by 2020. A descriptive study was undertaken using a Web-based questionnaire survey. Invited participants, including all PAs listed in the national PA database (n = 855) and all PAs at The University of Texas M. D. Anderson Cancer Center (Houston, TX; n = 159), were mailed letters directing them to the Web-based survey. The study produced a 30% response rate. A total of 186 PAs worked in medical oncology (the population of interest). Of the respondents, 80% were women, mean age was 36 years, average time employed as a PA was 9.5 years (6.5 years in oncology), 55% had obtained a master's degree, four had completed a postgraduate oncology program, 91% reported that direct mentorship by a supervising physician was very important in obtaining oncology-based knowledge, and 61% reported that becoming fully competent in the practice of oncology required 1 to 2 years. The majority of PAs (78.5%) worked 33 to 50 hours per week, and 56% of those reported working 41 to 50 hours per week. Three fourths (77%) wrote chemotherapy orders, most requiring physician co-signature, and 69% prescribed schedule III to V controlled substances. Additional data were gathered regarding clinical duties, research, and teaching. Oncology PAs are used in multiple medical settings, and many assume high-level responsibilities. Future research addressing function and factors that limit use of PAs may allow for improved organizational efficiency and enhancement in the delivery of health care.

Investigating Barriers in HIV-Testing Oncology Patients: The IBITOP Study, Phase I

PubMed Central

Merz, Laurent; Zimmermann, Stefan; Peters, Solange; Cavassini, Matthias

2016-01-01

Background. Although the prevalence of non-AIDS-defining cancers (non-ADCs) among people living with HIV is rising, we observed HIV testing rates below 5% at our oncology center, against a regional HIV prevalence of 0.2%–0.4%. We performed the Investigating Barriers in HIV-Testing Oncology Patients (IBITOP) study among oncology physicians and patients. Methods. Between July 1 and October 31, 2013, patients of unknown HIV status newly diagnosed with solid-organ non-ADCs referred to Lausanne University Hospital Oncology Service, Switzerland, were offered free HIV testing as part of their oncology work-up. The primary endpoints were (a) physician willingness to offer and patient acceptance of HIV testing and (b) physicians’ reasons for not offering testing. Results. Of 239 patients of unknown HIV status with a new non-ADC diagnosis, 43 (18%) were offered HIV testing, of whom 4 declined (acceptance rate: 39 of 43; 91%). Except for 21 patients tested prior to oncology consultation, 175 patients (of 239; 73%) were not offered testing. Testing rate declined among patients who were >70 years old (12% versus 30%; p = .04); no non-European patients were tested. Physicians gave reasons for not testing in 16% of cases, the main reason being patient follow-up elsewhere (10 patients; 5.7%). HIV testing during the IBITOP study increased the HIV testing rate to 18%. Conclusion. Although the IBITOP study increased HIV testing rates, most patients were not tested. Testing was low or nonexistent among individuals at risk of late HIV presentation (older patients and migrants). Barriers to testing appear to be physician-led, because patient acceptance of testing offered was very high (91%). In November 2013, the Swiss HIV testing recommendations were updated to propose testing in cancer patients. Phase II of the IBITOP study is examining the effect of these recommendations on HIV testing rates and focusing on physician-led testing barriers. Implications for Practice: Patients of

Artificial Intelligence in Medicine and Radiation Oncology

PubMed Central

Weidlich, Vincent

2018-01-01

Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations. PMID:29904616

Artificial Intelligence in Medicine and Radiation Oncology.

PubMed

Weidlich, Vincent; Weidlich, Georg A

2018-04-13

Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations.

Pragmatic precision oncology: the secondary uses of clinical tumor molecular profiling

PubMed Central

Thota, Ramya; Staggs, David B; Johnson, Douglas B; Warner, Jeremy L

2016-01-01

Background Precision oncology increasingly utilizes molecular profiling of tumors to determine treatment decisions with targeted therapeutics. The molecular profiling data is valuable in the treatment of individual patients as well as for multiple secondary uses. Objective To automatically parse, categorize, and aggregate clinical molecular profile data generated during cancer care as well as use this data to address multiple secondary use cases. Methods A system to parse, categorize and aggregate molecular profile data was created. A naÿve Bayesian classifier categorized results according to clinical groups. The accuracy of these systems were validated against a published expertly-curated subset of molecular profiling data. Results Following one year of operation, 819 samples have been accurately parsed and categorized to generate a data repository of 10,620 genetic variants. The database has been used for operational, clinical trial, and discovery science research. Conclusions A real-time database of molecular profiling data is a pragmatic solution to several knowledge management problems in the practice and science of precision oncology. PMID:27026612

Exercise-Based Oncology Rehabilitation: Leveraging the Cardiac Rehabilitation Model

PubMed Central

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

2014-01-01

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

Perioperative Palliative Care Considerations for Surgical Oncology Nurses.

PubMed

Sipples, Rebecca; Taylor, Richard; Kirk-Walker, Deborah; Bagcivan, Gulcan; Dionne-Odom, J Nicholas; Bakitas, Marie

2017-02-01

To explore the opportunities to incorporate palliative care into perioperative oncology patient management and education strategies for surgical oncology nurses. Articles related to palliative care and surgical oncology to determine the degree of integration, gaps, and implications for practice. Although evidence supports positive patient outcomes when palliative care is integrated in the perioperative period, uptake of palliative care into surgical settings is slow. Palliative care concepts are not adequately integrated into surgical and nursing education. With appropriate palliative care education and training, surgical oncology nurses will be empowered to foster surgical-palliative care collaborations to improve patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study.

PubMed

Schrank, Beate; Rumpold, Tamara; Amering, Michaela; Masel, Eva Katharina; Watzke, Herbert; Schur, Sophie

2017-06-01

In increasingly globalized societies, patient-centered cancer care requires culture-sensitive approaches in order to ensure patients well-being. While migrant patients' needs are frequently reported in the literature, staff members' perception of work with migrant patients, associated challenges, or individual work approaches are largely unknown. This study addresses this research gap through qualitative exploration of experiences of multicultural health care professionals in supportive oncology and palliative care, working with patients from different cultural backgrounds. This study aims to understand staff experience of the impact of culture on cancer care. This study was conducted at the Medical University of Vienna, including staff from different settings of oncology and palliative care, in different professional positions, and with a range of individual migration backgrounds. Semistructured interviews were conducted with 21 staff members working with patients from different cultural backgrounds. Interviews explored views on the impact of culture on care were audio-taped, transcribed, and analyzed using a rigorous method of thematic analysis, enhanced with grounded theory techniques. Interviews revealed 4 key topics: culture-specific differences, assumed reasons for differences, consequences of multicultural care, and tools for culture-sensitive care. Strategies to better deal with migrant patients and their families were suggested to improve work satisfaction amongst staff. This study identifies relevant staff challenges in work with migrant patients. Concrete suggestions for improvement include measures on an organizational level, team level, and personal tools. The suggested measures are applicable to improve work satisfaction and culture-sensitive care not only in cancer care but also in other areas of medicine. Copyright © 2016 John Wiley & Sons, Ltd.

Ethical problems experienced by oncology nurses.

PubMed

da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

2015-01-01

To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

Radiation oncology: a primer for medical students.

PubMed

Berman, Abigail T; Plastaras, John P; Vapiwala, Neha

2013-09-01

Radiation oncology requires a complex understanding of cancer biology, radiation physics, and clinical care. This paper equips the medical student to understand the fundamentals of radiation oncology, first with an introduction to cancer treatment and the use of radiation therapy. Considerations during radiation oncology consultations are discussed extensively with an emphasis on how to formulate an assessment and plan including which treatment modality to use. The treatment planning aspects of radiation oncology are then discussed with a brief introduction to how radiation works, followed by a detailed explanation of the nuances of simulation, including different imaging modalities, immobilization, and accounting for motion. The medical student is then instructed on how to participate in contouring, plan generation and evaluation, and the delivery of radiation on the machine. Lastly, potential adverse effects of radiation are discussed with a particular focus on the on-treatment patient.

How to Develop a Cardio-Oncology Clinic.

PubMed

Snipelisky, David; Park, Jae Yoon; Lerman, Amir; Mulvagh, Sharon; Lin, Grace; Pereira, Naveen; Rodriguez-Porcel, Martin; Villarraga, Hector R; Herrmann, Joerg

2017-04-01

Cardiovascular demands to the care of cancer patients are common and important given the implications for morbidity and mortality. As a consequence, interactions with cardiovascular disease specialists have intensified to the point of the development of a new discipline termed cardio-oncology. As an additional consequence, so-called cardio-oncology clinics have emerged, in most cases staffed by cardiologists with an interest in the field. This article addresses this gap and summarizes key points in the development of a cardio-oncology clinic. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review

PubMed Central

Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

2017-01-01

Background Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. Data sources A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010–2015). Study eligibility criteria All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Intervention Quality of reporting was assessed using the Key Methodological Score. Results 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Limitations Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. Conclusions & implications of key findings This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials

Simulation of PEP-II Accelerator Backgrounds Using TURTLE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barlow, R.J.; Fieguth, T.; /SLAC

2006-02-15

We present studies of accelerator-induced backgrounds in the BaBar detector at the SLAC B-Factory, carried out using LPTURTLE, a modified version of the DECAY TURTLE simulation package. Lost-particle backgrounds in PEP-II are dominated by a combination of beam-gas bremstrahlung, beam-gas Coulomb scattering, radiative-Bhabha events and beam-beam blow-up. The radiation damage and detector occupancy caused by the associated electromagnetic shower debris can limit the usable luminosity. In order to understand and mitigate such backgrounds, we have performed a full program of beam-gas and luminosity-background simulations, that include the effects of the detector solenoidal field, detailed modeling of limiting apertures in bothmore » collider rings, and optimization of the betatron collimation scheme in the presence of large transverse tails.« less

[Treatment Refusal in Pediatric Oncology].

PubMed

Špótová, A; Husáková, K; Hrašková, A; Mikesková, M; Puškáčová, J; Hederová, S; Jamárik, M; Rabenseifertová, E; Jalovecká, Z; Kolenová, A; Šubová, Z

2017-01-01

Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly against oncological treatment, potentially compromising their childrens rights for health care and to the chance for cure. In this paper, we report two cases of treatment refusal from our department and the impact of such decisions on the children themselves. Case no. 1 describes a child with retinoblastoma whose parents refused standard treatment in order to seek alternative treatment abroad. Case no. 2 describes a patient with a primary lymphoma of bone who received treatment by a court order after parental refusal. When parents refuse a treatment for potentially curable cancer, the medical team often focuses on the certainty of death without treatment. In the background, there is a smaller but still significant risk that - even if the treatment is eventually accepted or compelled - the child will still die from treatment-related complications or refractory disease, possibly with considerable suffering. The reasons for refusing a treatment vary. The entire medical team is tasked with trying to respectfully understand the reasoning behind the parents unwillingness to accept the treatment, in order to address all possible misunderstandings and to propose solutions that could be acceptable for the parents. In some situations however, it is necessary to resolve the dilemma by legal means in order to protect the life of the child.Key words: oncology - ethics - decision making - treatment refusal - legal guardians The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 7. 8. 2017Accepted: 7. 9. 2017.

Market uptake of biologic and small-molecule--targeted oncology drugs in Europe.

PubMed

Obradovic, Marko; Mrhar, Ales; Kos, Mitja

2009-12-01

The aim of this study was to investigate the market uptake of biologic and small-molecule-targeted oncology drugs in Europe. Targeted oncology drugs that were used in one of the selected European countries before the end of 2007 were eligible for inclusion in the analysis. The following European countries were included: Austria, Croatia, France, Germany, Hungary, Italy, Slovenia, and the United Kingdom. Monetary market uptake of targeted oncology drugs was assessed by using sales data (in euros) obtained from 2 large data- bases for the period 1997-2007. Market uptake was assessed in terms of expenditures for specific drugs in euros per capita and in market shares. The monetary market uptake of targeted oncology drugs had an exponential growth from 1997 to 2007 in all comparison countries and reached 40% of the total oncology drug market in 2007. Although the various European countries allocate substantially different amounts of resources per capita for oncology drugs, the share of expenditures attributed to targeted oncology drugs did not differ substantially among the countries. Biologic molecules were used in clinical practice before the small-molecule-targeted oncology drugs. Targeted oncology drugs that were introduced first to clinical practice in most of the comparison countries (ie, rituximab, trastuzumab, imatinib mesylate) maintained the leading positions on the market throughout the period of the analysis. In 2007, approximately 25% of all expenditures for oncology drugs were attributed to biologic oncology drugs, and approximately 15% were spent on small-molecule-targeted oncology drugs. Expenditures on targeted oncology drugs have been increasing exponentially in Europe throughout the past decade and have reached a 40% share of the oncology drug market. As of 2007, the market share of biologic oncology drugs was higher than the market share of small-molecule-targeted oncology drugs. Copyright 2009 Excerpta Medica Inc. All rights reserved.

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

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

A Nationwide Medical Student Assessment of Oncology Education.

PubMed

Mattes, Malcolm D; Patel, Krishnan R; Burt, Lindsay M; Hirsch, Ariel E

2016-12-01

Cancer is the second leading cause of death in the USA, but there is minimal data on how oncology is taught to medical students. The purpose of this study is to characterize oncology education at US medical schools. An electronic survey was sent between December 2014 and February 2015 to a convenience sample of medical students who either attended the American Society for Radiation Oncology annual meeting or serve as delegates to the American Association of Medical Colleges. Information on various aspects of oncology instruction at participants' medical schools was collected. Seventy-six responses from students in 28 states were received. Among the six most common causes of death in the USA, cancer reportedly received the fourth most curricular time. During the first, second, and third years of medical school, participants most commonly reported 6-10, 16-20, and 6-10 h of oncology teaching, respectively. Participants were less confident in their understanding of cancer treatment than workup/diagnosis or basic science/natural history of cancer (p < 0.01). During the preclinical years, pathologists, scientists/Ph.D.'s, and medical oncologists reportedly performed the majority of teaching, whereas during the clinical clerkships, medical and surgical oncologists reportedly performed the majority of teaching. Radiation oncologists were significantly less involved during both periods (p < 0.01). Most schools did not require any oncology-oriented clerkship. During each mandatory rotation, <20 % of patients had a primary diagnosis of cancer. Oncology education is often underemphasized and fragmented with wide variability in content and structure between medical schools, suggesting a need for reform.

Medical oncology future plan of the Spanish Society of Medical Oncology: challenges and future needs of the Spanish oncologists.

PubMed

Rivera, F; Andres, R; Felip, E; Garcia-Campelo, R; Lianes, P; Llombart, A; Piera, J M; Puente, J; Rodriguez, C A; Vera, R; Virizuela, J A; Martin, M; Garrido, P

2017-04-01

The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.

Scientific Advances Shaping the Future Roles of Oncology Nurses.

PubMed

Wujcik, Debra

2016-05-01

To discuss the recent scientific advances that influence current oncology care and explore the implications of these advances for the future of oncology nursing. Current nursing, medical and basic science literature; Clinicaltrials.gov. The future of oncology care will be influenced by an aging population and increasing number of patients diagnosed with cancer. The advancements in molecular sequencing will lead to more clinical trials, targeted therapies, and treatment decisions based on the genetic makeup of both the patient and the tumor. Nurses must stay current with an ever changing array of targeted therapies and developing science. Nurses will influence cancer care quality, value, cost, and patient satisfaction. It is critical for oncology nurses and nursing organizations to engage with all oncology care stakeholders in identifying the future needs of oncology patients and the environment in which care will be delivered. Nurses themselves must identify the roles that will be needed to ensure a workforce that is adequate in number and well trained to meet the future challenges of care delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients: Consensus Recommendations from a Children’s Oncology Group Expert Panel

PubMed Central

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P.; Bhatia, Smita; Bingen, Kristin M.; Bondurant, Patricia G.; Cohn, Susan L.; Dobrozsi, Sarah K.; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C.; Martin, Melissa; Murphy, Kathryn; Newman, Amy R.; Rodgers, Cheryl C.; Ruccione, Kathleen S.; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

2016-01-01

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology. PMID:27385664

The white book of radiation oncology in Spain.

PubMed

Herruzo, Ismael; Romero, Jesús; Palacios, Amalia; Mañas, Ana; Samper, Pilar; Bayo, Eloísa; Guedea, Ferran

2011-06-01

The White Book of Radiation Oncology provides a comprehensive overview of the current state of the speciality of radiation oncology in Spain and is intended to be used as a reference for physicians, health care administrators and hospital managers. The present paper summarises the most relevant aspects of the book's 13 chapters in order to bring the message to a wider audience. Among the topics discussed are the epidemiology of cancer in Spain, the role of the radiation oncologist in cancer care, human and material resource needs, new technologies, training of specialists, clinical and cost management, clinical practice, quality control, radiological protection, ethics, relevant legislation, research & development, the history of radiation oncology in Spain and the origins of the Spanish Society of Radiation Oncology (SEOR).

Teaching and Assessing Systems-Based Practice: A Pilot Course in Health Care Policy, Finance, and Law for Radiation Oncology Residents

PubMed Central

Mitchell, James D.; Parhar, Preeti; Narayana, Ashwatha

2010-01-01

Background Under the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project, residency programs are required to provide data on educational outcomes and evidence for how this information is used to improve resident education. Objective To teach and assess systems-based practice through a course in health care policy, finance, and law for radiation oncology residents, and to determine its efficacy. Methods and Materials We designed a pilot course in health care policy, finance, and law related to radiation oncology. Invited experts gave lectures on policy issues important to radiation oncology and half of the participants attended the American Society for Therapeutic Radiation and Oncology (ASTRO) Advocacy Day. Participants completed pre- and postcourse tests to assess their knowledge of health policy. Results Six radiation oncology residents participated, with 5 (84%) completing all components. For the 5 residents completing all assessments, the mean precourse score was 64% and the mean postcourse score was 84% (P  =  .05). Improvement was noted in all 3 sections of health policy, finance, and medical law. At the end of the course, 5 of 6 residents were motivated to learn about health policy, and 4 of 6 agreed it was important for physicians to be involved in policy matters. Conclusions Teaching radiation oncology residents systems-based practice through a course on health policy, finance, and law is feasible and was well received. Such a course can help teaching programs comply with the ACGME Outcome Project and would also be applicable to trainees in other specialties. PMID:21976087

Lay beliefs on Polish oncology in the evaluation of healthy individuals.

PubMed

Synowiec-Piłat, Małgorzata

2017-12-23

Poland is among the countries which reported the highest rates of mortality from cancer. The health behaviours of people are influenced, among other things, by their beliefs about cancer, but their evaluation of oncological institutions and specialists seems also to be of great importance. Objectives. 1. How the respondents evaluate Polish oncology: a) the conditions of treatment in oncology hospitals, b) access to oncological medical services, c) the competence of oncologists. 2. What are the socio-cultural factors of the assessment of Polish oncology? 3. What is the influence of the grade level of the assessment of Polish oncology on the degree of fear and the knowledge about cancer? The study was carried out with a sample of 910 adult residents of Wroclaw in south-west Poland. Quota sampling was used. An interview questionnaire was used as the method. Analysis of the data showed a negative image of Polish oncology, according to the study participants: dissatisfaction with both treatment conditions and with access to medical services. Assessment of Polish oncology depends primarily on education, age and economic situation, as well as 'family history of cancer', and attitude towards doctors. The lower the rating of Polish oncology, the lower the medical knowledge, and the higher the level of fear of cancer. Negative assessment of Polish oncology perpetuates the fear of cancer in society. There is a need for constant improvement of the quality of medical oncology services, for building public trust in physicians, to fight inequalities in health, and to take into account the lay perspectives in developing strategies to combat cancer.

Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

PubMed

Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

2015-12-01

Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

The Role of Oncology Nurses in Discussing Clinical Trials.

PubMed

Flocke, Susan A; Antognoli, Elizabeth; Daly, Barbara J; Jackson, Brigid; Fulton, Sarah E; Liu, Tasnuva M; Surdam, Jessica; Manne, Sharon; Meropol, Neal J

2017-09-01

To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. A qualitative study designed to elicit narratives from oncology nurses. 
. Community- and academic-based oncology clinics throughout the United States.
. 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings. The sample was drawn from members of the Oncology Nursing Society. 
. In-depth interviews were conducted and analyzed using a 
immersion/crystallization approach to identify themes and patterns. The analyses highlight specific issues, examples, and contexts that present challenges to clinical trial discussions with patients.
. Oncology nurses view their roles as patient educators and advocates to be inclusive of discussion of clinical trials. Barriers to such discussions include lack of knowledge and strategies for addressing patients' common misconceptions and uncertainty about the timing of discussions.
. These data indicate that enabling nurses to actively engage patients in discussions of clinical trials requires educational interventions to build self-efficacy and close knowledge gaps. 
. Oncology nurses can play a critical role in advancing cancer care by supporting patients in decision making about clinical trial participation. This will require training and education to build their knowledge, reduce barriers, and increase their self-efficacy to fulfill this responsibility in various clinical settings.

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…

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)

A Nationwide Medical Student Assessment of Oncology Education

PubMed Central

Patel, Krishnan R.; Burt, Lindsay M.; Hirsch, Ariel E.

2017-01-01

Cancer is the second leading cause of death in the USA, but there is minimal data on how oncology is taught to medical students. The purpose of this study is to characterize oncology education at US medical schools. An electronic survey was sent between December 2014 and February 2015 to a convenience sample of medical students who either attended the American Society for Radiation Oncology annual meeting or serve as delegates to the American Association of Medical Colleges. Information on various aspects of oncology instruction at participants’ medical schools was collected. Seventy-six responses from students in 28 states were received. Among the six most common causes of death in the USA, cancer reportedly received the fourth most curricular time. During the first, second, and third years of medical school, participants most commonly reported 6–10, 16–20, and 6–10 h of oncology teaching, respectively. Participants were less confident in their understanding of cancer treatment than workup/ diagnosis or basic science/natural history of cancer (p<0.01). During the preclinical years, pathologists, scientists/Ph.D.’s, and medical oncologists reportedly performed the majority of teaching, whereas during the clinical clerkships, medical and surgical oncologists reportedly performed the majority of teaching. Radiation oncologists were significantly less involved during both periods (p<0.01). Most schools did not require any oncology-oriented clerkship. During each mandatory rotation, ≤20 % of patients had a primary diagnosis of cancer. Oncology education is often underemphasized and fragmented with wide variability in content and structure between medical schools, suggesting a need for reform. PMID:26123764

Stress Levels of Nurses in Oncology Outpatient Units.

PubMed

Ko, Woonhwa; Kiser-Larson, Norma

2016-04-01

Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

Implications of Tobacco Industry Research on Packaging Colors for Designing Health Warning Labels.

PubMed

Lempert, Lauren K; Glantz, Stanton A

2016-09-01

Health warning labels (HWLs) are an important way to educate the public about the dangers of tobacco products. Tobacco companies conducted research to understand how pack colors affect consumers' perceptions of the products and make packages and their labeling more visually prominent. We analyzed previously secret tobacco industry documents concerning the tobacco industry's internal research on how cigarette package colors and design influence the visual prominence of packages and consumers' perceptions of the harmfulness of the products. The companies found that black is visually prominent, placing dark pack elements on a contrasting light background makes them stand out more, and black text on a white background is more prominent than white text on a black background. Yellow most quickly and effectively seizes and holds consumers' attention and signals warning or danger, while white connotes health and safety. Using black text on a bright contrasting background color, particularly yellow, attracts consumers' attention to the message. Tobacco industry research on pack color choices that make pack elements more prominent, attract and keep consumers' attention, and convey danger instead of health should guide governments in specifying requirements for HWLs. These factors suggest that HWLs printed on a yellow background with black lettering and borders would most effectively seize and keep consumers' attention and signal the danger of cigarettes and other tobacco products. Tobacco companies' internal research on improving the prominence of pack elements suggests that HWLs using black lettering on a contrasting yellow background would most effectively seize and hold consumers' attention and signal the danger of cigarettes and other tobacco products. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Scientific activity and needs among medical oncology units in sicily: a survey of the italian association of medical oncology.

PubMed

Amadio, P; Bordonaro, R; Borsellino, N; Butera, A; Caruso, M; Ferraù, F; Russello, R; Savio, G; Valenza, R; Zerilli, F; Gebbia, V

2010-02-01

In the era of targeted therapies and combined modalities of treatment, scientific research plays a role of paramount importance in improving knowledge of cancer treatment. The aim of this survey was to review the scientific activity of medical oncology units in Sicily and to analyze their needs and possible pitfalls in order to improve future scientific cooperation.The regional section of the Italian Association of medical Oncology (AIOM) approved this survey in November, 2007. A systematic review of scientific activity produced by medical oncology units in Sicily during the last 5 years has been reviewed. papers dealing with solid tumors reported in the pubmed web site have been included in the analysis. Data were reported as absolute number of published papers and impact factor per medical oncology unit and also as a ratio between global impact factor and the number of personnel working in each single unit to analyze scientific production according to the workforce of each institution.We identified a total of 283 papers reported in pubmed between 2004 and march, 2009. The mean number of publications/unit was 10.9 with a range of 0-50. The mean number of publications/year was 11.7 with a range of 0.2-10. The 15 units included in the impact factor evaluation published 252 papers with a total impact factor of 1014.6 points in 5 years with a mean of 63.4 points per institution and a mean of 4.02 points/paper. However only four medical oncology units reported a cumulative 5-year impact factor >100 points.This survey has shown that a minority of medical oncology units in Sicily is constantly involved in clinical research although at different levels of activity. Overall the percentage of patients enrolled in clinical trials is very low. The main reasons for lack of participation in clinical trials include insufficient medical personnel, the absence of a specifically dedicated research unit inside the medical oncology structures and in some cases lack of research

Integrative oncology: an overview.

PubMed

Deng, Gary; Cassileth, Barrie

2014-01-01

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

Survey of Medical Oncology Status in Korea (SOMOS-K): A National Survey of Medical Oncologists in the Korean Association for Clinical Oncology (KACO).

PubMed

Kim, Do Yeun; Lee, Yun Gyoo; Kim, Bong-Seog

2017-07-01

This study was conducted to investigate the current role of medical oncologists in cancer care with a focus on increasing the recognition of medical oncology as an independent specialty. Questionnaires modified from the Medical Oncology Status in Europe Survey dealing with oncology structure, resources, research, and patterns of care given by medical oncologists were selected. Several modifications were made to the questionnaire after feedback from the insurance and policy committee of the Korean Association for Clinical Oncology (KACO). The online survey was then sent to KACO members. A total of 214 medical oncologists (45.8% of the total inquiries), including 71 directors of medical oncology institutions, took the survey. Most institutions had various resources, including a medical oncology department (94.1%) and a department of radiation oncology (82.4%). There was an average of four medical oncologists at each institution. Medical oncologists were involved in various treatments from diagnosis to end-of-life care. They were also chemotherapy providers from a wide range of institutions that treated many types of solid cancers. In addition, 86.2% of the institutions conducted research. This is the first national survey in Korea to show that medical oncologists are involved in a wide range of cancer treatments and care. This survey emphasizes the contributions and proper roles of medical oncologists in the evolving health care environment in Korea.

Meta-analysis of studies comparing oncologic outcomes of radical prostatectomy and brachytherapy for localized prostate cancer

PubMed Central

Cozzi, Gabriele; Musi, Gennaro; Bianchi, Roberto; Bottero, Danilo; Brescia, Antonio; Cioffi, Antonio; Cordima, Giovanni; Delor, Maurizio; Di Trapani, Ettore; Ferro, Matteo; Matei, Deliu Victor; Russo, Andrea; Mistretta, Francesco Alessandro; De Cobelli, Ottavio

2017-01-01

Background: The aim of this study was to compare oncologic outcomes of radical prostatectomy (RP) with brachytherapy (BT). Methods: A literature review was conducted according to the ‘Preferred reporting items for systematic reviews and meta-analyses’ (PRISMA) statement. We included studies reporting comparative oncologic outcomes of RP versus BT for localized prostate cancer (PCa). From each comparative study, we extracted the study design, the number and features of the included patients, and the oncologic outcomes expressed as all-cause mortality (ACM), PCa-specific mortality (PCSM) or, when the former were unavailable, as biochemical recurrence (BCR). All of the data retrieved from the selected studies were recorded in an electronic database. Cumulative analysis was conducted using the Review Manager version 5.3 software, designed for composing Cochrane Reviews (Cochrane Collaboration, Oxford, UK). Statistical heterogeneity was tested using the Chi-square test. Results: Our cumulative analysis did not show any significant difference in terms of BCR, ACM or PCSM rates between the RP and BT cohorts. Only three studies reported risk-stratified outcomes of intermediate- and high-risk patients, which are the most prone to treatment failure. Conclusions: our analysis suggested that RP and BT may have similar oncologic outcomes. However, the analysis included a limited number of studies, and most of them were retrospective, making it impossible to derive any definitive conclusion, especially for intermediate- and high-risk patients. In this scenario, appropriate urologic counseling remains of utmost importance. PMID:29662542

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

2003 survey of Canadian radiation oncology residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yee, Don; Fairchild, Alysa; Keyes, Mira

2005-06-01

Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents wasmore » the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada.« less

49 CFR 173.24 - General requirements for packagings and packages.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) New packagings and packagings which are reused; and (3) Specification and non-specification packagings..., sufficient ullage (outage) must be left to ensure that neither leakage nor permanent distortion of the...

A reduction package for cross-dispersed echelle spectrograph data in IDL

NASA Astrophysics Data System (ADS)

Hall, Jeffrey C.; Neff, James E.

1992-12-01

We have written in IDL a data reduction package that performs reduction and extraction of cross-dispersed echelle spectrograph data. The present package includes a complete set of tools for extracting data from any number of spectral orders with arbitrary tilt and curvature. Essential elements include debiasing and flatfielding of the raw CCD image, removal of scattered light background, either nonoptimal or optimal extraction of data, and wavelength calibration and continuum normalization of the extracted orders. A growing set of support routines permits examination of the frame being processed to provide continuing checks on the statistical properties of the data and on the accuracy of the extraction. We will display some sample reductions and discuss the algorithms used. The inherent simplicity and user-friendliness of the IDL interface make this package a useful tool for spectroscopists. We will provide an email distribution list for those interested in receiving the package, and further documentation will be distributed at the meeting.

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.…

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

PubMed

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Technology for Innovation in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chetty, Indrin J.; Martel, Mary K., E-mail: mmartel@mdanderson.org; Jaffray, David A.

Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14,more » 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.« less

Technology for Innovation in Radiation Oncology.

PubMed

Chetty, Indrin J; Martel, Mary K; Jaffray, David A; Benedict, Stanley H; Hahn, Stephen M; Berbeco, Ross; Deye, James; Jeraj, Robert; Kavanagh, Brian; Krishnan, Sunil; Lee, Nancy; Low, Daniel A; Mankoff, David; Marks, Lawrence B; Ollendorf, Daniel; Paganetti, Harald; Ross, Brian; Siochi, Ramon Alfredo C; Timmerman, Robert D; Wong, John W

2015-11-01

Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled "Technology for Innovation in Radiation Oncology," which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic. Copyright © 2015 Elsevier Inc. All rights reserved.

Attitudes of Chinese Oncology Physicians Toward Death with Dignity.

PubMed

Chen, Hui-Ping; Huang, Bo-Yan; Yi, Ting-Wu; Deng, Yao-Tiao; Liu, Jie; Zhang, Jie; Wang, Yu-Qing; Zhang, Zong-Yan; Jiang, Yu

2016-08-01

Death with dignity (DWD) refers to the refusal of life-prolonging measures for terminally ill patients by "living wills" forms in advance. More and more oncology physicians are receiving DWD requests from advance cancer patients in mainland China. The study objective was to investigate the attitudes of Chinese oncology physicians toward the legalization and implementation of DWD. A questionnaire investigating the understanding and attitudes toward DWD was administered to 257 oncology physicians from 11 hospitals in mainland China. The effective response rate was 86.8% (223/257). The majority of oncology physicians (69.1%) had received DWD requests from patients. Half of the participants (52.5%) thought that the most important reason was the patients' unwillingness to maintain survival through machines. One-third of participants (33.0%) attributed the most important reason to suffering from painful symptoms. Most oncology physicians (78.9%) had knowledge about DWD. A fifth of respondents did not know the difference between DWD and euthanasia, and a few even considered DWD as euthanasia. The majority of oncology physicians supported the legalization (88.3%) and implementation (83.9%) of DWD. Many Chinese oncology physicians have received advanced cancer patients' DWD requests and think that DWD should be legalized and implemented. Chinese health management departments should consider the demands of physicians and patients. It is important to inform physicians about the difference between DWD and euthanasia, as one-fifth of them were confused about it.

[Psycho-oncology : the psyche and cancer].

PubMed

Heussner, P; Hiddemann, W

2012-11-01

The relationships between the psyche and cancer are manifold. Psycho-oncology focuses on the psychological adjustment to life-threatening illnesses. Crises are not unusual in health care, but the perception of cancer is totally different because the diagnosis of cancer often results in an irrational shock reaction in all parties involved. A diagnosis of cancer is much more negatively perceived than any other incurable disease, such as cardiopathy or neuropathy with a comparable or worse prognosis. During the shock of having received a diagnosis of cancer, there is no awareness that cancer can be cured. Improvement of quality of life, identification of psychological distress and prevention of mental disorders are the main tasks of psycho-oncology. Psycho-oncological services are not longer regarded a luxury, but are recognized by health care politicians as being important. However, the financing of services remains unclear.

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…

Analysis of oncology research from 2001 to 2010: a scientometric perspective.

PubMed

Shao, Hongfang; Yu, Qi; Bo, Xiaoming; Duan, Zhiguang

2013-04-01

Over the past half-century, the incidence of tumours has increased, resulting in cancer becoming one of the most lethal diseases in humans. In the present study, we elucidated the status of oncology research from 2001 to 2010. Studies published in 30 representative oncology journals were retrieved from the Web of Science (2001-2010) to compose our dataset. Knowledge domain visualisation, co-citation analysis and social network analysis methods were used. By mapping the oncology research performed from 2001 to 2010, we identified the primary research centres, including the top 20 institutions and countries and the 4 major oncology research fronts: i) the mechanism of abnormal oncogene expression; ii) tumour metastasis and angiogenesis; iii) the relationship between cancer cells and apoptosis; and iv) tumour vaccines. We also identified the 36 most collaborative academic communities, and multiple myeloma, angiogenesis and acute lymphocytic leukaemia were found to be the focuses of collaborative research in oncology from 2001 to 2010. Over the past 10 years, America has led oncology research, while China is the sole developing country to be ranked in the top 10. Analyses of the main research centres and forefronts may assist researchers in addressing these forefronts and ascertaining the developing trends in oncology. Analysis of the academic communities performing oncology research may provide scientific evidence and suggestions for policymakers to select the most prolific academic groups and leaders and to effectively manage and finance future oncology research. These selected groups and individuals will carry out additional joint undertakings and solve complex problems encountered in oncology research.

Managing integrated oncology treatment in virtual networks.

PubMed

Stanicki, Verena; Becker, Matthias; Böckmann, Britta

2015-01-01

Interdisciplinary and intersectoral coordinated healthcare management based on Clinical Practice Guidelines is essential to achieve high quality in oncological networks. The objective of our research project is to create a cookbook, which can be used by oncological networks as a template. The cookbook is based on guideline-compliant care processes. To develop these care processes, the three S3-guidelines breast, colon and prostate carcinoma have been formalized. The thus-obtained platform-independent process fragments were transformed into an underlying metamodel, which is based on HL7 and can be used for modeling clinical pathways. Additional, qualitative guided interviews were chosen to capitalize on the experts' (e.g. chief residents, resident specialists) wide knowledge and experience in oncological health care management. One of these use cases (tumor board scheduling) is developed for a healthcare management platform which is linked to a national electronic case record. The projected result of our approach is a cookbook which shows, how the treatment can be controlled by interdisciplinary and intersectoral care processes in an oncological network.

Predictors of Patient Satisfaction in Pediatric Oncology.

PubMed

Davis, Josh; Burrows, James F; Ben Khallouq, Bertha; Rosen, Paul

To understand key drivers of patient satisfaction in pediatric hematology/oncology. The "top-box" scores of patient satisfaction surveys from 4 pediatric hematology/oncology practices were collected from 2012 to 2014 at an integrated Children's Health Network. One item, "Likelihood of recommending practice," was used as the surrogate for overall patient satisfaction, and all other items were correlated to this item. A total of 1244 satisfaction surveys were included in this analysis. The most important predictors of overall patient satisfaction were cheerfulness of practice ( r = .69), wait time ( r = .60), and staff working together ( r = .60). The lowest scoring items were getting clinic on phone, information about delays, and wait time at clinic. Families bringing their children for outpatient care in a hematology/oncology practice want to experience a cheerful and collaborative medical team. Wait time at clinic may be a key driver in the overall experience for families with children with cancer. Future work should be directed at using this evidence to drive patient experience improvement processes in pediatric hematology/oncology.

Ethical problems experienced by oncology nurses1

PubMed Central

da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

2015-01-01

Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude. PMID:26626012

Creating a Culture of Professional Development for Oncology Nursing in Asia.

PubMed

Yi, Myungsun

2016-01-01

The importance of professional development of oncology nursing in Asia is growing along with growth in the cancer burden and disparity in cancer incidence and mortality between more- and less-developed regions, the latter of which includes most Asian countries. This paper proposes ways to advance the oncology nursing in terms of education, practice, and research in Asia. It also describes major challenges expected in developing and implementing a unique professional role for oncology nurses in Asia. This study will provide insights for Asian oncology nurses in developing culturally sensitive oncology nursing practices with limited health care resources.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grover, Surbhi, E-mail: surbhi.grover@uphs.upenn.edu; Swisher-McClure, Samuel; Sosnowicz, Stasha

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

WE-H-BRB-00: Big Data in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Big Data in Radiation Oncology: (1) Overview of the NIH 2015 Big Data Workshop, (2) Where do we stand in the applications of big data in radiation oncology?, and (3) Learning Health Systems for Radiation Oncology: Needs and Challenges for Future Success The overriding goal of this trio panel of presentations is to improve awareness of the wide ranging opportunities for big data impact on patient quality care and enhancing potential for research and collaboration opportunities with NIH and a host of new big data initiatives. This presentation will also summarize the Big Data workshop that was held at themore » NIH Campus on August 13–14, 2015 and sponsored by AAPM, ASTRO, and NIH. The workshop included discussion of current Big Data cancer registry initiatives, safety and incident reporting systems, and other strategies that will have the greatest impact on radiation oncology research, quality assurance, safety, and outcomes analysis. Learning Objectives: To discuss current and future sources of big data for use in radiation oncology research To optimize our current data collection by adopting new strategies from outside radiation oncology To determine what new knowledge big data can provide for clinical decision support for personalized medicine L. Xing, NIH/NCI Google Inc.« less

[The Association of Urological Oncology (AOU) German Cancer Society e.V. The competent counterpart for research in Uro-oncology].

PubMed

Rexer, H

2005-04-01

With more than 85,000 newly diagnosed cancers per year, uro-oncology alone represents a significant part in the field of oncology in Germany. Therefore, the Task Group for Uro-Oncology (The Association of Urogenital Oncology, AUO) of the German Cancer Association (DKG) was founded in 1989 to enforce high quality in research on urological cancer. The main aim has been to improve the quality of clinical cancer studies. The board of the AUO reviews, certifies and gives accreditation to study protocols with respect to GCP standards, likelihood of realisation and scientific impact of the study objectives. To support enrolment of patients, the AUO initiated a study group of more than 85 clinical centers of excellence and publishes timely details on the different studies in the appropriate media. Moreover, the members of the AUO board organize seminars, scientific meetings and pharmaceutical hearings. In this article, the organisation's structure is described in detail. Various aspects of AUO work, carried out over the years, are highlighted, and data presented on the outcome of studies.

Advancements in meat packaging.

PubMed

McMillin, Kenneth W

2017-10-01

Packaging of meat provides the same or similar benefits for raw chilled and processed meats as other types of food packaging. Although air-permeable packaging is most prevalent for raw chilled red meat, vacuum and modified atmosphere packaging offer longer shelf life. The major advancements in meat packaging have been in the widely used plastic polymers while biobased materials and their integration into composite packaging are receiving much attention for functionality and sustainability. At this time, active and intelligent packaging are not widely used for antioxidant, antimicrobial, and other functions to stabilize and enhance meat properties although many options are being developed and investigated. The advances being made in nanotechnology will be incorporated into food packaging and presumably into meat packaging when appropriate and useful. Intelligent packaging using sensors for transmission of desired information and prompting of subsequent changes in packaging materials, environments or the products to maintain safety and quality are still in developmental stages. Copyright © 2017 Elsevier Ltd. All rights reserved.

Energy therapies in oncology nursing.

PubMed

Coakley, Amanda Bulette; Barron, Anne-Marie

2012-02-01

To review the published research related to the interventions of Reiki, Therapeutic Touch, and Healing Touch representing energy therapies in relation to oncology nursing. Peer-reviewed literature. There is growing evidence that energy therapies have a positive effect on symptoms associated with cancer. While there is need for further research, it is clear that an appreciation for the value of research methods beyond the randomized control trial is important. Energy therapies offer additional strategies for oncology nurses providing integrated nursing care to alleviate suffering and symptom distress of patients with cancer. Copyright © 2012 Elsevier Inc. All rights reserved.

Standardizing Naming Conventions in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa

2012-07-15

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

MGGPOD: a Monte Carlo Suite for Modeling Instrumental Line and Continuum Backgrounds in Gamma-Ray Astronomy

NASA Technical Reports Server (NTRS)

Weidenspointner, G.; Harris, M. J.; Sturner, S.; Teegarden, B. J.; Ferguson, C.

2004-01-01

Intense and complex instrumental backgrounds, against which the much smaller signals from celestial sources have to be discerned, are a notorious problem for low and intermediate energy gamma-ray astronomy (approximately 50 keV - 10 MeV). Therefore a detailed qualitative and quantitative understanding of instrumental line and continuum backgrounds is crucial for most stages of gamma-ray astronomy missions, ranging from the design and development of new instrumentation through performance prediction to data reduction. We have developed MGGPOD, a user-friendly suite of Monte Carlo codes built around the widely used GEANT (Version 3.21) package, to simulate ab initio the physical processes relevant for the production of instrumental backgrounds. These include the build-up and delayed decay of radioactive isotopes as well as the prompt de-excitation of excited nuclei, both of which give rise to a plethora of instrumental gamma-ray background lines in addition t o continuum backgrounds. The MGGPOD package and documentation are publicly available for download. We demonstrate the capabilities of the MGGPOD suite by modeling high resolution gamma-ray spectra recorded by the Transient Gamma-Ray Spectrometer (TGRS) on board Wind during 1995. The TGRS is a Ge spectrometer operating in the 40 keV to 8 MeV range. Due to its fine energy resolution, these spectra reveal the complex instrumental background in formidable detail, particularly the many prompt and delayed gamma-ray lines. We evaluate the successes and failures of the MGGPOD package in reproducing TGRS data, and provide identifications for the numerous instrumental lines.

Physiologic and psychobehavioral research in oncology.

PubMed

Redd, W H; Silberfarb, P M; Andersen, B L; Andrykowski, M A; Bovbjerg, D H; Burish, T G; Carpenter, P J; Cleeland, C; Dolgin, M; Levy, S M

1991-02-01

A major thrust in research in psychosocial oncology is the study of the interaction of psychologic and physiologic variables. This discussion reviews the current status and future directions of such research. Areas addressed include pain, nausea and vomiting with chemotherapy, sexuality, effects of cancer on psychologic and neuropsychologic function, impact of psychologic factors on cancer and its treatment, and psychoneuroimmunology. In addition, specific recommendations for strategies to facilitate research in these areas of psychosocial oncology are proposed.

Regulatory and clinical considerations for biosimilar oncology drugs

PubMed Central

Bennett, Charles L; Chen, Brian; Hermanson, Terhi; Wyatt, Michael D; Schulz, Richard M; Georgantopoulos, Peter; Kessler, Samuel; Raisch, Dennis W; Qureshi, Zaina P; Lu, Z Kevin; Love, Bryan L; Noxon, Virginia; Bobolts, Laura; Armitage, Melissa; Bian, John; Ray, Paul; Ablin, Richard J; Hrushesky, William J; Macdougall, Iain C; Sartor, Oliver; Armitage, James O

2015-01-01

Biological oncology products are integral to cancer treatment, but their high costs pose challenges to patients, families, providers, and insurers. The introduction of biosimilar agents—molecules that are similar in structure, function, activity, immunogenicity, and safety to the original biological drugs—provide opportunities both to improve healthcare access and outcomes, and to reduce costs. Several international regulatory pathways have been developed to expedite entry of biosimilars into global marketplaces. The first wave of oncology biosimilar use was in Europe and India in 2007. Oncology biosimilars are now widely marketed in several countries in Europe, and in Australia, Japan, China, Russia, India, and South Korea. Their use is emerging worldwide, with the notable exception of the USA, where several regulatory and cost barriers to biosimilar approval exist. In this Review, we discuss oncology biosimilars and summarise their regulatory frameworks, clinical experiences, and safety concerns. PMID:25456378

The Evolution of Gero-Oncology Nursing

PubMed Central

Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

2016-01-01

Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

Ethics in oncology: consulting for the investment industry.

PubMed

Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F

2007-02-01

As Ethics Committee Chair, I am pleased to introduce the first in an ongoing series of ethics vignettes. These columns, which are based on true-to-life situations that arise in oncology research and practice, are intended to identify and explore important ethical issues and provide commentary that is specific to oncology. Please look for them periodically in both the Journal of Clinical Oncology and the Journal of Oncology Practice. The idea for publishing vignettes evolved through the joint efforts of the Ethics Committee and the Board of Directors. Rather than adopt a single set of ethical principles that applies vaguely to any situation and well to none, the Committee and the Board preferred to tackle ethical dilemmas individually, specifically, and directly. Because the Ethics Committee thought the ethical and legal implications of physician interactions with the investment industry were so important and timely, it chose to address this topic in both a position article, which was previously published in the January 20, 2007, issue of the Journal of Clinical Oncology (J Clin Oncol 25:338-340, 2007) and in its first vignette column. The Ethics Committee hopes this column will be the first of several that ASCO members will find helpful as they grapple with the many ethical issues that arise in daily practice in the field of oncology. Because these columns are intended to address the concerns of ASCO members, the Committee welcomes suggestions for future topics at vignettes@asco.org. Martin D. Abeloff, MD, Chair, Ethics Committee.

Community oncology in an era of payment reform.

PubMed

Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

75 FR 81283 - Oncologic Drugs Advisory Committee; Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory Committee scheduled for February 9, 2011, is...

77 FR 63839 - Oncologic Drugs Advisory Committee; Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory Committee Meeting scheduled for November 8, 2012, is...

Packaging Your Training Materials

ERIC Educational Resources Information Center

Espeland, Pamela

1977-01-01

The types of packaging and packaging materials to use for training materials should be determined during the planning of the training programs, according to the packaging market. Five steps to follow in shopping for packaging are presented, along with a list of packaging manufacturers. (MF)

Paediatric oncology information pack for general practitioners

PubMed Central

James, J A; Harris, D J; Mott, M G; Oakhill, A

1988-01-01

An information pack covering important aspects of paediatric oncology has been developed for general practitioners. Sixty general practitioners who received the information pack found that it helped them in managing children with neoplastic disease and their families. The pack has also improved communications between the oncology unit and general practitioners. Similar packs could be produced by paediatricians working in other specialties. PMID:3122972

Improving Oncology Nurses' Knowledge About Nutrition and Physical Activity for Cancer Survivors.

PubMed

van Veen, Merel R; Hoedjes, Meeke; Versteegen, Joline J; van de Meulengraaf-Wilhelm, Nienke; Kampman, Ellen; Beijer, Sandra

2017-07-01

To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed among those nurses.
. A cross-sectional study.
. A web-based survey among oncology nurses in the Netherlands.
. 355 oncology nurses provided advice on nutrition; of these, 327 provided advice on PA.
. From May to July 2013, oncology nurses were invited to complete an online questionnaire. Pearson's chi-squared tests and uni- and multivariate logistic regression analyses were conducted.
. Oncology nurses' perception of having sufficient or insufficient knowledge to be able to provide advice on nutrition and PA, the content of the advice, and the information sources on which the advice was based.
. 43% of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition, and 46% perceived insufficient knowledge to provide advice on PA. Factors associated with perceiving insufficient knowledge on nutrition were being aged younger, having lower education, and providing counseling during treatment only. Those nurses were more likely to suggest taking oral nutritional supplements or visiting a dietitian and were less likely to provide information on fluid intake. Nurses perceiving insufficient knowledge about PA used oncology guidelines less often.
. Almost half of the oncology nurses providing advice on nutrition and PA perceived themselves as having insufficient knowledge to be able to provide such advice. In particular, younger oncology nurses and oncology nurses with an intermediate vocational education may benefit most from education about these topics. 
. Educational training for oncology nurses should include nutrition and PA. Oncology nurses should collaborate with dietitians to discuss what information should be provided to patients by

Direct-to-consumer advertising in oncology.

PubMed

Abel, Gregory A; Penson, Richard T; Joffe, Steven; Schapira, Lidia; Chabner, Bruce A; Lynch, Thomas J

2006-02-01

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, which provides hope to patients and support to caregivers while encouraging the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum in which caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Increasingly, cancer patients are subjected to advertisements related to oncologic therapies and other cancer-related products in the popular media. Such direct-to-consumer advertising is controversial: while it may inform, educate, and perhaps even empower patients, it also has the ability to misinform patients, and strain their relationships with oncology providers. The U.S. Food and Drug Administration requires that direct-to-consumer advertising provide a balanced presentation of a product's benefits, risks, and side effects, but this can be difficult to achieve. Through a discussion of this topic by an oncology fellow, ethicist, cancer survivor, and senior oncologist, the role of direct-to-consumer advertising and its often subtle effects on clinical practice in oncology are explored. Although sparse, the medical literature on this increasingly prevalent type of medical communication is also reviewed.

Edible packaging materials.

PubMed

Janjarasskul, Theeranun; Krochta, John M

2010-01-01

Research groups and the food and pharmaceutical industries recognize edible packaging as a useful alternative or addition to conventional packaging to reduce waste and to create novel applications for improving product stability, quality, safety, variety, and convenience for consumers. Recent studies have explored the ability of biopolymer-based food packaging materials to carry and control-release active compounds. As diverse edible packaging materials derived from various by-products or waste from food industry are being developed, the dry thermoplastic process is advancing rapidly as a feasible commercial edible packaging manufacturing process. The employment of nanocomposite concepts to edible packaging materials promises to improve barrier and mechanical properties and facilitate effective incorporation of bioactive ingredients and other designed functions. In addition to the need for a more fundamental understanding to enable design to desired specifications, edible packaging has to overcome challenges such as regulatory requirements, consumer acceptance, and scaling-up research concepts to commercial applications.

Predictors of Timely Access of Oncology Services and Advanced-Stage Cancer in an HIV-Endemic Setting

PubMed Central

Suneja, Gita; Tapela, Neo; Mapes, Abigail; Pusoentsi, Malebogo; Mmalane, Mompati; Hodgeman, Ryan; Boyer, Matthew; Musimar, Zola; Ramogola-Masire, Doreen; Grover, Surbhi; Nsingo-Bvochora, Memory; Kayembe, Mukendi; Efstathiou, Jason; Lockman, Shahin; Dryden-Peterson, Scott

2016-01-01

Background. Three-quarters of cancer deaths occur in resource-limited countries, and delayed presentation contributes to poor outcome. In Botswana, where more than half of cancers arise in HIV-infected individuals, we sought to explore predictors of timely oncology care and evaluate the hypothesis that engagement in longitudinal HIV care improves access. Methods. Consenting patients presenting for oncology care from October 2010 to September 2014 were interviewed and their records were reviewed. Cox and logistic models were used to examine the effect of HIV and other predictors on time to oncology care and presentation with advanced cancer (stage III or IV). Results. Of the 1,146 patients analyzed, 584 (51%) had HIV and 615 (54%) had advanced cancer. The initial clinic visit occurred a mean of 144 days (median 29, interquartile range 0–185) after symptom onset, but subsequent mean time to oncology care was 406 days (median 160, interquartile range 59–653). HIV status was not significantly associated with time to oncology care (adjusted hazard ratio [aHR] 0.91, 95% confidence interval [CI] 0.79–1.06). However, patients who reported using traditional medicine/healers engaged in oncology care significantly faster (aHR 1.23, 95% CI 1.09–1.40) and those with advanced cancer entered care earlier (aHR 1.48, 95% CI 1.30–1.70). Factors significantly associated with advanced cancer included income <$50 per month (adjusted odds ratio [aOR] 1.35, 95% CI 1.05–1.75), male sex (aOR 1.45, 95% CI 1.12–1.87), and pain as the presenting symptom (aOR 1.39, 95% CI 1.03–1.88). Conclusion. Longitudinal HIV care did not reduce the substantial delay to cancer treatment. Research focused on reducing health system delay through coordination and navigation is needed. Implications for Practice: The majority (54%) of patients in this large cohort from Botswana presented with advanced-stage cancer despite universal access to free health care. Median time from first symptom to

Neuropsychological Practice in the Oncology Setting.

PubMed

Noll, Kyle R; Bradshaw, Mariana E; Rexer, Jennie; Wefel, Jeffrey S

2018-05-01

Oncology has experienced positive shifts in survival curves for many cancers largely due to the development of earlier diagnostics and better therapeutics. This has increased the visibility and need for survivorship services, including clinical neuropsychology. Patients with cancer frequently experience cognitive dysfunction related to the presence of cancer itself and treatment neurotoxicity. These cognitive difficulties can profoundly impact patient functioning and autonomy with accompanying declines in quality of life. Clinical neuropsychologists are uniquely positioned to evaluate the cognitive and affective sequelae of cancer and treatment and provide interventions and recommendations that can benefit well-being and potentially alter the disease course. Despite increasing recognition of the importance of neuropsychological issues to cancer survivorship, many neuropsychologists have limited training and guidance regarding navigating and implementing services within the oncology setting. This article provides the basic rationale for neuropsychological practice and research activities in oncology, as well as the experience of the Section of Neuropsychology at The University of Texas MD Anderson Cancer Center.

The Growth of Academic Radiation Oncology: A Survey of Endowed Professorships in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wasserman, Todd H.; Smith, Steven M.; Powell, Simon N.

2009-06-01

Purpose: The academic health of a medical specialty can be gauged by the level of university support through endowed professorships. Methods and Materials: We conducted a survey of the 86 academic programs in radiation oncology to determine the current status of endowed chairs in this discipline. Results: Over the past decade, the number of endowed chairs has more than doubled, and it has almost tripled over the past 13 years. The number of programs with at least one chair has increased from 31% to 65%. Conclusions: Coupled with other indicators of academic growth, such as the proportion of graduating residentsmore » seeking academic positions, there has been clear and sustained growth in academic radiation oncology.« less

Searching for wisdom in oncology care: A scoping review.

PubMed

Butlin, Helen; Kinsella, Elizabeth Anne; Garcia, Carla; Bauman, Glenn

2017-06-01

The concept of "wisdom" is beginning to emerge in the oncology literature, raising questions concerning: (1) how the concept of wisdom is used in oncology literature; (2) the ways in which wisdom has been a focus of inquiry within oncology care; and (3) how wisdom is characterized when the term is used. A scoping review, using Arksey and O'Malley's five-step framework, was undertaken to address these questions. In consultation with oncology reference librarians, "wisdom"- and "oncology"-related search terms were identified, and four electronic databases were searched: CINAHL, SocINDEX, PubMed, and PsychINFO. After removal of duplicates and application of inclusion and exclusion criteria, 58 records were identified and included for analysis. The concept of wisdom was employed with a breadth of meanings, and 58 records were schematized into 7 genres, including: (1) empirical research with wisdom foregrounded as a study focus (n = 2); (2) empirical research articles where "wisdom" appears in the findings (n = 16); (3) a quality-improvement project where wisdom is an embedded concept (n = 1); (4) essays where wisdom is an aspect of the discussion (n = 5); (5) commentary/opinion pieces where wisdom is an aspect of its focus (n = 6); (6) personal stories describing wisdom as something gleaned from lived experience with cancer (n = 2); and (7) everyday/taken-for-granted uses of wisdom (n = 26). The notion of wisdom has a taken-for-granted presence in the published oncology literature and holds promise for future research into patient and clinician wisdom in oncology care. Nonetheless, the terminology is varied and unclear. A scholarly focus on wisdom has not been brought to bear in cancer care to the degree it has in other fields, and research is in the early stages. Various characterizations of wisdom are present. If such a resource as "wisdom" exists, dwelling in human experiences and practices, there may be benefit in recognizing wisdom as informing the epistemologies

Perspectives on making big data analytics work for oncology.

PubMed

El Naqa, Issam

2016-12-01

Oncology, with its unique combination of clinical, physical, technological, and biological data provides an ideal case study for applying big data analytics to improve cancer treatment safety and outcomes. An oncology treatment course such as chemoradiotherapy can generate a large pool of information carrying the 5Vs hallmarks of big data. This data is comprised of a heterogeneous mixture of patient demographics, radiation/chemo dosimetry, multimodality imaging features, and biological markers generated over a treatment period that can span few days to several weeks. Efforts using commercial and in-house tools are underway to facilitate data aggregation, ontology creation, sharing, visualization and varying analytics in a secure environment. However, open questions related to proper data structure representation and effective analytics tools to support oncology decision-making need to be addressed. It is recognized that oncology data constitutes a mix of structured (tabulated) and unstructured (electronic documents) that need to be processed to facilitate searching and subsequent knowledge discovery from relational or NoSQL databases. In this context, methods based on advanced analytics and image feature extraction for oncology applications will be discussed. On the other hand, the classical p (variables)≫n (samples) inference problem of statistical learning is challenged in the Big data realm and this is particularly true for oncology applications where p-omics is witnessing exponential growth while the number of cancer incidences has generally plateaued over the past 5-years leading to a quasi-linear growth in samples per patient. Within the Big data paradigm, this kind of phenomenon may yield undesirable effects such as echo chamber anomalies, Yule-Simpson reversal paradox, or misleading ghost analytics. In this work, we will present these effects as they pertain to oncology and engage small thinking methodologies to counter these effects ranging from

Microsurgical Chest Wall Reconstruction After Oncologic Resections

PubMed Central

Sauerbier, Michael; Dittler, S.; Kreutzer, C.

2011-01-01

Defect reconstruction after radical oncologic resection of malignant chest wall tumors requires adequate soft tissue reconstruction with function, stability, integrity, and an aesthetically acceptable result of the chest wall. The purpose of this article is to describe possible reconstructive microsurgical pathways after full-thickness oncologic resections of the chest wall. Several reliable free flaps are described, and morbidity and mortality rates of patients are discussed. PMID:22294944

Reconstruction of Peripelvic Oncologic Defects.

PubMed

Weichman, Katie E; Matros, Evan; Disa, Joseph J

2017-10-01

After studying this article, the participant should be able to: 1. Understand the anatomy of the peripelvic area. 2. Understand the advantages and disadvantages of performing peripelvic reconstruction in patients undergoing oncologic resection. 3. Select the appropriate local, pedicled, or free-flap reconstruction based on the location of the defect and donor-site characteristics. Peripelvic reconstruction most commonly occurs in the setting of oncologic ablative surgery. The peripelvic area contains several distinct reconstructive regions, including vagina, vulva, penis, and scrotum. Each area provides unique reconstructive considerations. In addition, prior or future radiation therapy or chemotherapy along with cancer cachexia can increase the complexity of reconstruction.

Contemporary Trends in Radiation Oncology Resident Research

DOE Office of Scientific and Technical Information (OSTI.GOV)

Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A.

Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int Jmore » Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s

Contemporary Trends in Radiation Oncology Resident Research.

PubMed

Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A; Ojerholm, Eric

2016-11-15

To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals-most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These contemporary figures may be useful to medical students

Packaged die heater

DOEpatents

Spielberger, Richard; Ohme, Bruce Walker; Jensen, Ronald J.

2011-06-21

A heater for heating packaged die for burn-in and heat testing is described. The heater may be a ceramic-type heater with a metal filament. The heater may be incorporated into the integrated circuit package as an additional ceramic layer of the package, or may be an external heater placed in contact with the package to heat the die. Many different types of integrated circuit packages may be accommodated. The method provides increased energy efficiency for heating the die while reducing temperature stresses on testing equipment. The method allows the use of multiple heaters to heat die to different temperatures. Faulty die may be heated to weaken die attach material to facilitate removal of the die. The heater filament or a separate temperature thermistor located in the package may be used to accurately measure die temperature.

Sentinel lymph node mapping in gynecological oncology

PubMed Central

Du, Jiang; Li, Yaling; Wang, Qing; Batchu, Nasra; Zou, Junkai; Sun, Chao; Lv, Shulan; Song, Qing; Li, Qiling

2017-01-01

The intraoperative mapping of sentinel lymph nodes (SLNs) is part of the treatment strategy for a number of types of tumor. To retrospectively compare results from the mapping of pelvic SLNs for gynecological oncology, using distinct dyes, the present review was conducted to determine the clinical significance of SLN mapping for gynecological oncology. In addition, the present study aimed at identifying an improved choice for SLN mapping tracers in clinical application. Each dye exhibits demerits when applied in the clinical environment. The combination of radioisotopes and blue dyes was identified to exhibit the most accurate detection rate of SLN drainage of gynecological oncology. However, contrast agents were unable to identify whether a SLN is positive or negative for metastasis prior to pathologic examination; additional studies are required. PMID:29344213

Animal-assisted activities in pediatric oncology: results from a survey of top-ranked pediatric oncology hospitals

PubMed Central

Chubak, Jessica; Hawkes, Rene

2015-01-01

Animal-assisted activities (AAA) are increasingly common, yet little is known about practices in pediatric oncology. To address this gap, we surveyed the top twenty pediatric oncology hospitals in the United States in May and June of 2014. Questionnaires were sent via email and generally returned by email or postal mail. Among the nineteen responding hospitals, the 18 that offered AAA to pediatric patients formed the basis of our analysis. All sites had written AAA policies. Most programs were restricted to dogs. At 11 hospitals, children with cancer could participate in AAA activities. Outpatient waiting rooms and individual inpatient rooms were the most common locations for AAA with pediatric oncology patients. Safety precautions varied by hospital, but all required hand sanitation after visits and that animals receive an annual health examination, be on a leash or in a carrier, be ≥1 year old, and not be directly from a shelter. Our findings reveal consistencies and variations in practice that may help other hospitals develop their own programs and researchers identify areas of future study. PMID:26589356

Organizational Development for Thornlea; A Communication Package and Some Results

ERIC Educational Resources Information Center

Croft, John C.

1970-01-01

This case study discusses assumptions and objectives of organizational development (OD) in general, some background of a school which recently participated in a very brief taste of OD, some essential features of the package itself and some results, and some implications. Comments follow by Gilbert D. Moore, State University of New York, Buffalo,…

Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

PubMed

Keogh, Justin W L; Pühringer, Petra; Olsen, Alicia; Sargeant, Sally; Jones, Lynnette M; Climstein, Mike

2017-03-01

To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
. Cross-sectional survey.
. Australia and New Zealand.
. 119 registered oncology nurses.
. Self-reported online survey completed once per participant.
. Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
. Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
. Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
. Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

The National Cancer Institute's Physical Sciences - Oncology Network

NASA Astrophysics Data System (ADS)

Espey, Michael Graham

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

Implementation rates of uro-oncology multidisciplinary meeting decisions.

PubMed

Kinnear, Ned; Smith, Riley; Hennessey, Derek B; Bolton, Damien; Sengupta, Shomik

2017-11-01

To assess implementation rates of the consensus plans made at the uro-oncology multidisciplinary meeting (MDM) of an Australian tertiary centre, and analyse obstacles to implementation. A retrospective review was performed of all patients discussed at the uro-oncology MDM at our institution between 1 January and 30 June 2015. Rates of referral for MDM discussion after a new histological diagnosis of malignancy, categorised by tumour type, were assessed. Patient records were interrogated to confirm MDM plan implementation, with the outcomes examined being completion of MDM plan within 3 months and factors preventing implementation. During the enrolment period, from 291 uro-oncological procedures, 240 yielded malignant histology of which 160 (67%) were discussed at the MDM. Overall, 202 patients, including 32 females, were discussed at the uro-oncology MDM. MDM consensus plans were implemented in 184 (91.1%) patients. Reasons for deviation from the MDM plan included delay in care, patient deterioration or comorbidities, patient preference, consultant decision, loss to follow-up, and change in patient scenario due to additional new information. The MDM is increasingly important in the care of uro-oncology patients, with about two-thirds of new diagnoses currently captured. There appear to be few barriers to the implementation of consensus plans, with nearly all patients undergoing the recommended management. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden.

PubMed

Brédart, A; Robertson, C; Razavi, D; Batel-Copel, L; Larsson, G; Lichosik, D; Meyza, J; Schraub, S; von Essen, L; de Haes, J C J M

2003-01-01

There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries. Copyright 2002 John Wiley & Sons, Ltd.

Using Second Life to Facilitate Peer Storytelling for Grieving Oncology Nurses

PubMed Central

Rice, Karen L.; Bennett, Marsha J.; Billingsley, Luanne

2014-01-01

Background Oncology nurses often experience intense emotional reactions to patient deaths but may be forced to ignore or hide their feelings because of work-related responsibilities. The complexity of nurses' work and personal lives creates obstacles for participating in traditional support groups where grieving nurses can bond and share. We hypothesized that using a web-based, three-dimensional (3-D) virtual world technology (Second Life) may provide a venue to facilitate peer storytelling to support nurses dealing with grief. Methods We used a mixed-methods approach involving focus groups and surveys to explore the use of peer storytelling for grieving oncology nurses. Nine acute and ambulatory oncology nurses in groups of 3 participated using avatars in 5 group moderator-guided sessions lasting 1 hour each in a private 3-D outdoor virtual meeting space within Second Life. Baseline information was collected using a 12-item demographic and professional loss survey. At the end of the study, a 20-item survey was administered to measure professional losses during the study, exchange of support during sessions, and meaning-making and to evaluate peer storytelling using Second Life. Results Overall, nurses reported peer storytelling sessions in Second Life were helpful in making sense of and in identifying a benefit of their grief experience. They felt supported by both the group moderator and group members and were able to personally support group members during storytelling. Although nurses reported Second Life was helpful in facilitating storytelling sessions and expressed overall satisfaction with using Second Life, open-ended comments registered difficulties encountered, mostly with technology. Three central themes emerged in sessions, representing a dynamic relationship between mental, spiritual, and emotional-behavioral responses to grief: cognitive readiness to learn about death, death really takes death experience, and emotional resilience. Conclusion This

Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report.

PubMed

White, Chapin; Chan, Chris; Huckfeldt, Peter J; Kofner, Aaron; Mulcahy, Andrew W; Pollak, Julia; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

2015-07-15

This article describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target. The simulation offers several insights into the proposed payment model for oncology: (1) The care management payments used in the simulation analysis-$960 total per six-month episode-represent only 4 percent of projected average total spending per episode (around $27,000 in 2016), but they are large relative to the FFS revenues of participating oncology practices, which are projected to be around $2,000 per oncology episode. By themselves, the care management payments would increase physician practices' Medicare revenues by roughly 50 percent on average. This represents a substantial new outlay for the Medicare program and a substantial new source of revenues for oncology practices. (2) For the Medicare program to break even, participating oncology practices would have to reduce utilization and intensity by roughly 4 percent. (3) The break-even point can be reduced if the care management payments are reduced or if the performance-based payments are reduced.

Results of an Oncology Clinical Trial Nurse Role Delineation Study.

PubMed

Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

2017-09-01

To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

Pediatric oncology in Turkey.

PubMed

Kebudi, Rejin

2012-03-01

The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

49 CFR 173.24a - Additional general requirements for non-bulk packagings and packages.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subchapter. (b) Non-bulk packaging filling limits. (1) A single or composite non-bulk packaging may be filled... gross mass marked on the packaging. (3) A single or composite non-bulk packaging which is tested and... marked on the packaging, or 1.2 if not marked. In addition: (i) A single or composite non-bulk packaging...

49 CFR 173.24a - Additional general requirements for non-bulk packagings and packages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subchapter. (b) Non-bulk packaging filling limits. (1) A single or composite non-bulk packaging may be filled... gross mass marked on the packaging. (3) A single or composite non-bulk packaging which is tested and... marked on the packaging, or 1.2 if not marked. In addition: (i) A single or composite non-bulk packaging...

49 CFR 173.24a - Additional general requirements for non-bulk packagings and packages.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subchapter. (b) Non-bulk packaging filling limits. (1) A single or composite non-bulk packaging may be filled... gross mass marked on the packaging. (3) A single or composite non-bulk packaging which is tested and... marked on the packaging, or 1.2 if not marked. In addition: (i) A single or composite non-bulk packaging...

Dualities in the analysis of phage DNA packaging motors

PubMed Central

Serwer, Philip; Jiang, Wen

2012-01-01

The DNA packaging motors of double-stranded DNA phages are models for analysis of all multi-molecular motors and for analysis of several fundamental aspects of biology, including early evolution, relationship of in vivo to in vitro biochemistry and targets for anti-virals. Work on phage DNA packaging motors both has produced and is producing dualities in the interpretation of data obtained by use of both traditional techniques and the more recently developed procedures of single-molecule analysis. The dualities include (1) reductive vs. accretive evolution, (2) rotation vs. stasis of sub-assemblies of the motor, (3) thermal ratcheting vs. power stroking in generating force, (4) complete motor vs. spark plug role for the packaging ATPase, (5) use of previously isolated vs. new intermediates for analysis of the intermediate states of the motor and (6) a motor with one cycle vs. a motor with two cycles. We provide background for these dualities, some of which are under-emphasized in the literature. We suggest directions for future research. PMID:23532204

A Window Into Clinical Next-Generation Sequencing-Based Oncology Testing Practices.

PubMed

Nagarajan, Rakesh; Bartley, Angela N; Bridge, Julia A; Jennings, Lawrence J; Kamel-Reid, Suzanne; Kim, Annette; Lazar, Alexander J; Lindeman, Neal I; Moncur, Joel; Rai, Alex J; Routbort, Mark J; Vasalos, Patricia; Merker, Jason D

2017-12-01

- Detection of acquired variants in cancer is a paradigm of precision medicine, yet little has been reported about clinical laboratory practices across a broad range of laboratories. - To use College of American Pathologists proficiency testing survey results to report on the results from surveys on next-generation sequencing-based oncology testing practices. - College of American Pathologists proficiency testing survey results from more than 250 laboratories currently performing molecular oncology testing were used to determine laboratory trends in next-generation sequencing-based oncology testing. - These presented data provide key information about the number of laboratories that currently offer or are planning to offer next-generation sequencing-based oncology testing. Furthermore, we present data from 60 laboratories performing next-generation sequencing-based oncology testing regarding specimen requirements and assay characteristics. The findings indicate that most laboratories are performing tumor-only targeted sequencing to detect single-nucleotide variants and small insertions and deletions, using desktop sequencers and predesigned commercial kits. Despite these trends, a diversity of approaches to testing exists. - This information should be useful to further inform a variety of topics, including national discussions involving clinical laboratory quality systems, regulation and oversight of next-generation sequencing-based oncology testing, and precision oncology efforts in a data-driven manner.

Experts' perspectives on the role of medical marijuana in oncology: A semistructured interview study.

PubMed

Braun, I M; Meyer, F L; Gagne, J J; Nabati, L; Yuppa, D P; Carmona, M A; Burstein, H J; Suzuki, J; Nayak, M M; Martins, Y

2017-08-01

Expansion of medical marijuana (MM) laws in the United States may offer oncology new therapeutic options. However, the scientific evidence for MM remains in infancy. This study qualitatively explored professional opinion around the role of MM in cancer care. Semistructured interviews were administered to a sample of individuals with expertise at the interface of MM and oncology nationally. Key informant criteria included an oncologic clinical or research background and any of the following: publications, research, or lectures on cannabinoids or cancer symptoms; involvement in the development of MM dispensaries or legislation; and early adoption of state MM certification procedures. A gold standard, grounded, inductive approach was used to identify underlying themes. Participants (N = 15) were predominantly male, in their sixth decade, working in academic settings. Themes ranged from strong beliefs in marijuana's medical utility to reservations about this notion, with calls for expansion of the scientific evidence base and more stringent MM production standards. All participants cited nausea as an appropriate indication, and 13 of 15 pain. Over one-third believed MM to have a more attractive risk profile than opioids and benzodiazepines. Expert opinion was divided between convictions in marijuana's medicinal potential and guardedness in this assertion, with no participant refuting MM's utility outright. Emergent themes included that MM ameliorates cancer-related pain and nausea and is safer than certain conventional medications. Participants called for enhanced purity and production standards, and further research on MM's utility. Copyright © 2017 John Wiley & Sons, Ltd.

Cardio-Oncology - A new subspecialty with collaboration at its heart.

PubMed

Ghosh, Arjun K; Walker, J Malcolm

Cardio-Oncology is the care of cancer patients with cardiovascular disease, overt or occult, already established or acquired during treatment. Cancer patients can present with a variety of cardiovascular problems not all of which are directly related to cancer therapy (medications or radiotherapy). The cardiovascular problems of oncology patients can range from ischaemia to arrhythmias and can also include valve problems and heart failure. As such, within cardiology, teamwork is required with members of different cardiology subspecialties. The way forward will be to adopt a multidisciplinary approach to produce optimal individual care. Close collaboration between cardiology and oncology specialists in a Cardio-Oncology setting can make this happen. Copyright © 2017. Published by Elsevier B.V.

GENERAL PURPOSE ADA PACKAGES

NASA Technical Reports Server (NTRS)

Klumpp, A. R.

1994-01-01

Ten families of subprograms are bundled together for the General-Purpose Ada Packages. The families bring to Ada many features from HAL/S, PL/I, FORTRAN, and other languages. These families are: string subprograms (INDEX, TRIM, LOAD, etc.); scalar subprograms (MAX, MIN, REM, etc.); array subprograms (MAX, MIN, PROD, SUM, GET, and PUT); numerical subprograms (EXP, CUBIC, etc.); service subprograms (DATE_TIME function, etc.); Linear Algebra II; Runge-Kutta integrators; and three text I/O families of packages. In two cases, a family consists of a single non-generic package. In all other cases, a family comprises a generic package and its instances for a selected group of scalar types. All generic packages are designed to be easily instantiated for the types declared in the user facility. The linear algebra package is LINRAG2. This package includes subprograms supplementing those in NPO-17985, An Ada Linear Algebra Package Modeled After HAL/S (LINRAG). Please note that LINRAG2 cannot be compiled without LINRAG. Most packages have widespread applicability, although some are oriented for avionics applications. All are designed to facilitate writing new software in Ada. Several of the packages use conventions introduced by other programming languages. A package of string subprograms is based on HAL/S (a language designed for the avionics software in the Space Shuttle) and PL/I. Packages of scalar and array subprograms are taken from HAL/S or generalized current Ada subprograms. A package of Runge-Kutta integrators is patterned after a built-in MAC (MIT Algebraic Compiler) integrator. Those packages modeled after HAL/S make it easy to translate existing HAL/S software to Ada. The General-Purpose Ada Packages program source code is available on two 360K 5.25" MS-DOS format diskettes. The software was developed using VAX Ada v1.5 under DEC VMS v4.5. It should be portable to any validated Ada compiler and it should execute either interactively or in batch. The largest package

Oncology Education in Medical Schools: Towards an Approach that Reflects Australia's Health Care Needs.

PubMed

McRae, Robert J

2016-12-01

Cancer has recently overtaken heart disease to become the number 1 cause of mortality both globally and in Australia. As such, adequate oncology education must be an integral component of medical school if students are to achieve learning outcomes that meet the needs of the population. The aim of this review is to evaluate the current state of undergraduate oncology education and identify how Australian medical schools can improve oncology learning outcomes for students and, by derivative, improve healthcare outcomes for Australians with cancer. The review shows that oncology is generally not well represented in medical school curricula, that few medical schools offer mandatory oncology or palliative care rotations, and that junior doctors are exhibiting declining oncology knowledge and skills. To address these issues, Australian medical schools should implement the Oncology Education Committee's Ideal Oncology Curriculum, enact mandatory oncology and palliative care clinical rotations for students, and in doing so, appreciate the importance of students' differing approaches to learning.

Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

PubMed Central

Dauer, Lawrence T; Kelvin, Joanne F; Horan, Christopher L; St Germain, Jean

2006-01-01

Background Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. Methods A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. Results As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. Conclusion The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses. PMID:16762060

21 CFR 610.62 - Proper name; package label; legible type.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Proper name; package label; legible type. 610.62 Section 610.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... contrast in color value between the proper name and the background shall be at least as great as the color...

Detecting small holes in packages

DOEpatents

Kronberg, James W.; Cadieux, James R.

1996-01-01

A package containing a tracer gas, and a method for determining the presence of a hole in the package by sensing the presence of the gas outside the package. The preferred tracer gas, especially for food packaging, is sulfur hexafluoride. A quantity of the gas is added to the package and the package is closed. The concentration of the gas in the atmosphere outside the package is measured and compared to a predetermined value of the concentration of the gas in the absence of the package. A measured concentration greater than the predetermined value indicates the presence of a hole in the package. Measuring may be done in a chamber having a lower pressure than that in the package.

Global Oncology; Harvard Global Health Catalyst summit lecture notes

NASA Astrophysics Data System (ADS)

Ngwa, Wilfred; Nguyen, Paul

2017-08-01

The material presented in this book is at the cutting-edge of global oncology and provides highly illuminating examples, addresses frequently asked questions, and provides information and a reference for future work in global oncology care, research, education, and outreach.

The National Practice Benchmark for oncology, 2014 report on 2013 data.

PubMed

Towle, Elaine L; Barr, Thomas R; Senese, James L

2014-11-01

The National Practice Benchmark (NPB) is a unique tool to measure oncology practices against others across the country in a way that allows meaningful comparisons despite differences in practice size or setting. In today's economic environment every oncology practice, regardless of business structure or affiliation, should be able to produce, monitor, and benchmark basic metrics to meet current business pressures for increased efficiency and efficacy of care. Although we recognize that the NPB survey results do not capture the experience of all oncology practices, practices that can and do participate demonstrate exceptional managerial capability, and this year those practices are recognized for their participation. In this report, we continue to emphasize the methodology introduced last year in which we reported medical revenue net of the cost of the drugs as net medical revenue for the hematology/oncology product line. The effect of this is to capture only the gross margin attributable to drugs as revenue. New this year, we introduce six measures of clinical data density and expand the radiation oncology benchmarks. Copyright © 2014 by American Society of Clinical Oncology.

Packaging for Food Service

NASA Technical Reports Server (NTRS)

Stilwell, E. J.

1985-01-01

Most of the key areas of concern in packaging the three principle food forms for the space station were covered. It can be generally concluded that there are no significant voids in packaging materials availability or in current packaging technology. However, it must also be concluded that the process by which packaging decisions are made for the space station feeding program will be very synergistic. Packaging selection will depend heavily on the preparation mechanics, the preferred presentation and the achievable disposal systems. It will be important that packaging be considered as an integral part of each decision as these systems are developed.

The Cosmic Infrared Background Experiment (CIBER): A Sounding Rocket Payload to Study the near Infrared Extragalactic Background Light

NASA Astrophysics Data System (ADS)

Zemcov, M.; Arai, T.; Battle, J.; Bock, J.; Cooray, A.; Hristov, V.; Keating, B.; Kim, M. G.; Lee, D. H.; Levenson, L. R.; Mason, P.; Matsumoto, T.; Matsuura, S.; Nam, U. W.; Renbarger, T.; Sullivan, I.; Suzuki, K.; Tsumura, K.; Wada, T.

2013-08-01

The Cosmic Infrared Background Experiment (CIBER) is a suite of four instruments designed to study the near infrared (IR) background light from above the Earth's atmosphere. The instrument package comprises two imaging telescopes designed to characterize spatial anisotropy in the extragalactic IR background caused by cosmological structure during the epoch of reionization, a low resolution spectrometer to measure the absolute spectrum of the extragalactic IR background, and a narrow band spectrometer optimized to measure the absolute brightness of the zodiacal light foreground. In this paper we describe the design and characterization of the CIBER payload. The detailed mechanical, cryogenic, and electrical design of the system are presented, including all system components common to the four instruments. We present the methods and equipment used to characterize the instruments before and after flight, and give a detailed description of CIBER's flight profile and configurations. CIBER is designed to be recoverable and has flown four times, with modifications to the payload having been informed by analysis of the first flight data. All four instruments performed to specifications during the subsequent flights, and the scientific data from these flights are currently being analyzed.

THE COSMIC INFRARED BACKGROUND EXPERIMENT (CIBER): A SOUNDING ROCKET PAYLOAD TO STUDY THE NEAR INFRARED EXTRAGALACTIC BACKGROUND LIGHT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zemcov, M.; Bock, J.; Hristov, V.

2013-08-15

The Cosmic Infrared Background Experiment (CIBER) is a suite of four instruments designed to study the near infrared (IR) background light from above the Earth's atmosphere. The instrument package comprises two imaging telescopes designed to characterize spatial anisotropy in the extragalactic IR background caused by cosmological structure during the epoch of reionization, a low resolution spectrometer to measure the absolute spectrum of the extragalactic IR background, and a narrow band spectrometer optimized to measure the absolute brightness of the zodiacal light foreground. In this paper we describe the design and characterization of the CIBER payload. The detailed mechanical, cryogenic, andmore » electrical design of the system are presented, including all system components common to the four instruments. We present the methods and equipment used to characterize the instruments before and after flight, and give a detailed description of CIBER's flight profile and configurations. CIBER is designed to be recoverable and has flown four times, with modifications to the payload having been informed by analysis of the first flight data. All four instruments performed to specifications during the subsequent flights, and the scientific data from these flights are currently being analyzed.« less

Integrative oncology in North America.

PubMed

Sagar, Stephen M

2006-01-01

Integrative oncology is an evolving evidence-based specialty that uses complementary therapies in concert with medical treatment to enhance its efficacy, improve symptom control, alleviate patient distress and reduce suffering. In North America the evolution of research into complementary therapies was delayed by the narrow focus of the Flexner Report. A government-funded research agenda and incorporation of complementary therapies into medical school curricula have been driven by early evidence of efficacy and patient demand. Integrative oncology focuses on the role of natural health products (botanicals, vitamins, and minerals), nutrition, acupuncture, meditation and other mind-body approaches, music therapy, touch therapies, fitness therapies, and more. Some natural health products, such as herbs and their constituent phytochemicals, may be biologic response modifiers that could increase cancer control. Current research stretches from the laboratory to health services. Institutions are exploring the effectiveness gap in their clinical services and are determining efficacy of complementary therapies through randomized controlled trials. Eventually, the goal is to establish practice guidelines through determining relative effectiveness and value through cost-utility studies. The aim of integrative oncology should be one medicine, not alternative; it should be patient-focused; it should be evidence-based; and it should provide the best care for cancer cure, prevention, symptom control, and quality of life.

Detecting small holes in packages

DOEpatents

Kronberg, J.W.; Cadieux, J.R.

1996-03-19

A package containing a tracer gas, and a method for determining the presence of a hole in the package by sensing the presence of the gas outside the package are disclosed. The preferred tracer gas, especially for food packaging, is sulfur hexafluoride. A quantity of the gas is added to the package and the package is closed. The concentration of the gas in the atmosphere outside the package is measured and compared to a predetermined value of the concentration of the gas in the absence of the package. A measured concentration greater than the predetermined value indicates the presence of a hole in the package. Measuring may be done in a chamber having a lower pressure than that in the package. 3 figs.

Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care.

PubMed

Huang, Ya-Ling; Yates, Patsy; Prior, Deborah

2009-12-01

The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. Relevance to clinical practice. It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

Anhydrous Ammonia Training Module. Trainer's Package. Participant's Package.

ERIC Educational Resources Information Center

Beaudin, Bart; And Others

This document contains a trainer's and a participant's package for teaching employees on site safe handling procedures for working with anhydrous ammonia, especially on farms. The trainer's package includes the following: a description of the module; a competency; objectives; suggested instructional aids; a training outline (or lesson plan) for…

Patient-Reported Outcomes Are Changing the Landscape in Oncology Care: Challenges and Opportunities for Payers

PubMed Central

Zagadailov, Erin; Fine, Michael; Shields, Alan

2013-01-01

Background A patient-reported outcome (PRO) is a subjective report that comes from a patient without interpretation by a clinician. Because of the increasingly significant role of PROs in the development and evaluation of new medicines, the US Food and Drug Administration (FDA) issued a formal guidance to describe how PRO instruments will be reviewed and evaluated with respect to claims in approved medical product labeling. Meanwhile, PROs continue to appear in oncology clinical trials more frequently; however, it is unclear how payers and policymakers can use PRO data in the context of decision-making for cancer treatments. Objective The objective of this article is to discuss the challenges and opportunities of incorporating oncology-related PRO data into payer decision-making. Discussion Payer concerns with PRO instruments are often related to issues regarding measurement, relevance, quality, and interpretability of PROs. Payers may dismiss PROs that do not independently predict improved outcomes. The FDA guidance released in 2009 demonstrates, as evidenced by the case of ruxolitinib, how PRO questionnaires can be generated in a relevant, trustworthy, and meaningful way, which provides an opportunity for payers and policy decision makers to focus on how to use PRO data in their decision-making. This is particularly relevant in oncology, where a recent and sizable number of clinical trials include PRO measures. Conclusion As an increasing number of oncology medications enter the market with product labeling claims that contain PRO data, payers will need to better familiarize themselves with the opportunities associated with PRO questionnaires when making coverage decisions. PRO measures will continue to provide valuable information regarding the risk–benefit profile of novel agents. As such, PRO measures may provide evidence that should be considered in payers' decisions and discussions; however, the formal role of PROs and the pertinence of PROs in decision

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients.

PubMed

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

Distress and Coping Self-Efficacy in Inpatient Oncology Nurses.

PubMed

Wahlberg, Lara; Nirenberg, Anita; Capezuti, Elizabeth

2016-11-01

To examine distress and coping self-efficacy in inpatient oncology nurses. 
. Cross-sectional survey design.
. Oncology Nursing Society (ONS) chapter meetings and Hunter-Bellevue School of Nursing, both in New York, New York, as well as social media.
. 163 oncology nurses who work with an inpatient adult population.
. Participants were recruited through the ONS New York, New York, area chapter meetings, Hunter College, and ONS Facebook pages. An adapted Nurse Distress Thermometer (NDT) measured distress levels. The Occupational Coping Self-Efficacy Questionnaire for Nurses (OCSE-N) used a Likert-type scale to measure coping self-efficacy. Open-ended questions elicited additional perceptions of nurse respondents. 
. Descriptive statistics summarized sample demographics. A Pearson correlation between distress levels and coping self-efficacy scores was calculated. Low, normal, and high coping scores were compared to mean distress levels. 
. Survey participants showed high levels of distress, with a mean NDT score of 8.06. Those with higher coping self-efficacy scores reported less distress. A moderate, negative correlation was shown, with a statistically significant Pearson coefficient of -0.371. Responses to the open-ended questions revealed common stressors and pointed to solutions that institutions might implement to support nurses.
. Because coping self-efficacy related to lower distress levels in inpatient oncology nurses, institutional-level support for oncology nurses should be provided. 
. Interventions aimed at coping self-efficacy may prepare oncology nurses to cope better with their professional demands. Future research should explore how nurse distress affects patients.

Child-oriented marketing techniques in snack food packages in Guatemala

PubMed Central

2013-01-01

Background Childhood overweight in Guatemala is now becoming a public health concern. Child-oriented marketing contributes to increase children’s food preference, purchase and consumption. This study sought to assess the availability of child-oriented snack foods sold in school kiosks and convenience stores near public schools in Guatemala, to identify the marketing techniques used in child-oriented snack food packages and to classify the snacks as “healthy” or “less-healthy”. Methods We purchased all child-oriented snacks found in stores inside and within 200 square meters from four schools in an urban community. Snacks were classified as child-oriented if the package had any promotional characters, premium offers, children′s television/movie tie-ins, sports references, or the word “child”. We used a checklist to assess child-oriented references and price. Snacks were classified as “healthy” or “less-healthy” according to the UK standards for the Nutritional Profiling Model. Results We analyzed 106 packages found in 55 stores. The most commonly used technique was promotional characters (92.5%) of which 32.7% were brand-specific characters. Premium offers were found in 34% of packages and were mostly collectibles (50%). Most marketing techniques were located on the front and covered nearly 25% of the package surface. Median (interquartile range) price was US$ 0.19 (0.25). Nutrition labels were found in 91 (86%) packages and 41% had a nutrition related health claim. Most snacks (97.1%) were classified as “less-healthy”. Conclusion In Guatemala, the food industry targets children through several marketing techniques promoting inexpensive and unhealthy snacks in the school environment. Evidence-based policies restricting the use of promotional characters in unhealthy snack food packages need to be explored as a contributing strategy to control the obesity epidemic. PMID:24139325

The principle of respect for autonomy – Concordant with the experience of oncology physicians and molecular biologists in their daily work?

PubMed Central

Ebbesen, Mette; Pedersen, Birthe D

2008-01-01

Background This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. Methods This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company. Results We found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation. Conclusion In this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the

Integrating the healthcare enterprise in radiation oncology plug and play--the future of radiation oncology?

PubMed

Abdel-Wahab, May; Rengan, Ramesh; Curran, Bruce; Swerdloff, Stuart; Miettinen, Mika; Field, Colin; Ranjitkar, Sunita; Palta, Jatinder; Tripuraneni, Prabhakar

2010-02-01

To describe the processes and benefits of the integrating healthcare enterprises in radiation oncology (IHE-RO). The IHE-RO process includes five basic steps. The first step is to identify common interoperability issues encountered in radiation treatment planning and the delivery process. IHE-RO committees partner with vendors to develop solutions (integration profiles) to interoperability problems. The broad application of these integration profiles across a variety of vender platforms is tested annually at the Connectathon event. Demonstration of the seamless integration and transfer of patient data to the potential users are then presented by vendors at the public demonstration event. Users can then integrate these profiles into requests for proposals and vendor contracts by institutions. Incorporation of completed integration profiles into requests for proposals can be done when purchasing new equipment. Vendors can publish IHE integration statements to document the integration profiles supported by their products. As a result, users can reference integration profiles in requests for proposals, simplifying the systems acquisition process. These IHE-RO solutions are now available in many of the commercial radiation oncology-related treatment planning, delivery, and information systems. They are also implemented at cancer care sites around the world. IHE-RO serves an important purpose for the radiation oncology community at large. Copyright 2010 Elsevier Inc. All rights reserved.

Initiation and preliminary evaluation of an oncology pharmacy training course for staff pharmacists.

PubMed

Saylor, Matthew S; Blanchette, Lisa M; Smith, Morgan B; Cambron, Katie; Andricopulos, Katie; Brown, M Jay

2016-08-01

There is currently a disparity between oncology pharmacy job openings and PGY2 trained pharmacists completing residency training each year. As a result, pharmacists without specialized training in oncology are filling much needed oncology positions and may need on-the-job oncology training. To improve oncology knowledge among non-PGY2 trained pharmacists working in oncology positions, Novant Health coordinated an Oncology Pharmacy Training Course (OPTC). The primary objective was to assess efficacy of the OPTC through evaluation of post-intervention oncology knowledge. Secondary objectives included efficacy of each lecture, assessment of knowledge improvement in those with and without residency or chemotherapy training, and assessment of satisfaction with the OPTC. This was a prospective, cohort study. All pharmacists expressing interest in the OPTC were included unless PGY2 oncology residency trained or Board-Certified in Oncology Pharmacy (BCOP). Participants were invited to attend twice monthly lectures and were evaluated using questionnaires at baseline, 1, 3, 6, and 12 months. At the 3-month evaluation, 29 pharmacists completed the per-protocol evaluation. Knowledge scores increased from a mean of 29.6% to 52.2% (p < 0.01). Ten participants were chemotherapy trained. Baseline knowledge scores were slightly higher in the chemotherapy-trained than training naïve participants (mean 42.5% vs. 27.4%). Both groups experienced significantly improved knowledge scores at 3 months (mean 59% and 48.1% respectively, p < 0.01). Implementation of a formalized OPTC can improve oncology knowledge among staff pharmacists in a community hospital system. This improvement in knowledge is consistent regardless of baseline chemotherapy training. © The Author(s) 2015.

Oncology nursing: Finding the balance in a changing health care system.

PubMed

Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin

2006-01-01

Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.

Engineering and physical sciences in oncology: challenges and opportunities.

PubMed

Mitchell, Michael J; Jain, Rakesh K; Langer, Robert

2017-11-01

The principles of engineering and physics have been applied to oncology for nearly 50 years. Engineers and physical scientists have made contributions to all aspects of cancer biology, from quantitative understanding of tumour growth and progression to improved detection and treatment of cancer. Many early efforts focused on experimental and computational modelling of drug distribution, cell cycle kinetics and tumour growth dynamics. In the past decade, we have witnessed exponential growth at the interface of engineering, physics and oncology that has been fuelled by advances in fields including materials science, microfabrication, nanomedicine, microfluidics, imaging, and catalysed by new programmes at the National Institutes of Health (NIH), including the National Institute of Biomedical Imaging and Bioengineering (NIBIB), Physical Sciences in Oncology, and the National Cancer Institute (NCI) Alliance for Nanotechnology. Here, we review the advances made at the interface of engineering and physical sciences and oncology in four important areas: the physical microenvironment of the tumour and technological advances in drug delivery; cellular and molecular imaging; and microfluidics and microfabrication. We discussthe research advances, opportunities and challenges for integrating engineering and physical sciences with oncology to develop new methods to study, detect and treat cancer, and we also describe the future outlook for these emerging areas.

Engineering and physical sciences in oncology: challenges and opportunities

PubMed Central

Mitchell, Michael J.; Jain, Rakesh K.; Langer, Robert

2017-01-01

The principles of engineering and physics have been applied to oncology for nearly 50 years. Engineers and physical scientists have made contributions to all aspects of cancer biology, from quantitative understanding of tumour growth and progression to improved detection and treatment of cancer. Many early efforts focused on experimental and computational modelling of drug distribution, cell cycle kinetics and tumour growth dynamics. In the past decade, we have witnessed exponential growth at the interface of engineering, physics and oncology that has been fuelled by advances in fields including materials science, microfabrication, nanomedicine, microfluidics, imaging, and catalysed by new programmes at the National Institutes of Health (NIH), including the National Institute of Biomedical Imaging and Bioengineering (NIBIB), Physical Sciences in Oncology, and the National Cancer Institute (NCI) Alliance for Nanotechnology. Here, we review the advances made at the interface of engineering and physical sciences and oncology in four important areas: the physical microenvironment of the tumour and technological advances in drug delivery; cellular and molecular imaging; and microfluidics and microfabrication. We discussthe research advances, opportunities and challenges for integrating engineering and physical sciences with oncology to develop new methods to study, detect and treat cancer, and we also describe the future outlook for these emerging areas. PMID:29026204

Building a dream: creating an oncology day/evening hospital.

PubMed

Fletcher, K; Painter, V

2002-01-01

The demand for inpatient beds has reached and often exceeds capacity producing waiting lists for cancer care. There is a need to explore alternative approaches to oncology treatment. The Oncology Day/Evening Hospital (ODEH), originally envisioned in 1995 as a joint project between an ambulatory cancer centre and a large teaching hospital, is an important cancer treatment initiative offering extended hours of ambulatory oncology treatment on days, evenings, weekends and statutory holidays. A review of current inpatient treatment modalities revealed that many patients receiving inpatient therapy could be safely and effectively managed in the ambulatory setting if treatment regimens were modified and if ambulatory hours of operation were extended. Healthcare improvements expected were: appropriate movement of inpatient activity to the ambulatory setting; more opportunities for patient choice in treatment time thereby allowing for maintenance of normal living; better quality of life for patients through prevention of hospitalization; decrease in treatment waiting times; consolidation of patients into an ambulatory oncology treatment setting as opposed to utilization of adult medicine units; and more rational inpatient bed utilization with reduction of admissions and intra-treatment transfers. This article describes our experience in building a dream, the challenges and lessons learned in implementing a better way to deliver oncology care in an environment of rapid change and staff shortages.

Authorship in Radiation Oncology: Proliferation Trends Over 30 Years.

PubMed

Ojerholm, Eric; Swisher-McClure, Samuel

2015-11-15

To investigate authorship trends in the radiation oncology literature. We examined the authorship credits of "original research articles" within 2 popular radiation oncology journals-International Journal of Radiation Oncology, Biology, Physics and Radiotherapy and Oncology-in 1984, 1994, 2004, and 2014. We compared the number of authors per publication during these 4 time periods using simple linear regression as a test for trend. We investigated additional author characteristics in a subset of articles. A total of 2005 articles were eligible. The mean number of authors per publication rose from 4.3 in 1984 to 9.1 in 2014 (P<.001). On subset analysis of 400 articles, there was an increase in the percentage of multidisciplinary bylines (from 52% to 72%), multi-institutional bylines (from 20% to 53%), and publications with a trainee first author (from 16% to 56%) during the study period. The mean number of authors per publication has more than doubled over the last 30 years in the radiation oncology literature. Possible explanations include increasingly complex and collaborative research as well as honorary authorship. Explicit documentation of author contributions could help ensure that scientific work is credited according to accepted standards. Copyright © 2015 Elsevier Inc. All rights reserved.

Guidelines for treatment naming in radiation oncology

PubMed Central

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 laterality, 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. PACS number(s): 87.56.bd, 87.56.Fc, 87.55.Qr, 87.55.‐x, 87.55.N‐, 87.55.T‐, 87.55.D‐ PMID

Fish Oncology: Diseases, Diagnostics, and Therapeutics.

PubMed

Vergneau-Grosset, Claire; Nadeau, Marie-Eve; Groff, Joseph M

2017-01-01

The scientific literature contains a wealth of information concerning spontaneous fish neoplasms, although ornamental fish oncology is still in its infancy. The occurrence of fish neoplasms has often been associated with oncogenic viruses and environmental insults, making them useful markers for environmental contaminants. The use of fish, including zebrafish, as models of human carcinogenesis has been developed and knowledge gained from these models may also be applied to ornamental fish, although more studies are required. This review summarizes information available about fish oncology pertaining to veterinary clinicians. Copyright © 2016 Elsevier Inc. All rights reserved.

Citation analysis of Canadian psycho-oncology and supportive care researchers.

PubMed

Hack, Thomas F; Crooks, Dauna; Plohman, James; Kepron, Emma

2014-02-01

The purpose of this study was to conduct a historical review of psycho-oncology and supportive care research in Canada using citation analysis and to review the clinical impact of the research conducted by the most highly cited researchers. The lifetime journal publication records of 109 psycho-oncology and supportive care researchers in Canada were subject to citation analysis using the Scopus database, based on citations since 1996 of articles deemed relevant to psychosocial oncology and supportive care, excluding self-citations. Three primary types of analysis were performed for each individual: the number of citations for each journal publication, a summative citation count of all published articles, and the Scopus h-index. The top 20 psycho-oncology/supportive care researchers for each of five citation categories are presented: the number of citations for all publications; the number of citations for first-authored publications; the most highly cited first-authored publications; the Scopus h-index for all publications; and the Scopus h-index for first-authored publications. The three most highly cited Canadian psycho-oncology researchers are Dr. Kerry Courneya (University of Alberta), Dr. Lesley Degner, (University of Manitoba), and Dr. Harvey Chochinov (University of Manitoba). Citation analysis is useful for examining the research performance of psycho-oncology and supportive care researchers and identifying leaders among them.

IN-PACKAGE CHEMISTRY ABSTRACTION

DOE Office of Scientific and Technical Information (OSTI.GOV)

E. Thomas

2005-07-14

This report was developed in accordance with the requirements in ''Technical Work Plan for Postclosure Waste Form Modeling'' (BSC 2005 [DIRS 173246]). The purpose of the in-package chemistry model is to predict the bulk chemistry inside of a breached waste package and to provide simplified expressions of that chemistry as a function of time after breach to Total Systems Performance Assessment for the License Application (TSPA-LA). The scope of this report is to describe the development and validation of the in-package chemistry model. The in-package model is a combination of two models, a batch reactor model, which uses the EQ3/6more » geochemistry-modeling tool, and a surface complexation model, which is applied to the results of the batch reactor model. The batch reactor model considers chemical interactions of water with the waste package materials, and the waste form for commercial spent nuclear fuel (CSNF) waste packages and codisposed (CDSP) waste packages containing high-level waste glass (HLWG) and DOE spent fuel. The surface complexation model includes the impact of fluid-surface interactions (i.e., surface complexation) on the resulting fluid composition. The model examines two types of water influx: (1) the condensation of water vapor diffusing into the waste package, and (2) seepage water entering the waste package as a liquid from the drift. (1) Vapor-Influx Case: The condensation of vapor onto the waste package internals is simulated as pure H{sub 2}O and enters at a rate determined by the water vapor pressure for representative temperature and relative humidity conditions. (2) Liquid-Influx Case: The water entering a waste package from the drift is simulated as typical groundwater and enters at a rate determined by the amount of seepage available to flow through openings in a breached waste package.« less

The use of biosimilar medicines in oncology - position statement of the Brazilian Society of Clinical Oncology (SBOC).

PubMed

Fernandes, G S; Sternberg, C; Lopes, G; Chammas, R; Gifoni, M A C; Gil, R A; Araujo, D V

2018-01-11

A biosimilar is a biologic product that is similar to a reference biopharmaceutical product, the manufacturing process of which hinders the ability to identically replicate the structure of the original product, and therefore, it cannot be described as an absolute equivalent of the original medication. The currently available technology does not allow for an accurate copy of complex molecules, but it does allow the replication of similar molecules with the same activity. As biosimilars are about to be introduced in oncology practice, these must be evaluated through evidence-based medicine. This manuscript is a position paper, where the Brazilian Society of Clinical Oncology (SBOC) aims to describe pertinent issues regarding the approval and use of biosimilars in oncology. As a working group on behalf of SBOC, we discuss aspects related to definition, labeling/nomenclature, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, and the potential impact on financial burden in healthcare. We take a stand in favor of the introduction of biosimilars, as they offer a viable, safe, and cost-effective alternative to the biopharmaceutical products currently used in cancer. We hope this document can provide valuable information to support therapeutic decisions that maximize the clinical benefit for the thousands of cancer patients in Brazil and can contribute to expedite the introduction of this new drug class in clinical practice. We expect the conveyed information to serve as a basis for further discussion in Latin America, this being the first position paper issued by a Latin American Oncology Society.

Child-resistant and tamper-resistant packaging: A systematic review to inform tobacco packaging regulation.

PubMed

Jo, Catherine L; Ambs, Anita; Dresler, Carolyn M; Backinger, Cathy L

2017-02-01

We aimed to investigate the effects of special packaging (child-resistant, adult-friendly) and tamper-resistant packaging on health and behavioral outcomes in order to identify research gaps and implications for packaging standards for tobacco products. We searched seven databases for keywords related to special and tamper-resistant packaging, consulted experts, and reviewed citations of potentially relevant studies. 733 unique papers were identified. Two coders independently screened each title and abstract for eligibility. They then reviewed the full text of the remaining papers for a second round of eligibility screening. Included studies investigated a causal relationship between type of packaging or packaging regulation and behavioral or health outcomes and had a study population composed of consumers. Studies were excluded on the basis of publication type, if they were not peer-reviewed, and if they had low external validity. Two reviewers independently coded each paper for study and methodological characteristics and limitations. Discrepancies were discussed and resolved. The review included eight studies: four assessing people's ability to access the contents of different packaging types and four evaluating the impact of packaging requirements on health-related outcomes. Child-resistant packaging was generally more difficult to open than non-child-resistant packaging. Child-resistant packaging requirements have been associated with reductions in child mortality. Child-resistant packaging holds the expectation to reduce tobacco product poisonings among children under six. Published by Elsevier Inc.

Scoring Package

National Institute of Standards and Technology Data Gateway

NIST Scoring Package (PC database for purchase)   The NIST Scoring Package (Special Database 1) is a reference implementation of the draft Standard Method for Evaluating the Performance of Systems Intended to Recognize Hand-printed Characters from Image Data Scanned from Forms.

Bloodstream infections in pediatric oncology outpatients: a new healthcare systems challenge.

PubMed

Smith, Theresa L; Pullen, Gregg T; Crouse, Vonda; Rosenberg, Jon; Jarvis, William R

2002-05-01

To investigate a perceived increase in central venous catheter (CVC)-associated bloodstream infections (BSIs) among pediatric hematology-oncology outpatients. A case-control study. A pediatric hematology-oncology outpatient clinic at Fresno Children's Hospital. Pediatric hematology-oncology clinic outpatients with CVCs at Fresno Children's Hospital between November 1994 and October 1997. A case-patient was defined as any hematology-oncology outpatient with a CVC-associated BSI at Fresno Children's Hospital from November 1996 to October 1997 (study period) without a localizable infection. To identify case-patients, we reviewed Fresno Children's Hospital records for all hematology-oncology clinic patients, those with CVCs and those with CVCs and BSIs. Control-patients were randomly selected hematology-oncology outpatients with a CVC but no BSI during the study period. Case-patient and control-patient demographics, diagnoses, caretakers, catheter types, catheter care, and water exposure were compared. Twenty-five case-patients had 42 CVC-associated BSIs during the study period. No significant increase in CVC-associated BSI rates occurred among pediatric hematology-oncology patients. However, there was a statistically significant increase in nonendogenous, gram-negative (eg, Pseudomonas species) BSIs during summer months (May-October) compared with the rest of the year. Case-patients and control-patients differed only in catheter type; case-patients were more likely than control-patients to have a transcutaneous CVC. Summertime recreational water exposures were similar and high in the two groups. Hematology-oncology clinic patients with transcutaneous CVCs are at greater risk for CVC-associated BSI, particularly during the summer. Caretakers should be instructed on proper care of CVCs, particularly protection of CVCs during bathing and recreational summer water activities, to reduce the risk of nonendogenous, gram-negative BSIs.

Targeting communication interventions to decrease oncology family caregiver burden

PubMed Central

Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

2012-01-01

Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

Generic oncology drugs: are they all safe?

PubMed

Yang, Y Tony; Nagai, Sumimasa; Chen, Brian K; Qureshi, Zaina P; Lebby, Akida A; Kessler, Samuel; Georgantopoulos, Peter; Raisch, Dennis W; Sartor, Oliver; Hermanson, Terhi; Kane, Robert C; Hrushesky, William J; Riente, Joshua J; Norris, LeAnn B; Bobolts, Laura R; Armitage, James O; Bennett, Charles L

2016-11-01

Although the availability of generic oncology drugs allows access to contemporary care and reduces costs, there is international variability in the safety of this class of drugs. In this Series paper, we review clinical, policy, safety, and regulatory considerations for generic oncology drugs focusing on the USA, Canada, the European Union (EU), Japan, China, and India. Safety information about generic formulations is reviewed from one agent in each class, for heavy metal drugs (cisplatin), targeted agents (imatinib), and cytotoxic agents (docetaxel). We also review regulatory reports from Japan and the USA, countries with the largest pharmaceutical expenditures. Empirical studies did not identify safety concerns in the USA, Canada, the EU, and Japan, where regulations and enforcement are strong. Although manufacturing problems for generic pharmaceuticals exist in India, where 40% of all generic pharmaceuticals used in the USA are manufactured, increased inspections and communication by the US Food and Drug Administration are occurring, facilitating oversight and enforcement. No safety outbreaks among generic oncology drugs were reported in developed countries. For developing countries, oversight is less intensive, and concerns around drug safety still exist. Regulatory agencies should collaboratively develop procedures to monitor the production, shipment, storage, and post-marketing safety of generic oncology drugs. Regulatory agencies for each country should also aim towards identical definitions of bioequivalence, the cornerstone of regulatory approval. Copyright © 2016 Elsevier Ltd. All rights reserved.

Package Up Your Troubles--An Introduction to Package Libraries

ERIC Educational Resources Information Center

Frank, Colin

1978-01-01

Discusses a "package deal" library--a prefabricated building including interior furnishing--in terms of costs, fitness for purpose, and interior design, i.e., shelving, flooring, heating, lighting, and humidity. Advantages and disadvantages of the package library are also considered. (Author/MBR)

Improving oncology nurses' communication skills for difficult conversations.

PubMed

Baer, Linda; Weinstein, Elizabeth

2013-06-01

When oncology nurses have strong communication skills, they play a pivotal role in influencing patient satisfaction, adherence to plans of care, and overall clinical outcomes. However, research studies indicate that nurses tend to keep communication with patients and families at a superficial, nontherapeutic level. Processes for teaching goals-of-care communication skills and for implementing skills into clinical practice are not clearly defined. Nurses at a large comprehensive cancer center recognized the need for help with this skill set and sought out communication experts to assist in providing the needed education. An educational project was developed to improve therapeutic communication skills in oncology nurses during goals-of-care discussions and giving bad news. The program was tailored to nurses and social workers providing care to patients in a busy, urban, academic, outpatient oncology setting. Program topics included exploring the patient's world, eliciting hopes and concerns, and dealing with conflict about goals. Sharing and discussing specific difficult questions and scenarios were encouraged throughout the program. The program was well attended and well received by oncology nurses and social workers. Participants expressed interest in the continuation of communication programs to further enhance skills.

Relationships of Tubal Ligation to Endometrial Carcinoma Stage and Mortality in the NRG Oncology/Gynecologic Oncology Group 210 Trial

PubMed Central

Brinton, Louise A.; McMeekin, D. Scott; Creasman, William T.; Mutch, David; Cohn, David E.; Walker, Joan L.; Moore, Richard G.; Downs, Levi S.; Soslow, Robert A.; Zaino, Richard; Sherman, Mark E.

2015-01-01

Background: Stage is a critical determinant of treatment among endometrial carcinoma patients; understanding patterns of tumor spread may suggest approaches to improve staging. Specifically, the importance of exfoliation of endometrial carcinoma cells through the fallopian tubes into the peritoneum is ill defined. We assessed the hypothesis that tubal ligation (TL), which should impede transtubal passage of cells, is associated with lower endometrial carcinoma stage at presentation and, consequently, lower mortality. Methods: The NRG Oncology/Gynecologic Oncology Group (GOG) 210 Trial included 4489 endometrial carcinoma patients who completed a risk factor questionnaire that included TL history. Pathology data were derived from clinical reports and central review. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between TL with stage and peritoneal metastasis, overall and by tumor subtype. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals for TL and mortality. All statistical tests were two-sided. Results: Compared with stage I, TL was inversely associated with stage III (OR = 0.63, 95% CI = 0.52 to 0.78) and stage IV carcinomas (OR = 0.14, 95% CI = 0.08 to 0.24) overall and among individual tumor subtypes. TL was inversely related to peritoneal metastasis overall (OR = 0.39, 95% CI = 0.22 to 0.68) and among serous carcinomas (OR = 0.28, 95% CI = 0.11 to 0.68). In multivariable models unadjusted for stage, TL was associated with lower endometrial carcinoma-specific mortality (HR = 0.74, 95% CI = 0.61 to 0.91); however, adjustment for stage eliminated the survival advantage. Similar relationships with all-cause mortality were observed. Conclusions: TL is associated with lower stage and mortality among women with aggressive endometrial carcinomas, suggesting transtubal spread is clinically important. Future studies should evaluate whether detection of intraluminal tumor

Audits of oncology units - an effective and pragmatic approach.

PubMed

Abratt, Raymond Pierre; Eedes, David; Bailey, Belinda; Salmon, Chris; Govender, Yogi; Oelofse, Ivan; Burger, Henriette

2017-05-24

Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone. The audit self-assessment document listed quality-assurance measures or items in the physical and functional areas of the oncology unit. There were a total of 153 items included in the audit. The online survey took place in October 2016. The invitation to participate was sent to 59 oncology units at which staff members had completed the audit process. The online survey was completed by 54 (41%) of the 132 potential respondents. The online survey found that the audit was very or extremely useful in maintaining personal professional standards in 89% of responses. The audit process and feedback was rated as very or extremely satisfactory in 80% and 81%, respectively. The self-assessment audit document was scored by survey respondents as very or extremely practical in 63% of responses. The feedback on the audit was that it was very or extremely helpful in formulating improvement plans in oncology units in 82% of responses. Major and minor changes that occurred as a result of the audit process were reported as 8% and 88%, respectively. The survey findings show that the audit process and its self- assessment document meet the aims of being helpful and pragmatic.

Assessment of Risk Evaluation and Mitigation Strategies in Oncology: Summary of the Oncology Risk Evaluation and Mitigation Strategies Workshop

PubMed Central

Frame, James N.; Jacobson, Joseph O.; Vogel, Wendy H.; Griffith, Niesha; Wariabharaj, Darshan; Garg, Rekha; Zon, Robin; Stephens, Cyntha L.; Bialecki, Alison M.; Bruinooge, Suanna S.; Allen, Steven L.

2013-01-01

To address oncology community stakeholder concerns regarding implementation of the Risk Evaluation and Mitigation Strategies (REMS) program, ASCO sponsored a workshop to gather REMS experiences from representatives of professional societies, patient organizations, pharmaceutical companies, and the US Food and Drug Administration (FDA). Stakeholder presentations and topical panel discussions addressed REMS program development, implementation processes, and practice experiences, as well as oncology drug safety processes. A draft REMS decision tool prepared by the ASCO REMS Steering Committee was presented for group discussion with facilitated, goal-oriented feedback. The workshop identified several unintended consequences resulting from current oncology REMS: (1) the release of personal health information to drug sponsors as a condition for gaining access to a needed drug; (2) risk information that is not tailored—and therefore not accessible—to all literacy levels; (3) exclusive focus on drug risk, thereby affecting patient-provider treatment discussion; (4) REMS elements that do not consider existing, widely practiced oncology safety standards, professional training, and experience; and (5) administrative burdens that divert the health care team from direct patient care activities and, in some cases, could limit patient access to important therapies. Increased provider and professional society participation should form the basis of ongoing and future REMS standardization discussions with the FDA to work toward overall improvement of risk communication. PMID:23814522

Child-resistant and tamper-resistant packaging: A systematic review to inform tobacco packaging regulation

PubMed Central

Jo, Catherine L.; Ambs, Anita; Dresler, Carolyn M.; Backinger, Cathy L.

2017-01-01

Objective We aimed to investigate the effects of special packaging (child-resistant, adult-friendly) and tamper-resistant packaging on health and behavioral outcomes in order to identify research gaps and implications for packaging standards for tobacco products. Methods We searched seven databases for keywords related to special and tamper-resistant packaging, consulted experts, and reviewed citations of potentially relevant studies. 733 unique papers were identified. Two coders independently screened each title and abstract for eligibility. They then reviewed the full text of the remaining papers for a second round of eligibility screening. Included studies investigated a causal relationship between type of packaging or packaging regulation and behavioral or health outcomes and had a study population composed of consumers. Studies were excluded on the basis of publication type, if they were not peer-reviewed, and if they had low external validity. Two reviewers independently coded each paper for study and methodological characteristics and limitations. Discrepancies were discussed and resolved. Results The review included eight studies: four assessing people’s ability to access the contents of different packaging types and four evaluating the impact of packaging requirements on health-related outcomes. Child-resistant packaging was generally more difficult to open than non-child-resistant packaging. Child-resistant packaging requirements have been associated with reductions in child mortality. Conclusions Child-resistant packaging holds the expectation to reduce tobacco product poisonings among children under six. PMID:27939602

Review of optical coherence tomography in oncology

NASA Astrophysics Data System (ADS)

Wang, Jianfeng; Xu, Yang; Boppart, Stephen A.

2017-12-01

The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.

Evaluation and management of patients with heart disease and cancer: cardio-oncology.

PubMed

Herrmann, Joerg; Lerman, Amir; Sandhu, Nicole P; Villarraga, Hector R; Mulvagh, Sharon L; Kohli, Manish

2014-09-01

The care for patients with cancer has advanced greatly over the past decades. A combination of earlier cancer diagnosis and greater use of traditional and new systemic treatments has decreased cancer-related mortality. Effective cancer therapies, however, can result in short- and long-term comorbidities that can decrease the net clinical gain by affecting quality of life and survival. In particular, cardiovascular complications of cancer treatments can have a profound effect on the health of patients with cancer and are more common among those with recognized or unrecognized underlying cardiovascular diseases. A new discipline termed cardio-oncology has thus evolved to address the cardiovascular needs of patients with cancer and optimize their care in a multidisciplinary approach. This review provides a brief introduction and background on this emerging field and then focuses on its practical aspects including cardiovascular risk assessment and prevention before cancer treatment, cardiovascular surveillance and therapy during cancer treatment, and cardiovascular monitoring and management after cancer therapy. The content of this review is based on a literature search of PubMed between January 1, 1960, and February 1, 2014, using the search terms cancer, cardiomyopathy, cardiotoxicity, cardio-oncology, chemotherapy, heart failure, and radiation. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Pediatric oncology in Slovenia.

PubMed

Jereb, B; Anzic, J

1996-01-01

Slovenia, a new country and formerly a part of Yugoslavia, has had its Childrens Hospital in Ljubljana since 1865. This became a part of the University Hospital in 1945, and in the early 1960s the Department of Pediatric Hematology-Oncology was established. The Oncological Institute of Slovenia was established in 1938 and has developed into a modern facility for comprehensive cancer care, research, and teaching. In close cooperation, established in the 1960s, a team from these two institutions takes care of the approximately 60 children per year who develop cancer in Slovenia. Consisting of pediatricians, radiation oncologists, pathologists, cytologists, surgeons, and other ad hoc specialists, the team meets at least twice weekly to plan treatment, follow the patients, discuss the results, and teach. All patients are subject to regular follow-up indefinitely. A separate team has been formed to study the late effects of cancer treatment on survivors, who by now are mostly adults.

New Finsler package

NASA Astrophysics Data System (ADS)

Youssef, Nabil L.; Elgendi, S. G.

2014-03-01

The book “Handbook of Finsler geometry” has been included with a CD containing an elegant Maple package, FINSLER, for calculations in Finsler geometry. Using this package, an example concerning a Finsler generalization of Einstein’s vacuum field equations was treated. In this example, the calculation of the components of the hv-curvature of Cartan connection leads to wrong expressions. On the other hand, the FINSLER package works only in dimension four. We introduce a new Finsler package in which we fix the two problems and solve them. Moreover, we extend this package to compute not only the geometric objects associated with Cartan connection but also those associated with Berwald, Chern and Hashiguchi connections in any dimension. These improvements have been illustrated by a concrete example. Furthermore, the problem of simplifying tensor expressions is treated. This paper is intended to make calculations in Finsler geometry more easier and simpler.

Palliative care and palliative radiation therapy education in radiation oncology: A survey of US radiation oncology program directors.

PubMed

Wei, Randy L; Colbert, Lauren E; Jones, Joshua; Racsa, Margarita; Kane, Gabrielle; Lutz, Steve; Vapiwala, Neha; Dharmarajan, Kavita V

The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States. We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors. The survey consisted of questions on (1) perceived relevance of PSC and palliative RT to radiation oncology training, (2) formal didactic sessions on domains of PSC and palliative RT, (3) effective teaching formats for PSC and palliative RT education, and (4) perceived barriers for integrating PSC and palliative RT into the residency curriculum. A total of 57 responses (63%) was received. Most program directors agreed or strongly agreed that PSC (93%) and palliative radiation therapy (99%) are important competencies for radiation oncology residents and fellows; however, only 67% of residency programs had formal educational activities in principles and practice of PSC. Most programs had 1 or more hours of formal didactics on management of pain (67%), management of neuropathic pain (65%), and management of nausea and vomiting (63%); however, only 35%, 33%, and 30% had dedicated lectures on initial management of fatigue, assessing role of spirituality, and discussing advance care directives, respectively. Last, 85% of programs reported having a formal curriculum on palliative RT. Programs were most likely to have education on palliative radiation to brain, bone, and spine, but less likely on visceral, or skin, metastasis. Residency program directors believe that PSC and palliative RT are important competencies for their trainees and support increasing education in these 2 educational domains. Many residency programs have structured curricula on PSC and palliative radiation education, but room for improvement exists in

Putting Oncology Patients at Risk

PubMed Central

CARLSON, BOB

2012-01-01

Using genomic tests to personalize oncology treatment is a worthy endeavor. But when the rush to capitalize on biomedical research overcomes the rules of evidence, it’s the patients who suffer. PMID:23091430

Paperless Work Package Application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kilgore, Jr., William R.; Morrell, Jr., Otto K.; Morrison, Dan

2014-07-31

Paperless Work Package (PWP) System is a computer program process that takes information from Asset Suite, provides a platform for other electronic inputs, Processes the inputs into an electronic package that can be downloaded onto an electronic work tablet or laptop computer, provides a platform for electronic inputs into the work tablet, and then transposes those inputs back into Asset Suite and to permanent SRS records. The PWP System will basically eliminate paper requirements from the maintenance work control system. The program electronically relays the instructions given by the planner to work on a piece of equipment which is currentlymore » relayed via a printed work package. The program does not control/approve what is done. The planner will continue to plan the work package, the package will continue to be routed, approved, and scheduled. The supervisor reviews and approves the work to be performed and assigns work to individuals or to a work group. (The supervisor conducts pre job briefings with the workers involved in the job) The Operations Manager (Work Controlling Entity) approves the work package electronically for the work that will be done in his facility prior to work starting. The PWP System will provide the package in an electronic form. All the reviews, approvals, and safety measures taken by people outside the electronic package does not change from the paper driven work packages.« less

Simulation-based Bayesian inference for latent traits of item response models: Introduction to the ltbayes package for R.

PubMed

Johnson, Timothy R; Kuhn, Kristine M

2015-12-01

This paper introduces the ltbayes package for R. This package includes a suite of functions for investigating the posterior distribution of latent traits of item response models. These include functions for simulating realizations from the posterior distribution, profiling the posterior density or likelihood function, calculation of posterior modes or means, Fisher information functions and observed information, and profile likelihood confidence intervals. Inferences can be based on individual response patterns or sets of response patterns such as sum scores. Functions are included for several common binary and polytomous item response models, but the package can also be used with user-specified models. This paper introduces some background and motivation for the package, and includes several detailed examples of its use.

Prevention policies addressing packaging and packaging waste: Some emerging trends.

PubMed

Tencati, Antonio; Pogutz, Stefano; Moda, Beatrice; Brambilla, Matteo; Cacia, Claudia

2016-10-01

Packaging waste is a major issue in several countries. Representing in industrialized countries around 30-35% of municipal solid waste yearly generated, this waste stream has steadily grown over the years even if, especially in Europe, specific recycling and recovery targets have been fixed. Therefore, an increasing attention starts to be devoted to prevention measures and interventions. Filling a gap in the current literature, this explorative paper is a first attempt to map the increasingly important phenomenon of prevention policies in the packaging sector. Through a theoretical sampling, 11 countries/states (7 in and 4 outside Europe) have been selected and analyzed by gathering and studying primary and secondary data. Results show evidence of three specific trends in packaging waste prevention policies: fostering the adoption of measures directed at improving packaging design and production through an extensive use of the life cycle assessment; raising the awareness of final consumers by increasing the accountability of firms; promoting collaborative efforts along the packaging supply chains. Copyright © 2016 Elsevier Ltd. All rights reserved.

Food packages for Space Shuttle

NASA Technical Reports Server (NTRS)

Fohey, M. F.; Sauer, R. L.; Westover, J. B.; Rockafeller, E. F.

1978-01-01

The paper reviews food packaging techniques used in space flight missions and describes the system developed for the Space Shuttle. Attention is directed to bite-size food cubes used in Gemini, Gemini rehydratable food packages, Apollo spoon-bowl rehydratable packages, thermostabilized flex pouch for Apollo, tear-top commercial food cans used in Skylab, polyethylene beverage containers, Skylab rehydratable food package, Space Shuttle food package configuration, duck-bill septum rehydration device, and a drinking/dispensing nozzle for Space Shuttle liquids. Constraints and testing of packaging is considered, a comparison of food package materials is presented, and typical Shuttle foods and beverages are listed.

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

PubMed Central

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-01-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients. PMID:26229680

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards.

PubMed

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-06-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

[Raman spectroscopy fluorescence background correction and its application in clustering analysis of medicines].

PubMed

Chen, Shan; Li, Xiao-ning; Liang, Yi-zeng; Zhang, Zhi-min; Liu, Zhao-xia; Zhang, Qi-ming; Ding, Li-xia; Ye, Fei

2010-08-01

During Raman spectroscopy analysis, the organic molecules and contaminations will obscure or swamp Raman signals. The present study starts from Raman spectra of prednisone acetate tablets and glibenclamide tables, which are acquired from the BWTek i-Raman spectrometer. The background is corrected by R package baselineWavelet. Then principle component analysis and random forests are used to perform clustering analysis. Through analyzing the Raman spectra of two medicines, the accurate and validity of this background-correction algorithm is checked and the influences of fluorescence background on Raman spectra clustering analysis is discussed. Thus, it is concluded that it is important to correct fluorescence background for further analysis, and an effective background correction solution is provided for clustering or other analysis.

Oncological image analysis.

PubMed

Brady, Sir Michael; Highnam, Ralph; Irving, Benjamin; Schnabel, Julia A

2016-10-01

Cancer is one of the world's major healthcare challenges and, as such, an important application of medical image analysis. After a brief introduction to cancer, we summarise some of the major developments in oncological image analysis over the past 20 years, but concentrating those in the authors' laboratories, and then outline opportunities and challenges for the next decade. Copyright © 2016 Elsevier B.V. All rights reserved.

In-Package Chemistry Abstraction

DOE Office of Scientific and Technical Information (OSTI.GOV)

E. Thomas

2004-11-09

This report was developed in accordance with the requirements in ''Technical Work Plan for: Regulatory Integration Modeling and Analysis of the Waste Form and Waste Package'' (BSC 2004 [DIRS 171583]). The purpose of the in-package chemistry model is to predict the bulk chemistry inside of a breached waste package and to provide simplified expressions of that chemistry as function of time after breach to Total Systems Performance Assessment for the License Application (TSPA-LA). The scope of this report is to describe the development and validation of the in-package chemistry model. The in-package model is a combination of two models, amore » batch reactor model that uses the EQ3/6 geochemistry-modeling tool, and a surface complexation model that is applied to the results of the batch reactor model. The batch reactor model considers chemical interactions of water with the waste package materials and the waste form for commercial spent nuclear fuel (CSNF) waste packages and codisposed waste packages that contain both high-level waste glass (HLWG) and DOE spent fuel. The surface complexation model includes the impact of fluid-surface interactions (i.e., surface complexation) on the resulting fluid composition. The model examines two types of water influx: (1) the condensation of water vapor that diffuses into the waste package, and (2) seepage water that enters the waste package from the drift as a liquid. (1) Vapor Influx Case: The condensation of vapor onto the waste package internals is simulated as pure H2O and enters at a rate determined by the water vapor pressure for representative temperature and relative humidity conditions. (2) Water Influx Case: The water entering a waste package from the drift is simulated as typical groundwater and enters at a rate determined by the amount of seepage available to flow through openings in a breached waste package. TSPA-LA uses the vapor influx case for the nominal scenario for simulations where the waste package has been

Comparable Efficacy With Varying Dosages of Glucarpidase in Pediatric Oncology Patients

PubMed Central

Scott, Jeffrey R.; Zhou, Yinmei; Cheng, Cheng; Ward, Deborah A.; Swanson, Hope D.; Molinelli, Alejandro R.; Stewart, Clinton F.; Navid, Fariba; Jeha, Sima; Relling, Mary V.; Crews, Kristine R.

2016-01-01

Background Glucarpidase rapidly reduces methotrexate plasma concentrations in patients experiencing methotrexate-induced renal dysfunction. Debate exists regarding the role of glucarpidase in therapy given its high cost. The use of reduced-dose glucarpidase has been reported, and may allow more institutions to supply this drug to their patients. This report explores the relationship between glucarpidase dosage and patient outcomes in pediatric oncology patients. Methods The authors evaluated data from 26 patients who received glucarpidase after high-dose methotrexate. Decrease in plasma methotrexate concentrations and time to renal recovery were evaluated for an association with glucarpidase dosage, which ranged from 13 to 90 units/kg. Results No significant relationship was found between glucarpidase dosage (units/kg) and percent decrease in methotrexate plasma concentrations measured by TDx (P >0.1) or HPLC (P >0.5). Patients who received glucarpidase dosages <50 units/kg had a median percent reduction in methotrexate plasma concentration of 99.4% (range, 98–100) measured by HPLC compared to a median percent reduction of 99.4% (range, 77.2–100) in patients who received ≥50 units/kg. Time to SCr recovery was not related to glucarpidase dosage (P >0.8). Conclusions The efficacy of glucarpidase in the treatment of HDMTX-induced kidney injury was not dosage-dependent in this retrospective analysis of pediatric oncology patients. Pediatr Blood Cancer 2015;62:1518–1522. PMID:25631103

Molecular level in silico studies for oncology. Direct models review

NASA Astrophysics Data System (ADS)

Psakhie, S. G.; Tsukanov, A. A.

2017-09-01

The combination of therapy and diagnostics in one process "theranostics" is a trend in a modern medicine, especially in oncology. Such an approach requires development and usage of multifunctional hybrid nanoparticles with a hierarchical structure. Numerical methods and mathematical models play a significant role in the design of the hierarchical nanoparticles and allow looking inside the nanoscale mechanisms of agent-cell interactions. The current position of in silico approach in biomedicine and oncology is discussed. The review of the molecular level in silico studies in oncology, which are using the direct models, is presented.

Essential Genetic and Genomic Nursing Competencies for the Oncology Nurse

PubMed Central

Jenkins, Jean

2010-01-01

Objectives To review the opportunities and possibilities for advancing oncology nursing competencies in genetic/genomics through the illustration of case scenarios in clinical care. Data Sources Literature; research reports. Conclusions Oncology nurses have the potential to influence whether or not cutting edge research discoveries are utilized at the bedside. Clinical integration of genetic/genomic information has the potential to optimize health outcomes and lengthen patient lives. Implications for Nursing Practice Oncology nurses need to include genetics/genomics in their practice in order to impact quality patient care today and for the future. PMID:21255714

Oncology data management in the UK--BODMA's view. British Oncology Data Managers Association.

PubMed Central

Riley, D.; Ward, L.; Young, T.

1994-01-01

Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager and trial coordinator. Increasing numbers of such personnel are now being employed, covering a wide diversity of work areas, including clinical research, medical audit and the cancer registries. The British Oncology Data Managers Association (BODMA) was founded in 1987 and is now in a good position to review the current status of data management in the UK. It is proposed that a national network of data managers and trial coordinators within specialist trials centres, oncology departments and district general hospitals, with a good training programme, plus a recognised career structure, is the way to make the best use of this key resource. BODMA is addressing many of these issues and aims to improve and maintain the quality of data management. PMID:8080719

Report of China's innovation increase and research growth in radiation oncology.

PubMed

Zhu, Hongcheng; Yang, Xi; Qin, Qin; Bian, Kangqi; Zhang, Chi; Liu, Jia; Cheng, Hongyan; Sun, Xinchen

2014-06-01

To investigate the research status of radiation oncology in China through survey of literature in international radiation oncology journals and retrospectively compare the outputs of radiation oncology articles of the three major regions of China-Mainland (ML), Taiwan (TW) and Hong Kong (HK). Radiation oncology journals were selected from "oncology" and "radiology, nuclear & medical image" category from Science Citation Index Expand (SCIE). Articles from the ML, TW and HK were retrieved from MEDLINE. The number of total articles, clinical trials, case reports, impact factors (IF), institutions and articles published in each journals were conducted for quantity and quality comparisons. A total 818 articles from 13 radiation oncology journals were searched, of which 427 are from ML, 259 from TW, and 132 from HK. Ninety-seven clinical trials and 5 case reports are reported in China. Accumulated IF of articles from ML (1,417.11) was much higher than that of TW (1,003.093) and HK (544.711), while the average IF of articles from ML is the lowest. The total number of articles from China especially ML increased significantly in the last decade. The number of articles published from the ML has exceeded those from TW and HK. However, the quality of articles from TW and HK is better than that from ML.

Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children's Oncology Group.

PubMed

Smolik, Suzanne; Arland, Lesley; Hensley, Mary Ann; Schissel, Debra; Shepperd, Barbara; Thomas, Kristin; Rodgers, Cheryl

Peripheral neuropathy is a known side effect of several chemotherapy agents, including vinca alkaloids and platinum-based chemotherapy. Early recognition and monitoring of this side effect is an important role of the pediatric oncology nurse. There are a variety of peripheral neuropathy assessment tools currently in use, but the usefulness of these tools in identifying and grading neuropathy in children varies, and there is currently no standardized tool in place to evaluate peripheral neuropathy in pediatric oncology. A systematic review was performed to identify the peripheral neuropathy assessment tools that best evaluate the early onset and progression of peripheral neuropathy in pediatric patients receiving vincristine. Because of the limited information available in pediatric oncology, this review was extended to any pediatric patient with neuropathy. A total of 8 studies were included in the evidence synthesis. Based on available evidence, the pediatric-modified Total Neuropathy Scale (ped-m TNS) and the Total Neuropathy Score-pediatric version (TNS-PV) are recommended for the assessment of vincristine-induced peripheral neuropathy in children 6 years of age and older. In addition, several studies demonstrated that subjective symptoms alone are not adequate to assess for vincristine-induced peripheral neuropathy. Nursing assessment of peripheral neuropathy should be an integral and regular part of patient care throughout the course of chemotherapy treatment.

WGCNA: an R package for weighted correlation network analysis

PubMed Central

Langfelder, Peter; Horvath, Steve

2008-01-01

Background Correlation networks are increasingly being used in bioinformatics applications. For example, weighted gene co-expression network analysis is a systems biology method for describing the correlation patterns among genes across microarray samples. Weighted correlation network analysis (WGCNA) can be used for finding clusters (modules) of highly correlated genes, for summarizing such clusters using the module eigengene or an intramodular hub gene, for relating modules to one another and to external sample traits (using eigengene network methodology), and for calculating module membership measures. Correlation networks facilitate network based gene screening methods that can be used to identify candidate biomarkers or therapeutic targets. These methods have been successfully applied in various biological contexts, e.g. cancer, mouse genetics, yeast genetics, and analysis of brain imaging data. While parts of the correlation network methodology have been described in separate publications, there is a need to provide a user-friendly, comprehensive, and consistent software implementation and an accompanying tutorial. Results The WGCNA R software package is a comprehensive collection of R functions for performing various aspects of weighted correlation network analysis. The package includes functions for network construction, module detection, gene selection, calculations of topological properties, data simulation, visualization, and interfacing with external software. Along with the R package we also present R software tutorials. While the methods development was motivated by gene expression data, the underlying data mining approach can be applied to a variety of different settings. Conclusion The WGCNA package provides R functions for weighted correlation network analysis, e.g. co-expression network analysis of gene expression data. The R package along with its source code and additional material are freely available at . PMID:19114008

Packaging colour research by tobacco companies: the pack as a product characteristic

PubMed Central

Lempert, Lauren K; Glantz, Stanton

2016-01-01

Background Tobacco companies use colour on cigarette packaging and labelling to communicate brand imagery, diminish health concerns, and as a replacement for prohibited descriptive words (‘light’ and ‘mild’) to make misleading claims about reduced risks. Methods We analysed previously secret tobacco industry documents to identify additional ways in which cigarette companies tested and manipulated pack colours to affect consumers’ perceptions of the cigarettes’ flavour and strength. Results Cigarette companies’ approach to package design is based on ‘sensation transference’ in which consumers transfer sensations they derive from the packaging to the product itself. Companies manipulate consumers’ perceptions of the taste and strength of cigarettes by changing the colour of the packaging. For example, even without changes to the tobacco blends, flavourings or additives, consumers perceive the taste of cigarettes in packages with red and darker colours to be fuller flavoured and stronger, and cigarettes in packs with more white and lighter colours are perceived to taste lighter and be less harmful. Conclusions Companies use pack colours to manipulate consumers’ perceptions of the taste, strength and health impacts of the cigarettes inside the packs, thereby altering their characteristics and effectively creating new products. In countries that do not require standardised packaging, regulators should consider colour equivalently to other changes in cigarette characteristics (eg, physical characteristics, ingredients, additives and flavourings) when making determinations about whether or not to permit new products on the market. PMID:27255118

Patient-Reported Outcomes and Survivorship in Radiation Oncology: Overcoming the Cons

PubMed Central

Siddiqui, Farzan; Liu, Arthur K.; Watkins-Bruner, Deborah; Movsas, Benjamin

2014-01-01

Purpose Although patient-reported outcomes (PROs) have become a key component of clinical oncology trials, many challenges exist regarding their optimal application. The goal of this article is to methodically review these barriers and suggest strategies to overcome them. This review will primarily focus on radiation oncology examples, will address issues regarding the “why, how, and what” of PROs, and will provide strategies for difficult problems such as methods for reducing missing data. This review will also address cancer survivorship because it closely relates to PROs. Methods Key articles focusing on PROs, quality of life, and survivorship issues in oncology trials are highlighted, with an emphasis on radiation oncology clinical trials. Publications and Web sites of various governmental and regulatory agencies are also reviewed. Results The study of PROs in clinical oncology trials has become well established. There are guidelines provided by organizations such as the US Food and Drug Administration that clearly indicate the importance of and methodology for studying PROs. Clinical trials in oncology have repeatedly demonstrated the value of studying PROs and suggested ways to overcome some of the key challenges. The Radiation Therapy Oncology Group (RTOG) has led some of these efforts, and their contributions are highlighted. The current state of cancer survivorship guidelines is also discussed. Conclusion The study of PROs presents significant benefits in understanding and treating toxicities and enhancing quality of life; however, challenges remain. Strategies are presented to overcome these hurdles, which will ultimately improve cancer survivorship. PMID:25113760

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey.

PubMed

Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

2016-01-01

Early integration of palliative care in oncology practice ("simultaneous care", SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

Women in oncology: progress, challenges, and keys to success.

PubMed

Reeder-Hayes, Katherine; Felip, Enriqueta; Patt, Debra; Jaffee, Elizabeth

2013-01-01

Women have an increasingly significant presence in the oncology physician workforce but remain underrepresented in leadership positions and at the senior levels of academic medicine. Initiatives to close these gaps are underway both in the United States and Europe. However, many areas for improvement remain on an organizational level and in the trenches of career development and mentorship for individual female oncologists in both community and academic settings. Solutions to advance women in the oncology workforce will involve policy initiatives by professional and funding organizations, individual initiatives by universities and practices to recognize and develop female leaders, an increased focus on teamwork and novel practice arrangements, and high-quality mentorship of young women entering the oncology field.

Packaging and Labeling of Pharmaceutical Products Obtained from the Internet

PubMed Central

2011-01-01

Background For patients, the prescription container label may be the only source of instructions on how to take their medicines. In the United States, the legal requirements for a prescription label are set by federal law and state statutes. The container should be comparable to that which manufacturers use to package drug products and should preserve a product’s identity, strength, quality, and purity and prevent contamination. Safety features such as a child-resistant closure should be provided. Pharmaceutical products purchased from international online pharmacies are not approved by the Food and Drug Administration (FDA) and may not meet US guidelines for labeling and packaging. Objective The study objective was to determine whether commonly purchased pharmaceutical products obtained from international online pharmacies are comparable to products dispensed in the United States with regard to labeling and packaging. Methods During March 2006 through January 2007, 41 pharmaceutical oral dosage form samples were obtained from international Internet pharmacy websites for evaluation: 18 generic simvastatin samples, 18 generic amlodipine samples, and 5 generic sildenafil samples. Contents for each package were observed and recorded and comparison of the prescription labeling and packaging of these products was made with prescription labeling and packaging requirements in the United States. Results Of the 41 drug products obtained from online pharmacies from 12 different countries, only 1 product (from Canada) would meet both labeling and packaging guidelines for products dispensed in the United States. Of those not meeting the requirements, 7 were dispensed in paper envelopes with label affixed that was either handwritten or typed and contained missing information such as name and address of dispenser, name of prescriber, name of patient, and directions for use. Another 3 products did not have a label affixed to the drug product, but information was printed on a

Understanding the Differences Between Oncology Patients and Oncology Health Professionals Concerning Spirituality/Religiosity

PubMed Central

de Camargos, Mayara Goulart; Paiva, Carlos Eduardo; Barroso, Eliane Marçon; Carneseca, Estela Cristina; Paiva, Bianca Sakamoto Ribeiro

2015-01-01

Abstract This study investigated whether spirituality/religiosity (S/R) plays an important role in the lives of cancer patients and in the work of health professionals who provide care for these patients. The correlations between spiritual quality of life (QOL) and the other QOL domain scores of patients and health professionals were also assessed. Moreover, QOL domain scores were compared between patients and health professionals. In this cross-sectional study, 1050 participants (525 oncology patients and 525 health professionals) were interviewed. Quality of life was assessed with the World Health Organization quality of life spiritual, religious, and personal beliefs (WHOQOL-SRPB). To compare the groups with respect to the instruments’ domains, a quantile regression and an analysis of covariance model were used. The WHOQOL-Bref and WHOQOL-SRPB domains were correlated by performing Pearson and partial correlation tests. It was demonstrated that 94.1% of patients considered it important that health professionals addressed their spiritual beliefs, and 99.2% of patients relied on S/R to face cancer. Approximately, 99.6% of the patients reported that S/R support is necessary during cancer treatment; 98.3% of health professionals agreed that spiritual and religious support was necessary for oncology patients. Positive correlations between spiritual QOL and the other QOL domains were observed. When compared among themselves, patients exhibited significantly higher levels of spiritual QOL. In conclusion, S/R was an important construct in the minds of cancer patients and health professionals. Both groups often use S/R resources in their daily lives, which seems to positively affect their perceptions of QOL. Further studies are needed to determine how health professionals effectively address S/R during oncology practice. PMID:26632743

Components of Adenovirus Genome Packaging

PubMed Central

Ahi, Yadvinder S.; Mittal, Suresh K.

2016-01-01

Adenoviruses (AdVs) are icosahedral viruses with double-stranded DNA (dsDNA) genomes. Genome packaging in AdV is thought to be similar to that seen in dsDNA containing icosahedral bacteriophages and herpesviruses. Specific recognition of the AdV genome is mediated by a packaging domain located close to the left end of the viral genome and is mediated by the viral packaging machinery. Our understanding of the role of various components of the viral packaging machinery in AdV genome packaging has greatly advanced in recent years. Characterization of empty capsids assembled in the absence of one or more components involved in packaging, identification of the unique vertex, and demonstration of the role of IVa2, the putative packaging ATPase, in genome packaging have provided compelling evidence that AdVs follow a sequential assembly pathway. This review provides a detailed discussion on the functions of the various viral and cellular factors involved in AdV genome packaging. We conclude by briefly discussing the roles of the empty capsids, assembly intermediates, scaffolding proteins, portal vertex and DNA encapsidating enzymes in AdV assembly and packaging. PMID:27721809

Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015.

PubMed

Camarillo, Jimvert I

2016-01-01

Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2 nd AONS Conference was held in Seoul, South Korea under the theme of "Flying the Spirits of Asian Oncology Nursing." A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field of oncology nursing from the academe to clinical practice and to research. The issues that have been discussed in this 2-day symposium were Professional Development of Oncology Nursing, Quality of Life, Putting Evidence into Practice, Nursing Research, and Health Insurance for Cancer Care in Asia.

Green Packaging Management of Logistics Enterprises

NASA Astrophysics Data System (ADS)

Zhang, Guirong; Zhao, Zongjian

From the connotation of green logistics management, we discuss the principles of green packaging, and from the two levels of government and enterprises, we put forward a specific management strategy. The management of green packaging can be directly and indirectly promoted by laws, regulations, taxation, institutional and other measures. The government can also promote new investment to the development of green packaging materials, and establish specialized institutions to identify new packaging materials, standardization of packaging must also be accomplished through the power of the government. Business units of large scale through the packaging and container-based to reduce the use of packaging materials, develop and use green packaging materials and easy recycling packaging materials for proper packaging.

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Manley, Stephen, E-mail: stephen.manley@ncahs.health.nsw.gov.au; Last, Andrew; Fu, Kenneth

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of ourmore » conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.« less

Modular avionics packaging standardization

NASA Astrophysics Data System (ADS)

Austin, M.; McNichols, J. K.

The Modular Avionics Packaging (MAP) Program for packaging future military avionics systems with the objective of improving reliability, maintainability, and supportability, and reducing equipment life cycle costs is addressed. The basic MAP packaging concepts called the Standard Avionics Module, the Standard Enclosure, and the Integrated Rack are summarized, and the benefits of modular avionics packaging, including low risk design, technology independence with common functions, improved maintainability and life cycle costs are discussed. Progress made in MAP is briefly reviewed.

Optimizing reconstruction of oncologic sternectomy defects based on surgical outcomes.

PubMed

Butterworth, James A; Garvey, Patrick B; Baumann, Donald P; Zhang, Hong; Rice, David C; Butler, Charles E

2013-08-01

The optimal strategy for oncologic sternectomy reconstruction has not been well characterized. We hypothesized that the major factors driving the reconstructive strategy for oncologic sternectomy include the need for skin replacement, extent of the bony sternectomy defect, and status of the internal mammary vessels. We reviewed consecutive oncologic sternectomy reconstructions performed at The University of Texas MD Anderson Cancer Center during a 10-year period. Regression models analyzed associations between patient, defect, and treatment factors and outcomes to identify patient and treatment selection criteria. We developed a generalized management algorithm based on these data. Forty-nine consecutive patients underwent oncologic sternectomy reconstruction (mean follow-up 18 ± 23 months). More sternectomies were partial (74%) rather than total/subtotal (26%). Most defects (n = 40 [82%]) required skeletal reconstruction. Pectoralis muscle flaps were most commonly used for sternectomies with intact overlying skin (64%) and infrequently used when a presternal skin defect was present (36%; p = 0.06). Free flaps were more often used for total/subtotal vs partial sternectomy defects (75% vs 25%, respectively; p = 0.02). Complication rates for total/subtotal sternectomy and partial sternectomy were equivalent (46% vs 44%, respectively; p = 0.92). Despite more extensive sternal resections, total/subtotal sternectomies resulted in equivalent postoperative complications when combined with the appropriate soft-tissue reconstruction. Good surgical and oncologic outcomes can be achieved with defect-characteristic-matched reconstructive strategies for these complex oncologic sternectomy resections. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Enhanced recovery pathways in gynecologic oncology.

PubMed

Nelson, Gregg; Kalogera, Eleftheria; Dowdy, Sean C

2014-12-01

Many commonplace perioperative practices are lacking in scientific evidence and may interfere with the goal of optimizing patient recovery. Individual components of perioperative care have therefore been scrutinized, resulting in the creation of so-called "enhanced recovery" pathways (ERP), with the goal of hastening surgical recovery through attenuation of the stress response. In this review we examine the evidence for ERP in gynecologic oncology using data from our specialty and general surgery. We performed a systematic literature search on ERP in gynecologic oncology in June 2014 using PubMed/MEDLINE, EMBASE, and The Cochrane Library. All study types were included. References were hand reviewed to ensure completeness. The Enhanced Recovery After Surgery (ERAS) Society was contacted to identify any unpublished protocols. Seven investigations were identified that examined the role of ERP in gynecologic oncology. Common interventions included allowing oral intake of fluids up to 2 hours before induction of anesthesia, solids up to 6 hours before anesthesia, carbohydrate supplementation, intra- and postoperative euvolemia, aggressive nausea/vomiting prophylaxis, and oral nutrition and ambulation the day of surgery. In addition, bowel preparations, the NPO after midnight rule, nasogastric tubes, and intravenous opioids were discontinued. While no randomized data are available in gynecologic oncology, significant improvements in patient satisfaction, length of stay (up to 4 days), and cost (up to $7600 in savings per patient) were observed in ERP cohorts compared to historical controls. Morbidity, mortality, and readmission rates were no different between groups. Enhanced recovery is a safe perioperative management strategy for patients undergoing surgery for gynecologic malignancies, reduces length of stay and cost, and is considered standard of care at a growing number of institutions. Our specialty would benefit from a formalized ERP such as ERAS which audits

Agreement between oncology guidelines and clinical practice in Italy: the 'right' program. A project of the Italian Association of Medical Oncology (AIOM).

PubMed

Barni, S; Venturini, M; Beretta, G D; Gori, S; Molino, A; Carnaghi, C; Labianca, R; Sgarbi, S; Simoni, L; Maiello, E

2007-06-01

RIGHT (Research for the Identification of the most effective and hIGhly accepted clinical guidelines for the cancer Treatment) is a project promoted by the Italian Association of Medical Oncology (AIOM) to measure the concordance between oncology guidelines and clinical practice. The goal of this pilot phase was to develop and test a reliable process to measure this concordance nationwide. Twenty Italian centers participated to the survey. Breast cancer (BC) and colorectal cancer (CRC): guidelines issued by AIOM in 2003 were selected. A total of 29 indicators linked to the process of care were abstracted. Patients who had their first visit at the oncology center between February 2004 and June 2005, with a diagnosis of invasive BC (stage 1 or 2), colon cancer (stage 3), rectal cancer (stage T3-4 or N1-2) or advanced CRC were enclosed. One hundred and sixty-one patients (80%) were analyzed. On average, 93% of BC and 80.3% of colorectal patients received recommended care. These first results indicate that the RIGHT system provides a valid measurement of oncology care to assess agreement with guidelines. A second larger phase of this nationwide monitoring program will enable results to be generalized.

Economic impact of a head and neck oncologic surgeon: the case mix index.

PubMed

Jalisi, Scharukh; Sanan, Akshay; Mcdonough, Katie; Hussein, Khalil; Platt, Michael; Truong, Minh Tam; Couch, Marion; Burkey, Brian B

2014-10-01

Head and neck oncologic surgery is a time-consuming specialty that requires extensive resources and manpower. Case mix index (CMI) is used in evaluating the complexity and economic impact of surgeons. Head and neck oncologic surgeons generate significant revenue for hospitals, yet compensation is relatively low. Retrospective review of a tertiary hospital's case mix data for 605 otolaryngology admissions from 2009 to 2011 was performed. CMI comparison for head and neck oncologic surgeons versus general otolaryngology was performed. In an otolaryngology department of 9 surgeons; there was a significant difference (p < .01) in the CMI and a significantly greater chance to have a "good CMI" (CMI >1) favoring head and neck oncologic surgeons. Head and neck oncologic surgeons increase the CMI for hospitals and ultimately influence the hospital's reimbursement. There is a need for increased collaboration between hospitals and departments in fostering and furthering their head and neck surgical oncology programs by taking CMI into consideration. © 2013 Wiley Periodicals, Inc.

Food packaging history and innovations.

PubMed

Risch, Sara J

2009-09-23

Food packaging has evolved from simply a container to hold food to something today that can play an active role in food quality. Many packages are still simply containers, but they have properties that have been developed to protect the food. These include barriers to oxygen, moisture, and flavors. Active packaging, or that which plays an active role in food quality, includes some microwave packaging as well as packaging that has absorbers built in to remove oxygen from the atmosphere surrounding the product or to provide antimicrobials to the surface of the food. Packaging has allowed access to many foods year-round that otherwise could not be preserved. It is interesting to note that some packages have actually allowed the creation of new categories in the supermarket. Examples include microwave popcorn and fresh-cut produce, which owe their existence to the unique packaging that has been developed.

Trends in Food Packaging.

ERIC Educational Resources Information Center

Ott, Dana B.

1988-01-01

This article discusses developments in food packaging, processing, and preservation techniques in terms of packaging materials, technologies, consumer benefits, and current and potential food product applications. Covers implications due to consumer life-style changes, cost-effectiveness of packaging materials, and the ecological impact of…

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

PubMed Central

2010-01-01

Background It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. Methods The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Results Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Conclusion Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts. PMID:20540787

Cardio-oncology: Concepts and practice

PubMed Central

Cubbon, Richard M.; Lyon, Alexander R.

2016-01-01

Substantial progress in cancer therapy increasingly allows higher cure rates, and even advanced disease can be stabilized, allowing improved survival with quality of life for months to years, meaning comorbid diseases are a growing determinant of outcome. Cardiovascular events substantially contribute to long-term morbidity and mortality in people living with or surviving cancer. In recognition of this, the subspecialty of cardio-oncology has emerged, and aims to promote cardiovascular heath, whilst facilitating the most effective cancer therapy. This review describes the concept of cardio-oncology, and illustrates the role played by a specialist team in improving outcomes, using heart failure secondary to breast cancer treatment as an example. We aim to highlight pivotal original research and comprehensive summaries of the most relevant topics, providing an overview for cardiologists and oncologists about this increasingly important medical problem. PMID:27056658

First Author Research Productivity of United States Radiation Oncology Residents: 2002-2007

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morgan, Peter B.; Sopka, Dennis M.; Kathpal, Madeera

2009-08-01

Purpose: Participation in investigative research is a required element of radiation oncology residency in the United States. Our purpose was to quantify the first author research productivity of recent U.S. radiation oncology residents during their residency training. Methods and Materials: We performed a computer-based search of PubMed and a manual review of the proceedings of the annual meetings of the American Society for Therapeutic Radiology and Oncology to identify all publications and presented abstracts with a radiation oncology resident as the first author between 2002 and 2007. Results: Of 1,098 residents trained at 81 programs, 50% published {>=}1 article (range,more » 0-9), and 53% presented {>=}1 abstract (range, 0-3) at an American Society for Therapeutic Radiology and Oncology annual meeting. The national average was 1.01 articles published and 1.09 abstracts presented per resident during 4 years of training. Of 678 articles published, 82% represented original research and 18% were review articles. Residents contributed 15% of all abstracts at American Society for Therapeutic Radiology and Oncology annual meetings, and the resident contribution to orally presented abstracts increased from 12% to 21% during the study period. Individuals training at programs with >6 residents produced roughly twice as many articles and abstracts. Holman Research Pathway residents produced double the national average of articles and abstracts. Conclusion: Although variability exists among individuals and among training programs, U.S. radiation oncology residents routinely participate in investigative research suitable for publication or presentation at a scientific meeting. These data provide national research benchmarks that can assist current and future radiation oncology residents and training programs in their self-assessment and research planning.« less

[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.

Oncology in Cambodia.

PubMed

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

2012-01-01

Cambodia, a country of 14 million inhabitants, was devastated during the Khmer Rouge period and thereafter. The resources of treatment are rare: only one radiotherapy department, renovated in 2003, with an old cobalt machine; few surgeons trained to operate on cancer patients; no hematology; no facilities to use intensive chemotherapy; no nuclear medicine department and no palliative care unit. Cervical cancer incidence is one of the highest in the world, while in men liver cancer ranks first (20% of all male cancers). Cancers are seen at stage 3 or 4 for 70% of patients. There is no prevention program - only a vaccination program against hepatitis B for newborns - and no screening program for cervical cancer or breast cancer. In 2010, oncology, recognized as a full specialty, was created to train the future oncologists on site at the University of Phnom Penh. A new National Cancer Center will be built in 2013 with modern facilities for radiotherapy, medical oncology, hematology and nuclear medicine. Cooperation with foreign countries, especially France, and international organizations has been established and is ongoing. Progress is occurring slowly due to the shortage of money for Cambodian institutions and the lay public. Copyright © 2012 S. Karger AG, Basel.

Robotic-assisted surgery in gynecologic oncology.

PubMed

Sinno, Abdulrahman K; Fader, Amanda N

2014-10-01

The quest for improved patient outcomes has been a driving force for adoption of novel surgical innovations across surgical subspecialties. Gynecologic oncology is one such surgical discipline in which minimally invasive surgery has had a robust and evolving role in defining standards of care. Robotic-assisted surgery has developed during the past two decades as a more technologically advanced form of minimally invasive surgery in an effort to mitigate the limitations of conventional laparoscopy and improved patient outcomes. Robotically assisted technology offers potential advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve surgeon dexterity, and tremor canceling software that improves surgical precision. These technological advances may allow the gynecologic oncology surgeon to perform increasingly radical oncologic surgeries in complex patients. However, the platform is not without limitations, including high cost, lack of haptic feedback, and the requirement for additional training to achieve competence. This review describes the role of robotic-assisted surgery in the management of endometrial, cervical, and ovarian cancer, with an emphasis on comparison with laparotomy and conventional laparoscopy. The literature on novel robotic innovations, special patient populations, cost effectiveness, and fellowship training is also appraised critically in this regard. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Personalized medicine in oncology: ethical implications for the delivery of healthcare.

PubMed

Egalite, Nathalie; Groisman, Iris Jaitovich; Godard, Beatrice

2014-09-01

While personalized medicine brings benefits for the treatment of cancer, there are still key ethical issues at stake in developing personalized medicine in oncology. We propose an ethical analysis of personalized medicine in oncology that highlights the particularities of cancer care, critically assesses the scientific advances behind personalized medicine in oncology and emphasizes fairness in resource allocation in the delivery of personalized healthcare. This allows for a broader understanding of the real impacts on both recipients and the healthcare system.

Food Packaging Materials

NASA Technical Reports Server (NTRS)

1978-01-01

The photos show a few of the food products packaged in Alure, a metallized plastic material developed and manufactured by St. Regis Paper Company's Flexible Packaging Division, Dallas, Texas. The material incorporates a metallized film originally developed for space applications. Among the suppliers of the film to St. Regis is King-Seeley Thermos Company, Winchester, Ma'ssachusetts. Initially used by NASA as a signal-bouncing reflective coating for the Echo 1 communications satellite, the film was developed by a company later absorbed by King-Seeley. The metallized film was also used as insulating material for components of a number of other spacecraft. St. Regis developed Alure to meet a multiple packaging material need: good eye appeal, product protection for long periods and the ability to be used successfully on a wide variety of food packaging equipment. When the cost of aluminum foil skyrocketed, packagers sought substitute metallized materials but experiments with a number of them uncovered problems; some were too expensive, some did not adequately protect the product, some were difficult for the machinery to handle. Alure offers a solution. St. Regis created Alure by sandwiching the metallized film between layers of plastics. The resulting laminated metallized material has the superior eye appeal of foil but is less expensive and more easily machined. Alure effectively blocks out light, moisture and oxygen and therefore gives the packaged food long shelf life. A major packaging firm conducted its own tests of the material and confirmed the advantages of machinability and shelf life, adding that it runs faster on machines than materials used in the past and it decreases product waste; the net effect is increased productivity.

An R package for analyzing and modeling ranking data

PubMed Central

2013-01-01

Background In medical informatics, psychology, market research and many other fields, researchers often need to analyze and model ranking data. However, there is no statistical software that provides tools for the comprehensive analysis of ranking data. Here, we present pmr, an R package for analyzing and modeling ranking data with a bundle of tools. The pmr package enables descriptive statistics (mean rank, pairwise frequencies, and marginal matrix), Analytic Hierarchy Process models (with Saaty’s and Koczkodaj’s inconsistencies), probability models (Luce model, distance-based model, and rank-ordered logit model), and the visualization of ranking data with multidimensional preference analysis. Results Examples of the use of package pmr are given using a real ranking dataset from medical informatics, in which 566 Hong Kong physicians ranked the top five incentives (1: competitive pressures; 2: increased savings; 3: government regulation; 4: improved efficiency; 5: improved quality care; 6: patient demand; 7: financial incentives) to the computerization of clinical practice. The mean rank showed that item 4 is the most preferred item and item 3 is the least preferred item, and significance difference was found between physicians’ preferences with respect to their monthly income. A multidimensional preference analysis identified two dimensions that explain 42% of the total variance. The first can be interpreted as the overall preference of the seven items (labeled as “internal/external”), and the second dimension can be interpreted as their overall variance of (labeled as “push/pull factors”). Various statistical models were fitted, and the best were found to be weighted distance-based models with Spearman’s footrule distance. Conclusions In this paper, we presented the R package pmr, the first package for analyzing and modeling ranking data. The package provides insight to users through descriptive statistics of ranking data. Users can also visualize

Shifting the focus to practice quality improvement in radiation oncology.

PubMed

Crozier, Cheryl; Erickson-Wittmann, Beth; Movsas, Benjamin; Owen, Jean; Khalid, Najma; Wilson, J Frank

2011-09-01

To demonstrate how the American College of Radiology, Quality Research in Radiation Oncology (QRRO) process survey database can serve as an evidence base for assessing quality of care in radiation oncology. QRRO has drawn a stratified random sample of radiation oncology facilities in the USA and invited those facilities to participate in a Process Survey. Information from a prior QRRO Facilities Survey has been used along with data collected under the current National Process Survey to calculate national averages and make statistically valid inferences for national process measures for selected cancers in which radiation therapy plays a major role. These measures affect outcomes important to patients and providers and measure quality of care. QRRO's survey data provides national benchmark data for numerous quality indicators. The Process Survey is "fully qualified" as a Practice Quality Improvement project by the American Board of Radiology under its Maintenance of Certification requirements for radiation oncology and radiation physics. © 2011 National Association for Healthcare Quality.

Cardio-oncology: conflicting priorities of anticancer treatment and cardiovascular outcome.

PubMed

Tilemann, Lisa M; Heckmann, Markus B; Katus, Hugo A; Lehmann, Lorenz H; Müller, Oliver J

2018-04-01

This article about the emerging field of cardio-oncology highlights typical side effects of oncological therapies in the cardiovascular system, cardiovascular complications of malignancies itself, and potential preventive or therapeutic modalities. We performed a selective literature search in PubMed until September 2016. Cardiovascular events in cancer patients can be frequently attributed to oncological therapies or to the underlying malignancy itself. Furthermore, many patients with cancer have pre-existing cardiovascular diseases that can be aggravated by the malignancy or its therapy. Cardiovascular abnormalities in oncological patients comprise a broad spectrum from alterations in electrophysiological, laboratory or imaging tests to the occurrence of thromboembolic, ischemic or rhythmological events and the impairment of left ventricular function or manifest heart failure. A close interdisciplinary collaboration between oncologists and cardiologists/angiologists as well as an increased awareness of potential cardiovascular complications could improve clinical care of cancer patients and provides a basis for an improved understanding of underlying mechanisms of cardiovascular morbidity.

Subspecialist training in surgical gynecologic oncology in the Nordic countries.

PubMed

Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B; Auranen, Annika; Salvarsdottir, Anna; Høgdall, Claus

2011-08-01

To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries, we developed an online questionnaire in co-operation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian gynecological centers in charge of surgical treatment of cancer patients. Twenty (91%) centers participated. Four centers reported to be accredited European subspecialty training centers, a further six were interested in being accredited, and 11 centers were accredited by the respective National Board. Fourteen (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecologic oncology training in Scandinavia and to facilitate the exchange of fellows between Nordic countries. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Restricted mouth opening and trismus in oral oncology.

PubMed

Satheeshkumar, P S; Mohan, Minu P; Jacob, Jayan

2014-06-01

Restricted mouth opening (RMO) and trismus are terms commonly used in oral oncology in instances where there is difficulty in mouth opening. The term trismus in oral oncology is mainly used to indicate the radiation-induced fibrosis of the muscles of mastication. The treatment given for RMO as reported in the literature is given for muscular dysfunction trismus, whereas RMO in oral oncology can occur owing to various reasons other than muscular dysfunction. RMO occurs in various conditions of the oral cavity; in posterior pharyngeal infection, where it is termed reflectory trismus; in oral submucous fibrosis; in oral mucosal disorders; in the use of certain drugs; and in minor dental procedures of the posterior oral cavity. The usage of the term trismus in all RMO cases would complicate the treatment; thus, the word should not be used in all RMO cases. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015

PubMed Central

Camarillo, Jimvert I.

2016-01-01

Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2nd AONS Conference was held in Seoul, South Korea under the theme of “Flying the Spirits of Asian Oncology Nursing.” A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field of oncology nursing from the academe to clinical practice and to research. The issues that have been discussed in this 2-day symposium were Professional Development of Oncology Nursing, Quality of Life, Putting Evidence into Practice, Nursing Research, and Health Insurance for Cancer Care in Asia. PMID:27981128

Packaging of electronic modules

NASA Technical Reports Server (NTRS)

Katzin, L.

1966-01-01

Study of design approaches that are taken toward optimizing the packaging of electronic modules with respect to size, shape, component orientation, interconnections, and structural support. The study does not present a solution to specific packaging problems, but rather the factors to be considered to achieve optimum packaging designs.

QL-10NEURO-ONCOLOGY TELEMEDICINE FOLLOW-UP VISITS

PubMed Central

Green, Richard; Woyshner, Emily

2014-01-01

We report our 18 month experience with the use of a videoconferencing system to perform neuro-oncology follow-up visits. The Neuro-oncology Program at the Kaiser Permanente-Los Angeles Medical center serves the majority of Kaiser HMO patients in the Southern California region. We installed a videoconferencing system (Cisco TelePresence EX90, Cisco Systems, San Jose, CA) in our office in Los Angeles and in a medical office building in Anaheim, CA at a distance of 35 miles. Established neuro-oncology patients from Orange County chose between in-person and remote visits. Patients were seated in an examination room and the neuro-oncology provider alerted by text page. A focused history and physical examination was performed, followed by desktop sharing of clinical and laboratory data using an electronic medical record (Epic Systems Corporation, Verona, WI) and of neuroimages (Phillips iSite PACS, Andover, MA). Patients were asked, but not required, to complete an anonymous online 16 question satisfaction survey after each visit. Visits were performed by either a neuro-oncologist (179) or a Physician's Assistant (12). Of the 191 visits, 174 included evaluation of neuroimaging and 77 included evaluation of response to ongoing chemotherapy. During 12 visits chemotherapy was initiated, and during 15 visits the chemotherapy regimen was changed based on imaging findings. One-hundred and eleven surveys (58% of visits) were completed. Patients reported a high level of satisfaction with the visits (average 9.6, on a 1-10 scale). The average estimated travel time saved was 118 minutes per visit. Four surveys reported technical problems and 1 indicated a preference for an in-person visit. No adverse events could be attributed to use of the telemedicine system. These data suggest that neuro-oncology follow-up visits can be practiced safely and effectively using a telemedicine system, with high levels of patient satisfaction.

Feasibility and Outcomes of Oncology Teaching for 5th Year Medical Students.

PubMed

Al Suwayri, Saad Mohammed

2018-02-01

This study explored medical students' opinions of undergraduate oncology teaching, aiming to define optimal strategies for nonspecialist oncology teaching. A cross-sectional study was conducted at Al Imam Muhammed Ibn Saud Islamic University, Riyadh, Saudi Arabia. Between August 2014 and June 2015, 124 medical students completing the oncology course in the fifth year at the College of Medicine, Al Imam Muhammed Ibn Saud Islamic University, were given a 47-item questionnaire. One hundred and five students completed the questionnaire. Students reported that the oncology teaching fitted well with the course and that they gained knowledge and clinical skills, including understanding of how to break bad news. There was no consensus regarding whether physicians had an ongoing responsibility of care if patients were unable to embrace the treatment offered and whether pain was adequately controlled in patients with cancer. There was good understanding of the ethics of analgesia use and the need to involve patients in the decision-making process. There was a wide spread of opinion when asked if the physician should "decide for themselves how much information to give." Forty-four percent of students stated that they would attend an oncology summer school. This study shows the undergraduate oncology course to be effective in teaching knowledge, ethics, and skills and to be well received by fifth year medical students. Inclusion of appropriate teaching in medical school curricula may be the most effective way to ensure all clinicians acquire appropriate training in oncology.

Analysis of outcomes in radiation oncology: An integrated computational platform

PubMed Central

Liu, Dezhi; Ajlouni, Munther; Jin, Jian-Yue; Ryu, Samuel; Siddiqui, Farzan; Patel, Anushka; Movsas, Benjamin; Chetty, Indrin J.

2009-01-01

Radiotherapy research and outcome analyses are essential for evaluating new methods of radiation delivery and for assessing the benefits of a given technology on locoregional control and overall survival. In this article, a computational platform is presented to facilitate radiotherapy research and outcome studies in radiation oncology. This computational platform consists of (1) an infrastructural database that stores patient diagnosis, IMRT treatment details, and follow-up information, (2) an interface tool that is used to import and export IMRT plans in DICOM RT and AAPM/RTOG formats from a wide range of planning systems to facilitate reproducible research, (3) a graphical data analysis and programming tool that visualizes all aspects of an IMRT plan including dose, contour, and image data to aid the analysis of treatment plans, and (4) a software package that calculates radiobiological models to evaluate IMRT treatment plans. Given the limited number of general-purpose computational environments for radiotherapy research and outcome studies, this computational platform represents a powerful and convenient tool that is well suited for analyzing dose distributions biologically and correlating them with the delivered radiation dose distributions and other patient-related clinical factors. In addition the database is web-based and accessible by multiple users, facilitating its convenient application and use. PMID:19544785

Integrative oncology in Indian subcontinent: an overview.

PubMed

Ramamoorthy, Ananthalakshmi; Janardhanan, Sunitha; Jeevakarunyam, Sathiyajeeva; Jeddy, Nadheem; Eagappan, Senthil

2015-03-01

Integrative oncology is a combination of one where complementary and alternative medicine (CAM) with conventional cancer treatment modalities is used to manage symptoms, control side-effects and improve the state of mental wellbeing. The ancient Indian medicinal approach in cancer treatment and management has a wide array of herbs and practices. There is an increasing demand for traditional and natural medicine by the cancer patients. The conventional oncologic surgeons and physicians should be aware of the role of cCAM that are available in Indian subcontinent and provide a treatment that focuses on the physical and mental state of wellness in combating cancer.

Role of music therapy in integrative oncology.

PubMed

Magill, Lucanne

2006-01-01

Music therapy is an evidence-based complementary therapy that enhances quality of life in cancer patients and their caregivers. The role of music therapy in integrative oncology encompassed care and treatment of patients and family members , ongoing collaboration with the health care team, and the provision of music therapy services that may benefit the cancer center community. Clinical work includes ongoing assessment and the implementation of specific music therapy techniques aimed at reducing challenging symptoms and enhancing overall well-being and quality of life. This article outlines music therapy methods and the role that the music therapist has in integrative oncology programs.

Patient understanding and impression of hematology/oncology fellows.

PubMed

Curley, Brendan; Thomas, Roby; Curley, Anjaly; Truong, Quoc; Culp, Mark; Hu, Yanqing; Almubarak, Mohammed

2014-09-01

Hematologists/Oncologists spend years of training in a fellowship program. At academic centers, patients receiving treatment are often seen by fellows. It has not been established what patients understand about fellowship training, therefore the purpose of this study was to explore their understanding and whether they are content with fellows taking part in their care. At West Virginia University/Mary Babb Randolph Cancer Center, the authors drafted a survey. This anonymous and voluntary survey abstracted basic patient demographic data and experience being cared for by fellows and basic knowledge of a Hematology/Oncology fellowship. Multiple-choice questions were drafted with 4 to 6 answer choices with no option for unknown. Surveys were collected over a 3-week period in July 2012. Patients were surveyed at outpatient appointments, infusion center visits, and laboratory draws. Two hundred twenty-six surveys were collected. Statistical analysis was performed and a binomial regression was fit to the data. There is evidence that higher levels of education are more likely to give correct answers (P = 0.035). Patients who stated that they had not seen a fellow or were unsure whether they had seen a fellow were more likely to select incorrect answers (P = 0.001). There is no statistical significance differentiating between cancer types in likelihood of getting answers correct. Of those surveyed, 1.77% felt that they completely understand the role of a fellow in their care, whereas 80.45% desired further information about fellows. Only 2.2% disliked having a fellow involved in their care. Patients at academic centers being seen by Hematology/Oncology fellows appear to have a lack of knowledge of a fellow's role and background but have a desire to be educated. Educational initiatives can be introduced to teaching institutions to help patients better understand the role of a fellow.

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

Cancer.gov

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

AllergoOncology - The impact of Allergy in Oncology. EAACI Position Paper

PubMed Central

Jensen-Jarolim, E; Bax, HJ; Bianchini, R; Capron, M; Corrigan, C; Castells, M; Dombrowicz, D; Daniels-Wells, TR; Fazekas, J; Fiebiger, E; Gatault, S; Gould, HJ; Janda, J; Josephs, DH; Karagiannis, P; Levi-Schaffer, F; Meshcheryakova, A; Mechtcheriakova, D; Mekori, Y; Mungenast, F; Nigro, EA; Penichet, ML; Redegeld, F; Saul, L; Singer, J; Spicer, JF; Siccardi, AG; Spillner, E; Turner, MC; Untersmayr, E; Vangelista, L; Karagiannis, SN

2017-01-01

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both anti-tumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Co-incident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intra-tumoural innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the cross-talk between allergic response and cancer is paving the way for new avenues of treatment. PMID:28032353

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

PubMed

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

2016-01-01

Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Modular assembly of chimeric phi29 packaging RNAs that support DNA packaging.

PubMed

Fang, Yun; Shu, Dan; Xiao, Feng; Guo, Peixuan; Qin, Peter Z

2008-08-08

The bacteriophage phi29 DNA packaging motor is a protein/RNA complex that can produce strong force to condense the linear-double-stranded DNA genome into a pre-formed protein capsid. The RNA component, called the packaging RNA (pRNA), utilizes magnesium-dependent inter-molecular base-pairing interactions to form ring-shaped complexes. The pRNA is a class of non-coding RNA, interacting with phi29 motor proteins to enable DNA packaging. Here, we report a two-piece chimeric pRNA construct that is fully competent in interacting with partner pRNA to form ring-shaped complexes, in packaging DNA via the motor, and in assembling infectious phi29 virions in vitro. This is the first example of a fully functional pRNA assembled using two non-covalently interacting fragments. The results support the notion of modular pRNA architecture in the phi29 packaging motor.

Modular assembly of chimeric phi29 packaging RNAs that support DNA packaging

PubMed Central

Fang, Yun; Shu, Dan; Xiao, Feng; Guo, Peixuan; Qin, Peter Z.

2008-01-01

The bacteriophage phi29 DNA packaging motor is a protein/RNA complex that can produce strong force to condense the linear-double stranded DNA genome into a pre-formed protein capsid. The RNA component, called the packaging RNA (pRNA), utilizes magnesium-dependent intermolecular base-pairing interactions to form ring-shaped complexes. The pRNA is a class of non-coding RNA, interacting with phi29 motor proteins to enable DNA packaging. Here, we report a 2-piece chimeric pRNA construct that is fully competent in interacting with partner pRNA to form ring-shaped complexes, in packaging DNA via the motor, and in assembling infectious phi29 virions in vitro. This is the first example of a fully functional pRNA assembled using two non-covalently interacting fragments. The results support the notion of modular pRNA architecture in the phi29 packaging motor. PMID:18514064

Outcomes Definitions and Statistical Tests in Oncology Studies: A Systematic Review of the Reporting Consistency

PubMed Central

Rivoirard, Romain; Duplay, Vianney; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Magne, Nicolas; Bourmaud, Aurelie

2016-01-01

Background Quality of reporting for Randomized Clinical Trials (RCTs) in oncology was analyzed in several systematic reviews, but, in this setting, there is paucity of data for the outcomes definitions and consistency of reporting for statistical tests in RCTs and Observational Studies (OBS). The objective of this review was to describe those two reporting aspects, for OBS and RCTs in oncology. Methods From a list of 19 medical journals, three were retained for analysis, after a random selection: British Medical Journal (BMJ), Annals of Oncology (AoO) and British Journal of Cancer (BJC). All original articles published between March 2009 and March 2014 were screened. Only studies whose main outcome was accompanied by a corresponding statistical test were included in the analysis. Studies based on censored data were excluded. Primary outcome was to assess quality of reporting for description of primary outcome measure in RCTs and of variables of interest in OBS. A logistic regression was performed to identify covariates of studies potentially associated with concordance of tests between Methods and Results parts. Results 826 studies were included in the review, and 698 were OBS. Variables were described in Methods section for all OBS studies and primary endpoint was clearly detailed in Methods section for 109 RCTs (85.2%). 295 OBS (42.2%) and 43 RCTs (33.6%) had perfect agreement for reported statistical test between Methods and Results parts. In multivariable analysis, variable "number of included patients in study" was associated with test consistency: aOR (adjusted Odds Ratio) for third group compared to first group was equal to: aOR Grp3 = 0.52 [0.31–0.89] (P value = 0.009). Conclusion Variables in OBS and primary endpoint in RCTs are reported and described with a high frequency. However, statistical tests consistency between methods and Results sections of OBS is not always noted. Therefore, we encourage authors and peer reviewers to verify consistency of

Publication status of contemporary oncology randomised controlled trials worldwide.

PubMed

Chen, Yu-Pei; Liu, Xu; Lv, Jia-Wei; Li, Wen-Fei; Zhang, Yuan; Guo, Ying; Lin, Ai-Hua; Sun, Ying; Mao, Yan-Ping; Ma, Jun

2016-10-01

Little is known about the extent of selective publication in contemporary oncology randomised controlled trials (RCTs) worldwide. This study aimed to evaluate the rates of publication and timely publication (within 24 months) for contemporary oncology RCTs from all over the world. We also investigated the trial characteristics associated with publication and timely publication. We identified all phase III oncology RCTs registered on ClinicalTrials.gov with a primary completion date between January 2008 and December 2012. We searched PubMed and EMBASE to identify publications. The final search date was 31 December 2015. Our primary outcome measure was the time to publication from the primary completion date to the date of primary publication in a peer-reviewed journal. We identified 598 completed oncology RCTs; overall, 398 (66.6%) had been published. For published trials, the median time to publication was 25 months (interquartile range, 16-37 months). Only 192 trials (32.1%) were published within 24 months. Timely publication was independently associated with trials completed late in 2012. Trials conducted in Asia and other regions were less likely to have timely publication, but trials conducted in different locations were all equally likely to be published. Industry- and NIH-funded trials were equally likely to be published timely or at any time after trial completion. Among 391 published trials with clear primary outcomes, there was a trend for timely publication of positive trials compared with negative trials. Despite the ethical obligations and societal expectations of disclosing findings promptly, oncology RCTs performed poorly. Copyright © 2016 Elsevier Ltd. All rights reserved.

The IR Evolution in Oncology: Tools, Treatments, and Guidelines.

PubMed

de Baere, Thierry

2017-01-01

Early focus of interventional oncologists was developing tools and imaging guidance, performing "procedures" acting as a skillful technician without knowledge of clinical patient outcomes, beyond post-treatment image findings. Interventional oncologists must deliver "treatments" and not "procedures", and focus on clinically relevant outcomes, provide clinical continuity of care, which means stand at multidisciplinary tumor boards, see patients in consultation before treatment and for follow-up. Interventional oncologists have fought for the same "market" with surgery in a head to head, bloody competition called red ocean strategy in marketing terms, resulting in many aborted trials. Wide adoption of interventional oncology is facing the challenge to build evidence with overall survival as endpoint in randomized trials while the benefits of a treatment on overall survival are diluted by the effects of possible/inevitable subsequent therapies. Because interventional oncology is a disruptive force in medicine achieving same results as others (surgery) using different, less invasive approaches, patients where surgery is irrelevant can be target with a blue ocean strategy (to propose treatment where there is no competition). Recently interventional oncology has been included in the ESMO guidelines for colorectal cancer with oligometastatic disease with both surgical resection, and thermal ablation classified in the same category called "local ablative treatments". Interventional oncologists have to shape the future by publications in oncologic journal, by being active members of oncology scientific societies, and use modern public megaphone (blog, video sharing, …) to disseminate information and let society know that interventional is not a me-too product but a disruptive treatment.

Multiple Authorship in Two English-Language Journals in Radiation Oncology.

ERIC Educational Resources Information Center

Halperin, Edward C.; And Others

1992-01-01

A study of multiple authorship in 1,908 papers in the "International Journal of Radiation Oncology, Biology, and Physics" and "Radiotherapy and Oncology" from 1983-87 investigated patterns and trends in number of authors per article by journal, article type, country, author's institution, author gender, and order of listing of…

Providing grief resolution as an oncology nurse retention strategy: a literature review.

PubMed

Hildebrandt, Lori

2012-12-01

Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.

Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study.

PubMed

Dennett, Amy M; Peiris, Casey L; Shields, Nora; Morgan, Delwyn; Taylor, Nicholas F

2017-10-01

Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation. A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription. Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals. Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care. © 2016 John Wiley & Sons Australia, Ltd.

Comparative Packaging Study

NASA Technical Reports Server (NTRS)

Perchonok, Michele H.; Oziomek, Thomas V.

2009-01-01

Future long duration manned space flights beyond low earth orbit will require the food system to remain safe, acceptable and nutritious. Development of high barrier food packaging will enable this requirement by preventing the ingress and egress of gases and moisture. New high barrier food packaging materials have been identified through a trade study. Practical application of this packaging material within a shelf life test will allow for better determination of whether this material will allow the food system to meet given requirements after the package has undergone processing. The reason to conduct shelf life testing, using a variety of packaging materials, stems from the need to preserve food used for mission durations of several years. Chemical reactions that take place during longer durations may decrease food quality to a point where crew physical or psychological well-being is compromised. This can result in a reduction or loss of mission success. The rate of chemical reactions, including oxidative rancidity and staling, can be controlled by limiting the reactants, reducing the amount of energy available to drive the reaction, and minimizing the amount of water available. Water not only acts as a media for microbial growth, but also as a reactant and means by which two reactants may come into contact with each other. The objective of this study is to evaluate three packaging materials for potential use in long duration space exploration missions.

Antidrug Antibody Formation in Oncology: Clinical Relevance and Challenges.

PubMed

van Brummelen, Emilie M J; Ros, Willeke; Wolbink, Gertjan; Beijnen, Jos H; Schellens, Jan H M

2016-10-01

: In oncology, an increasing number of targeted anticancer agents and immunotherapies are of biological origin. These biological drugs may trigger immune responses that lead to the formation of antidrug antibodies (ADAs). ADAs are directed against immunogenic parts of the drug and may affect efficacy and safety. In other medical fields, such as rheumatology and hematology, the relevance of ADA formation is well established. However, the relevance of ADAs in oncology is just starting to be recognized, and literature on this topic is scarce. In an attempt to fill this gap in the literature, we provide an up-to-date status of ADA formation in oncology. In this focused review, data on ADAs was extracted from 81 clinical trials with biological anticancer agents. We found that most biological anticancer drugs in these trials are immunogenic and induce ADAs (63%). However, it is difficult to establish the clinical relevance of these ADAs. In order to determine this relevance, the possible effects of ADAs on pharmacokinetics, efficacy, and safety parameters need to be investigated. Our data show that this was done in fewer than 50% of the trials. In addition, we describe the incidence and consequences of ADAs for registered agents. We highlight the challenges in ADA detection and argue for the importance of validating, standardizing, and describing well the used assays. Finally, we discuss prevention strategies such as immunosuppression and regimen adaptations. We encourage the launch of clinical trials that explore these strategies in oncology. Because of the increasing use of biologicals in oncology, many patients are at risk of developing antidrug antibodies (ADAs) during therapy. Although clinical consequences are uncertain, ADAs may affect pharmacokinetics, patient safety, and treatment efficacy. ADA detection and reporting is currently highly inconsistent, which makes it difficult to evaluate the clinical consequences. Standardized reporting of ADA investigations in

Interventional Oncology.

PubMed

Culp, William T N

2016-05-01

The approach to the treatment of cancer in veterinary patients is constantly evolving. Whenever possible and practical, surgery is pursued because it provides the greatest opportunity for tumor control and may result in a cure. Other cancer treatments, such as chemotherapy and radiation therapy, are commonplace in veterinary medicine, and the data outlining treatment regimens are growing rapidly. An absence of treatment options for veterinary cancer patients, however, has historically existed for some tumors. Interventional oncology options have opened the door to the potential for better therapeutic response and improved patient quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials.

PubMed

Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael

2015-01-01

In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

Recent trends for drug lag in clinical development of oncology drugs in Japan: does the oncology drug lag still exist in Japan?

PubMed

Maeda, Hideki; Kurokawa, Tatsuo

2015-12-01

This study exhaustively and historically investigated the status of drug lag for oncology drugs approved in Japan. We comprehensively investigated oncology drugs approved in Japan between April 2001 and July 2014, using publicly available information. We also examined changes in the status of drug lag between Japan and the United States, as well as factors influencing drug lag. This study included 120 applications for approval of oncology drugs in Japan. The median difference over a 13-year period in the approval date between the United States and Japan was 875 days (29.2 months). This figure peaked in 2002, and showed a tendency to decline gradually each year thereafter. In 2014, the median approval lag was 281 days (9.4 months). Multiple regression analysis identified the following potential factors that reduce drug lag: "Japan's participation in global clinical trials"; "bridging strategies"; "designation of priority review in Japan"; and "molecularly targeted drugs". From 2001 to 2014, molecularly targeted drugs emerged as the predominant oncology drug, and the method of development has changed from full development in Japan or bridging strategy to global simultaneous development by Japan's taking part in global clinical trials. In line with these changes, the drug lag between the United States and Japan has significantly reduced to less than 1 year.

Phase 3 Oncology Clinical Trials in South Africa: Experimentation or Therapeutic Misconception?

PubMed

Malan, Tina; Moodley, Keymanthri

2016-02-01

Although clinical research in oncology is vital to improve current understanding of cancer and to validate new treatment options, voluntary informed consent is a critical component. Oncology research participants are a particularly vulnerable population; hence, therapeutic misconception often leads to ethical and legal challenges. We conducted a qualitative study administering semi-structured questionnaires on 29 adult, Phase 3, oncology clinical trial participants at three different private oncology clinical trial sites in South Africa. A descriptive content analysis was performed to identify perceptions of these participants regarding Phase 3 clinical trials. We found that most participants provided consent to be included in the trial for self-benefit. More than half of the participants had a poor understanding of Phase 3 clinical trials, and almost half the participants believed the clinical trial did not pose any significant risk to them. The word "hope" was used frequently by participants, displaying clear optimism with regard to the clinical trial and its outcome. This indicated that therapeutic misconception does occur in the South African oncology research setting and has the potential to lead to underestimation of the risks of a Phase 3 clinical trial. Emphasizing the experimental nature of a clinical trial during the consent process is critical to address therapeutic misconception in oncology research. © The Author(s) 2016.

Iodine-131 tositumomab (Bexxar) in a radiation oncology environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Macklis, Roger M.

2006-10-01

Iodine-131 (I-131) tositumomab (Bexxar; GlaxoSmithKline, Research Triangle Park, NC) is one of two recently approved radiolabeled antibodies directed against the CD20 surface antigen found on normal B cells and in more than 95% of B cell non-Hodgkin's lymphoma. The compound itself is formulated as an IgG2a immunoglobulin radiolabeled with the mixed beta/gamma emitter I-131. Multicenter clinical trials have repeatedly shown impressive clinical responses (20-40% complete response rates and 60-80% overall response rates) in the patient groups for whom this treatment is indicated. Treatment-related toxicity is generally extremely mild and typically involves only reversible hematopoietic suppression and (in some cases) amore » risk of treatment-induced hypothyroidism. Owing to Radiation safety concerns necessitated by the clinical use of this targeted radiopharmaceutical, it is important for radiation oncology departments wishing to participate in the care of these patients to establish methodologies and standard operating procedures for safe and efficient departmental use. This summary reviews the pertinent background information related to the current clinical experience with I-131 tositumomab and highlights some of the major opportunities for the participation of radiation oncology in the patient evaluation and treatment process. I-131 tositumomab provides an excellent example of the way in which the increasingly important new field of 'targeted therapy' intersects with the practice of clinical radiotherapy. The author contends that it will be worth the time and effort involved in establishing a firm basis for the development of a comprehensive program for systemic targeted radiopharmaceutical therapies (STaRT) within Radiation medicine domain.« less

Creative Thinking Package

ERIC Educational Resources Information Center

Jones, Clive

1972-01-01

A look at the latest package from a British managment training organization, which explains and demonstrates creative thinking techniques, including brainstorming. The package, designed for groups of twelve or more, consists of tapes, visuals, and associated exercises. (Editor/JB)

Comparative Packaging Study

NASA Technical Reports Server (NTRS)

Perchonok, Michele; Antonini, David

2008-01-01

This viewgraph presentation describes a comparative packaging study for use on long duration space missions. The topics include: 1) Purpose; 2) Deliverables; 3) Food Sample Selection; 4) Experimental Design Matrix; 5) Permeation Rate Comparison; and 6) Packaging Material Information.

Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers’ Survey on Knowledge, Attitudes, and Practice Behaviors

PubMed Central

Tamargo, Christina L.; Sanchez, Julian A.

2017-01-01

Background: Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers’ lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. Methods: A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Results: Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Conclusion: Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population’s specific needs. PMID:28991160

19 CFR 191.13 - Packaging materials.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Packaging materials. 191.13 Section 191.13 Customs... (CONTINUED) DRAWBACK General Provisions § 191.13 Packaging materials. (a) Imported packaging material... packaging material when used to package or repackage merchandise or articles exported or destroyed pursuant...

Warpage of QFN Package in Post Mold Cure Process of integrated circuit packaging

NASA Astrophysics Data System (ADS)

Sriwithoon, Nattha; Ugsornrat, Kessararat; Srisuwitthanon, Warayoot; Thonglor, Panakamon

2017-09-01

This research studied about warpage of QFN package in post mold cure process of integrated circuit (IC) packages using pre-plated (PPF) leadframe. For IC package, epoxy molding compound (EMC) are molded by cross linking of compound stiffness but incomplete crosslinked network and leading the fully cured thermoset by post mold cure (PMC) process. The cure temperature of PMC can change microstructure of EMC in term of stress inside the package and effect to warpage of the package due to coefficient of thermal expansion (CTE) between EMC and leadframe. In experiment, cure temperatures were varied to check the effect of internal stress due to different cure temperature after completed post mold cure for TDFN 2×3 8L. The cure temperature were varied with 180 °C, 170 °C, 160 °C, and 150°C with cure time 4 and 6 hours, respectively. For analysis, the TDFN 2×3 8L packages were analyzed the warpage by thickness gauge and scanning acoustic microscope (SAM) after take the test samples out from the oven cure. The results confirmed that effect of different CTE between EMC and leadframe due to different cure temperature resulting to warpage of the TDFN 2×3 8L packages.

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

PubMed

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

2014-01-01

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

Effects of Age Expectations on Oncology Social Workers' Clinical Judgment

ERIC Educational Resources Information Center

Conlon, Annemarie; Choi, Namkee G.

2014-01-01

Objective: This study examined the influence of oncology social workers' expectations regarding aging (ERA) and ERA with cancer (ERAC) on their clinical judgment. Methods: Oncology social workers (N = 322) were randomly assigned to one of four vignettes describing a patient with lung cancer. The vignettes were identical except for the patent's age…

Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout.

PubMed

Hlubocky, Fay J; Rose, Miko; Epstein, Ronald M

2017-01-01

Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one's relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.

Packaging Concerns/Techniques for Large Devices

NASA Technical Reports Server (NTRS)

Sampson, Michael J.

2009-01-01

This slide presentation reviews packaging challenges and options for electronic parts. The presentation includes information about non-hermetic packages, space challenges for packaging and complex package variations.

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

International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer.

PubMed

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

2014-08-20

To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. 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. 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. There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base.

Analysis of XMM-Newton Data from Extended Sources and the Diffuse X-Ray Background

NASA Technical Reports Server (NTRS)

Snowden, Steven

2011-01-01

Reduction of X-ray data from extended objects and the diffuse background is a complicated process that requires attention to the details of the instrumental response as well as an understanding of the multiple background components. We present methods and software that we have developed to reduce data from XMM-Newton EPIC imaging observations for both the MOS and PN instruments. The software has now been included in the Science Analysis System (SAS) package available through the XMM-Newton Science Operations Center (SOC).

Developing a national radiation oncology registry: From acorns to oaks.

PubMed

Palta, Jatinder R; Efstathiou, Jason A; Bekelman, Justin E; Mutic, Sasa; Bogardus, Carl R; McNutt, Todd R; Gabriel, Peter E; Lawton, Colleen A; Zietman, Anthony L; Rose, Christopher M

2012-01-01

The National Radiation Oncology Registry (NROR) is a collaborative initiative of the Radiation Oncology Institute and the American Society of Radiation Oncology, with input and guidance from other major stakeholders in oncology. The overarching mission of the NROR is to improve the care of cancer patients by capturing reliable information on treatment delivery and health outcomes. The NROR will collect patient-specific radiotherapy data electronically to allow for rapid comparison of the many competing treatment modalities and account for effectiveness, outcome, utilization, quality, safety, and cost. It will provide benchmark data and quality improvement tools for individual practitioners. The NROR steering committee has determined that prostate cancer provides an appropriate model to test the concept and the data capturing software in a limited number of sites. The NROR pilot project will begin with this disease-gathering treatment and outcomes data from a limited number of treatment sites across the range of practice; once feasibility is proven, it will scale up to more sites and diseases. When the NROR is fully implemented, all radiotherapy facilities, along with their radiation oncologists, will be solicited to participate in it. With the broader participation of the radiation oncology community, NROR has the potential to serve as a resource for determining national patterns of care, gaps in treatment quality, comparative effectiveness, and hypothesis generation to identify new linkages between therapeutic processes and outcomes. The NROR will benefit radiation oncologists and other care providers, payors, vendors, policy-makers, and, most importantly, cancer patients by capturing reliable information on population-based radiation treatment delivery. Copyright © 2012 (c) 2010 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved. Published by Elsevier Inc. All rights reserved.

Factors Associated with Short-Term Mortality After Surgical Oncologic Emergencies.

PubMed

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

2016-06-01

The clinical outcome of patients with oncologic emergencies is often poor and mortality is high. It is important to determine which patients may benefit from invasive treatment, and for whom conservative treatment and/or palliative care would be appropriate. In this study, prognostic factors for clinical outcome are identified in order to facilitate the decision-making process for patients with surgical oncologic emergencies. This was a prospective registration study for patients over 18 years of age, who were consulted for surgical oncologic emergencies between November 2013 and April 2014. Multiple variables were registered upon emergency consultation, and the follow-up period was 90 days. Multivariate logistic regression analysis was performed to identify factors associated with 30- and 90-day mortality. During the study period, 207 patients experienced surgical oncologic emergencies-101 (48.8 %) men and 106 (51.2 %) women, with a median age of 64 years (range 19-92). The 30-day mortality was 12.6 % and 90-day mortality was 21.7 %. Factors significantly associated with 30-day mortality were palliative intent of cancer treatment prior to emergency consultation (p = 0.006), Eastern Cooperative Oncology Group performance score (ECOG-PS) >0 (p for trend: p = 0.03), and raised lactate dehydrogenase (LDH) (p < 0.001). Additional factors associated with 90-day mortality were low handgrip strength (HGS) (p = 0.01) and low albumin (p = 0.002). Defining the intent of prior cancer treatment and the ECOG-PS are of prognostic value when deciding on treatment for patients with surgical oncologic emergencies. Additional measurements of HGS, LDH, and albumin levels can serve as objective parameters to support the clinical assessment of individual prognosis.

Pediatric Oncology Branch - training- resident electives | Center for Cancer Research

Cancer.gov

Resident Electives Select pediatric residents may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The resident is supervised directly by the Branch’s attending physician and clinical fellows. Residents attend daily in-patient and out-patient

Optimal segmentation and packaging process

DOEpatents

Kostelnik, Kevin M.; Meservey, Richard H.; Landon, Mark D.

1999-01-01

A process for improving packaging efficiency uses three dimensional, computer simulated models with various optimization algorithms to determine the optimal segmentation process and packaging configurations based on constraints including container limitations. The present invention is applied to a process for decontaminating, decommissioning (D&D), and remediating a nuclear facility involving the segmentation and packaging of contaminated items in waste containers in order to minimize the number of cuts, maximize packaging density, and reduce worker radiation exposure. A three-dimensional, computer simulated, facility model of the contaminated items are created. The contaminated items are differentiated. The optimal location, orientation and sequence of the segmentation and packaging of the contaminated items is determined using the simulated model, the algorithms, and various constraints including container limitations. The cut locations and orientations are transposed to the simulated model. The contaminated items are actually segmented and packaged. The segmentation and packaging may be simulated beforehand. In addition, the contaminated items may be cataloged and recorded.

Optimal segmentation and packaging process

DOEpatents

Kostelnik, K.M.; Meservey, R.H.; Landon, M.D.

1999-08-10

A process for improving packaging efficiency uses three dimensional, computer simulated models with various optimization algorithms to determine the optimal segmentation process and packaging configurations based on constraints including container limitations. The present invention is applied to a process for decontaminating, decommissioning (D and D), and remediating a nuclear facility involving the segmentation and packaging of contaminated items in waste containers in order to minimize the number of cuts, maximize packaging density, and reduce worker radiation exposure. A three-dimensional, computer simulated, facility model of the contaminated items are created. The contaminated items are differentiated. The optimal location, orientation and sequence of the segmentation and packaging of the contaminated items is determined using the simulated model, the algorithms, and various constraints including container limitations. The cut locations and orientations are transposed to the simulated model. The contaminated items are actually segmented and packaged. The segmentation and packaging may be simulated beforehand. In addition, the contaminated items may be cataloged and recorded. 3 figs.

Spoilage and safety characteristics of ground beef packaged in traditional and modified atmosphere packages.

PubMed

Brooks, J C; Alvarado, M; Stephens, T P; Kellermeier, J D; Tittor, A W; Miller, M F; Brashears, M M

2008-02-01

Two separate studies, one with pathogen-inoculated product and one with noninoculated product, were conducted to determine the safety and spoilage characteristics of modified atmosphere packaging (MAP) and traditional packaging of ground beef patties. Ground beef patties were allotted to five packaging treatments (i) control (foam tray with film overwrap; traditional), (ii) high-oxygen MAP (80% 02, 20% CO2), (iii) high-oxygen MAP with added rosemary extract, (iv) low-oxygen carbon monoxide MAP (0.4% CO, 30% CO2, 69.6% N2), and (v) low-oxygen carbon monoxide MAP with added rosemary extract. Beef patties were evaluated for changes over time (0, 1, 3, 5, 7, 14, and 21 days) during lighted display. Results indicated low-oxygen carbon monoxide gas flush had a stabilizing effect on meat color after the formation of carboxymyoglobin and was effective for preventing the development of surface discoloration. Consumers indicated that beef patties packaged in atmospheres containing carbon monoxide were more likely to smell fresh at 7, 14, and 21 days of display, but the majority would probably not consume these products after 14 days of display because of their odor. MAP suppressed the growth of psychrophilic aerobic bacteria when compared with control packages. Generally, control packages had significantly higher total aerobic bacteria and Lactobacillus counts than did modified atmosphere packages. In the inoculated ground beef (approximately 10(5) CFU/g) in MAP, Escherichia coli O157 populations ranged from 4.51 to 4.73 log CFU/g with no differences among the various packages, but the total E. coli O157:H7 in the ground beef in the control packages was significantly higher at 5.61 log CFU/g after 21 days of storage. On days 14 and 21, the total Salmonella in the ground beef in control packages was at 5.29 and 5.27 log CFU/g, respectively, which was significantly higher than counts in the modified atmosphere packages (3.99 to 4.31 log CFU/g on day 14 and 3.76 to 4.02 log CFU

Oncology Nurse Navigation: Results of the 2016 Role Delineation Study.

PubMed

Lubejko, Barbara G; Bellfield, Sonia; Kahn, Elisa; Lee, Carrie; Peterson, Nicole; Rose, Traudi; Murphy, Cynthia Miller; McCorkle, Michele

2017-02-01

In 2011, an oncology nurse navigator (ONN) role delineation survey (RDS) was conducted by the Oncology Nursing Society (ONS) when the role was relatively new to oncology. Results did not demonstrate a unique skill set for the ONN; however, since then, the role has expanded. ONS and the Oncology Nursing Certification Corporation partnered in 2016 to complete an RDS of ONNs to redefine the role and determine the need for an ONN certification examination. A structured RDS was conducted using a formal consensus-building process. A survey was developed and released to examine the specific tasks, knowledge, and skills for the ONN as well as to determine which role possesses more responsibility for the tasks. The ONN role is evolving, and more was learned about its key tasks, including differences in the responsibilities of the ONN and the clinical or staff nurse. However, the RDS did not find an adequate difference in the knowledge required by the ONN and the clinical or staff nurse to support the need for a separate ONN certification.

A snapshot of patients' perceptions of oncology providers' cultural competence.

PubMed

Davey, Maureen P; Waite, Roberta; Nuñez, Ana; Niño, Alba; Kissil, Karni

2014-12-01

In this paper, we describe an anonymous cross-sectional survey with a sample of 100 racially diverse adult oncology patients using a newly developed patient-reported measure of providers' cultural competence, the Physicians' Cultural Competence for Patient Satisfaction Scale (PCCPS) [1, 2], which was developed using a US midwestern sample of primary care patients. Our primary aims were to examine the reliability of the PCCPS in a more racially diverse urban oncology clinical setting and to identify salient domains of oncology provider cultural competence based on patient-reported satisfaction with direct clinical encounters. Results suggest that patient-reported satisfaction was significantly associated with one of the four domains measured by the PCCPS, physician's patient-centered cultural competence (r = 0.40, p = 0.01), and female patients were more satisfied (t (91) = 5.23, p = 0.02). The PCCPS demonstrated good reliability in an urban diverse cancer patient population. Results help to inform the development of clinical tools that can improve oncology providers' cultural competency.

Integrated Approach to Industrial Packaging Design

NASA Astrophysics Data System (ADS)

Vorobeva, O.

2017-11-01

The article reviews studies in the field of industrial packaging design. The major factors which influence technological, ergonomic, economic and ecological features of packaging are established. The main modern trends in packaging design are defined, the principles of marketing communications and their influence on consumers’ consciousness are indicated, and the function of packaging as a transmitter of brand values is specified. Peculiarities of packaging technology and printing techniques in modern printing industry are considered. The role of designers in the stage-by-stage development of the construction, form and graphic design concept of packaging is defined. The examples of authentic packaging are given and the mention of the tetrahedron packaging history is made. At the end of the article, conclusions on the key research aspects are made.

Oncology of Reptiles: Diseases, Diagnosis, and Treatment.

PubMed

Christman, Jane; Devau, Michael; Wilson-Robles, Heather; Hoppes, Sharman; Rech, Raquel; Russell, Karen E; Heatley, J Jill

2017-01-01

Based on necropsy review, neoplasia in reptiles has a comparable frequency to that of mammals and birds. Reptile neoplasia is now more frequently diagnosed in clinical practice based on increased use of advanced diagnostic techniques and improvements in reptilian husbandry allowing greater longevity of these species. This article reviews the current literature on neoplasia in reptiles, and focuses on advanced diagnostics and therapeutic options for reptilian patientssuffering neoplastic disease. Although most applied clinical reptile oncology is translated from dog and cat oncology, considerations specific to reptilian patients commonly encountered in clinical practice (turtles, tortoises, snakes, and lizards) are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical use of organic near-infrared fluorescent contrast agents in image-guided oncologic procedures and its potential in veterinary oncology.

PubMed

Favril, Sophie; Abma, Eline; Blasi, Francesco; Stock, Emmelie; Devriendt, Nausikaa; Vanderperren, Katrien; de Rooster, Hilde

2018-04-28

One of the major challenges in surgical oncology is the intraoperative discrimination of tumoural versus healthy tissue. Until today, surgeons rely on visual inspection and palpation to define the tumoural margins during surgery and, unfortunately, for various cancer types, the local recurrence rate thus remains unacceptably high. Near-infrared (NIR) fluorescence imaging is an optical imaging technique that can provide real-time preoperative and intraoperative information after administration of a fluorescent probe that emits NIR light once exposed to a NIR light source. This technique is safe, cost-effective and technically easy. Several NIR fluorescent probes are currently studied for their ability to highlight neoplastic cells. In addition, NIR fluorescence imaging holds great promise for sentinel lymph node mapping. The aim of this manuscript is to provide a literature review of the current organic NIR fluorescent probes tested in the light of human oncology and to introduce fluorescence imaging as a valuable asset in veterinary oncology. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Illness perception differences between Russian- and Hebrew-speaking Israeli oncology patients.

PubMed

Popov, Nadia; Heruti, Irit; Levy, Sigal; Lulav-Grinwald, Doron; Bar-Sela, Gil

2014-03-01

Illness perception influences health and illness behaviors. This study was designed to estimate illness perception differences between Russian-speaking and Hebrew-speaking Israeli oncology patients. Changes in illness perception associated with time spent in Israel among Russian-speaking patients were also evaluated. Additionally, we evaluated differences in illness perception of patients exposed to Chernobyl's consequences. A total of 144 oncology patients (77 Hebrew-speaking, 67 Russian-speaking) completed personal data questionnaires and The illness perception questionnaire revised, translated into Russian for this study. Significantly more Russian-speaking oncology patients perceived their illness as chronic and having negative consequences on life (p < .01). Russian-speaking oncology patients tend to have a more negative perception of cancer compared to Hebrew-speaking patients. Time spent in Israel may create more positive perceptions of cancer among these patients. No illness perception differences were found concerning Chernobyl consequences.

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

PubMed Central

Duker, Leah I. Stein

2016-01-01

Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. PMID:27295001

Romanian experience on packaging testing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vieru, G.

2007-07-01

With more than twenty years ago, the Institute for Nuclear Research Pitesti (INR), through its Reliability and Testing Laboratory, was licensed by the Romanian Nuclear Regulatory Body- CNCAN and to carry out qualification tests [1] for packages intended to be used for the transport and storage of radioactive materials. Radioactive materials, generated by Romanian nuclear facilities [2] are packaged in accordance with national [3] and the IAEA's Regulations [1,6] for a safe transport to the disposal center. Subjecting these packages to the normal and simulating test conditions accomplish the evaluation and certification in order to prove the package technical performances.more » The paper describes the qualification tests for type A and B packages used for transport and storage of radioactive materials, during a period of 20 years of experience. Testing is used to substantiate assumption in analytical models and to demonstrate package structural response. The Romanian test facilities [1,3,6] are used to simulate the required qualification tests and have been developed at INR Pitesti, the main supplier of type A packages used for transport and storage of low radioactive wastes in Romania. The testing programme will continue to be a strong option to support future package development, to perform a broad range of verification and certification tests on radioactive material packages or component sections, such as packages used for transport of radioactive sources to be used for industrial or medical purposes [2,8]. The paper describes and contain illustrations showing some of the various tests packages which have been performed during certain periods and how they relate to normal conditions and minor mishaps during transport. Quality assurance and quality controls measures taken in order to meet technical specification provided by the design there are also presented and commented. (authors)« less

Radiation therapy oncology group gynecologic oncology working group: comprehensive results.

PubMed

Gaffney, David K; Jhingran, Anuja; Portelance, Lorraine; Viswanathan, Akila; Schefter, Tracey; Weidhaas, Joanne; Small, William

2014-06-01

The purpose of this report was to comprehensively describe the activities of the Gynecologic Oncology Working Group within the Radiation Therapy Oncology Group (RTOG). Clinical trials will be reviewed as well as translational science and ancillary activities. During the past 40 years, a myriad of clinical trials have been performed within the RTOG with the aim of improving overall survival (OS) and decreasing morbidity in women with cervical or endometrial cancer. Major study questions have included hyperbaric oxygen, neutron radiotherapy, altered fractionation, hypoxic cell sensitization, chemosensitization, and volume-directed radiotherapy.RTOG 7920 demonstrated improvement in OS in patients with stages IB through IIB cervical carcinoma receiving prophylactic para-aortic irradiation compared to pelvic radiation alone. RTOG 9001 demonstrated that cisplatin and 5-FU chemoradiotherapy to the pelvis for advanced cervix cancer markedly improved OS compared to extended field radiotherapy alone. More recent trials have used radioprotectors, molecular-targeted therapy, and intensity-modulated radiation therapy. Ancillary studies have developed clinical target volume atlases for research protocols and routine clinical use. Worldwide practice patterns have been investigated in cervix, endometrial, and vulvar cancer through the Gynecologic Cancer Intergroup. Translational studies have focused on immunohistochemical markers, changes in gene expression, and miRNA patterns impacting prognosis.The RTOG gynecologic working group has performed clinical trials that have defined the standard of care, improved survival, and added to our understanding of the biology of cervical and endometrial cancers.

The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria.

PubMed

Nayak, Lakshmi; DeAngelis, Lisa M; Brandes, Alba A; Peereboom, David M; Galanis, Evanthia; Lin, Nancy U; Soffietti, Riccardo; Macdonald, David R; Chamberlain, Marc; Perry, James; Jaeckle, Kurt; Mehta, Minesh; Stupp, Roger; Muzikansky, Alona; Pentsova, Elena; Cloughesy, Timothy; Iwamoto, Fabio M; Tonn, Joerg-Christian; Vogelbaum, Michael A; Wen, Patrick Y; van den Bent, Martin J; Reardon, David A

2017-05-01

The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology. An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility. The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3-5). The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions

The IR Evolution in Oncology: Tools, Treatments, and Guidelines

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baere, Thierry de, E-mail: thierry.debaere@gustaveroussy.fr

Early focus of interventional oncologists was developing tools and imaging guidance, performing “procedures” acting as a skillful technician without knowledge of clinical patient outcomes, beyond post-treatment image findings. Interventional oncologists must deliver “treatments” and not “procedures”, and focus on clinically relevant outcomes, provide clinical continuity of care, which means stand at multidisciplinary tumor boards, see patients in consultation before treatment and for follow-up. Interventional oncologists have fought for the same “market” with surgery in a head to head, bloody competition called red ocean strategy in marketing terms, resulting in many aborted trials. Wide adoption of interventional oncology is facing themore » challenge to build evidence with overall survival as endpoint in randomized trials while the benefits of a treatment on overall survival are diluted by the effects of possible/inevitable subsequent therapies. Because interventional oncology is a disruptive force in medicine achieving same results as others (surgery) using different, less invasive approaches, patients where surgery is irrelevant can be target with a blue ocean strategy (to propose treatment where there is no competition). Recently interventional oncology has been included in the ESMO guidelines for colorectal cancer with oligometastatic disease with both surgical resection, and thermal ablation classified in the same category called “local ablative treatments”. Interventional oncologists have to shape the future by publications in oncologic journal, by being active members of oncology scientific societies, and use modern public megaphone (blog, video sharing, …) to disseminate information and let society know that interventional is not a me-too product but a disruptive treatment.« less

User's Guide for MapIMG 2: Map Image Re-projection Software Package

USGS Publications Warehouse

Finn, Michael P.; Trent, Jason R.; Buehler, Robert A.

2006-01-01

BACKGROUND Scientists routinely accomplish small-scale geospatial modeling in the raster domain, using high-resolution datasets for large parts of continents and low-resolution to high-resolution datasets for the entire globe. Direct implementation of point-to-point transformation with appropriate functions yields the variety of projections available in commercial software packages, but implementation with data other than points requires specific adaptation of the transformation equations or prior preparation of the data to allow the transformation to succeed. It seems that some of these packages use the U.S. Geological Survey's (USGS) General Cartographic Transformation Package (GCTP) or similar point transformations without adaptation to the specific characteristics of raster data (Usery and others, 2003a). Usery and others (2003b) compiled and tabulated the accuracy of categorical areas in projected raster datasets of global extent. Based on the shortcomings identified in these studies, geographers and applications programmers at the USGS expanded and evolved a USGS software package, MapIMG, for raster map projection transformation (Finn and Trent, 2004). Daniel R. Steinwand of Science Applications International Corporation, National Center for Earth Resources Observation and Science, originally developed MapIMG for the USGS, basing it on GCTP. Through previous and continuing efforts at the USGS' National Geospatial Technical Operations Center, this program has been transformed from an application based on command line input into a software package based on a graphical user interface for Windows, Linux, and other UNIX machines.

Oncology pain in veterinary patients.

PubMed

Looney, Andrea

2010-02-01

Cancer, cancer pain, and the undertreatment of cancer pain are epidemic in both the human and veterinary medical field. Concerns over recognition, assessment, and treatment of oncologic pain in our veterinary patients are multiplied when one realizes the interaction of the primary tumor, the pain itself, and even cancer treatments with fatigue, disability, dyspnea, weakness, impaired gastrointestinal motility, cognition, and urinary/defecation issues. The patient's overall health status, as well as owner psychological and spiritual distress, plays a large part in quality-of-life decisions. We will discuss classification and assessment of cancer pain, quality-of-life issues, and therapies for managing cancer pain, including pharmacologic, nonpharmacologic, and interventional techniques. The goal will be establishment of a new oncologic treatment pyramid or scale for veterinary patients, one that will guide clinicians mechanistically into thinking through the anamnesis, physical examination, and assessment of the whole patient, and on toward diagnostics and treatments available for companion animals with cancer. Copyright 2010 Elsevier Inc. All rights reserved.

Cardio-oncology: the Nuclear Option.

PubMed

Alvarez, Jorge A; Russell, Raymond R

2017-04-01

Cardio-oncology focuses increased effort to decrease cancer treatment-related cardiotoxicity while continuing to improve outcomes. We sought to synthesize the latest in nuclear cardiology as it pertains to the assessment of left ventricular function in preventative guidelines and comparison to other modalities, novel molecular markers of pre-clinical cardiotoxicity, and its role in cardiac amyloid diagnosis. Planar ERNA (equilibrium radionuclide angiocardiography) provides a reliable and proven means of monitoring and preventing anthracycline cardiotoxicity, and SPECT ERNA using solid-state gamma cameras may provide reproducible assessments of left ventricular function with reduced radiation exposure. While certain chemotherapeutics have vascular side effects, the use of stress perfusion imaging has still not been adequately studied for routine use. Similarly, markers of apoptosis, inflammation, and sympathetic nerve dysfunction are promising, but are still not ready for uniform usage. SPECT tracers can assist in nonbiopsy diagnosis of cardiac amyloid. Nuclear cardiology is a significant contributor to the multimodality approach to cardio-oncology.

Breast cancer patients' presentation for oncological treatment: a single centre study.

PubMed

Akinkuolie, Akinbolaji Andrew; Etonyeaku, Amarachukwu Chiduziem; Olasehinde, Olalekan; Arowolo, Olukayode Adeolu; Babalola, Rereloluwa Nicodemus

2016-01-01

Breast cancer patients are presenting at advanced stages for oncological treatment in Nigeria and World Health Organization predicted developing countries' breast cancer incidence and mortality to increase by year 2020. Prospective observational hospital based study that enrolled breast cancer patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. Patients' demographics, breast cancer burden and health care giver presentation variables were analysed for causal factors of seeking medical help and what determines commencement of effective oncological treatment. Forty-six patients were enrolled, 19.6% of them presented primarily to oncologist while 80.4% presented secondarily for oncological treatment. There is a significant difference in presentation time for oncological treatment (t = -3.56, df = 42.90, p = 0.001) between primary (M =11.56 ± 5.21 weeks) and secondary presentation (M= 52.56 ± 10.27weeks). Tumor burden of those that presented secondarily were significantly more advanced (U = 78.5, p = 0.011) and, univariate analysis reveals that: patients' matrimonial setting, breast cancer awareness and mode of discovery of breast symptoms are patient related factors that determines their choice of health care providers and, determinant of effective oncological treatment is patient first contact health care provider. Patients' bio-characteristics that determine their choice of health care provider should be incorporated into community breast cancer sensitization drives. Additionally, there is a need for a government agency assign the task of accrediting and defining scope of enterprise of health care institutions and their health care providers in our pluralist health system.

Breast cancer patients’ presentation for oncological treatment: a single centre study

PubMed Central

Akinkuolie, Akinbolaji Andrew; Etonyeaku, Amarachukwu Chiduziem; Olasehinde, Olalekan; Arowolo, Olukayode Adeolu; Babalola, Rereloluwa Nicodemus

2016-01-01

Introduction Breast cancer patients are presenting at advanced stages for oncological treatment in Nigeria and World Health Organization predicted developing countries’ breast cancer incidence and mortality to increase by year 2020. Methods Prospective observational hospital based study that enrolled breast cancer patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. Patients’ demographics, breast cancer burden and health care giver presentation variables were analysed for causal factors of seeking medical help and what determines commencement of effective oncological treatment. Results Forty-six patients were enrolled, 19.6% of them presented primarily to oncologist while 80.4% presented secondarily for oncological treatment. There is a significant difference in presentation time for oncological treatment (t = -3.56, df = 42.90, p = 0.001) between primary (M =11.56 ± 5.21 weeks) and secondary presentation (M= 52.56 ± 10.27weeks). Tumor burden of those that presented secondarily were significantly more advanced (U = 78.5, p = 0.011) and, univariate analysis reveals that: patients’ matrimonial setting, breast cancer awareness and mode of discovery of breast symptoms are patient related factors that determines their choice of health care providers and, determinant of effective oncological treatment is patient first contact health care provider. Conclusion Patients’ bio-characteristics that determine their choice of health care provider should be incorporated into community breast cancer sensitization drives. Additionally, there is a need for a government agency assign the task of accrediting and defining scope of enterprise of health care institutions and their health care providers in our pluralist health system. PMID:27642404

Two approaches to bridging the knowledge-practice gap in oncology nursing.

PubMed

Peek, Gloanna J

2015-01-01

The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

Process mining in oncology using the MIMIC-III dataset

NASA Astrophysics Data System (ADS)

Prima Kurniati, Angelina; Hall, Geoff; Hogg, David; Johnson, Owen

2018-03-01

Process mining is a data analytics approach to discover and analyse process models based on the real activities captured in information systems. There is a growing body of literature on process mining in healthcare, including oncology, the study of cancer. In earlier work we found 37 peer-reviewed papers describing process mining research in oncology with a regular complaint being the limited availability and accessibility of datasets with suitable information for process mining. Publicly available datasets are one option and this paper describes the potential to use MIMIC-III, for process mining in oncology. MIMIC-III is a large open access dataset of de-identified patient records. There are 134 publications listed as using the MIMIC dataset, but none of them have used process mining. The MIMIC-III dataset has 16 event tables which are potentially useful for process mining and this paper demonstrates the opportunities to use MIMIC-III for process mining in oncology. Our research applied the L* lifecycle method to provide a worked example showing how process mining can be used to analyse cancer pathways. The results and data quality limitations are discussed along with opportunities for further work and reflection on the value of MIMIC-III for reproducible process mining research.

Improvement of Oncology Education at the University of Washington School of Medicine, 1984-1988.

ERIC Educational Resources Information Center

Bleyer, W. Archie; And Others

1990-01-01

After development and implementation of a revised oncology curriculum at the University of Washington School of Medicine student performance on oncology related questions on the National Board of Medical Examiners examination indicated substantial improvement relative to student performance in non-oncology areas and to the national average. (DB)

Healthcare-associated infections among pediatric oncology patients in Pakistan: risk factors and outcome.

PubMed

Siddiqui, Naveed-ur-Rehman; Wali, Rabia; Haque, Anwar-ul; Fadoo, Zehra

2012-05-14

Pediatric oncology patients are at increased risk of contracting healthcare-associated infections (HAIs), which are responsible for increased morbidity and mortality rates as well as treatment costs.  This study aimed to identify the frequency of HAIs among pediatric oncology patients and their outcome. Pediatric oncology patients admitted between January 2009 and June 2010 in a pediatric ward at Aga Khan University Hospital, Karachi, Pakistan, who developed HAIs, were analyzed. A total of 90 HAIs were identified in 32 patients in 70 admissions. The HAI rate among pediatric oncology patients was 3.1/100 admission episodes. Bloodstream infections (63 episodes, 90.0%) were the most common, followed by urinary tract infection (two episodes, 2.9%). Gram-positive infections were seen in 54 (60%) patients, followed by Gram-negative infection in 34 (37.8%), and fungi in 2 (2.8%) cases. Coagulase negative staphylococci was the most common Gram-positive and Escherichia coli and Pseudomonas aeruginosa were most common Gram-negative infections. Mortality rate among pediatric oncology patients who developed HAIs was 12.5% (4/32). Total parental nutrition use and length of stay longer than 30 days were the identified risk factors associated with increased mortality among pediatric oncology patients who developed HAIs. We report an HAI rate among pediatric oncology patients of 3.1/100 admission episodes with a mortality rate of 12.5% in Pakistan. Further studies should be done, especially in the developing world, to identify the risk factors associated with increased mortality among pediatric oncology patients so that adequate measures can be taken to reduce the mortality among these patients.

Packaging of electro-microfluidic devices

DOEpatents

Benavides, Gilbert L.; Galambos, Paul C.; Emerson, John A.; Peterson, Kenneth A.; Giunta, Rachel K.; Zamora, David Lee; Watson, Robert D.

2003-04-15

A new architecture for packaging surface micromachined electro-microfluidic devices is presented. This architecture relies on two scales of packaging to bring fluid to the device scale (picoliters) from the macro-scale (microliters). The architecture emulates and utilizes electronics packaging technology. The larger package consists of a circuit board with embedded fluidic channels and standard fluidic connectors (e.g. Fluidic Printed Wiring Board). The embedded channels connect to the smaller package, an Electro-Microfluidic Dual-Inline-Package (EMDIP) that takes fluid to the microfluidic integrated circuit (MIC). The fluidic connection is made to the back of the MIC through Bosch-etched holes that take fluid to surface micromachined channels on the front of the MIC. Electrical connection is made to bond pads on the front of the MIC.

Packaging of electro-microfluidic devices

DOEpatents

Benavides, Gilbert L.; Galambos, Paul C.; Emerson, John A.; Peterson, Kenneth A.; Giunta, Rachel K.; Watson, Robert D.

2002-01-01

A new architecture for packaging surface micromachined electro-microfluidic devices is presented. This architecture relies on two scales of packaging to bring fluid to the device scale (picoliters) from the macro-scale (microliters). The architecture emulates and utilizes electronics packaging technology. The larger package consists of a circuit board with embedded fluidic channels and standard fluidic connectors (e.g. Fluidic Printed Wiring Board). The embedded channels connect to the smaller package, an Electro-Microfluidic Dual-Inline-Package (EMDIP) that takes fluid to the microfluidic integrated circuit (MIC). The fluidic connection is made to the back of the MIC through Bosch-etched holes that take fluid to surface micromachined channels on the front of the MIC. Electrical connection is made to bond pads on the front of the MIC.

Nonspecialty Nurse Education: Evaluation of the Oncology Intensives Initiative, an Oncology Curriculum to Improve Patient Care

PubMed

Bagley, Kimberly A; Dunn, Sarah E; Chuang, Eliseu Y; Dorr, Victoria J; Thompson, Julie A; Smith, Sophia K

2018-04-01

A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork. A two-group, pre-/post-test design was implemented. Group 1 consisted of nurses who attended the didactic boot camp classes alone, whereas group 2 was comprised of nurses who attended the didactic boot camp classes and the simulation sessions. Results of data analysis showed a decrease in worries and an increase in positive attitudes toward chemotherapy administration in both groups, as well as an increase in self-efficacy among members of group 2.

Value: A Framework for Radiation Oncology

PubMed Central

Teckie, Sewit; McCloskey, Susan A.; Steinberg, Michael L.

2014-01-01

In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment. PMID:25113759

A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water

PubMed Central

Williams, Ashley R.; Bain, Robert E. S.; Fisher, Michael B.; Cronk, Ryan; Kelly, Emma R.; Bartram, Jamie

2015-01-01

Background Packaged water products provide an increasingly important source of water for consumption. However, recent studies raise concerns over their safety. Objectives To assess the microbial safety of packaged water, examine differences between regions, country incomes, packaged water types, and compare packaged water with other water sources. Methods We performed a systematic review and meta-analysis. Articles published in English, French, Portuguese, Spanish and Turkish, with no date restrictions were identified from online databases and two previous reviews. Studies published before April 2014 that assessed packaged water for the presence of Escherichia coli, thermotolerant or total coliforms were included provided they tested at least ten samples or brands. Results A total of 170 studies were included in the review. The majority of studies did not detect fecal indicator bacteria in packaged water (78/141). Compared to packaged water from upper-middle and high-income countries, packaged water from low and lower-middle-income countries was 4.6 (95% CI: 2.6–8.1) and 13.6 (95% CI: 6.9–26.7) times more likely to contain fecal indicator bacteria and total coliforms, respectively. Compared to all other packaged water types, water from small bottles was less likely to be contaminated with fecal indicator bacteria (OR = 0.32, 95%CI: 0.17–0.58) and total coliforms (OR = 0.10, 95%CI: 0.05, 0.22). Packaged water was less likely to contain fecal indicator bacteria (OR = 0.35, 95%CI: 0.20, 0.62) compared to other water sources used for consumption. Conclusions Policymakers and regulators should recognize the potential benefits of packaged water in providing safer water for consumption at and away from home, especially for those who are otherwise unlikely to gain access to a reliable, safe water supply in the near future. To improve the quality of packaged water products they should be integrated into regulatory and monitoring frameworks. PMID:26505745

Genetics and Genomics in Oncology Nursing: What Does Every Nurse Need to Know?

PubMed

Eggert, Julie

2017-03-01

In addition to the need for basic education about genetics/genomics, other approaches are suggested to include awareness campaigns, continuing education courses, policy review, and onsite clinical development. These alternative learning strategies encourage oncology nurses across the continuum of care, from the bedside/seatside to oncology nurse research, to integrate genomics into all levels of practice and research in the specialty of oncology nursing. All nurses are warriors in the fight against cancer. The goal of this article is to identify genomic information that oncology nurses, at all levels of care, need to know and use as tools in the war against cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

Music therapy services in pediatric oncology: a national clinical practice review.

PubMed

Tucquet, Belinda; Leung, Maggie

2014-01-01

This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Asian Society of Gynecologic Oncology International Workshop 2014.

PubMed

Park, Jeong Yeol; Ngan, Hextan Yuen Sheung; Park, Won; Cao, Zeyi; Wu, Xiaohua; Ju, Woong; Chung, Hyun Hoon; Chang, Suk Joon; Park, Sang Yoon; Ryu, Sang Young; Kim, Jae Hoon; Cho, Chi Heum; Lee, Keun Ho; Lee, Jeong Won; Kumarasamy, Suresh; Kim, Jae Weon; Wilailak, Sarikapan; Kim, Byoung Gie; Kim, Dae Yeon; Konishi, Ikuo; Lee, Jae Kwan; Wang, Kung Liahng; Nam, Joo Hyun

2015-01-01

The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers.

Asian Society of Gynecologic Oncology International Workshop 2014

PubMed Central

Park, Jeong-Yeol; Ngan, Hextan Yuen Sheung; Park, Won; Cao, Zeyi; Wu, Xiaohua; Ju, Woong; Chung, Hyun Hoon; Chang, Suk-Joon; Park, Sang-Yoon; Ryu, Sang-Young; Kim, Jae-Hoon; Cho, Chi-Heum; Lee, Keun Ho; Lee, Jeong-Won; Kumarasamy, Suresh; Kim, Jae-Weon; Wilailak, Sarikapan; Kim, Byoung-Gie; Kim, Dae-Yeon; Konishi, Ikuo; Lee, Jae-Kwan; Wang, Kung-Liahng

2015-01-01

The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers. PMID:25609163

[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.

Oncology nurses’ communication challenges with patients and families: A qualitative study

PubMed Central

Banerjee, Smita C.; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A.; Parker, Patricia A.; Bylund, Carma L.

2016-01-01

The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. PMID:26278636

TH-D-204-00: The Pursuit of Radiation Oncology Performance Excellence

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance U.S. business competitiveness and economic growth. Administered by the National Institute of Standards and Technology NIST, the Act created the Baldrige National Quality Program, now 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,more » increasing patient satisfaction, building employee engagement, and boosting organizational innovation. The methodology also provides a valuable framework for benchmarking an individual radiation oncology practice against guidelines defined by accreditation and professional organizations and regulatory agencies. Learning Objectives: To gain knowledge of the Baldrige Performance Excellence Program as it relates to Radiation Oncology. To appreciate the value of a multidisciplinary self-assessment approach in the pursuit of Radiation Oncology quality care, patient satisfaction, and workforce commitment. To acquire a set of useful measurement tools with which an individual Radiation Oncology practice can benchmark its performance against guidelines defined by accreditation and professional organizations and regulatory agencies.« less

TH-D-204-01: The Pursuit of Radiation Oncology Performance Excellence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sternick, E.

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance U.S. business competitiveness and economic growth. Administered by the National Institute of Standards and Technology NIST, the Act created the Baldrige National Quality Program, now 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,more » increasing patient satisfaction, building employee engagement, and boosting organizational innovation. The methodology also provides a valuable framework for benchmarking an individual radiation oncology practice against guidelines defined by accreditation and professional organizations and regulatory agencies. Learning Objectives: To gain knowledge of the Baldrige Performance Excellence Program as it relates to Radiation Oncology. To appreciate the value of a multidisciplinary self-assessment approach in the pursuit of Radiation Oncology quality care, patient satisfaction, and workforce commitment. To acquire a set of useful measurement tools with which an individual Radiation Oncology practice can benchmark its performance against guidelines defined by accreditation and professional organizations and regulatory agencies.« less

Oncology nurses' communication challenges with patients and families: A qualitative study.

PubMed

Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

2016-01-01

The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew

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

Electro-Microfluidic Packaging

NASA Astrophysics Data System (ADS)

Benavides, G. L.; Galambos, P. C.

2002-06-01

There are many examples of electro-microfluidic products that require cost effective packaging solutions. Industry has responded to a demand for products such as drop ejectors, chemical sensors, and biological sensors. Drop ejectors have consumer applications such as ink jet printing and scientific applications such as patterning self-assembled monolayers or ejecting picoliters of expensive analytes/reagents for chemical analysis. Drop ejectors can be used to perform chemical analysis, combinatorial chemistry, drug manufacture, drug discovery, drug delivery, and DNA sequencing. Chemical and biological micro-sensors can sniff the ambient environment for traces of dangerous materials such as explosives, toxins, or pathogens. Other biological sensors can be used to improve world health by providing timely diagnostics and applying corrective measures to the human body. Electro-microfluidic packaging can easily represent over fifty percent of the product cost and, as with Integrated Circuits (IC), the industry should evolve to standard packaging solutions. Standard packaging schemes will minimize cost and bring products to market sooner.

AllergoOncology - the impact of allergy in oncology: EAACI position paper.

PubMed

Jensen-Jarolim, E; Bax, H J; Bianchini, R; Capron, M; Corrigan, C; Castells, M; Dombrowicz, D; Daniels-Wells, T R; Fazekas, J; Fiebiger, E; Gatault, S; Gould, H J; Janda, J; Josephs, D H; Karagiannis, P; Levi-Schaffer, F; Meshcheryakova, A; Mechtcheriakova, D; Mekori, Y; Mungenast, F; Nigro, E A; Penichet, M L; Redegeld, F; Saul, L; Singer, J; Spicer, J F; Siccardi, A G; Spillner, E; Turner, M C; Untersmayr, E; Vangelista, L; Karagiannis, S N

2017-06-01

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveillance, immunomodulation and the functions of IgE-mediated immune responses against cancer, to derive novel insights into more effective treatments. Coincident with rapid expansion in clinical application of cancer immunotherapies, here we review the current state-of-the-art and future translational opportunities, as well as challenges in this relatively new field. Recent developments include improved understanding of Th2 antibodies, intratumoral innate allergy effector cells and mediators, IgE-mediated tumour antigen cross-presentation by dendritic cells, as well as immunotherapeutic strategies such as vaccines and recombinant antibodies, and finally, the management of allergy in daily clinical oncology. Shedding light on the crosstalk between allergic response and cancer is paving the way for new avenues of treatment. © 2016 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.

Responses of advanced directives by Jehovah’s Witnesses on a gynecologic oncology service

PubMed Central

Nagarsheth, Nimesh P; Gupta, Nikhil; Gupta, Arpeta; Moshier, Erin; Gretz, Herbert; Shander, Aryeh

2015-01-01

Objectives To review the responses of advance directives signed by Jehovah’s Witness patients prior to undergoing surgery at a gynecologic oncology service. Study design A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998–2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. Results No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385). However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001). In addition, all gynecologic oncology patients (100%) accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001). Conclusion Our results confirm the commonly held belief that the majority of Jehovah’s Witness patients refuse to accept major blood components. However, Jehovah’s Witness patients at a gynecologic oncology service will accept a variety of blood-derived products (minor fractions) and interventions designed to optimize outcomes when undergoing transfusion-free surgery. Patients presenting to a gynecologic oncology service respond differently to advanced directives related to bloodless surgery, as compared to patients from an obstetrical service. PMID:25565911

Palliative care and active disease management are synergistic in modern surgical oncology.

PubMed

Sadler, Erin M; Hawley, Philippa H; Easson, Alexandra M

2018-04-01

Palliative care has long been described in medical literature but only recently is being discussed in the surgical domain. Mounting evidence suggests that early integration of palliative care improves patient outcomes and this is especially true of oncology patients. Thus, the pendulum is swinging toward recognizing that palliative care and active disease management are not mutually exclusive but rather synergistic in modern surgical oncology. Here we use a patient vignette to demonstrate the new challenges and possibilities in modern surgical oncology, we then discuss the historic perspective of palliative care and describe how the paradigm is shifting. Finally, we introduce a model that may be beneficial in conceptualizing this new way of thinking about and integrating palliative care into surgical oncology. Copyright © 2017 Elsevier Inc. All rights reserved.

Why the Quality Oncology Practice Initiative Matters: It's Not Just About Cost.

PubMed

Chiang, Anne C

2016-01-01

The nature and cost of cancer care is evolving, affecting more patients and often involving expensive treatment options. The upward cost trends also coincide with a national landscape of increasing regulatory mandates that may demand improved outcomes and value, but that often require significant up-front investment in infrastructure to achieve safety and quality. Oncology practices participating in the American Society of Clinical Oncology (ASCO) Institute for Quality's Quality Oncology Practice Initiative (QOPI) and the QOPI Certification Program (QCP) continue to grow in number and reflect changing demographics of the provision of cancer care. QOPI and QCP benchmarking can be used to achieve quality improvement and to build collaborative quality communities. These programs may be useful tools for oncology practices to comply with new legislation such as the Medicare Access and CHIP Reauthorization Act (MACRA).

The American Society for Radiation Oncology's 2010 Core Physics Curriculum for Radiation Oncology Residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xiao Ying, E-mail: ying.xiao@jefferson.edu; De Amorim Bernstein, Karen; Chetty, Indrin J.

Purpose: In 2004, the American Society for Radiation Oncology (ASTRO) published its first physics education curriculum for residents, which was updated in 2007. A committee composed of physicists and physicians from various residency program teaching institutions was reconvened again to update the curriculum in 2009. Methods and Materials: Members of this committee have associations with ASTRO, the American Association of Physicists in Medicine, the Association of Residents in Radiation Oncology, the American Board of Radiology (ABR), and the American College of Radiology. Members reviewed and updated assigned subjects from the last curriculum. The updated curriculum was carefully reviewed by amore » representative from the ABR and other physics and clinical experts. Results: The new curriculum resulted in a recommended 56-h course, excluding initial orientation. Learning objectives are provided for each subject area, and a detailed outline of material to be covered is given for each lecture hour. Some recent changes in the curriculum include the addition of Radiation Incidents and Bioterrorism Response Training as a subject and updates that reflect new treatment techniques and modalities in a number of core subjects. The new curriculum was approved by the ASTRO board in April 2010. We anticipate that physicists will use this curriculum for structuring their teaching programs, and subsequently the ABR will adopt this educational program for its written examination. Currently, the American College of Radiology uses the ASTRO curriculum for their training examination topics. In addition to the curriculum, the committee updated suggested references and the glossary. Conclusions: The ASTRO physics education curriculum for radiation oncology residents has been updated. To ensure continued commitment to a current and relevant curriculum, the subject matter will be updated again in 2 years.« less

The American Society for Radiation Oncology's 2010 core physics curriculum for radiation oncology residents.

PubMed

Xiao, Ying; Bernstein, Karen De Amorim; Chetty, Indrin J; Eifel, Patricia; Hughes, Lesley; Klein, Eric E; McDermott, Patrick; Prisciandaro, Joann; Paliwal, Bhudatt; Price, Robert A; Werner-Wasik, Maria; Palta, Jatinder R

2011-11-15

In 2004, the American Society for Radiation Oncology (ASTRO) published its first physics education curriculum for residents, which was updated in 2007. A committee composed of physicists and physicians from various residency program teaching institutions was reconvened again to update the curriculum in 2009. Members of this committee have associations with ASTRO, the American Association of Physicists in Medicine, the Association of Residents in Radiation Oncology, the American Board of Radiology (ABR), and the American College of Radiology. Members reviewed and updated assigned subjects from the last curriculum. The updated curriculum was carefully reviewed by a representative from the ABR and other physics and clinical experts. The new curriculum resulted in a recommended 56-h course, excluding initial orientation. Learning objectives are provided for each subject area, and a detailed outline of material to be covered is given for each lecture hour. Some recent changes in the curriculum include the addition of Radiation Incidents and Bioterrorism Response Training as a subject and updates that reflect new treatment techniques and modalities in a number of core subjects. The new curriculum was approved by the ASTRO board in April 2010. We anticipate that physicists will use this curriculum for structuring their teaching programs, and subsequently the ABR will adopt this educational program for its written examination. Currently, the American College of Radiology uses the ASTRO curriculum for their training examination topics. In addition to the curriculum, the committee updated suggested references and the glossary. The ASTRO physics education curriculum for radiation oncology residents has been updated. To ensure continued commitment to a current and relevant curriculum, the subject matter will be updated again in 2 years. Copyright © 2011 Elsevier Inc. All rights reserved.

Sensory impacts of food-packaging interactions.

PubMed

Duncan, Susan E; Webster, Janet B

2009-01-01

Sensory changes in food products result from intentional or unintentional interactions with packaging materials and from failure of materials to protect product integrity or quality. Resolving sensory issues related to plastic food packaging involves knowledge provided by sensory scientists, materials scientists, packaging manufacturers, food processors, and consumers. Effective communication among scientists and engineers from different disciplines and industries can help scientists understand package-product interactions. Very limited published literature describes sensory perceptions associated with food-package interactions. This article discusses sensory impacts, with emphasis on oxidation reactions, associated with the interaction of food and materials, including taints, scalping, changes in food quality as a function of packaging, and examples of material innovations for smart packaging that can improve sensory quality of foods and beverages. Sensory evaluation is an important tool for improved package selection and development of new materials.

Modular electronics packaging system

NASA Technical Reports Server (NTRS)

Hunter, Don J. (Inventor)

2001-01-01

A modular electronics packaging system includes multiple packaging slices that are mounted horizontally to a base structure. The slices interlock to provide added structural support. Each packaging slice includes a rigid and thermally conductive housing having four side walls that together form a cavity to house an electronic circuit. The chamber is enclosed on one end by an end wall, or web, that isolates the electronic circuit from a circuit in an adjacent packaging slice. The web also provides a thermal path between the electronic circuit and the base structure. Each slice also includes a mounting bracket that connects the packaging slice to the base structure. Four guide pins protrude from the slice into four corresponding receptacles in an adjacent slice. A locking element, such as a set screw, protrudes into each receptacle and interlocks with the corresponding guide pin. A conduit is formed in the slice to allow electrical connection to the electronic circuit.

What does it mean to be an oncology nurse? Reexamining the life cycle concepts.

PubMed

Cohen, Marlene Z; Ferrell, Betty R; Vrabel, Mark; Visovsky, Constance; Schaefer, Brandi

2010-09-01

To summarize the current research pertaining to the concepts initially examined by the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force and related projects completed in 1994. Published articles on the 21 concepts from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force work. Research published in English from 1995-2009 was obtained from PubMed, CINAHL(R), PsycINFO, ISI Science, and EBSCO Health Source(R): Nursing/Academic Edition databases. Most of the concepts identified from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force have been examined in the literature. Relationships and witnessing suffering were common concepts among studies of the meaning of oncology nursing. Nurses provide holistic care, and not surprisingly, holistic interventions have been found useful to support nurses. Interventions included storytelling, clinical support of nurses, workshops to find balance in lives, and dream work. Additional support comes from mentoring. The research identified was primarily descriptive, with very few interventions reported. Findings have been consistent over time in diverse countries. This review indicates that although the healthcare system has changed significantly in 15 years, nurses' experiences of providing care to patients with cancer have remained consistent. The need for interventions to support nurses remains.

Collaborative Genomics Study Advances Precision Oncology

Cancer.gov

A collaborative study conducted by two Office of Cancer Genomics (OCG) initiatives highlights the importance of integrating structural and functional genomics programs to improve cancer therapies, and more specifically, contribute to precision oncology treatments for children.

The National Practice Benchmark for Oncology: 2015 Report for 2014 Data

PubMed Central

Balch, Carla; Ogle, John D.

2016-01-01

The National Practice Benchmark (NPB) is a unique tool used to measure oncology practices against others across the country in a meaningful way despite variations in practice demographics, size, and setting. In today’s challenging economic environment, each practice positions service offerings and competitive advantages to attract patients. Although the data in the NPB report are primarily reported by community oncology practices, the business structure and arrangements with regional health care systems are also reflected in the benchmark report. The ability to produce detailed metrics is an accomplishment of excellence in business and clinical management. With these metrics, a practice should be able to measure and analyze its current business practices and make appropriate changes, if necessary. In this report, we build on the foundation initially established by Oncology Metrics (acquired by Flatiron Health in 2014) over years of data collection and refine definitions to deliver the NPB, which is uniquely meaningful in the oncology market. PMID:27006357

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care.

PubMed

Sleight, Alix G; Duker, Leah I Stein

2016-01-01

Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Coping With Moral Distress in Oncology Practice: Nurse and Physician Strategies.

PubMed

Lievrouw, An; Vanheule, Stijn; Deveugele, Myriam; Vos, Martine; Pattyn, Piet; Belle, Van; Benoit, Dominique D

2016-07-01

To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting.
. Qualitative interview study.
. Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium.
. 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. 
. Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis.
. Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes. Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding.
. Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress.

Natural biopolimers in organic food packaging

NASA Astrophysics Data System (ADS)

Wieczynska, Justyna; Cavoski, Ivana; Chami, Ziad Al; Mondelli, Donato; Di Donato, Paola; Di Terlizzi, Biagio

2014-05-01

Concerns on environmental and waste problems caused by use of non-biodegradable and non-renewable based plastic packaging have caused an increase interest in developing biodegradable packaging using renewable natural biopolymers. Recently, different types of biopolymers like starch, cellulose, chitosan, casein, whey protein, collagen, egg white, soybean protein, corn zein, gelatin and wheat gluten have attracted considerable attention as potential food packaging materials. Recyclable or biodegradable packaging material in organic processing standards is preferable where possible but specific principles of packaging are not precisely defined and standards have to be assessed. There is evidence that consumers of organic products have specific expectations not only with respect to quality characteristics of processed food but also in social and environmental aspects of food production. Growing consumer sophistication is leading to a proliferation in food eco-label like carbon footprint. Biopolymers based packaging for organic products can help to create a green industry. Moreover, biopolymers can be appropriate materials for the development of an active surfaces designed to deliver incorporated natural antimicrobials into environment surrounding packaged food. Active packaging is an innovative mode of packaging in which the product and the environment interact to prolong shelf life or enhance safety or sensory properties, while maintaining the quality of the product. The work will discuss the various techniques that have been used for development of an active antimicrobial biodegradable packaging materials focusing on a recent findings in research studies. With the current focus on exploring a new generation of biopolymer-based food packaging materials with possible applications in organic food packaging. Keywords: organic food, active packaging, biopolymers , green technology

Uncertainty in assessing value of oncology treatments.

PubMed

Mullins, C Daniel; Montgomery, Russ; Tunis, Sean

2010-01-01

Patients, clinicians, payers, and policymakers face an environment of significant evidentiary uncertainty as they attempt to achieve maximum value, or the greatest level of benefit possible at a given level of cost in their respective health care decisions. This is particularly true in the area of oncology, for which published evidence from clinical trials is often incongruent with real-world patient care, and a substantial portion of clinical use is for off-label indications that have not been systematically evaluated. It is this uncertainty in the knowledge of the clinical harms and benefits associated with oncology treatments that prevents postregulatory decision makers from making accurate assessments of the value of these treatments. Because of the incentives inherent in the clinical research enterprise, randomized control trials (RCTs) are designed for the specific purpose of regulatory approval and maximizing market penetration. The pursuit of these goals results in RCT study designs that achieve maximal internal validity at the expense of generalizability to diverse real-world patient populations that may have significant comorbidities and other clinically mitigating factors. As such, systematic reviews for the purposes of coverage and treatment decisions often find relevant and high-quality evidence to be limited or nonexistent. For a number of reasons, including frequent off-label use of medications and the expedited approval process for cancer drugs by the U.S. Food and Drug Administration, this situation is exacerbated in the area of oncology. This paper investigates the convergence of incentives and circumstances that lead to widespread uncertainty in oncology and proposes new paradigms for clinical research, including pragmatic clinical trials, methodological guidance, and coverage with evidence development. Each of these initiatives would support the design of clinical research that is more informative for postregulatory decision makers, and would

International collaboration for pediatric oncology nursing leadership: Nicaragua and Canada.

PubMed

Orozco, A; Marin, V; Reyes, S; Challinor, J; Carpio, B

2009-01-01

In 2005, with financial support from the Pediatric Oncology Group of Ontario, a pilot nursing leadership project linked pediatric oncology nurses from Canada with nurses at the La Mascota Hospital in Managua, Nicaragua. Following consultation with the pediatric oncology team in Nicaragua, a program was developed to strengthen clinical nursing leadership in a clinical setting through continuing education. The nurses believed that care of the patient and family improved due to the increased leadership skills of nurses in the unit and as the profile and credibility of nurses as peers in the health care team became evident. Providing nurses with the autonomy and financing for a project related directly to nursing care represented an important development for leadership in the profession.

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

AMCP Partnership Forum: Driving Value and Outcomes in Oncology.

PubMed

2017-05-01

Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself. The Academy of Managed Care Pharmacy (AMCP) convened a Partnership Forum to address how to improve value and outcomes in cancer care. In this multistakeholder forum, several areas were addressed: current methods for assessing the value of oncology products, the need for balancing population management with precision medicine, and the outlook for value-based contracting for oncology medications in managed care settings. Participants recommended ways in which stakeholders can work toward solutions in these areas. The forum brought together stakeholders from health plans, integrated delivery systems, pharmacy benefit managers, clinical practice, biopharmaceutical industry, and laboratory companies. Also participating were representatives from trade and professional associations. During this 1.5-day forum, participants identified current challenges, readiness, and ways to address value and improve outcomes in cancer therapy. Some of the challenges identified include choosing a viable (and practical) outcome target for value-based contracting in oncology, the development and use of value frameworks and clinical pathways, managing cancer diagnostics, utilization of alternative payment systems, moving from a large evidence base to a small clinical trial base in considering targeted treatments, and lack of best practices in value-based payment

Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum

DOE Office of Scientific and Technical Information (OSTI.GOV)

Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu; Spektor, Alexander; Rudra, Sonali

Purpose: To develop and evaluate a structured didactic curriculum to complement clinical experiences during radiation oncology clerkships at 2 academic medical centers. Methods and Materials: A structured didactic curriculum was developed to teach fundamentals of radiation oncology and improve confidence in clinical competence. Curriculum lectures included: (1) an overview of radiation oncology (history, types of treatments, and basic clinic flow); (2) fundamentals of radiation biology and physics; and (3) practical aspects of radiation treatment simulation and planning. In addition, a hands-on dosimetry session taught students fundamentals of treatment planning. The curriculum was implemented at 2 academic departments in 2012. Studentsmore » completed anonymous evaluations using a Likert scale to rate the usefulness of curriculum components (1 = not at all, 5 = extremely). Likert scores are reported as (median [interquartile range]). Results: Eighteen students completed the curriculum during their 4-week rotation (University of Chicago n=13, Harvard Longwood Campus n=5). All curriculum components were rated as extremely useful: introduction to radiation oncology (5 [4-5]); radiation biology and physics (5 [5-5]); practical aspects of radiation oncology (5 [4-5]); and the treatment planning session (5 [5-5]). Students rated the curriculum as “quite useful” to “extremely useful” (1) to help students understand radiation oncology as a specialty; (2) to increase student comfort with their specialty decision; and (3) to help students with their future transition to a radiation oncology residency. Conclusions: A standardized curriculum for medical students completing a 4-week radiation oncology clerkship was successfully implemented at 2 institutions. The curriculum was favorably reviewed. As a result of completing the curriculum, medical students felt more comfortable with their specialty decision and better prepared to begin radiation oncology residency.« less

RH Packaging Program Guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Washington TRU Solutions LLC

The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package (also known as the "RH-TRU 72-B cask") and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: "...each package must be prepared for shipmentmore » and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application." It further states: "...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application." Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M&O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with Title 10 Code of Federal Regulations (CFR) §71.8, "Deliberate Misconduct." Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. The CBFO will evaluate the issue and notify the NRC if required.In accordance with 10 CFR Part 71, "Packaging and Transportation of Radioactive Material," certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, "Reporting of Defects and Noncompliance," regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a

RH Packaging Program Guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Washington TRU Solutions LLC

The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: "...each package must be prepared for shipment and operated in accordance with the proceduresmore » described in Chapter 7.0, Operating Procedures, of the application." It further states: "...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application." Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M&O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with 10 Code of Federal Regulations (CFR) §71.8, "Deliberate Misconduct." Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. In accordance with 10 CFR Part 71, "Packaging and Transportation of Radioactive Material," certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, "Reporting of Defects and Noncompliance," regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous location where the activities subject

Transforming Oncology Care: Developing a Strategy and Measuring Success.

PubMed

Reid Ponte, Patricia; Berry, Donna; Buswell, Lori; Gross, Anne; Hayes, Carolyn; Kostka, Judy; Poyner-Reed, Mary; West, Colleen

2016-05-01

To examine accountability and performance measurement in health care and present a case study that illustrates the link between goal setting and measurement and how a strategic plan can provide a framework for metric selection. National reports, literature review and institutional experience. Nurse leaders and clinicians in oncology settings are challenged to anticipate future trends in oncology care and create a culture, infrastructure, and practice environment that supports innovation, advancement of oncology nursing practice and excellence in patient- and family-centered care. Performance metrics assessing key processes and outcomes of care are essential to meet this challenge. With an increasing number of national organizations offering their version of key quality standards and metrics, it is critical for nurses to have a formal process in place to determine and implement the measures most useful in guiding change for a particular clinical setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding and surviving the transition to value-based oncology.

PubMed

Cox, John V; Sprandio, John D; Barkley, Ronald

2013-01-01

This paper and the three presentations it supports are drawn from the theme of the 2012 Cancer Center Business Summit (CCBS): "Transitioning to Value-Based Oncology: Strategies to Survive and Thrive." The CCBS is a forum on oncology business innovation, and the principal question the organizers address each year is "What are the creative, innovative, and best business models and practices that are being conceived or piloted today that may provide a responsible and sustainable platform for the delivery of cancer care tomorrow?" At this moment in health care-when so much is in flux and new business models and solutions abound-the oncology sector has a solemn responsibility: to forge the business models and relationships that will help to define a new cancer care value proposition and a sustainable health care system of tomorrow for the benefit of the patients it serves to get it "right."

Space station power semiconductor package

NASA Technical Reports Server (NTRS)

Balodis, Vilnis; Berman, Albert; Devance, Darrell; Ludlow, Gerry; Wagner, Lee

1987-01-01

A package of high-power switching semiconductors for the space station have been designed and fabricated. The package includes a high-voltage (600 volts) high current (50 amps) NPN Fast Switching Power Transistor and a high-voltage (1200 volts), high-current (50 amps) Fast Recovery Diode. The package features an isolated collector for the transistors and an isolated anode for the diode. Beryllia is used as the isolation material resulting in a thermal resistance for both devices of .2 degrees per watt. Additional features include a hermetical seal for long life -- greater than 10 years in a space environment. Also, the package design resulted in a low electrical energy loss with the reduction of eddy currents, stray inductances, circuit inductance, and capacitance. The required package design and device parameters have been achieved. Test results for the transistor and diode utilizing the space station package is given.

Integration of oncology and palliative care: a systematic review.

PubMed

Hui, David; Kim, Yu Jung; Park, Ji Chan; Zhang, Yi; Strasser, Florian; Cherny, Nathan; Kaasa, Stein; Davis, Mellar P; Bruera, Eduardo

2015-01-01

Both the American Society of Clinical Oncology and the European Society for Medical Oncology strongly endorse integrating oncology and palliative care (PC); however, a global consensus on what constitutes integration is currently lacking. To better understand what integration entails, we conducted a systematic review to identify articles addressing the clinical, educational, research, and administrative indicators of integration. We searched Ovid MEDLINE and Ovid EMBase between 1948 and 2013. Two researchers independently reviewed each citation for inclusion and extracted the indicators related to integration. The inter-rater agreement was high (κ = 0.96, p < .001). Of the 431 publications in our initial search, 101 were included. A majority were review articles (58%) published in oncology journals (59%) and in or after 2010 (64%, p < .001). A total of 55 articles (54%), 33 articles (32%), 24 articles (24%), and 14 articles (14%) discussed the role of outpatient clinics, community-based care, PC units, and inpatient consultation teams in integration, respectively. Process indicators of integration include interdisciplinary PC teams (n = 72), simultaneous care approach (n = 71), routine symptom screening (n = 25), PC guidelines (n = 33), care pathways (n = 11), and combined tumor boards (n = 10). A total of 66 articles (65%) mentioned early involvement of PC, 18 (18%) provided a specific timing, and 28 (28%) discussed referral criteria. A total of 45 articles (45%), 20 articles (20%), and 66 articles (65%) discussed 8, 4, and 9 indicators related to the educational, research, and administrative aspects of integration, respectively. Integration was a heterogeneously defined concept. Our systematic review highlighted 38 clinical, educational, research, and administrative indicators. With further refinement, these indicators may facilitate assessment of the level of integration of oncology and PC. ©AlphaMed Press.

Identification of the Key Fields and Their Key Technical Points of Oncology by Patent Analysis.

PubMed

Zhang, Ting; Chen, Juan; Jia, Xiaofeng

2015-01-01

This paper aims to identify the key fields and their key technical points of oncology by patent analysis. Patents of oncology applied from 2006 to 2012 were searched in the Thomson Innovation database. The key fields and their key technical points were determined by analyzing the Derwent Classification (DC) and the International Patent Classification (IPC), respectively. Patent applications in the top ten DC occupied 80% of all the patent applications of oncology, which were the ten fields of oncology to be analyzed. The number of patent applications in these ten fields of oncology was standardized based on patent applications of oncology from 2006 to 2012. For each field, standardization was conducted separately for each of the seven years (2006-2012) and the mean of the seven standardized values was calculated to reflect the relative amount of patent applications in that field; meanwhile, regression analysis using time (year) and the standardized values of patent applications in seven years (2006-2012) was conducted so as to evaluate the trend of patent applications in each field. Two-dimensional quadrant analysis, together with the professional knowledge of oncology, was taken into consideration in determining the key fields of oncology. The fields located in the quadrant with high relative amount or increasing trend of patent applications are identified as key ones. By using the same method, the key technical points in each key field were identified. Altogether 116,820 patents of oncology applied from 2006 to 2012 were retrieved, and four key fields with twenty-nine key technical points were identified, including "natural products and polymers" with nine key technical points, "fermentation industry" with twelve ones, "electrical medical equipment" with four ones, and "diagnosis, surgery" with four ones. The results of this study could provide guidance on the development direction of oncology, and also help researchers broaden innovative ideas and discover new

40 CFR 157.27 - Unit packaging.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Unit packaging. 157.27 Section 157.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PACKAGING REQUIREMENTS FOR PESTICIDES AND DEVICES Child-Resistant Packaging § 157.27 Unit packaging. Pesticide products...

Increasing minority patient participation in cancer clinical trials using oncology nurse navigation.

PubMed

Holmes, Dennis Ricky; Major, Jacquelyn; Lyonga, Doris Efosi; Alleyne, Rebecca Simone; Clayton, Sheilah Marie

2012-04-01

Residential distance from an academic or cancer center is a significant barrier to minority patient participation in cancer research. Most cancer clinical trials (CTs) are only accessible at academic and cancer centers, yet most cancer patients receive treatment in their home communities where access to CTs may be limited. Oncology nurse navigation is an innovative approach for increasing minority CT participation by facilitating access to cancer CTs in communities where minority patients live. The purpose of this study was to evaluate the impact of oncology nurse navigation on community-based recruitment of black patients to breast cancer CTs at a major cancer center. We merged the roles of a traditional oncology research nurse and a professional patient navigator to create a novel health care provider role, the oncology nurse navigator. The primary duties of the oncology nurse navigator were to engage black cancer patients in the offices of their community physicians and to collaborate with community physicians to increase black patient participation in cancer research. The oncology nurse navigator played a key role in all phases of the CT participation process (e.g., screening for eligibility and completion of informed consent and clinical research forms) and guided each patient around barriers in the health care system. The accrual of eligible patients to breast cancer CTs was used to assess the impact of oncology nurse navigation on community-based recruitment of blacks to cancer CTs. Between January 2007 and December 2008, a total of 132 black breast cancer patients were screened by a single oncology nurse navigator for eligibility to University of Southern California-sponsored breast cancer CTs. Fifty-nine patients were eligible for CTs, and each was invited to participate in 1 or more CTs for which they were eligible. Fifty-one of 59 eligible black patients (86% of eligible patients) were enrolled to 1 or more research protocols. The estimated cost per

Culturally and linguistically diverse oncology patients' perspectives of consultation audio recordings and question prompt lists.

PubMed

Hyatt, Amelia; Lipson-Smith, Ruby; Gough, Karla; Butow, Phyllis; Jefford, Michael; Hack, Thomas F; Hale, Sandra; Zucchi, Emiliano; White, Shane; Ozolins, Uldis; Schofield, Penelope

2018-06-11

Ethnicity and migrant status results in disparities with cancer burden and survival; with communication difficulties cited as the main barrier to access. Our research team tested a communication intervention package comprising consultation audio-recordings (ARs) and question prompt lists (QPLs) for Low English Speaking (LES) patients with cancer. This study explored LES patient experiences, preferences, and recommendations regarding the communication package. Participants completed a questionnaire and qualitative interview regarding ARs and QPLs. Eligibility criteria comprised: aged ≥18 years old; a consultation with an oncologist between 1st June 2015 and 1st April 2016; an Arabic, Cantonese, Greek, or Mandarin professional interpreter booked for that consultation; and randomised to receive the communication intervention. Eighteen patients completed the qualitative interview and 17 completed the questionnaire. Fifteen reported listening to the AR at least once. Participants reported that QPLs and ARs provide support and assist with remembering and understanding medical information. Both resources were seen as having applicability beyond the oncology setting in regards to improving health service delivery and continuity of care. However, patients felt that individual tailoring of the resources should be considered. Patients also found it useful to share ARs with family. The LES participants in this study considered the ARs and QPLs useful for most but not all contexts. Recommendations regarding delivery and use highlight that these resources should be tailored and patient-driven. Further, patients foresaw a range of additional uses for consultation ARs within the broader healthcare context. This article is protected by copyright. All rights reserved.

High-Performance Power-Semiconductor Packages

NASA Technical Reports Server (NTRS)

Renz, David; Hansen, Irving; Berman, Albert

1989-01-01

A 600-V, 50-A transistor and 1,200-V, 50-A diode in rugged, compact, lightweight packages intended for use in inverter-type power supplies having switching frequencies up to 20 kHz. Packages provide low-inductance connections, low loss, electrical isolation, and long-life hermetic seal. Low inductance achieved by making all electrical connections to each package on same plane. Also reduces high-frequency losses by reducing coupling into inherent shorted turns in packaging material around conductor axes. Stranded internal power conductors aid conduction at high frequencies, where skin effect predominates. Design of packages solves historical problem of separation of electrical interface from thermal interface of high-power semiconductor device.

Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.

PubMed

Kline, Ronald M; Muldoon, L Daniel; Schumacher, Heidi K; Strawbridge, Larisa M; York, Andrew W; Mortimer, Laura K; Falb, Alison F; Cox, Katherine J; Bazell, Carol; Lukens, Ellen W; Kapp, Mary C; Rajkumar, Rahul; Bassano, Amy; Conway, Patrick H

2017-07-01

The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations. Policy and technical decisions include the definition of the episode, including its initiation, duration, and included services; the identification of beneficiaries included in the model; and beneficiary attribution to practitioners with overall responsibility for managing their care. In addition, the calculation and risk adjustment of benchmark episode prices for the bundle of services must reflect geographic cost variations and diverse patient populations, including varying disease subtypes, medical comorbidities, changes in standards of care over time, the adoption of expensive new drugs (especially in oncology), as well as diverse practice patterns. Other steps include timely monitoring and intervention as needed to avoid shifting the attribution of beneficiaries on the basis of their expected episode expenditures as well as to ensure the provision of necessary medical services and the development of a meaningful link to quality measurement and improvement through the episode-based payment methodology. The complex and diverse nature of oncology business relationships and the specific rules and requirements of Medicare payment systems for different types of providers intensify these issues. The Centers for Medicare & Medicaid Services believes that by sharing its approach to addressing these decisions and challenges, it may facilitate greater understanding of the model within the oncology

Sustainable Library Development Training Package

ERIC Educational Resources Information Center

Peace Corps, 2012

2012-01-01

This Sustainable Library Development Training Package supports Peace Corps' Focus In/Train Up strategy, which was implemented following the 2010 Comprehensive Agency Assessment. Sustainable Library Development is a technical training package in Peace Corps programming within the Education sector. The training package addresses the Volunteer…

40 CFR 262.30 - Packaging.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Packaging. 262.30 Section 262.30... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.30 Packaging. Before... the waste in accordance with the applicable Department of Transportation regulations on packaging...

Packaging Software Assets for Reuse

NASA Astrophysics Data System (ADS)

Mattmann, C. A.; Marshall, J. J.; Downs, R. R.

2010-12-01

The reuse of existing software assets such as code, architecture, libraries, and modules in current software and systems development projects can provide many benefits, including reduced costs, in time and effort, and increased reliability. Many reusable assets are currently available in various online catalogs and repositories, usually broken down by disciplines such as programming language (Ibiblio for Maven/Java developers, PyPI for Python developers, CPAN for Perl developers, etc.). The way these assets are packaged for distribution can play a role in their reuse - an asset that is packaged simply and logically is typically easier to understand, install, and use, thereby increasing its reusability. A well-packaged asset has advantages in being more reusable and thus more likely to provide benefits through its reuse. This presentation will discuss various aspects of software asset packaging and how they can affect the reusability of the assets. The characteristics of well-packaged software will be described. A software packaging domain model will be introduced, and some existing packaging approaches examined. An example case study of a Reuse Enablement System (RES), currently being created by near-term Earth science decadal survey missions, will provide information about the use of the domain model. Awareness of these factors will help software developers package their reusable assets so that they can provide the most benefits for software reuse.

Current challenges in European oncology pharmacy practice.

PubMed

Hoppe-Tichy, Torsten

2010-03-01

The demand for pharmacy cancer services is expected to at least double over the next 10 years, as the population ages and new treatments are introduced. Safe and efficient handling of cytotoxic products minimises risks to staff and reduces medication errors. To identify and describe strategies for coping safely and effectively with heavier workloads in the hospital oncology pharmacy, currently and in the future. The PubMed database was searched for literature on approaches to safe handling of antineoplastic agents and to decreasing medication errors in the hospital pharmacy. Articles that were judged to be of prime importance to the hospital oncologist were reviewed. These safety concepts are put into the context of contemporary hospital oncology pharmacy practice through discussion of key issues, including increased demand, the role of the pharmacist in determining the hospital formulary, and growth in patient preferences for oral chemotherapy. Recommendations on best practices are also provided, based on relevant literature and author experience. Efficient, safe hospital pharmacy operations can be aided by capacity planning, dose banding, and knowledge of novel products and procedures that can reduce risks to health while increasing the number of patients who are safely treated. Consideration may also be given to the economic role of oncology pharmacists in formulary development.

Naval Waste Package Design Sensitivity

DOE Office of Scientific and Technical Information (OSTI.GOV)

T. Schmitt

2006-12-13

The purpose of this calculation is to determine the sensitivity of the structural response of the Naval waste packages to varying inner cavity dimensions when subjected to a comer drop and tip-over from elevated surface. This calculation will also determine the sensitivity of the structural response of the Naval waste packages to the upper bound of the naval canister masses. The scope of this document is limited to reporting the calculation results in terms of through-wall stress intensities in the outer corrosion barrier. This calculation is intended for use in support of the preliminary design activities for the license applicationmore » design of the Naval waste package. It examines the effects of small changes between the naval canister and the inner vessel, and in these dimensions, the Naval Long waste package and Naval Short waste package are similar. Therefore, only the Naval Long waste package is used in this calculation and is based on the proposed potential designs presented by the drawings and sketches in References 2.1.10 to 2.1.17 and 2.1.20. All conclusions are valid for both the Naval Long and Naval Short waste packages.« less

7 CFR 33.6 - Package.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Package. 33.6 Section 33.6 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... ISSUED UNDER AUTHORITY OF THE EXPORT APPLE ACT Definitions § 33.6 Package. Package means any container of...

[A psychological perspective on the problems faced by the oncology patients and their care teams].

PubMed

Kalvodová, L; Vorlícek, J; Adam, Z; Svacina, P

2010-06-01

Survey of the history and study of the psychical expressions of the oncology patients, the rules of communication ofoncologist and his patient. Personality of oncology patient and a Model of Kübler-Ross, then a decalogue of speaking about the oncology diagnosis. Clinical psychologict as an integral part of the medical team, which brings a supportive care for the oncology patients, then the psychopatological behaviour appears iside a medical team. In the end there are the authentic patients stories with the psychologist commentary.

49 CFR 173.29 - Empty packagings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Empty packagings. 173.29 Section 173.29... SHIPMENTS AND PACKAGINGS Preparation of Hazardous Materials for Transportation § 173.29 Empty packagings. (a) General. Except as otherwise provided in this section, an empty packaging containing only the residue of a...

Packaging food for radiation processing

NASA Astrophysics Data System (ADS)

Komolprasert, Vanee

2016-12-01

Irradiation can play an important role in reducing pathogens that cause food borne illness. Food processors and food safety experts prefer that food be irradiated after packaging to prevent post-irradiation contamination. Food irradiation has been studied for the last century. However, the implementation of irradiation on prepackaged food still faces challenges on how to assess the suitability and safety of these packaging materials used during irradiation. Irradiation is known to induce chemical changes to the food packaging materials resulting in the formation of breakdown products, so called radiolysis products (RP), which may migrate into foods and affect the safety of the irradiated foods. Therefore, the safety of the food packaging material (both polymers and adjuvants) must be determined to ensure safety of irradiated packaged food. Evaluating the safety of food packaging materials presents technical challenges because of the range of possible chemicals generated by ionizing radiation. These challenges and the U.S. regulations on food irradiation are discussed in this article.

The European Society for Medical Oncology (ESMO) Precision Medicine Glossary.

PubMed

Yates, L R; Seoane, J; Le Tourneau, C; Siu, L L; Marais, R; Michiels, S; Soria, J C; Campbell, P; Normanno, N; Scarpa, A; Reis-Filho, J S; Rodon, J; Swanton, C; Andre, F

2018-01-01

Precision medicine is rapidly evolving within the field of oncology and has brought many new concepts and terminologies that are often poorly defined when first introduced, which may subsequently lead to miscommunication within the oncology community. The European Society for Medical Oncology (ESMO) recognises these challenges and is committed to support the adoption of precision medicine in oncology. To add clarity to the language used by oncologists and basic scientists within the context of precision medicine, the ESMO Translational Research and Personalised Medicine Working Group has developed a standardised glossary of relevant terms. Relevant terms for inclusion in the glossary were identified via an ESMO member survey conducted in Autumn 2016, and by the ESMO Translational Research and Personalised Medicine Working Group members. Each term was defined by experts in the field, discussed and, if necessary, modified by the Working Group before reaching consensus approval. A literature search was carried out to determine which of the terms, 'precision medicine' and 'personalised medicine', is most appropriate to describe this field. A total of 43 terms are included in the glossary, grouped into five main themes-(i) mechanisms of decision, (ii) characteristics of molecular alterations, (iii) tumour characteristics, (iv) clinical trials and statistics and (v) new research tools. The glossary classes 'precision medicine' or 'personalised medicine' as technically interchangeable but the term 'precision medicine' is favoured as it more accurately reflects the highly precise nature of new technologies that permit base pair resolution dissection of cancer genomes and is less likely to be misinterpreted. The ESMO Precision Medicine Glossary provides a resource to facilitate consistent communication in this field by clarifying and raising awareness of the language employed in cancer research and oncology practice. The glossary will be a dynamic entity, undergoing

The effect of a psychological empowerment program based on psychodrama on empowerment perception and burnout levels in oncology nurses: Psychological empowerment in oncology nurses.

PubMed

Özbaş, Azize Atli; Tel, Havva

2016-08-01

Oncology nursing is stressful by its nature, and nurses in the field experience a high amount of stress and burnout. In order to cope with occupational stress, nurses need to employ flexible adjustment mechanisms that allow them the power to process their experiences. Failure of efficient stress management causes burnout, and burnout is closely related to powerlessness. It is therefore believed that the occurrence of burnout can be reduced by means of psychological empowerment of nurses. Our study was conducted to determine the effect of a "psychodrama-based psychological empowerment program" on (1) the perception of empowerment and (2) the levels of burnout in oncology nurses. The sample was made up of 82 oncology nurses (38 nurses in the study group and 44 in the control/comparison group). Study data were collected using the Psychological Empowerment Scale, the Nurse Work Empowerment Scale, and Maslach's Burnout Inventory. The study group attended a "psychodrama-based psychological empowerment program" (2 hours, 1 day a week, for 10 weeks). For data assessment, we employed an independent t test and one-way analysis of variance. The psychological empowerment and workplace empowerment scores of nurses in the study group increased and their burnout scores decreased following attendance in the psychodrama-based psychological empowerment program. We found that the psychodrama-based psychological empowerment program increased psychological empowerment and enhanced perception of workplace empowerment while decreasing levels of burnout in oncology nurses. The program is recommended and should allow oncology nurses to benefit from their personal experiences and thus increase self-empowerment, to enhance their perception of empowerment, and to prevent burnout.

AN ADA NAMELIST PACKAGE

NASA Technical Reports Server (NTRS)

Klumpp, A. R.

1994-01-01

The Ada Namelist Package, developed for the Ada programming language, enables a calling program to read and write FORTRAN-style namelist files. A namelist file consists of any number of assignment statements in any order. Features of the Ada Namelist Package are: the handling of any combination of user-defined types; the ability to read vectors, matrices, and slices of vectors and matrices; the handling of mismatches between variables in the namelist file and those in the programmed list of namelist variables; and the ability to avoid searching the entire input file for each variable. The principle user benefits of this software are the following: the ability to write namelist-readable files, the ability to detect most file errors in the initialization phase, a package organization that reduces the number of instantiated units to a few packages rather than to many subprograms, a reduced number of restrictions, and an increased execution speed. The Ada Namelist reads data from an input file into variables declared within a user program. It then writes data from the user program to an output file, printer, or display. The input file contains a sequence of assignment statements in arbitrary order. The output is in namelist-readable form. There is a one-to-one correspondence between namelist I/O statements executed in the user program and variables read or written. Nevertheless, in the input file, mismatches are allowed between assignment statements in the file and the namelist read procedure statements in the user program. The Ada Namelist Package itself is non-generic. However, it has a group of nested generic packages following the nongeneric opening portion. The opening portion declares a variety of useraccessible constants, variables and subprograms. The subprograms are procedures for initializing namelists for reading, reading and writing strings. The subprograms are also functions for analyzing the content of the current dataset and diagnosing errors. Two nested

21 CFR 820.130 - Device packaging.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Device packaging. 820.130 Section 820.130 Food and... QUALITY SYSTEM REGULATION Labeling and Packaging Control § 820.130 Device packaging. Each manufacturer shall ensure that device packaging and shipping containers are designed and constructed to protect the...

Lessons learned from the science of caring: Extending the reach of psychosocial oncology: The International Psycho-Oncology Society 2016 Sutherland Award Lecture.

PubMed

Bultz, Barry D

2017-06-01

In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work, and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment, or end-of-life distress. These observations are usually based on clinical acumen not on metrics. In psychosocial oncology, by committing to the science of caring and relying on the use of standardized tools to screen for distress, the multidisciplinary cancer care team assess, communicate, and intervene on what is measured. That is, health care providers can begin to address the patients' identified concerns. Branding distress as the 6th vital sign and incorporating screening for distress into standard cancer practice can be an effective strategy to challenging the resistance in implementation of psychosocial oncology in cancer care institutions. Accreditation agencies are endorsing the need to assess patient distress and better manage symptoms of distress as part of routine and standardized patient care. While many international organizations and societies support the importance of screening, implementing screening for distress still has a long way to go to be operationalized in many cancer care programs. Screening for distress when implemented does, however, create an opportunity for psychosocial oncology to extend its reach into cancer care programs and institutions. Copyright © 2017 John Wiley & Sons, Ltd.

New Trends and Recent Care Approaches in Pediatric Oncology Nursing

PubMed Central

Toruner, Ebru Kilicarslan; Altay, Naime

2018-01-01

Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches. PMID:29607375

49 CFR 173.459 - Mixing of fissile material packages with non-fissile or fissile-excepted material packages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Mixing of fissile material packages with non... (Radioactive) Materials § 173.459 Mixing of fissile material packages with non-fissile or fissile-excepted material packages. Mixing of fissile material packages with other types of Class 7 (radioactive) materials...

49 CFR 173.459 - Mixing of fissile material packages with non-fissile or fissile-excepted material packages.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Mixing of fissile material packages with non... (Radioactive) Materials § 173.459 Mixing of fissile material packages with non-fissile or fissile-excepted material packages. Mixing of fissile material packages with other types of Class 7 (radioactive) materials...

49 CFR 173.459 - Mixing of fissile material packages with non-fissile or fissile-excepted material packages.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Mixing of fissile material packages with non... (Radioactive) Materials § 173.459 Mixing of fissile material packages with non-fissile or fissile-excepted material packages. Mixing of fissile material packages with other types of Class 7 (radioactive) materials...

49 CFR 173.459 - Mixing of fissile material packages with non-fissile or fissile-excepted material packages.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Mixing of fissile material packages with non... (Radioactive) Materials § 173.459 Mixing of fissile material packages with non-fissile or fissile-excepted material packages. Mixing of fissile material packages with other types of Class 7 (radioactive) materials...

49 CFR 173.459 - Mixing of fissile material packages with non-fissile or fissile-excepted material packages.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Mixing of fissile material packages with non... (Radioactive) Materials § 173.459 Mixing of fissile material packages with non-fissile or fissile-excepted material packages. Mixing of fissile material packages with other types of Class 7 (radioactive) materials...

Metals as radio-enhancers in oncology: The industry perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pottier, Agnés, E-mail: agnes.pottier@nanobiotix.com; Borghi, Elsa; Levy, Laurent

Radio-enhancers, metal-based nanosized agents, could play a key role in oncology. They may unlock the potential of radiotherapy by enhancing the radiation dose deposit within tumors when the ionizing radiation source is ‘on’, while exhibiting chemically inert behavior in cellular and subcellular systems when the radiation beam is ‘off’. Important decision points support the development of these new type of therapeutic agents originated from nanotechnology. Here, we discuss from an industry perspective, the interest of developing radio-enhancer agents to improve tumor control, the relevance of nanotechnology to achieve adequate therapeutic attributes, and present some considerations for their development in oncology.more » - Highlights: • Oncology is a field of high unmet medical need. • Despites of its widespread usage, radiation therapy presents a narrow therapeutic window. • High density material at the nanoscale may enhance radiation dose deposit from cancer cells. • Metal-based nanosized radio-enhancers could unlock the potential of radiotherapy.« less

9 CFR 354.72 - Packaging.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Packaging. 354.72 Section 354.72... CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Supervision of Marking and Packaging § 354.72 Packaging. No container which bears or may bear any official identification or any abbreviation...

Mobile Apps in Oncology: A Survey on Health Care Professionals' Attitude Toward Telemedicine, mHealth, and Oncological Apps.

PubMed

Kessel, Kerstin A; Vogel, Marco Me; Schmidt-Graf, Friederike; Combs, Stephanie E

2016-11-24

Mobile apps are an evolving trend in the medical field. To date, few apps in an oncological context exist. The aim was to analyze the attitude of health care professionals (HCPs) toward telemedicine, mHealth, and mobile apps in the field of oncology. We developed and conducted an online survey with 24 questions evaluating HCPs' general attitude toward telemedicine and patients using medical mobile apps. Specific questions on the possible functionality for patients and the resulting advantages and disadvantages for both the patients' and HCPs' daily clinical routine were evaluated. A total of 108 HCPs completed the survey. In all, 88.9% (96/108) considered telemedicine useful and 84.3% (91/108) supported the idea of an oncological app complementing classical treatment. Automatic reminders, timetables, and assessment of side effects and quality of life during therapy were rated as the most important functions. In contrast, uncertainty regarding medical responsibility and data privacy were reasons mostly named by critics. Most (64.8%, 70/108) were in favor of an alert function due to data input needing further clarification, and 94% (66/70) were willing to contact the patient after a critical alert. In all, 93.5% (101/108) supported the idea of using the collected data for scientific research. Moreover, 75.0% (81/108) believed establishing a mobile app could be beneficial for the providing hospital. A majority of HCPs are in favor of telemedicine and the use of oncological apps by patients. Assessing side effects can lead to quicker response and thus lower inconvenience for patients. Clinical data, such as life quality and treatment satisfaction, could be used to evaluate and improve the therapy workflow. Eventually, a mobile app would enhance the patients' relationship to their treating department because they are in permanent contact. ©Kerstin A Kessel, Marco ME Vogel, Friederike Schmidt-Graf, Stephanie E Combs. Originally published in the Journal of Medical

The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation.

PubMed

Mayer, Simone; Teufel, Martin; Schaeffeler, Norbert; Keim, Ulrike; Garbe, Claus; Eigentler, Thomas Kurt; Zipfel, Stephan; Forschner, Andrea

2017-09-01

Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients' psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients' self-evaluation concerning the need for psycho-oncological support with the results of established screening tools.We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients' subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support.Patients' subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients' self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients' self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included.In addition to the results obtained by screening tools like the DT, we could demonstrate that patients' self-evaluation is an important instrument to identify patients who need psycho-oncological support.

Package for integrated optic circuit and method

DOEpatents

Kravitz, Stanley H.; Hadley, G. Ronald; Warren, Mial E.; Carson, Richard F.; Armendariz, Marcelino G.

1998-01-01

A structure and method for packaging an integrated optic circuit. The package comprises a first wall having a plurality of microlenses formed therein to establish channels of optical communication with an integrated optic circuit within the package. A first registration pattern is provided on an inside surface of one of the walls of the package for alignment and attachment of the integrated optic circuit. The package in one embodiment may further comprise a fiber holder for aligning and attaching a plurality of optical fibers to the package and extending the channels of optical communication to the fibers outside the package. In another embodiment, a fiber holder may be used to hold the fibers and align the fibers to the package. The fiber holder may be detachably connected to the package.

Package for integrated optic circuit and method

DOEpatents

Kravitz, S.H.; Hadley, G.R.; Warren, M.E.; Carson, R.F.; Armendariz, M.G.

1998-08-04

A structure and method are disclosed for packaging an integrated optic circuit. The package comprises a first wall having a plurality of microlenses formed therein to establish channels of optical communication with an integrated optic circuit within the package. A first registration pattern is provided on an inside surface of one of the walls of the package for alignment and attachment of the integrated optic circuit. The package in one embodiment may further comprise a fiber holder for aligning and attaching a plurality of optical fibers to the package and extending the channels of optical communication to the fibers outside the package. In another embodiment, a fiber holder may be used to hold the fibers and align the fibers to the package. The fiber holder may be detachably connected to the package. 6 figs.

Medical Student Oncology Congress: Designed and Implemented by Brazilian Medical Students.

PubMed

de Camargo, Celeste Rodovalho Soares; Schoueri, Jean Henri Maselli; Neto, Felippe Lazar; Segalla, Paola Boaro; Del Giglio, Auro; Cubero, Daniel I G

2017-03-30