End-of-life care of oncology inpatients: Are we getting it right?

PubMed

Batten, Monique; Nguyen, Bella; Burke, Brandon; Harryanto, Hilman; Mitchell, Imogen; Davis, Alison

2018-06-13

To examine the current patterns of end-of-life care of medical oncology patients dying in an Australian tertiary acute hospital setting in order to determine potential areas for improvement. A retrospective observational study was undertaken of 295 consecutive adult medical oncology inpatients dying between 2010 and 2015. Charts were reviewed for evidence of (1) resuscitation plans, (2) acute interventions in the 48-h period prior to death, (3) palliative care involvement and (4) recognition of the dying patient and comfort care plans. At the time of death, 98% of patients had a resuscitation plan, 71% of which were completed by the medical oncology team. Fifty-nine percent of medical emergency team reviews occurred in patients without a documented resuscitation plan. Within 48 h of death, active interventions were still being given to 64% of patients in the total patient population. Comfort care plans were documented in 86% of patients; however, 62% of these were only documented within 48 h of death and 20% of patients with a documented comfort care plan still received noncomfort measures. There was a high level of documented resuscitation plans, comfort care plans and recognition of dying. However, active interventions were common within 48 h of death, and comfort care plans and recognition of dying often occurred late. These data indicate a gap between documenting a resuscitation plan and providing timely and appropriate end-of-life care. Understanding the gaps in delivering appropriate care provides an opportunity for improving end-of-life care. © 2018 John Wiley & Sons Australia, Ltd.

Integrated Information Systems for Electronic Chemotherapy Medication Administration

PubMed Central

Levy, Mia A.; Giuse, Dario A.; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K.

2011-01-01

Introduction: Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. Methods: We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. Results: We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Conclusion: Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations. PMID:22043185

Oncologic profile of maxillary odontogenic myxoma: A rare case.

PubMed

Sarkar, Reena Radhikaprasad

2013-07-01

Odontogenic myxoma (OM) is an ectomesenchyme derived neoplasm, almost exclusively found in jaws. This article presents a maxillary OM with a brief review of the molecular and proteomic antecedents of OMs, capturing its histopathogenesis.

An analysis of electronic document management in oncology care.

PubMed

Poulter, Thomas; Gannon, Brian; Bath, Peter A

2012-06-01

In this research in progress, a reference model for the use of electronic patient record (EPR) systems in oncology is described. The model, termed CICERO, comprises technical and functional components, and emphasises usability, clinical safety and user acceptance. One of the functional components of the model-an electronic document and records management (EDRM) system-is monitored in the course of its deployment at a leading oncology centre in the UK. Specifically, the user requirements and design of the EDRM solution are described.The study is interpretative and forms part a wider research programme to define and validate the CICERO model. Preliminary conclusions confirm the importance of a socio-technical perspective in Onco-EPR system design.

NCI at ASCO: A brief overview on women's cancers

Cancer.gov

The 2014 annual American Society of Clinical Oncology (ASCO) meeting in Chicago in June highlighted results from a number of NCI-supported and -sponsored clinical trial results in women’s cancers. Taken together, these results represent important advances

[Development and integration of the Oncological Documentation System ODS].

PubMed

Raab, G; van Den Bergh, M

2001-08-01

To simplify clinical routine and to improve medical quality without exceeding the existing resources. Intensifying communication and cooperation between all institutions of patients' health care. The huge amount of documentation work of physicians can no longer be done without modern tools of paperless data processing. The development of ODS was a tight cooperation between physician and technician which resulted in a mutual understanding and led to a high level of user convenience. - At present all cases of gynecology, especially gynecologic oncology can be documented and processed by ODS. Users easily will adopt the system as data entry within different program areas follows the same rules. In addition users can choose between an individual input of data and assistants guiding them through highly specific areas of documentation. ODS is a modern, modular structured and very fast multiuser database environment for in- and outpatient documentation. It automatically generates a lot of reports for clinical day to day business. Statistical routines will help the user reflecting his work and its quality. Documentation of clinical trials according to the GCP guidelines can be done by ODS using the internet or offline datasharing. As ODS is the synthesis of a computer based patient administration system and an oncological documentation database, it represents the basis for the construction of the electronical patient chart as well as the digital documentation of clinical trials. The introduction of this new technology to physicians and nurses has to be done slowly and carefully, in order to increase motivation and to improve the results.

An early evaluation of implementation of brief intervention for unhealthy alcohol use in the US Veterans Health Administration

PubMed Central

Williams, Emily C.; Rubinsky, Anna D.; Chavez, Laura J.; Lapham, Gwen T.; Rittmueller, Stacey E.; Achtmeyer, Carol E.; Bradley, Katharine A.

2014-01-01

Aims The US Veterans Health Administration [Veterans Affairs (VA)] used performance measures and electronic clinical reminders to implement brief intervention for unhealthy alcohol use. We evaluated whether documented brief intervention was associated with subsequent changes in drinking during early implementation. Design Observational, retrospective cohort study using secondary clinical and administrative data. Setting Thirty VA facilities. Participants Outpatients who screened positive for unhealthy alcohol use [Alcohol Use Disorders Identification Test Consumption (AUDIT-C ≥ 5)] in the 6 months after the brief intervention performance measure (n = 22 214) and had follow-up screening 9–15 months later (n = 6210; 28%). Measurements Multi-level logistic regression estimated the adjusted prevalence of resolution of unhealthy alcohol use (follow-up AUDIT-C <5 with ≥2 point reduction) for patients with and without documented brief intervention (documented advice to reduce or abstain from drinking). Findings Among 6210 patients with follow-up alcohol screening, 1751 (28%) had brief intervention and 2922 (47%) resolved unhealthy alcohol use at follow-up. Patients with documented brief intervention were older and more likely to have other substance use disorders, mental health conditions, poor health and more severe unhealthy alcohol use than those without (P-values < 0.05). Adjusted prevalences of resolution were 47% [95% confidence interval (CI) = 42–52%] and 48% (95% CI = 42–54%) for patients with and without documented brief intervention, respectively (P = 0.50). Conclusions During early implementation of brief intervention in the US Veterans Health Administration, documented brief intervention was not associated with subsequent changes in drinking among outpatients with unhealthy alcohol use and repeat alcohol screening. PMID:24773590

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

PubMed

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

2017-09-01

One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society. © 2016 John Wiley & Sons Ltd.

If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records.

PubMed

Quinn, Gwendolyn P; Block, Rebecca G; Clayman, Marla L; Kelvin, Joanne; Arvey, Sarah R; Lee, Ji-Hyun; Reinecke, Joyce; Sehovic, Ivana; Jacobsen, Paul B; Reed, Damon; Gonzalez, Luis; Vadaparampil, Susan T; Laronga, Christine; Lee, M Catherine; Pow-Sang, Julio; Eggly, Susan; Franklin, Anna; Shah, Bijal; Fulp, William J; Hayes-Lattin, Brandon

2015-03-01

The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers. All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist. Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001). The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation. Copyright © 2014 by American Society of Clinical Oncology.

Cancer Nanotechnology Plan

Cancer.gov

The Cancer Nanotechnology Plan serves as a strategic document to the NCI Alliance for Nanotechnology in Cancer as well as a guiding document to the cancer nanotechnology and oncology fields, as a whole.

An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology

PubMed Central

Gianfaldoni, Serena; Gianfaldoni, Roberto; Wollina, Uwe; Lotti, Jacopo; Tchernev, Georgi; Lotti, Torello

2017-01-01

For more than a century, radiotherapy has been an effective treatment for oncologic patients. The Authors report a brief history of the radiation therapy and its actual indication for the treatments of cutaneous malignant diseases. PMID:28785349

Documented Brief Intervention Not Associated with Resolution of Unhealthy Alcohol Use One Year Later among VA Patients Living with HIV

PubMed Central

Williams, Emily C.; Lapham, Gwen T.; Bobb, Jennifer F.; Rubinsky, Anna D.; Catz, Sheryl L.; Shortreed, Susan M.; Bensley, Kara M.; Bradley, Katharine A.

2017-01-01

Objective Unhealthy alcohol use is particularly risky for patients living with HIV (PLWH). Brief interventions reduce drinking among patients with unhealthy alcohol use, but whether its receipt in routine outpatient settings is associated with reduced drinking among PLWH with unhealthy alcohol use is unknown. We assessed whether PLWH who screened positive for unhealthy alcohol use were more likely to resolve unhealthy drinking one year later if they had brief alcohol intervention (BI) documented in their electronic health record in a national sample of PLWH from the Veterans Health Administration. Methods Secondary VA clinical and administrative data from the electronic medical record (EMR) were used to identify all positive alcohol screens (AUDIT-C score ≥ 5) documented among PLWH (10/01/09-5/30/13) followed by another alcohol screen documented 9–15 months later. Unadjusted and adjusted Poisson regression models assessed the association between brief intervention (advice to reduce drinking or abstain documented in EMR) and resolution of unhealthy alcohol use (follow-up AUDIT-C <5 with ≥ 2 point reduction). Results Overall 2,101 PLWH with unhealthy drinking (10/01/09-5/30/13) had repeat alcohol screens 9–15 months later. Of those, 77% had brief intervention documented after their first screen, and 61% resolved unhealthy alcohol use at follow-up. Documented brief intervention was not associated with resolution [Adjusted incidence rate ratio 0.96, (95% CI 0.90–1.02)]. Conclusions Documented brief intervention was not associated with resolving unhealthy alcohol use at follow-up screening among VA PLWH with unhealthy alcohol use. Effective methods of resolving unhealthy alcohol use in this vulnerable population are needed. PMID:28554608

Avian Disease and Oncology Laboratory (ADOL) research update

USDA-ARS?s Scientific Manuscript database

GENOMICS To meet the growing demands of consumers, the poultry industry will need to continue to improve methods of selection in breeding programs for production and associated traits. One possible solution is genome-wide marker-assisted selection (GWMAS). In brief, evenly-spaced genetic markers s...

Combining dictionary techniques with extensible markup language (XML)--requirements to a new approach towards flexible and standardized documentation.

PubMed Central

Altmann, U.; Tafazzoli, A. G.; Noelle, G.; Huybrechts, T.; Schweiger, R.; Wächter, W.; Dudeck, J. W.

1999-01-01

In oncology various international and national standards exist for the documentation of different aspects of a disease. Since elements of these standards are repeated in different contexts, a common data dictionary could support consistent representation in any context. For the construction of such a dictionary existing documents have to be worked up in a complex procedure, that considers aspects of hierarchical decomposition of documents and of domain control as well as aspects of user presentation and models of the underlying model of patient data. In contrast to other thesauri, text chunks like definitions or explanations are very important and have to be preserved, since oncologic documentation often means coding and classification on an aggregate level and the safe use of coding systems is an important precondition for comparability of data. This paper discusses the potentials of the use of XML in combination with a dictionary for the promotion and development of standard conformable applications for tumor documentation. PMID:10566311

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.

Psycho-oncology: a brief history and case study.

PubMed

Kurkjian, Natalie; Kurkjian, Carla; Pant, Shubham; Tucker, Phebe

2013-12-01

Ms. W. is a 55-year-old retired Caucasian woman who was diagnosed with esophageal cancer in October 2011. She underwent neoadjuvant chemotherapy with subsequent esophagectomy. She sought psychiatric help after receiving her cancer diagnosis. The field of psycho-oncology was developed to assist cancer patients and caregivers through their "cancer journey" from the time of diagnosis, throughout treatment and beyond. Criteria-defined psychiatric disorder, with adjustment disorder being the most common, is reported in approximately 33% to 50% of cancer patients. These realities have given psychiatry a role in the multi-disciplinary care approach in major cancer centers around the country. In this article, we describe the challenges faced by Ms. W. during her cancer diagnosis and provide a review of the literature in the emerging field of psycho-oncology and its role in the multidisciplinary care of cancer patients.

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

Guidance document publications list - Office of Environmental Policy and Assistance RCRA/CERCLA Division (EH-413)

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

NONE

1995-08-01

This document provides a listing of Guidance Documents from the RCRA/CERCLA Division for August 1995. Documents are listed under the following categories: RCRA Guidance Manuals; RCRA Information Briefs; CERCLA Guidance Manuals; CERCLA Regulatory Bulletins; RCRA/CERCLA Guidance Manuals; TSCA Guidance Manuals; TSCA Information Briefs; and, Cross Cut Manuals.

Awareness and consideration of malnutrition among oncologists: Insights from an exploratory survey.

PubMed

Caccialanza, Riccardo; Cereda, Emanuele; Pinto, Carmine; Cotogni, Paolo; Farina, Gabriella; Gavazzi, Cecilia; Gandini, Chiara; Nardi, Mariateresa; Zagonel, Vittorina; Pedrazzoli, Paolo

2016-09-01

The attitude toward malnutrition varies considerably among oncologists and many malnourished cancer patients receive inadequate nutritional support. The aim of this brief report was to report the results of the exploratory national survey conducted by the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE) before publication of a consensus document aimed at evaluating current attitudes toward malnutrition and management of nutrition, among Italian medical oncologists. Between January and July 2015, the AIOM and the SINPE conducted a national web-based exploratory survey to investigate the attitude of oncologists toward malnutrition, and the management of nutritional support, before publication of an intersociety consensus document. Of the 2375 AIOM members, 135 (5.7%) participated in the survey, with a satisfactory distribution across all Italian regions. Nutritional assessment and support were routinely integrated into patient care for 38 (28%) responders. According to 66 (49%) participants, nutritional assessment was carried out only at the patients' request (n = 62), or not at all (n = 4). Availability of clinical nutritionists was reported by 88 (65%) participants. For 131 responders (97%), nutritional status was decisive (n = 63) or often crucial (n = 68) in assessing whether anticancer treatment was practicable or would be tolerated. The low response rate may reflect the lack of awareness and consideration of nutritional issues among Italian oncologists. Although malnutrition and nutritional support seemed to be perceived by the responders as relevant factors for the efficacy of oncologic treatments, it seems that nutritional care practices may well be inappropriate. The lack of collaboration between oncologists and clinical nutritionists may be the first obstacle to overcome. Educational intersociety initiatives aimed at improving nutritional support management for cancer patients in Italy appear urgently needed. Copyright © 2016 Elsevier Inc. All rights reserved.

The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study.

PubMed

Schutte, Tim; van Eekeren, Rike; Richir, Milan; van Staveren, Jojanneke; van Puijenbroek, Eugène; Tichelaar, Jelle; van Agtmael, Michiel

2018-01-01

In a new prescribing qualification course for specialist oncology nurses, we thought that it is important to emphasize pharmacovigilance and adverse drug reaction (ADR) reporting. We aimed to develop and evaluate an ADR reporting assignment for specialist oncology nurses. The quality of report documentation was assessed with the "Clinical Documentation tool to assess Individual Case Safety Reports" (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses' opinions of the assignment were evaluated using an E-survey. Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were "serious" according to CIOMS criteria. In five cases (15%), the suspect drugs were listed for additional monitoring by EMA and in seven cases (21%), the ADR was not mentioned in the Summary of Product Characteristics. Twenty-five (78.1%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%) and had extensive clinical experience (6-33 years). All agreed or completely agreed that the reporting assignment was useful, that it fitted in daily practice and that it increased their attention for medication/patient safety. A large majority (84.0%) agreed the assignment changed how they dealt with ADRs. Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

Ethics in oncology: principles and responsibilities declared in the Italian Ragusa statement.

PubMed

Gori, Stefania; Pinto, Carmine; Caminiti, Caterina; Aprile, Giuseppe; Marchetti, Paolo; Perrone, Francesco; Di Maio, Massimo; Omodeo Salè, Emanuela; Mancuso, Annamaria; De Cicco, Maurizio; Di Costanzo, Francesco; Crispino, Sergio; Passalacqua, Rodolfo; Merlano, Marco; Zagonel, Vittorina; Fioretto, Luisa; Micallo, Giovanni; Labianca, Roberto; Bordonaro, Roberto; Comandone, Alessandro; Spinsanti, Sandro; Iacono, Carmelo; Nicolis, Fabrizio

2016-12-01

Cancer care involves many ethical issues. The need for more patient-centered healthcare together with the improved empowerment of every person diagnosed with cancer have been transposed by the Italian Association of Medical Oncology (AIOM) and eventually translated in the Ragusa statement. This position paper describes the philosophy that lies beneath this document and its fundamental principles.

[Quality assurance in ENT tumor surgery].

PubMed

Eckel, H E; Streppel, M; Schmalenbach, K; Volling, P; Schrappe, M; Dietz, A; Bootz, F

2000-12-01

Quality control is of special importance in head and neck oncology since the quality of medical care constitutes a vital parameter for the diseased patient. In contrast to other medical specialties, no quality assurance program for head and neck cancer patients has yet been established in Germany. Therefore, a survey was conducted to assess the quality assurance instruments that are in use today in otorhinolaryngology-head and neck (ORL-HNS) centers. In a nationwide survey, questionnaires were sent out to 146 German ORL-HNS departments (the return rate was 75%). 56% of all departments apply dedicated quality assurance processes, and 38% have appointed a formal quality assurance officer. Interdisciplinary oncological conferences are held in the vast majority of all departments with the participation of radiation oncologists in 86 (78%), medical oncologists in 84 (76%), diagnostic radiologists in 82 (74%), and pathologists in 73 (66%). Morbidity-mortality conferences are held in seven departments (6%). A standardized follow-up of oncological patients is carried out in 95 units (86%), and 53 departments use computer-assisted data bases to organize their follow-up data (48%). A wide variety of documentation systems is in use throughout the country: 78 units (71%) offer formal follow-up to their oncological patients. This survey documents a wide-spread interest in quality assurance procedures. Many individual efforts are being undertaken. However, no uniform quality assurance or auditing system is currently in use in Germany nor is a commonly accepted data base available. The ability to offer oncological follow-up within the national social security system is generally considered indispensable for the maintenance of high-quality oncological care in ORL-HNS departments.

Development of the family symptom inventory: a psychosocial screener for children with hematology/oncology conditions.

PubMed

Karlson, Cynthia W; Haynes, Stacey; Faith, Melissa A; Elkin, Thomas D; Smith, Maria L; Megason, Gail

2015-03-01

A growing body of literature has begun to underscore the importance of integrating family-based comprehensive psychological screening into standard medical care for children with oncology and hematology conditions. There are no known family-based measures designed to screen for clinically significant emotional and behavioral concerns in pediatric oncology and hematology patients. The aim of this study was to develop and evaluate the Family Symptom Inventory (FSI), a brief screener of patient and family member psychological symptoms. The FSI also screens for common comorbid physical symptoms (pain and sleep disturbance) and is designed for use at any point during treatment and follow-up. A total of 488 caregivers completed the FSI during regular hematology/oncology visits for 193 cancer, 219 sickle cell disease, and 76 hematology pediatric patients. Exploratory factor analysis, confirmatory factor analysis, and tests of reliability and preliminary validity were conducted. Exploratory factor analysis suggested a 34-item, 4-factor solution, which was confirmed in an independent sample using confirmatory factor analysis (factor loadings=0.49 to 0.88). The FSI demonstrated good internal reliability (α's=0.86 to 0.92) and good preliminary validity. Regular psychosocial screening throughout the course of treatment and follow-up may lead to improved quality of care for children with oncology and hematology conditions.

Assessing Scientific Performance.

ERIC Educational Resources Information Center

Weiner, John M.; And Others

1984-01-01

A method for assessing scientific performance based on relationships displayed numerically in published documents is proposed and illustrated using published documents in pediatric oncology for the period 1979-1982. Contributions of a major clinical investigations group, the Childrens Cancer Study Group, are analyzed. Twenty-nine references are…

Digestive oncologist in the gastroenterology training curriculum

PubMed Central

Mulder, Chris Jacob Johan; Peeters, Marc; Cats, Annemieke; Dahele, Anna; Droste, Jochim Terhaar sive

2011-01-01

Until the late 1980s, gastroenterology (GE) was considered a subspecialty of Internal Medicine. Today, GE also incorporates Hepatology. However, Digestive Oncology training is poorly defined in the Hepatogastroenterology (HGE)-curriculum. Therefore, a Digestive Oncology curriculum should be developed and this document might be a starting point for such a curriculum. HGE-specialists are increasingly resisting the paradigm in which they play only a diagnostic and technical role in the management of digestive tumors. We suggest minimum end-points in the standard HGE-curriculum for oncology, and recommend a focus year in the Netherlands for Digestive Oncology in the HGE-curriculum. To produce well-trained digestive oncologists, an advanced Digestive Oncology training program with specific qualifications in Digestive Oncology (2 years) has been developed. The schedule in Belgium includes a period of at least 6 mo to be spent in a medical oncology department. The goal of these programs remains the production of well-trained digestive oncologists. HGE specialists are part of the multidisciplinary oncological teams, and some have been administering chemotherapy in their countries for years. In this article, we provide a road map for the organization of a proper training in Digestive Oncology. We hope that the World Gastroenterology Organisation and other (inter)national societies will support the necessary certifications for this specific training in the HGE-curriculum. PMID:21556128

Mycobacterium phocaicum bacteremia: an emerging infection in pediatric hematology-oncology patients.

PubMed

Shachor-Meyouhas, Yael; Geffen, Yuval; Arad-Cohen, Nira; Zaidman, Irina; Ben-Barak, Ayelet; Davidson, Sima; Kassis, Imad

2014-12-01

Nontuberculous mycobacteria may cause central venous catheter-associated bacteremia. Between March 2011 and October 2013, 6 cases of Mycobacterium phocaicum bacteremia were found in the pediatric hematology-oncology department. All patients recovered. No positive blood culture was documented after removal of the central venous catheter. All 4 patients with pulsed field gel electrophoresis had the same pattern, different from the water sample, suggesting a common water source.

Prostate Dose Escalation by Innovative Inverse Planning-Driven IMRT

DTIC Science & Technology

2005-11-01

Galvin, J. M.; Low, D.; Palta , J. R.; Rosen, I.; Sharpe, M. B.; Xia, P.; Xiao, Y.; Xing, L.; Yu, C. X., Guidance document on delivery, treatment planning... Palta , J., Implementing IMRT in clinical practice: ajoint document of the American Society for Therapeutic Radiology and Oncology and the American

Synthetic Gene Expression Circuits for Designing Precision Tools in Oncology

PubMed Central

Re, Angela

2017-01-01

Precision medicine in oncology needs to enhance its capabilities to match diagnostic and therapeutic technologies to individual patients. Synthetic biology streamlines the design and construction of functionalized devices through standardization and rational engineering of basic biological elements decoupled from their natural context. Remarkable improvements have opened the prospects for the availability of synthetic devices of enhanced mechanism clarity, robustness, sensitivity, as well as scalability and portability, which might bring new capabilities in precision cancer medicine implementations. In this review, we begin by presenting a brief overview of some of the major advances in the engineering of synthetic genetic circuits aimed to the control of gene expression and operating at the transcriptional, post-transcriptional/translational, and post-translational levels. We then focus on engineering synthetic circuits as an enabling methodology for the successful establishment of precision technologies in oncology. We describe significant advancements in our capabilities to tailor synthetic genetic circuits to specific applications in tumor diagnosis, tumor cell- and gene-based therapy, and drug delivery. PMID:28894736

47 CFR 1.734 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Specifications as to pleadings, briefs, and other documents; subscription. 1.734 Section 1.734 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... submitted both as hard copies and on computer disk formatted to be compatible with the Commission's computer...

47 CFR 1.734 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Specifications as to pleadings, briefs, and other documents; subscription. 1.734 Section 1.734 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... submitted both as hard copies and on computer disk formatted to be compatible with the Commission's computer...

47 CFR 1.734 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Specifications as to pleadings, briefs, and other documents; subscription. 1.734 Section 1.734 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... submitted both as hard copies and on computer disk formatted to be compatible with the Commission's computer...

Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients.

PubMed

Agulnik, Asya; Forbes, Peter W; Stenquist, Nicole; Rodriguez-Galindo, Carlos; Kleinman, Monica

2016-04-01

To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. We performed a retrospective matched case-control study, comparing the highest documented Pediatric Early Warning Score within 24 hours prior to unplanned PICU transfers in hospitalized pediatric oncology and hematopoietic stem cell transplant patients between September 2011 and December 2013. Controls were patients who remained on the inpatient unit and were matched 2:1 using age, condition (oncology vs hematopoietic stem cell transplant), and length of hospital stay. Pediatric Early Warning Scores were documented by nursing staff at least every 4 hours as part of routine care. Need for transfer was determined by a PICU physician called to evaluate the patient. A large tertiary/quaternary free-standing academic children's hospital. One hundred ten hospitalized pediatric oncology patients (42 oncology, 68 hematopoietic stem cell transplant) requiring unplanned PICU transfer and 220 matched controls. None. Using the highest score in the 24 hours prior to transfer for cases and a matched time period for controls, the Pediatric Early Warning Score was highly correlated with the need for PICU transfer overall (area under the receiver operating characteristic = 0.96), and in the oncology and hematopoietic stem cell transplant groups individually (area under the receiver operating characteristic = 0.95 and 0.96, respectively). The difference in Pediatric Early Warning Score results between the cases and controls was noted as early as 24 hours prior to PICU admission. Seventeen patients died (15.4%). Patients with higher Pediatric Early Warning Scores prior to transfer had increased PICU mortality (p = 0.028) and length of stay (p = 0.004). We demonstrate that our institution's Pediatric Early Warning Score is highly correlated with the need for unplanned PICU transfer in hospitalized oncology and hematopoietic stem cell transplant patients. Furthermore, we found an association between higher scores and PICU mortality. This is the first validation of a Pediatric Early Warning Score specific to the pediatric oncology and hematopoietic stem cell transplant populations, and supports the use of Pediatric Early Warning Scores as a method of early identification of clinical deterioration in this high-risk population.

Work-related stress and reward: an Australian study of multidisciplinary pediatric oncology healthcare providers.

PubMed

Bowden, M J; Mukherjee, S; Williams, L K; DeGraves, S; Jackson, M; McCarthy, M C

2015-11-01

Managing staff stress and preventing long-term burnout in oncology staff are highly important for both staff and patient well-being. Research addressing work-related stress in adult oncology is well documented; however, less is known about this topic in the pediatric context. This study examined sources of work-related stress and reward specific to multidisciplinary staff working in pediatric oncology in Australia. Participants were 107 pediatric oncology clinicians, including medical, nursing, and allied health staff from two Australian pediatric oncology centers. Participants completed an online survey using two newly developed measures: the work stressors scale-pediatric oncology and the work rewards scale-pediatric oncology. The most commonly reported sources of both stress and reward are related to patient care and interactions with children. Results indicated that levels of work-related stress and reward were similar between the professional disciplines and between the two hospitals. Regression analyses revealed no demographic or organizational factors that were associated with either stress or reward. Work-related stress and reward are not mutually exclusive; particular situations and events can be simultaneously stressful and rewarding for healthcare providers. Although patient care and interactions with children was found to be the most stressful aspect of working in this speciality, it was also the greatest source of reward. Results are discussed in relation to workplace approaches to staff well-being and stress reduction. Copyright © 2015 John Wiley & Sons, Ltd.

Generic School Grounds Design Brief.

ERIC Educational Resources Information Center

Dorset County Council, Dorchester (England).

This document was produced to provide architects, planners, and builders with an educational design brief for Dorset, England school grounds. The County Education Planning and Development Department will use it as an educational and curriculum statement to complement their more detailed and specific building briefs. The brief uses many of the…

An evaluation system for electronic retrospective analyses in radiation oncology: implemented exemplarily for pancreatic cancer

NASA Astrophysics Data System (ADS)

Kessel, Kerstin A.; Jäger, Andreas; Bohn, Christian; Habermehl, Daniel; Zhang, Lanlan; Engelmann, Uwe; Bougatf, Nina; Bendl, Rolf; Debus, Jürgen; Combs, Stephanie E.

2013-03-01

To date, conducting retrospective clinical analyses is rather difficult and time consuming. Especially in radiation oncology, handling voluminous datasets from various information systems and different documentation styles efficiently is crucial for patient care and research. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using analysis tools connected with a documentation system. A total number of 783 patients have been documented into a professional, web-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported. For patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose-volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are stored in the database and included in statistical calculations. The main goal of using an automatic evaluation system is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the evaluation system to other types of tumors in radiation oncology.

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.

Tracking Patient Education Documentation across Time and Care Settings

PubMed Central

Janousek, Lisa; Heermann, Judith; Eilers, June

2005-01-01

Results of a formative evaluation of a patient education documentation system will be presented. Both quantitative and qualitative approaches to data collection are being used. The goal of integrating patient education documentation into the electronic patient record is to facilitate seamless, multidisciplinary patient/family education across time and settings. The system is being piloted by oncology services at The Nebraska Medical Center. The evaluation addresses the usability and comprehensiveness of the system. PMID:16779280

[Recommendations for the diagnosis, staging and treatment of pre-malignant lesions and pancreatic adenocarcinoma].

PubMed

Martin-Richard, Marta; Ginès, Angels; Ayuso, Juan Ramón; Sabater, Luis; Fabregat, Joan; Mendez, Ramiro; Fernández-Esparrach, Glòria; Molero, Xavier; Vaquero, Eva C; Cuatrecasas, Miriam; Ferrández, Antonio; Maurel, Joan

2016-11-18

Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo. Experts in the field from different specialties (Gastroenterology, Surgery, Radiology, Pathology, Medical Oncology and Radiation Oncology) met to prepare the present document. The current literature was reviewed and discussed, with subsequent deliberation on the evidence. Final recommendations were established in view of all the above. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Characteristics and associations of pain intensity in patients referred to a specialist cancer pain clinic.

PubMed

Pina, Paulo; Sabri, Elham; Lawlor, Peter G

2015-01-01

Uncontrolled cancer pain (CP) may impair quality of life. Given the multidimensional nature of CP, its poor control is often attributed to poor assessment and classification. To determine the characteristics and associations of pain intensity in a specialist CP clinic. Consecutive patients referred to the CP clinic of the Portuguese Cancer Institute (Lisbon, Portugal) had standardized initial assessments and status documentation of the following: Brief Pain Inventory ratings for 'pain now' as the outcome variable; initial pain intensity (iPI) on a 0 to 10 scale; pain mechanism (using the Douleur Neuropathique 4 tool to assess neuropathic pain); episodic pain; Eastern Cooperative Oncology Group rating; oral morphine equivalent daily dose (MEDD); Hospital Anxiety Depression Scale and Emotional Thermometer scores; and cancer diagnosis, metastases, treatment and pain duration. Univariable analyses were conducted to test the association of independent variables with iPI. Variables with P<0.1 were entered into a multivariable regression model, using backward elimination and a cut-point of P=0.2 for final model selection. Of 371 participants, 285 (77%) had moderate (4 to 6) or severe (7 to 10) iPI. The initial median MEDD was relatively low (30 mg [range 20 mg to 60 mg]). In the multivariable model, higher income, Eastern Cooperative Oncology Group rating 3 to 4, cancer diagnosis (head and neck, genitourinary and gastrointestinal), adjuvant use and initial MEDD were associated with iPI (P<0.05). The model's R2 was 18.6, which explained only 19% of iPI variance. The diversity of factors associated with pain intensity and their limited explanation of its variance underscore the biopsychosocial complexity of CP. Adequacy of CP management warrants further exploration.

Quantitative and qualitative analysis of study-related patient information sheets in randomised neuro-oncology phase III-trials.

PubMed

Reinert, Christiane; Kremmler, Lukas; Burock, Susen; Bogdahn, Ulrich; Wick, Wolfgang; Gleiter, Christoph H; Koller, Michael; Hau, Peter

2014-01-01

In randomised controlled trials (RCTs), patient informed consent documents are an essential cornerstone of the study flow. However, these documents are often oversized in format and content. Clinical experience suggests that study information sheets are often not used as an aid to decision-making due to their complexity. We analysed nine patient informed consent documents from clinical neuro-oncological phase III-studies running at a German Brain Tumour Centre with the objective to investigate the quality of these documents. Text length, formal layout, readability, application of ethical and legal requirements, scientific evidence and social aspects were used as rating categories. Results were assessed quantitatively by two independents investigators and were depicted using net diagrams. All patient informed consent documents were of insufficient quality in all categories except that ethical and legal requirements were fulfilled. Notably, graduate levels were required to read and understand five of nine consent documents. Quality deficits were consistent between the individual study information texts. Irrespective of formal aspects, a document that is intended to inform and motivate patients to participate in a study needs to be well-structured and understandable. We therefore strongly mandate to re-design patient informed consent documents in a patient-friendly way. Specifically, standardised components with a scientific foundation should be provided that could be retrieved at various times, adapted to the mode of treatment and the patient's knowledge, and could weigh information dependent of the stage of treatment decision. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of Evidence-Based Nursing Pain Management Practice

PubMed Central

Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

2014-01-01

Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

COSMIC program documentation experience

NASA Technical Reports Server (NTRS)

Kalar, M. C.

1970-01-01

A brief history of COSMIC as it relates to the handling of program documentation is summarized; the items that are essential for computer program documentation are also discussed. COSMIC documentation and program standards handbook is appended.

Tools & Services - SEER Registrars

Cancer.gov

View glossary for registrars. Access ICD conversion programs, SEER Abstracting Tool, SEER Data Viewer, SEER interactive drug database for coding oncology drugs, data documentation, variable recodes, and SEER Application Programming Interface for developers.

Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey.

PubMed

Yu, Hairong; Jiang, Anli; Shen, Jie

2016-05-01

Cancer is a leading cause of death worldwide. Given the complexity of caring work, recent studies have focused on the professional quality of life of oncology nurses. China, the world's largest developing country, faces heavy burdens of care for cancer patients. Chinese oncology nurses may be encountering the negative side of their professional life. However, studies in this field are scarce, and little is known about the prevalence and predictors of oncology nurses' professional quality of life. To describe and explore the prevalence of predictors of professional quality of life (compassion fatigue, burnout and compassion satisfaction) among Chinese oncology nurses under the guidance of two theoretical models. A cross-sectional design with a survey. Ten tertiary hospitals and five secondary hospitals in Shanghai, China. A convenience and cluster sample of 669 oncology nurses was used. All of the nurses worked in oncology departments and had over 1 year of oncology nursing experience. Of the selected nurses, 650 returned valid questionnaires that were used for statistical analyses. The participants completed the demographic and work-related questionnaire, the Chinese version of the Professional Quality of Life Scale for Nurses, the Chinese version of the Jefferson Scales of Empathy, the Simplified Coping Style Questionnaire, the Perceived Social Support Scale, and the Chinese Big Five Personality Inventory brief version. Descriptive statistics, t-tests, one-way analysis of variance, simple and multiple linear regressions were used to determine the predictors of the main research variables. Higher compassion fatigue and burnout were found among oncology nurses who had more years of nursing experience, worked in secondary hospitals and adopted passive coping styles. Cognitive empathy, training and support from organizations were identified as significant protectors, and 'perspective taking' was the strongest predictor of compassion satisfaction, explaining 23.0% of the variance. Personality traits of openness and conscientiousness were positively associated with compassion satisfaction, while neuroticism was a negative predictor, accounting for 24.2% and 19.8% of the variance in compassion fatigue and burnout, respectively. Oncology care has unique features, and oncology nurses may suffer from more work-related stressors compared with other types of nurses. Various predictors can influence the professional quality of life, and some of these should be considered in the Chinese nursing context. The results may provide clues to help nurse administrators identify oncology nurses' vulnerability to compassion fatigue and burnout and develop comprehensive strategies to improve their professional quality of life. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Patient-Centredness, Job Satisfaction and Psychological Distress: a Brief Survey Comparing Oncology Nurses and Doctors.

PubMed

Chan, Caryn Mei Hsien; Wan Ahmad, Wan Azman; Yusof, Mastura Md; Ho, Gwo Fuang; Krupat, Edward

2015-01-01

We aimed to explore whether levels of patient-centredness, job satisfaction and psychological distress varied between oncology nurses and doctors. In a cross-sectional study using self-administered questionnaires, a total of 24 nurses and 43 doctors were assessed for patient-centredness, psychological distress, and job satisfaction using the Patient-Practitioner Orientation Scale, Hospital Anxiety and Depression Scale, and Job Satisfaction Scale. Data were analysed using descriptive statistics, independent samples t-test and MANCOVA, with p<0.05 considered significant. Overall response rate was 95.6% (43/45) for physicians and 85.7% (24/28) for nurses. Even after adjusting for known covariates, our principal finding was that doctors reported greater psychological distress compared to nurses (p=0.009). Doctors also reported lower job satisfaction compared to nurses (p = 0.017), despite higher levels of patient-centredness found in nurses (p=0.001). Findings may be explained in part by differences in job characteristics and demands. Mental health is an important concern not just in cancer patients but among healthcare professionals in oncology.

Brief report on pediatric oncology in Bangladesh

PubMed Central

Islam, Afiqul; Eden, Tim

2013-01-01

Cancer in children is emerging as a significant threat to life as deaths from infections and malnutrition have begun to decrease due to concerted maternal and child health initiatives. Efforts are being made to create a comprehensive service for children with Cancer. The major challenges to be overcome are professional and public awareness, late diagnosis, perceptions of incurablity, treatment refusal and abandonment, toxic deaths and drug costs/inconsistent availability. PMID:24455571

[Database supported electronic retrospective analyses in radiation oncology: establishing a workflow using the example of pancreatic cancer].

PubMed

Kessel, K A; Habermehl, D; Bohn, C; Jäger, A; Floca, R O; Zhang, L; Bougatf, N; Bendl, R; Debus, J; Combs, S E

2012-12-01

Especially in the field of radiation oncology, handling a large variety of voluminous datasets from various information systems in different documentation styles efficiently is crucial for patient care and research. To date, conducting retrospective clinical analyses is rather difficult and time consuming. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using an analysis system connected with a documentation system. A total number of 783 patients have been documented into a professional, database-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported into the web-based system. For 36 patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After an automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are saved in the database and included in statistical calculations. The main goal of using an automatic analysis tool is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the analysis system to other types of tumors in radiation oncology.

Electronic Medical Record-Based Radiation Oncology Toxicity Recording Instrument Aids Benchmarking and Quality Improvement in the Clinic.

PubMed

Albuquerque, Kevin; Rodgers, Kellie; Spangler, Ann; Rahimi, Asal; Willett, DuWayne

2018-03-01

The on-treatment visit (OTV) for radiation oncology is essential for patient management. Radiation toxicities recorded during the OTV may be inconsistent because of the use of free text and the lack of treatment site-specific templates. We developed a radiation oncology toxicity recording instrument (ROTOX) in a health system electronic medical record (EMR). Our aims were to assess improvement in documentation of toxicities and to develop clinic toxicity benchmarks. A ROTOX that was based on National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0) with flow-sheet functionality was developed in the EMR. Improvement in documentation was assessed at various time intervals. High-grade toxicities (ie, grade ≥ 3 by CTCAE) by site were audited to develop benchmarks and to track nursing and physician actions taken in response to these. A random sample of OTV notes from each clinic physician before ROTOX implementation was reviewed and assigned a numerical document quality score (DQS) that was based on completeness and comprehensiveness of toxicity grading. The mean DQS improved from an initial level of 41% to 99% (of the maximum possible DQS) when resampled at 6 months post-ROTOX. This high-level DQS was maintained 3 years after ROTOX implementation at 96% of the maximum. For months 7 to 9 after implementation (during a 3-month period), toxicity grading was recorded in 4,443 OTVs for 698 unique patients; 107 episodes of high-grade toxicity were identified during this period, and toxicity-specific intervention was documented in 95%. An EMR-based ROTOX enables consistent recording of treatment toxicity. In a uniform sample of patients, local population toxicity benchmarks can be developed, and clinic response can be tracked.

Tumor Slice Culture: A New Avatar in Personalized Oncology

DTIC Science & Technology

2017-08-01

official Department of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No...sensitivity and to correlate the results with clinical and molecular data. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT...differences in pre-operative treatments. Indeed, the viability scores significantly correlated with pathologic assessment of tumor viability/necrosis

[ANMCO/AICO/AIOM Consensus document: Clinical and management pathways in cardio-oncology].

PubMed

Tarantini, Luigi; Gulizia, Michele Massimo; Di Lenarda, Andrea; Maurea, Nicola; Abrignani, Maurizio Giuseppe; Bisceglia, Irma; Bovelli, Daniella; De Gennaro, Luisa; Del Sindaco, Donatella; Macera, Francesca; Parrini, Iris; Radini, Donatella; Russo, Giulia; Scardovi, Angela Beatrice; Inno, Alessandro

2017-01-01

In Italy, cardiovascular diseases and cancer are the leading causes of death. Both diseases share the same risk factors and, having the highest incidence and prevalence in the elderly, they often coexist in the same individual. Furthermore, the enhanced survival of cancer patients registered in the last decades and linked to early diagnosis and improvement of care, not infrequently exposes them to the appearance of ominous cardiovascular complications due to the deleterious effects of cancer treatment on the heart and circulatory system. The above considerations have led to the development of a new branch of clinical cardiology based on the principles of multidisciplinary collaboration between cardiologists and oncologists: Cardio-oncology, which aims to find solutions to the prevention, monitoring, diagnosis and treatment of heart damage induced by cancer care in order to pursue, in the individual patient, the best possible care for cancer while minimizing the risk of cardiac toxicity. In this consensus document we provide practical recommendations on how to assess, monitor, treat and supervise the candidate or patient treated with potentially cardiotoxic cancer therapy in order to treat cancer and protect the heart at all stages of the oncological disease.

Quality of narrative operative reports in pancreatic surgery

PubMed Central

Wiebe, Meagan E.; Sandhu, Lakhbir; Takata, Julie L.; Kennedy, Erin D.; Baxter, Nancy N.; Gagliardi, Anna R.; Urbach, David R.; Wei, Alice C.

2013-01-01

Background Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. Methods We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. Results We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13–54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. Conclusion The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care. PMID:24067527

Quality of narrative operative reports in pancreatic surgery.

PubMed

Wiebe, Meagan E; Sandhu, Lakhbir; Takata, Julie L; Kennedy, Erin D; Baxter, Nancy N; Gagliardi, Anna R; Urbach, David R; Wei, Alice C

2013-10-01

Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13-54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care.

Implementation of Electronic Checklists in an Oncology Medical Record: Initial Clinical Experience

PubMed Central

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

2011-01-01

Purpose: The quality of any medical treatment depends on the accurate processing of multiple complex components of information, with proper delivery to the patient. This is true for radiation oncology, in which treatment delivery is as complex as a surgical procedure but more dependent on hardware and software technology. Uncorrected errors, even if small or infrequent, can result in catastrophic consequences for the patient. We developed electronic checklists (ECLs) within the oncology electronic medical record (EMR) and evaluated their use and report on our initial clinical experience. Methods: Using the Mosaiq EMR, we developed checklists within the clinical assessment section. These checklists are based on the process flow of information from one group to another within the clinic and enable the processing, confirmation, and documentation of relevant patient information before the delivery of radiation therapy. The clinical use of the ECL was documented by means of a customized report. Results: Use of ECL has reduced the number of times that physicians were called to the treatment unit. In particular, the ECL has ensured that therapists have a better understanding of the treatment plan before the initiation of treatment. An evaluation of ECL compliance showed that, with additional staff training, > 94% of the records were completed. Conclusion: The ECL can be used to ensure standardization of procedures and documentation that the pretreatment checks have been performed before patient treatment. We believe that the implementation of ECLs will improve patient safety and reduce the likelihood of treatment errors. PMID:22043184

Documentation for the Waste Reduction Model (WARM)

EPA Pesticide Factsheets

This page describes the WARM documentation files and provides links to all documentation files associated with EPA’s Waste Reduction Model (WARM). The page includes a brief summary of the chapters documenting the greenhouse gas emission and energy factors.

Oncology drugs for orphan indications: how are HTA processes evolving for this specific drug category?

PubMed

Adkins, Elizabeth M; Nicholson, Lindsay; Floyd, David; Ratcliffe, Mark; Chevrou-Severac, Helene

2017-01-01

Orphan drugs (ODs) are intended for the diagnosis, prevention, or treatment of rare diseases. Many cancer subtypes, including all childhood cancers, are defined as rare diseases, and over one-third of ODs are now intended to treat oncology indications. However, market access for oncology ODs is becoming increasingly challenging; ODs are prone to significant uncertainty around their cost-effectiveness, while payers must balance the need for these vital innovations with growing sensitivity to rising costs. The objective of this review was to evaluate different mechanisms that have been introduced to facilitate patient access to oncology ODs in five different countries (Australia, Canada, England, France, and Sweden), using eight oncology ODs and non-orphan oncology drugs as examples of their application. A targeted literature review of health technology assessment (HTA) agency websites was undertaken to identify country-specific guidance and HTA documentation for recently evaluated oncology ODs and non-orphan oncology drugs. None of these countries were found to have explicit HTA criteria for the assessment of ODs, and therefore, oncology ODs are assessed through the usual HTA process. However, distinct and additional processes are adopted to facilitate access to oncology ODs. Review of eight case-study drugs showed that these additional assessment processes were rarely used, and decisions were largely driven by proving cost-effectiveness using standard incremental cost-effectiveness ratio (ICER) thresholds. The predominant implication arising from this study is that application of standard HTA criteria to oncology ODs in many countries fails to take into account any uncertainties around their clinical- and cost-effectiveness, resulting in disparities in HTA reimbursement decisions based on differences in addressing or accepting uncertainty. In order to address this issue, HTA agencies should adopt a more flexible approach to cost-effectiveness, as typified by the Tandvårds-och Läkemedelsförmånsverket in Sweden, which takes into account the small patient numbers involved, limited budget impact, and high unmet medical needs.

Oncology drugs for orphan indications: how are HTA processes evolving for this specific drug category?

PubMed Central

Adkins, Elizabeth M; Nicholson, Lindsay; Floyd, David; Ratcliffe, Mark; Chevrou-Severac, Helene

2017-01-01

Orphan drugs (ODs) are intended for the diagnosis, prevention, or treatment of rare diseases. Many cancer subtypes, including all childhood cancers, are defined as rare diseases, and over one-third of ODs are now intended to treat oncology indications. However, market access for oncology ODs is becoming increasingly challenging; ODs are prone to significant uncertainty around their cost-effectiveness, while payers must balance the need for these vital innovations with growing sensitivity to rising costs. The objective of this review was to evaluate different mechanisms that have been introduced to facilitate patient access to oncology ODs in five different countries (Australia, Canada, England, France, and Sweden), using eight oncology ODs and non-orphan oncology drugs as examples of their application. A targeted literature review of health technology assessment (HTA) agency websites was undertaken to identify country-specific guidance and HTA documentation for recently evaluated oncology ODs and non-orphan oncology drugs. None of these countries were found to have explicit HTA criteria for the assessment of ODs, and therefore, oncology ODs are assessed through the usual HTA process. However, distinct and additional processes are adopted to facilitate access to oncology ODs. Review of eight case-study drugs showed that these additional assessment processes were rarely used, and decisions were largely driven by proving cost-effectiveness using standard incremental cost-effectiveness ratio (ICER) thresholds. The predominant implication arising from this study is that application of standard HTA criteria to oncology ODs in many countries fails to take into account any uncertainties around their clinical- and cost-effectiveness, resulting in disparities in HTA reimbursement decisions based on differences in addressing or accepting uncertainty. In order to address this issue, HTA agencies should adopt a more flexible approach to cost-effectiveness, as typified by the Tandvårds-och Läkemedelsförmånsverket in Sweden, which takes into account the small patient numbers involved, limited budget impact, and high unmet medical needs. PMID:28652787

Evaluation of Evidence-based Nursing Pain Management Practice.

PubMed

Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

2015-08-01

It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

PubMed

Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

2016-10-01

To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and establishing a motivated and skilled project or program team. The lack of evaluative data made it difficult to identify the most effective interventions or models of care. The CanIMPACT Casebook documents Canadian efforts to improve or support the coordination of cancer care by PCPs and oncology specialists as a means to improve patient outcomes and cancer system performance. Copyright© the College of Family Physicians of Canada.

Validation of the Persian Version of the Brief Pain Inventory (BPI-P) in Chronic Pain Patients.

PubMed

Majedi, Hossein; Dehghani, S Sharareh; Soleyman-Jahi, Saeed; Emami Meibodi, S Ali; Mireskandari, S Mohammad; Hajiaghababaei, Marzieh; Tafakhori, Abbas; Mendoza, Tito R; Cleeland, Charles S

2017-07-01

Chronic pain needs to be evaluated with a standard instrument. The Brief Pain Inventory (BPI) is a pain assessment tool that has been validated in many languages. The aim of the present study was to develop the Persian version of the Brief Pain Inventory (BPI-P) and also to evaluate the psychometric properties of the BPI-P in the Iranian population. The BPI-P was translated from the original version of BPI using standard procedure. The Persian version of the BPI and 12-item Short-Form Health Survey (SF-12) were completed by 201 patients with chronic pain who were referred to a tertiary pain care clinic from 2013 to 2015. The performance status of the patients was evaluated by physicians using Eastern Cooperative Oncology Group performance test. Factor analysis of the BPI-P identified two scales: pain intensity and pain interference with life. These two factors explained 68.4% of the variance. Coefficient alpha values for BPI-P items ranging from 0.87 to 0.91 showed good internal consistency of the factors. The high intraclass correlation coefficients for the items of the questionnaire confirmed the test-retest reliability for the BPI-P. Patients with higher scores in Eastern Cooperative Oncology Group performance test reported higher levels of pain intensity and pain interference with life. Pain intensity in BPI-P correlated with physical functioning, bodily pain, mental health, and vitality of the SF-12 questionnaire, whereas pain interference was associated with general health, bodily pain, mental health, vitality, and social functioning. The present study demonstrated that the Persian version of the BPI could be a valid and reliable instrument for pain assessment in Persian-speaking patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Management of Hepatoblastoma: ICMR Consensus Document.

PubMed

Agarwala, Sandeep; Gupta, Alisha; Bansal, Deepak; Vora, Tushar; Prasad, Maya; Arora, Brijesh; Kapoor, Gauri; Chinnaswamy, Girish; Radhakrishnan, Venkatraman; Laskar, Siddharth; Kaur, Tanvir; Dhaliwal, Rupinder Singh; Rath, G K; Bakhshi, Sameer

2017-06-01

Dramatic advancement has been made in the management of children with hepatoblastoma (HB) over the past 3 decades owing to the improvement in diagnostic imaging, new chemotherapeutic agents, better surgical care and availability of liver transplantation. These advances are the end results of contributions from 4 major study groups across the globe including International Society of Pediatric Oncology - Liver Tumor Strategy Group (SIOPEL), Children's Oncology Group (COG), German Pediatric Hematology Oncology Group (GPOH) and Japanese Pediatric Liver Tumor Study Group (JPLT). The current manuscript is written with the objective of developing a consensus guideline for practitioners at a National level. Based on literature and personal experience over last 3 decades, the Indian Council of Medical Research (ICMR) Expert group has made recommendations for management of children with HB in resource-challenged nations including India.

Prevention of bacterial infection in pediatric oncology: what do we know, what can we learn?

PubMed

Alexander, Sarah; Nieder, Michael; Zerr, Danielle M; Fisher, Brian T; Dvorak, Christopher C; Sung, Lillian

2012-07-15

Bacterial sepsis continues to be a leading cause of morbidity and toxic death in children receiving intensive therapy for cancer. Empiric therapy for suspected infections and treatment of documented infections are well-established standards of care. The routine use of prophylactic strategies is much less common in pediatric oncology. This paper will review the current literature on the use and risks of antimicrobial prophylaxis as well as non-pharmacological methods for infection prevention and will address areas in need of further research. Copyright © 2011 Wiley Periodicals, Inc.

7 CFR 1753.58 - Closeout documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... followed in the preparation of closeout documents for the FAP. (2) The period between the completion of... documents required to close the FAP are listed in the following table. The following is a brief description...

7 CFR 1753.58 - Closeout documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... followed in the preparation of closeout documents for the FAP. (2) The period between the completion of... documents required to close the FAP are listed in the following table. The following is a brief description...

7 CFR 1753.58 - Closeout documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... followed in the preparation of closeout documents for the FAP. (2) The period between the completion of... documents required to close the FAP are listed in the following table. The following is a brief description...

7 CFR 1753.58 - Closeout documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... followed in the preparation of closeout documents for the FAP. (2) The period between the completion of... documents required to close the FAP are listed in the following table. The following is a brief description...

7 CFR 1753.58 - Closeout documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... followed in the preparation of closeout documents for the FAP. (2) The period between the completion of... documents required to close the FAP are listed in the following table. The following is a brief description...

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

NONE

This large document provides a catalog of the location of large numbers of reports pertaining to the charge of the Presidential Advisory Committee on Human Radiation Research and is arranged as a series of appendices. Titles of the appendices are Appendix A- Records at the Washington National Records Center Reviewed in Whole or Part by DoD Personnel or Advisory Committee Staff; Appendix B- Brief Descriptions of Records Accessions in the Advisory Committee on Human Radiation Experiments (ACHRE) Research Document Collection; Appendix C- Bibliography of Secondary Sources Used by ACHRE; Appendix D- Brief Descriptions of Human Radiation Experiments Identified by ACHRE,more » and Indexes; Appendix E- Documents Cited in the ACHRE Final Report and other Separately Described Materials from the ACHRE Document Collection; Appendix F- Schedule of Advisory Committee Meetings and Meeting Documentation; and Appendix G- Technology Note.« less

[Quality management in oncology supported by clinical cancer registries].

PubMed

Klinkhammer-Schalke, Monika; Gerken, Michael; Barlag, Hagen; Tillack, Anett

2015-01-01

Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising. Copyright © 2015. Published by Elsevier GmbH.

Technical aspects of quality assurance in radiation oncology

PubMed Central

Saw, CB; Ferenci, MS; Wanger, H

2008-01-01

The technical aspects of quality assurance (QA) in radiation oncology as practice in the United States will be reviewed and updated in the spirit of offering the experience to the radiation oncology communities in the Asia-Pacific region. The word “technical” is used to express the organisational components or processes and not the materials within the QA program. A comprehensive QA program in radiation oncology will have an official statement declaring the quality plan for effective patient care services it provides in a document. The QA program will include all aspects of patient care: physical, clinical, and medical aspects of the services. The document will describe the organisational structure, responsibilities, checks and procedures, and resources allocated to ensure the successful implementation of the quality of patient management. Regulatory guidelines and guidelines from accreditation agencies should be incorporated in the QA program to ensure compliance. The organisational structure will have a multidisciplinary QA committee that has the authority to evaluate continuously the effectiveness of the QA program to provide prompt corrective recommendations and to request feedback as needed to monitor the response. The continuous monitoring aspects require meetings to be held at regular intervals with the minutes of the meetings officially recorded and documented. To ensure that a QA program is effective, the program itself should be audited for quality at regular intervals at least annually. It has been recognised that the current QA program has not kept abreast with the rapid implementation of new and advanced radiation therapy technologies with the most recent in image-based radiation therapy technology. The societal bodies (ASTRO and AAPM) and federal agency (NCI) acknowledge this inadequacy and have held workshops to address this issue. The challenges for the societal bodies and federal agency are numerous that include (a) the prescriptive methodology used may not be appropriate for currently implemented new technologies, (b) resources are becoming scarce, (c) advanced radiation therapy technologies have been introduced too rapidly, (d) advances in radiation therapy technologies have become too sophisticated and specialised with each therapy modality having its own separate set of equipment, for example its own dose planning software, computer system and dose delivery systems requiring individualised QA procedures. At the present time, industrial engineers are being recruited to assist in devising a methodology that is broad-based and more process-oriented risk-based formulation of QA in radiation oncology. PMID:21611011

17 CFR 10.102 - Review of initial decisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the appeal with respect to the issues presented, and the reasons therefor, and citations to supporting... answering brief generally shall follow the same style as prescribed for the appeal brief but may omit a... reference citations to the record contained in its brief or in any other document. If an appellee deems it...

Achieving College Success: The Impact of the College Success/STEM Program on Students' Matriculation to and Persistence in College. Research Brief

ERIC Educational Resources Information Center

Lane, Brett; Souvanna, Phomdaen

2014-01-01

This College Success Research Brief is one of a series of briefs documenting the implementation and impact of Mass Insight's College Success/STEM program. The research briefs are intended to share key findings, highlight ongoing questions and lines of inquiry, and inform the thinking of practitioners and policymakers on how to scale up efforts to…

22 CFR 41.105 - Supporting documents and fingerprinting.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Section 41.105 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.105 Supporting documents... receive a nonimmigrant visa. All documents and other evidence presented by the alien, including briefs...

22 CFR 41.105 - Supporting documents and fingerprinting.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Section 41.105 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.105 Supporting documents... receive a nonimmigrant visa. All documents and other evidence presented by the alien, including briefs...

22 CFR 41.105 - Supporting documents and fingerprinting.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Section 41.105 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.105 Supporting documents... receive a nonimmigrant visa. All documents and other evidence presented by the alien, including briefs...

22 CFR 41.105 - Supporting documents and fingerprinting.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Section 41.105 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.105 Supporting documents... receive a nonimmigrant visa. All documents and other evidence presented by the alien, including briefs...

22 CFR 41.105 - Supporting documents and fingerprinting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 41.105 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.105 Supporting documents... receive a nonimmigrant visa. All documents and other evidence presented by the alien, including briefs...

Delegation of medical tasks in French radiation oncology departments: current situation and impact on residents' training.

PubMed

Thureau, S; Challand, T; Bibault, J-E; Biau, J; Cervellera, M; Diaz, O; Faivre, J-C; Fumagalli, I; Leroy, T; Lescut, N; Martin, V; Pichon, B; Riou, O; Dubray, B; Giraud, P; Hennequin, C

2013-10-01

A national survey was conducted among the radiation oncology residents about their clinical activities and responsibilities. The aim was to evaluate the clinical workload and to assess how medical tasks are delegated and supervised. A first questionnaire was administered to radiation oncology residents during a national course. A second questionnaire was mailed to 59 heads of departments. The response rate was 62% for radiation oncology residents (99 questionnaires) and 51% for heads of department (30). Eighteen heads of department (64%) declared having written specifications describing the residents' clinical tasks and roles, while only 31 radiation oncology residents (34%) knew about such a document (P=0.009). A majority of residents were satisfied with the amount of medical tasks that were delegated to them. Older residents complained about insufficient exposure to new patient's consultation, treatment planning and portal images validation. The variations observed between departments may induce heterogeneous trainings and should be addressed specifically. National specifications are necessary to reduce heterogeneities in training, and to insure that the residents' training covers all the professional skills required to practice radiation oncology. A frame endorsed by academic and professional societies would also clarify the responsibilities of both residents and seniors. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Veterinary interventional oncology: from concept to clinic.

PubMed

Weisse, Chick

2015-08-01

Interventional radiology (IR) involves the use of contemporary imaging modalities to gain access to different structures in order to deliver materials for therapeutic purposes. Veterinarians have been expanding the use of these minimally invasive techniques in animals with a variety of conditions involving all of the major body systems. Interventional oncology (IO) is a growing subspecialty of IR in human medicine used (1) to restore patency to malignant obstructions through endoluminal stenting, (2) to provide dose escalations to tumors without increasing systemic chemotherapy toxicities via superselective transarterial chemotherapy delivery, (3) to stop hemorrhage or reduce blood flow to tumors via transarterial embolization or chemoembolization, and (4) to provide therapies for those cancers with no safe or effective alternative options. This review provides a brief introduction to a few of the techniques currently available to veterinarians for cancer treatment. For each technique, the concept for improved palliation, patient quality of life, or tumor control is presented, followed by the most current veterinary clinical information available. Although promising, more studies will be necessary to determine if veterinary IO will provide the same benefits as has already been demonstrated in oncology care in humans. Copyright © 2015 Elsevier Ltd. All rights reserved.

Technical publications catalog : October 2006-September 2007

DOT National Transportation Integrated Search

2008-01-01

This is a comprehensive listing of Turner-Fairbank Highway Research Center research documents published from October 2006 through September 2007, and includes listings of fact sheets, flyers, product briefs, reports, summaries, and TechBriefs.

Technical publications catalog : October 2003-September 2005

DOT National Transportation Integrated Search

2005-01-01

This is a comprehensive listing of Turner-Fairbank Highway Research Center research documents published from October 2003 through September 2005, and includes listings of fact sheets, flyers, product briefs, summaries, and TechBriefs.

Technical publications catalog : October 2007-September 2008

DOT National Transportation Integrated Search

2009-01-01

This is a comprehensive listing of Turner-Fairbank Highway Research Center research documents published from October 2007 through September 2008, and includes listings of fact sheets, flyers, product briefs, reports, summaries, and TechBriefs.

Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward

PubMed Central

Tzolos, Evangelos; Salawu, Abdulazeez

2014-01-01

Phlebitis from peripheral intravenous infusions is an important potential source of oncology patient morbidity. Important factors found to determine phlebitis incidence include the kind of infusion and dwell time of intravenous cannula. Early studies showed incidence rates of between 25–70% worldwide, and association with up to 10% of S. aureus bacteraemia. The introduction of the visual infusion phlebitis (VIP) score tool for assessment of the early signs of phlebitis, along with prompt removal of peripheral intravenous cannulas, has been very successful in reducing the incidence below the acceptable rate of 5%. However, achieving this goal depends on strict compliance with guidelines for cannula insertion, documentation, and assessment using the VIP tool. This study aimed to increase the use of VIP scoring tool to 100% on an oncology ward during a four to six month period in order to maximise its utility in phlebitis prevention. Three plan-do-study-act (PDSA) cycles were carried out, during which two major interventions were introduced. The first cycle aimed to improve junior doctors’ awareness of VIP scoring using presentations in induction meetings and posters. The second cycle ensured that ready access to the VIP tool was provided in the form of bedside intentional rounding charts. Proportions of intravenous cannulas with proper documentation and VIP assessment were measured before intervention and at nine subsequent bi-weekly time points. Pre-intervention, under 30% of cannulas were properly documented and assessed. This proportion rose to around 80% by the end of the second PDSA cycle and achieved 100% by the end of the third cycle. PMID:26734282

Tumor Slice Culture: A New Avatar in Personalized Oncology

DTIC Science & Technology

2017-09-01

of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188...significantly correlated with pathologic assessment of tumor viability/necrosis. We continue to optimize the conditions for TSC by manipulating growth...following exposure to treatments. We are in the process of assessing the pathologic outcome using H&E staining of the treated slices and correlating the

Tumor Slice Culture: A New Avatar in Personalized Oncology

DTIC Science & Technology

2017-09-01

the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public... correlated with pathologic assessment of tumor viability/necrosis. We continue to optimize the conditions for TSC by manipulating growth factors...exposure to treatments. We are in the process of assessing the pathologic outcome using H&E staining of the treated slices and correlating the results

The interferons.

PubMed Central

Toy, J L

1983-01-01

An overview of the interferons is presented. A description of something of what is known about them is given, including: their genes; their protein structures and characteristics; their mechanisms of actions; and their varied biological effects emphasising particularly their immunomodulatory actions. Finally, a brief summary is made of the current status of human clinical studies that have been conducted with interferons in the oncological and viral fields, mentioning also recent findings in patients who have the acquired immunodeficiency syndrome (AIDS). PMID:6193915

The frequency of fibromyalgia syndrome and quality of life in hospitalized cancer patients.

PubMed

Eyigor, S; Karapolat, H; Korkmaz, O K; Eyigor, C; Durmaz, B; Uslu, R; Uyar, M

2009-03-01

To explore the frequency of fibromyalgia syndrome (FMS) among hospitalized cancer patients and address the relationships between pain, fatigue and quality of life with regard to the extent of pain, a cross-sectional and descriptive study was carried out in the Oncology Supportive Care Unit on 122 hospitalized cancer patients. Pain, sleep, disease impact (Fibromyalgia Impact Questionnaire), fatigue (Brief Fatigue Inventory), quality of life (Short Form 36 and European Organization for Research on Treatment of Cancer questionnaires Quality of Life-C30) were gathered using standardized measures. Thirteen of the hospitalized cancer patients (10.7%) included in the study were diagnosed with FMS. There were no statistically significant differences among three pain groups with respect to demographic characteristics (P > 0.05). There were significant differences among groups with regard to the presence of metastasis, fatigue, sleep disorder, pain, Brief Fatigue Inventory, Fibromyalgia Impact Questionnaire, most of subscores of Short Form 36 and European Organization for Research on Treatment of Cancer questionnaires Quality of Life-C30 scores (P < 0.05). In the present study, we have calculated the frequency of FMS among patients admitted to the oncology hospital in addition to establishing the relationships between pain, fatigue and quality of life with regard to the extent of pain. We believe that the descriptive data presented in this study would be helpful in future studies and therapeutic approaches.

Maintenance of Certification for Radiation Oncology

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

Kun, Larry E.; Ang, Kian; Erickson, Beth

2005-06-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements ofmore » the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development.« less

Current Status and Recommendations for the Future of Research, Teaching, and Testing in the Biological Sciences of Radiation Oncology: Report of the American Society for Radiation Oncology Cancer Biology/Radiation Biology Task Force, Executive Summary

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

Wallner, Paul E., E-mail: pwallner@theabr.org; Anscher, Mitchell S.; Barker, Christopher A.

In early 2011, a dialogue was initiated within the Board of Directors (BOD) of the American Society for Radiation Oncology (ASTRO) regarding the future of the basic sciences of the specialty, primarily focused on the current state and potential future direction of basic research within radiation oncology. After consideration of the complexity of the issues involved and the precise nature of the undertaking, in August 2011, the BOD empanelled a Cancer Biology/Radiation Biology Task Force (TF). The TF was charged with developing an accurate snapshot of the current state of basic (preclinical) research in radiation oncology from the perspective ofmore » relevance to the modern clinical practice of radiation oncology as well as the education of our trainees and attending physicians in the biological sciences. The TF was further charged with making suggestions as to critical areas of biological basic research investigation that might be most likely to maintain and build further the scientific foundation and vitality of radiation oncology as an independent and vibrant medical specialty. It was not within the scope of service of the TF to consider the quality of ongoing research efforts within the broader radiation oncology space, to presume to consider their future potential, or to discourage in any way the investigators committed to areas of interest other than those targeted. The TF charge specifically precluded consideration of research issues related to technology, physics, or clinical investigations. This document represents an Executive Summary of the Task Force report.« less

Current status and recommendations for the future of research, teaching, and testing in the biological sciences of radiation oncology: report of the American Society for Radiation Oncology Cancer Biology/Radiation Biology Task Force, executive summary.

PubMed

Wallner, Paul E; Anscher, Mitchell S; Barker, Christopher A; Bassetti, Michael; Bristow, Robert G; Cha, Yong I; Dicker, Adam P; Formenti, Silvia C; Graves, Edward E; Hahn, Stephen M; Hei, Tom K; Kimmelman, Alec C; Kirsch, David G; Kozak, Kevin R; Lawrence, Theodore S; Marples, Brian; McBride, William H; Mikkelsen, Ross B; Park, Catherine C; Weidhaas, Joanne B; Zietman, Anthony L; Steinberg, Michael

2014-01-01

In early 2011, a dialogue was initiated within the Board of Directors (BOD) of the American Society for Radiation Oncology (ASTRO) regarding the future of the basic sciences of the specialty, primarily focused on the current state and potential future direction of basic research within radiation oncology. After consideration of the complexity of the issues involved and the precise nature of the undertaking, in August 2011, the BOD empanelled a Cancer Biology/Radiation Biology Task Force (TF). The TF was charged with developing an accurate snapshot of the current state of basic (preclinical) research in radiation oncology from the perspective of relevance to the modern clinical practice of radiation oncology as well as the education of our trainees and attending physicians in the biological sciences. The TF was further charged with making suggestions as to critical areas of biological basic research investigation that might be most likely to maintain and build further the scientific foundation and vitality of radiation oncology as an independent and vibrant medical specialty. It was not within the scope of service of the TF to consider the quality of ongoing research efforts within the broader radiation oncology space, to presume to consider their future potential, or to discourage in any way the investigators committed to areas of interest other than those targeted. The TF charge specifically precluded consideration of research issues related to technology, physics, or clinical investigations. This document represents an Executive Summary of the Task Force report. Copyright © 2014 Elsevier Inc. All rights reserved.

Validation of a pediatric early warning system for hospitalized pediatric oncology patients in a resource-limited setting.

PubMed

Agulnik, Asya; Méndez Aceituno, Alejandra; Mora Robles, Lupe Nataly; Forbes, Peter W; Soberanis Vasquez, Dora Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Kleinman, Monica; Rodriguez-Galindo, Carlos

2017-12-15

Pediatric oncology patients are at high risk of clinical deterioration, particularly in hospitals with resource limitations. The performance of pediatric early warning systems (PEWS) to identify deterioration has not been assessed in these settings. This study evaluates the validity of PEWS to predict the need for unplanned transfer to the pediatric intensive care unit (PICU) among pediatric oncology patients in a resource-limited hospital. A retrospective case-control study comparing the highest documented and corrected PEWS score before unplanned PICU transfer in pediatric oncology patients (129 cases) with matched controls (those not requiring PICU care) was performed. Documented and corrected PEWS scores were found to be highly correlated with the need for PICU transfer (area under the receiver operating characteristic, 0.940 and 0.930, respectively). PEWS scores increased 24 hours prior to unplanned transfer (P = .0006). In cases, organ dysfunction at the time of PICU admission correlated with maximum PEWS score (correlation coefficient, 0.26; P = .003), patients with PEWS results ≥4 had a higher Pediatric Index of Mortality 2 (PIM2) (P = .028), and PEWS results were higher in patients with septic shock (P = .01). The PICU mortality rate was 17.1%; nonsurvivors had higher mean PEWS scores before PICU transfer (P = .0009). A single-point increase in the PEWS score increased the odds of mechanical ventilation or vasopressors within the first 24 hours and during PICU admission (odds ratio 1.3-1.4). PEWS accurately predicted the need for unplanned PICU transfer in pediatric oncology patients in this resource-limited setting, with abnormal results beginning 24 hours before PICU admission and higher scores predicting the severity of illness at the time of PICU admission, need for PICU interventions, and mortality. These results demonstrate that PEWS aid in the identification of clinical deterioration in this high-risk population, regardless of a hospital's resource-level. Cancer 2017;123:4903-13. © 2017 American Cancer Society. © 2017 American Cancer Society.

EURECCA colorectal: multidisciplinary management: European consensus conference colon & rectum.

PubMed

van de Velde, Cornelis J H; Boelens, Petra G; Borras, Josep M; Coebergh, Jan-Willem; Cervantes, Andres; Blomqvist, Lennart; Beets-Tan, Regina G H; van den Broek, Colette B M; Brown, Gina; Van Cutsem, Eric; Espin, Eloy; Haustermans, Karin; Glimelius, Bengt; Iversen, Lene H; van Krieken, J Han; Marijnen, Corrie A M; Henning, Geoffrey; Gore-Booth, Jola; Meldolesi, Elisa; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm; Schmoll, Hans J; Smith, Jason J; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Wiggers, Theo; Gambacorta, Maria A; Aristei, Cynthia; Valentini, Vincenzo

2014-01-01

Care for patients with colon and rectal cancer has improved in the last 20years; however considerable variation still exists in cancer management and outcome between European countries. Large variation is also apparent between national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which is the acronym of European Registration of Cancer Care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012, the first multidisciplinary consensus conference about cancer of the colon and rectum was held. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Consensus was achieved using the Delphi method. For the Delphi process, multidisciplinary experts were invited to comment and vote three web-based online voting rounds and to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. This manuscript covers all sentences of the consensus document with the result of the voting. The consensus document represents sections on diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and metastatic colorectal disease separately. Moreover, evidence based algorithms for diagnostics and treatment were composed which were also submitted to the Delphi process. The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members. Multidisciplinary consensus on key diagnostic and treatment issues for colon and rectal cancer management using the Delphi method was successful. This consensus document embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe. Copyright © 2013 Elsevier Ltd. All rights reserved.

Major clinical research advances in gynecologic cancer in 2017.

PubMed

Suh, Dong Hoon; Kim, Miseon; Lee, Kyung Hun; Eom, Keun Yong; Kjeldsen, Maj Kamille; Mirza, Mansoor Raza; Kim, Jae Weon

2018-03-01

In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer. For ovarian cancer, 5 topics were selected including poly(ADP-ribose) polymerases inhibitors and immunotherapy. The other potential practice changers covered in this review were lymphadenectomy in advanced disease, secondary cytoreductive surgery in recurrent disease, weekly dose-dense regimen for first-line chemotherapy, incorporation of bevacizumab maintenance in platinum-sensitive recurrent disease, and effect of platinum-free interval prolongation. Conflicting opinions of academic societies on periodic pelvic examination were introduced in conjunction with relevant literature review. For the field of radiation oncology, results of 2 big trials, The Postoperative Radiation Therapy in Endometrial Carcinoma-3 and Gynecologic Oncology Group-258, for endometrial cancer and recent advance in high-dose-rate brachytherapy for cervical cancer were reported. Topics for breast cancer covered adjuvant capecitabine after preoperative chemotherapy, adjuvant pertuzumab and trastuzumab in early human epidermal growth factor receptor 2-positive disease, olaparib for metastatic cancer in patients with a germline BRCA mutation, 20-year risks of recurrence after stopping endocrine therapy at 5 years, and contemporary hormonal contraception and the risk of breast cancer. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

Drought Resilience and Water Conservation Technical Brief

EPA Pesticide Factsheets

In many areas of the US, the frequency, intensity, and duration of drought events are increasing, this brief highlights EPA drought and conservation activities across the nation and includes links to additional materials and reference documents.

2013-2014 National Health Law Moot Court Competition Best Brief.

PubMed

Robinson DeShon, Jessica; Jackson, Brandon; Ward, Matthew

2014-01-01

This document was judged Best Brief submitted to the 2013–2014 National Health Law Moot Court Competition. The brief was submitted by students Jessica Robinson DeShon, Brandon Jackson, and Matthew Ward on behalf of Faulkner University School of Law in Montgomery, Alabama. Address correspondence to Professor Joe Lester at Jlester@Faulkner.edu.

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

The role of tumor board conferences in neuro-oncology: a nationwide provider survey.

PubMed

Snyder, James; Schultz, Lonni; Walbert, Tobias

2017-05-01

The tumor board or multidisciplinary cancer meeting (MCM) is the foundation of high value multidisciplinary oncology care, coordinating teams of specialists. Little is known on how these meetings are implemented in Neuro-oncology. Benefits of MCMs include coordination, direction for complicated cases, education, and a forum for communication, emerging technology, and clinical trials. This study identifies participation and utilization of neuro-oncology MCMs. A cross-sectional descriptive survey was dispersed through an internet questionnaire. The Society of Neuro-Oncology and the American Brain Tumor Association provided a list of dedicated neuro-oncology centers. All National Cancer Institute designated centers, and participants in the Adult Brain Tumor Consortium or the Brain Tumor Trials Collaborative were included, identifying 85 centers. Discussion included primary brain tumors (100%), challenging cases (98%), recurrent disease (96%), neoplastic spine disease (93%), metastatic brain lesions (89%), pre-surgical cases (82%), pathology (76%), and paraneoplastic disease (40%). MCMs were composed of neuro-oncologists, neurosurgeons, and radiation oncologists (100%), radiologists (98%), pathologists (96%), and clinical trial participants (64%). Individual preparation ranged from 15 to 300 min. MCMs were valued for clinical decision making (94%), education (89%), and access to clinical trials (69%). 13% documented MCMs in the medical record. 38% of centers used a molecular tumor board; however, many commented with uncertainty as to how this is defined. Neuro-oncology MCMs at leading U.S. institutions demonstrate congruity of core disciplines, cases discussed, and perceived value. We identified variability in preparation time and implementation of MCM recommendations. There is high uncertainty as to the definition and application of a molecular tumor board.

Policy statement on multidisciplinary cancer care.

PubMed

Borras, Josep M; Albreht, Tit; Audisio, Riccardo; Briers, Erik; Casali, Paolo; Esperou, Hélène; Grube, Birgitte; Hamoir, Marc; Henning, Geoffrey; Kelly, Joan; Knox, Susan; Nabal, Maria; Pierotti, Marco; Lombardo, Claudio; van Harten, Wim; Poston, Graeme; Prades, Joan; Sant, Milena; Travado, Luzia; Valentini, Vincenzo; van de Velde, Cornelis; van den Bogaert, Saskia; van den Bulcke, Marc; van Hoof, Elke; van den Neucker, Ingrid; Wilson, Robin

2014-02-01

Cancer care is undergoing an important paradigm shift from a disease-focused management to a patient-centred approach, in which increasingly more attention is paid to psychosocial aspects, quality of life, patients' rights and empowerment and survivorship. In this context, multidisciplinary teams emerge as a practical necessity for optimal coordination among health professionals and clear communication with patients. The European Partnership for Action Against Cancer (EPAAC), an initiative launched by the European Commission in 2009, addressed the multidisciplinary care from a policy perspective in order to define the core elements that all tumour-based multidisciplinary teams (MDTs) should include. To that effect, a working group conference was held in January 2013 within the EPAAC Work Package 7 (on Healthcare) framework. The consensus group consisted of high-level representatives from the following European scientific societies, patient associations and stakeholders: European CanCer Organisation (ECCO), European SocieTy for Radiology & Oncology (ESTRO), European Society for Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), International Society of Geriatric Oncology (SIOG), European Association for Palliative Care (EAPC), European Oncology Nursing Society (EONS), International Psycho-Oncology Society (IPOS),European Cancer Patient Coalition (ECPC), EuropaColon, Europa Donna - The European Breast Cancer Coalition, Association of European Cancer Leagues (ECL), Organisation of European Cancer Institutes (OECI), EUSOMA - European Society of Breast Cancer Specialists, European Hospital and Healthcare Federation (HOPE) and EPAAC Work Packages 5 (Health promotion and prevention), 7, 8 (Research), 9 (Information systems) and 10 (Cancer plans). A background document with a list of 26 core issues drawn from a systematic review of the literature was used to guide the discussion. Five areas related to MDTs were covered: care objectives, organisation, clinical assessment, patients' rights and empowerment and policy support. Preliminary drafts of the document were widely circulated for consultation and amendments by the working group before final approval. The working group unanimously formulated a Policy Statement on Multidisciplinary Cancer Care to define the core elements that should be implemented by all tumour-based MDTs. This document identifies MDTs as the core component in cancer care organisation and sets down the key elements to guide changes across all European health systems. MDTs are an essential instrument of effective cancer care policy, and their continued development crucial to providing patients the care they need and deserve. While implementation must remain in local hands, European health systems can still benefit from having a basis for an effective multidisciplinary model of cooperation. This policy statement is intended to serve as a reference for policymakers and healthcare providers who wish to improve the services currently provided to the cancer patients whose lives and well-being depend on their action. Copyright © 2013 Elsevier Ltd. All rights reserved.

Environmental Research Brief: Predicting Movement Of Selected Metals In Soil Application To Disposal Problems

EPA Science Inventory

This research brief was developed by EPA's Risk Reduction Engineering Laboratory , Cincinnati, OH, to announce key findings of the research projects that are fully documented in separate reports and journal articles.

Enhancing Hormonal Therapy for Breast Cancer by Combination with a Well-Known Approved Pharmaceutical with Little Toxicity

DTIC Science & Technology

2008-07-01

node- positive , and estrogen receptor- positive breast cancer patients : a Southwest Oncology Group study. J Clin Oncol 12(10):2078–2085 7. Woods KE...official Department of the Army position , policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form...ER) positive metastatic breast cancer are limited by the phenomenon of hormonal resistance. We have found that valproic acid (VPA), a pharmaceutical

Authorship in Radiation Oncology: Proliferation Trends Over 30 Years

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

Ojerholm, Eric, E-mail: eric.ojerholm@uphs.upenn.edu; Swisher-McClure, Samuel

Purpose: To investigate authorship trends in the radiation oncology literature. Methods and Materials: 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. Results: 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).more » 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. Conclusions: 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.« less

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.

Photodynamic therapy with topical photosensitizers in mucosal and semimucosal areas: review from a dermatologic perspective.

PubMed

Grandi, Vieri; Sessa, Maurizio; Pisano, Luigi; Rossi, Riccardo; Galvan, Arturo; Gattai, Riccardo; Mori, Moira; Tiradritti, Luana; Bacci, Stefano; Zuccati, Giuliano; Cappugi, Pietro; Pimpinelli, Nicola

2018-04-15

Photodynamic Therapy is a procedure based on the interaction between a Photo Sensitizer, a light source with a specific wavelength and oxygen. Aim of this Review is to provide a brief and updated analysis of scientific reports of the use of PDT with topical PS in the management of oncological, infectious, and inflammatory disorders involving mucosal and semimucosal areas, with a specific focus on diseases of dermatologic interest. Copyright © 2018. Published by Elsevier B.V.

Diffusion weighted magnetic resonance imaging and its recent trend—a survey

PubMed Central

Chilla, Geetha Soujanya; Tan, Cher Heng

2015-01-01

Since its inception in 1985, diffusion weighted magnetic resonance imaging has been evolving and is becoming instrumental in diagnosis and investigation of tissue functions in various organs including brain, cartilage, and liver. Even though brain related pathology and/or investigation remains as the main application, diffusion weighted magnetic resonance imaging (DWI) is becoming a standard in oncology and in several other applications. This review article provides a brief introduction of diffusion weighted magnetic resonance imaging, challenges involved and recent advancements. PMID:26029644

Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

PubMed

Cortez, Susan; Dietrich, Mary S; Wells, Nancy

2016-07-01

To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

Designing Flightdeck Procedures

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Mauro, Robert; Degani, Asaf; Loukopoulou, Loukia

2016-01-01

The primary goal of this document is to provide guidance on how to design, implement, and evaluate flight deck procedures. It provides a process for developing procedures that meet clear and specific requirements. This document provides a brief overview of: 1) the requirements for procedures, 2) a process for the design of procedures, and 3) a process for the design of checklists. The brief overview is followed by amplified procedures that follow the above steps and provide details for the proper design, implementation and evaluation of good flight deck procedures and checklists.

Protocol for selecting ASR-affected structures for lithium treatment

DOT National Transportation Integrated Search

2006-02-01

This TechBrief describes a protocol for evaluating damaged concrete structures to determine whether they are suitable candidates for lithium treatment to address alkali-silica reactivity (ASR). A major part of the TechBrief's source document, Protoco...

Workload Impact of Medical Subspecialties in the Teaching Hospital

ERIC Educational Resources Information Center

Van Peenen, Hubert J.

1973-01-01

This paper documents, using a single test as a model, the significant increase in clinical laboratory workload which occurred in a university hospital when strong sections of nephrology, hematology-oncology, and immunology-rheumatology were added to the department of medicine. (Author)

A Prospective Cohort Quality Improvement Study to Reduce the Time to Antibiotics for New Fever in Neutropenic Pediatric Oncology Inpatients.

PubMed

Green, Adam L; Yi, Joanna; Bezler, Natalie; Pikman, Yana; Tubman, Venée N; Obeng, Esther A; O'Neil, Teresa; Mersereau, Robert; Morrissey, Lisa; Billett, Amy L

2016-01-01

Fever and neutropenia (F&N) is a pediatric oncology emergency due to the risk of disseminated infection. Quality improvement (QI) efforts to improve time to antibiotics for F&N in the emergency department have been documented, but the issue has not been studied in the established inpatient setting. We undertook a prospective cohort QI study to decrease time to antibiotics for neutropenic pediatric oncology inpatients with new fever to <60 min. Our key intervention was discussion of a plan in case of new fever, including antibiotic(s) to be started, for each patient on rounds. Timing for each step in the process, from fever identification to antibiotic administration, was measured through the electronic medical record for each fever event. The median time to antibiotics during the 3-three month intervention study period was 76.0 min, although the distribution was skewed due to several long outliers (mean 142.5, interquartile range 51-206, range 47-593 min). Time to antibiotics was significantly shorter when a fever contingency plan was documented in the most recent note than not (mean 102 vs. 254 min, P = 0.039). Over the total 2.75 year data-collection period, the quarterly percentage of patients receiving antibiotics within 60 min has improved from 35 to 65, whereas quarterly mean time to antibiotics has improved from 99 to 50 min. Daily discussion of a fever contingency plan appears effective in decreasing the time to antibiotics for neutropenic pediatric oncology inpatients with new fever, likely by circumventing the need for multi-level discussion of the antibiotic plan when fever is identified. © 2015 Wiley Periodicals, Inc.

Managed Entry Agreements for Oncology Drugs: Lessons from the European Experience to Inform the Future

PubMed Central

Pauwels, Kim; Huys, Isabelle; Vogler, Sabine; Casteels, Minne; Simoens, Steven

2017-01-01

Objectives: The aim of this study is to conduct an analysis on the regulation and application of managed entry agreements (MEA) for oncology drugs across different European countries. Methods: Literature search and document analysis were performed between September 2015 and June 2016 to collect information on the regulatory framework and practice of MEA in Belgium, The Netherlands, Scotland, England and Wales, Sweden, Italy, Czech Republic and France. An overview of the content and typology of MEA applied for oncology drugs between 2008 and 2015 was generated based on publically available sources and contributions by national health authorities. Semi-structured interviews were conducted with representatives of national health authorities involved in the management or negotiation of MEA. Results: The application of MEA differs across countries and across different indications for the same drug. Financial based agreements are prevailing due to their simplicity compared to performance-based agreements. Performance-based agreements are less commonly applied in the European countries except for Italy. In the Netherlands, application of performance-based agreements was stopped due to their inability to deal with dynamics in the market, which is highly relevant for oncology drugs. Conclusions: MEA constitute a common policy tool that public payers in European countries use to ensure early access to highly priced oncology drugs. In light of strengths and weaknesses observed for MEA and the expected developments in the oncology area, the importance of MEA is likely to grow in the future. PMID:28420990

Object-oriented business process analysis of the cooperative soft tissue sarcoma trial of the german society for paediatric oncology and haematology (GPOH).

PubMed

Weber, R; Knaup, P; Knietitg, R; Haux, R; Merzweiler, A; Mludek, V; Schilling, F H; Wiedemann, T

2001-01-01

The German Society for Paediatric Oncology and Haematology (GPOH) runs nation-wide multicentre clinical trials to improve the treatment of children suffering from malignant diseases. We want to provide methods and tools to support the centres of these trials in developing trial specific modules for the computer-based DOcumentation System for Paediatric Oncology (DOSPO). For this we carried out an object-oriented business process analysis for the Cooperative Soft Tissue Sarcoma Trial at the Olgahospital Stuttgart for Child and Adolescent Medicine. The result is a comprehensive business process model consisting of UML-diagrams and use case specifications. We recommend the object-oriented business process analysis as a method for the definition of requirements in information processing projects in the field of clinical trials in general. For this our model can serve as basis because it slightly can be adjusted to each type of clinical trial.

External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

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

Shakespeare, Thomas P.; Back, Michael F.; Lu, Jiade J.

2006-03-01

Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/qualitymore » assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs.« less

Briefing Book for Education.

ERIC Educational Resources Information Center

National Governors' Association, Washington, DC.

This document presents briefing papers for the seven gubernatorial task forces proposed in the National Governors' Association Action Plan for Attaining Educational Excellence. An introductory section discusses the complementary responsibilities of Federal, State, and local governments for assuring access to educational opportunities for all…

Phase II Study Proposal Briefs.

ERIC Educational Resources Information Center

National Center for the Study of Postsecondary Educational Supports, Honolulu, HI.

This document collects 23 study proposal briefs presented to the National Center for the Study of Postsecondary Educational Supports. The proposals address the following topics concerned with postsecondary services for students with disabilities: cultural empowerment, longitudinal analysis of postsecondary students' experience, effective models of…

GATEWAY Report Brief: SSL Demonstration: Long-Term Evaluation of Indoor Field Performance

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

None, None

Report brief summarizing a GATEWAY program evaluation of the long-term performance characteristics (chromaticity change, maintained illuminance, and operations and maintenance) of LED lighting systems in four field installations previously documented in separate DOE GATEWAY reports.

Therapists in Oncology Settings

ERIC Educational Resources Information Center

Hendrick, Susan S.

2013-01-01

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

Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma.

PubMed

Batra, U; Parikh, P M; Prabhash, K; Tongaonkar, H B; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, S K; Rajappa, S; Rajendranath, R; Rawal, S K; Singh, Manisha; Singh, R; Somashekhar, S P; Sood, R

2016-01-01

The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of "Take Home Messages" at the end is a convenient tool for busy practitioners.

Documenting Collective Development in Online Settings

ERIC Educational Resources Information Center

Dean, Chrystal; Silverman, Jason

2015-01-01

In this paper the authors explored the question of collective understanding in online mathematics education settings and presented a brief overview of traditional methods for documenting norms and collective mathematical practices. A method for documenting collective development was proposed that builds on existing methods and frameworks yet is…

Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters.

PubMed

Traeger, Lara; Park, Elyse R; Sporn, Nora; Repper-DeLisi, Jennifer; Convery, Mary Susan; Jacobo, Michelle; Pirl, William F

2013-07-01

To reduce workplace stress by developing a brief psychological skills training for nurses and to evaluate program feasibility, acceptability, and preliminary efficacy in decreasing burnout and stress. Intervention development and evaluation. Outpatient chemotherapy unit at a comprehensive cancer center. 26 infusion nurses and oncology social workers. Focus groups were conducted with nurses. Results informed the development and evaluation of training for nurses. Participants completed the Maslach Burnout Inventory and Perceived Stress Scale post-training. Burnout and stress. Focus groups indicated strong commitment among nurses to psychosocial care and supported the idea that relationships with patients and families were sources of reward and stress. Stressors included factors that interfered with psychosocial care such as difficult family dynamics, patient behaviors and end-of-life care issues. Psychological skills training was developed to address these stressors. Evaluations suggested that the program was feasible and acceptable to nurses. At two months, participants showed reductions in emotional exhaustion (p = 0.02) and stress (p = 0.04). Psychological skills training for managing difficult encounters showed feasibility, acceptability, and potential benefit in reducing emotional exhaustion and stress. Brief training that targets sources of clinical stress may be useful for nurses in outpatient chemotherapy units. Specific stressors in relationships with patients and families present challenges to nurses' therapeutic use of self. Targeted psychological skills training may help nurses problem-solve difficult encounters while taking care of themselves. System-level strategies are needed to support and promote training participation.

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.

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... as to the contents and style of briefs. (2) Papers may be reproduced by any duplicating process...

Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations.

PubMed

Prabhu, Arpan V; Hansberry, David R; Agarwal, Nitin; Clump, David A; Heron, Dwight E

2016-11-01

Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive and efficient. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Gestalt Theory to Teach Document Design and Graphics.

ERIC Educational Resources Information Center

Moore, Patrick; Fitz, Chad

1993-01-01

Presents a brief overview of Gestalt theory. Discusses and illustrates six key principles of Gestalt psychology as they apply to document design and graphics. Presents exercise that students may use to improve their understanding of the principles and develop their document design skills. Distinguishes between Gestalt theory and rhetoric. (RS)

Finance issue brief: medical necessity: year end report-2003.

PubMed

MacEachern, Lillian

2003-12-31

The information in this issue brief is based on a 50--state survey and a recent literature review. The Health Policy Tracking Service recognizes the complexity of this issue and discourages the use of this document as a sole resource on the issue.

Finance issue brief: medical necessity: year end report-2002.

PubMed

Morgan, Rachel; MacEachern, Lillian

2002-12-31

The information in this issue brief is based on a 50--state survey and a recent literature review. The Health Policy Tracking Service recognizes the complexity of this issue and discourages the use of this document as a sole resource on the issue.

Moving survivorship care plans forward: focus on care coordination.

PubMed

Salz, Talya; Baxi, Shrujal

2016-07-01

After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Briefing Number 3 to Space Station Operations Task Force Oversight Committee

NASA Technical Reports Server (NTRS)

Lyman, Peter; Shelley, Carl

1987-01-01

This document reviews certain issues in relationship to the operation of the Space Station Freedom. The document is in outline format and includes some organizational hierarchy charts, pert charts and decision charts.

DATAS Hardware Diagnostic Tests

DOT National Transportation Integrated Search

1990-10-01

This document is reference material for personnel using the Data Link and : Analysis System (DATAS) for hardware diagnostic testing. Included in this : document is a brief overall description of the DATAS, and a thorough : description of how to opera...

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.

Outcomes of Computerized Physician Order Entry in an Electronic Health Record After Implementation in an Outpatient Oncology Setting

PubMed Central

Harshberger, Cara A.; Harper, Abigail J.; Carro, George W.; Spath, Wayne E.; Hui, Wendy C.; Lawton, Jessica M.; Brockstein, Bruce E.

2011-01-01

Purpose: Computerized physician order entry (CPOE) in electronic health records (EHR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after implementation of an outpatient oncology EHR/ CPOE system in a hospital-based outpatient cancer center within three treatment sites. Methods: This study is a retrospective chart review of 90 patients who received one of the following regimens between 1999 and 2006: FOLFOX, AC, carboplatin + paclitaxel, ABVD, cisplatin + etoposide, R-CHOP, and clinical trials. Documentation completeness scores were assigned to each chart based on the number of documented data points found out of the total data points assessed. EHR/CPOE documentation completeness was compared with completeness of paper charts orders of the same regimens. A user satisfaction survey of the paper chart and EHR/CPOE system was conducted among the physicians, nurses, and pharmacists who worked with both systems. Results: The mean percentage of identified data points successfully found in the EHR/CPOE charts was 93% versus 67% in the paper charts (P < .001). Regimen complexity did not alter the number of data points found. The survey response rate was 64%, and the results showed that satisfaction was statistically significant in favor of the EHR/CPOE system. Conclusion: Using EHR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. EHR/CPOE requires constant vigilance and maintenance to optimize patient safety. PMID:22043187

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 incorporating prior knowledge, using information-theoretic techniques to modern ensemble machine learning approaches or combination of these. We will particularly discuss the pros and cons of different approaches to improve mining of big data in oncology. Copyright © 2016 Elsevier Inc. All rights reserved.

Resilience in adults with cancer: development of a conceptual model.

PubMed

Deshields, Teresa L; Heiland, Mark F; Kracen, Amanda C; Dua, Priya

2016-01-01

Resilience is a construct addressed in the psycho-oncology literature and is especially relevant to cancer survivorship. The purpose of this paper is to propose a model for resilience that is specific to adults diagnosed with cancer. To establish the proposed model, a brief review of the various definitions of resilience and of the resilience literature in oncology is provided. The proposed model includes baseline attributes (personal and environmental) which impact how an individual responds to an adverse event, which in this paper is cancer-related. The survivor has an initial response that fits somewhere on the distress-resilience continuum; however, post-cancer experiences (and interventions) can modify the initial response through a process of recalibration. The literature reviewed indicates that resilience is a common response to cancer diagnosis or treatment. The proposed model supports the view of resilience as both an outcome and a dynamic process. Given the process of recalibration, a discussion is provided of interventions that might facilitate resilience in adults with cancer. Copyright © 2015 John Wiley & Sons, Ltd.

Concomitant weekly cisplatin and thoracic radiotherapy for Pancoast tumors of the lung: pilot experience of the San Antonio Cancer Institute.

PubMed

Barnes, Jonathan B; Johnson, Scott B; Dahiya, Rajiv S; Temes, R Thomas; Herman, Terence S; Thomas, Charles R

2002-02-01

Pancoast (superior sulcus tumors) comprise a subset of non-small-cell lung cancers that have a unique clinical presentation by virtue of the locoregional pattern of disease progression. We herein report a brief report on our group's pilot experience in managing these challenging lung neoplasms with an aggressive concomitant modality approach. These results and those of the recent Southwest Oncology-lead Intergroup prospective phase 2 trial (SWOG-9416/INT-0160) support the use of concomitant chemoradiation followed by an attempt at surgical resection.

Publication Production: An Annotated Bibliography.

ERIC Educational Resources Information Center

Firman, Anthony H.

1994-01-01

Offers brief annotations of 52 articles and papers on document production (from the Society for Technical Communication's journal and proceedings) on 9 topics: information processing, document design, using color, typography, tables, illustrations, photography, printing and binding, and production management. (SR)

Wisconsin Response to Intervention: A Guiding Document

ERIC Educational Resources Information Center

Wisconsin Department of Public Instruction, 2010

2010-01-01

To assist Wisconsin education leaders with planning for Response to Intervention (RtI), the Wisconsin Department of Public Instruction (DPI), in partnership with Wisconsin education stakeholders, has developed this informational brief. This brief is intended to provide guidance for implementation of RtI and should not be read as administrative…

A Brief Introduction to Foreign Languages Education Policy in China

ERIC Educational Resources Information Center

Zhang, Weiwen

2012-01-01

Based on a series of official published documents and relevant research reports, the paper make a brief introduction to foreign languages education policies in China, which included national English teaching guidance, national English language textbooks, national English curriculum standard and the massive English teachers training program, etc.…

A Brief History of the Flathead Tribes.

ERIC Educational Resources Information Center

Woodcock, Clarence; And Others

A source document, illustrated with many black and white photographs of tribe members and activities, provides a brief history of the American Indian tribes, now called the Flatheads, living on the Flathead Indian Reservation in Montana and describes some of their cultural traditions, particularly their ceremonial dances. The booklet traces the…

The EDUTECH Report, 2002-2003.

ERIC Educational Resources Information Center

Warger, Thomas, Ed.

2003-01-01

This document consists of 12 issues, an entire volume year, of "The EDUTECH Report." The newsletter's purpose is to alert faculty and administrators to issues in educational technology. Each issue contains two feature articles, a page of news briefs, and a question and answer column. Most issues also contain brief quotations on education…

The EDUTECH Report, 2001-2002.

ERIC Educational Resources Information Center

Warger, Thomas, Ed.

2002-01-01

This document consists of 12 issues of the "EDUTECH Report." The newsletter's purpose is to alert faculty and administrators to issues in educational technology. Each issue contains two feature articles, a page of news briefs, and a question and answer column. Issues also contain brief quotations on education technology topics. The…

FMCSA safety program effectiveness measurement compliance review effectiveness model results for carriers with compliance reviews in fiscal year 2009 : [analysis brief].

DOT National Transportation Integrated Search

2014-04-01

This Analysis Brief documents the methodology and results from the Compliance Review Effectiveness Model (CREM) for carriers receiving CRs in fiscal year (FY) 2009. The model measures the effectiveness of the compliance review (CR) program, one of th...

Improving access to skilled attendance at delivery: a policy brief for Uganda.

PubMed

Nabudere, Harriet; Asiimwe, Delius; Amandua, Jacinto

2013-04-01

This study describes the process of production, findings for a policy brief on Increasing Access to Skilled Birth Attendance, and subsequent use of the report by policy makers and others from the health sector in Uganda. The methods used to prepare the policy brief use the SUPPORT Tools for evidence-informed health policy making. The problem that this evidence brief addresses was identified through an explicit priority setting process involving policy makers and other stakeholders, further clarification with key informant interviews of relevant policy makers, and review of relevant documents. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options, and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The proportion of pregnant women delivering from public and private non-profit facilities was low at 34 percent in 2008/09. The three policy options discussed in the report could be adopted independently or complementary to the other to increase access to skilled care. The Ministry of Health in deliberating to provide intrapartum care at first level health facilities from the second level of care, requested for research evidence to support these decisions. Maternal waiting shelters and working with the private-for-profit sector to facilitate deliveries in health facilities are promising complementary interventions that have been piloted in both the public and private health sector. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogue meetings involving members of parliament, policy makers, health managers, researchers, civil society, professional organizations, and the media.

Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

PubMed Central

Batra, U; Parikh, PM; Prabhash, K; Tongaonkar, HB; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, SK; Rajappa, S; Rajendranath, R; Rawal, SK; Singh, Manisha; Singh, R; Somashekhar, SP; Sood, R

2016-01-01

The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of “Take Home Messages” at the end is a convenient tool for busy practitioners. PMID:28032079

Standard of Care for Neuropsychological Monitoring in Pediatric Neuro-Oncology: Lessons From the Children's Oncology Group (COG).

PubMed

Walsh, Karin S; Noll, Robert B; Annett, Robert D; Patel, Sunita K; Patenaude, Andrea F; Embry, Leanne

2016-02-01

As the mortality of pediatric cancers has decreased, focus on neuropsychological morbidities of treatment sequelae have increased. Neuropsychological evaluations are essential diagnostic tools that assess cognitive functioning and neurobiological integrity. These tests provide vital information to support ongoing medical care, documenting cognitive morbidity and response to interventions. We frame standards for neuropsychological monitoring of pediatric patients with CNS malignancy or who received cancer-directed therapies involving the CNS and discuss billing for these services in the United States in the context of clinical research. We describe a cost-effective, efficient model of neuropsychological monitoring that may increases access to neuropsychological care. © 2015 Wiley Periodicals, Inc.

Assessment of oral mucositis in adult and pediatric oncology patients: an evidence-based approach.

PubMed

Farrington, Michele; Cullen, Laura; Dawson, Cindy

2010-01-01

Oral mucositis is a frequent side effect of cancer treatment and can lead to delayed treatment, reduced treatment dosage, altered nutrition, dehydration, infections, xerostomia, pain, and higher healthcare costs. Mucositis is defined as "inflammatory lesions of the oral and/or gastrointestinal tract caused by high-dose cancer therapies. Alimentary tract mucositis refers to the expression of mucosal injury across the continuum of oral and gastrointestinal mucosa, from the mouth to the anus" (Peterson, Bensadoun, & Roila, 2008, p. ii122). Evidence demonstrates that oral mucositis is quite distressing for patients. In addition, the majority of oncology nurses are unaware of available guidelines related to the care of oral mucositis. A multidisciplinary Oral Mucositis Committee was formed by the University of Iowa Hospitals and Clinics to develop evidence-based prevention and treatment strategies for adult and pediatric oncology patients experiencing oral mucositis. The first step was implementing an evidence-based nursing oral assessment. The Iowa Model was used to guide this evidence-based practice initiative. The Oral Assessment Guide (OAG) is reliable and valid, feasible, and sensitive to changing conditions. The OAG was piloted on an Adult Leukemia and Bone Marrow Transplant Unit leading to modification and adaptation. The pilot evaluation found 87% of patients had an abnormal oral assessment involving all categories in the tool. Nursing questionnaires showed that staff (8/23; 35% response) felt they were able to identify at risk patients using the OAG (3.3; 1-4 scale), and the tool accurately identifies mucosal changes (2.9; 1-4 scale). A knowledge assessment found nurses correctly identified OAG components 63% of the time. Unlike results from a national survey, most University of Iowa Hospitals and Clinics nurses (63%) were aware of national guidelines for prevention and treatment of oral mucositis. Developing an evidence-based nursing policy and updating documentation systems was done before implementation occurred. Computer-based and printed educational materials were developed for nursing staff caring for oncology patients. Team members were responsible for facilitating adoption in clinical areas. After organizational roll out, the nursing assessment was documented in all patients 87% of the time, and 99% for inpatients. The highest risk population, head and neck cancer patients receiving radiation, had documentation in 88% of audited visits. Other clinics required further work. Changing the system to the electronic medical record created an additional need for integration of the evidence-based practice with housewide documentation of oral assessment being completed 60.9% of the time. Use of an evidence-based assessment is the first step in a comprehensive program to reduce a common and highly distressing side effect of cancer treatment. Nursing documentation of oral assessment is well integrated on inpatient units. Opportunities for improvement remain in ambulatory care. Multidisciplinary team collaborations to expand evidence-based assessment and research questions generated from this work will be shared.

Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

PubMed

Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

2015-03-01

Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P < .001), with the most dramatic changes occurring during the last 2 months. Patients with longer duration of continuity of care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

A Feature Mining Based Approach for the Classification of Text Documents into Disjoint Classes.

ERIC Educational Resources Information Center

Nieto Sanchez, Salvador; Triantaphyllou, Evangelos; Kraft, Donald

2002-01-01

Proposes a new approach for classifying text documents into two disjoint classes. Highlights include a brief overview of document clustering; a data mining approach called the One Clause at a Time (OCAT) algorithm which is based on mathematical logic; vector space model (VSM); and comparing the OCAT to the VSM. (Author/LRW)

VET in Schools, 2006: Terms and Definitions. Support Document

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2008

2008-01-01

This document covers the data terms used in the "VET in Schools, 2006" report. The primary purpose of this document is to help users understand the specific data terms used in the report. Terms that appear in the report are listed in alphabetical order with the following information provided for each: (1) Definition: a brief explanation…

Indian Society of Neuro-Oncology consensus guidelines for the contemporary management of medulloblastoma.

PubMed

Gupta, Tejpal; Sarkar, Chitra; Rajshekhar, Vedantam; Chatterjee, Sandip; Shirsat, Neelam; Muzumdar, Dattatreya; Pungavkar, Sona; Chinnaswamy, Girish; Jalali, Rakesh

2017-01-01

The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes. The Indian Society of Neuro-Oncology (ISNO) constituted an expert multi-disciplinary panel with adequate representation from all stakeholders to prepare national consensus guidelines for the contemporary management of medulloblastoma. Minimum desirable, as well as preferable though optional recommendations (as appropriate), were developed and adopted for the pre-surgical work-up including neuroimaging; neurosurgical management including surgical principles, techniques, and complications; neuropathology reporting and molecular testing; contemporary risk-stratification in the molecular era; appropriate adjuvant therapy (radiotherapy and chemotherapy); and follow-up schedule in medulloblastoma. The current document represents a broad consensus reached amongst various stakeholders within the neuro-oncology community involved in the contemporary curative-intent management of children with medulloblastoma. It provides both general as well as specific guidelines and recommendations to be adopted by physicians and health care providers across India to achieve uniformity of care, improve disease-related outcomes, and compare results between institutions within the country.

Addressing Burnout in Oncology: Why Cancer Care Clinicians Are At Risk, What Individuals Can Do, and How Organizations Can Respond.

PubMed

Hlubocky, Fay J; Back, Anthony L; Shanafelt, Tait D

2016-01-01

Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.

From a Content Delivery Portal to a Knowledge Management System for Standardized Cancer Documentation.

PubMed

Schlue, Danijela; Mate, Sebastian; Haier, Jörg; Kadioglu, Dennis; Prokosch, Hans-Ulrich; Breil, Bernhard

2017-01-01

Heterogeneous tumor documentation and its challenges of interpretation of medical terms lead to problems in analyses of data from clinical and epidemiological cancer registries. The objective of this project was to design, implement and improve a national content delivery portal for oncological terms. Data elements of existing handbooks and documentation sources were analyzed, combined and summarized by medical experts of different comprehensive cancer centers. Informatics experts created a generic data model based on an existing metadata repository. In order to establish a national knowledge management system for standardized cancer documentation, a prototypical tumor wiki was designed and implemented. Requirements engineering techniques were applied to optimize this platform. It is targeted to user groups such as documentation officers, physicians and patients. The linkage to other information sources like PubMed and MeSH was realized.

Serum Procalcitonin for Predicting Significant Infections and Mortality in Pediatric Oncology.

PubMed

Gunasekaran, Vinod; Radhakrishnan, Nita; Dinand, Veronique; Sachdeva, Anupam

2016-12-15

To evaluate the role of serum procalcitonin (PCT) level at admission in predicting significant infections and deaths among children on chemotherapy presenting with fever. Children with clinically significant (CSI) and microbiologically documented (MDI) infections were identified using standard definitions. Association of PCT with CSI, MDI and mortality was analyzed. We evaluated 821 febrile episodes in 316 children. CSI, MDI and deaths were seen in 40.9%, 20.1% and 2.9%, respectively. PCT levels ranged from 0.05-560ng/mL. Median PCT was higher in episodes with CSI (0.80 vs. 0.28) and MDI (0.71 vs. 0.34) (P<0.001). PCT ≥0.7ng/mL optimally predicted CSI (AUC-0.740) and MDI (AUC-0.636). Relative risk of mortality for PCT ≥5ng/mL was 7.1. PCT ≥0.7ng/mL had poor sensitivity (45-55%) but good specificity and NPV (70-90%). PCT was elevated in nearly half of documented viral and fungal infections. PCT predicts significant infections and mortality in pediatric oncology but it has poor sensitivity to guide clinical decisions.

The Present and Future Opportunities of the Rare Cancer Network: An International Consortium for Advancement of Oncologic Care

PubMed Central

2015-01-01

To date, the Rare Cancer Network (RCN) has initiated more than 90 studies and 54 peer-reviewed publications were produced as a result. The Second International Symposium of the Rare Cancer Network recently took place in Istanbul, Turkey on April 17-18, 2015, and update was given on multiple currently ongoing projects, while also giving room for new proposals which will shape the direction of future studies for the group. This companion issue of the RCN Proceedings summarized the findings of this meeting, while also serving as a call for fresh projects and papers which will continue to energize the group and advance the oncologic science. A brief introduction to the principles, history, and vision of the RCN was also included. To review, the academic year of 2014-15 marked an enormous success for the international members of the RCN, with the generation of 8 fully published papers and more than 12 newly proposed topics. By the collective efforts of all RCN members, in the future, we look forward to the upcoming opportunities in continuing to advance the standard of chemo- and radiotherapeutic oncologic care for selected rare tumor topics. The studies of these rare cancers often do not allow the design and execution of prospectively enrolled trials; however, these uncommon malignancies do impact the humankind and add to its suffering globally in significant ways. PMID:26500735

ANMCO/AIOM/AICO Consensus Document on clinical and management pathways of cardio-oncology: executive summary.

PubMed

Tarantini, Luigi; Massimo Gulizia, Michele; Di Lenarda, Andrea; Maurea, Nicola; Giuseppe Abrignani, Maurizio; Bisceglia, Irma; Bovelli, Daniella; De Gennaro, Luisa; Del Sindaco, Donatella; Macera, Francesca; Parrini, Iris; Radini, Donatella; Russo, Giulia; Beatrice Scardovi, Angela; Inno, Alessandro

2017-05-01

Cardiovascular disease and cancer are leading causes of death. Both diseases share the same risk factors and, having the highest incidence and prevalence in the elderly, they often coexist in the same individual. Furthermore, the enhanced survival of cancer patients registered in the last decades and linked to early diagnosis and improvement of care, not infrequently exposes them to the appearance of ominous cardiovascular complications due to the deleterious effects of cancer treatment on the heart and circulatory system. The above considerations have led to the development of a new branch of clinical cardiology based on the principles of multidisciplinary collaboration between cardiologists and oncologists: Cardio-oncology, which aims to find solutions to the prevention, monitoring, diagnosis and treatment of heart damage induced by cancer care in order to pursue, in the individual patient, the best possible care for cancer while minimizing the risk of cardiac toxicity. In this consensus document we provide practical recommendations on how to assess, monitor, treat and supervise the candidate or patient treated with potentially cardiotoxic cancer therapy in order to treat cancer and protect the heart at all stages of the oncological disease. Cardiovascular diseases and cancer often share the same risk factors and can coexist in the same individual. Such possibility is amplified by the deleterious effects of cancer treatment on the heart. The above considerations have led to the development of a new branch of clinical cardiology, based on multidisciplinary collaboration between cardiologist and oncologist: the cardio-oncology. It aims to prevent, monitor, and treat heart damages induced by cancer therapies in order to achieve the most effective cancer treatment, while minimizing the risk of cardiac toxicity. In this paper, we provide practical recommendations on how to assess, monitor, treat and supervise patients treated with potential cardiotoxic cancer therapies.

ANMCO/AIOM/AICO Consensus Document on clinical and management pathways of cardio-oncology: executive summary

PubMed Central

Tarantini, Luigi; Massimo Gulizia, Michele; Di Lenarda, Andrea; Maurea, Nicola; Giuseppe Abrignani, Maurizio; Bisceglia, Irma; Bovelli, Daniella; De Gennaro, Luisa; Del Sindaco, Donatella; Macera, Francesca; Parrini, Iris; Radini, Donatella; Russo, Giulia; Beatrice Scardovi, Angela; Inno, Alessandro

2017-01-01

Abstract Cardiovascular disease and cancer are leading causes of death. Both diseases share the same risk factors and, having the highest incidence and prevalence in the elderly, they often coexist in the same individual. Furthermore, the enhanced survival of cancer patients registered in the last decades and linked to early diagnosis and improvement of care, not infrequently exposes them to the appearance of ominous cardiovascular complications due to the deleterious effects of cancer treatment on the heart and circulatory system. The above considerations have led to the development of a new branch of clinical cardiology based on the principles of multidisciplinary collaboration between cardiologists and oncologists: Cardio-oncology, which aims to find solutions to the prevention, monitoring, diagnosis and treatment of heart damage induced by cancer care in order to pursue, in the individual patient, the best possible care for cancer while minimizing the risk of cardiac toxicity. In this consensus document we provide practical recommendations on how to assess, monitor, treat and supervise the candidate or patient treated with potentially cardiotoxic cancer therapy in order to treat cancer and protect the heart at all stages of the oncological disease. Cardiovascular diseases and cancer often share the same risk factors and can coexist in the same individual. Such possibility is amplified by the deleterious effects of cancer treatment on the heart. The above considerations have led to the development of a new branch of clinical cardiology, based on multidisciplinary collaboration between cardiologist and oncologist: the cardio-oncology. It aims to prevent, monitor, and treat heart damages induced by cancer therapies in order to achieve the most effective cancer treatment, while minimizing the risk of cardiac toxicity. In this paper, we provide practical recommendations on how to assess, monitor, treat and supervise patients treated with potential cardiotoxic cancer therapies. PMID:28751851

Developing emotional intelligence ability in oncology nurses: a clinical rounds approach.

PubMed

Codier, Estelle; Freitas, Beth; Muneno, Lynn

2013-01-01

To explore the feasibility and impact of an emotional intelligence ability development program on staff and patient care. A mixed method, pre/post-test design. A tertiary care hospital in urban Honolulu, HI. Rounds took place on a 24-bed inpatient oncology unit. 33 RNs in an oncology unit. After collection of baseline data, the emotional intelligence rounds were conducted in an inpatient oncology nursing unit on all shifts during a 10-month period. Demographic information, emotional intelligence scores, data from rounds, chart reviews of emotional care documentation, and unit-wide satisfaction and safety data. The ability to identify emotions in self and others was demonstrated less frequently than expected in this population. The low test response rate prevented comparison of scores pre- and postintervention. The staff's 94% participation in rounds, the positive (100%) evaluation of rounds, and poststudy improvements in emotional care documentation and emotional care planning suggest a positive effect from the intervention. Additional research is recommended over a longer period of time to evaluate the impact emotional intelligence specifically has on the staff's identification of emotions. Because the intervention involved minimal time and resources, feasibility for continuation of the intervention poststudy was rated "high" by the research team. Research in other disciplines suggests that improvement in emotional intelligence ability in clinical staff nurses may improve retention, performance, and teamwork in nursing, which would be of particular significance in high-risk clinical practice environments. Few research studies have explored development of emotional intelligence abilities in clinical staff nurses. Evidence from this study suggests that interventions in the clinical environment may be used to develop emotional intelligence ability. Impact from such development may be used in the future to not only improve the quality of nursing care, but also potentially limit the negative effects of high-stress environments on nurses.

Impact of oncology pharmacist-managed oral anticancer therapy in patients with chronic myelogenous leukemia.

PubMed

Lam, Masha Sh; Cheung, Nathan

2016-12-01

Studies have identified non-adherence as one of the major contributing factors to treatment failure in chronic myelogenous leukemia (CML) patients receiving imatinib. Published literature has demonstrated a unique role of oncology pharmacists, as part of a multidisciplinary team, in contributing to overall positive outcomes for patients. To evaluate the impact of an oncology pharmacist-managed oral anticancer therapy program on oral medication adherence in CML patients versus usual care. Electronic refill history and medical records of patients diagnosed with CML treated with oral tyrosine kinase inhibitors (TKIs) managed by oncology pharmacists during a 6-year period, were retrospectively reviewed. Imatinib adherence rate, as the primary endpoint, was compared with the rate for those in the usual care group within the same organization. The secondary endpoints were descriptive to characterize pharmacist interventions for all TKIs. A total of 56 patients including 45 who were treated with imatinib, were evaluated. The group managed by oncology pharmacists resulted in a higher percentage of imatinib adherence rate compared to usual care (88.6% vs 65.8%, p = 0.0046). A total of 3432 pharmacist encounters were reviewed, and 567 interventions of six categories including side effect monitoring/management (n = 95; 16.8%); drug interaction detection (n = 109; 19.2%); TKI dose adjustment (n = 82; 14.5%); laboratory monitoring (n = 200; 35.3%); non-CML related drug choice (n = 74; 13.1%); and copay assistance (n = 7; 1.2%), were documented. This resulted in a mean of 10.1 interventions per patient. Our oncology pharmacist-managed oral anticancer therapy program significantly improved TKI adherence rates in CML patients. We attribute the success of our program to consistent follow-up by utilizing routine phone, and secure email follow-ups, that allowed our oncology pharmacists to build a close and trustworthy relationship with patients and families. © The Author(s) 2015.

Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations

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

Prabhu, Arpan V.; Hansberry, David R.; Agarwal, Nitin

Purpose: Physicians encourage patients to be informed about their health care options, but much of the online health care–related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Methods: Radiation oncology–related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Associationmore » of Physicists in Medicine, American Brachytherapy Society, (RadiologyInfo.org), and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. Results: When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Conclusion: Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive and efficient.« less

How Data Packages Lacking Phase III Pivotal Trial Data Can Support Regulatory Approval and Reimbursement for Oncologics in Australia.

PubMed

Macaulay, Richard; Siddiqui, Mohammad Kashif; Stoddart, Samuel

2015-05-01

Oncology drugs lacking supportive phase III trial data have achieved Food and Drug Administration (FDA) and European Medicines Agency (EMA) regulatory approval and even European reimbursement approval where no therapeutic alternative exists and early-stage data indicate dramatic clinical benefits. This research aimed to compare under what circumstances oncologics can obtain both regulatory and reimbursement approval in Australia on this basis. Therapeutic Goods Administration (TGA) Australian Public Assessment Reports, EMA, FDA, and Pharmaceutical Benefits Advisory Committee (PBAC) Public Summary Documents were extracted for any oncologic indication appraised in Australia on a pivotal trial package lacking phase III data, excluding pediatric indications and new formulations. Australian Public Assessment Reports were available for six TGA-appraised oncologics across seven indications on such a data package: five of seven approved, one of seven restricted, and one of seven rejected. The EMA and the FDA issued recommendations on these indications an average of 1 and 2 years earlier, respectively. The PBAC appraised six oncologics across 10 indications on such a data package, with four (nilotinib, dasatinib, imatinib, and brentuximab vedotin) approved and two rejected (cetuximab and bevacizumab). Seven of the eight approved indications required multiple submissions, with inadequate clinical data frequently cited as key. Six of the eight PBAC-approved indications included economic modeling on a cost-benefit approach. The TGA will approve oncologics that offer potentially substantial clinical benefits on the basis of an indirect comparison of single-arm trials but at a delay versus the EMA and the FDA. The PBAC reimbursement approval also requires more rigorous supportive clinical data and acceptable cost-effectiveness as demonstrated on a cost-benefit or cost-quality-adjusted life-year metric. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Effects of a Brief Video Intervention on White University Students' Racial Attitudes

ERIC Educational Resources Information Center

Soble, Jason R.; Spanierman, Lisa B.; Liao, Hsin-Ya

2011-01-01

The authors investigated the effects of a brief video intervention on the racial attitudes of White university students. One hundred thirty-eight self-identified White students were randomly assigned to either an experimental condition in which they viewed a video documenting the pervasiveness of institutional racism and White privilege in the…

Creating Access to Opportunities for Youth in Transition from Foster Care. An AYPF Policy Brief

ERIC Educational Resources Information Center

Russ, Erin; Fryar, Garet

2014-01-01

What happens to youth in foster care when they turn 18? Many face unprecedented challenges like homelessness, lack of financial resources, difficulty accessing educational opportunities, and unemployment. In this issue brief, The American Youth Policy Forum (AYPF) document these challenges and opportunities in three distinct yet overlapping areas…

10 CFR 2.346 - Authority of the Secretary.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Adjudicatory Hearings § 2.346 Authority of the Secretary. When briefs, motions or other documents are submitted... filing of briefs, motions, or other pleadings, when the schedules differ from those prescribed by the rules of this part or when the rules of this part do not prescribe a schedule; (b) Rule on motions for...

Children Exposed to Drugs: What Policymakers Can Do. SERVE Policy Brief.

ERIC Educational Resources Information Center

Thomas, Jan

This policy brief addresses the current and future impact of substance abuse by pregnant women on their infants and children. It provides data on incidence estimates in 1985, 1989, 1995, and 2000. Findings of studies in Alabama, Florida, Georgia, Mississippi, North Carolina, and South Carolina provide documentation for varying incidence estimates.…

Children in Families Experiencing Separation and Divorce: An Investigation of the Effects of Planned Brief Intervention.

ERIC Educational Resources Information Center

Freeman, Rhonda

Although research documents the adverse effects of parental divorce on children, there is little information on clinical intervention for this population. To empirically test the effectiveness and relative contribution of differing treatments, a program of planned, brief (6 weeks) intervention, aimed at altering children's negative attitudes or…

The EDUTECH Report, 1997-1998.

ERIC Educational Resources Information Center

EDUTECH Report, 1998

1998-01-01

This document consists of 12 issues of the EDUTECH Report. 1998. The newsletter's purpose is to alert faculty and administrators to issues in educational technology. Each issue contains two feature articles, a page of news briefs, a preview of the upcoming issue, and a question and answer column. Most issues also contain brief quotations on…

Implementing No Child Left Behind in Three States. Research Brief

ERIC Educational Resources Information Center

Stecher, Brian M.; Epstein, Scott; Hamilton, Laura S.; Marsh, Julie A.; Robyn, Abby; McCombs, Jennifer Sloan; Russell, Jennifer; Naftel, Scott

2008-01-01

This research brief describes work done for RAND Education and documented in "Pain and Gain: Implementing No Child Left Behind in Three States, 2004-2006", Brian M. Stecher, Scott Epstein, Laura S. Hamilton, Julie A. Marsh, Abby Robyn, Jennifer Sloan McCombs, Jennifer Russell, and Scott Naftel." The three states discussed are:…

Effects of a brief psychosocial intervention in patients with cancer receiving adjuvant therapy.

PubMed

Oh, Pok Ja; Kim, Soo Hyun

2010-03-01

To test the effects of a brief psychosocial intervention using CD-ROM (BPIC) on psychosocial (fighting spirit, helplessness or hopelessness, anxiety, and depression) and behavioral (self-care behaviors) outcomes in patients with cancer receiving adjuvant therapy. Quasi-experimental. A comprehensive cancer center in Seoul, South Korea. 71 patients undergoing adjuvant therapy. The study participants were assigned to either BPIC or a control group. The experimental group underwent a two-week psychosocial intervention via CD-ROM, booklet, and telephone counseling. Fighting spirit, helplessness or hopelessness, anxiety, depression, and self-care behaviors. After BPIC, the experimental group showed significantly higher scores than the control group for fighting spirit (p = 0.005) and self-care behaviors (p < 0.001). However, the groups showed no significant differences in helplessness or hopelessness (p = 0.42), anxiety (p = 0.279), and depression (p = 0.068). BPIC use improved fighting spirit and self-care behaviors in study participants. The results partially support the effectiveness of BPIC for adaptation among patients with cancer receiving adjuvant therapy. A brief psychosocial intervention using multimedia can be used effectively in clinical oncology settings to accelerate adaptation among patients with cancer in the adjuvant phase.

Efficacy of a brief nurse-led pilot psychosocial intervention for newly diagnosed Asian cancer patients.

PubMed

Mahendran, Rathi; Lim, Haikel A; Tan, Joyce Y S; Chua, Joanne; Lim, Siew Eng; Ang, Emily N K; Kua, Ee Heok

2015-08-01

Cancer patients experience distress and high levels of psychosocial concerns. However, in Asian countries like Singapore, patients are often unwilling to seek support and help from mental healthcare professionals, but, instead, are more willing to confide in nurses. This quasi-experimental study developed and tested the efficacy of a brief nurse-led psychosocial intervention to alleviate these patients' distress, minor psychiatric morbidity, and psychosocial concerns. The semi-structured intervention comprised 20- to 30-minute face-to-face sessions with trained oncology nurses, monthly for 2 months and then bimonthly for 4 months. Patients received psycho-education on symptoms of stress, anxiety, and depression and counseling and were taught behavioral techniques such as deep breathing, progressive muscle relaxation, and positive self-talk. The results of this study found that patients who received the intervention had reduced distress, depression, and anxiety levels and improved quality of life (QOL) at 6 months. Although further research is necessary to explore the efficacy and viability of this intervention, findings support brief nurse-led psycho-educational interventions in Asian settings especially for cancer patients reluctant to seek help from mental health professionals.

Evaluation of clinical pharmacy services in a hematology/oncology outpatient setting.

PubMed

Shah, Sachin; Dowell, Jonathan; Greene, Shane

2006-09-01

The Veterans Affairs North Texas Health Care System in Dallas, TX, provides a unique opportunity for clinical pharmacists to work as providers. Even though clinical pharmacists are actively involved in patient care, many of their efforts remain undocumented, resulting in an underestimation of the importance of their services and missed opportunities for improvements and new directions. To document and evaluate the services of a hematology/oncology clinical pharmacy in the outpatient setting. Pendragon Forms 3.2 software was used to design the documentation template. The template was designed to collect diagnoses, supportive care issues, drug-specific interventions, and prescriptions written. This template was uploaded to the personal digital assistant (PDA) for documentation. Patient-specific information was documented in a password-protected PDA. Data collected from November 1, 2002, to October 31, 2003, were retrospectively analyzed. Clinical pharmacists were involved in 423 patient visits for chemotherapy follow-up or disease management. Cancer diagnoses included colorectal (n = 99), multiple myeloma (59), non-small cell lung (56), chronic lymphocytic leukemia (44), myelodysplastic syndromes (22), and chronic myelogenous leukemia (19). During the 423 patient visits, 342 supportive care issues were addressed including anemia (34%), pain management (22%), constipation/diarrhea (15%), and nausea/vomiting (8%). Major drug-specific interventions included drug addition (41%), discontinuation (23%), and adjustment (21%). Four hundred forty-five prescriptions were filled, of which 181 were new and 150 were refilled. This is the first study, as of July 25, 2006, to document considerable contribution of an outpatient clinical pharmacist in direct cancer patient care. Although the disease management and supportive care issues addressed here may differ based on institution and patient population, the results of our study show that clinical pharmacists have ever-growing roles in the management of these patients.

Management of venous thromboembolism.

PubMed

Parakh, R; Kakkar, V V; Kakkar, A K

2007-01-01

Venous Thromboembolism is an important healthcare problem the world over, resulting in significant morbidity, mortality and resource expenditure. The rationale for use of thromboprophylaxis is based on solid principles and scientific evidence. Indian perspective on this topic is lacking due to the non-availability of published Indian data. This document reviews the available International and Indian data and discusses the relevance of recommendations for prevention and management of Venous Thromboembolism (VTE) in the Indian context. Meetings of various specialists from different Indian hospitals in the field of Gastrointestinal Surgery, General and Vascular Surgery, Hematology, Intensive Care, Obstetrics and Gynecology, Oncology and Orthopedics were held in the months of August 2005 to January 2006. The guidelines published by American College of Chest Physicians (ACCP), the International Union of Angiology (IUA), and the Royal College of Obstetricians and Gynecologists (RCOG), were discussed during these meetings. The relevance of these guidelines and the practical implications of following these in a developing country like India were also discussed. Any published data from India was collected from data base searches and the results, along with personal experiences of the participating specialists were discussed. The experiences and impressions of the experts during these meetings have been included in this document. Data from recent sources (International Union of Angiology and the National Comprehensive Cancer Network (NCCN) Practice guidelines in Oncology on Venous thromboembolic disease) was subsequently also included in this document. The suggestions formulated in this document are practical, and would intend to serve as a useful practical reference. A number of unanswered questions remain in the field of thromboprophylaxis, and carefully designed research protocols may help answer some of these. Implementation of the suggestions outlined in the document remains to be studied in the Indian context.

Florida Initiative for Quality Cancer Care: improvements on colorectal cancer quality of care indicators during a 3-year interval.

PubMed

Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

2014-01-01

The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥ 12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. Copyright © 2014. Published by Elsevier Inc.

Africa.

ERIC Educational Resources Information Center

Happel, Sue; Loeb, Joyce

Although the activities in this unit are designed primarily for students in the intermediate grades, the document's text, illustrations, and bibliographic references are suitable for anyone interested in learning about Africa. Following a brief introduction and map work, the document is arranged into six sections. Section 1 traces Africa's history…

Cryogenic adhesives and sealants: Abstracted publications

NASA Technical Reports Server (NTRS)

Williamson, F. R.; Olien, N. A.

1977-01-01

Abstracts of primary documents containing original experimental data on the properties of adhesives and sealants at cryogenic temperatures are presented. The most important references mentioned in each document are cited. In addition, a brief annotation is given for documents considered secondary in nature, such as republications or variations of original reports, progress reports leading to final reports included as primary documents, and experimental data on adhesive properties at temperatures between about 130 K and room temperature.

Opportunities and challenges in leveraging electronic health record data in oncology.

PubMed

Berger, Marc L; Curtis, Melissa D; Smith, Gregory; Harnett, James; Abernethy, Amy P

2016-05-01

The widespread adoption of electronic health records (EHRs) and the growing wealth of digitized information sources about patients is ushering in an era of 'Big Data' that may revolutionize clinical research in oncology. Research will likely be more efficient and potentially more accurate than the current gold standard of manual chart review studies. However, EHRs as they exist today have significant limitations: important data elements are missing or are only captured in free text or PDF documents. Using two case studies, we illustrate the challenges of leveraging the data that are routinely collected by the healthcare system in EHRs (e.g., real-world data), specific challenges encountered in the cancer domain and opportunities that can be achieved when these are overcome.

National Earthquake Information Center systems overview and integration

USGS Publications Warehouse

Guy, Michelle R.; Patton, John M.; Fee, Jeremy; Hearne, Mike; Martinez, Eric; Ketchum, D.; Worden, Charles; Quitoriano, Vince; Hunter, Edward; Smoczyk, Gregory; Schwarz, Stan

2015-08-18

It is important to note that this document provides a brief introduction to the work of dozens of software developers and IT specialists, spanning in many cases more than a decade. References to significant amounts of supporting documentation, code, and information are supplied within.

How to Start Intergenerational Programs in Communities.

ERIC Educational Resources Information Center

2002

This document is designed for use by community organizers in creating, developing and maintaining an intergenerational program. Starting with a brief overview of the Maryland Intergenerational Coalition, the document describes (in short, bulleted entries) the activities and accomplishments of various intergenerational programs in Maryland, such as…

Illinois Occupational Skill Standards: Telecommunications Technician Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for workforce preparation program providers, details the Illinois Occupational Skill Standards for programs preparing students for employment in the telecommunications technician occupational cluster. The document begins with a brief overview of the Illinois perspective on occupational skills standards…

DRI Model of the U.S. Economy -- Model Documentation

EIA Publications

1993-01-01

Provides documentation on Data Resources, Inc., DRI Model of the U.S. Economy and the DRI Personal Computer Input/Output Model. It also describes the theoretical basis, structure and functions of both DRI models; and contains brief descriptions of the models and their equations.

Supportive Care in Hemato-Oncology: A Review in Light of the Latest Guidelines

PubMed Central

Gündüz, Eren; Gülbaş, Zafer

2012-01-01

Recent developments in cancer therapy have resulted in increases in treatment success rates and survival. One of thebasic goals of such therapy is improving patient quality of life. Chemotherapy protocols for solid or hematologicalmalignancies-most of which include multiple agents-negatively impact patient quality of life. Additionally, there havebeen developments in supportive care, which seeks to ameliorate or minimize the negative effects of chemotherapy.Herein we present a review and brief summarization of some of the agents used for supportive care in cancer patientsin light of the latest guidelines. PMID:24744617

Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

PubMed

Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

2014-02-01

The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve.

Single dose filgastrim in cytotoxic-induced neutropaenia in children.

PubMed

Abdallah, F K

2008-01-01

To document the impact of fixed dose weight adjusted filgastrim (G-CSF) in cytotoxic-induced neutropaenia. A descriptive cross-sectional study. Paediatric Oncology Unit at Kenyatta National Hospital, Nairobi, Kenya. All paediatric oncology patients who had developed cytotoxic-induced neutropaenia. The following were documented for every tissue proven case of malignancy; age, sex, type of malignancy, treatment regimen and schedule, initial blood count at the time of neutropaenia; subsequent blood counts daily for five days from day one of single dose filgastrim, and the calculated neutrophil incremental count. Initially eight patients with solid tumours previously treated with filgastrim revealed that cytotoxic induced neutropaenia could be ameliorated by a single dose of filgastrim. Subsequently, the study listed thirty patients. This cohort consisted of; 37% rhabdomyosarcoma, 30% Burkitts, 27% acute lymphoblastic leukaemia and 6% Hodgkin's lymphoma. Increased neutrophil count after 48 hours was documented in 26 (87%) patients, with absolute neutrophil counts range of 0.5 to 31.5 x 10(9)/L. This response was significantly influenced by gender (p>0.0001), malignancy type and chemotherapy regimen (p>0.001). The study shows that chemotherapy induced neutropaenia can be alleviated by a single dose of filgastrim without adverse effects on lymphoblastic leukaemia. This study suggests that a single dose of filgastrim should be first tried in cytotoxic induced neutropaenia in the paediatric age group.

Campaign To Reduce Child Poverty. Progress Report [and] Policy Briefs 1-5.

ERIC Educational Resources Information Center

New Mexico Advocates for Children & Families, Albuquerque.

This document is comprised of a progress report and five policy briefs related to the New Mexico Advocates for Children and Families' Campaign To Reduce Child Poverty. This multi-year initiative educates the public and policymakers about child poverty and promotes public policy changes that would reduce poverty. The progress report presents…

Machine-Aided Indexing in Practice: An Encounter with Automatic Indexing of the Third Kind.

ERIC Educational Resources Information Center

Klingbiel, Paul H.

This three-part report includes a brief history of the Defense Documentation Center (DDC) with a description of the collections and their accessibility; categorization of automatic indexing into three kinds with a brief description of the DDC system of machine-aided indexing; and an indication of some operational experiences with the system.…

Preserving Knowledge: The Case for Alkaline Paper. ARL Briefing Package Number 3.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC.

This briefing package consists of a compilation of over 15 papers, fact sheets, and other materials focusing on the use of acid-free papers in books and other publications. The document contains the following: Executive Summary and List of Contents; Some Frequently Asked Questions; "Paper Preservation in Library Collections: Basic Information.…

Foreign Language Training in the United States Peace Corps.

ERIC Educational Resources Information Center

Kulakow, Allan

This document reports on the foreign language training offered in the Peace Corps. Following a brief introductory statement, a list of languages taught by the Peace Corps in the years 1961-67 is provided, as well as a brief description of Peace Corps language training methods. Guidelines for language coordinators are outlined, and the approach to…

A Brief History of the Transfer System in British Columbia

ERIC Educational Resources Information Center

Gaber, Devron

2005-01-01

This document presents a brief history of important events in the development and maintenance of the post-secondary transfer system in British Columbia (BC) over the last six decades. Information is presented in point form and in chronological order. Several points related to the expansion of the post-secondary system are included, and hence the…

Do Foreclosures Affect Boston Public School Student Academic Performance? Public Policy Brief No. 13-5

ERIC Educational Resources Information Center

Bradbury, Katharine; Burke, Mary A.; Triest, Robert K.

2013-01-01

Foreclosures have well-documented adverse consequences for families living in or owning properties undergoing foreclosure and on surrounding neighborhoods, but they may also have other costs. This policy brief summarizes our research on the impact of mortgage foreclosures on academic performance among Boston public school students. The data show…

Briefs for Parents in Ready-To-Copy Form: English and Spanish. 1993 Compilation.

ERIC Educational Resources Information Center

Howley, Craig; Cahape, Pat

This document contains English and Spanish versions of six one-page reports for parents. Each brief provides background, suggestions, and sources of further information on educational and child-rearing topics of common interest to parents. Titles are: "The Best and Worst of Times: Support Groups Help" ("Los tiempos mejores y peores: Los grupos…

Establishing end-of-life boards for palliative care of patients with advanced diseases.

PubMed

Masel, Eva K; Unseld, Matthias; Adamidis, Feroniki; Roider-Schur, Sophie; Watzke, Herbert H

2018-04-01

Interdisciplinary tumor board decisions improve the quality of oncological therapies, while no such boards exist for end-of-life (EOL) decisions. The aim of this study was to assess the willingness of hemato-oncological and palliative care professionals to develop and participate in EOL boards. An aim of an EOL board would be to establish an interdisciplinary and comprehensive care for the remaining lifetime of patients suffering from advanced incurable diseases. Staff from the interdisciplinary teams of all hemato-oncological and palliative care wards in Vienna were invited to anonymously participate in an online survey. 309 professionals responded. 91% respondents reported a need to establish an EOL board, 63% expressed their willingness to actively participate in an EOL board, and 25% were indecisive. Regarding patient presence, 50% voted for an EOL board in the presence of the patients, and 36% voted for an EOL board in the absence of the patients. 95% had the opinion that an EOL board could improve patient care in the last phase of life. 64% stated that the development of an EOL board would be worthwhile, while 28% did not see enough resources available at their institutions. Regarding the desired type of documentation, 61% voted for a centrally available EOL decision, and 31% supported an in-house-based documentation. 94% voted for the availability of an information folder about EOL care. The willingness of professionals to establish an EOL board was very high. Further steps should be taken to implement such boards to improve EOL care.

47 CFR 14.51 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2012 CFR

2012-10-01

... other documents; subscription. 14.51 Section 14.51 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping... improper purpose. (d) All proposed orders shall be submitted both as hard copies and on computer disk...

47 CFR 14.51 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2014 CFR

2014-10-01

... other documents; subscription. 14.51 Section 14.51 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping... improper purpose. (d) All proposed orders shall be submitted both as hard copies and on computer disk...

47 CFR 14.51 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2013 CFR

2013-10-01

... other documents; subscription. 14.51 Section 14.51 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping... improper purpose. (d) All proposed orders shall be submitted both as hard copies and on computer disk...

Illinois Occupational Skill Standards: Chemical Process Technical Operators.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended for workforce preparation program providers, details the Illinois Occupational Skill Standards for programs preparing students for employment as chemical process technical operators. The document begins with a brief overview of the Illinois perspective on occupational skill standards and credentialing, the process…

Financing the School Plant. Draft.

ERIC Educational Resources Information Center

King, Dave; Kimbrough, Ted

Thirteen methods of financing school buildings in California are described in this document. A brief introduction reviews recent changes in California school financing, following passage of Proposition 13, and explains the need for new financing methods. For each method, the document provides a description (which also points out limitations),…

Illinois Occupational Skill Standards. Beef Production Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for workforce preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the beef production cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards and…

Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer.

PubMed

Nyrop, Kirsten A; Deal, Allison M; Williams, Grant R; Guerard, Emily J; Pergolotti, Mackenzi; Muss, Hyman B

2016-02-01

National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about physical activity during routine clinic visits with patients with early-stage breast, colon, or prostate cancer. This study used a retrospective chart review for documentation of inquiries or recommendations pertaining to physical activity in clinician notes and after-visit patient summaries. In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early-stage cancer patients. Thirty-five percent of these encounters included a provider communication about "physical activity," "exercise," or "activity." Encounters with a medical oncologist resulted in a physical activity communication 55% of the time, whereas encounters with other clinician specialties did so 20% of the time (P < .0001). The likelihood of a physical activity communication increased with patient age (P < .001). When the encounter was with a patient who was being seen for surveillance, chemotherapy, or endocrine treatment, the rate of physical activity communications was significantly higher (46%, 37%, and 58%, respectively) than the rate when the visit was during radiation treatment or surgery (6% and 19%, respectively; P < .0001). This study shows that it is feasible for oncology providers to have physical activity communications during routine clinic visits; however, the frequency of physical activity communications varies among providers. Interventions are needed to remind and encourage all oncology providers to encourage their patients with early-stage cancer to be physically active. . © 2015 American Cancer Society.

[Artificial intelligence applied to radiation oncology].

PubMed

Bibault, J-E; Burgun, A; Giraud, P

2017-05-01

Performing randomised comparative clinical trials in radiation oncology remains a challenge when new treatment modalities become available. One of the most recent examples is the lack of phase III trials demonstrating the superiority of intensity-modulated radiation therapy in most of its current indications. A new paradigm is developing that consists in the mining of large databases to answer clinical or translational issues. Beyond national databases (such as SEER or NCDB), that often lack the necessary level of details on the population studied or the treatments performed, electronic health records can be used to create detailed phenotypic profiles of any patients. In parallel, the Record-and-Verify Systems used in radiation oncology precisely document the planned and performed treatments. Artificial Intelligence and machine learning algorithms can be used to incrementally analyse these data in order to generate hypothesis to better personalize treatments. This review discusses how these methods have already been used in previous studies. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

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

Leimkuhler, B.; Hermans, J.; Skeel, R.D.

A workshop was held on algorithms and parallel implementations for macromolecular dynamics, protein folding, and structural refinement. This document contains abstracts and brief reports from that workshop.

Report on National Collegiate Alcohol Awareness Week, Fall 1988.

ERIC Educational Resources Information Center

Rapaport, Ross J.

This document presents a report of the education and prevention activities undertaken at Central Michigan University in Mt. Pleasant, Michiagn, during the fall semester of 1988, in recognition of National Collegiate Alcohol Awareness Week (NCAAW). The document begins with a brief review of the university's campus-wide programs, goals, and…

Automotive Technology. 2002 Revision.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.

This document examines the origins and content of Ohio's Automobile Technician Training Certification Program, which is designed to improve the quality of training offered at secondary and postsecondary schools throughout Ohio. The document begins with a brief overview of the certification program, which is under the oversight of the Board of the…

Documenting Progress and Demonstrating Results: Evaluating Local Out-of-School Time Programs.

ERIC Educational Resources Information Center

Little, Priscilla; DuPree, Sharon; Deich, Sharon

A collaborative publication between Harvard Family Research Project and The Finance Project, this brief offers guidance in documenting progress and demonstrating results in local out-of-school-time programs. Following introductory remarks providing a rationale for program evaluation, discussing principles of program evaluation, and clarifying key…

Illinois Occupational Skill Standards: Clinical Laboratory Science/Biotechnology Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended to serve as a guide for workforce preparation program providers, details the Illinois Occupational Skill Standards for clinical laboratory occupations programs. The document begins with a brief overview of the Illinois perspective on occupational skill standards and credentialing, the process used to develop the…

Environmental Programs Information: Affecting Kansas Public Schools

ERIC Educational Resources Information Center

Kansas State Department of Education, 2004

2004-01-01

This document provides a brief overview of the environmental issues that affect Kansas public schools. Specific programs that address these problems are included, along with their contact information. This document contains information on the following issues and programs: (1) Department of Health and Environment; (2) air; (3) asbestos; (4)…

Illinois Occupational Skill Standards: Mechanical Drafting Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the mechanical drafting cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards and…

Missouri Comprehensive Outdoor Recreation Plan: Executive Summary.

ERIC Educational Resources Information Center

Missouri State Inter-Agency for Outdoor Recreation, Jefferson.

The document is a summary of the Missouri State Comprehensive Outdoor Recreation Plan, which was designed to provide guidelines for allocation of resources for needed recreation facilities. The plan identifies the present and future needs for outdoor recreation and recommends ways of meeting these needs. This 1967 document provides a brief history…

Illinois Occupational Skill Standards: Architectural Drafting Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the architectural drafting cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards and…

Microenterprise Development: An Employment Option for Welfare Recipients.

ERIC Educational Resources Information Center

Friedman, Pamela

2001-01-01

This document examines microenterprise development as an employment option for Temporary Assistance for Needy Families (TANF) recipients. The document begins with a brief discussion of the feasibility of self-employment as an option for TANF recipients, particularly in a slow economy. The next section answers policy questions pertaining to the…

Illinois Occupational Skill Standards: In-Store Retailing Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended to serve as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the in-store retailing cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards…

Illinois Occupational Skill Standards: Entry-Level Truck Driver.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended to serve as a guide for workforce preparation program providers, details the Illinois Occupational Skill Standards for programs preparing students for employment as entry-level truck drivers. The document begins with a brief overview of the Illinois perspective on occupational skill standards and credentialing, the…

Wisconsin's Drug Laws and Enforcement. Staff Brief 89-1.

ERIC Educational Resources Information Center

Matthias, Mary

This document provides information on current Wisconsin statutes and state-level activities relating to the enforcement of controlled substances laws, including assistance provided to local law enforcement agencies. Part I of this document describes the Uniform Controlled Substances Act as enacted by Wisconsin, other statutes which may be used to…

Illinois Occupational Skill Standards: Finishing and Distribution Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the finishing and distribution cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards…

30 CFR 250.490 - Hydrogen sulfide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mitigate damage to property and the environment caused by H2S. You must follow the requirements of this... documentation do I need? For each individual working on the platform, either: (i) You must have documentation of... respirator; practice in donning and adjusting the assigned respirator; information on the safe briefing areas...

Illinois Occupational Skill Standards: Imaging/Pre-Press Cluster.

ERIC Educational Resources Information Center

Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

This document, which is intended as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in occupations in the imaging/pre-press cluster. The document begins with a brief overview of the Illinois perspective on occupational skill standards and…

Continuous Improvement in Online Education: Documenting Teaching Effectiveness in the Online Environment through Observations

ERIC Educational Resources Information Center

Purcell, Jennifer W.; Scott, Heather I.; Mixson-Brookshire, Deborah

2017-01-01

Teaching observations are commonly used among educators to document and improve teaching effectiveness. Unfortunately, the necessary protocols and supporting infrastructure are not consistently available for faculty who teach online. This paper presents a brief literature review and reflective narratives of educators representing online education…

Joint Department of Defense, Advance Planning Briefing to Industry, Held at Kissimmee, Florida, on 30 April - 2 May 1996

DTIC Science & Technology

1996-05-01

Systems 17 Motion Bases Upgraded Aero Misc > Contact Info • AMC, Lt Col Letica , Phone (618) 256-5696 L8 Upgrade Flow Plan Advance Planning Briefing...Projected Schedule: FY 05 > Requirement Document: AMMP >• Projected Program Size: ? < $40M > Funding Status/Stability: > POCs: • AMC, Lt Col Letica

Do Disadvantaged Students Get Less Effective Teaching? Key Findings from Recent Institute of Education Sciences Studies. NCEE Evaluation Brief. Technical Appendix. NCEE 2014-4010

ERIC Educational Resources Information Center

Max, Jeffrey; Glazerman, Steven

2014-01-01

This document represents the technical appendix intended to accompany "Do Disadvantaged Students Get Less Effective Teaching? Key Findings from Recent Institute of Education Sciences Studies. NCEE Evaluation Brief. NCEE 2014-4010." Contents include: (1) Summary of Related, Non-Peer-Reviewed Studies; (2) Methods for Comparing Findings…

Are Charter Schools Making a Difference? A Study of Student Outcomes in Eight States. Research Brief

ERIC Educational Resources Information Center

Li, Jennifer

2009-01-01

Charter schools do not generally draw the top students from other public schools. Their test-score gains are similar to those of traditional public schools, but they have higher rates of students graduating high school and attending college. [This research brief describes work done for RAND Education documented in Charter Schools in Eight States:…

Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

ERIC Educational Resources Information Center

Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

2011-01-01

Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and…

State Requirements for Teacher Evaluation Policies Promoted by Race to the Top. NCEE Evaluation Brief. NCEE 2014-4016

ERIC Educational Resources Information Center

Hallgren, Kristin; James-Burdumy, Susanne; Perez-Johnson, Irma

2014-01-01

This brief describes the extent to which states required teacher evaluation policies aligned with the Race to the Top (RTT) initiative as of spring 2012. Although teacher evaluation policies appear to be rapidly evolving, documenting policy requirements in the early years of RTT implementation can help inform policymakers about the pace of policy…

Career Education--The Early Years. [and] Let's Get Serious about Career Education for Elementary Students. AACE Bonus Briefs.

ERIC Educational Resources Information Center

Woal, S. Theodore; DuVall, Patricia S.

This document consists of two brief articles on career education in elementary school. The first article, "Career Education--The Early Years" by S. Theodore Woal, suggests that elementary school is the time to begin to infuse career education concepts and to correlate and integrate career guidance in the school curriculum. Three activities are…

Early Childhood Education and Care for Native Hawaiian Children in Hawai'i: A Brief History

ERIC Educational Resources Information Center

Grace, Donna J.; Ku'ulei Serna, Alethea

2013-01-01

This study provides a brief overview of the history of early childhood education and care for Native Hawaiian children in Hawai'i. Data sources include a literature review, examination of archival documents, and interviews with a sample of Native Hawaiian parents and community members. We trace the emergence of outside-the-home early childhood…

Early Musical Training in Bel Canto Vocal Technique: A Brief History and Philosophy.

ERIC Educational Resources Information Center

Gerstein, Christine Wondolowski

This paper offers a brief history and philosophy of the origins of bel canto vocal style and describes the pedagogical methods used to achieve bel canto ideals in singing. The document discusses the adoption and development of this technique and how it developed over long periods of preparation in the foregoing centuries before the Baroque era.…

Effective Schooling in Rural Africa Report 3: Case Study Briefs on Rural Schooling.

ERIC Educational Resources Information Center

World Bank, Washington, DC. Human Development Network.

This document contains 20 case study briefs about efforts to improve rural schools and teachers in Africa, Latin America, and Asia. Some reforms focus on a part of the education system or a particular population; others attempt to change the national education system. At least seven programs were begun as an alternative to government schools. Most…

The Patient-Healthcare Professional Relationship and Communication in the Oncology Outpatient Setting: A Systematic Review.

PubMed

Prip, Anne; Møller, Kirsten Alling; Nielsen, Dorte Lisbet; Jarden, Mary; Olsen, Marie-Helene; Danielsen, Anne Kjaergaard

2017-07-27

Today, cancer care and treatment primarily take place in an outpatient setting where encounters between patients and healthcare professionals are often brief. The aim of this study was to summarize the literature of adult patients' experiences of and need for relationships and communication with healthcare professionals during chemotherapy in the oncology outpatient setting. The systematic literature review was carried out according to PRISMA guidelines and the PICO framework, and a systematic search was conducted in MEDLINE, CINAHL, The Cochrane Library, and Joanna Briggs Institute Evidence Based Practice Database. Nine studies were included, qualitative (n = 5) and quantitative (n = 4). The studies identified that the relationship between patients and healthcare professionals was important for the patients' ability to cope with cancer and has an impact on satisfaction of care, that hope and positivity are both a need and a strategy for patients with cancer and were facilitated by healthcare professionals, and that outpatient clinic visits framed and influenced communication and relationships. The relationship and communication between patients and healthcare professionals in the outpatient setting were important for the patients' ability to cope with cancer. Healthcare professionals need to pay special attention to the relational aspects of communication in an outpatient clinic because encounters are often brief. More research is needed to investigate the type of interaction and intervention that would be the most effective in supporting adult patients' coping during chemotherapy in an outpatient clinic.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Patient training in cancer pain management using integrated print and video materials: a multisite randomized controlled trial.

PubMed

Syrjala, Karen L; Abrams, Janet R; Polissar, Nayak L; Hansberry, Jennifer; Robison, Jeanne; DuPen, Stuart; Stillman, Mark; Fredrickson, Marvin; Rivkin, Saul; Feldman, Eric; Gralow, Julie; Rieke, John W; Raish, Robert J; Lee, Douglas J; Cleeland, Charles S; DuPen, Anna

2008-03-01

Standard guidelines for cancer pain treatment routinely recommend training patients to reduce barriers to pain relief, use medications appropriately, and communicate their pain-related needs. Methods are needed to reduce professional time required while achieving sustained intervention effectiveness. In a multisite, randomized controlled trial, this study tested a pain training method versus a nutrition control. At six oncology clinics, physicians (N=22) and nurses (N=23) enrolled patients (N=93) who were over 18 years of age, with cancer diagnoses, pain, and a life expectancy of at least 6 months. Pain training and control interventions were matched for materials and method. Patients watched a video followed by about 20 min of manual-standardized training with an oncology nurse focused on reviewing the printed material and adapted to individual concerns of patients. A follow-up phone call after 72 h addressed individualized treatment content and pain communication. Assessments at baseline, one, three, and 6 months included barriers, the Brief Pain Inventory, opioid use, and physician and nurse ratings of their patients' pain. Trained versus control patients reported reduced barriers to pain relief (P<.001), lower usual pain (P=.03), and greater opioid use (P<.001). No pain training patients reported severe pain (>6 on a 0-10 scale) at 1-month outcomes (P=.03). Physician and nurse ratings were closer to patients' ratings of pain for trained versus nutrition groups (P=.04 and <.001, respectively). Training efficacy was not modified by patient characteristics. Using video and print materials, with brief individualized training, effectively improved pain management over time for cancer patients of varying diagnostic and demographic groups.

The Surveillance, Epidemiology and End Results (SEER) Program and Pathology: Towards Strengthening the Critical Relationship

PubMed Central

Duggan, Máire A.; Anderson, William F.; Altekruse, Sean; Penberthy, Lynne; Sherman, Mark E.

2016-01-01

The Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute collects data on cancer diagnoses, treatment and survival for approximately 30% of the United States (U.S.) population. To reflect advances in research and oncology practice, approaches to cancer control are evolving from simply enumerating the development of cancers by organ sites in populations to include monitoring of cancer occurrence by histopathologic and molecular subtype, as defined by driver mutations and other alterations. SEER is an important population-based resource for understanding the implications of pathology diagnoses across demographic groups, geographic regions, and time, and provides unique insights into the practice of oncology in the U.S that are not attainable from other sources. It provides incidence, survival and mortality data for histopathologic cancer subtypes, and data by molecular subtyping is expanding. The program is developing systems to capture additional biomarker data, results from special populations, and expand bio-specimen banking to enable cutting edge cancer research that can improve oncology practice. Pathology has always been central and critical to the effectiveness of SEER, and strengthening this relationship in this modern era of cancer diagnosis could be mutually beneficial. Achieving this goal requires close interactions between pathologists and the SEER program. This review provides a brief overview of SEER, focuses on facets relevant to pathology practice and research, and highlights the opportunities and challenges for pathologists to benefit from and enhance the value of SEER data. PMID:27740970

Which prescription for the illegible and unreadable DTC (direct-to-consumer) brief summary--major surgery or euthanasia?

PubMed

Hochhauser, Mark

2002-01-01

Healthcare costs are rising, mostly because of increased prescription drug use, chiefly as the result of direct-to-consumer drug ads on television, newspapers, and magazines. However, the FDA's requirement for a brief summary in direct-to-consumer drug ads has produced summaries that are ineffective because they are illegible and unreadable, create information overload, and require literacy skills not possessed by most consumers. If the FDA wants brief summaries to be in a patient-friendly format, it should provide document design templates and plain language examples. Unless brief summaries are written so that they can be understood by the average patient, they should be overhauled or done away with.

Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.

PubMed

Lapham, Gwen T; Rubinsky, Anna D; Shortreed, Susan M; Hawkins, Eric J; Richards, Julie; Williams, Emily C; Berger, Douglas; Chavez, Laura J; Kivlahan, Daniel R; Bradley, Katharine A

2015-08-01

Performance measures for brief alcohol interventions (BIs) are currently based on provider documentation of BI. However, provider documentation may not be a reliable measure of whether or not patients are offered clinically meaningful BIs. In particular, BI documented with clinical decision support in an electronic medical record (EMR) could appear identical irrespective of the quality of BI provided. We hypothesized that differences in how BI was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. Male outpatients with unhealthy alcohol use identified by confidential satisfaction surveys (2009-2012) were assessed for whether they reported receiving BI in the past year (patient-reported BI) and whether they had BI documented in the EMR during the same period (documented BI). We evaluated and compared the prevalence of documented BI to patient-reported BI across 21 VA networks to determine whether documented BI had a variable association with patient-reported BI across the networks. Of 9896 eligible male outpatients with unhealthy alcohol use, 59.0% (95% CI 57.4-60.5%) reported BI (50.4-64.9% across networks) and 37.4% (95% CI 36.0-38.9%) had BI documented in the EMR (28.0-44.2% across networks). Overall, 72.9% (95% CI 70.8-75.5%) of patients with documented BI also reported BI. The association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models. Performance measures of BI that rely on provider documentation in EMRs appear comparable to patient report for comparing care across VA networks. Published by Elsevier Ireland Ltd.

Prophylactic antibiotics for preventing early Gram-positive central venous catheter infections in oncology patients, a Cochrane systematic review.

PubMed

van de Wetering, M D; van Woensel, J B M; Kremer, L C M; Caron, H N

2005-05-01

Long-term tunnelled central venous catheters (TCVC) are increasingly used in oncology patients. Infections are a frequent complication of TCVC, mostly caused by Gram-positive bacteria. The objective of this review is to evaluate the efficacy of antibiotics in the prevention of early Gram-positive TCVC infections, in oncology patients. We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Register up to July 2003. We selected randomised controlled trials (RCT) evaluating prophylactic antibiotics prior to insertion of the TCVC, and the combination of an antibiotic and heparin to flush the TCVC, in paediatric and adult oncology patients. The primary outcome was documented Gram-positive bacteraemia in patients with a TCVC. All trials identified were assessed and the data extracted independently by two reviewers. There were nine trials included. Four trials reported on vancomycin/teicoplanin prior to insertion of the TCVC compared to no antibiotics. There was no reduction in the number of Gram-positive TCVC infections with an Odds ratio of 0.42 (95% confidence interval 0.13-1.31). Five trials studied flushing of the TCVC with a vancomycin/heparin solution compared to heparin flushing only. This method decreased the number of TCVC infections significantly with an Odds ratio of 0.43 (95% CI 0.21-0.87). Flushing the TCVC with a vancomycin/heparin solution reduced the incidence of Gram-positive infections.

Use of the Word "Cure" in the Oncology Literature.

PubMed

Prasad, Vinay

2015-08-01

"Cure" is an important word in oncology but its use in the published literature has not been examined. I investigated all oncology articles using cure in the title field and published in 2012. The definition of cure was examined, specifically whether or not authors use the word to connote some surviving subset of patients who go on to experience outcomes similar to age-matched, normal controls-a definition favored by researchers and employed in survival function analyses. All articles published between January 1, 2012, and December 31, 2012, with the word cure in the title field were retrieved from Thompson Reuters' Web of Science. After exclusions, articles were read in full to examine what definitions of cure was used. Additionally, for each situation (type of cancer, stage/grade) where the word cure was used, a literature search was performed to ascertain whether there existed documented cases of cure. Twenty-nine oncology articles used the word cure in their title in 2012. Nearly half, 14 (48%) of 29, used the term in situations (cancer type, stage/grade) currently considered incurable. Approximately one-third (34.5%) of the articles used the word consistent with the definition that, after a set period of time, some surviving subset of patients experience survival similar to normal controls. There is heterogeneity in the use of the word cure in the literature. © The Author(s) 2014.

Robot-assisted surgery in gynecological oncology: current status and controversies on patient benefits, cost and surgeon conditions - a systematic review.

PubMed

Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel; Dalsgaard, Tórur; Bjørn, Signe F; Frøding, Ligita P; Kehlet, Henrik; Høgdall, Claus K; Lajer, Henrik

2017-03-01

Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. A database search in PubMed and EMBASE was performed up until 4 March 2016. The search strategy was developed in collaboration with an information specialist, and by application of the PRISMA guidelines. Human participants and English language were the only restrictive filters applied. Selection was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous surgical methods. Controversies arise because current knowledge does not clearly document the benefit of robot-assisted surgery, on perioperative outcome compared with the increased costs of the acquisition and application. The rapid development in robot-assisted surgery calls for long-term detailed prospective cohorts or randomized controlled trials. The costs associated with acquisition, application, and maintenance have an unfavorable impact on cost-benefit evaluations, especially when compared with laparoscopy. Future developments in robot-assisted surgery will hopefully lead to competition in the market, which will decrease costs. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Assessing Self-Efficacy for Coping with Cancer: Development and Psychometric Analysis of the Brief Version of the Cancer Behavior Inventory (CBI-B)

PubMed Central

Heitzmann, Carolyn A.; Merluzzi, Thomas V.; Jean-Pierre, Pascal; Roscoe, Joseph A.; Kirsh, Kenneth L.; Passik, Steven D.

2010-01-01

Introduction The Cancer Behavior Inventory-Brief Version (CBI-B), a 12-item measure of self-efficacy for coping with cancer derived from the longer 33-item version (CBI-L), was subjected to psychometric analysis. Method Participants consisted of three samples: 735 cancer patients from a multi-center CCOP study, 199 from central Indiana, and 370 from a national sample. Samples were mixed with respect to initial cancer diagnosis. Participants completed the CBI-B and measures of quality of life, optimism, life satisfaction, depression, and sickness impact. Results EFA with oblique rotation yielded four factors in the first sample: 1) Maintaining Independence and Positive Attitude; 2) Participating in Medical Care; 3) Coping and Stress Management; and 4) Managing Affect, which were confirmed in subsequent samples. Cronbach α coefficient for the 12-item CBI-B ranged from .84 to .88. Validity of the CBI-B was demonstrated by positive correlations with measures of quality of life and optimism and negative correlations with measures of depression and sickness impact. Discussion The CBI-B is a valid brief measure of self-efficacy for coping that could be easily integrated into clinical oncology research and practice and also be used in screening patients. PMID:11351373

American Society for Radiation Oncology (ASTRO) 2012 Workforce Study: The Radiation Oncologists' and Residents' Perspectives

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

Pohar, Surjeet, E-mail: spohar@iuhealth.org; Fung, Claire Y.; Hopkins, Shane

Purpose: The American Society for Radiation Oncology (ASTRO) conducted the 2012 Radiation Oncology Workforce Survey to obtain an up-to-date picture of the workforce, assess its needs and concerns, and identify quality and safety improvement opportunities. The results pertaining to radiation oncologists (ROs) and residents (RORs) are presented here. Methods: The ASTRO Workforce Subcommittee, in collaboration with allied radiation oncology professional societies, conducted a survey study in early 2012. An online survey questionnaire was sent to all segments of the radiation oncology workforce. Respondents who were actively working were included in the analysis. This manuscript describes the data for ROs andmore » RORs. Results: A total of 3618 ROs and 568 RORs were surveyed. The response rate for both groups was 29%, with 1047 RO and 165 ROR responses. Among ROs, the 2 most common racial groups were white (80%) and Asian (15%), and the male-to-female ratio was 2.85 (74% male). The median age of ROs was 51. ROs averaged 253.4 new patient consults in a year and 22.9 on-treatment patients. More than 86% of ROs reported being satisfied or very satisfied overall with their career. Close to half of ROs reported having burnout feelings. There was a trend toward more frequent burnout feelings with increasing numbers of new patient consults. ROs' top concerns were related to documentation, reimbursement, and patients' health insurance coverage. Ninety-five percent of ROs felt confident when implementing new technology. Fifty-one percent of ROs thought that the supply of ROs was balanced with demand, and 33% perceived an oversupply. Conclusions: This study provides a current snapshot of the 2012 radiation oncology physician workforce. There was a predominance of whites and men. Job satisfaction level was high. However a substantial fraction of ROs reported burnout feelings. Perceptions about supply and demand balance were mixed. ROs top concerns reflect areas of attention for the healthcare sector as a whole.« less

Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States.

PubMed

Nabavizadeh, Nima; Burt, Lindsay M; Mancini, Brandon R; Morris, Zachary S; Walker, Amanda J; Miller, Seth M; Bhavsar, Shripal; Mohindra, Pranshu; Kim, Miranda B; Kharofa, Jordan

2016-02-01

The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This analysis may serve as a valuable tool for those seeking to improve training of the next generation of oncology leaders. Copyright © 2016 Elsevier Inc. All rights reserved.

The Third Reich in Perspective: A Resource Unit for Teachers and Group Leaders.

ERIC Educational Resources Information Center

B'nai B'rith, New York, NY. Anti-Defamation League.

A brief history of the Nazi rise to power and genocide of Jews is contained in this pamphlet. The pamphlet was designed to supplement secondary social studies textbooks when it was found that most texts omit or skim over the treatment of the Jews by the Nazis. The document begins with a brief overview of historical content which the developers…

Federal Child Care Policy. Current and Proposed. Family Impact Seminar (Washington, D.C., April 28, 1989). Meeting Highlights and Background Briefing Report.

ERIC Educational Resources Information Center

Ooms, Theodora; Herendeen, Lisa

The purpose of this policy seminar, one of a series of family impact seminars, was to consider current and proposed policies of the federal government that concern child care. This document provides highlights of presentations by the seminar panelists and a background briefing report prepared before the meeting. The highlights section summarizes:…

Establishing Teacher Competencies in Early Care and Education: A Review of Current Models and Options for California. Building California's Preschool for All Workforce. A Series of Policy Briefs

ERIC Educational Resources Information Center

Bellm, Dan

2005-01-01

This policy brief provides guidelines grouped into five areas: personal and professional behavior; classroom environment; health, safety and nutrition; working with families and communities; and administration and management. The document discusses the topics that teacher competencies generally cover, options for how they might be developed and…

Many Eligible Children Don't Participate in School Nutrition Programs: Reauthorization Offers Opportunities to Improve. National Issue Brief Number 85

ERIC Educational Resources Information Center

Carson, Jessica A.

2015-01-01

This brief uses data from the 2013 Current Population Survey's Food Security Supplement to document levels of participation in two of the largest programs authorized by the Healthy, Hunger-Free Kids Act of 2010--the National School Lunch Program and the School Breakfast Program--by region and place type (rural, suburban, and city), to identify…

Designing and Financing an Integrated Program of College Study: Lessons from the California Academy of Liberal Studies

ERIC Educational Resources Information Center

Goldberger, Susan; Haynes, Leslie

2005-01-01

This document represents the first in a series of design briefs on models for early college high schools. The briefs focus on the academic and organizational design of the college component and tie those key features to a sustainable financing model. By engaging students in up to two years of demanding college-level work while still in high…

Impact of Brief Intervention Services on Drug-Using Truant Youths' Self-Reported Delinquency and Arrest Charges: A Longitudinal Study

ERIC Educational Resources Information Center

Dembo, Richard; Schmeidler, James; Wareham, Jennifer; Briones-Robinson, Rhissa; Winters, Ken C.; Ungaro, Rocio

2016-01-01

The issue of delinquency among truant youths is insufficiently documented in the literature. There is a need to elucidate this issue, and assess the efficacy of interventions to reduce this problem behavior. The present National Institute on Drug Abuse (NIDA)-funded study addressed this gap by examining the impact of a Brief Intervention (BI),…

More than a Paycheck? The Impact of Summer Youth Employment on Students' Educational Engagement and Success. IESP Policy Brief No. 02-12

ERIC Educational Resources Information Center

Leos-Urbel, Jacob; Schwartz, Amy Ellen; Weinstein, Meryle; Weitzman, Beth C.

2012-01-01

This policy brief presents initial findings of the impact of New York City's Summer Youth Employment Program (SYEP) on academic outcomes for public school students. Despite the broad appeal of providing summer jobs for urban youth, there is little research documenting the relationship between summer employment and educational outcomes for high…

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

PubMed

Chatterjee, Koushik; Bhaumik, Gautam; Chattopadhyay, Bhargab

2018-01-01

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

An Analysis of the Horticulture Equipment and Services Occupation.

ERIC Educational Resources Information Center

Harbage, Monroe; Lechner, Donald L.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the horticulture equipment and services occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Fourteen duties are…

Advanced Marketing/Coop Course Outline.

ERIC Educational Resources Information Center

Dixon, Bobby

This document contains the information required to present a 1-year school course that is the capstone class of a 2-year marketing major and is designed for high school students wishing to develop the skills required for entry into the marketing industry. The document begins with a rationale, brief course description, list of course objectives,…

Videoconferencing as a Tool for Welfare and Workforce Reform.

ERIC Educational Resources Information Center

Kaplan, April; Van Lare, Barry

2000-01-01

This document explains how agencies serving recipients of Temporary Assistance for Needy Families (TANF) can use videoconferencing as a tool for welfare and work force reform. The document begins with a brief overview of how videoconferencing and other communications technologies can be used in designing and delivering welfare and work force…

An Analysis of the Commercial Art Occupation.

ERIC Educational Resources Information Center

Mowen, Kenneth A.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the commercial artist occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Seventeen duties are broken down into a…

An Analysis of the Machine Trades Occupation.

ERIC Educational Resources Information Center

Hall, Charles W.; Emory, Harold L.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the machine trades occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Fifteen duties are broken down into a number…

Iowa School-to-Work Employer Participation Ideas. Developing a Workforce.

ERIC Educational Resources Information Center

Iowa School-to-Work Office, Des Moines.

This document, which is intended for Iowa employers and elementary and secondary educators, outlines 11 activities through which employers can participate in school-to-work (STW) programs in Iowa's elementary and secondary schools. The document begins with a definition of work-based learning and a brief overview of information and other resources…

An Analysis of the Laboratory Assisting Occupation.

ERIC Educational Resources Information Center

McGee, Patricia; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the laboratory assistant occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eleven duties are broken down into a…

[Myths and Realities of Life for Older Americans.

ERIC Educational Resources Information Center

Perspective on Aging, 1975

1975-01-01

The document is comprised of brief excerpts from the Louis Harris and Associates' study for the National Council on the Aging, "The Myth and Reality of Aging in America," the most extensive study ever conducted to determine public attitudes and perceptions of aging in this country, and to document older Americans' views and attitudes…

An Analysis of the Insurance Sales Occupation.

ERIC Educational Resources Information Center

Moore, Gordon; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the insurance sales occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eleven duties are broken down into a number…

An Analysis of the Purchasing Occupation.

ERIC Educational Resources Information Center

Lustic, Gary; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the purchasing occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Fourteen duties are broken down into a number of…

Neuroscience and Special Education. inForum

ERIC Educational Resources Information Center

Muller, Eve

2011-01-01

The purpose of this document is to provide a brief overview of how links are being developed between the rapidly expanding field of neuroscience and the practice of special education. The first part of the document introduces definitions and terminology, provides an overview of how findings from neuroscience are being applied to the field of…

Educational Exchanges between the United States and the Soviet Union.

ERIC Educational Resources Information Center

Altenberger, Alicja

1989-01-01

Following a brief introductory discussion concerning organizations, activities, and agreements that promote exchanges between the United States and the Soviet Union, this document provides: (1) an annotated bibliography of 18 ERIC documents and books on cultural, scientific, and educational exchanges between the U.S. and the U.S.S.R.; and (2) a…

Research on School Television in Japan, 1953-1983.

ERIC Educational Resources Information Center

Akiyama, Takashiro

Published on the occasion of the 30th anniversary of the school television broadcasting industry in Japan, this document reviews and summarizes the results of past research on the Japanese school television system and considers its future direction. After a brief introduction, the document is divided into six sections: (1) a prehistory of school…

An Analysis of the Lithographic Printing Occupation.

ERIC Educational Resources Information Center

Innis, Gene A.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the lithographic printing occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Nine duties are broken down into a…

Portfolio langagier en francais (Language Portfolios in French).

ERIC Educational Resources Information Center

Laplante, Bernard; Christiansen, Helen

2001-01-01

Suggests that first-year college students learning French should create a language portfolio that contains documents that illustrate what they have learned in French, along with a brief statement of what linguistic skill the document demonstrates. The goal of the portfolio is to make students more aware of their own learning, their strengths, and…

An Analysis of the Information Receptionist Occupation.

ERIC Educational Resources Information Center

Sams, Helen C.; Snyder, Lois M.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the information receptionist occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Ten duties are broken down into a…

An Analysis of the Industrial Sales Occupation.

ERIC Educational Resources Information Center

Kitzmiller, Charles C.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the industrial sales occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eight duties are broken down into a number…

Aquaculture Thesaurus: Descriptors Used in the National Aquaculture Information System.

ERIC Educational Resources Information Center

Lanier, James A.; And Others

This document provides a listing of descriptors used in the National Aquaculture Information System (NAIS), a computer information storage and retrieval system on marine, brackish, and freshwater organisms. Included are an explanation of how to use the document, subject index terms, and a brief bibliography of the literature used in developing the…

Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience.

PubMed

Li, Meng-Ju; Chang, Hsiu-Hao; Yang, Yung-Li; Lu, Meng-Yao; Shao, Pei-Lan; Fu, Chun-Min; Chou, An-Kuo; Liu, Yen-Lin; Lin, Kai-Hsin; Huang, Li-Min; Lin, Dong-Tsamn; Jou, Shiann-Tarng

2017-10-01

Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection. © 2017 Wiley Periodicals, Inc.

Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital.

PubMed

Agulnik, Asya; Mora Robles, Lupe Nataly; Forbes, Peter W; Soberanis Vasquez, Doris Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Kleinman, Monica; Rodriguez-Galindo, Carlos

2017-08-01

Hospitalized pediatric oncology patients are at high risk of clinical decline and mortality, particularly in resource-limited settings. Pediatric early warning systems (PEWS) aid in the early identification of clinical deterioration; however, there are limited data regarding their feasibility or impact in low-resource settings. This study describes the successful implementation of PEWS at the Unidad Nacional de Oncología Pediátrica (UNOP), a pediatric oncology hospital in Guatemala, resulting in improved inpatient outcomes. A modified PEWS was implemented at UNOP with systems to track errors, transfers to a higher level of care, and high scores. A retrospective cohort study was used to evaluate clinical deterioration events in the year before and after PEWS implementation. After PEWS implementation at UNOP, there was 100% compliance with PEWS documentation and an error rate of <10%. Implementation resulted in 5 high PEWS per week, with 30% of patients transferring to a higher level of care. Among patients requiring transfer to the pediatric intensive care unit (PICU), 93% had an abnormal PEWS before transfer. The rate of clinical deterioration events decreased after PEWS implementation (9.3 vs 6.5 per 1000-hospitalpatient-days, p = .003). Despite an 18% increase in total hospital patient-days, PICU utilization for inpatient transfers decreased from 1376 to 1088 PICU patient-days per year (21% decrease; P<.001). This study describes the successful implementation of PEWS in a pediatric oncology hospital in Guatemala, resulting in decreased inpatient clinical deterioration events and PICU utilization. This work demonstrates that PEWS is a feasible and effective quality improvement measure to improve hospital care for children with cancer in hospitals with limited resources. Cancer 2017;123:2965-74. © 2017 American Cancer Society. © 2017 American Cancer Society.

The radiation oncology workforce: A focus on medical dosimetry

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

Robinson, Gregg F., E-mail: grobinson@medicaldosimetry.org; Mobile, Katherine; Yu, Yan

2014-07-01

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

Escalation of Oncologic Services at the End of Life Among Patients With Gynecologic Cancer at an Urban, Public Hospital

PubMed Central

Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G.

2015-01-01

Purpose: Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Methods: Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Results: Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P < .001), with the most dramatic changes occurring during the last 2 months. Patients with longer duration of continuity of care used significantly fewer resources toward the end of life. Conclusion: To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. PMID:25604595

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 patients to play a role in their care. Critical for most patients, this also improves the physician-patient relationship, the quality of cancer care, and the well-being of patients and their families.

Optimizing clinical and organizational practice in cancer survivor transitions between specialized oncology and primary care teams: a realist evaluation of multiple case studies.

PubMed

Tremblay, Dominique; Prady, Catherine; Bilodeau, Karine; Touati, Nassera; Chouinard, Maud-Christine; Fortin, Martin; Gaboury, Isabelle; Rodrigue, Jean; L'Italien, Marie-France

2017-12-16

Cancer is now viewed as a chronic disease, presenting challenges to follow-up and survivorship care. Models to shift from haphazard, suboptimal and fragmented episodes of care to an integrated cancer care continuum must be developed, tested and implemented. Numerous studies demonstrate improved care when follow-up is assured by both oncology and primary care providers rather than either group alone. However, there is little data on the roles assumed by specialized oncology teams and primary care providers and the extent to which they work together. This study aims to develop, pilot test and measure outcomes of an innovative risk-based coordinated cancer care model for patients transitioning from specialized oncology teams to primary care providers. This multiple case study using a sequential mixed-methods design rests on a theory-driven realist evaluation approach to understand how transitions might be improved. The cases are two health regions in Quebec, Canada, defined by their geographic territory. Each case includes a Cancer Centre and three Family Medicine Groups selected based on differences in their determining characteristics. Qualitative data will be collected from document review (scientific journal, grey literature, local documentation), semi-directed interviews with key informants, and observation of care coordination practices. Qualitative data will be supplemented with a survey to measure the outcome of the coordinated model among providers (scope of practice, collaboration, relational coordination, leadership) and patients diagnosed with breast, colorectal or prostate cancer (access to care, patient-centredness, communication, self-care, survivorship profile, quality of life). Results from descriptive and regression analyses will be triangulated with thematic analysis of qualitative data. Qualitative, quantitative, and mixed methods data will be interpreted within and across cases in order to identify context-mechanism associations that explain outcomes. The study will provide empirical data on a risk-based coordinated model of cancer care to guide actions at different levels in the health system. This in-depth multiple case study using a realist approach considers both the need for context-specific intervention research and the imperative to address research gaps regarding coordinated models of cancer care.

EMSE at TREC 2015 Clinical Decision Support Track

DTIC Science & Technology

2015-11-20

pseudo relevant documents, semantic ressources of UMLS , and a hybrid approach called SMERA that combines LSI and UMLS based approaches. Only three of...approach to query expansion uses ontologies ( UMLS ) and a lo- cal approach based on pseudo relevant feedback documents using LSI. A brief description of...pseudo relevance feedback documents, and a semantic method based on UMLS concepts. The LSI-based method was used only to expand summary terms that can’t

Chemotherapy extravasations: prevention, identification, management, and documentation.

PubMed

Gonzalez, Tulia

2013-02-01

The nurses' role in safe and effective practice of chemotherapy administration is paramount. The purpose of this article is to present nurses administering chemotherapy with evidence-based information useful in eliminating or reducing the severity of an injury from a chemotherapy extravasation. Nurse education is essential to prevent, recognize, manage, and document chemotherapy extravasations. The classification of the cytotoxic drug and its mechanism of action is useful when selecting the IV access device and also will direct the nurse's intervention to manage the injury. The Oncology Nursing Society's Chemotherapy and Biotherapy Guidelines and Recommendations for Practice and the drug manufacturer are the best sources offering pharmacologic and nonpharmacologic recommendations. The nurse's best ally in the prevention, prompt recognition, and management of an extravasation is the educated patient. Documenting chemotherapy extravasation is another important step to guide the treatment plan; therefore, the document must provide complete details and the extent of the event.

Natural Channel Design Review Checklist

EPA Pesticide Factsheets

This document presents a brief description of the checklist items by the following sections: Watershed and Geomorphic Assessment, Preliminary Design, Final Design, and Maintenance and Monitoring Plans.

A Community for All Generations -- Teens and Adults Working Together. A Guide for Public Dialogue and Problem Solving. Version 1.0.

ERIC Educational Resources Information Center

Campbell, Sarah vL.

This document is intended to create an opportunity for teens and adults to talk together and find ways to make their community a place where young people can grow up successfully. The discussion guide begins with a brief statement of purpose and a brief explanation of study circles and their objectives. The remainder of the guide consists of…

Instructional Time for Third- and Eighth-Graders in Public and Private Schools: School Year 2011-12. Stats in Brief. NCES 2017-076

ERIC Educational Resources Information Center

Hoyer, Kathleen Mulvaney; Sparks, Dinah

2017-01-01

The National Center for Education Statistics (NCES) has published a number of reports documenting the amount of time that students have received instruction in various subjects. Using more recent data and similar measures, this Statistics in Brief builds on prior reports to provide an updated look at time spent on instruction in various subjects.…

Policy Level Information on Logistics-Oriented Research.

DTIC Science & Technology

1980-08-01

Logistics Planann and System Long-Range Management Technology Planning Evaluation of Rold Miasion of Support Organizacion Effective Cross-Service Policies...guidelines, solution procedures, etc. The documentation format (technical report, user’s manual , briefing slides, etc.) also falls into this category...CHECK AT LEAST ONE) PhD Dissertation SMaster’s Thesis 7 Memorandum L Briefing Q Technical Report 7 Software Product O Hardware Product Q7 User’s Manual

Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO).

PubMed

Rieger, C T; Liss, B; Mellinghoff, S; Buchheidt, D; Cornely, O A; Egerer, G; Heinz, W J; Hentrich, M; Maschmeyer, G; Mayer, K; Sandherr, M; Silling, G; Ullmann, A; Vehreschild, M J G T; von Lilienfeld-Toal, M; Wolf, H H; Lehners, N

2018-06-01

Infectious complications are a significant cause of morbidity and mortality in patients with malignancies specifically when receiving anticancer treatments. Prevention of infection through vaccines is an important aspect of clinical care of cancer patients. Immunocompromising effects of the underlying disease as well as of antineoplastic therapies need to be considered when devising vaccination strategies. This guideline provides clinical recommendations on vaccine use in cancer patients including autologous stem cell transplant recipients, while allogeneic stem cell transplantation is subject of a separate guideline. The document was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) by reviewing currently available data and applying evidence-based medicine criteria.

Guidelines for biomarker testing in gastroenteropancreatic neuroendocrine neoplasms: a national consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology.

PubMed

García-Carbonero, R; Vilardell, F; Jiménez-Fonseca, P; González-Campora, R; González, E; Cuatrecasas, M; Capdevila, J; Aranda, I; Barriuso, J; Matías-Guiu, X

2014-03-01

The annual incidence of neuroendocrine tumours in the Caucasian population ranges from 2.5 to 5 new cases per 100,000 inhabitants. Gastroenteropancreatic neuroendocrine tumours is a family of neoplasms widely variable in terms of anatomical location, hormone composition, clinical syndromes they cause and in their biological behaviour. This high complexity and clinical heterogeneity, together with the known difficulty of predicting their behaviour from their pathological features, are reflected in the many classifications that have been developed over the years in this field. This article reviews the main tissue and clinical biomarkers and makes recommendations for their use in medical practice. This document represents a consensus reached jointly by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP).

An Analysis of the Real Estate Property Managing Occupation.

ERIC Educational Resources Information Center

Bryan, James E.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the real estate property manager occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eleven duties are broken down…

An Analysis of the Payroll Clerking Occupation.

ERIC Educational Resources Information Center

Peal, Sharyn; Rose, Virginia

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the payroll clerk occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Ten duties are broken down into a number of…

An Analysis of the Auto Body Repair Occupation.

ERIC Educational Resources Information Center

Stranke, Edward J.; Speck, Samuel R.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the auto body mechanic occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eleven duties are broken down into a…

First Steps to Endangered Language Documentation: The Kalasha Language, a Case Study

ERIC Educational Resources Information Center

Mela-Athanasopoulou, Elizabeth

2011-01-01

The present paper based on extensive fieldwork D conducted on Kalasha, an endangered language spoken in the three small valleys in Chitral District of Northwestern Pakistan, exposes a spontaneous dialogue-based elicitation of linguistic material used for the description and documentation of the language. After a brief display of the basic typology…

An Analysis of the Waste Water Treatment Maintenance Mechanic Occupation.

ERIC Educational Resources Information Center

Clark, Anthony B.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the waste water treatment mechanics occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Twelve duties are broken…

An Analysis of the Television and Radio Service Occupation.

ERIC Educational Resources Information Center

Pomeroy, James W.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the television and radio service occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Eight duties are broken down…

An Analysis of the Air Conditioning, Refrigerating and Heating Occupation.

ERIC Educational Resources Information Center

Frass, Melvin R.; Krause, Marvin

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the air conditioning, refrigerating, and heating occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Six duties are…

An Analysis of the Diesel Truck Mechanic Occupation.

ERIC Educational Resources Information Center

Kilo, Joseph L.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the diesel truck mechanic occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Thirteen duties are broken down into a…

Oyster Reef Communities in the Chesapeake Bay: A Brief Primer. VORTEX: Virginia's Oyster Reef Teaching EXperience.

ERIC Educational Resources Information Center

Harding, Juliana M.; Mann, Roger; Clark, Vicki P.

This document introduces Virginia's Oyster Reef Teaching EXperience (VORTEX), which is an interdisciplinary program focusing on the importance of oyster reef communities in the Chesapeake Bay ecosystem. The VORTEX program uses field and laboratory experience supported by multimedia instruction. This document presents an overview on the biology of…

Music Accommodation in Secondary Schools. A Design Guide. Building Bulletin 86.

ERIC Educational Resources Information Center

Watson, Lucy; Wadsworth, Alison; Nichols, Helen; Daniels, Richard; Marshall, Christopher; Orlowski, Rafal

This document provides guidance on accommodations in secondary schools, concentrating on the needs of 11- to 16-year-old pupils. The guidance is intended to assist all those who may be involved in the briefing and design process. It discusses the issues that arise when considering both new and existing accommodations. The document covers the range…

An Analysis of the Dental Assisting Occupation.

ERIC Educational Resources Information Center

Hough, Sharon L.; And Others

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the dental assistant occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Six duties are broken down into a number of…

Quality research in radiation oncology: a self-improvement initiative 30 years ahead of its time?

PubMed

Wilson, J Frank; Owen, Jean

2005-12-01

The quality of cancer care in the United States should be better than it is. Society has demanded improvement, but much work remains to be done to define and measure both the current quality of care and the steps needed to optimize such care. Various public and private organizations are directing early efforts toward attempts to determine the quality of selected oncology services as a first step in a broad-based quality improvement process. In contrast, the ACR Patterns of Care Study (PCS) for over 30 years has relied on exemplary voluntary engagement by American radiation oncologists in critical self-assessment and self-improvement as a highly effective pathway to improved practice quality. This article provides an overview of the documented historical and recent impact of PCS research findings on practice and describes the deliberate adaptation of the PCS identity and methodology to the quality-sensitive national environment with the new project name Quality Research in Radiation Oncology. The article concludes with a discussion of the rationale for continuing this unique quality improvement initiative and some of the challenges to this imperative that are being faced.

Position paper of the Italian Association of Medical Oncology on early palliative care in oncology practice (Simultaneous Care).

PubMed

Zagonel, Vittorina; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Broglia, Chiara; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Marchetti, Paolo; Massa, Elena; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Nacci, Angelo; Pavese, Ida; Piva, Erico; Quirino, Michela; Roselli, Mario; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ucci, Giovanni; Labianca, Roberto; Gori, Stefania; Pinto, Carmine; Cascinu, Stefano

2017-01-21

One of the priorities of personalized medicine regards the role of early integration of palliative care with cancer-directed treatments, called simultaneous care. This article, written by the Italian Association of Medical Oncology (AIOM) Simultaneous and Continuous Care Task Force, represents the position of Italian medical oncologists about simultaneous care, and is the result of a 2-step project: a Web-based survey among medical oncologists and a consensus conference. We present the opinion of more than 600 oncologists who helped formulate these recommendations. This document covers 4 main aspects of simultaneous care: 1) ethical, cultural, and relational aspects of cancer and implications for patient communication; 2) training of medical oncologists in palliative medicine; 3) research on the integration between cancer treatments and palliative care; and 4) organizational and management models for the realization of simultaneous care. The resulting recommendations highlight the role of skills and competence in palliative care along with implementation of adequate organizational models to accomplish simultaneous care, which is considered a high priority of AIOM in order to grant the best quality of life for cancer patients and their families.

A multisite evaluation of summer camps for children with cancer and their siblings.

PubMed

Wu, Yelena P; McPhail, Jessica; Mooney, Ryan; Martiniuk, Alexandra; Amylon, Michael D

2016-01-01

Summer camps for pediatric cancer patients and their families are ubiquitous. However, there is relatively little research, particularly studies including more than one camp, documenting outcomes associated with children's participation in summer camp. The current cross-sectional study used a standardized measure to examine the role of demographic, illness, and camp factors in predicting children's oncology camp-related outcomes. In total, 2,114 children at 19 camps participated. Campers were asked to complete the pediatric camp outcome measure, which assesses camp-specific self-esteem, emotional, physical, and social functioning. Campers reported high levels of emotional, physical, social, and self-esteem functioning. There were differences in functioning based on demographic and illness characteristics, including gender, whether campers/siblings were on or off active cancer treatment, age, and number of prior years attending camp. Results indicated that summer camps can be beneficial for pediatric oncology patients and their siblings, regardless of demographic factors (e.g., gender, treatment status) and camp factors (e.g., whether camp sessions included patients only, siblings only, or both). Future work could advance the oncology summer camp literature by examining other outcomes linked to summer camp attendance, using longitudinal designs, and including comparison groups.

[Methodology for the development of policy brief in public health].

PubMed

Felt, Emily; Carrasco, José Miguel; Vives-Cases, Carmen

2018-01-10

A policy brief is a document that summarizes research to inform policy. In a brief and succinct way, it defines a policy problem, presents a synthesis of relevant evidence, identifies possible courses of action and makes recommendations or key points. The objective of this note is to describe the methodology used to produce a policy brief for communicating public health research. This note is based on the model presented by Eugene Bardach in addition to the authors' own experiences. We describe six steps: 1) identifying the audience; 2) defining the problem; 3) gathering information and evidence; 4) consideration of policy alternatives; 5) projecting results and designing recommendations; and 6) telling the story. We make a case for the use of policy briefs as a part of an overall communications strategy for research that aims to bring together research teams and stakeholders. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

A Review of Equation of State Models, Chemical Equilibrium Calculations and CERV Code Requirements for SHS Detonation Modelling

DTIC Science & Technology

2009-10-01

parameters for a large number of species. These authors provide many sample calculations with the JCZS database incorporated in CHEETAH 2.0, including...FORM (highest classification of Title, Abstract, Keywords) DOCUMENT CONTROL DATA (Security classification of title, body of abstract and...CLASSIFICATION OF FORM 13. ABSTRACT (a brief and factual summary of the document. It may also appear elsewhere in the body of the document itself

National Computer Security Conference (15th) held in Baltimore, Maryland on October 13-16, 1992. Volume 1: Proceedings

DTIC Science & Technology

1992-10-16

The Spread of Viruses Programs have been developed to attack some of these problems , primarily in the virus arena. Pick up any PC magazine and you...a particular DBMS-specific research area. These documents discuss the research problem , present an overview of relevant research and development ...MITRE has developed to date and a brief discussion those documents currently under development . For each companion document, the problem being

1st Evidence-based Italian consensus conference on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinosis from ovarian cancer.

PubMed

Cavaliere, Davide; Cirocchi, Roberto; Coccolini, Federico; Fagotti, Anna; Fambrini, Massimiliano; Federici, Orietta; Lorusso, Domenica; Vaira, Marco; Ceresoli, Marco; Delrio, Paolo; Garofalo, Alfredo; Pignata, Sandro; Scollo, Paolo; Trojano, Vito; Amadori, Andrea; Ansaloni, Luca; Cariti, Giuseppe; De Cian, Franco; De Iaco, Pierandrea; De Simone, Michele; Deraco, Marcello; Donini, Annibale; Fiorentini, Giammaria; Frigerio, Luigi; Greggi, Stefano; Macrì, Antonio; Pasqual, Enrico Maria; Roviello, Franco; Sammartino, Paolo; Sassaroli, Cinzia; Scambia, Giovanni; Staudacher, Carlo; Vici, Patrizia; Vizza, Enrico; Valle, Mario

2017-11-23

Ovarian cancer (OC) remains relatively rare, although it is among the top 4 causes of cancer death for women younger than 50. The aggressive nature of the disease and its often late diagnosis with peritoneal involvement have an impact on prognosis. The current scientific literature presents ambiguous or uncertain indications for management of peritoneal carcinosis (PC) from OC, both owing to the lack of sufficient scientific data and their heterogeneity or lack of consistency. Therefore, the Italian Society of Surgical Oncology (SICO), the Italian Society of Obstetrics and Gynaecology, the Italian Association of Hospital Obstetricians and Gynaecologists, and the Italian Association of Medical Oncology conducted a multidisciplinary consensus conference (CC) on management of advanced OC presenting with PC during the SICO annual meeting in Naples, Italy, on September 10-11, 2015. An expert committee developed questions on diagnosis and staging work-up, indications, and procedural aspects for peritonectomy, systemic chemotherapy, and hyperthermic intraperitoneal chemotherapy for PC from OC. These questions were provided to 6 invited speakers who answered with an evidence-based report. Each report was submitted to a jury panel, representative of Italian experts in the fields of surgical oncology, gynecology, and medical oncology. The jury panel revised the reports before and after the open discussion during the CC. This article is the final document containing the clinical evidence reports and statements, revised and approved by all the authors before submission.

Software tool for physics chart checks.

PubMed

Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

2014-01-01

Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

Review of the role of NICE in promoting the adoption of innovative cardiac technologies.

PubMed

Groves, Peter H; Pomfrett, Chris; Marlow, Mirella

2018-05-17

The National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) promotes the adoption of innovative diagnostic and therapeutic technologies into National Health Service (NHS) clinical practice through the publication of guidance and briefing documents. Since the inception of the programme in 2009, there have been 7 medical technologiesguidance, 3 diagnostics guidance and 23 medtechinnovation briefing documents published that are relevant to the heart and circulation. Medical technologies guidance is published by NICE for selected single technologies if they offer plausible additional benefits to patients and the healthcare system. Diagnostic guidance is published for diagnostic technologies if they have the potential to improve health outcomes, but if their introduction may be associated with an increase in overall cost to the NHS. Medtechinnovation briefings provide evidence-based advice to those considering the implementation of new medical devices or diagnostic technologies. This review provides reference to all of the guidance and briefing medical technology documents that NICE has published that are relevant to the heart and circulation and reflect on their diverse recommendations. The interaction of MTEP with other NICE programmes is integral to its effectiveness and the means by which consistency is ensured across the different NICE programmes is described. The importance of the input of clinical experts from the cardiovascular professional community and the engagement by NICE with cardiovascular professional societies is highlighted as being fundamental to ensuring the quality of guidance outputs as well as to promoting their implementation and adoption. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

In search of colonial El Niño events and a brief history of meteorology in Ecuador

NASA Astrophysics Data System (ADS)

Terneus, A.; Gioda, A.

2006-02-01

This study shows a brief overview of the development of meteorology in Ecuador from historical documentation of climatic events in the Colonial era through to modern data collection. In the colonial era (16th century-1824), historical documents of rogation ceremonies and municipal proceedings, from the Quito area, provide a rich source of climate information, including El Niño events. Our preliminary findings show that very few of the historically documented catastrophes and other marked environmental events in Quito match known El Niño episodes. Independently, the first meteorological data was collected in Ecuador (beginning with La Condamine in 1738), followed by the earliest attempts to build a national meteorological network in the 1860's, linked closely to President Gabriel García Moreno and the Jesuits. The 1925 El Niño phenomenon was the first important meteorological episode recorded with scientific instrumentation in Ecuador, with newspapers providing complementary archives about the extreme impact of this event.

Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life.

PubMed

Galvão, Daniel A; Newton, Robert U; Gardiner, Robert A; Girgis, Afaf; Lepore, Stephen J; Stiller, Anna; Occhipinti, Stefano; Chambers, Suzanne K

2015-06-18

The purpose of this study was to determine prevalence of Australian prostate cancer survivors meeting contemporary exercise-oncology guidelines and identify associations with distress, unmet supportive care needs, and quality of life. A population-based cohort of 463 prostate cancer survivors who were on 10.8 months post-curative therapy was assessed for compliance with current exercise guidelines for cancer survivors, motivational readiness for physical activity, psychological distress, unmet supportive care needs, and quality of life. Only 57 men (12.3%) reported sufficient exercise levels (150 min of moderate intensity or 75 min of strenuous exercise per week and twice weekly resistance exercise), 186 (40.2%) were insufficiently active, and 220 (47.5%) were inactive. Among inactive men, 99 (45.0%) were in the contemplation or preparation stage of motivation readiness. Inactive men had higher global distress (p = 0.01) and Brief Symptom Inventory-Anxiety (p < 0.05) than those who were insufficiently active. Total Supportive Care Needs and International Prostate Cancer Symptom scores were higher in inactive than insufficiently and sufficiently active men (p < 0.05). Lack of physical activity contributed to poorer quality of life. Only a small proportion of Australian prostate cancer survivors met contemporary exercise-oncology recommendations despite increasing recognition of exercise to improve patient outcomes. Strategies are urgently required to increase prostate cancer survivors' participation in aerobic and resistance exercise training.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Cancer Prehabilitation for Patients Starting from Active Treatment to Surveillance

PubMed Central

Shun, Shiow-Ching

2016-01-01

The purpose of this brief summary is to introduce the concept of cancer prehabilitation and the role of oncology nurses in prehabilitation care. Cancer prehabilitation has been defined by Sliver and Baima (2013) as “a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment.” The evidence supports the notion that prehabilitation programs can improve physical and psychological health outcomes and decrease overall health care costs. The care model for cancer prehabilitation should include timely and efficient assessment throughout the care continuum with a focus on improving outcomes in cancer at every stage. During the cancer journey, three types of assessment with different aims are included: (1) prehabilitation assessment pretreatment, (2) rehabilitation assessment at early post treatment, and (3) health promotion assessment at the end of treatment. Specific prehabilitation assessment and interventions for treatment-related complications or major side-effects should be considered. Teaching, counseling, discharge planning, and coordination should also be part of an oncology nurse's role in cancer prehabilitation. It is suggested that cancer care managers or navigators be trained in the assessment of their patients’ physical and psychological status once the cancer diagnosis has been identified and the patient has decided to receive active treatment, especially for those waiting for surgery at home. Oncology nurses could increase their competence with prehabilitation care by gaining knowledge about cancer-related treatments and their outcomes for specific cancers and by strengthening the ability to assess the functional status and psychological distress of their patients. PMID:27981135

Coordinating Demand-Side Efficiency Evaluation, Measurement and Verification Among Western States: Options for Documenting Energy and Non-Energy Impacts for the Power Sector

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

Schiller, Steven R.; Schwartz, Lisa C.

Demand-side energy efficiency (efficiency) represents a low-cost opportunity to reduce electricity consumption and demand and provide a wide range of non-energy benefits, including avoiding air pollution. Efficiency-related energy and non-energy impacts are determined and documented by implementing evaluation, measurement and verification (EM&V) systems. This technical brief describes efficiency EM&V coordination strategies that Western states can consider taking on together, outlines EM&V-related products that might be appropriate for multistate coordination, and identifies some implications of coordination. Coordinating efficiency EM&V activities can save both time and costs for state agencies and stakeholders engaged in efficiency activities and can be particularly beneficial formore » multiple states served by the same utility. First, the brief summarizes basic information on efficiency, its myriad potential benefits and EM&V for assessing those benefits. Second, the brief introduces the concept of multistate EM&V coordination in the context of assessing such benefits, including achievement of state and federal goals to reduce air pollutants.1 Next, the brief presents three coordination strategy options for efficiency EM&V: information clearinghouse/exchange, EM&V product development, and a regional energy efficiency tracking system platform. The brief then describes five regional EM&V products that could be developed on a multistate basis: EM&V reporting formats, database of consistent deemed electricity savings values, glossary of definitions and concepts, efficiency EM&V methodologies, and EM&V professional standards or accreditation processes. Finally, the brief discusses options for next steps that Western states can take to consider multistate coordination on efficiency EM&V. Appendices provide background information on efficiency and EM&V, as well as definitions and suggested resources on the covered topics. This brief is intended to inform state public utility commissions, boards for public and consumer-owned utilities, state energy offices and air agencies, and other organizations involved in discussions about the use of efficiency EM&V.« less

Total Body Irradiation: Guidelines from the International Lymphoma Radiation Oncology Group (ILROG).

PubMed

Wong, Jeffrey Y C; Filippi, Andrea Riccardo; Dabaja, Bouthaina Shbib; Yahalom, Joachim; Specht, Lena

2018-07-01

Total body irradiation (TBI) remains an effective myeloablative treatment in regimens used for preparation and conditioning before allogeneic stem cell transplantation for leukemia. The regimens used vary across institutions in terms of dose, dose rate, fractionation, and technique. The objective of this document is to provide comprehensive guidelines for the current practice of delivering total body irradiation. Copyright © 2018 Elsevier Inc. All rights reserved.

Does certification status of oncology nurses make a difference in patient outcomes?

PubMed

Frank-Stromborg, Marilyn; Ward, Sandra; Hughes, Linda; Brown, Karen; Coleman, Ann; Grindel, Cecelia Gatson; Miller Murphy, Cynthia

2002-05-01

To test hypotheses that patients cared for by Oncology Certified Nurses (OCNs(r)) have superior outcomes compared to those cared for by noncertified nurses. Descriptive ex post facto. A homecare agency in the midwestern United States. 20 nurses (7 certified and 13 noncertified) and charts for 181 of their patients. Retrospective chart review. Symptom management (i.e., pain and fatigue), adverse events (e.g., infection and decubitus ulcers), and episodic care utilization (e.g., visits to care facilities, admissions to care facilities, unscheduled home visits). Contrary to hypotheses, the two groups did not differ with respect to assessment of pain at admission, number of pain assessments subsequent to admission, assessment of fatigue at admission, number of unplanned visits to care facilities, admissions to care facilities, and number of unscheduled home visits. As hypothesized, the OCNs(r) documented a higher number of postadmission fatigue assessments (p less than 0.05). Contrary to hypotheses, patients of OCNs(r) had a greater number of infections and fewer documented instances of patient teaching regarding infection. Little support was found for the hypothesis that nursing care by OCNs(r) results in superior patient outcomes in comparison to care by noncertified nurses. Further research is needed to examine the dimensions of clinical practice that may demonstrate the benefits of care by OCNs(r).

Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

NASA Astrophysics Data System (ADS)

De Jesús, M.; Trujillo-Zamudio, F. E.

2010-12-01

A building project of Radiotherapy & Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

Mental Health, Substance Use, and Delinquency among Truant Youth in a Brief Intervention Project: A Longitudinal Study

ERIC Educational Resources Information Center

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Winters, Ken C.; Schmeidler, James; Ungaro, Rocio Aracelis; Karas, Lora; Belenko, Steven; Gulledge, Laura

2013-01-01

The relationship between substance use, mental health disorders, and delinquency among youth is well documented. What has received far less attention from researchers is the relationship between these issues among truant youth, in spite of studies that document truants are a population at risk for negative outcomes. This study bridges this gap by…

Contracts for field projects and supporting research on enhanced oil recovery. Progress review No. 82, quarterly report, January--March 1995

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

NONE

This document consists of a list of projects supporting work on oil recovery programs. A publications list and index of companies and institutions is provided. The remaining portion of the document provides brief descriptions on projects in chemical flooding, gas displacement, thermal recovery, geoscience, resource assessment, and reservoir class field demonstrations.

The Alexander N. Charters Library of Resources for Educators of Adults at Syracuse University Library.

ERIC Educational Resources Information Center

Keenan, Terrance

This document describes the contents of the Alexander N. Charters Library of Resources for Educators of Adults at Syracuse University Library. The document begins with a brief history of the development of the library's collections, which occupy 900 feet of shelf space and contain more than 50 groups of personal papers and records of organizations…

78 FR 69172 - Requested Administrative Waiver of the Coastwise Trade Laws: Vessel PURSE PRINCESS; Invitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-18

.... A request for such a waiver has been received by MARAD. The vessel, and a brief description of the... 10 a.m. and 5 p.m., E.T., Monday through Friday, except federal holidays. An electronic version of this document and all documents entered into this docket is available on the World Wide Web at http...

Writing Clinic for Business and Technical Writers.

ERIC Educational Resources Information Center

Mercer County Community Coll., Trenton, NJ.

This document offers brief lesson plans for four courses: (1) an 8-hour refresher course for employees who write memos, short reports, and letters; (2) an 8-hour refresher course on creating a short document; (3) a 16-hour course on technical manual writing; and (4) an 8-hour course on technical manual writing. The courses were part of a workplace…

Astronomical catalog desk reference, 1994 edition

NASA Technical Reports Server (NTRS)

1994-01-01

The Astronomical Catalog Desk Reference is designed to aid astronomers in locating machine readable catalogs in the Astronomical Data Center (ADC) archives. The key reference components of this document are as follows: A listing of shortened titles for all catalogs available from the ADC (includes the name of the lead author and year of publication), brief descriptions of over 300 astronomical catalogs, an index of ADC catalog numbers by subject keyword, and an index of ADC catalog numbers by author. The heart of this document is the set of brief descriptions generated by the ADC staff. The 1994 edition of the Astronomical Catalog Desk Reference contains descriptions for over one third of the catalogs in the ADC archives. Readers are encouraged to refer to this section for concise summaries of those catalogs and their contents.

Understanding the perceived need for complementary and alternative nutraceuticals: lifestyle issues.

PubMed

Whitman, M

2001-01-01

Nutraceuticals are biological therapies used to promote wellness, prevent malignant processes, and control symptoms. The use of complementary and alternative nutraceuticals increased dramatically after passage of the Dietary Supplement and Health Education Act of 1994. Motivations for use of these products include changes in eating patterns, concerns about adequacy of consumer food supply, and interactions with conventional healthcare providers that are perceived to be insensitive, too brief, or uncaring. By becoming knowledgeable about complementary and alternative nutraceuticals and the nutritional needs of people with cancer, communicating with empathy and patience, and involving dietitians, pharmacist, and other professional providers as needed, oncology nurses can provide accurate information and support for people with cancer and their families.

The effectiveness of positive psychology intervention on the well-being, meaning, and life satisfaction of mothers of children with cancer: A brief report.

PubMed

Damreihani, Nafiseh; Behzadipour, Sareh; Haghpanh, Sezaneh; Bordbar, Mohammadreza

2018-01-01

The aim of this study was to promote emotional well-being, hope, life satisfaction, and meaning to mothers of children with cancer utilizing a positive psychology intervention. The study population included 50 mothers who had children with cancer attending an outpatient oncology clinic. The participants (experimental and control groups) completed Ryff's Psychological Well-being Scale (PWBS), Satisfaction with Life Scale (SWLS), Snyder's Hope Scale (HS), and Meaning in Life Questionnaire (MLQ) before and after the intervention and also one month after the end of intervention. Variables of the study significantly increased in the experimental group compared to the control group.

Lessons Learnt from Past Incidents and Accidents in Radiation Oncology.

PubMed

Knöös, T

2017-09-01

The purpose of this report is to review and compile what have been and can be learnt from incidents and accidents in radiation oncology, especially in external beam and brachytherapy. Some major accidents from the last 20 years will be discussed. The relationship between major events and minor or so-called near misses is mentioned, leading to the next topic of exploring the knowledge hidden among them. The main lessons learnt from the discussion here and elsewhere are that a well-functioning and safe radiotherapy department should help staff to work with awareness and alertness and that documentation and procedures should be in place and known by everyone. It also requires that trained and educated staff with the required competences are in place and, finally, functions and responsibilities are defined and well known. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States

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

Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu; Burt, Lindsay M.; Mancini, Brandon R.

Purpose: The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. Methods and Materials: During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Results: Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent ofmore » residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. Conclusions: This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This analysis may serve as a valuable tool for those seeking to improve training of the next generation of oncology leaders.« less

Bacteremia in nonneutropenic pediatric oncology patients with central venous catheters in the ED.

PubMed

Moskalewicz, Risha L; Isenalumhe, Leidy L; Luu, Cindy; Wee, Choo Phei; Nager, Alan L

2017-01-01

To examine clinical characteristics associated with bacteremia in febrile nonneutropenic pediatric oncology patients with central venous catheters (CVCs) in the emergency department (ED). Fever is the primary reason pediatric oncology patients present to the ED. The literature states that 0.9% to 39% of febrile nonneutropenic oncology patients are bacteremic, yet few studies have investigated infectious risk factors in this population. This was a retrospective cohort study in a pediatric ED, reviewing medical records from 2002 to 2014. Inclusion criteria were patients with cancer, temperature at least 38°C, presence of a CVC, absolute neutrophil count greater than 500 cells/μL, and age less than 22 years. Exclusion criteria were repeat ED visits within 72 hours, bloodwork results not reported by the laboratory, and patients without oncologic history documented at the study hospital. The primary outcome measure is a positive blood culture (+BC). Other variables include age, sex, CVC type, cancer diagnosis, absolute neutrophil count, vital signs, upper respiratory infection (URI) symptoms, and amount of intravenous (IV) normal saline (NS) administered in the ED. Data were analyzed using descriptive statistics and a multiple logistic regression model. A total of 1322 ED visits were sampled, with 534 enrolled, and 39 visits had +BC (7.3%). Variables associated with an increased risk of +BC included the following: absence of URI symptoms (odds ratio [OR], 2.30; 95% CI, 1.13-4.69), neuroblastoma (OR, 3.65; 95% CI, 1.47-9.09), "other" cancer diagnosis (OR, 4.56; 95% CI, 1.93-10.76), tunneled externalized CVC (OR, 5.04; 95% CI, 2.25-11.28), and receiving at least 20 mL/kg IV NS (OR, 2.34; 95% CI, 1.2-4.55). The results of a multiple logistic regression model also showed these variables to be associated with +BC. The absence of URI symptoms, presence of an externalized CVC, neuroblastoma or other cancer diagnosis, and receiving at least 20 mL/kg IV NS in the ED are associated with increased risk of bacteremia in nonneutropenic pediatric oncology patients with a CVC. Copyright © 2016 Elsevier Inc. All rights reserved.

Advisory Committee on human radiation experiments. Final report, Supplemental Volume 2. Sources and documentation

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

NONE

This volume and its appendixes supplement the Advisory Committee`s final report by reporting how we went about looking for information concerning human radiation experiments and intentional releases, a description of what we found and where we found it, and a finding aid for the information that we collected. This volume begins with an overview of federal records, including general descriptions of the types of records that have been useful and how the federal government handles these records. This is followed by an agency-by-agency account of the discovery process and descriptions of the records reviewed, together with instructions on how tomore » obtain further information from those agencies. There is also a description of other sources of information that have been important, including institutional records, print resources, and nonprint media and interviews. The third part contains brief accounts of ACHRE`s two major contemporary survey projects (these are described in greater detail in the final report and another supplemental volume) and other research activities. The final section describes how the ACHRE information-nation collections were managed and the records that ACHRE created in the course of its work; this constitutes a general finding aid for the materials deposited with the National Archives. The appendices provide brief references to federal records reviewed, descriptions of the accessions that comprise the ACHRE Research Document Collection, and descriptions of the documents selected for individual treatment. Also included are an account of the documentation available for ACHRE meetings, brief abstracts of the almost 4,000 experiments individually described by ACHRE staff, a full bibliography of secondary sources used, and other information.« less

Web Service

MedlinePlus

... on the relevance score as determined by the search engine. Generally, the first document in the first results ... Spanish . snippet Brief result summary generated by the search engine that provides a preview of the relevant content ...

Requirements and design aspects of a data model for a data dictionary in paediatric oncology.

PubMed

Merzweiler, A; Knaup, P; Creutzig, U; Ehlerding, H; Haux, R; Mludek, V; Schilling, F H; Weber, R; Wiedemann, T

2000-01-01

German children suffering from cancer are mostly treated within the framework of multicentre clinical trials. An important task of conducting these trials is an extensive information and knowledge exchange, which has to be based on a standardised documentation. To support this effort, it is the aim of a nationwide project to define a standardised terminology that should be used by clinical trials for therapy documentation. In order to support terminology maintenance we are currently developing a data dictionary. In this paper we describe requirements and design aspects of the data model used for the data dictionary as first results of our research. We compare it with other terminology systems.

Concept document of the repository-based software engineering program: A constructive appraisal

NASA Technical Reports Server (NTRS)

1992-01-01

A constructive appraisal of the Concept Document of the Repository-Based Software Engineering Program is provided. The Concept Document is designed to provide an overview of the Repository-Based Software Engineering (RBSE) Program. The Document should be brief and provide the context for reading subsequent requirements and product specifications. That is, all requirements to be developed should be traceable to the Concept Document. Applied Expertise's analysis of the Document was directed toward assuring that: (1) the Executive Summary provides a clear, concise, and comprehensive overview of the Concept (rewrite as necessary); (2) the sections of the Document make best use of the NASA 'Data Item Description' for concept documents; (3) the information contained in the Document provides a foundation for subsequent requirements; and (4) the document adequately: identifies the problem being addressed; articulates RBSE's specific role; specifies the unique aspects of the program; and identifies the nature and extent of the program's users.

Seminal nanotechnology literature: a review.

PubMed

Kostoff, Ronald N; Koytcheff, Raymond G; Lau, Clifford G Y

2009-11-01

This paper uses complementary text mining techniques to identify and retrieve the high impact (seminal) nanotechnology literature over a span of time. Following a brief scientometric analysis of the seminal articles retrieved, these seminal articles are then used as a basis for a comprehensive literature survey of nanoscience and nanotechnology. The paper ends with a global analysis of the relation of seminal nanotechnology document production to total nanotechnology document production.

Bibliographic Services throughout the World. Supplement: 1981-1982 = Les services bibliographiques dans le monde. Supplement, 1981-1982.

ERIC Educational Resources Information Center

Beaudiquez, Marcelle

This compilation provides an overall view of the state of national bibliographic services in 101 countries. The document includes data gathered via a questionnaire that was sent to 160 countries of whom 101 replied. Introductory materials include a list of the countries listed in the document; a brief discussion of the survey and how the results…

Putting the Boys in the Picture: A Review of Programs To Promote Sexual Responsibility among Young Males.

ERIC Educational Resources Information Center

Dryfoos, Joy G.

This document focuses entirely on pregnancy prevention and young males. It begins with a brief review of current literature on male involvement from which many of the findings and program ideas reported in the document were compiled. A short essay on the self-reported life experiences of adolescent males is followed with statistical data on the…

Overview of the Final 2013 VGP

EPA Pesticide Factsheets

This document is a brief overview of the final 2013 VGP that provides NPDES permit coverage nationwide for discharges incidental to the normal operation of commercial vessels greater than 79 feet in length.

No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations

PubMed Central

Hantel, Andrew; Wroblewski, Kristen; Balachandran, Jay S.; Chow, Selina; DeBoer, Rebecca; Fleming, Gini F.; Hahn, Olwen M.; Kline, Justin; Liu, Hongtao; Patel, Bhakti K.; Verma, Anshu; Witt, Leah J.; Fukui, Mayumi; Kumar, Aditi; Howell, Michael D.; Polite, Blase N.

2016-01-01

Purpose: Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. Methods: This was a retrospective case series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Results: Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Conclusion: Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care. PMID:27601514

Smoking Cessation Counseling Beliefs and Behaviors of Outpatient Oncology Providers

PubMed Central

Danhauer, Suzanne C.; Tooze, Janet A.; Blackstock, A. William; Spangler, John; Thomas, Leslie; Sutfin, Erin L.

2012-01-01

Purpose. Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the “teachable moment” of cancer diagnosis to provide smoking cessation assistance. Providers and Methods. Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices. Results. Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for both current smokers and recent quitters. Rates of advising patients to quit smoking were also high (86.5% frequently or always), but <30% of providers reported frequently or always providing intervention to smoking patients (e.g., nicotine replacement therapy or other medications, self-help materials, and/or referrals). Only 30% of providers reported that they frequently or always followed up with patients to assess progress with quitting. Few providers (18.1%) reported high levels of confidence in their ability to counsel smoking patients. Patients' lack of motivation was identified as the most important barrier to smoking cessation. Conclusions. Although beliefs about providing cessation services to smoking patients were generally positive, few providers reported commonly providing interventions beyond advice to quit. Additional training and clinic-based interventions may improve adherence to tobacco cessation practice guidelines in the outpatient oncology setting. PMID:22334454

The Safety of Acupuncture in Patients with Cancer Therapy–Related Thrombocytopenia

PubMed Central

Cybularz, Paul A.; Brothers, Karen; Singh, Gurneet M.; Feingold, Jennifer L.; Niesley, Michelle L.

2015-01-01

Abstract Background: Acceptance of acupuncture as an efficacious integrative modality for oncology-related side-effect management is rapidly expanding. It is imperative that guidelines regarding safe treatment supported by clinical experience are established. Oncology patients frequently experience thrombocytopenia as a side-effect of chemotherapy or radiation. However, safety data for acupuncture in adult patients with cancer who are thrombocytopenic is lacking. Materials and Methods: The medical records of 684 patients who received acupuncture treatments in an established acupuncture program at a private cancer treatment hospital were reviewed for adverse events occurring within the context of thrombocytopenia. Results: Of 2135 visits eligible for evaluation, 98 individual acupuncture visits occurred in patients with platelet counts <100,000/μL, including nine visits in which platelet counts were <50,000/μL. No adverse events of increased bruising or bleeding were noted. Medications and nutritional supplements or botanicals that may influence coagulation were also tabulated, with no apparent adverse events in this patient population. Conclusions: Discrepancies in the literature highlight the need to create cohesive safety guidelines backed by clinical research, specifically for groups at higher risk for adverse events. The preliminary evidence put forth in this study lays the foundation that supports the notion that acupuncture can be used safely with a high-need oncology population within an integrated model of care. In this descriptive retrospective case series of adult oncology patients with thrombocytopenia, no adverse events of increased bruising or bleeding were documented. Prospective trials are needed to confirm these initial observations. PMID:26401193

Improving patient safety in the radiation oncology setting through crew resource management.

PubMed

Sundararaman, Srinath; Babbo, Angela E; Brown, John A; Doss, Richard

2014-01-01

This paper demonstrates how the communication patterns and protocol rigors of a methodology called crew resource management (CRM) can be adapted to a radiation oncology environment to create a culture of patient safety. CRM training was introduced to our comprehensive radiation oncology department in the autumn of 2009. With 34 full-time equivalent staff, we see 100-125 patients daily on 2 hospital campuses. We were assisted by a consulting group with considerable experience in helping hospitals incorporate CRM principles and practices. Implementation steps included developing change initiative skills for key leaders, providing training in teamwork and communications, creating site-specific tools for safety and efficiency, and collecting data to document results. Our goals were to improve patient safety, teamwork, communication, and efficiency through the use of tools we developed that emphasized teamwork and communication, cross-checking, and routinizing specific protocols. Our CRM plan relies on the following 4 pillars: patient identification methods; "pause for the cause"; enabling all staff to halt treatment and question decisions; and daily morning meetings. We discuss some of the hurdles to change we encountered. Our safety record has improved. Our near-miss rate before CRM implementation averaged 11 per month; our near-miss rate currently averages 1.2 per month. In the 5 years prior to CRM implementation, we experienced 1 treatment deviation per year, although none rose to the level of "mis-administration." Since implementing CRM, our current patient treatment setup and delivery process has eliminated all treatment deviations. Our practices have identified situations where ambiguity or conflicting documentation could have resulted in inappropriate treatment or treatment inefficiencies. Our staff members have developed an extraordinary sense of teamwork combined with a high degree of personal responsibility to assure patient safety and have spoken up when they considered something potentially unsafe. We have increased our efficiency (and profitability); in 2012, our units of service were up 11.3% over 2009 levels with the same staffing level. The rigor and standardization introduced into our practice, combined with the increase in communication and teamwork have improved both safety and efficiency while improving both staff and patient satisfaction. CRM principles are highly adaptable and applicable to the radiation oncology setting. © 2014. Published by Elsevier Inc. All rights reserved.

Constructed Wetlands for Wastewater Treatment and Wildlife Habitat: 17 Case Studies

EPA Pesticide Factsheets

This document provides brief descriptions of 17 wetland treatment systems from across the country that are providing significant water quality benefits while demonstrating additional benefits such as wildlife habitat.

Voice Response System Statistics Program : Operational Handbook.

DOT National Transportation Integrated Search

1980-06-01

This report documents the Voice Response System (VRS) Statistics Program developed for the preflight weather briefing VRS. It describes the VRS statistical report format and contents, the software program structure, and the program operation.

Pavement Remaining Service Interval [Tech Brief

DOT National Transportation Integrated Search

2013-05-01

This document is a technical summary of the Federal Highway Administration reports, "Reformulated Pavement Remaining Service Life Framework" (FHWA-HRT-13-038) and "Pavement Remaining Service Interval Implementation Guidelines" (FHWA-HRT-13-050). At t...

Advancing palliative care in the Uganda health system: an evidence-based policy brief.

PubMed

Nabudere, Harriet; Obuku, Ekwaro; Lamorde, Mohammed

2014-12-01

This paper describes the development and findings for a policy brief on "Advancing the Integration of Palliative Care into the National Health System" and the subsequent use of this report. Key stakeholders involved with palliative care helped identify the problem and potential policy solutions to scale up these services within the health system. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The palliative burden is not only high but increasing due to the rise in population and life expectancy. A few options for holistic, supportive care include: Home-based care increases chances of a peaceful death for the terminally ill surrounded by their loved ones; supporting informal caregivers improves their quality of life and discharge planning reduces unscheduled admissions and has the potential to free up capacity for acute care services. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogues whose main outcome was that a comprehensive national palliative care policy should be instituted to include all the options, which need to be integrated within the public health system. A draft policy is now in process.

US radiation oncology practice patterns for posttreatment survivor care.

PubMed

Koontz, Bridget F; Benda, Rashmi; De Los Santos, Jennifer; Hoffman, Karen E; Huq, M Saiful; Morrell, Rosalyn; Sims, Amber; Stevens, Stephanie; Yu, James B; Chen, Ronald C

2016-01-01

Increasing numbers of cancer survivors have driven a greater focus on care of cancer patients after treatment. Radiation oncologists have long considered follow-up of patients an integral part of practice. We sought to document current survivor-focused care patterns and identify barriers to meeting new regulatory commission guidelines for survivorship care plans (SCPs) and provide guidance for survivorship care. A 23-question electronic survey was e-mailed to all practicing US physician American Society of Radiation Oncology members. Responses were collected for 25 days in March 2014. Survey data were descriptively analyzed. A total of 574 eligible providers responded, for a response percentage of 14.7%. Almost all providers follow their patients after treatment (97%). Length of follow-up was frequently extensive: 17% followed up to 2 years, 40% for 3-5 years, 12% for 6-10 years, and 31% indefinitely. Ancillary services, particularly social work and nutrition services, are commonly available onsite to patients in follow-up. Fewer than half of respondents (40%) indicated that they currently use SCPs for curative intent patients and those who do generally use internally developed templates. SCPs typically go to patients (91%), but infrequently to primary care providers (22%). The top 3 barriers to implementation of SCPs were cost (57%), duplicative survivorship care plans provided by other physicians (43%), and lack of consensus or professional guidelines (40%). Eighty-seven percent indicated that SCPs built into an electronic medical record system would be useful. A significant part of radiation oncology practice includes the care of those in the surveillance of follow-up phase of care. SCPs may be beneficial in improving communication with the patient and other care but are not widely used within our field. This survey identified key barriers to use of SCPs and provides specialty guidance for important information to be included in a radiation oncology oriented SCP. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Results of the 2012-2013 Association of Residents in Radiation Oncology (ARRO) Job Search and Career Planning Survey of Graduating Residents in the United States

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

Mattes, Malcolm D., E-mail: mdm9007@nyp.org; Kharofa, Jordan; Zeidan, Youssef H.

Purpose/Objective(s): To determine the timeline used by postgraduate year (PGY)-5 radiation oncology residents during the job application process and the factors most important to them when deciding on a first job. Methods and Materials: In 2012 and 2013, the Association of Residents in Radiation Oncology conducted a nationwide electronic survey of PGY-5 radiation oncology residents in the United States during the final 2 months of their training. Descriptive statistics are reported. In addition, subgroup analysis was performed. Results: Surveys were completed by 180 of 314 residents contacted. The median time to start networking for the purpose of employment was Januarymore » PGY-4; to start contacting practices, complete and upload a curriculum vitae to a job search website, and use the American Society of Radiation Oncology Career Center was June PGY-4; to obtain letters of recommendation was July PGY-5; to start interviewing was August PGY-5; to finish interviewing was December PGY-5; and to accept a contract was January PGY-5. Those applying for a community position began interviewing at an earlier average time than did those applying for an academic position (P=.04). The most important factors to residents when they evaluated job offers included (in order from most to least important) a collegial environment, geographic location, emphasis on best patient care, quality of support staff and facility, and multidisciplinary approach to patient care. Factors that were rated significantly different between subgroups based on the type of position applied for included adequate mentoring, dedicated research time, access to clinical trials, amount of time it takes to become a partner, geographic location, size of group, starting salary, and amount of vacation and days off. Conclusions: The residents' perspective on the job application process over 2 years is documented to provide a resource for current and future residents and employers to use.« less

Oncology patient-reported claims: maximising the chance for success.

PubMed

Kitchen, H; Rofail, D; Caron, M; Emery, M-P

2011-01-01

To review Patient Reported Outcome (PRO) labelling claims achieved in oncology in Europe and in the United States and consider the benefits, and challenges faced. PROLabels database was searched to identify oncology products with PRO labelling approved in Europe since 1995 or in the United States since 1998. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) websites and guidance documents were reviewed. PUBMED was searched for articles on PRO claims in oncology. Among all oncology products approved, 22 were identified with PRO claims; 10 in the United States, 7 in Europe, and 5 in both. The language used in the labelling was limited to benefit (e.g. "…resulted in symptom benefits by significantly prolonging time to deterioration in cough, dyspnoea, and pain, versus placebo") and equivalence (e.g. "no statistical differences were observed between treatment groups for global QoL"). Seven products used a validated HRQoL tool; two used symptom tools; two used both; seven used single-item symptom measures (one was unknown). The following emerged as likely reasons for success: ensuring systematic PRO data collection; clear rationale for pre-specified endpoints; adequately powered trials to detect differences and clinically significant changes; adjusting for multiplicity; developing an a priori statistical analysis plan including primary and subgroup analyses, dealing with missing data, pooling multiple-site data; establishing clinical versus statistical significance; interpreting failure to detect change. End-stage patient drop-out rates and cessation of trials due to exceptional therapeutic benefit pose significant challenges to demonstrating treatment PRO improvement. PRO labelling claims demonstrate treatment impact and the trade-off between efficacy and side effects ultimately facilitating product differentiation. Reliable and valid instruments specific to the desired language, claim, and target population are required. Practical considerations include rationale for study endpoints, transparency in assumptions, and attention to subtle variations in data.

Oncology patient-reported claims: maximising the chance for success

PubMed Central

Kitchen, H; Rofail, D; Caron, M; Emery, M-P

2011-01-01

Objectives/purpose: To review Patient Reported Outcome (PRO) labelling claims achieved in oncology in Europe and in the United States and consider the benefits, and challenges faced. Methods: PROLabels database was searched to identify oncology products with PRO labelling approved in Europe since 1995 or in the United States since 1998. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) websites and guidance documents were reviewed. PUBMED was searched for articles on PRO claims in oncology. Results: Among all oncology products approved, 22 were identified with PRO claims; 10 in the United States, 7 in Europe, and 5 in both. The language used in the labelling was limited to benefit (e.g. “…resulted in symptom benefits by significantly prolonging time to deterioration in cough, dyspnoea, and pain, versus placebo”) and equivalence (e.g. “no statistical differences were observed between treatment groups for global QoL”). Seven products used a validated HRQoL tool; two used symptom tools; two used both; seven used single-item symptom measures (one was unknown). The following emerged as likely reasons for success: ensuring systematic PRO data collection; clear rationale for pre-specified endpoints; adequately powered trials to detect differences and clinically significant changes; adjusting for multiplicity; developing an a priori statistical analysis plan including primary and subgroup analyses, dealing with missing data, pooling multiple-site data; establishing clinical versus statistical significance; interpreting failure to detect change. End-stage patient drop-out rates and cessation of trials due to exceptional therapeutic benefit pose significant challenges to demonstrating treatment PRO improvement. Conclusions: PRO labelling claims demonstrate treatment impact and the trade-off between efficacy and side effects ultimately facilitating product differentiation. Reliable and valid instruments specific to the desired language, claim, and target population are required. Practical considerations include rationale for study endpoints, transparency in assumptions, and attention to subtle variations in data. PMID:22276055

Outbreak of vancomycin-resistant enterococcus colonization among pediatric oncology patients.

PubMed

Nolan, Sheila M; Gerber, Jeffrey S; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L; Reilly, Anne F; Coffin, Susan E

2009-04-01

To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. Retrospective case-control study. The Children's Hospital of Philadelphia. Pediatric oncology patients hospitalized from June 2006 through December 2007. Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49-198.21]; P= .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04-15.56]; P= .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms.

Attrition rates, reasons, and predictive factors in supportive care and palliative oncology clinical trials.

PubMed

Hui, David; Glitza, Isabella; Chisholm, Gary; Yennu, Sriram; Bruera, Eduardo

2013-03-01

Attrition is common among supportive care/palliative oncology clinical trials. However, to the authors' knowledge, few studies to date have documented the reasons and predictors for dropout. In the current study, the authors' objective was to determine the rate, reasons, and factors associated with attrition both before reaching the primary endpoint and at the end of the study. A review of all prospective interventional supportive care/palliative oncology trials conducted in the Department of Palliative Care and Rehabilitation Medicine at The University of Texas MD Anderson Cancer Center in Houston between 1999 and 2011 was performed. Patient and study characteristics and attrition data were extracted. A total of 1214 patients were included in 18 clinical trials. The median age of the patients was 60 years. Approximately 41% had an Eastern Cooperative Oncology Group performance status of ≥ 3, a median Edmonton Symptom Assessment Scale (ESAS) for fatigue of 7 of 10, and a median ESAS for dyspnea of 2 of 10. The attrition rate was 26% (95% confidence interval [95% CI], 23%-28%) for the primary endpoint and 44% (95% CI, 41%-47%) for the end of the study. Common reasons for primary endpoint dropout were symptom burden (21%), patient preference (15%), hospitalization (10%), and death (6%). Primary endpoint attrition was associated with a higher baseline intensity of fatigue (odds ratio [OR], 1.10 per point; P = .01) and a longer study duration (P = .04). End-of-study attrition was associated with higher baseline levels of dyspnea (OR, 1.06; P = .01), fatigue (OR, 1.08; P = .01), Hispanic race (OR, 1.87; P = .002), higher level of education (P = .02), longer study duration (P = .01), and outpatient studies (P = 0.05). The attrition rate was high in supportive care/palliative oncology clinical trials, and was associated with various patient characteristics and a high baseline symptom burden. These findings have implications for future clinical trial design including eligibility criteria and sample size calculation. Copyright © 2012 American Cancer Society.

Outbreak of Vancomycin-Resistant Enterococcus Colonization Among Pediatric Oncology Patients

PubMed Central

Nolan, Sheila M.; Gerber, Jeffrey S.; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L.; Reilly, Anne F.; Coffin, Susan E.

2010-01-01

OBJECTIVE To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. DESIGN Retrospective case-control study. SETTING The Children’s Hospital of Philadelphia. PATIENTS Pediatric oncology patients hospitalized from June 2006 through December 2007. METHODS Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. RESULTS The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49–198.21]; P = .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04–15.56]; P = .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. CONCLUSIONS Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms. PMID:19239375

Results of the 2012-2013 Association of Residents in Radiation Oncology (ARRO) job search and career planning survey of graduating residents in the United States.

PubMed

Mattes, Malcolm D; Kharofa, Jordan; Zeidan, Youssef H; Tung, Kaity; Gondi, Vinai; Golden, Daniel W

2014-01-01

To determine the timeline used by postgraduate year (PGY)-5 radiation oncology residents during the job application process and the factors most important to them when deciding on a first job. In 2012 and 2013, the Association of Residents in Radiation Oncology conducted a nationwide electronic survey of PGY-5 radiation oncology residents in the United States during the final 2 months of their training. Descriptive statistics are reported. In addition, subgroup analysis was performed. Surveys were completed by 180 of 314 residents contacted. The median time to start networking for the purpose of employment was January PGY-4; to start contacting practices, complete and upload a curriculum vitae to a job search website, and use the American Society of Radiation Oncology Career Center was June PGY-4; to obtain letters of recommendation was July PGY-5; to start interviewing was August PGY-5; to finish interviewing was December PGY-5; and to accept a contract was January PGY-5. Those applying for a community position began interviewing at an earlier average time than did those applying for an academic position (P=.04). The most important factors to residents when they evaluated job offers included (in order from most to least important) a collegial environment, geographic location, emphasis on best patient care, quality of support staff and facility, and multidisciplinary approach to patient care. Factors that were rated significantly different between subgroups based on the type of position applied for included adequate mentoring, dedicated research time, access to clinical trials, amount of time it takes to become a partner, geographic location, size of group, starting salary, and amount of vacation and days off. The residents' perspective on the job application process over 2 years is documented to provide a resource for current and future residents and employers to use. Copyright © 2014 Elsevier Inc. All rights reserved.

Integrating cancer genomic data into electronic health records.

PubMed

Warner, Jeremy L; Jain, Sandeep K; Levy, Mia A

2016-10-26

The rise of genomically targeted therapies and immunotherapy has revolutionized the practice of oncology in the last 10-15 years. At the same time, new technologies and the electronic health record (EHR) in particular have permeated the oncology clinic. Initially designed as billing and clinical documentation systems, EHR systems have not anticipated the complexity and variety of genomic information that needs to be reviewed, interpreted, and acted upon on a daily basis. Improved integration of cancer genomic data with EHR systems will help guide clinician decision making, support secondary uses, and ultimately improve patient care within oncology clinics. Some of the key factors relating to the challenge of integrating cancer genomic data into EHRs include: the bioinformatics pipelines that translate raw genomic data into meaningful, actionable results; the role of human curation in the interpretation of variant calls; and the need for consistent standards with regard to genomic and clinical data. Several emerging paradigms for integration are discussed in this review, including: non-standardized efforts between individual institutions and genomic testing laboratories; "middleware" products that portray genomic information, albeit outside of the clinical workflow; and application programming interfaces that have the potential to work within clinical workflow. The critical need for clinical-genomic knowledge bases, which can be independent or integrated into the aforementioned solutions, is also discussed.

Paths to partnership: Veterans Health Administration's Journey in pilot testing breast cancer care quality measures.

PubMed

Hogg, Lori Hoffman

2014-01-01

Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.

Clinical applications of PET in oncology.

PubMed

Rohren, Eric M; Turkington, Timothy G; Coleman, R Edward

2004-05-01

Positron emission tomography (PET) provides metabolic information that has been documented to be useful in patient care. The properties of positron decay permit accurate imaging of the distribution of positron-emitting radiopharmaceuticals. The wide array of positron-emitting radiopharmaceuticals has been used to characterize multiple physiologic and pathologic states. PET is used for characterizing brain disorders such as Alzheimer disease and epilepsy and cardiac disorders such as coronary artery disease and myocardial viability. The neurologic and cardiac applications of PET are not covered in this review. The major utilization of PET clinically is in oncology and consists of imaging the distribution of fluorine 18 fluorodeoxyglucose (FDG). FDG, an analogue of glucose, accumulates in most tumors in a greater amount than it does in normal tissue. FDG PET is being used in diagnosis and follow-up of several malignancies, and the list of articles supporting its use continues to grow. In this review, the physics and instrumentation aspects of PET are described. Many of the clinical applications in oncology are mature and readily covered by third-party payers. Other applications are being used clinically but have not been as carefully evaluated in the literature, and these applications may not be covered by third-party payers. The developing applications of PET are included in this review.

School-based brief psycho-educational intervention to raise adolescent cancer awareness and address barriers to medical help-seeking about cancer: a cluster randomised controlled trial.

PubMed

Hubbard, Gill; Stoddart, Iona; Forbat, Liz; Neal, Richard D; O'Carroll, Ronan E; Haw, Sally; Rauchhaus, Petra; Kyle, Richard G

2016-07-01

Raising cancer awareness and addressing barriers to help-seeking may improve early diagnosis. The aim was to assess whether a psycho-educational intervention increased adolescents' cancer awareness and addressed help-seeking barriers. This was a cluster randomised controlled trial involving 2173 adolescents in 20 schools. The intervention was a 50-min presentation delivered by a member of Teenage Cancer Trust's (UK charity) education team. Schools were stratified by deprivation and roll size and randomly allocated to intervention/control conditions within these strata. Outcome measures were the number of cancer warning signs and cancer risk factors recognised, help-seeking barriers endorsed and cancer communication. Communication self-efficacy and intervention fidelity were also assessed. Regression models showed significant differences in the number of cancer warning signs and risk factors recognised between intervention and control groups. In intervention schools, the greatest increases in recognition of cancer warning signs at 6-month follow-up were for unexplained weight loss (from 44.2% to 62.0%) and change in the appearance of a mole (from 46.3% to 70.7%), up by 17.8% and 24.4%, respectively. Greatest increases in recognition of cancer risk factors were for getting sunburnt more than once as a child (from 41.0% to 57.6%) and being overweight (from 42.7% to 55.5%), up by 16.6% and 12.8%, respectively. Regression models showed that adolescents in intervention schools were 2.7 times more likely to discuss cancer at 2-week follow-up compared with the control group. No differences in endorsement of barriers to help-seeking were observed. School-based brief psycho-educational interventions are easy to deliver, require little resource and improve cancer awareness. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Screening for cognitive deficits in 8 to 14-year old children with cerebellar tumors using self-report measures of executive and behavioral functioning and health-related quality of life.

PubMed

Bull, Kim S; Liossi, Christina; Peacock, Janet L; Yuen, Ho Ming; Kennedy, Colin R

2015-12-01

We aimed to identify a brief screening measure for detection of cognitive deficit in children treated for cerebellar tumors that would be useful in clinical practice. A sample of 72 children, aged 8-14 years, and within 3 years post diagnosis for standard-risk medulloblastoma (n = 37) or low-grade cerebellar astrocytoma (n = 35) and 38 children in a nontumor group were assessed using teacher-, parent-, and child-report of the Behavior Rating Inventory of Executive Function (BRIEF), Strengths and Difficulties Questionnaire (SDQ), and Pediatric Quality of Life Inventory (PedsQL). The accuracy of these scores as a screen for a full-scale Intelligence Quotient (FSIQ) < 80 on the Wechsler Intelligence Scale for Children (WISC-IV UK) was assessed using their receiver operating characteristic (ROC) curves. The questionnaires with the highest areas under the ROC curves were the child- and parent-report PedsQL, the teacher-report BRIEF, and the SDQ. At optimal cutoff scores, their sensitivities (95% CIs) to cases of FSIQ < 80 were 84 (60-96)%, 65 (41-84)%, 79 (54-93)%, and 84 (60-96)%, and their specificities (95% CIs) were 79 (68-86)%, 87 (77-93)%, 77 (66-86)%, and 71 (64-84)% respectively. All cases of FSIQ < 80 screened positive on either teacher-report SDQ or self-report PedsQL. The PedsQL child- and parent-report and the teacher-report BRIEF and SDQ have moderately good accuracy for discriminating between children with and without a FSIQ < 80. The PedsQL could be used in a clinical setting, and the BRIEF and SDQ in an educational setting, to screen for cases with FSIQ < 80 in children treated for brain tumors. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe.

PubMed

van de Velde, Cornelis J H; Aristei, Cynthia; Boelens, Petra G; Beets-Tan, Regina G H; Blomqvist, Lennart; Borras, Josep M; van den Broek, Colette B M; Brown, Gina; Coebergh, Jan-Willem; Cutsem, Eric Van; Espin, Eloy; Gore-Booth, Jola; Glimelius, Bengt; Haustermans, Karin; Henning, Geoffrey; Iversen, Lene H; Han van Krieken, J; Marijnen, Corrie A M; Mroczkowski, Pawel; Nagtegaal, Iris; Naredi, Peter; Ortiz, Hector; Påhlman, Lars; Quirke, Philip; Rödel, Claus; Roth, Arnaud; Rutten, Harm J T; Schmoll, Hans J; Smith, Jason; Tanis, Pieter J; Taylor, Claire; Wibe, Arne; Gambacorta, Maria Antonietta; Meldolesi, Elisa; Wiggers, Theo; Cervantes, Andres; Valentini, Vincenzo

2013-09-01

Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method. The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members. It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe. Copyright © 2013 Elsevier Ltd. All rights reserved.

Explanation of Change Cost and Schedule Growth Study Interim Status Briefing

NASA Technical Reports Server (NTRS)

Croonce, Thomas; Bitten, Bob; Emmons, Debra

2010-01-01

This slide presentation reviews the study to understand the changes in cost and schedule growth for NASA projects. A second goal was to determine the percentage of growth that was outside the control of the project. The study examined project documentation, conducted interviews with key project personnel, and allocated growth events to an Explanation of Change (EoC) tree to quantify the reasons for growth in the scheduled time. This briefing reviews the results of the study of the first 20 missions.

Abuses in Guardianship of the Elderly and Infirm: A National Disgrace. A Briefing by the Chairman of the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, One Hundredth Congress, First Session (September 25, 1987).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This document presents a briefing by Representative Claude Pepper on the abuses in guardianship of the elderly and infirm, and testimony from witnesses at the Congressional hearing called to examine the issue of guardianship abuse. The opening statement of Representative Pepper and a prepared statement of Representative Helen Delich Bentley are…

SU-F-P-05: Initial Experience with an Independent Certification Program for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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

Solberg, T; Robar, J; Gevaert, T

Purpose: The ASTRO document “Safety is no accident: A FRAMEWORK FOR QUALITY RADIATION ONCOLOGY AND CARE” recommends external reviews of specialized modalities. The purpose of this presentation is to describe the implementation of such a program for Stereotactic Radiosurgery (SRS) and Stereotactic Body radiation Therapy (SBRT). Methods: The margin of error for SRS and SBRT delivery is significantly smaller than that of conventional radiotherapy and therefore requires special attention and diligence. The Novalis Certified program was created to fill an unmet need for specialized SRS / SBRT credentialing. A standards document was drafted by a panel of experts from severalmore » disciplines, including medical physics, radiation oncology and neurosurgery. The document, based on national and international standards, covers requirements in program structure, personnel, training, clinical application, technology, quality management, and patient and equipment QA. The credentialing process was modeled after existing certification programs and includes an institution-generated self-study, extensive document review and an onsite audit. Reviewers generate a descriptive report, which is reviewed by a multidisciplinary expert panel. Outcomes of the review may include mandatory requirements and optional recommendations. Results: 15 institutions have received Novalis Certification, including 3 in the US, 7 in Europe, 4 in Australia and 1 in Asia. 87 other centers are at various stages of the process. Nine reviews have resulted in mandatory requirements, however all of these were addressed within three months of the audit report. All reviews have produced specific recommendations ranging from programmatic to technical in nature. Institutions felt that the credentialing process addressed a critical need and was highly valuable to the institution. Conclusion: Novalis Certification is a unique peer review program assessing safety and quality in SRS and SBRT, while recognizing international practice standards. The approach is capable of highlighting outstanding requirements and providing recommendations to enhance both new and established programs. Timothy Solberg is co-owner of Global Radiosurgery services, LLC.« less

The Effects of Self-Book© Art Therapy on Cancer-Related Distress in Female Cancer Patients during Active Treatment: A Randomized Controlled Trial.

PubMed

Radl, Donna; Vita, Maureen; Gerber, Nancy; Gracely, Edward J; Bradt, Joke

2018-05-10

National attention on patients' cancer-related emotional distress produced a need for evidence-based, psychosocial interventions in oncology care. The purpose of this study was to evaluate the efficacy of Self-Book© art therapy for emotional distress and psychological well-being of female oncology patients during active oncology treatment. Sixty consenting women with cancer were randomly assigned to either a six-session Self-Book© art therapy program or standard care. A repeated measures randomized controlled trial design was employed. Data were collected using the Distress Thermometer (DT), Perceived Emotional Distress Inventory (PEDI), Patient-Reported Outcomes Measurement Information System (PROMIS) Brief Psychological Well-being test, and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being (FACIT-Sp). Measurements were obtained at baseline, week 3, week 6, and 1-to-2 months post-intervention. Forty participants were included in the final analysis. No significant differences between groups were found for the primary outcome measures: emotional distress and psychological well-being. Greater improvements in Self-Book© art therapy participants' spiritual well-being were found compared to the standard care control participants (p = 0.02). Although no statistically significant differences were present between the groups for the primary outcomes, several positive trends were noted. Thirty percent of Self-Book© art therapy participants reported post-intervention emotional distress scores that were below the abnormal range for emotional distress, compared with only 5% of standard care control participants, suggesting that Self-Book© art therapy may have clinical value. Further studies are recommended to better understand the therapeutic mechanisms of Self-Book© art therapy for enhancing psychological well-being. This article is protected by copyright. All rights reserved.

Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment.

PubMed

Veronesi, Paolo; De Lorenzi, Francesca; Loschi, Pietro; Rietjens, Mario; Veronesi, Umberto

2016-04-01

Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular-subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Entity Profiling for Intelligence Using the Graphical Overview of Social and Semantic Interactions of People (GOSSIP) Software Tool

DTIC Science & Technology

2010-11-01

TR 2010-188; R & D pour la défense Canada – Toronto; Novembre 2010. Introduction ou contexte : En règle générale, l’analyste du renseignement ou...model humans Series3 DRDC Toronto TR 2010-188 13 Figure 4. continued. Profiles for famous names generated by subjects and the model...document is classified) 13 . ABSTRACT (A brief and factual summary of the document. It may also appear elsewhere in the body of the document itself. It is

Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

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

Gondi, Vinai, E-mail: gondi@humonc.wisc.edu; Bernard, Johnny Ray; Jabbari, Siavash

2011-11-15

Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 tomore » 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties. Conclusions: Trends in clinical training and resident working conditions over 3 years are documented to allow residents and program directors to assess their residency training.« less

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

None

Along the Yuma Sector Border Patrol Area in Yuma, Arizona, the GATEWAY program conducted a trial demonstration in which the incumbent quartz metal halide area lighting was replaced with LED at three pole locations at the Yuma Sector Border Patrol Area in Yuma, Arizona. The retrofit was documented to better understand LED technology performance in high-temperature environments. This document is a summary brief of the Phase 1.0 and 1.1 reports previously published on this demonstration.

Curso: Auxiliar de Farmacia. Guia. Farmacia Teorica: Manual del Estudiante. Matematica General: Manual del Estudiante. Documento de Trabajo (Pharmacy Assistant Course Guide. Theoretical Pharmacy Student Manual. General Mathematics Student Manual. Working Document).

ERIC Educational Resources Information Center

Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

The three parts of this document are intended for a 3-semester course for pharmacy assistants. The course guide contains the following sections: occupational description; educational philosophy; general objectives; tasks/competencies for each unit; course organization; brief description of the topics; student standards; and evaluation methods.…

The Development of Instructional Materials for Vocational Personnel Serving Students Who Are Speakers of Other Languages and Have Limited English Proficiency. Final Report.

ERIC Educational Resources Information Center

Adamsky, Richard A.; And Others

The first part of this document provides a brief account of a project to develop learning modules on the microcomputer and the microscope for use with limited English-proficient speakers of other languages who are enrolled in vocational education courses. The bulk of the document consists of appendixes presenting the modules themselves. The…

Peridynamics with LAMMPS : a user guide.

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

Lehoucq, Richard B.; Silling, Stewart Andrew; Plimpton, Steven James

2008-01-01

Peridynamics is a nonlocal formulation of continuum mechanics. The discrete peridynamic model has the same computational structure as a molecular dynamic model. This document details the implementation of a discrete peridynamic model within the LAMMPS molecular dynamic code. This document provides a brief overview of the peridynamic model of a continuum, then discusses how the peridynamic model is discretized, and overviews the LAMMPS implementation. A nontrivial example problem is also included.

Orbital operations study. Appendix C: Data sources and vehicle descriptions

NASA Technical Reports Server (NTRS)

Steinwachs, W. L.

1972-01-01

A bibliography of published documents referred to throughout the orbital operations study is presented. A brief description of all of the space program elements included in the study vehicle inventory is developed.

Sustainable concrete pavements : a manual of practice.

DOT National Transportation Integrated Search

2011-08-01

Developed as a more detailed follow-up to a 2009 briefing document, Building Sustainable Pavement with Concrete, this guide provides a clear, concise, and cohesive discussion of pavement sustainability concepts and of recommended practices for maximi...

ITS Projects In The Northeast Corridor

DOT National Transportation Integrated Search

1996-01-01

THIS DOCUMENT CONTAINS BRIEF DESCRIPTIONS OF ITS PROJECTS RECENTLY COMPLETED, UNDERWAY OR PLANNED WITHIN THE NORTHEAST CORRIDOR. THE BASIC SOURCE OF THIS INFORMATION IS FROM THE SPONSORING AGENCIES ALTHOUGH OTHER SECONDARY SOURCES HAVE ALSO BEEN USED...

Eco-logical successes : January 2011

DOT National Transportation Integrated Search

2011-01-01

This document identifies and explains each Eco-Logical signatory agency's strategic environmental programs, projects, and efforts that are either directly related to or share the vision set forth in Eco-Logical. A brief description of an agency's key...

Feasibility and Acceptability of a Best Supportive Care Checklist among Clinicians.

PubMed

Boucher, Nathan A; Nicolla, Jonathan; Ogunseitan, Adeboye; Kessler, Elizabeth R; Ritchie, Christine S; Zafar, Yousuf Y

2018-04-23

Best supportive care (BSC) is often not standardized across sites, consistent with best evidence, or sufficiently described. We developed a consensus-based checklist to document BSC delivery, including symptom management, decision making, and care planning. We hypothesized that BSC can be feasibly documented with this checklist consistent with consolidated standards of reporting trials. To determine feasibility/acceptability of a BSC checklist among clinicians. To test feasibility of a BSC checklist in standard care, we enrolled a sample of clinicians treating patients with advanced cancer at four centers. Clinicians were asked to complete the checklist at eligible patient encounters. We surveyed enrollees regarding checklist use generating descriptive statistics and frequencies. We surveyed 15 clinicians and 9 advanced practice providers. Mean age was 41 (SD = 7.9). Mean years since fellowship for physicians was 7.2 (SD = 4.5). Represented specialties are medical oncology (n = 8), gynecologic oncology (n = 4), palliative care (n = 2), and other (n = 1). For "overall impact on your delivery of supportive/palliative care," 40% noted improved impact with using BSC. For "overall impact on your documentation of supportive/palliative care," 46% noted improvement. Impact on "frequency of comprehensive symptom assessment" was noted to be "increased" by 33% of providers. None noted decreased frequency or worsening impact on any measure with use of BSC. Regarding feasibility of integrating the checklist into workflow, 73% agreed/strongly agreed that checklists could be easily integrated, 73% saw value in integration, and 80% found it easy to use. Clinicians viewed the BSC checklist favorably illustrating proof of concept, minor workflow impact, and potential of benefit to patients.

[Nutritional support and parenteral nutrition in the oncological patient: an expert group consensus report].

PubMed

Camblor-Álvarez, Miguel; Ocón-Bretón, María Julia; Luengo-Pérez, Luis Miguel; Viruzuela, Juan Antonio; Sendrós-Maroño, María José; Cervera-Peris, Mercedes; Grande, Enrique; Álvarez-Hernández, Julia; Jiménez-Fonseca, Paula

2018-01-10

Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients. A literature search, which included articles published in Spanish, English, and French until February 2017, was carried out. The document was organized as a questionnaire with those questions that, according to the panel's criteria, could generate greater controversy or doubt. Of the 18 questions addressed, 9 focused on nutritional support: 5 were related to PN and 4 about HPN. Among the different recommendations, the panel emphasized that in the cancer patient, PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer Patients.

Screening for depression in cancer patients receiving radiotherapy: Feasibility and identification of effective tools in the NRG Oncology RTOG 0841 trial.

PubMed

Wagner, Lynne I; Pugh, Stephanie L; Small, William; Kirshner, Jeffrey; Sidhu, Kulbir; Bury, Martin J; DeNittis, Albert S; Alpert, Tracy E; Tran, Binh; Bloom, Beatrice F; Mai, Julie; Yeh, Alexander; Sarma, Kalika; Becker, Mark; James, Jennifer; Bruner, Deborah Watkins

2017-02-01

Brief tools are needed to screen oncology outpatients for depressive symptoms. Patients starting radiotherapy for the first diagnosis of any tumor completed distress screening tools, including the 9-item Patient Health Questionnaire (PHQ-9), the 2-item Patient Health Questionnaire (PHQ-2), the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT), and the Hopkins Symptom Checklist (HSCL) (25-item version). Patients exceeding validated cutoff scores and a systematic sample of patients whose screening was negative completed the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone. Four hundred sixty-three patients from 35 community-based radiation oncology sites and 2 academic radiation oncology sites were recruited. Sixty-six percent of the 455 eligible patients (n = 299) were women, and the eligible patients had breast (45%), gastrointestinal (11%), lung (10%), gynecologic (6%), or other cancers (27%). Seventy-five (16.5%) exceeded screening cutoffs for depressive symptoms. Forty-two of these patients completed the SCID. Another 37 patients whose screening was negative completed the SCID. Among the 79 patients completing the SCID, 8 (10.1%) met the criteria for major depression, 2 (2.5%) met the criteria for dysthymia, and 6 (7.6%) met the criteria for an adjustment disorder. The PHQ-2 demonstrated good psychometric properties for screening for mood disorders with a cutoff score of ≥3 (receiver operating characteristic area under the curve [AUC], 0.83) and was comparable to the PHQ-9 ( > 9; AUC = 0.85). The NCCN-DT did not detect depression (AUC = 0.59). The PHQ-2 demonstrated good psychometric properties for screening for mood disorders, which were equivalent to the PHQ-9 and superior to the NCCN-DT. These findings support using the PHQ-2 to identify patients in need of further assessment for depression, which has a low prevalence but is a clinically significant comorbidity. These findings could inform the implementation of distress screening accreditation standards. Cancer 2017;123:485-493. © 2016 American Cancer Society. © 2016 American Cancer Society.

Combined therapy versus usual care for the treatment of depression in oncologic patients: a randomized controlled trial.

PubMed

Rodríguez Vega, B; Palao, A; Torres, G; Hospital, A; Benito, G; Pérez, E; Dieguez, M; Castelo, B; Bayón, C

2011-09-01

To compare narrative therapy (NT) plus escitalopram versus escitalopram plus usual care on quality of life and depressive symptomatology of depressed patients with oncologic disease. A total of 72 subjects (mean age 54.6 years), predominantly female with non-metastatic breast, lung and colon cancer and depressive disorder (DSM-IV-TR) were randomized to receive treatment with NT plus escitalopram (n=39) or escitalopram (10-20 mg QD) plus usual care (n=33). Main endpoints were improvement in dimensions of quality of life measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and reduction of depressive symptoms using the Hospital Anxiety and Depression Scale at weeks 12 and 24. The combined therapy group showed significantly greater improvement in all the functioning dimensions (p<0.01), pain scale (p=0.02), global health (p=0.02), and global quality of life (p=0.007) at weeks 12 and 24. There were no statistically significant differences in depressive symptomatology between the groups. From week 12 to week 24 study retention was higher in the combined treatment group (p=0.01). Brief NT in combination with escitalopram was superior to usual care and escitalopram in improving functioning dimensions of quality life. Copyright © 2010 John Wiley & Sons, Ltd.

The James Supportive Care Screening: integrating science and practice to meet the NCCN guidelines for distress management at a Comprehensive Cancer Center.

PubMed

Wells-Di Gregorio, Sharla; Porensky, Emily K; Minotti, Matthew; Brown, Susan; Snapp, Janet; Taylor, Robert M; Adolph, Michael D; Everett, Sherman; Lowther, Kenneth; Callahan, Kelly; Streva, Devita; Heinke, Vicki; Leno, Debra; Flower, Courtney; McVey, Anne; Andersen, Barbara Lee

2013-09-01

Selecting a measure for oncology distress screening can be challenging. The measure must be brief, but comprehensive, capturing patients' most distressing concerns. The measure must provide meaningful coverage of multiple domains, assess symptom and problem-related distress, and ideally be suited for both clinical and research purposes. From March 2006 to August 2012, the James Supportive Care Screening (SCS) was developed and validated in three phases including content validation, factor analysis, and measure validation. Exploratory factor analyses were completed with 596 oncology patients followed by a confirmatory factor analysis with 477 patients. Six factors were identified and confirmed including (i) emotional concerns; (ii) physical symptoms; (iii) social/practical problems; (iv) spiritual problems; (v) cognitive concerns; and (vi) healthcare decision making/communication issues. Subscale evaluation reveals good to excellent internal consistency, test-retest reliability, and convergent, divergent, and predictive validity. Specificity of individual items was 0.90 and 0.87, respectively, for identifying patients with DSM-IV-TR diagnoses of major depression and generalized anxiety disorder. Results support use of the James SCS to quickly detect the most frequent and distressing symptoms and concerns of cancer patients. The James SCS is an efficient, reliable, and valid clinical and research outcomes measure. Copyright © 2013 John Wiley & Sons, Ltd.

The effect of behavioral intervention on the psychological distress of Holocaust survivors with cancer.

PubMed

Baider, L; Peretz, T; Kaplan De-Nour, A

1997-01-01

This study describes a particular psychological intervention offered to a unique self-selected population of cancer patients who, 50 years earlier, had experienced the extreme trauma of the Holocaust. A total of 45 patients in follow-up at the Outpatient Clinic of the Oncology Department at the Hadassah University Hospital were approached. Two self-reports were administered: the Brief Symptom Inventory to assess psychological distress, and the Impact of Events Scale to assess intrusion and avoidance. There was a significant decrease in distress by the specific short-term psychological intervention used in this traumatized population. However, 3 months later the improvement virtually disappeared. This study failed to demonstrate a long-lasting effect of behavioral intervention upon Holocaust survivors with cancer.

[Information production by scientists and the history of science: typological study of personal archives].

PubMed

Silva, Maria Celina Soares de Mello E; Trancoso, Márcia Cristina Duarte

2015-01-01

This article addresses the study of document typology in the personal archives of scientists and its importance in the history of science studies and for the archivist's work. A brief history is presented of diplomatic to typological information, emphasizing that identifying document production activity as essential for its classification. The article illustrates personal archive characteristics as regards the diversity of documental types and, in particular, those belonging to physicists. Furthermore, it presents five examples of documental types found in the archives of physicists as examples of research in progress. It also highlights the elaboration of a glossary of different documental kinds and types found in the private archives of Museum of Astronomy and Related Sciences in Rio de Janeiro.

Adaptive Recreational Equipment.

ERIC Educational Resources Information Center

Schilling, Mary Lou, Ed.

1983-01-01

Designed for teachers interested in therapeutic recreation, the document lists sources of adaptive recreational equipment and their homemade counterparts. Brief descriptions for ordering or constructing recreational equipment for the visually impaired, poorly coordinated, physically impaired, and mentally retarded are given. Specific adaptations…

A Structured Approach to Teaching Applied Problem Solving through Technology Assessment.

ERIC Educational Resources Information Center

Fischbach, Fritz A.; Sell, Nancy J.

1986-01-01

Describes an approach to problem solving based on real-world problems. Discusses problem analysis and definitions, preparation of briefing documents, solution finding techniques (brainstorming and synectics), solution evaluation and judgment, and implementation. (JM)

Health Effects Assessment for Pyrene

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data for pyrene. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-rel...

HEALTH EFFECTS ASSESSMENT FOR ETHYLBENZENE

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

Health Effects Assessment for Naphthalene

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

HEALTH EFFECTS ASSESSMENT FOR BENZENE

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

Health Effects Assessment for Acetone

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

Health Effects Assessment for Chloroform

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

Removing the Shackles of Euclid: 1 Classification.

ERIC Educational Resources Information Center

Fielker, David S.

1981-01-01

A new approach to classifying quadrilaterals is presented that tries to classify all possible combinations of shapes and angles by removing the traditional Euclidean viewpoints. The document concludes with a brief look at other types of polygons. (MP)

Federal Aviation Administration Curriculum Guide for Aviation Magnet Schools Programs

DOT National Transportation Integrated Search

1994-01-01

Prepared ca. 1994. This publication is designed to provide: : - a brief history of the role of aviation in motivating young : people to learn. : - examples of aviation magnet activities, programs, projects and : school curriculums. : - documentation ...

Job Briefs. Career Education Guide.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

The document contains 288 one-page job descriptions based on 1973 information for the following 11 career clusters: automotive technology, business/clerical/sales, computer technology, electricity/electronics, graphic communications, health/cosmetology, agriculture/conservation, artistic/literary/music, mechanical/transportation/construction,…

Marine Safety Center briefing book

DOT National Transportation Integrated Search

1997-10-30

The U.S. Coast Guard Marine Safety Center was established in 1986 as a consolidation of district Merchant Marine Technical Offices. Our offices are located on the sixth floor of the DOT Headquarters building in Washington, DC. This document provides ...

Developing Your Employee Handbook: Job Descriptions.

ERIC Educational Resources Information Center

Perreault, Joe

1988-01-01

A job description is a brief document that conveys to employees the importance of their jobs to the overall success of the day-care center. If properly written, it can contribute to effective employee motivation and supervision. (RJC)

Comparison Of Rehabilitation Strategies For AC Pavements

DOT National Transportation Integrated Search

2000-11-01

This TechBrief summarizes the results of a study of the Specific Pavement Study 5 (SPS-5) experiment entitled, "Performance of Rehabilitated Asphalt Concrete Pavements in the LTPP Experiments--Data Collected Through February 1997." The study document...

45 CFR 509.3 - Exhibits and documents in support of claim.

Code of Federal Regulations, 2010 CFR

2010-10-01

... translation thereof duly verified under oath by its translator to be a true and accurate translation thereof, together with the name and address of the translator. (c) Preparation of papers. All claims, briefs, and...

The Mental Health, Substance Use, and Delinquency among Truant Youths in a Brief Intervention Project: A Longitudinal Study

PubMed Central

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Winters, Ken C.; Schmeidler, James; Ungaro, Rocio; Karas, Lora M.; Belenko, Steven; Gulledge, Laura

2011-01-01

The relationship between substance use, mental health disorders, and delinquency among youth is well documented. What has received far less attention from researchers is the relationship between these issues among truant youth, in spite of studies that document truants are a population at-risk for negative outcomes. The present study bridges this gap by (1) examining psychosocial functioning and delinquency among truants, and (2) assessing the efficacy of a Brief Intervention (BI) in reducing delinquent behavior over time. To meet these objectives, data were collected from 183 truant youth enrolled in an ongoing NIDA-funded BI project. Informed by a developmental damage perspective, a structural equation model was formulated and estimated. Interim results provide overall support for the model, and suggest the BI may be a promising, innovative intervention for truant youth. Service delivery implications and directions for future analyses are discussed. PMID:23914129

National briefing summaries: Nuclear fuel cycle and waste management

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

Schneider, K.J.; Bradley, D.J.; Fletcher, J.F.

Since 1976, the International Program Support Office (IPSO) at the Pacific Northwest Laboratory (PNL) has collected and compiled publicly available information concerning foreign and international radioactive waste management programs. This National Briefing Summaries is a printout of an electronic database that has been compiled and is maintained by the IPSO staff. The database contains current information concerning the radioactive waste management programs (with supporting information on nuclear power and the nuclear fuel cycle) of most of the nations (except eastern European countries) that now have or are contemplating nuclear power, and of the multinational agencies that are active in radioactivemore » waste management. Information in this document is included for three additional countries (China, Mexico, and USSR) compared to the prior issue. The database and this document were developed in response to needs of the US Department of Energy.« less

National briefing summaries: Nuclear fuel cycle and waste management

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

Schneider, K.J.; Lakey, L.T.; Silviera, D.J.

The National Briefing Summaries is a compilation of publicly available information concerning the nuclear fuel cycle and radioactive waste management strategies and programs of 21 nations, including the United States and three international agencies that have publicized their activities in this field. It presents available highlight information with references that may be used by the reader for additional information. The information in this document is compiled primarily for use by the US Department of Energy and other US federal agencies and their contractors to provide summary information on radioactive waste management activities in other countries. This document provides an awarenessmore » to managers and technical staff of what is occurring in other countries with regard to strategies, activities, and facilities. The information may be useful in program planning to improve and benefit United States' programs through foreign information exchange. Benefits to foreign exchange may be derived through a number of exchange activities.« less

MO-DE-304-01: The Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services: Round IV

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

Mills, M.

The Abt study of medical physicist work values for radiation oncology physics services, Round IV is completed. It supersedes the Abt III study of 2008. The 2015 Abt study measured qualified medical physicist (QMP) work associated with routine radiation oncology procedures as well as some special procedures. As before, a work model was created to allow the medical physicist to defend QMP work based on both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The Abt study Round IV was designed tomore » empower the medical physicist to negotiate a service or employment contract with providers based on measured national QMP workforce and staffing data. For a variety of reasons, the diagnostic imaging contingent of AAPM has had a more difficult time trying estimate workforce requirements than their therapy counterparts. Over the past several years, the Diagnostic Work and Workforce Study Subcommittee (DWWSS) has collected survey data from AAPM members, but the data have been very difficult to interpret. The DWWSS has reached out to include more AAPM volunteers to create a more full and accurate representation of actual clinical practice models on the subcommittee. Though much work remains, through hours of discussion and brainstorming, the DWWSS has somewhat of a clear path forward. This talk will provide attendees with an update on the efforts of the subcommittee. Learning Objectives: Understand the new information documented in the Abt studies. Understand how to use the Abt studies to justify medical physicist staffing. Learn relevant historical information on imaging physicist workforce. Understand the process of the DWWSS in 2014. Understand the intended path forward for the DWWSS.« less

Medication safety and the administration of intravenous vincristine: international survey of oncology pharmacists.

PubMed

Gilbar, Peter; Chambers, Carole R; Larizza, Maria

2015-02-01

The risk of medication errors with vincristine administration is well documented. Our objective was to ascertain how vincristine is administered worldwide and determine what strategies for preventing the accidental intrathecal administration of vincristine are in place. A survey, comprising 28 questions, was distributed to 363 International Society of Oncology Pharmacy Practitioners members from 42 countries via email. Questions were asked on methods of vincristine administration, intrathecal drug administration and strategies used to prevent medication errors. A reminder was sent and the survey was available on the International Society of Oncology Pharmacy Practitioners website. Only one survey per institution was requested. In all, 62 responses from 15 countries were received, with the majority from Australia. Vincristine was dispensed in mini-bags in 77.4% of centres, though some also used syringes. Syringes were used in 31.1% of centres, with half these doses prepared undiluted. Administration took 5 to 15 minutes in most centres (78.8%). The most common reasons for still using syringes were perceived risk of extravasation and faster infusion time. Despite numerous vincristine administrations, extravasation was very rare. Other recommended strategies for error prevention were in use in the majority of centres. Comparisons with three previous surveys are difficult as the majority of respondents in those studies were from the USA. A number of areas appear to have improved, particularly the preparation of vincristine in mini-bags, but they are far from perfect. Deaths continue to occur following accidental intrathecal administration of vincristine. International Society of Oncology Pharmacy Practitioner members are urged to lead the way in incorporating strategies for prevention into institutions worldwide. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Evolution of the randomized controlled trial in oncology over three decades.

PubMed

Booth, Christopher M; Cescon, David W; Wang, Lisa; Tannock, Ian F; Krzyzanowska, Monika K

2008-11-20

The randomized controlled trial (RCT) is the gold standard for establishing new therapies in clinical oncology. Here we document changes with time in design, sponsorship, and outcomes of oncology RCTs. Reports of RCTs evaluating systemic therapy for breast, colorectal (CRC), and non-small-cell lung cancer (NSCLC) published 1975 to 2004 in six major journals were reviewed. Two authors abstracted data regarding trial design, results, and conclusions. Conclusions of authors were graded using a 7-point Likert scale. For each study the effect size for the primary end point was converted to a summary measure. A total of 321 eligible RCTs were included (48% breast, 24% CRC, 28% NSCLC). Over time, the number and size of RCTs increased considerably. For-profit/mixed sponsorship increased substantially during the study period (4% to 57%; P < .001). There was increasing use of time-to-event measures (39% to 78%) and decreasing use of response rate (54% to 14%) as primary end point (P < .001). Effect size remained stable over the study period. Authors have become more likely to strongly endorse the experimental arm (P = .017). A significant P value for the primary end point and industry sponsorship were each independently associated with endorsement of the experimental agent (odds ratio [OR] = 19.6, 95% CI, 8.9 to 43.1, and OR = 3.5, 95% CI, 1.6 to 7.5, respectively). RCTs in oncology have become larger and are more likely to be sponsored by industry. Authors of modern RCTs are more likely to strongly endorse novel therapies. For-profit sponsorship and statistically significant results are independently associated with endorsement of the experimental arm.

Outpatient rapid 4-step desensitization for gynecologic oncology patients with mild to low-risk, moderate hypersensitivity reactions to carboplatin/cisplatin.

PubMed

Li, Quan; Cohn, David; Waller, Allyson; Backes, Floor; Copeland, Larry; Fowler, Jeffrey; Salani, Ritu; O'Malley, David

2014-10-01

The primary objective of this study is to assess the efficacy and safety of an outpatient, 4-step, one-solution desensitization protocol in gynecologic oncology patients with history of mild to low-risk, moderate hypersensitivity reactions (HSRs) to platinums (carboplatin and cisplatin). This was a single institutional retrospective review. Gynecologic oncology patients with a documented history of mild or low-risk, moderate immediate HSRs to carboplatin/cisplatin and continued treatment with 4-step, one-solution desensitization protocols in the outpatient infusion center were included. Patients with delayed HSRs or immediate high-risk, moderate or severe HSRs were excluded. The primary end point was the rate of successful administrations of each course of platinums. From January 2011 to June 2013, eighteen eligible patients were evaluated for outpatient 4-step, one-solution desensitization. Thirteen patients had a history of HSRs to carboplatin and 5 with HSRs to cisplatin. All of 18 patients successfully completed 94 (98.9%) of 95 desensitization courses in the outpatient infusion center. Eight of 8 (100%) patients with initial mild HSRs completed 29/29 (100%) desensitization courses, and 9 of 10 (90%) of patients with initial moderate HSRs completed 65/66 (94%) desensitization courses. In total, 65/95 (68%) desensitizations resulted in no breakthrough reactions, and mild, moderate and severe breakthrough reactions were seen in 19%, 12% and 1% desensitizations, respectively. No patients were hospitalized during desensitization. The outpatient rapid, 4-step, one-solution desensitization protocol was effective and appeared safe among gynecologic oncology patients who experienced mild to low-risk, moderate HSRs to carboplatin/cisplatin. Copyright © 2014 Elsevier Inc. All rights reserved.

Respiratory support in oncology ward setting: a prospective descriptive study.

PubMed

Mishra, Seema; Bhatnagar, Sushma; Gupta, Deepak; Goyal, Gaurav Nirvani; Agrawal, Ravi; Jain, Roopesh; Chauhan, Himanshu

2009-01-01

Mechanical ventilation in cancer patients is a critical issue The present prospective descriptive study was designed (1) to assess the patient population needing respirator support in ward setting at a premier state-run oncology institute in India, (2) to observe and analyze the course of their disease while on respirator, and (3) to coordinate better quality of life measures in cancer patients at the institute based on the present study's outcomes. Beginning from March 2005 to March 2006, all cancer patients who were connected to respirator in the wards were enrolled in the current study. Our anesthesiology department at the cancer institute also has primary responsibility for airway management and mechanical ventilation in high dependency units of oncology wards. Preventilation variables in cancer patients were assessed to judge the futility of mechanical ventilation in ward setting. Subsequently, patients were observed for disease course while on respirator. Final outcome with its etio-pathogenesis was correlated with predicted futility of mechanical ventilation. Over a period of 1 year, 132 (46 men and 86 women) cancer patients with median age 40 years (range 1-75 years) were connected to respirator in oncology wards. Based on the preventilation variables and indications for respirator support, right prediction of medical futility and hospital discharge was made in 77% of patients. Underestimation and overestimation of survival to hospital discharge was made in 10% cases and 13% cases, respectively. Based on preventilation variables, prediction of outcome in cancer patients needing respirator support can be made in 77% cases. This high probability of prediction can be used to educate patients, and their families and primary physicians, for well-informed and documented advance directives, formulated and regularly revised DNAR policies, and judicious use of respirator support for better quality-of-life outcomes.

Documentation to the NCES Common Core of Data Local Education Agency Universe Survey: School Year 2011-12. Provisional Version 1a. NCES 2014-035

ERIC Educational Resources Information Center

Keaton, Patrick

2014-01-01

This documentation is for the provisional version 1a file of the National Center for Education Statistics' (NCES) Common Core of Data (CCD) Local Education Agency (LEA) Universe Survey for SY 2011-12. It contains a brief description of the data collection, along with information required to understand and access the data file. The CCD is a…

Documentation to the NCES Common Core of Data Public Elementary/Secondary School Universe Survey: School Year 2011-12. Provisional Version 1a. NCES 2014-100

ERIC Educational Resources Information Center

Keaton, Patrick

2013-01-01

The documentation for this provisional version 1a file of the National Center for Education Statistics' (NCES) Common Core of Data (CCD) Public Elementary/Secondary School Universe Survey for SY 2011-12, contains a brief description of the data collection, along with information required to understand and access the data file. The SY 2011-12…

Controls Over Ministry of Interior Fuel Contracts Could be Improved

DTIC Science & Technology

2016-01-20

Fiscal Year 1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel...1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel consumption...of Defense F r a u d , W a s t e & A b u s e FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY Results in Brief Controls Over Ministry of Interior Fuel

Classroom Observations: Documenting Shifts in Instruction for Districtwide Improvement. Formative Evaluation Cycle Report for the Math in Common Initiative, Volume 2

ERIC Educational Resources Information Center

Perry, Rebecca R.; Seago, Nanette M.; Burr, Elizabeth; Broek, Marie; Finkelstein, Neal D.

2015-01-01

Math in Common® (MiC) is a five-year initiative that supports a formal network of 10 California school districts as they implement the Common Core State Standards in Mathematics (CCSS-M) across grades K-8. This research brief explores how best to select or develop and use classroom observation systems in order to document instructional shifts and…

Michigan Oncology Medical Home Demonstration Project: First-Year Results.

PubMed

Kuntz, Gordon; Tozer, Jane; Snegosky, Jeff; Fox, John; Neumann, Kurt

2014-03-01

The Michigan Oncology Medical Home Demonstration Project (MOMHDP) is an innovative multipractice oncology medical home model, supported by payment reform. Sponsored by Priority Health, Physician Resource Management, and ION Solutions, MOMHDP includes four oncology practices and 29 physicians. Oncology practices used existing technologies, with MOMHDP providing evidence-based treatment guideline selection and compliance tracking, automated physician order entry, a patient portal, symptom management/standardized nurse triage, and advance care planning. To support changes in care and administrative models and to focus on quality, MOMHDP modifies provider payments. The program replaces the average sales price payment methodology with a drug acquisition reimbursement plus a care management fee, calculated to increase total drug reimbursement. Additionally, it reimburses for chemotherapy and treatment planning and advance care planning consultation. There is also a shared savings opportunity. MOMHDP will be enhanced in its second year to include a survivorship program, patient distress screening, imaging guidelines, and standardized patient satisfaction surveys. Priority Health patients receiving chemotherapy for a cancer diagnosis were recruited to the program. Results for this group were compared with a control group of patients from a prior period. In addition to the financial results, the project also accomplished the following: (1) adherence to practice-selected guidelines, (2) institution of advance care planning, (3) effective and standardized symptom management; and (4) payment reform. We have identified a number of critical success factors: strong payer/provider collaboration built on trust through transparent use and cost data; timing of clinical standardization must come from the practices, so they can effectively absorb new approaches; having comprehensive, written program documentation and consistently applied training facilitate practice understanding; existing, off-the-shelf technologies help control costs; independent clinical, administrative, and technical coordination improves provider/payer collaboration; everything takes longer than anticipated, including practice commitment, contracting, and technology implementation. Practices are willing to take on clinical standardization with payment reform. Neither practice size nor technology platform variation was a barrier to participation or success in the project. These results represent preliminary reporting from the first multipractice oncology medical home in the United States, to our knowledge, with payer support that includes payment reform. The results are promising, and the concept warrants further study, review, and reporting. [Table: see text].

U.S. History Skits: Just a Spoonful of Sugar...

ERIC Educational Resources Information Center

Saeed, Sheryl Raffat

2016-01-01

This articles suggests the advantages of incorporating brief, informal, yet content-rich classroom history skits as a way to motivate students, generate interest, and ease students into the more "academic" content found in textbooks and primary source documents.

Health Effects Assessment for Carbon Tetrachloride (1986)

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

Transportation Analysis and Simulation System Requirements

DOT National Transportation Integrated Search

1973-04-01

This document provides: : a. A brief summary of overall project (PPA OS223) accomplishments during FY 72. : b. A detailed summary of the following two major FY 72 activities: : 1. Analysis of TSC's computation resources and their utilization; : 2. Pr...

Pavement Structural Evaluation at the Network Level [Tech Brief

DOT National Transportation Integrated Search

2016-03-01

This document is a technical summary of the Federal Highway Administration (FHWA) report, Pavement Structural Evaluation at the Network Level (FHWA-HRT-15-074). It addresses the use of traffic speed deflection devices for the structural evaluation of...

Overview of the EPA Quality System for Environmental Data and Technology

EPA Pesticide Factsheets

This document provides a brief summary of EPA’s Quality System for environmental data and technology for EPA and non-EPA organizations who are not familiar with the system but are subject to its requirements.

Integrating Module - NEMS Documentation

EIA Publications

2014-01-01

Provides an overview of the complete National Energy Modeling System (NEMS) model, and includes brief descriptions of the modules with which the Integrating Module interacts. The emphasis and focus, however, is on the structure and function of the Integrating Module of NEMS.

Unconventional Treatments for Vitiligo: Are They (Un) Satisfactory?

PubMed

Gianfaldoni, Serena; Tchernev, Georgi; Lotti, Jacopo; Wollina, Uwe; Satolli, Francesca; Rovesti, Miriam; França, Katlein; Lotti, Torello

2018-01-25

The authors show a brief overview of the vitiligo's unconventional therapies. A part for well-documented effectiveness of L-phenylalanine, PGE2 and antioxidant agents in the treatment of vitiligo, for the other therapeutical approaches more investigations are needed.

29 CFR 458.88 - Submission of the Administrative Law Judge's recommended decision and order to the Assistant...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR STANDARDS OF CONDUCT STANDARDS OF..., objections, depositions, exhibits, documentary evidence and any briefs or other documents submitted by the...

45 CFR 508.6 - Résumé of hearing, preparation of.

Code of Federal Regulations, 2010 CFR

2010-10-01

... which the hearing was based, and including a list of documents and contents and other items relative to the issues that were introduced as evidence. A brief analysis of oral testimony will also be prepared...

Tobacco documents research methodology

PubMed Central

McCandless, Phyra M; Klausner, Kim; Taketa, Rachel; Yerger, Valerie B

2011-01-01

Tobacco documents research has developed into a thriving academic enterprise since its inception in 1995. The technology supporting tobacco documents archiving, searching and retrieval has improved greatly since that time, and consequently tobacco documents researchers have considerably more access to resources than was the case when researchers had to travel to physical archives and/or electronically search poorly and incompletely indexed documents. The authors of the papers presented in this supplement all followed the same basic research methodology. Rather than leave the reader of the supplement to read the same discussion of methods in each individual paper, presented here is an overview of the methods all authors followed. In the individual articles that follow in this supplement, the authors present the additional methodological information specific to their topics. This brief discussion also highlights technological capabilities in the Legacy Tobacco Documents Library and updates methods for organising internal tobacco documents data and findings. PMID:21504933

Brief for the United States as Amicus Curiae Supporting Petitioner. On Writ of Certiorari to the United States Court of Appeals for the Sixth Circuit. Barbara Grutter, Petitioner, v. Lee Bollinger, et al. In the Supreme Court of the United States.

ERIC Educational Resources Information Center

United States Supreme Court, Washington, DC.

This legal document examines whether the University of Michigan Law School's use of racial preferences in student admissions violates the Equal Protection Clause of the Fourteenth Amendment, Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et. seq.), or 42 U.S.C. 1981. This brief filed by the federal government in support of the…

4MOST systems engineering: from conceptual design to preliminary design review

NASA Astrophysics Data System (ADS)

Bellido-Tirado, Olga; Frey, Steffen; Barden, Samuel C.; Brynnel, Joar; Giannone, Domenico; Haynes, Roger; de Jong, Roelof S.; Phillips, Daniel; Schnurr, Olivier; Walcher, Jakob; Winkler, Roland

2016-08-01

The 4MOST Facility is a high-multiplex, wide-field, brief-fed spectrograph system for the ESO VISTA telescope. It aims to create a world-class spectroscopic survey facility unique in its combination of wide-field multiplex, spectral resolution, spectral coverage, and sensitivity. At the end of 2014, after a successful concept optimization design phase, 4MOST entered into its Preliminary Design Phase. Here we present the process and tools adopted during the Preliminary Design Phase to define the subsystems specifications, coordinate the interface control documents and draft the system verification procedures.

Pediatric hematology in Poland: past and present.

PubMed

Boguslawska-Jaworska, J

1994-01-01

Pediatric hematology/oncology gradually developed in Poland in the beginning of the 20th century. The first pediatric hematology books written by M. Erlich were published in 1918 and 1924. In 1939, Jan Raszek-Rosenbusch was the first to use the intramedullary route of injection of living bone marrow cells in children suffering from lymphatic leukemia. The national cooperative chemotherapy group in Poland was formed in 1974. The studies carried out by the group in children with leukemia and lymphoma are documented by publications in international journals.

A unique case of spontaneous regression of metastatic papillary renal cell carcinoma: a case report

PubMed Central

Lim, Rebecca; Tan, Puay Hoon; Cheng, Christopher; Agasthian, Thirugnanam; Tan, Hwei Ling; Teh, Bin Tean

2009-01-01

Spontaneous regression of cancer is a rare, but well documented, phenomenon. We present a unique case of an 82 year old Chinese male who experienced spontaneous regression of histologically-verified metastatic type II papillary renal cell carcinoma in the absence of intervening systemic therapy or surgery. This is the first reported case of spontaneous regression of papillary renal cell carcinoma. The mechanism of spontaneous regression remains unknown, and represents a challenge for existing oncology paradigms. PMID:19918481

Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. Report of the AAPM Radiation Therapy Committee Task Group 63.

PubMed

Reft, Chester; Alecu, Rodica; Das, Indra J; Gerbi, Bruce J; Keall, Paul; Lief, Eugene; Mijnheer, Ben J; Papanikolaou, Nikos; Sibata, Claudio; Van Dyk, Jake

2003-06-01

This document is the report of a task group of the Radiation Therapy Committee of the AAPM and has been prepared primarily to advise hospital physicists involved in external beam treatment of patients with pelvic malignancies who have high atomic number (Z) hip prostheses. The purpose of the report is to make the radiation oncology community aware of the problems arising from the presence of these devices in the radiation beam, to quantify the dose perturbations they cause, and, finally, to provide recommendations for treatment planning and delivery. Some of the data and recommendations are also applicable to patients having implanted high-Z prosthetic devices such as pins, humeral head replacements. The scientific understanding and methodology of clinical dosimetry for these situations is still incomplete. This report is intended to reflect the current state of scientific understanding and technical methodology in clinical dosimetry for radiation oncology patients with high-Z hip prostheses.

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

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

Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.

2011-03-01

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal,more » breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.« less

Building Information Modelling for Cultural Heritage: A review

NASA Astrophysics Data System (ADS)

Logothetis, S.; Delinasiou, A.; Stylianidis, E.

2015-08-01

We discuss the evolution and state-of-the-art of the use of Building Information Modelling (BIM) in the field of culture heritage documentation. BIM is a hot theme involving different characteristics including principles, technology, even privacy rights for the cultural heritage objects. Modern documentation needs identified the potential of BIM in the recent years. Many architects, archaeologists, conservationists, engineers regard BIM as a disruptive force, changing the way professionals can document and manage a cultural heritage structure. The latest years, there are many developments in the BIM field while the developed technology and methods challenged the cultural heritage community in the documentation framework. In this review article, following a brief historic background for the BIM, we review the recent developments focusing in the cultural heritage documentation perspective.

A Brief History of Physics in China,

DTIC Science & Technology

1982-08-31

birth and death unknown) of the Yuan dynasty stated that lotus seeds were initially submerged in four different salt solutions whose concentration was...34 documented the construction metho. of the south-pointing cart by Yian Su (960-1040) in 1027 and Wu De-Ren (dates of birth and death unknown) in 1107. The...book also documented how Lu Dao-Long (dates of birth and death unknown) constructed the distance-registering cart in 1027. According to the record

Agora VI: Reporting on Human Capital. Is It Possible To Report on Human Capital and, If So, Why and How? (Thessaloniki, Greece, June 24-25, 1999). CEDEFOP Panorama Series.

ERIC Educational Resources Information Center

Guggenheim, Eric Fries, Ed.

This document contains 11 reports from a 2-day meeting on how to report on investments in vocational education and training in enterprises and whether such reporting is worthwhile. The document begins with a brief overview of the meeting and the meeting agenda. The remainder of the report is devoted to the meeting papers, which are titled as…

Development of integrated programs for Aerospace-vehicle Design (IPAD): Product program management systems

NASA Technical Reports Server (NTRS)

Isenberg, J. M.; Southall, J. W.

1979-01-01

The Integrated Programs for Aerospace Vehicle Design (IPAD) is a computing system to support company-wide design information processing. This document presents a brief description of the management system used to direct and control a product-oriented program. This document, together with the reference design process (CR 2981) and the manufacture interactions with the design process (CR 2982), comprises the reference information that forms the basis for specifying IPAD system requirements.

Documentation for the NCES Common Core of Data National Public Education Financial Survey (NPEFS), School Year 2008-09 (Fiscal Year 2009). Revised File Version 1b. NCES 2011-330rev

ERIC Educational Resources Information Center

Cornman, Stephen Q.; Zhou, Lei; Nakamoto, Nanae

2012-01-01

This documentation is for the revised file (Version 1b) of the National Center for Education Statistics' (NCES) Common Core of Data (CCD) National Public Education Financial Survey (NPEFS) for school year 2008-2009, fiscal year 2009 (FY 09). It contains a brief description of the data collection along with information required to understand and…

Pacific Northwest Laboratory annual report for 1988 to the DOE Office of Energy Research: Part 4, Physical sciences

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

Touburen, L.H.

1989-03-01

This document contains brief descriptions of various research programs in the physical science. Topics include Chernobyl Information Management, Supercritical Fluids, Laser Spectroscopy, DNA Adducts, Dosimetry, Biophysics, and Genetic Damage. (TEM)

47 CFR 1.734 - Specifications as to pleadings, briefs, and other documents; subscription.

Code of Federal Regulations, 2010 CFR

2010-10-01

... submitted both as hard copies and on computer disk formatted to be compatible with the Commission's computer... copies of tariffs or reports with their hard copies need not include such tariffs or reports on the disk...

Data Link Test and Analysis System/TCAS Monitor User's Guide

DOT National Transportation Integrated Search

1991-02-01

This document is a user's guide for the Data Link Test and Analysis System : (DATAS) Traffic Alert and Collision Avoidance System (TCAS) monitor application. : It provides a brief overall hardware description of DATAS configured as a TCAS : Monitor, ...

Health Effects Assessment for 1,1,2,2-Tetrachloroethane

EPA Science Inventory

The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

76 FR 40150 - Semiannual Regulatory Agenda

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... Commission publishes its semiannual regulatory flexibility agenda. In addition, this document includes an...) requires each agency to publish twice each year a regulatory flexibility agenda containing a brief... 12866 requires each agency to publish twice each year a regulatory agenda of regulations under...

Global partnerships for climate change

USDA-ARS?s Scientific Manuscript database

In a position paper published by the ASABE Global Engagement Task Force (Resource Magazine, ASABE, Spring 2015 Issue), authors outlined the goals for the Agricultural and Biological Engineering Global Initiative. This brief document is intended to represent the first action in this global partnersh...

ROTONET Primer

NASA Technical Reports Server (NTRS)

Prichard, Devon S.

1996-01-01

This document provides a brief overview of use of the ROTONET rotorcraft system noise prediction capability within the Aircraft Noise Program (ANOPP). Reviews are given on rotorcraft noise, the state-of-the-art of system noise prediction, and methods for using the various ROTONET prediction modules.

Ten-year results of quality assurance in radiotherapy chart round.

PubMed

Taghavi Bayat, Bardia; Gill, Suki; Siva, Shankar; Tai, Keen Hun; Joon, Michael Lim; Foroudi, Farshad

2013-04-23

The Royal Australian and New Zealand College of Radiologists (RANZCR) initiated a unique instrument to audit the quality of patient notes and radiotherapy prescriptions. We present our experience collected over ten years from the use of the RANZCR audit instrument. In this study, the results of data collected prospectively from January 1999 to June 2009 through the audit instrument were assessed. Radiotherapy chart rounds were held weekly in the uro-oncology tumour stream and real time feedback was provided. Electronic medical records were retrospectively assessed in September 2009 to see if any omissions were subsequently corrected. In total 2597 patients were audited. One hundred and thirty seven (5%) patients had one hundred and ninety nine omissions in documentation or radiotherapy prescription. In 79% of chart rounds no omissions were found at all, in 12% of chart rounds one omission was found and in 9% of chart rounds two or more omissions were found. Out of 199 omissions, 95% were of record keeping and 2% were omissions in the treatment prescription. Of omissions, 152 (76%) were unfiled investigation results of which 77 (51%) were subsequently corrected. Real-time audit with feedback is an effective tool in assessing the standards of radiotherapy documentation in our department, and also probably contributed to the high level of attentiveness. A large proportion of omissions were investigation results, which highlights the need for an improved system of retrieval of investigation results in the radiation oncology department.

Conduct, Oversight, and Ethical Considerations of Clinical Trials in Companion Animals with Cancer: Report of a Workshop on Best Practice Recommendations.

PubMed

Page, R; Baneux, P; Vail, D; Duda, L; Olson, P; Anestidou, L; Dybdal, N; Golab, G; Shelton, W; Salgaller, M; Hardy, C

2016-01-01

Development of effective and safe treatments for companion animals with cancer requires the collaboration of numerous animal health professionals and the full engagement of animal owners. Establishing 'Best Practice Recommendations' for clinical trials in veterinary oncology represents an important step toward meeting the goal of rigorous clinical trial design and conduct that is required to establish valid evidence. Likewise, optimizing patient welfare and owner education and advocacy is crucial to meet the unique ethical obligations to both owners and animals enrolled in these clinical trials and to ensure trust in the team conducting the research. To date, 'Best Practice Recommendations' for clinical trial conduct have not been reported for veterinary oncology. This document summarizes the consensus of a workshop held in November, 2014 to identify relevant ethical principles and to ensure responsible conduct of clinical research in companion animals with cancer. It is intended as a working document that will be updated as advances in science and ethical considerations require. To the extent possible, existing guidelines for the conduct and oversight of clinical trials in humans have been adapted for veterinary trials to avoid duplicative effort and to facilitate integration of clinical trials such that translational research with benefits for both companion animals and humans are encouraged. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Development of a Cancer Care Summary Through the Electronic Health Record.

PubMed

Carr, Laurie L; Zelarney, Pearlanne; Meadows, Sarah; Kern, Jeffrey A; Long, M Bronwyn; Kern, Elizabeth

2016-02-01

Our objective was to improve communication concerning lung cancer patients by developing and distributing a Cancer Care Summary that would provide clinically useful information about the patient's diagnosis and care to providers in diverse settings. We designed structured, electronic forms for the electronic health record (EHR), detailing tumor staging, classification, and treatment. To ensure completeness and accuracy of the information, we implemented a data quality cycle, composed of reports that are reviewed by oncology clinicians. The data from the EHR forms are extracted into a structured query language database system on a daily basis, from which the Summaries are derived. We conducted focus groups regarding the utility, format, and content of the Summary. Cancer Care Summaries are automatically generated 4 months after a patient's date of diagnosis, then every 6 months for those receiving treatment, and on an as-needed basis for urgent care or hospital admission. The product of our improvement project is the Cancer Care Summary. To date, 102 individual patient Summaries have been generated. These documents are automatically entered into the National Jewish Health (NJH) EHR, attached to correspondence to primary care providers, available to patients as electronic documents on the NJH patient portal, and faxed to emergency departments and admitting physicians on patient evaluation. We developed a sustainable tool to improve cancer care communication. The Cancer Care Summary integrates information from the EHR in a timely manner and distributes the information through multiple avenues. Copyright © 2016 by American Society of Clinical Oncology.

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...

Native American Art and Culture: Documentary Resources.

ERIC Educational Resources Information Center

Lawrence, Deirdre

1992-01-01

Presents a brief overview of the evolution of documentary material of Native American cultures and problems confronted by researchers in locating relevant information. Bibliographic sources for research are discussed and a directory of major repositories of Native American art documentation is provided. (EA)

Los Angeles congestion reduction demonstration (Metro ExpressLanes) program. National evaluation : exogenous factors test plan.

DOT National Transportation Integrated Search

1999-12-01

The Traceability document consists of brief introductory material and a series of appended Trace Tables. These tables provide complete traceability of ITS User Service Requirements (USR) to elements of the National ITS Architecture. Additional Trace ...

DJANAL user's manual

NASA Technical Reports Server (NTRS)

Pitts, E. R.

1976-01-01

The DJANAL (DisJunct ANALyzer) Program provides a means for the LSI designer to format output from the Mask Analysis Program (MAP) for input to the FETLOG (FETSIM/LOGSIM) processor. This document presents a brief description of the operation of DJANAL and provides comprehensive instruction for its use.

Data link test and analysis system/TCAS monitor user's guide

NASA Astrophysics Data System (ADS)

Vandongen, John; Wapelhorst, Leo

1991-02-01

This document is a user's guide for the Data Link Test and Analysis System (DATAS) Traffic Alert and Collision Avoidance System (TCAS) monitor. It provides a brief overall hardware description of DATAS configured as a TCAS monitor, and the applications software.

12 CFR 19.100 - Filing documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... motions; briefs; the record filed by the administrative law judge after the issuance of a recommended decision; the recommended decision filed by the administrative law judge following a motion for summary disposition; referrals by the administrative law judge of motions for interlocutory review; exceptions and...

VIRTUAL SYMPOSIUM: STATE OF THE SCIENCE--PPCPS AS ENVIRONMENTAL POLLUTANTS

EPA Science Inventory

This document provides a brief summary of how this pioneering meeting for the ACS was conducted, as well as some perspective and insights that could prove useful for those who might beinterested in organizing and hosting their own "virtual" meeting.

Radium in Humans: A Review of U.S. Studies.

DOE R&D Accomplishments Database

Rowland, R. E.

1994-09-01

This document was originally conceived as a description of the radium studies that took place at Argonne National Laboratory. It soon became evident, however, that to document the widespread use of radium, a brief review of the application of radium in medicine and in the US dial painting industry is required. Further, because the Argonne studies were not the only such efforts, brief overviews of the other radium programs are included. Even so, much material has been omitted. The extensive references included will allow the interested reader to find additional information. The effects of internally deposited radium in humans have been studied in this country for more than 75 years. Some 2,400 subjects have had their body contents of radium measured, and a majority of them have been followed for most of their adult lives, to understand and quantify the effects of radium. Many more individuals acquired radium internally but were never measured. Some of this group have been located and followed until death; in these cases the cause of death is known without a body content measurement. As a consequence of the efforts made to locate, measure, and follow exposed individuals, a great deal of information about the effects of radium is available. Nevertheless, great gaps remain in the knowledge of radium toxicity. The Argonne study is the largest every undertaken of the effects on humans of an internally deposited radioelement, in which the insult has been quantitated by actual measurements of the retained radioisotope. The study has now been terminated, even though more than 1,000 subjects with measured radium burdens are still alive. This document is written as a brief summary of current knowledge accumulated in this incomplete study.

Neonatal records and the computer.

PubMed Central

Walker, C H

1977-01-01

To use a combined single document clinical case sheet/computer record which can form the basic document for a life medical record is a practical proposition. With adequate briefing doctors and nurses soon become familiar with the record and appreciate its value. Secretarial and clerical requirements are reduced to a minimum as transcription of medical data is eliminated, so greatly speeding up processing and feed back to the medical services. A few illustrations of trends in neonatal statistics and of computer linked maternal/neonatal data are presented. PMID:879830

Documenting the Physical Universe:Preserving the Record of SLAC from 1962 to 2005

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

Deken, Jean Marie; /SLAC

2006-03-10

Since 1905, Albert Einstein's ''miraculous year'', modern physics has advanced explosively. In 2005, the World Year of Physics, a session at the SAA Annual meeting discusses three institutional initiatives--Einstein's collected papers, an international geophysical program, and a research laboratory--to examine how physics and physicists are documented and how that documentation is being collected, preserved, and used. This paper provides a brief introduction to the research laboratory (SLAC), discusses the origins of the SLAC Archives and History Office, its present-day operations, and the present and future challenges it faces in attempting to preserve an accurate historical record of SLAC's activities.

Everything you might want to know about the Internet but are afraid to ask!. A new users resource

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

Thiel, E.

This document is a guide to accessing the Internet and the services available on Internet. The document contains a short explanation of the Internet by E. Kroll and E. Hoffman, brief descriptions of the primary access tools, a glossary, answers to frequently asked questions about the Internet, J. Martin`s `Search for Internet Treasure` and other helpful information. The data access tools discussed in this document include Gopher, World Wide Web, WAIS, ASTRA, ARCHIE, WHOIS, NETSERV, and TRICKLE. The file transfer tool discussed is BITFTP. The two communication services discussed are NETNEWS and LISTSERV.

Electronic nicotine delivery systems: a policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology.

PubMed

Brandon, Thomas H; Goniewicz, Maciej L; Hanna, Nasser H; Hatsukami, Dorothy K; Herbst, Roy S; Hobin, Jennifer A; Ostroff, Jamie S; Shields, Peter G; Toll, Benjamin A; Tyne, Courtney A; Viswanath, Kasisomayajula; Warren, Graham W

2015-03-10

Combustible tobacco use remains the number-one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the health of the public; however, definitive data are lacking. The AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the US Food and Drug Administration and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. This policy statement was developed by a joint writing group composed of members from the Tobacco and Cancer Subcommittee of the American Association for Cancer Research (AACR) Science Policy and Government Affairs (SPGA) Committee and American Society of Clinical Oncology (ASCO) Tobacco Cessation and Control Subcommittee of the Cancer Prevention Committee (CaPC). The statement was reviewed by both parent committees (ie, the AACR SPGA Committee and the ASCO CaPC) and was approved by the AACR Boards of Directors on August 6, 2014, and the ASCO Executive Committee on September 18, 2014. This policy statement was published jointly by invitation and consent in both Clinical Cancer Research and Journal of Clinical Oncology. Copyright 2015 American Association for Cancer Research and American Society of Clinical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or storage in any information storage and retrieval system, without written permission by the American Association for Cancer Research and the American Society of Clinical Oncology. © 2015 by American Association for Cancer Research and American Society of Clinical Oncology.

The effect of complementary and alternative medicine on quality of life, depression, anxiety, and fatigue levels among cancer patients during active oncology treatment: phase II study.

PubMed

Bar-Sela, Gil; Danos, Sara; Visel, Bella; Mashiach, Tanya; Mitnik, Inbal

2015-07-01

During the past decade, there has been growing interest in complementary and alternative medicine (CAM) among cancer patients and it is being integrated more frequently within conventional cancer centers. The long-term effect of mind-body therapies on quality of life (QoL), depression, anxiety, and fatigue was tested prospectively in this study. Cancer patients who received six weekly sessions of CAM during their oncological treatments participated in the study. The Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI) and QoL-EORTC-C30 were completed during the intervention and follow-up period. Over a two-year period, 163 patients entered the study, 135 of whom completed all six CAM sessions. An improvement was demonstrated in the median of BFI from 4.8 to 3.9 (p < 0.001), HADS-Anxiety from 8 to 7 (p < 0.001) and HADS-Depression from 7 to 6 (p < 0.001) after 12 weeks. In addition, the median of global QoL improved from 50 to 67 (p < 0.001), and a significant improvement was noticed in several parameters on the functioning and symptoms scales of the QoL-EORTC-C30. Cancer patients who completed six weekly sessions of CAM improved significantly on measured outcomes, regardless of their demographic characteristics.

Therapeutic Potential, Challenges and Future Perspective of Cancer Stem Cells in Translational Oncology: A Critical Review.

PubMed

Shukla, Gaurav; Khera, Harvinder Kour; Srivastava, Amit Kumar; Khare, Piush; Patidar, Rahul; Saxena, Rajiv

2017-01-01

Stem cell research is a rapidly developing field that offers effective treatment for a variety of malignant and non-malignant diseases. Stem cell is a regenerative medicine associated with the replacement, repair, and restoration of injured tissue. Stem cell research is a promising field having maximum therapeutic potential. Cancer stem cells (CSCs) are the cells within the tumor that posses capacity of selfrenewal and have a root cause for the failure of traditional therapies leading to re-occurrence of cancer. CSCs have been identified in blood, breast, brain, and colon cancer. Traditional therapies target only fast growing tumor mass, but not slow-dividing cancer stem cells. It has been shown that embryonic pathways such as Wnt, Hedgehog and Notch, control self-renewal capacity and involved in cancer stem cell maintenance. Targeting of these pathways may be effective in eradicating cancer stem cells and preventing chemotherapy and radiotherapy resistance. Targeting CSCs has become one of the most effective approaches to improve the cancer survival by eradicating the main root cause of cancer. The present review will address, in brief, the importance of cancer stem cells in targeting cancer as better and effective treatment along with a concluding outlook on the scope and challenges in the implication of cancer stem cells in translational oncology. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Decision to Send Humans Back to the Moon and on to Mars: Space Exploration Initiative History Project

NASA Technical Reports Server (NTRS)

McCurdy, Howard E.

1992-01-01

This folder contains working papers collected to date on a NASA-sponsored history project to document the events leading up to the July 20, 1989 speech setting forth the objectives of the Space Exploration Initiative. Included are a chronology of events, briefing papers produced by the NASA Working Group laying out proposal, briefing charts used to present the proposal, a copy of the President's speech, and an essay summarizing the events that led up to the announcement. Additionally, two fo the interviews conducted as part of the project are enclosed.

Case Citations 1991. Eleventh Series.

ERIC Educational Resources Information Center

Sharp, Linda A., Ed.

Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

Library Bulletin [International Planned Parenthood Federation, May 1976].

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

This loose-leaf collection includes a brief discussion of usage procedures for International Planned Parenthood Federation (IPPF) libraries. A set of annotated bibliographies follows, including descriptions of documents on the following topics: family planning and biomedical science, social sciences related to family planning, education and…

Seismic rehabilitation of skewed and curved bridges using a new generation of buckling restrained braces : research brief.

DOT National Transportation Integrated Search

2016-12-01

Damage to skewed and curved bridges during strong earthquakes is documented. This project investigates whether such damage could be mitigated by using buckling restrained braces. Nonlinear models show that using buckling restrained braces to mitigate...

78 FR 20324 - Proposed Information Collection Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

..., document the experiences of program participants, examine differences in service receipt and educational experiences between program and control group members, describe the intervention as it was implemented in each... leadership/ managers, instructional staff, case managers/advisors, partners and employers; (d) a brief survey...

Splice length of prestressing strand in field-cast ultra-high performance concrete connections, TechBrief

DOT National Transportation Integrated Search

2014-02-02

The objective of this research was to determine the lap splice length of untensioned prestressing strand in field-cast ultrahigh performance concrete (UHPC). This document is a technical summary of the Federal Highway Administration report, Splice Le...

Power Transformers: Technical Terminology Bulletin. Terminotech, Vol.2, No. 6.

ERIC Educational Resources Information Center

General Electric Co. of Canada, Ltd., Montreal, Quebec.

This issue of a bulletin of technological terminology is devoted to power transformers. A brief narrative on the subject is presented in both French and English. An English-French dictionary of terms comprises the bulk of the document. Explanatory illustrations are appended. (JB)

Electric Motors: Technical Terminology Bulletin. Terminotech, Vol. 1, No. 2.

ERIC Educational Resources Information Center

General Electric Co. of Canada, Ltd., Montreal, Quebec.

This issue of a bulletin of technological terminology is devoted to electric motors. A brief narrative on the subject is included in both French and English. An English-French dictionary of terms comprises the bulk of the document. Explanatory illustrations are appended (JB).

Drug Free Campus Statement.

ERIC Educational Resources Information Center

Casper Coll., WY.

These three brief documents, a policy statement, a summary of pertinent laws on alcohol and illegal drugs, and a substance addiction specialist curriculum description, taken together describe the Casper College (Wyoming) drug and alcohol abuse prevention program. The policy statement briefly summarizes the health risks associated with drug and…

7 CFR 4280.128 - Application and documentation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Program General Renewable Energy System and Energy Efficiency Improvement Guaranteed Loans § 4280.128... capital improvements to an existing renewable energy system) or to make energy efficiency improvements. The response to § 4280.113(a) must include a brief description of the system or improvement. This...

7 CFR 4280.128 - Application and documentation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Program General Renewable Energy System and Energy Efficiency Improvement Guaranteed Loans § 4280.128... capital improvements to an existing renewable energy system) or to make energy efficiency improvements. The response to § 4280.113(a) must include a brief description of the system or improvement. This...

7 CFR 4280.128 - Application and documentation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Program General Renewable Energy System and Energy Efficiency Improvement Guaranteed Loans § 4280.128... capital improvements to an existing renewable energy system) or to make energy efficiency improvements. The response to § 4280.113(a) must include a brief description of the system or improvement. This...

The Zoo, Benchmarks & You: How To Reach the Oregon State Benchmarks with Zoo Resources.

ERIC Educational Resources Information Center

2002

This document aligns Oregon state educational benchmarks and standards with Oregon Zoo resources. Benchmark areas examined include English, mathematics, science, social studies, and career and life roles. Brief descriptions of the programs offered by the zoo are presented. (SOE)

Evaluation of Video Detection Systems and Development of Application Guidelines at Signalized Intersections

DOT National Transportation Integrated Search

2010-07-01

This report documents the results of a study on evaluating three major video imaging vehicle detection systems (VIVDS) currently deployed in Nevadas urban areas. The report first provides a brief review of the features and functions of some major ...

Mathematics Equity. A Resource Book.

ERIC Educational Resources Information Center

Tyree, Eddy; And Others

Provided in this document is a brief summary of current research on equity in mathematics, readings on the topic, and lists of selected programs and resource materials. Readings presented include: "Teaching Mathematics in a Multicultural Setting: Some Considerations when Teachers and Students are of Differing Cultural Backgrounds"…

75 FR 17898 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... COMMISSION ON CIVIL RIGHTS Sunshine Act Notice AGENCY: United States Commission on Civil Rights... Discussion of Staff Level Meeting with EEOC re: its Compliance with Request for Documents Related to Civil...: Diversity Discussion of Timetable for Briefing Reports Update on National Civil Rights Conference Update on...

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.

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...

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...

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

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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...

[Constitutional syndrome associated to metformin induced hepatotoxicity].

PubMed

de la Poza Gómez, Gema; Rivero Fernández, Miguel; Vázquez Romero, Manuel; Angueira Lapeña, Teresa; Arranz de la Mata, Gemma; Boixeda de Miquel, Daniel

2008-12-01

Metformin is an oral antidiabetic agent frequently used to manage type II diabetes. This drug produces nonspecific gastrointestinal symptoms in 5-20% of patients and, more rarely, has also been associated with severe adverse effects such as lactic acidosis. Only a few isolated cases of hepatotoxicity due to this drug have been documented. We report the case of an 83-year-old man with constitutional syndrome and hepatic biochemical alterations, which were attributed to metformin after ruling out an oncologic etiology and observing complete clinical and biochemical resolution after withdrawal of the drug.

Automated Classification of Pathology Reports.

PubMed

Oleynik, Michel; Finger, Marcelo; Patrão, Diogo F C

2015-01-01

This work develops an automated classifier of pathology reports which infers the topography and the morphology classes of a tumor using codes from the International Classification of Diseases for Oncology (ICD-O). Data from 94,980 patients of the A.C. Camargo Cancer Center was used for training and validation of Naive Bayes classifiers, evaluated by the F1-score. Measures greater than 74% in the topographic group and 61% in the morphologic group are reported. Our work provides a successful baseline for future research for the classification of medical documents written in Portuguese and in other domains.

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

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

Ahmed, Awad A.; Hwang, Wei-Ting; Holliday, Emma B.

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

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

PubMed

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

2017-05-01

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

Evaluation of Treatment- and Disease-Related Symptoms in Advanced Head and Neck Cancer: Validation of the National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Head and Neck Cancer Symptom Index-22 (NFHNSI-22)

PubMed Central

Pearman, Timothy P.; Beaumont, Jennifer L.; Paul, Diane; Abernethy, Amy P.; Jacobsen, Paul B.; Syrjala, Karen L.; Von Roenn, Jamie; Cella, David

2018-01-01

Context The Functional Assessment of Cancer Therapy-Head and Neck is a well-validated assessment of quality of life used with patients diagnosed with head and neck cancers (HCNs). The present study is an attempt to evaluate and modify this instrument as necessary in light of the recent regulatory guidelines from the Food and Drug Administration on the use of patient-reported outcomes in clinical trials. Objectives Overall, the goal was to identify patients’ highest priority cancer symptoms, compare these symptoms with those suggested by oncology experts, and construct a brief symptom index to assess these symptoms and categorize them as treatment-related, disease-related, or related to general function and well-being. Methods Patients (N = 49) with advanced (Stages III and IV) HCNs were recruited from participating National Comprehensive Cancer Network institutions and community cancer support organizations in the Chicago area. Patients completed open-ended interviews and symptom checklists. Participating oncology physician experts also rated symptoms. Content validity was obtained by evaluating results alongside items in the Functional Assessment of Chronic Illness Therapy system. Eleven oncologists categorized symptoms in terms of importance and also whether the symptoms were primarily related to disease, treatment, or functional well-being. Results HCN-related symptoms endorsed as high priority by both patients and oncology experts were selected for the new National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Head and Neck Cancer Symptom Index-22. The final version includes 22 items, which are broken down into disease-related symptoms, treatment side effects, or general function and well-being. The new scale has acceptable internal consistency (Cronbach’s coefficient alpha = 0.86), content validity for use in chemotherapy trials of patients with advanced disease, and concurrent validity as demonstrated by moderate-to-strong correlations with the existing Functional Assessment of Chronic Illness Therapy measure. Conclusion The National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Head and Neck Cancer Symptom Index-22 adequately reflects symptom and side effect concerns of advanced HCN patients as well as oncology physicians. This instrument can be used to evaluate the most important disease-related symptoms, treatment side effects, and function/well-being in patients with advanced HCNs in clinical practice and research. PMID:23017622

Prevalence of neuropathic pain in radiotherapy oncology units.

PubMed

Mañas, Ana; Monroy, Jose Luis; Ramos, Avelino Alia; Cano, Carmen; López-Gómez, Vanessa; Masramón, Xavier; Pérez, María

2011-10-01

Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 ±12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs. Copyright © 2011 Elsevier Inc. All rights reserved.

Transforming Cancer Prevention through Precision Medicine and Immune-oncology.

PubMed

Kensler, Thomas W; Spira, Avrum; Garber, Judy E; Szabo, Eva; Lee, J Jack; Dong, Zigang; Dannenberg, Andrew J; Hait, William N; Blackburn, Elizabeth; Davidson, Nancy E; Foti, Margaret; Lippman, Scott M

2016-01-01

We have entered a transformative period in cancer prevention (including early detection). Remarkable progress in precision medicine and immune-oncology, driven by extraordinary recent advances in genome-wide sequencing, big-data analytics, blood-based technologies, and deep understanding of the tumor immune microenvironment (TME), has provided unprecedented possibilities to study the biology of premalignancy. The pace of research and discovery in precision medicine and immunoprevention has been astonishing and includes the following clinical firsts reported in 2015: driver mutations detected in circulating cell-free DNA in patients with premalignant lesions (lung); clonal hematopoiesis shown to be a premalignant state; molecular selection in chemoprevention randomized controlled trial (RCT; oral); striking efficacy in RCT of combination chemoprevention targeting signaling pathway alterations mechanistically linked to germline mutation (duodenum); molecular markers for early detection validated for lung cancer and showing promise for pancreatic, liver, and ovarian cancer. Identification of HPV as the essential cause of a major global cancer burden, including HPV16 as the single driver of an epidemic of oropharyngeal cancer in men, provides unique opportunities for the dissemination and implementation of public health interventions. Important to immunoprevention beyond viral vaccines, genetic drivers of premalignant progression were associated with increasing immunosuppressive TME; and Kras vaccine efficacy in pancreas genetically engineered mouse (GEM) model required an inhibitory adjuvant (Treg depletion). In addition to developing new (e.g., epigenetic) TME regulators, recent mechanistic studies of repurposed drugs (aspirin, metformin, and tamoxifen) have identified potent immune activity. Just as precision medicine and immune-oncology are revolutionizing cancer therapy, these approaches are transforming cancer prevention. Here, we set out a brief agenda for the immediate future of cancer prevention research (including a "Pre-Cancer Genome Atlas" or "PCGA"), which will involve the inter-related fields of precision medicine and immunoprevention - pivotal elements of a broader domain of personalized public health. ©2016 American Association for Cancer Research.

Prevalence of Neuropathic Pain in Radiotherapy Oncology Units

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

Manas, Ana; Monroy, Jose Luis; Ramos, Avelino Alia

Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxietymore » and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs.« less

A concise evaluation and management curriculum for physicians in training improved billing at an outpatient academic rheumatology clinic.

PubMed

Hirsh, Joel M; Collier, David H; Boyle, Dennis J; Gardner, Edward M

2010-04-01

To study whether providing house staff with a brief lecture and handout about proper documentation could improve billing at an academic rheumatology clinic. The authors created an educational sheet about documentation and billing after a review of the common documentation omissions responsible for down coding (Appendix, Supplemental Digital Content 1, available at: http://links.lww.com/RHU/A8). Beginning in November of 2006, the house staff were provided with this sheet and a brief lecture regarding how outpatient evaluation and management levels of service are coded. The results of clinic billing from January 1, 2006 to October 31, 2006 and November 1, 2006 to August 31, 2007 were obtained from the physician billing office. The authors compared the average level of service, by appointment type, in the prepost comparison periods using the student t test. There was a significant improvement in the level of service billed for new visits (P < 0.001), consults (P < 0.001), and return visits (P < 0.001) after November 1, 2006. The percentage of patients evaluated for the first time who were billed as consults improved from 15% to 78% (P < 0.001 by chi2). These changes resulted in $34,342 of additional billing during the postintervention period. A simple strategy for educating the house staff about proper documentation of the history, physical examination, and clinical decision making resulted in a significant improvement in an academic rheumatology division's outpatient billing.

Functional organ preservation in laryngeal and hypopharyngeal cancer

PubMed Central

Ambrosch, Petra; Fazel, Asita

2012-01-01

The principles of open versus laser microsurgical approaches for partial resections of the larynx are described, oncologic as well as functional results discussed and corresponding outcomes following primary radiotherapy are opposed. Over the last decade, the endoscopic partial resection of the larynx has developed to an accepted approach in the treatment of early glottic and supraglottic carcinomas thus leading to a remarkable decline in the use of open surgery. Comparing the various surgical approaches of laryngeal partial resections, the oncological outcome of the patients, as far as survival and organ preservation are concerned, are comparable, whereas functional results of the endoscopic procedures are superior with less morbidity. The surgical procedures put together, are all superior to radiotherapy concerning organ preservation. Transoral laser microsurgery has been used successfully for vocal cord carcinomas with impaired mobility or fixation of the vocal cord, supraglottic carcinomas with infiltration of the pre- and/or paraglottic space as well as for selected hypopharyngeal carcinomas. It has been well documented that laser microsurgery achieves good oncological as well as functional results with reasonable morbidity. However, patients with those tumours have been successfully treated by open partial resections of the larynx at medical centres with appropriate expertise. The initially enthusiastic assessment of study results concerning the efficacy of various protocols of chemoradiation with the intent of organ preservation for laryngeal and hypopharyngeal carcinomas are judged more cautious, today, due to recent reports of rather high rates of late toxicity complications. PMID:22558052

Practical Communication Guidance to Improve Phase I Informed Consent Conversations and Decision-Making in Pediatric Oncology

PubMed Central

Johnson, Liza-Marie; Leek, Angela C.; Drotar, Dennis; Noll, Robert B.; Rheingold, Susan R.; Kodish, Eric D.; Baker, Justin N.

2015-01-01

Background It can be difficult to explain pediatric Phase I oncology trials to families of children with refractory cancer. Parents may misunderstand the information presented to them, and physicians may assume that certain topics are covered in the informed consent document and need not be discussed. Communication models can help to ensure effective discussions. Methods Suggestions for improving the informed consent process were first solicited from Phase I study clinicians via questionnaire. Eight parents who had enrolled their child on a Phase I pediatric oncology trial were recruited for an advisory group designed to assess the clinicians’ suggestions and make additional recommendations for improving informed consent for pediatric Phase I trials. Results A Phase I Communication Model was designed to incorporate the suggestions of clinicians and families. It focuses on education of parents/families about Phase I trials at specific time points during a child’s illness, but specifically at the point of relapse. We also present an informative Phase I fact sheet that can be distributed to families. Conclusions Families who will be offered information about a Phase I clinical trial can first receive a standardized fact sheet explaining the general purpose of these early-phase clinical trials. Parental understanding may be further enhanced when oncologists address key themes, beginning at diagnosis and continuing through important decision points during the child’s illness. This model should be prospectively evaluated. PMID:25873253

The significance of Bartonella henselae bacterias for oncological diagnosis in children.

PubMed

Mazur-Melewska, Katarzyna; Jończyk-Potoczna, Katarzyna; Mania, Anna; Kemnitz, Paweł; Szydłowski, Jarosław; Służewski, Wojciech; Figlerowicz, Magdalena

2015-01-01

Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion. We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors. About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test. CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.

The impact of the written request process on drug development in childhood cancer.

PubMed

Snyder, Kristen M; Reaman, Gregory; Avant, Debbie; Pazdur, Richard

2013-04-01

The Food and Drug Administration (FDA) Modernization Act, enacted in 1997, created a pediatric exclusivity incentive allowing sponsors to qualify for an additional 6 months of marketing exclusivity after satisfying the requirements outlined in the Written Request (WR). This review evaluates the impact of the WR mechanism on the development of oncology drugs in children. A search of the FDA document archiving, reporting, and regulatory tracking system was performed for January 1, 2000 to December 31, 2010. Drugs were identified and pediatric-specific labeling information was obtained from Drugs@fda.gov and FDA Pediatric Labeling Changes Table. Fifty WRs have been issued for oncology drugs. Pediatric studies have been submitted for 14 drugs. Thirteen received pediatric exclusivity. As of December 31, 2010, labeling changes have been made for 11 drugs. Three drugs were approved for pediatric use. WRs have provided a mechanism to promote the study of drugs in pediatric malignancies. Information from studies resulting from the WRs regarding safety, pharmacokinetics, and tolerability of oncology drugs has been incorporated into pediatric labeling for 11/14 of the drugs. Earlier communication and collaboration between the FDA, National Cancer Institute, clinical investigators, and commercial sponsors are envisioned to facilitate the identification and prioritization of emerging new drugs of interest for WR consideration. Since this is the only regulatory mechanism, resulting from specific legislative initiatives relevant to cancer drug development for children, efforts to enhance its impact on increasing drug approval for pediatric cancer indications are warranted. Copyright © 2013 Wiley Periodicals, Inc.

An exploration of the prevalence and predictors of work-related well-being among psychosocial oncology professionals: An application of the job demands-resources model.

PubMed

Turnell, Adrienne; Rasmussen, Victoria; Butow, Phyllis; Juraskova, Ilona; Kirsten, Laura; Wiener, Lori; Patenaude, Andrea; Hoekstra-Weebers, Josette; Grassi, Luigi

2016-02-01

Burnout is reportedly high among oncology healthcare workers. Psychosocial oncologists may be particularly vulnerable to burnout. However, their work engagement may also be high, counteracting stress in the workplace. This study aimed to document the prevalence of both burnout and work engagement, and the predictors of both, utilizing the job demands-resources (JD-R) model, within a sample of psychosocial oncologists. Psychosocial-oncologist (N = 417) clinicians, recruited through 10 international and national psychosocial-oncology societies, completed an online questionnaire. Measures included demographic and work characteristics, burnout (the MBI-HSS Emotional Exhaustion (EE) and Depersonalization (DP) subscales), the Utrecht Work Engagement Scale, and measures of job demands and resources. High EE and DP was reported by 20.2 and 6.6% of participants, respectively, while 95.3% reported average to high work engagement. Lower levels of job resources and higher levels of job demands predicted greater burnout, as predicted by the JD-R model, but the predicted interaction between these characteristics and burnout was not significant. Higher levels of job resources predicted higher levels of work engagement. Burnout was surprisingly low and work engagement high in this sample. Nonetheless, one in five psychosocial oncologists have high EE. Our results suggest that both the positive (resources) and negative (demands) aspects of this work environment have an on impact burnout and engagement, offering opportunities for intervention. Theories such as the JD-R model can be useful in guiding research in this area.

3T MRI and 128-slice dual-source CT cisternography images of the cranial nerves a brief pictorial review for clinicians.

PubMed

Roldan-Valadez, Ernesto; Martinez-Anda, Jaime J; Corona-Cedillo, Roberto

2014-01-01

There is a broad community of health sciences professionals interested in the anatomy of the cranial nerves (CNs): specialists in neurology, neurosurgery, radiology, otolaryngology, ophthalmology, maxillofacial surgery, radiation oncology, and emergency medicine, as well as other related fields. Advances in neuroimaging using high-resolution images from computed tomography (CT) and magnetic resonance (MR) have made highly-detailed visualization of brain structures possible, allowing normal findings to be routinely assessed and nervous system pathology to be detected. In this article we present an integrated perspective of the normal anatomy of the CNs established by radiologists and neurosurgeons in order to provide a practical imaging review, which combines 128-slice dual-source multiplanar images from CT cisternography and 3T MR curved reconstructed images. The information about the CNs includes their origin, course (with emphasis on the cisternal segments and location of the orifices at the skull base transmitting them), function, and a brief listing of the most common pathologies affecting them. The scope of the article is clinical anatomy; readers will find specialized texts presenting detailed information about particular topics. Our aim in this article is to provide a helpful reference for understanding the complex anatomy of the cranial nerves. Copyright © 2013 Wiley Periodicals, Inc.

Foundation for the Future.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. Directorate for Education and Human Resources.

This document describes some of the many programs sponsored by the National Science Foundation in its efforts to continue to promote systemic science and mathematics education reform. Brief descriptions of the following programs are included: (1) Interactive Math Program Restructures 9-12 Math Education; (2) Algebra I Project Sparks Citywide…

SUMMARY PAPER: IN SITU BIOREMEDIATION OF CONTAMINATED VADOSE ZONE SOIL

EPA Science Inventory

The Robert S. Kerr Environmental Research Laboratory (RSKERL) has developed a number of Issue Papers and Briefing Documents which are designed to exchange up-to-date information related to the remediation of contaminated soil and ground water at hazardous waste sites. In an attem...

Professional Learning Communities: Assessment--Development--Effects.

ERIC Educational Resources Information Center

Hipp, Kristine Kiefer; Huffman, Jane Bumpers

This presentation addresses three topics: (1) the assessment of professional learning communities in schools; (2) the design and development of professional learning communities in schools; and (3) the effects of professional learning communities in schools. The purpose of this brief document is to share descriptions, processes, and materials…

Women Reading the World. Policies and Practices of Literacy in Asia. UIE Studies 6.

ERIC Educational Resources Information Center

Medel-Anonuevo, Carolyn, Ed.

Papers from national seminars in five countries documenting the literacy practices that have developed through time include: "Preface" (Medel-Anonuevo); "Introduction"; "Illiteracy Eradication in Vietnam; Past Achievements and Orientation for Development in the New Stage" (Mac); "Brief Situationer of Women's…

Practices of Waldorf-Inspired Schools. Research Brief

ERIC Educational Resources Information Center

Friedlaender, Diane; Beckham, Kyle; Zheng, Xinhua; Darling-Hammond, Linda

2015-01-01

"Growing a Waldorf-Inspired Approach in a Public School District" documents the practices and outcomes of Alice Birney, a Waldorf-Inspired School in Sacramento City Unified School District (SCUSD). This study highlights how such a school addresses students' academic, social, emotional, physical, and creative development. The study also…

Sexually Transmitted Diseases: A Selective, Annotated Bibliography.

ERIC Educational Resources Information Center

Planned Parenthood Federation of America, Inc., New York, NY. Education Dept.

This document contains a reference sheet and an annotated bibliography concerned with sexually transmitted diseases (STD). The reference sheet provides a brief, accurate overview of STDs which includes both statistical and background information. The bibliography contains 83 entries, listed alphabetically, that deal with STDs. Books and articles…

FID Statutes, Rules of Procedures, Terms of Reference.

ERIC Educational Resources Information Center

International Federation for Documentation, The Hague (Netherlands).

Following a brief historical chronology of the International Federation for Documentation (FID), the organization's statutes are presented in the original French text and in English. The rules of procedures outline membership policy, conduct of technical bodies, FID conferences, publications, and regional commissions. Terms of reference are…