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Sample records for italy cooperative oncology

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

    PubMed

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

    2016-06-01

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

  2. [Social cooperatives in Italy].

    PubMed

    Villotti, P; Zaniboni, S; Fraccaroli, F

    2014-06-01

    This paper describes the role of social cooperatives in Italy as a type of economic, non-profit organization and their role in contributing to the economic and social growth of the country. The purpose of this paper is to learn more about the experience of the Italian social cooperatives in promoting the work integration process of disadvantaged workers, especially those suffering from mental disorders, from a theoretical and an empirical point of view. Social enterprise is the most popular and consolidated legal and organizational model for social enterprises in Italy, introduced by Law 381/91. Developed during the early 1980s, and formally recognized by law in the early 1990s, social cooperatives aim at pursuing the general interest of the community to promote the human needs and social inclusion of citizens. They are orientated towards aims that go beyond the interest of the business owners, the primary beneficiary of their activities is the community, or groups of disadvantaged people. In Italy, Law 381/91 distinguishes between two categories of social cooperatives, those producing goods of social utility, such as culture, welfare and educational services (A-type), and those providing economic activities for the integration of disadvantaged people into employment (B-type). The main purpose of B-type social cooperatives is to integrate disadvantaged people into the open labour market. This goal is reached after a period of training and working experience inside the firm, during which the staff works to improve both the social and professional abilities of disadvantaged people. During the years, B-type social co-ops acquired a particular relevance in the care of people with mental disorders by offering them with job opportunities. Having a job is central in the recovery process of people suffering from mental diseases, meaning that B-type social co-ops in Italy play an important rehabilitative and integrative role for this vulnerable population of workers. The

  3. Spiritual support for adolescent cancer patients: a survey of pediatric oncology centers in Italy and Spain.

    PubMed

    Proserpio, Tullio; Veneroni, Laura; Silva, Matteo; Lassaletta, Alvaro; Lorenzo, Rosalia; Magni, Chiara; Bertolotti, Marina; Barisone, Elena; Mascarin, Maurizio; Jankovic, Momcilo; D'Angelo, Paolo; Clerici, Carlo A; Garrido-Colino, Carmen; Gutierrez-Carrasco, Ignacio; Echebarria, Aizpea; Biondi, Andrea; Massimino, Maura; Casale, Fiorina; Tamburini, Angela; Ferrari, Andrea

    2016-08-03

    Spirituality is a fundamental aspect of the psychological well-being of adolescents with cancer. This study reports on a survey conducted at pediatric oncology centers in Italy and Spain to examine the situation concerning the provision of spiritual support. An ad hoc questionnaire was distributed including multiple-choice questions on whether or not spiritual support was available; the spiritual counselor's role; how often the spiritual counselor visited the unit; and the type of training this person had received. A spiritual support service was available at 24 of the 26 responding centers in Italy and 34/36 in Spain. The training received by the spiritual counselor was exclusively theological in most cases (with medical or psychological training in a few cases). In both countries the spiritual counselor was mainly involved in providing religious services and support at the terminal stage of the disease or in talking with patients and families. Cooperation with caregivers was reported by 27.3% and 46.7% of the Italian and Spanish centers, respectively, while the daily presence of the chaplain on the ward was reported by 18.2% and 26.7%. The role of the spiritual counselor in pediatric oncology - in Italy and Spain at least - is still neither well-established nor based on standardized operating methods or training requirements. A model that implies the constant presence of a spiritual counselor in hospital wards may be proposed to provide appropriate spiritual support to adolescents with cancer.

  4. Puget sound oncology nursing education cooperative.

    PubMed

    Whipple, V T; Hogeland-Drummond, S; Purrier, M; Tofthagen, C

    2000-01-01

    The purpose of the Leadership & Professional Development feature is to provide readers with information, ideas, and exemplars of leadership competencies and professional roles in oncology nursing. Manuscripts submitted to the Leadership & Professional Development feature should be prepared according to the Information for Authors published in the Oncology Nursing Forum (ONF) but limited to six to eight double-spaced typed pages. Submit two copies of the manuscript using IBM-compatible software along with a computer disk copy, or submit a copy of the manuscript as an e-mail attachment to Joan Such Lockhart, PhD, RN, CORLN, ONF Associate Editor, 1365 Simona Drive, Pittsburgh, PA 15201; lockhart /duq.edu (e-mail). Manuscripts should be referenced and include tables, figures, or illustrations as appropriate. Ideas for possible manuscripts are welcome.

  5. Funding oncology clinical trials: are cooperative group trials sustainable?

    PubMed

    Seow, Hsien-Yeang; Whelan, Patrick; Levine, Mark N; Cowan, Kathryn; Lysakowski, Barbara; Kowaleski, Brenda; Snider, Anne; Xu, Rebecca Y; Arnold, Andrew

    2012-05-01

    Many oncology clinical trials departments (CTDs) are in serious fiscal deficit and their sustainability is in jeopardy. This study investigates whether the payment models used to fund industry versus cooperative group trials contribute to the fiscal deficit of a CTD. We examined the lifetime costs of all cooperative group and industry trials activated in the CTD of a cancer center between 2007 and 2011. A trial's lifetime is defined as being from the date the first patient was accrued until the last patient's actual or projected final follow-up visit. For each trial, we calculated the lifetime monthly net income, which was defined as monthly revenue minus monthly costs. Data sources included study protocols, trial budgets, and accrual data. Of the 97 trials analyzed, 64 (66%) were cooperative group trials. The pattern of lifetime net income for cooperative group trials has a positive peak during patient accrual followed by a negative trough during follow-up. In contrast, the pattern for industry trials resembled an "l" shape. The patterns reflect the differing payment models: upfront lump-sum payments (cooperative group) versus milestone payments (industry). The negative trough in the lifetime net income of a cooperative group trial occurs because follow-up costs are typically not funded or are underfunded. CTDs accrue more patients in new trials to offset that deficit. The CTD uses revenue from accrual to existing trials to cross-subsidize past trials in follow-up. As the number of patients on follow-up increases, the fiscal deficit grows larger each year, perpetuating the cycle.

  6. Important risk factors in melanoma from the Dermato-Oncologic Unit of Brescia, Italy.

    PubMed

    Manganoni, Ausilia Maria; Zanotti, Federica; Farisoglio, Camillo; Feroldi, Piero; Facchetti, Fabio; Calzavara-Pinton, Piergiacomo

    2010-01-15

    One of the most significant risk factors for melanoma is a positive family history of the disease. It is estimated that approximately 10 percent of melanoma cases report a first-or second-degree relative with melanoma. We reported the experience of the Dermato-Oncologic Unit of Brescia, Italy.

  7. Pediatric hematology and oncology in Italy: half a century of progress, an ongoing search for improvement.

    PubMed

    Massimo, L M

    1995-01-01

    Pediatric hematology and oncology has been a well-organized specialty throughout Italy only since 1974. However, it seemed interesting and fitting to review some of the milestones lying at the base of the development of this field of medicine: the first Italian Children's Hospital created in Florence in the fifteenth century; the first textbook of pediatrics, De Morbis Puerorum, by G. Mercuriale of Bologna; the first hematologic breakthroughs in the seventeenth, eighteenth, and nineteenth centuries; and the paramount achievements in pediatric hematology and oncology over the last 50 years.

  8. An overview of viral oncology in Italy - report from the Pavia meeting on solid tumors.

    PubMed

    Perfetti, Vittorio; Ricotti, Mattia; Buonaguro, Franco; Tirelli, Umberto; Pedrazzoli, Paolo

    2012-09-05

    This is a report on some of the research activities currently ongoing in Italy as outlined at the "Viruses and solid tumors" meeting jointly organized by the Oncology Sections of IRCCS Policlinico "San Matteo" (Pavia) and IRCCS National Cancer Institute (Aviano), held in Pavia, Italy, on October 2011. Experts from the various disciplines involved in the study of the complex relationships between solid tumors and viruses met to discuss recent developments in the field and to report their personal contributions to the specified topics. Secondary end point was to establish a multidisciplinary work group specifically devoted to solid tumors and infectious agents, aimed to identify areas of common interest, promoting and establishing collaborative projects and programs, and to coordinate clinical and research activities. The group, which will be named IVOG (Italian Viral Oncology Group), will operate under the patronage of the various scientific societies of interest.

  9. Development of Clinical Trials in a Cooperative Group Setting: The Eastern Cooperative Oncology Group

    PubMed Central

    Sandler, Alan; Cheng, Steven; Crites, Joshua; Ferranti, Lori; Wu, Amy; Gray, Robert; MacDonald, Jean; Marinucci, Donna; Comis, Robert

    2009-01-01

    PURPOSE We examine the processes and document the calendar time required to activate Phase II and III clinical trials by an oncology group: the Eastern Cooperative Oncology Group (ECOG). METHODS Setup steps were documented by: 1) interviewing ECOG headquarters and statistical center staff, and committee chairs, 2) reviewing standard operating procedure manuals, and 3) inspecting study records, documents, and emails to identify additional steps. Calendar time was collected for each major process for each study in this set. RESULTS Twenty-eight Phase III studies were activated by ECOG during the 01/2000–07/2006 study period. We examined in detail a sample of 16 of those studies. More than 481 distinct processes were required for study activation: 420 working steps, 61 major decision points, 26 processing loops, and 13 stopping points. Median calendar days to activate a trial in the Phase III subset was 783 days (median, 285 to 1542 days) from executive approval and 808 days (range, 435 to 1604 days) from initial conception of the study. Data were collected for all Phase II and Phase III trials activated and completed during this time period (n=52) for which development time represented 43.9% and 54.1% of the total trial time respectively. CONCLUSION The steps required to develop and activate a clinical trial may require as much or more time than the actual completion of a trial. The data demonstrates that to improve the activation process, research should to be directed toward streamlining both internal and external groups and processes. PMID:18519773

  10. Cooperation between medicine and sociology in head and neck oncology.

    PubMed

    Babin, Emmanuel; Grandazzi, Guillaume

    2014-05-01

    Twenty-first-century medicine is facing many challenges--knowledge and command of technical advances, research development, team management, knowledge transmission, and adaptation to economic constraints--without neglecting "human" aspects, via transformed carer-patient relationships, social change, and so on. The "modern" physicians know that simply treating disease is no longer enough. One of their essential missions lies in offering the individual patient overall care, which implies acknowledging the latter as an individual within a family, social, and professional environment. Indeed, medical practice requires pluridimensional knowledge of the patients' experience of their disease. Yet the contribution sociology can offer to health care remains largely unknown to many physicians, and medical training includes only limited instruction in the human sciences. On the basis of a few observations taken from sociological research, we would like to demonstrate how, in head and neck oncology, interdisciplinary collaboration between medicine and sociology can prove propitious to improving patient care and attention to their close relations.

  11. Cooperatives as a social enterprise in Italy: a place for social integration and rehabilitation.

    PubMed

    Savio, M; Righetti, A

    1993-10-01

    This article analyses the history and development of an integrated cooperative established in 1981 in northern Italy. Integrated cooperatives, otherwise known as social enterprises, are among the most interesting activities developed in the area of social assistance and rehabilitation in recent years in Italy. In particular, they acquired relevance in the care of mentally disordered people by providing them with job opportunities, which is an important rehabilitative and integrative factor. The aim of social enterprises is two-fold. They have the economic goal of offering remunerative work just as any other commercial enterprise, as well as the social mandate of promoting the physical, social, and mental health of their members. A positive coexistence between market competition and rehabilitation is therefore constantly pursued. This research aimed at analysing the working and social experience of people employed by the cooperative during its 10-year life. The study was limited to those who had a social or health problem when entering the cooperative. The investigation was promoted by cooperative members, who felt the need to document their experience and to undertake initiatives towards evaluating the rehabilitative value of the social enterprise. The results show that cooperative members come from different marginalized areas of social and health distress, of which the two largest are social service users and psychiatric service users. There is a noticeable turn-over rate, which underlines one function of the cooperative as being a transitional working context from which users can gain access to other more rewarding job opportunities in the labour market.

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. Radiotherapy in Italy after conservative treatment of early breast cancer. A survey by the Italian Society of Radiation Oncology (AIRO).

    PubMed

    Aristei, Cynthia; Amichetti, Maurizio; Ciocca, Mario; Nardone, Luigia; Bertoni, Filippo; Vidali, Cristiana

    2008-01-01

    The aim of surveys on clinical practice is to stimulate discussion and optimize practice. In this paper the current Italian radiotherapy practice after breast-conserving surgery for early breast cancer is described and adherence to national and international guidelines is assessed. Furthermore, results are compared with an earlier survey in northern Italy and international reports. A multiple-choice questionnaire sent to all 138 Italian radiation oncology centers. 48% of centers responded. Most performed breast-conserving surgery when tumor size was < or =3 cm. All centers routinely performed axillary dissection; 45 carried out sentinel node biopsy followed by axillary dissection when the sentinel node was positive. Most centers re-excised when resection margins were positive. The median interval between surgery and radiotherapy, when chemotherapy was not administered, was 60 days. Adjuvant chemotherapy was preferably administered before radiotherapy. Regional lymph nodes were never irradiated in 10 centers; in all others irradiation depended on the number of positive lymph nodes and/or involvement of axillary fat and/or tumor location in medial quadrants. All centers used standard fractionation; hypofractionated schemes were available in 6. Most centers used 4-6 MV photons. In 59 centers the boost dose of 10 Gy could be increased if margins were not negative. All centers ensured patient setup reproducibility. Treatment planning was computerized in 59 centers. The irradiation dose was prescribed at the ICRU point in 56 centers and portal films were made in 54 centers. Intraoperative radiotherapy was used in 4 centers: for partial breast irradiation in 1 and for boost administration in 3 centers. Although the quality of radiotherapy delivery has improved in Italy in recent years, approaches that do not conform to international standards persist.

  15. Close cooperation with Health Technology Assessment expertise is crucial for implementation and ultimately reimbursement of innovations in oncology

    PubMed Central

    van Harten, WH; Retèl, VP

    2016-01-01

    The Organisation of European Cancer Institutes OECI working group on Health Economics and Cost Benefit in Oncology suggests four actions that are needed to improve alignment and integration between clinicians, researchers, and Health Technology Assessment (HTA) experts and agencies: 1) HTA expertise is necessary close to or within the comprehensive cancer centres (CCC); 2) HTA expertise should be physically present throughout the translational research process; 3) Appropriate knowledge is necessary within the research staff; 4) Close cooperation between translational researchers, clinicians, and health economists guarantees clinical ownership. Fulfilling these conditions may help the translational research field in oncology to interact with agencies and efficiently move innovative technologies through the translational research stages into that of implementation and diffusion. This brings innovative treatments faster to the patient with a greater chance of reimbursement. PMID:27994642

  16. Time to market and patient access to new oncology products in Italy: a multistep pathway from European context to regional health care providers.

    PubMed

    Russo, P; Mennini, F S; Siviero, P D; Rasi, G

    2010-10-01

    The main purpose of this study was to identify each sequential phase followed by an oncology product, from European assessment until to patient access in each Italian region (IR). A panel of oncology products approved by the European Medicines Agency (EMA) in the period 2006-2008 was considered. The explored sequential phases included the times to market for: the EMA; pharmaceutical companies; the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA); and IRs as final providers of health care. The IR's time to market was also analyzed by a Cox regression model. The overall mean time required before patients access was 2.3 years. EMA accounted for the greater proportion of time (31.8%), followed by AIFA (28.2%). However, the duration for both pharmaceutical companies and IRs was associated with the highest variability. An oncology product authorized with a risk-sharing agreement showed an early access in the IRs. On the contrary, the introduction in IRs having a compulsory formulary was delayed. Both a high forecast of economic impact and a high oncology product price can also delay the patient access. The process before patient access to an oncology product is time and cost consuming. This study identifies the main predictors that affect the missing overlap between market and patient access in Italy.

  17. Italy.

    PubMed

    1987-04-01

    For "Background Notes" on Italy, the U.S. State Department, Bureau of Public Affairs, covers geography, people, history, government, politics, economy, defense and foreign relations. Italy had 57.3 million persons in 1986, with a growth rate of 2.3%. The life expectancy is 73 years; the infant mortality rate is 14.3/1000 live births. 98% of the people are literate. The current constitutional republic has existed since 1948. Mean per capita income is $6,447. The people work mainly in services (60%), industry (30%) and agriculture (10%). Most of the country is mountainous, without significant food, energy or natural resources, so Italy's central position in the Mediterranean has influenced economic development since ancient times. The nation is highly homogeneous, as the government is centralized. Although there are several influential political parties, the diverse structure of the Christian Democrats has given them power since the war. The current prime minister, Bettino Craxi, is a member of the centralist Italian Socialist Party. The Italian Communist Party is the largest such party in the free world, polling 30% of the vote in 1983. Italy is a member of NATO.

  18. Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study.

    PubMed

    Repetto, Lazzaro; Fratino, Lucia; Audisio, Riccardo A; Venturino, Antonella; Gianni, Walter; Vercelli, Marina; Parodi, Stefano; Dal Lago, Denise; Gioia, Flora; Monfardini, Silvio; Aapro, Matti S; Serraino, Diego; Zagonel, Vittorina

    2002-01-15

    To appraise the performance of Comprehensive Geriatric Assessment (CGA) in elderly cancer patients (> or = 65 years) and to evaluate whether it could add further information with respect to the Eastern Cooperative Oncology Group performance status (PS). We studied 363 elderly cancer patients (195 males, 168 females; median age, 72 years) with solid (n = 271) or hematologic (n = 92) tumors. In addition to PS, their physical function was assessed by means of the activity of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbidities were categorized according to Satariano's index. The association between PS, comorbidity, and the items of the CGA was assessed by means of logistic regression analysis. These 363 elderly cancer patients had a good functional and mental status: 74% had a good PS (ie, lower than 2), 86% were ADL-independent, and 52% were IADL-independent. Forty-one percent of patients had one or more comorbid conditions. Of the patients with a good PS, 13.0% had two or more comorbidities; 9.3% and 37.7% had ADL or IADL limitations, respectively. By multivariate analysis, elderly cancer patients who were ADL-dependent or IADL-dependent had a nearly two-fold higher probability of having an elevated Satariano's index than independent patients. A strong association emerged between PS and CGA, with a nearly five-fold increased probability of having a poor PS (ie, > or = 2) recorded in patients dependent for ADL or IADL. The CGA adds substantial information on the functional assessment of elderly cancer patients, including patients with a good PS. The role of PS as unique marker of functional status needs to be reappraised among elderly cancer patients.

  19. Merging of the National Cancer Institute-funded cooperative oncology group data with an administrative data source to develop a more effective platform for clinical trial analysis and comparative effectiveness research: a report from the Children's Oncology Group.

    PubMed

    Aplenc, R; Fisher, B T; Huang, Y S; Li, Y; Alonzo, T A; Gerbing, R B; Hall, M; Bertoch, D; Keren, R; Seif, A E; Sung, L; Adamson, P C; Gamis, A

    2012-05-01

    The National Cancer Institute-funded cooperative oncology group trials have improved overall survival for children with cancer from 10% to 85% and have set standards of care for adults with malignancies. Despite these successes, cooperative oncology groups currently face substantial challenges. We are working to develop methods to improve the efficiency and effectiveness of these trials. Specifically, we merged data from the Children's Oncology Group (COG) and the Pediatric Health Information Systems (PHIS) to improve toxicity monitoring, to estimate treatment-associated resource utilization and costs, and to address important clinical epidemiology questions. COG and PHIS data on patients enrolled on a phase III COG trial for de novo acute myeloid leukemia at 43 PHIS hospitals were merged using a probabilistic algorithm. Resource utilization summary statistics were then tabulated for the first chemotherapy course based on PHIS data. Of 416 patients enrolled on the phase III COG trial at PHIS centers, 392 (94%) were successfully matched. Of these, 378 (96%) had inpatient PHIS data available beginning at the date of study enrollment. For these, daily blood product usage and anti-infective exposures were tabulated and standardized costs were described. These data demonstrate that patients enrolled in a cooperative group oncology trial can be successfully identified in an administrative data set and that supportive care resource utilization can be described. Further work is required to optimize the merging algorithm, map resource utilization metrics to the National Cancer Institute Common Toxicity Criteria for monitoring toxicity, to perform comparative effectiveness studies, and to estimate the costs associated with protocol therapy. Copyright © 2012 John Wiley & Sons, Ltd.

  20. 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.

  1. Cooperation.

    ERIC Educational Resources Information Center

    Online-Offline, 1997

    1997-01-01

    The theme of this month's issue is "cooperation"--related to animal, personal, national, and global cooperation; rules and regulations; and team efforts. K-8 resources on the theme include World Wide Web sites, CD-ROM, software, videos, books, and others. Features include cooperative living, alliances of nations, songs of cooperation, and animals…

  2. Civil society, third sector, and healthcare: the case of social cooperatives in Italy.

    PubMed

    Borzaga, Carlo; Fazzi, Luca

    2014-12-01

    In many European countries, the third sector is considered an actor able to improve both the efficiency and the efficacy of public healthcare systems afflicted by the crisis of the welfare state. Attributed to third-sector organizations is the role of a hybrid actor tasked with the professional supply of services, not for profit but rather for mutualistic purposes, and to serve the public interest. However, empirical evidence on the capacity of the third sector to pursue objectives of social inclusion in a phase of withdrawal by the public sector is almost entirely lacking in the European countries. The article describes the results of research on the transformation of the Italian healthcare system and on the emergence of a new third sector in Italy. The results of the inquiry highlight the strategies, characteristics, and governance processes which enable third-sector organizations operating in the healthcare sector to pursue objectives of inclusion, and to serve the needs of disadvantaged groups by assuming the form of social enterprises.

  3. Sequential Assessments of the Eastern Cooperative Oncology Group Performance Scale Enhance Prognostic Value in Patients With Terminally Ill Cancer Receiving Palliative Care.

    PubMed

    Peng, Meng-Ting; Liu, Chien-Ting; Hung, Yu-Shin; Kao, Chen-Yi; Chang, Pei-Hung; Yeh, Kun-Yun; Wang, Hung-Ming; Lin, Yung-Chang; Chou, Wen-Chi

    2016-06-01

    This study aimed to assess the utility of the Eastern Cooperative Oncology Group (ECOG) performance scale assessments on days 1 and 8 of palliative care, as well as scale change between these assessments, as prognostic tools for patients with terminally ill cancer. A total of 2392 patients with terminally ill cancer who received palliative care between January 2006 and December 2011 at a single medical center were analyzed. Our study showed that the ECOG scale is a useful prognostic tool to predict life expectancy in patients with terminally ill cancer. The ECOG scale assessments at different time points under palliative care were independent predictors for overall survival. The combined ECOG scale assessments on days 1 and 8 predicted survival more precisely than using day 1 ECOG scale assessment alone.

  4. The `MOON Mapping' Project to Promote Cooperation Between Students of Italy and China

    NASA Astrophysics Data System (ADS)

    Scaioni, M.; Giommi, P.; Brunetti, M. T.; Carli, C.; Cerroni, P.; Cremonese, G.; Forlani, G.; Gamba, P.; Lavagna, M.; Melis, M. T.; Massironi, M.; Ori, G.; Salese, F.; Zinzi, A.; Xie, G.; Kang, Z.; Shi, R.; Sun, Y.; Wu, Y.

    2016-06-01

    The research project `Moon Mapping' has been established in 2014 between the Italian and Chinese Governments to promote cooperation and exchange between undergraduate students from both countries. The operational phase of the project started in early 2015, and will end in 2017, for a total length of three years. The main aim is to train new scholars to be able to work on different kinds of remotely-sensed data collected over the Moon surface by the Chinese space missions Chang'E-1/2. The project coordination has been assigned to the Italian Space Agency for the Italian side and to the Center of Space Exploration, China Ministry of Education, for the Chinese side. Several Chinese universities and Italian national research institutes and universities have been officially involved in this project. Six main research topics have been identified: (1) map of the solar wind ion; (2) geomorphological map of the Moon; (3) data preprocessing of Chang'E-1 mission; (4) map of element distribution; (5) establishment of 3D digital visualization system; and (6) compilation and publication of a tutorial on joint lunar mapping.

  5. Nab-paclitaxel plus gemcitabine as first-line palliative chemotherapy in a patient with metastatic pancreatic cancer with Eastern Cooperative Oncology Group performance status of 2.

    PubMed

    Martín, Andrés J Muñoz; Alfonso, Pilar García; Rupérez, Ana B; Jiménez, Miguel Martín

    2016-07-01

    Metastatic pancreatic cancer (PC) has been associated with a considerably poor prognosis. Due to its toxicity, first-line combination chemotherapy is limited to patients with a good performance status (PS). Previously nab-paclitaxel plus gemcitabine has been demonstrated to improve the overall survival rate in patients with advanced pancreatic cancer with a good PS. The present study reports a case of a patient with metastatic PC with a poor PS (Eastern Cooperative Oncology Group 2) and a complex set of comorbidities treated with nab-paclitaxel plus gemcitabine as a first-line palliative therapy. Adjusted doses of nab-paclitaxel plus gemcitabine reached a favourable clinical, radiological and biochemical response in the present patient, which increased the quality of life for the patient. Eventually, the patient succumbed to acute cholangitis. Based on the results of the present study, nab-paclitaxel plus gemcitabine appears to be a favourable treatment as first-line palliative chemotherapy for patients with metastatic PC, comorbidities and poor PS.

  6. Oncologic imaging

    SciTech Connect

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

    1985-01-01

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

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

    PubMed

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

    2013-09-01

    Obesity increases the risk of death from many adverse health outcomes and has also been linked with cancer outcomes. The impact of obesity on outcomes of advanced non-small-cell lung cancer patients is unclear. The authors evaluated the association of body mass index (BMI) and outcomes in 2585 eligible patients enrolled in three consecutive first-line trials conducted by the Eastern Cooperative Oncology Group. BMI was categorized as underweight (BMI < 18.5 kg/m), normal weight (BMI: 18.5 to < 25 kg/m), overweight (BMI: 25 to < 30 kg/m), and obese (BMI ≥ 30 kg/m). In addition to analyzing overall and progression-free survival, reasons for treatment discontinuation were also assessed by BMI group. Of the patients enrolled, 4.6% were underweight, 44.1% were normal weight, 34.3% of patients were classified as overweight, and 16.9% were obese. Nonproportional hazards existed for obese patients relative to the other three groups of patients, with a change in overall survival hazard occurring at approximately 16 months. In multivariable Cox models, obese patients had superior outcomes earlier on study compared with normal/overweight patients 0.86 (HR=0.86, p=0.04; 95% CI: 0.75-0.99), but later experienced increased hazard (HR=1.54, p< 0.001; 95% CI: 1.22-1.94), indicating a time effect while undergoing treatment. Data from these three trials suggest differential outcomes associated with BMI, and additional studies of the mechanisms underlying this observation, as well as dietary and lifestyle interventions, are warranted to help optimize therapy.

  8. Local Excision Alone Without Irradiation for Ductal Carcinoma In Situ of the Breast: A Trial of the Eastern Cooperative Oncology Group

    PubMed Central

    Hughes, Lorie L.; Wang, Molin; Page, David L.; Gray, Robert; Solin, Lawrence J.; Davidson, Nancy E.; Lowen, Mary Ann; Ingle, James N.; Recht, Abram; Wood, William C.

    2009-01-01

    Purpose To determine the risk of ipsilateral breast events in patients with ductal carcinoma in situ (DCIS) treated with local excision without irradiation. Patients and Methods Patients with either low- or intermediate-grade DCIS measuring 2.5 cm or smaller, or high-grade DCIS measuring 1 cm or smaller who had microscopic margin widths of 3 mm or wider and no residual calcifications on postoperative mammograms were eligible for a prospective trial conducted from 1997 to 2002 by the Eastern Cooperative Oncology Group and North Central Cancer Treatment Group. Patients entered in 2000 and later could take tamoxifen if they wished. Median age at last surgery for the entire population was 60 years (range, 28 to 88 years), and median tumor sizes in the two strata were 6 mm and 5 mm, respectively. Results With a median follow-up of 6.2 years, the 5-year rate of ipsilateral breast events in the 565 eligible patients in the low/intermediate grade stratum was 6.1% (95% CI, 4.1% to 8.2%). With a median follow-up of 6.7 years, this incidence for the 105 eligible patients in the high-grade stratum was 15.3% (95% CI, 8.2% to 22.5%). Conclusion Rigorously evaluated and selected patients with low- to intermediate-grade DCIS with margins 3 mm or wider had an acceptably low rate of ipsilateral breast events at 5 years after excision without irradiation. Patients with high-grade lesions had a much higher rate, suggesting that excision alone is inadequate treatment. Further follow-up is necessary to document long-term results. PMID:19826126

  9. Maternal Coping Strategies in Response to a Child's Chronic and Oncological Disease: a Cross-Cultural Study in Italy and Portugal.

    PubMed

    Perricone, Giovanna; Guerra, Marina Prista; Cruz, Orlanda; Polizzi, Concetta; Lima, Lígia; Morales, Maria Regina; de Lemos, Marina Serra; Fontana, Valentina

    2013-06-13

    A child's oncological or chronic disease is a stressful situation for parents. This stress may make it difficult for appropriate management strategies aimed at promoting the child's wellbeing and helping him or her cope with a disease to be adopted. In particular, this study focuses on the possible connections between the variable national cultural influences and the parental strategies used to cope with a child's severe disease by comparing the experiences of Italian and Portuguese mothers. The study investigates differences and cross-cultural elements among the coping strategies used by Italian and Portuguese mothers of children with oncological or chronic disease. Two groups of mothers took part: 59 Italian mothers (average age 37.7 years; SD=4.5) and 36 Portuguese mothers (average age 39.3 years; SD=4.6). The tool used was the Italian and the Portuguese versions of the COPE inventory that measures five coping strategies: Social Support, Avoidance Coping, Positive Aptitude, Religious Faith and Humor, Active Coping. There were statistically significant differences between Portuguese and Italian mothers regarding Social Support (F(3, 94)=6.32, P=0.014, ɳ(2)=0.065), Religious Faith and Humor (F(3, 94)=20.06, P=0.001, ɳ(2)=0.18, higher values for Portuguese mothers) and Avoidance Coping (F(3, 94)=3.30, P=0.06, ɳ(2)=0.035, higher values for Italian mothers). Regarding child's disease, the only statistically significant difference was in Religious Faith and Humor (F(3, 94)=7.49, P=0.007, ɳ(2)=0.076, higher values for mothers of children with chronic disease). The findings of specific cultural transversalities provide the basis for reflection on important factors emerging on the relationship between physicians and parents. In fact, mothers' coping abilities may allow health workers involved in a child's care not only to understand how parents face a distressful event, but also to provide them with professional support.

  10. Patterns of postoperative radiotherapy for head and neck cancer in Italy: a prospective, observational study by the head and neck group of the Italian Association for Radiation Oncology (AIRO).

    PubMed

    Palazzi, Mauro; Alterio, Daniela; Tonoli, Sandro; Caspiani, Orietta; Bolner, Andrea; Colombo, Sara; Dall'oglio, Stefano; Lastrucci, Luciana; Bunkheila, Feisal; Cianciulli, Michele; Vigna Taglianti, Riccardo; Cante, Domenico; Merlotti, Anna; Bianchi, Ernestina; Rampino, Monica; Podhradska, Andrea; Fontana, Antonella; Paiar, Fabiola; Miccichè, Francesco; Manzo, Roberto; Ursino, Stefano; Bruschieri, Lorenza; Bacigalupo, Almalina; Iannone, Tiziana; Barca, Raffaella; Tomatis, Stefano

    2011-01-01

    Our previous survey showed that the patterns of postoperative radiotherapy (PORT) for head and neck cancer (HNC) in Italy might be suboptimal. A prospective observational study was therefore designed to evaluate this issue in greater detail. All radiotherapy centers involved in the HNC Working Group of the Italian Radiation Oncology Association were asked to enter into the study all patients treated with PORT during a 6-month period. A total of 200 patients were accrued by 24 centers from December 2008 to May 2009. Larynx (38%) and oral cavity (34%) were the most common primary sites. The median time between surgery and the start of radiotherapy was 69 days (range, 25-215 days). Seventy-nine percent of cases with no evidence of risk factors for local recurrence were treated with high-dose radiotherapy to the primary site. In about 75% of cases the pN0 neck was included in the target volume. Concomitant chemotherapy was delivered to about 60% of patients with major risk factors and 21% of patients with no risk factors. Three issues emerged from our study as potential targets for future investigations: the impact on clinical outcome of the interval between surgery and the start of PORT; factors driving radiation oncologists to overtreat volumes at low risk of recurrence; and problems associated with the delivery of concomitant chemotherapy.

  11. Maternal Coping Strategies in Response to a Child’s Chronic and Oncological Disease: a Cross-Cultural Study in Italy and Portugal

    PubMed Central

    Perricone, Giovanna; Guerra, Marina Prista; Cruz, Orlanda; Polizzi, Concetta; Lima, Lígia; Morales, Maria Regina; de Lemos, Marina Serra; Fontana, Valentina

    2013-01-01

    A child’s oncological or chronic disease is a stressful situation for parents. This stress may make it difficult for appropriate management strategies aimed at promoting the child’s wellbeing and helping him or her cope with a disease to be adopted. In particular, this study focuses on the possible connections between the variable national cultural influences and the parental strategies used to cope with a child’s severe disease by comparing the experiences of Italian and Portuguese mothers. The study investigates differences and cross-cultural elements among the coping strategies used by Italian and Portuguese mothers of children with oncological or chronic disease. Two groups of mothers took part: 59 Italian mothers (average age 37.7 years; SD=4.5) and 36 Portuguese mothers (average age 39.3 years; SD=4.6). The tool used was the Italian and the Portuguese versions of the COPE inventory that measures five coping strategies: Social Support, Avoidance Coping, Positive Aptitude, Religious Faith and Humor, Active Coping. There were statistically significant differences between Portuguese and Italian mothers regarding Social Support (F(3, 94)=6.32, P=0.014, ɳ2=0.065), Religious Faith and Humor (F(3, 94)=20.06, P=0.001, ɳ2=0.18, higher values for Portuguese mothers) and Avoidance Coping (F(3, 94)=3.30, P=0.06, ɳ2=0.035, higher values for Italian mothers). Regarding child’s disease, the only statistically significant difference was in Religious Faith and Humor (F(3, 94)=7.49, P=0.007, ɳ2=0.076, higher values for mothers of children with chronic disease). The findings of specific cultural transversalities provide the basis for reflection on important factors emerging on the relationship between physicians and parents. In fact, mothers’ coping abilities may allow health workers involved in a child’s care not only to understand how parents face a distressful event, but also to provide them with professional support. PMID:23904966

  12. Computational oncology.

    PubMed

    Lefor, Alan T

    2011-08-01

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

  13. [Seven cases of port-a-cath contamination caused by Pantoea agglomerans in the Oncological Service of Iseo Hospital, Brescia (Italy)].

    PubMed

    Izzo, Ilaria; Lania, Donatella; Castro, Antonino; Lanzini, Fernanda; Bella, Daniele; Pagani, Adriano; Colombini, Paolo

    2014-06-01

    Pantoea agglomerans, a gram negative bacillus in the Enterobacteriaceae family, has been isolated from feculent material, plants and soil. Soft tissue and bone-joint infections due to P. agglomerans following penetrating trauma by vegetation and bacteraemia in association with intravenous fluid, total parenteral nutrition, blood products and anaesthetic agent contamination have been reported. Between October 2009 and January 2010 seven cases of port a cath contamination caused by P. agglomerans were observed in the Oncological Service of our hospital. All patients presented with septic fever after heparinization of the central venous catheter. 5/7 patients were female; mean age was 67 years (range 58-75). 6/7 patients were affected by colorectal adenocarcinoma, 1/7 by mammarian cancer. Mean time from CVC insertion was 23.8 months (range 13-42) at the time of fever. In three cases, port a cath was removed following the oncologist prescription. P. agglomerans was isolated from the catheter tip in one case and from CVC blood culture in 6-7 cases. In all cases peripheral blood cultures were negative. Patients were treated with ciprofloxacin lock therapy and systemic therapy (per os), obtaining negative cultures from port a cath. Notwithstanding the absence of isolation of Pantoea strains from environmental cultures, after educational intervention, which underlined some faulty procedures in CVC management, no further cases were observed.

  14. Treatment induced seroconversion to HBsAb following HBV reactivation in the immunosuppressed haematology and oncology patient: a clinical survey of 5 cases in Catania, Italy.

    PubMed

    Montineri, Arturo; Nigro, Luciano; La Rosa, Rosario; Iacobello, Carmelo; Larocca, Licia; Cappello, Elisa; Fiumara, Paolo Fabio; Di Raimondo, Francesco; Fatuzzo, Filippo

    2011-12-01

    In onco-haematological patients inactive or occult HBV infection may be reactivated as a result of disease-related immuno-suppression and/or chemotherapy with rituximab. This study reports the clinical features of five patients affected by onco-haematological disorders who experienced hepatitis B reactivation. From 2005 to 2010, five onco-haematological patients with hepatitis B reactivation were admitted to the department of Infectious Diseases, Ferrarotto Hospital, Catania, Italy. At the time of onco-haematological disease diagnosis, 3 patients were HBcAb positive; 1 HBsAb and HBcAb positive; and 1 HBsAg positive, HBV DNA negative. None of the patients received hepatitis B prophylaxis. Reactivation was observed following chemotherapy. One patient was treated with lamivudine, 2 with tenofovir and 2 with telbivudine. Following treatment all patients achieved undetectable HBV DNA and normalization of transaminases. Three patients, those treated with lamivudine and tenofovir, cleared HBsAg and developed protective titres of HBsAb. The remaining patients, who were treated with telbivudine, were HBV DNA negative and HBsAg positive one at 27 months and the other at 5 months of therapy. Treatment thus continued in these patients. HBV reactivation can be a severe complication in onco-haematological patients undergoing chemotherapy with rituximab. In our experience all nucleos(t)ide analogues were safe and effective. Three patients seroconverted to HBsAb. This may be as a result of the antivirals enhancing the immune response to HBV. A similar role may also be played by immune recovery following the withdrawal of immune-suppressive treatment. This report confirms the importance of anti-viral prophylaxis in patients with a high risk of HBV reactivation. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. [Galen's oncology].

    PubMed

    Vigliani, R

    1995-10-01

    "Claudius Galenus" is the Author of "De tumoribus praeter naturam". The book was studied on the original Greek text with Latin version edited by K.G. Kühn ("Opera omnia Claudii Galeni": VII, 705-732). This Galen's clinical and pathological oncology was examined as far as categorization, classification, morphology, etiology, pathogenesis, morphogenesis, topography, behaviour (with related therapeutic and prognostic implications) and terminology are concerned. Problems, aspects and concepts, more or less clarified by Galen, were extensively discussed with special reference to the Galen's scientific knowledge and compared with the modern oncology.

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

    SciTech Connect

    Tokumaru, Sunao; Toita, Takafumi; Oguchi, Masahiko; Ohno, Tatsuya; Kato, Shingo; Niibe, Yuzuru; Kazumoto, Tomoko; Kodaira, Takeshi; Kataoka, Masaaki; Shikama, Naoto; Kenjo, Masahiro; Yamauchi, Chikako; Suzuki, Osamu; Sakurai, Hideyuki; Teshima, Teruki; Kagami, Yoshikazu; Nakano, Takashi; Hiraoka, Masahiro; and others

    2012-10-01

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

  17. Randomized Phase III Trial of ABVD Versus Stanford V With or Without Radiation Therapy in Locally Extensive and Advanced-Stage Hodgkin Lymphoma: An Intergroup Study Coordinated by the Eastern Cooperative Oncology Group (E2496)

    PubMed Central

    Gordon, Leo I.; Hong, Fangxin; Fisher, Richard I.; Bartlett, Nancy L.; Connors, Joseph M.; Gascoyne, Randy D.; Wagner, Henry; Stiff, Patrick J.; Cheson, Bruce D.; Gospodarowicz, Mary; Advani, Ranjana; Kahl, Brad S.; Friedberg, Jonathan W.; Blum, Kristie A.; Habermann, Thomas M.; Tuscano, Joseph M.; Hoppe, Richard T.; Horning, Sandra J.

    2013-01-01

    Purpose Although ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) has been established as the standard of care in patients with advanced Hodgkin lymphoma, newer regimens have been investigated, which have appeared superior in early phase II studies. Our aim was to determine if failure-free survival was superior in patients treated with the Stanford V regimen compared with ABVD. Patients and Methods The Eastern Cooperative Oncology Group, along with the Cancer and Leukemia Group B, the Southwest Oncology Group, and the Canadian NCIC Clinical Trials Group, conducted this randomized phase III trial in patients with advanced Hodgkin lymphoma. Stratification factors included extent of disease (localized v extensive) and International Prognostic Factors Project Score (0 to 2 v 3 to 7). The primary end point was failure-free survival (FFS), defined as the time from random assignment to progression, relapse, or death, whichever occurred first. Overall survival, a secondary end point, was measured from random assignment to death as a result of any cause. This design provided 87% power to detect a 33% reduction in FFS hazard rate, or a difference in 5-year FFS of 64% versus 74% at two-sided .05 significance level. Results There was no significant difference in the overall response rate between the two arms, with complete remission and clinical complete remission rates of 73% for ABVD and 69% for Stanford V. At a median follow-up of 6.4 years, there was no difference in FFS: 74% for ABVD and 71% for Stanford V at 5 years (P = .32). Conclusion ABVD remains the standard of care for patients with advanced Hodgkin lymphoma. PMID:23182987

  18. The Complementary Nature of Patient-Reported Outcomes and Adverse Event Reporting in Cooperative Group Oncology Clinical Trials: A Pooled Analysis (NCCTG N0591).

    PubMed

    Atherton, Pamela J; Watkins-Bruner, Deborah W; Gotay, Carolyn; Moinpour, Carol M; Satele, Daniel V; Winter, Kathryn A; Schaefer, Paul L; Movsas, Benjamin; Sloan, Jeff A

    2015-10-01

    Clinical trials use clinician-graded adverse events (AEs) and patient-reported outcomes (PROs) to describe symptoms. The aim of the study was to examine the agreement between PROs and AEs in the clinical trial setting. Patient-level data were pooled from seven North Central Cancer Treatment Group, two Southwest Oncology Group, and three Radiation Therapy Oncology Group lung studies that included both PROs and AE data. Ten-point changes (on a 0-100 scale) in PRO scores were considered clinically significant differences (CSDs). PRO score changes were compared to AE grade (Gr) categories (2+ yes vs. no and 3+ yes vs. no) using Wilcoxon rank-sum or two-sample t-tests between Gr categories. Incidence rates and concordance of CSD in PRO scores and AE Gr categories were compiled. Spearman correlations were computed between PRO scores and AE severity. PROs completed by patients (n = 1013) were the Uniscale, Lung Cancer Symptom Scale (LCSS), Functional Assessment of Cancer Therapy-Lung (FACT-L), Symptom Distress Scale, and/or Functional Living Index-Cancer. Significantly worse PRO score changes were found for the FACT-L in patients with Gr 2+ AEs. Worse scores were seen for the Uniscale for patients with Gr 2+ AEs (P = 0.07) and LCSS for patients with Gr 3+ AEs (P = 0.09). Agreement between incidence of any Gr 2+ (Gr 3+) AE and a CSD in PROs ranged from 27% to 67% (36%-61%). Correlations between PRO scores and AE severity were low: -0.06 Uniscale, -0.03 LCSS, 0.10 FACT-L, -0.11 Symptom Distress Scale, and -0.51 Functional Living Index-Cancer. These results support previous work and an a priori hypothesis that AEs and PROs measure differing aspects of the disease experience and are complementary. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2014-01-01

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

  20. Oncology in Cambodia.

    PubMed

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

    2012-01-01

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

  1. Integrative Oncology.

    PubMed

    Lopez, Gabriel; Mao, Jun J; Cohen, Lorenzo

    2017-09-01

    Integrative oncology helps support the health of patients with cancer and their caregivers through an evidence-informed approach to lifestyle and behavior modification and the use of complementary health therapies as part of conventional cancer care. Integrative approaches can provide patients relief from cancer and cancer treatment-related symptoms, leading to improvements in their physical and psychosocial health. An evidence-informed approach is important when recommending an integrative cancer plan. Efforts at enhancing communication between patients and health care providers, as well as between integrative practitioners and conventional health care teams, are critical to achieving optimal health and healing for patients with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Outcomes in adolescents and young adults with Hodgkin lymphoma treated on US cooperative group protocols: An adult intergroup (E2496) and Children's Oncology Group (COG AHOD0031) comparative analysis.

    PubMed

    Henderson, Tara O; Parsons, Susan K; Wroblewski, Kristen E; Chen, Lu; Hong, Fangxin; Smith, Sonali M; McNeer, Jennifer L; Advani, Ranjana H; Gascoyne, Randy D; Constine, Louis S; Horning, Sandra; Bartlett, Nancy L; Shah, Bijal; Connors, Joseph M; Leonard, John I; Kahl, Brad S; Kelly, Kara M; Schwartz, Cindy L; Li, Hongli; Friedberg, Jonathan W; Friedman, Debra L; Gordon, Leo I; Evens, Andrew M

    2017-09-13

    There is no clear consensus between pediatric and adult providers about the treatment of adolescents and young adults (AYAs) with Hodgkin lymphoma (HL). Failure-free survival (FFS) and overall survival (OS) were compared between 114 patients ages 17 to 21 years with HL who were treated on the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Intergroup adult E2496 study and 391 similarly patients ages 17 to 21 years with HL who were treated on the pediatric Children's Oncology Group (COG) AHOD0031 study. Comparing AYAs from the COG and E2496 studies, there were no significant differences in extralymphatic disease, anemia, or hypoalbuminemia. More AYAs in the E2496 trial had stage III and IV disease (63% vs 29%; P < .001) and B symptoms (63% vs 27%; P < .001), and fewer had bulk disease (33% vs 77%; P < .001). More AYAs on the COG trial received radiotherapy (76% vs 66%; P = .03), although in smaller doses. E2496 AYA The 5-year FFS and OS rates were 68% and 89%, respectively in the E2496 AYAs and 81% and 97%, respectively, in the COG AYAs, indicating a statistically superior compared in the COG AYAs (P = .001). In stratified multivariable analyses, E2496 AYAs had worse FFS than COG AYAs in all strata except patients who had stage I and II HL without anemia. Propensity score analysis (based on stage, anemia, and bulk disease) confirmed inferior FFS for E2496 AYAs compared with COG AYAs (P = .004). On the E2496 study, FFS was significantly divergent across age groups (P = .005), with inferior outcomes for those ages 17 to 21 years versus 22-44 years. There was no difference across age on the COG study. Younger AYA patients with HL appear to have better outcomes when treated on a pediatric trial than patients of similar age on an adult trial. Prospective studies examining these differences are warranted. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. Randomized phase III trial of single-agent pemetrexed versus carboplatin and pemetrexed in patients with advanced non-small-cell lung cancer and Eastern Cooperative Oncology Group performance status of 2.

    PubMed

    Zukin, Mauro; Barrios, Carlos H; Pereira, Jose Rodrigues; Ribeiro, Ronaldo De Albuquerque; Beato, Carlos Augusto de Mendonça; do Nascimento, Yeni Neron; Murad, Andre; Franke, Fabio A; Precivale, Maristela; Araujo, Luiz Henrique de Lima; Baldotto, Clarissa Serodio Da Rocha; Vieira, Fernando Meton; Small, Isabele A; Ferreira, Carlos G; Lilenbaum, Rogerio C

    2013-08-10

    To compare single-agent pemetrexed (P) versus the combination of carboplatin and pemetrexed (CP) in first-line therapy for patients with advanced non-small-cell lung cancer (NSCLC) with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2. In a multicenter phase III randomized trial, patients with advanced NSCLC, ECOG PS of 2, any histology at first and later amended to nonsquamous only, no prior chemotherapy, and adequate organ function were randomly assigned to P alone (500 mg/m(2)) or CP (area under the curve of 5 and 500 mg/m(2), respectively) administered every 3 weeks for a total of four cycles. The primary end point was overall survival (OS). A total of 205 eligible patients were enrolled from eight centers in Brazil and one in the United States from April 2008 to July 2011. The response rates were 10.3% for P and 23.8% for CP (P = .032). In the intent-to-treat population, the median PFS was 2.8 months for P and 5.8 months for CP (hazard ratio [HR], 0.46; 95% CI, 0.35 to 0.63; P < .001), and the median OS was 5.3 months for P and 9.3 months for CP (HR, 0.62; 95% CI, 0.46 to 0.83; P = .001). One-year survival rates were 21.9% and 40.1%, respectively. Similar results were seen when patients with squamous disease were excluded from the analysis. Anemia (grade 3, 3.9%; grade 4, 11.7%) and neutropenia (grade 3, 1%; grade 4, 6.8%) were more frequent with CP. There were four treatment-related deaths in the CP arm. Combination chemotherapy with CP significantly improves survival in patients with advanced NSCLC and ECOG PS of 2.

  4. Prospective randomized multicenter adjuvant dermatologic cooperative oncology group trial of low-dose interferon alfa-2b with or without a modified high-dose interferon alfa-2b induction phase in patients with lymph node-negative melanoma.

    PubMed

    Hauschild, Axel; Weichenthal, Michael; Rass, Knuth; Linse, Ruthild; Ulrich, Jens; Stadler, Rudolf; Volkenandt, Matthias; Grabbe, Stephan; Proske, Ulrike; Schadendorf, Dirk; Brockmeyer, Norbert; Vogt, Thomas; Rompel, Rainer; Kaufmann, Roland; Kaatz, Martin; Näher, Helmut; Mohr, Peter; Eigentler, Thomas; Livingstone, Elisabeth; Garbe, Claus

    2009-07-20

    PURPOSE Interferon alfa (IFN-alpha) has shown clinical efficacy in the adjuvant treatment of patients with high-risk melanoma in several clinical trials, but optimal dosing and duration of treatment are still under discussion. It has been argued that in high-dose IFN-alpha (HDI), the intravenous (IV) induction phase might be critical for the clinical benefit of the regimen. PATIENTS AND METHODS In an attempt to investigate the potential role of a modified high-dose induction phase, lymph node-negative patients with resected primary malignant melanoma of more than 1.5-mm tumor thickness were included in this prospective randomized multicenter Dermatologic Cooperative Oncology Group trial. Six hundred seventy-four patients were randomly assigned to receive 4 weeks of a modified HDI scheme. This schedule consisted of 5 times weekly 10 MU/m(2) IFN-alpha-2b IV for 2 weeks and 5 times weekly 10 MU/m(2) IFN-alpha-2b administered subcutaneously (SC) for another 2 weeks followed by 23 months of low-dose IFN-alpha-2b (LDI) 3 MU SC three times a week (arm A). LDI 3 MU three times a week was given for 24 months in arm B. Results Of 650 assessable patients, there were 92 relapses among the 321 patients receiving high-dose induction as compared with 95 relapses among the 329 patients receiving LDI only. Five-year relapse-free survival rates were 68.0% (arm A) and 67.1% (arm B), respectively. Likewise, melanoma-related fatalities were similar between both groups, resulting in 5-year overall survival rates of 80.2% (arm A) and 82.9% (arm B). CONCLUSION The addition of a 4-week modified HDI induction phase to a 2-year low-dose adjuvant IFN-alpha-2b treatment schedule did not improve the clinical outcome.

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

    PubMed

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

    1999-08-01

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

  6. A phase II study of pemetrexed monotherapy in chemo-naïve Eastern Cooperative Oncology Group performance status 2 patients with EGFR wild-type or unknown advanced non-squamous non-small cell lung cancer (HANSHIN Oncology Group 002).

    PubMed

    Hata, Akito; Katakami, Nobuyuki; Fujita, Shiro; Nanjo, Shigeki; Takeshita, Jumpei; Tanaka, Kosuke; Kaneda, Toshihiko; Nishiyama, Akihiro; Nishimura, Takashi; Nakagawa, Atsushi; Otsuka, Kojiro; Morita, Satoshi; Urata, Yoshiko; Negoro, Shunichi

    2015-06-01

    The aim of our study was to investigate the efficacy and safety of pemetrexed monotherapy in chemo-naïve Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 patients with epidermal growth factor receptor (EGFR) wild-type or unknown advanced non-squamous non-small cell lung cancer (NSCLC). Pemetrexed was administered at 500 mg/m(2) triweekly until progression with supplementations in chemo-naïve ECOG PS 2 patients with EGFR wild-type or unknown advanced non-squamous NSCLC. Between September 2009 and April 2013, twenty-eight patients were enrolled. Median age was 75 (range 59-89). Nineteen (68 %) of 28 were ever smoker, and 18 (64 %) had pulmonary emphysema. Sixteen (57 %) had comorbidities such as hypertension, heart disease, and/or diabetes. In 26 eligible patients, the overall response rate, disease control rate, median PFS, and median overall survival were 11.5, 53.8 %, 3.0 [95 % confidence interval (CI) 1.9-5.7] months and 9.5 (95 % CI 3.3-12.5) months, respectively. Median administered course number was 3 (range 1-14). Median duration of PS maintenance ≤2 was 4.9 (95 % CI 1.3-9.7) months. Common (≥10 %) grade 3/4 toxicities included 7 (27 %) neutropenia, 7 (27 %) leukopenia, 4 (15 %) fatigue, and 3 (12 %) thrombocytopenia. Febrile neutropenia and interstitial lung disease were not observed. There were no treatment-related deaths. Pemetrexed monotherapy demonstrated moderate efficacy and good safety in chemo-naïve PS 2 patients with EGFR wild-type or unknown non-squamous NSCLC. It can be a therapeutic option in "frail" PS 2 non-squamous NSCLC patients without the indication of combination regimens, if the patient is EGFR wild-type.

  7. Patterns of domestic migrations and access to childhood cancer care centres in Italy: a report from the hospital based registry of the Italian Association of Pediatric Hematology and Oncology (AIEOP).

    PubMed

    Dama, Elisa; Rondelli, Roberto; De Rosa, Marisa; Aricò, Maurizio; Carli, Modesto; Bellani, Franca Fossati; Magnani, Corrado; Merletti, Franco; Pastore, Guido; Pession, Andrea

    2008-10-01

    Tertiary care centres, grouped in the Italian Association of Paediatric Haematology and Oncology (AIEOP) are unevenly distributed across the country. In an attempt to describe their perceived efficacy, we matched the residence and the location of the treatment centre in 18,441 patients aged oncology network with social and economic implications.

  8. Nanotechnology in radiation oncology.

    PubMed

    Wang, Andrew Z; Tepper, Joel E

    2014-09-10

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

  9. International cooperation and networking in genetic health care provision: issues arising from the genetic services plan for the Emilia-Romagna region, Italy.

    PubMed

    Calzolari, E; Baroncini, A

    2005-01-01

    The aims of this report are to describe the genetic plan for Emilia-Romagna, a region in Italy, and to contribute to the international exchange of information on developing and applying policy frameworks to provide high-quality and comprehensive genetic health care in the publicly funded health systems. At the present time there is no national policy for genetic medicine in Italy, and only two regions, Emilia-Romagna and Liguria, have formally agreed to a strategic plan for health care in genetics. The current provision of genetic services in Emilia-Romagna is described focusing on the intra- and inter-organizational linkages to ensure a comprehensive system of coordinated activities. Strengths and implementation areas are highlighted. Points that must be solved within the regional or national context are the definition of the level of assistance required in genetic medicine, the formal professional recognition of the genetic counselor and the adjustment of the billing mechanisms to the complexities of clinical genetic services. Issues that need to be addressed at a wider level include full assessment of genetic tests before their introduction into clinical practice, networking to provide tests for the rarest genetic diseases, consensus on fundamental terminology and clinical and administrative data sets to promote a cohesive framework for the flow of information throughout the health care systems with respect to genetics.

  10. Nanotechnology in Radiation Oncology

    PubMed Central

    Wang, Andrew Z.; Tepper, Joel E.

    2014-01-01

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

  11. Moral distress in nurses in oncology and haematology units.

    PubMed

    Lazzarin, Michela; Biondi, Andrea; Di Mauro, Stefania

    2012-03-01

    One of the difficulties nurses experience in clinical practice in relation to ethical issues in connection with young oncology patients is moral distress. In this descriptive correlational study, the Moral Distress Scale-Paediatric Version (MDS-PV) was translated from the original language and tested on a conventional sample of nurses working in paediatric oncology and haematology wards, in six north paediatric hospitals of Italy. 13.7% of the total respondents claimed that they had changed unit or hospital due to moral distress. The items with the highest mean intensity in the sample were almost all connected with medical and nursing competence and have considerably higher values than frequency. The instrument was found to be reliable. The results confirmed the validity of the MDS-PV (Cronbach's alpha = 0.959). This study represents the first small-scale attempt to validate MDS-PV for use in paediatric oncology-haematology nurses in Italy.

  12. Decreasing Frequency of Osteonecrosis of the Jaw in Cancer and Myeloma Patients Treated with Bisphosphonates: The Experience of the Oncology Network of Piedmont and Aosta Valley (North-Western Italy)

    PubMed Central

    Fusco, Vittorio; Galassi, Claudia; Berruti, Alfredo; Ortega, Cinzia; Ciuffreda, Libero; Scoletta, Matteo; Goia, Franco; Migliario, Mario; Baraldi, Anna; Boccadoro, Mario; Loidoris, Anastasios; Bertetto, Oscar

    2013-01-01

    Background. Data concerning frequency of Osteonecrosis of Jaws (ONJ) are mostly based on single center experiences. Patients and Methods. Since 2005 a multidisciplinary study group collected data of cases of ONJ in patients treated with Bisphosphonates (BP) and observed in oncology and hematology centers of a regional network. Results. By December 2008, 221 cases were registered. We report details of 200 cases, identified after cross-checking reports from centres of medical oncology, haematology, and oral care. Primary neoplasm was breast cancer (39%), myeloma (32%), prostate cancer (16%), and other types of cancer (8%). In about 50% of the cases a history of dental extraction was present. Zoledronic acid was administered (alone or with other BP) to 178 patients (89%). Median time from first infusion to ONJ diagnosis was 21.0 (zoledronic acid only) and 39.0 months (pamidronate only). The number of ONJ cases per year was 3 in 2003, 21 in 2004, 58 in 2005, 60 in 2006, 37 in 2007, and 21 in 2008. Conclusion. The number of new ONJ cases in cancer and myeloma patients increased until 2006 and then reduced. The possible reasons of this trend (introduction of zoledronic acid; increase of ONJ awareness; diffusion of preventive dental measures; late modifications of BP prescription) are herein discussed. PMID:23533811

  13. Central Italy

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Clouds and haze cover most of the Italian peninsula in this view of central Italy (41.5N, 14.0E) but the Bay of Naples region with Mt. Vesuvius and the island of Capri are clear. The Adriatic Sea in the background separates Italy from the cloud covered Balkans of eastern Europe and the Tyrrhenian Sea in the foreground lies between the Italian mainland and the off scene islands of Corsica and Sardinia. Several aircraft contrails can also be seen.

  14. Speed of Accrual Into Phase III Oncology Trials: A Comparison Across Geographic Locations.

    PubMed

    Ruther, Nancy R; Mathiason, Michelle A; Wee, Sandra K; Emmel, Ann E; Go, Ronald S

    2015-12-01

    We sought to determine the speed at which patients were accrued into published phase III oncology trials across geographic locations and to identify the factors that may influence this process. We searched OVID-Medline and identified all phase III oncology therapeutic trials published in 2006 to 2010. The speed of accrual for each trial was calculated by dividing the number of patients enrolled by the number of months the trial was open (patients/mo). Five hundred forty-six trials were included in our study. Most of the trials were for adults (96%), late-stage cancers (78%), sponsored by either cooperative groups or academic centers (66%), and had negative results (58%). The most common trial locations were multinational (45%), United States (16%), Italy (7%), Germany (6%), Japan (6%), and France (5%). Compared with trials conducted in a single country, multinational trials accrued significantly more patients per trial, completed enrollment faster, and were published sooner (all P≤0.01). Multivariate analyses showed that multinational (P=0.001), breast cancer (P=0.001), industry sponsored (P=0.001), and equivalency trials (P=0.039) accrued significantly faster than other types of trials. Placebo-controlled and non-placebo-controlled trials accrued at similar speeds. We found no difference in speed of accrual between the United States and Europe. Speed of accrual for phase III oncology trials is fastest among multinational trials and independently influenced by the type of trial sponsor, cancer investigated, and study outcome, but not by placebo use. Trials conducted in single countries seem to accrue at similar speeds.

  15. Frequency of psycho-oncologic and social service counseling in cancer centers relative to center site and hospital characteristics: Findings from 879 center sites in Germany, Austria, Switzerland, and Italy.

    PubMed

    Kowalski, Christoph; Ferencz, Julia; Singer, Susanne; Weis, Ilse; Wesselmann, Simone

    2016-08-02

    There is extensive evidence that patients with cancer and cancer survivors have a strong need for expert support in relation to the psychological and social consequences of the disease. The requirements set out in the German Cancer Society's cancer center certification system include the routine provision of psycho-oncologic care (POC) and social service counseling for every patient. The current study investigated which organizational and structural characteristics in hospitals account for variations in psychosocial care provision in these centers. Data routinely collected during the certification process regarding the percentages of psychosocial care provision and characteristics of center sites and hospitals were matched with data with regard to size of the municipality, teaching hospital status, and institutional ownership. Linear multilevel regression analyses were performed to identify the characteristics of hospitals and center sites that were related to psychosocial care provision. Substantial differences were found for different types of cancer (eg, a greater provision of psychosocial care in centers specializing in breast rather than prostate cancer). There was more POC provision in longer-certified centers and less in rural areas and university hospitals. Much of the variation between hospitals remains unexplained. Although the implementation of mandatory psychosocial services generally provides patients with access to POC and social service counseling, the wide differences in the provision of counseling indicate that additional measures are needed to avoid inequalities resulting from the center at which a patient receives cancer treatment. Cancer 2016. © 2016 American Cancer Society. © 2016 American Cancer Society.

  16. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    PubMed

    Vogel, Wendy H

    2016-01-01

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

  17. Global radiation oncology waybill

    PubMed Central

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

    2013-01-01

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

  18. Oncology Nursing Society

    MedlinePlus

    ... Account Login Cart Search the ONS website Continuing Nursing Education Courses and Activities Access Devices: The Virtual ... Vomiting Chemotherapy for Non-Oncology Conditions Clinical Trials Nursing 101 Cognitive Impairment Fundamentals of Blood and Marrow ...

  19. Imaging in interventional oncology.

    PubMed

    Solomon, Stephen B; Silverman, Stuart G

    2010-12-01

    Medical imaging in interventional oncology is used differently than in diagnostic radiology and prioritizes different imaging features. Whereas diagnostic imaging prioritizes the highest-quality imaging, interventional imaging prioritizes real-time imaging with lower radiation dose in addition to high-quality imaging. In general, medical imaging plays five key roles in image-guided therapy, and interventional oncology, in particular. These roles are (a) preprocedure planning, (b) intraprocedural targeting, (c) intraprocedural monitoring, (d) intraprocedural control, and (e) postprocedure assessment. Although many of these roles are still relatively basic in interventional oncology, as research and development in medical imaging focuses on interventional needs, it is likely that the role of medical imaging in intervention will become even more integral and more widely applied. In this review, the current status of medical imaging for intervention in oncology will be described and directions for future development will be examined.

  20. Gaps in Oncology

    Cancer.gov

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

  1. Creating opportunities to support oncology nursing practice: surviving and thriving.

    PubMed

    Rashleigh, Laura; Cordon, Charissa; Wong, Jiahui

    2011-01-01

    There is a growing body of evidence to support that specialization in nursing leads to improved outcomes for patients, including increased QOL, improved symptom management, and fewer hospital admissions. Oncology nurses face several challenges in pursuing specialization, due to individual and system issues such as limited time and resources. To address these challenges, de Souza Institute launched a province-wide study group for nurses in Ontario who planned to write the Canadian Nurses Association (CNA) Oncology Certification Exam. The study group was led by educators from de Souza and Princess Margaret Hospital and drew expertise from nursing leaders across Ontario who shared the same vision of oncology nursing excellence. The study group was innovative by embracing telemedicine and web-based technology, which enabled flexibility for nurses' work schedules, learning styles, physical location and practice experience. The study group utilized several theoretical perspectives and frameworks to guide the curriculum: Adult Learning Theories, Cooperative Learning, Generational Learning Styles, CANO standards for practice and the CNA exam competencies. This approach enabled 107 oncology nurses across the province in 17 different sites to connect, as a group, study interactively and fully engage in their learning. A detailed evaluation method was utilized to assess baseline knowledge, learning needs, cooperative group process, exam success rates, and document unexpected outcomes. Ninety-four per cent of participants passed the CNA Oncology Exam. Lessons learned and future implications are discussed. The commitment remains to enable thriving through generating new possibilities, building communities of practice, mentoring nurses and fostering excellence in oncology practice.

  2. Southern Italy

    NASA Image and Video Library

    1973-06-22

    SL2-05-359 (22 June 1973) --- This rare cloud free view of southern Italy (41.0N, 16.0E) shows almost all of the famous `boot' configuration of the peninsula up to just north of Naples and Mount Vesuvius. The land mass of this historic peninsula contrasts sharply with the sparkling blue waters of the Mediterranean Sea. Photo credit: NASA

  3. Comparison of the safety and efficacy of paclitaxel plus gemcitabine combination in young and elderly patients with locally advanced or metastatic non-small cell lung cancer. A retrospective analysis of the Southern Italy Cooperative Oncology Group trials.

    PubMed

    Comella, Pasquale; Gambardella, Antonio; Frasci, Giuseppe; Avallone, Antonio; Costanzo, Raffaele

    2008-02-01

    We retrospectively assessed tolerability and efficacy of paclitaxel plus gemcitabine combination in 259 patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) enrolled in three randomized SICOG trials according to their age (70 years) at study entry. Apart from age, demographic and clinical characteristics were similar in the two groups. Response rate of paclitaxel plus gemcitabine was similar in younger and in elderly (36% versus 30%). Chemotherapy was well tolerated, but severe neutropenia (12% versus 7%), anaemia (6.6% versus 1.8%), and vomiting (5% versus 0) were more frequent in elderly patients. Both median progression-free survival (PFS, 5.5 months versus 4.2 months), and overall survival (OS, 11.1 months versus 9.1 months) resulted slightly prolonged for younger patients. However, only stage and performance status resulted independently affecting PFS and OS. In conclusion, paclitaxel plus gemcitabine were similarly tolerated and active in younger and elderly patients. This regimen should be considered an option for the management of fit elderly patients.

  4. Subspecialist training in surgical gynecologic oncology in the Nordic countries.

    PubMed

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

    2011-08-01

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

  5. Venice, Italy

    NASA Image and Video Library

    2002-09-24

    Four hundred bridges cross the labyrinth of canals that form the 120 islands of Venice, situated in a saltwater lagoon between the mouths of the Po and Piave rivers in northeast Italy. All traffic in the city moves by boat. Venice is connected to the mainland, 4 kilometers (2.5 miles) away, by ferries as well as a causeway for road and rail traffic. The Grand Canal winds through the city for about 3 kilometers (about 2 miles), dividing it into two nearly equal sections. According to tradition, Venice was founded in 452, when the inhabitants of Aquileia, Padua, and several other northern Italian cities took refuge on the islands of the lagoon from the Teutonic tribes invading Italy at that time. This image was acquired on December 9, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER will image Earth for the next 6 years to map and monitor the changing surface of our planet. http://photojournal.jpl.nasa.gov/catalog/PIA03860

  6. Comparative oncology today.

    PubMed

    Paoloni, Melissa C; Khanna, Chand

    2007-11-01

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

  7. 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.

  8. Globalization and human cooperation.

    PubMed

    Buchan, Nancy R; Grimalda, Gianluca; Wilson, Rick; Brewer, Marilynn; Fatas, Enrique; Foddy, Margaret

    2009-03-17

    Globalization magnifies the problems that affect all people and that require large-scale human cooperation, for example, the overharvesting of natural resources and human-induced global warming. However, what does globalization imply for the cooperation needed to address such global social dilemmas? Two competing hypotheses are offered. One hypothesis is that globalization prompts reactionary movements that reinforce parochial distinctions among people. Large-scale cooperation then focuses on favoring one's own ethnic, racial, or language group. The alternative hypothesis suggests that globalization strengthens cosmopolitan attitudes by weakening the relevance of ethnicity, locality, or nationhood as sources of identification. In essence, globalization, the increasing interconnectedness of people worldwide, broadens the group boundaries within which individuals perceive they belong. We test these hypotheses by measuring globalization at both the country and individual levels and analyzing the relationship between globalization and individual cooperation with distal others in multilevel sequential cooperation experiments in which players can contribute to individual, local, and/or global accounts. Our samples were drawn from the general populations of the United States, Italy, Russia, Argentina, South Africa, and Iran. We find that as country and individual levels of globalization increase, so too does individual cooperation at the global level vis-à-vis the local level. In essence, "globalized" individuals draw broader group boundaries than others, eschewing parochial motivations in favor of cosmopolitan ones. Globalization may thus be fundamental in shaping contemporary large-scale cooperation and may be a positive force toward the provision of global public goods.

  9. Globalization and human cooperation

    PubMed Central

    Buchan, Nancy R.; Grimalda, Gianluca; Wilson, Rick; Brewer, Marilynn; Fatas, Enrique; Foddy, Margaret

    2009-01-01

    Globalization magnifies the problems that affect all people and that require large-scale human cooperation, for example, the overharvesting of natural resources and human-induced global warming. However, what does globalization imply for the cooperation needed to address such global social dilemmas? Two competing hypotheses are offered. One hypothesis is that globalization prompts reactionary movements that reinforce parochial distinctions among people. Large-scale cooperation then focuses on favoring one's own ethnic, racial, or language group. The alternative hypothesis suggests that globalization strengthens cosmopolitan attitudes by weakening the relevance of ethnicity, locality, or nationhood as sources of identification. In essence, globalization, the increasing interconnectedness of people worldwide, broadens the group boundaries within which individuals perceive they belong. We test these hypotheses by measuring globalization at both the country and individual levels and analyzing the relationship between globalization and individual cooperation with distal others in multilevel sequential cooperation experiments in which players can contribute to individual, local, and/or global accounts. Our samples were drawn from the general populations of the United States, Italy, Russia, Argentina, South Africa, and Iran. We find that as country and individual levels of globalization increase, so too does individual cooperation at the global level vis-à-vis the local level. In essence, “globalized” individuals draw broader group boundaries than others, eschewing parochial motivations in favor of cosmopolitan ones. Globalization may thus be fundamental in shaping contemporary large-scale cooperation and may be a positive force toward the provision of global public goods. PMID:19255433

  10. Development of cancer cooperative groups in Japan.

    PubMed

    Fukuda, Haruhiko

    2010-09-01

    Investigator-initiated clinical trials are essential for improving the standard of care for cancer patients, because pharmaceutical companies do not conduct trials that evaluate combination chemotherapy using drugs from different companies, surgery, radiotherapy or multimodal treatments. Government-sponsored cooperative groups have played a vital role in developing cancer therapeutics since the 1950s in the USA; however, the establishment of these groups in Japan did not take place until 30 years later. Methodological standards for multicenter cancer clinical trials were established in the 1980s by the National Cancer Institute and cooperative groups. The Japan Clinical Oncology Group, one of the largest cooperative groups in the country, was instituted in 1990. Its data center and operations office, formed during the 1990s, applied the standard methods of US cooperative groups. At present, the Japan Clinical Oncology Group consists of 14 subgroups, a Data Center, an Operations Office, nine standing committees and an Executive Committee represented by the Japan Clinical Oncology Group Chair. Quality control and quality assurance at the Japan Clinical Oncology Group, including regular central monitoring, statistical methods, interim analyses, adverse event reporting and site visit audit, have complied with international standards. Other cooperative groups have also been established in Japan since the 1980s; however, nobody figures out all of them. A project involving the restructuring of US cooperative groups has been ongoing since 2005. Learning from the success of this project will permit further progress of the cancer clinical trials enterprise in Japan.

  11. Nanomedicine in veterinary oncology.

    PubMed

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

    2015-08-01

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

  12. Imaging in oncology.

    PubMed

    Hourani, Mukbil H; Nassar, Lara; Haydar, Mohamad; Hourany-Rizk, Roula G

    2009-01-01

    Imaging plays an important role in the management of cancer patients, and in screening of asymptomatic individuals for early detection of cancer. This paper will review the clinical applications of oncologic imaging in the diagnosis, staging and followup in cancer patients and screening for cancer.

  13. Venice, Italy

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Four hundred bridges cross the labyrinth of canals that form the 120 islands of Venice, situated in a saltwater lagoon between the mouths of the Po and Piave rivers in northeast Italy. All traffic in the city moves by boat. Venice is connected to the mainland, 4 kilometers (2.5 miles) away, by ferries as well as a causeway for road and rail traffic. The Grand Canal winds through the city for about 3 kilometers (about 2 miles), dividing it into two nearly equal sections. According to tradition, Venice was founded in 452, when the inhabitants of Aquileia, Padua, and several other northern Italian cities took refuge on the islands of the lagoon from the Teutonic tribes invading Italy at that time.

    This image was acquired on December 9, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER will image Earth for the next 6 years to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance.

    Dr. Anne

  14. Venice, Italy

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Four hundred bridges cross the labyrinth of canals that form the 120 islands of Venice, situated in a saltwater lagoon between the mouths of the Po and Piave rivers in northeast Italy. All traffic in the city moves by boat. Venice is connected to the mainland, 4 kilometers (2.5 miles) away, by ferries as well as a causeway for road and rail traffic. The Grand Canal winds through the city for about 3 kilometers (about 2 miles), dividing it into two nearly equal sections. According to tradition, Venice was founded in 452, when the inhabitants of Aquileia, Padua, and several other northern Italian cities took refuge on the islands of the lagoon from the Teutonic tribes invading Italy at that time.

    This image was acquired on December 9, 2001 by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER will image Earth for the next 6 years to map and monitor the changing surface of our planet.

    ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for surface mapping, and monitoring dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance.

    Dr. Anne

  15. [Biosimilars in oncology].

    PubMed

    Barroso, Sérgio; Coutinho, Jorge; Damasceno, Margarida; Dinis, José; Forjaz de Lacerda, João; Gervásio, Helena; Leal da Costa, Fernando; Marques Pereira, Ana; Parreira, António; Principe, Fernando; Rodrigues, Helena; Sá, Anabela; Teixeira, Adriana

    2009-01-01

    The development of biotechnology drugs represents one of the great advances in medical therapy and it was observed an exponential growth in its use. The resource to these drugs in Oncology and Hematology is no exception and it soon became an essential element of an integrated and directed therapy strategy. The expiry of the first biotechnology drugs patents has opened the door for the development and marketing of biosimilars, which entry in the Portuguese market was recently approved. This article was built on the analysis of the available state-of-the-art information on biotechnology drugs, biosimilars and current legislation and it expresses the opinion of Oncology and Hematology experts about the substituition of biological drugs by biosimilars in clinical practice.

  16. Quality in radiation oncology

    SciTech Connect

    Pawlicki, Todd; Mundt, Arno J.

    2007-05-15

    A modern approach to quality was developed in the United States at Bell Telephone Laboratories during the first part of the 20th century. Over the years, those quality techniques have been adopted and extended by almost every industry. Medicine in general and radiation oncology in particular have been slow to adopt modern quality techniques. This work contains a brief description of the history of research on quality that led to the development of organization-wide quality programs such as Six Sigma. The aim is to discuss the current approach to quality in radiation oncology as well as where quality should be in the future. A strategy is suggested with the goal to provide a threshold improvement in quality over the next 10 years.

  17. 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

  18. Biopsies in oncology.

    PubMed

    de Bazelaire, C; Coffin, A; Cohen, S; Scemama, A; de Kerviler, E

    2014-01-01

    Imaging-guided percutaneous biopsies in patients in oncology provide an accurate diagnosis of malignant tumors. Percutaneous biopsy results are improved by correct use of sampling procedures. The risks of percutaneous biopsy are low and its complications are generally moderate. These risks can be reduced using aids such as blund tip introducers, hydrodissection and correct patient positioning. The multidisciplinary team meetings dialogue between oncologist, surgeon and radiologist correctly defines the indications in order to improve the treatment strategies.

  19. Introduction to pediatric oncology

    SciTech Connect

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

    1987-01-01

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

  20. [Depression in oncology].

    PubMed

    Reich, M

    2010-10-01

    The purpose of this paper was to make a brief review of the main problematics raised by depression in oncology in terms of prevalence, semiology, screening, risk, prognosis factors and treatment. This reflection was based on recent literature data obtained through a PubMed search. Depressive disorders have frequently been encountered in cancer patients. During routine oncology daily care, depression screening, assessment and treatment are of paramount importance regarding psychosocial management. Depressive elements have a tremendous impact on the quality of life, tolerance and compliance with anticancer treatment. Moreover, depression morbidity and its possible influence on prognosis represent an important challenge in terms of prevention. A specific semiology for depressive disorders in the oncologic field might be more relevant with practical clinical implications. Optimal care of these mood disorders have to be implemented as soon as possible and be supported by the association of pharmacological treatment and psychotherapy. Copyright © 2010 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  1. Pediatric oncology in Turkey.

    PubMed

    Kebudi, Rejin

    2012-03-01

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

  2. Hybrid Imaging in Oncology.

    PubMed

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

    2015-01-01

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

  3. [Factitious diseases in oncology].

    PubMed

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

    2015-12-01

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

  4. Quality Indicators in Radiation Oncology

    SciTech Connect

    Albert, Jeffrey M.; Das, Prajnan

    2013-03-15

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

  5. Lowered Cisplatin Dose and No Bleomycin in the Treatment of Pediatric Germ Cell Tumors: Results of the GCT-99 Protocol From the Brazilian Germ Cell Pediatric Oncology Cooperative Group.

    PubMed

    Lopes, Luiz Fernando; Macedo, Carla Renata Pacheco Donato; Aguiar, Simone Dos Santos; Barreto, Jose Henrique S; Martins, Gisele Eiras; Sonaglio, Viviane; Milone, Marcelo; Lima, Eduardo Ribeiro; Almeida, Maria Teresa de Assis; Lopes, Paula Maria Azevedo Allemand; Watanabe, Flora Mitie; D'Andrea, Maria Lydia Mello; Pianovski, Mara Albonei; Melaragno, Renato; Vianna, Sonia Maria Rossi; Moreira, Mauber Eduardo Schultz; Bruniera, Paula; de Oliveira, Cleyton Zanardo

    2016-02-20

    We describe the results of a risk-adapted, response-based therapeutic approach from the Brazilian GCT-99 study on germ cell tumors. From May 1999 to October 2009, 579 participants were enrolled in the Brazilian GCT-99 study. Treatment, defined as specific chemotherapy regimen and number of cycles, was allocated by means of risk-group assignment at diagnosis with consideration for stage and primary tumor site. Patients at low risk received no chemotherapy. Patients at intermediate risk (IR) with a good response (GR) received four cycles of platinum and etoposide (PE), for total doses of platinum 420 mg/m(2) and etoposide 2,040 mg/m(2). Patients at IR with a partial response (PR) received three cycles of PE plus three cycles of ifosfamide, vinblastine, and bleomycin. Patients at high risk (HR) with a GR received four cycles of PE and ifosfamide (PEI) at total doses of platinum 420 mg/m(2), etoposide 1,200 mg/m(2), and ifosfamide 30 g/m(2). Patients at HR with a PR received six cycles of PEI. The risk-group distribution was 213 LR, 138 IR, and 129 HR for 480 evaluable patients. Overall survival (OS) and event-free survival (EFS) rates at 10 years were, respectively, 90% and 88.6% in the IR-GR group (n = 126) and 74.1% and 74.1% in the IR-PR group (n = 12). Ten-year rates for the HR-GR group (n = 86) were an OS of 66.8% and an EFS of 62.5%. The HR-PR group (n = 43) had an OS of 74.8% and an EFS of 73.4%. In univariable and multivariable analysis, increased serum lactate dehydrogenase level and histology for a metastatic immature teratoma were prognostic of a worsened outcome. Reduction of therapy to two drugs did not compromise survival outcomes for patients in the IR-GR group, and escalation of therapy with PEI did not significantly improve OS and EFS in patients at HR. © 2016 by American Society of Clinical Oncology.

  6. Postgraduate Courses in Pharmaceutical Medicine in Italy.

    PubMed

    Criscuolo, Domenico

    2017-01-01

    Italy has a significant tradition of excellence in the area of clinical trials (CTRs): important achievements in the clinical development of rifampicin and adriamycin, the two most famous drugs discovered in the research laboratories of two Italian pharmaceutical companies, paved the way to the establishment of a culture of clinical development, mainly in the areas of antimicrobials and oncology. Despite the fact that now the Italian market of pharmaceuticals is largely dominated by multinational companies with headquarters outside Italy, the contribution of Italian studies to the clinical development of new drugs is still significant. Indeed, it largely exceeds the percentage of Italian inhabitants versus the ones living in the remaining EU countries, as Italy has about 12% of EU population, but has a 17% share of the EU CTRs. Education in Pharmaceutical Medicine is now a must for all professionals interested to work either in pharma companies or in contract research organizations: several Italian universities are offering high quality courses, and in the last 10 years, more than 1,200 professionals received a postgraduate education in pharmaceutical medicine. This result places Italy on top of countries concerned about the professional education of people involved in drug development and will represent an asset for a larger involvement of Italian clinical sites in the global process of clinical research.

  7. Distance learning in the Applied Sciences of Oncology.

    PubMed

    Barton, Michael B; Thode, Richard J

    2010-04-01

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

  8. Vocational Training in Italy.

    ERIC Educational Resources Information Center

    European Centre for the Development of Vocational Training, Berlin (West Germany).

    This document on vocational training in Italy contains eight chapters. Chapter 1 describes the population of Italy. Chapter 2 describes the Italian economy through the agricultural, industrial, and service sectors. Chapter 3 describes education and vocational training in Italy, including regional agricultural and nonagricultural vocational…

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

    PubMed Central

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

    2014-01-01

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

  10. Advances in viral oncology

    SciTech Connect

    Klein, G.

    1987-01-01

    Volume 6 of Advances in Viral Oncology presents experimental approaches to multifactorial interactions in tumor development. Included are in-depth analyses of malignant phenotypes by oncogene complementation, as well as studies of complementary interactions among DNA viral oncogenes; multiple cell-derived sequences in single retroviral genomes; and sequences that influence the transforming activity and expression of the mos oncogene. The genetic regulation of tumorigenic expression in somatic cell hybrids, the inhibition of oncogenes by cellular genes, and the interaction of genes that favor and genes that suppress tumorigenesis are examined in detail. The book concludes with a study of the relationship of oncogenes to the evolution of the metastatic phenotype.

  11. Oncology disease management.

    PubMed

    Fetterolf, Donald E; Terry, Rachel

    2007-02-01

    Oncologic conditions are ubiquitous medical illnesses that present a particular challenge for medical management programs designed to address quality and cost issues in patient populations. Disease management strategies represent a reasonable and effective approach for employers and health plans in their arsenal of health management strategies. Multiple reasons exist for the development of specialized disease management programs that deal with cancer patients, some unique to this group of individuals. Health plans and/or employers have solid justification for addressing these issues directly through programs developed specifically to work with cancer patients. Whether developed within a health plan, or "carved out" to an external vendor, proper evaluation of outcomes is essential.

  12. Medicinal cannabis in oncology.

    PubMed

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

    2007-12-01

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

  13. American Society of Clinical Oncology

    MedlinePlus

    ... The 10th Joint MSKCC/HSS/IOR Course in Musculoskeletal Tumor Pathology and Clinical Oncology New York, New York, United ... The 10th Joint MSKCC/HSS/IOR Course in Musculoskeletal Tumor Pathology and Clinical Oncology Memorial Sloan Kettering Cancer Center ...

  14. Lesson in psycho-oncology.

    PubMed

    Holland, Jimmie C

    2002-01-01

    As a new subspecialty of oncology, psycho-oncology's emergent role reflects the growing interest and concern over the past 25 years, on the part of both oncologists and the general public, in the psychological, behavioral, and social factors related to cancer prevention and treatment. Today, total care of cancer patients must include concern for psychosocial well-being and management of distress must be fully integrated with the other aspects of the patient's treatment plan. Prevention efforts are rooted in the willingness and ability of individuals to change lifestyle and risk behaviors, and this has to be elucidated by research in psycho-oncology. Further, psycho-oncology advances theory and practice related to the effects of cancer on psychological function and provides expertise in the prevention of cancer. Thus, psycho-oncology has a unique role to play in cancer treatment and prevention.

  15. Stress in pediatric oncology nurses.

    PubMed

    Hecktman, Hillary Michelle

    2012-01-01

    Although the onset of physiological and emotional stress can greatly affect outcomes for a child with cancer, the focus of this review targets pediatric oncology nurses and their daily occupation-related stress. Literature currently exists that discusses the etiology of stress in the oncology work environment as well as coping strategies and their effects on pediatric oncology nurses' stress levels. To date, however, no literature review has been assembled to comprehensively address practice implications and provide recommendations for pediatric oncology staff nurses. This review of literature seeks to provide a general overview of stress experienced in the pediatric oncology work environment and supportive interventions to decrease negative outcomes such as compassion fatigue and burnout. Recommendations and conclusions are made based on existing interventions, thus creating a framework for future research to be conducted to compare the effectiveness of these measures and optimize patient experiences through caregiver well-being.

  16. Foreign children with cancer in Italy

    PubMed Central

    2011-01-01

    Background There has been a noticeable annual increase in the number of children coming to Italy for medical treatment, just like it has happened in the rest of the European Union. In Italy, the assistance to children suffering from cancer is assured by the current network of 54 centres members of the Italian Association of Paediatric Haematology and Oncology (AIEOP), which has kept records of all demographic and clinical data in the database of Mod.1.01 Registry since 1989. Methods We used the information stored in the already mentioned database to assess the impact of immigration of foreign children with cancer on centres' activity, with the scope of drawing a map of the assistance to these cases. Results Out of 14,738 cases recorded by all centres in the period from 1999 to 2008, 92.2% were born and resident in Italy, 4.1% (608) were born abroad and living abroad and 3.7% (538) were born abroad and living in Italy. Foreign children cases have increased over the years from 2.5% in 1999 to. 8.1% in 2008. Most immigrant children came from Europe (65.7%), whereas patients who came from America, Asia and Oceania amounted to 13.2%, 10.1%, 0.2%, respectively. The immigrant survival rate was lower compared to that of children who were born in Italy. This is especially true for acute lymphoblastic leukaemia patients entered an AIEOP protocol, who showed a 10-years survival rate of 71.0% vs. 80.7% (p < 0.001) for immigrants and patients born in Italy, respectively. Conclusions Children and adolescents are an increasingly important part of the immigration phenomenon, which occurs in many parts of the world. In Italy the vast majority of children affected by malignancies are treated in AIEOP centres. Since immigrant children are predominantly treated in northern Italy, these centres have developed a special expertise in treating immigrant patients, which is certainly very useful for the entire AIEOP network. PMID:21923939

  17. Phase III Randomized Study of 4 Weeks of High-Dose Interferon-α-2b in Stage T2bNO, T3a-bNO, T4a-bNO, and T1-4N1a-2a (microscopic) Melanoma: A Trial of the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Cancer Research Group (E1697).

    PubMed

    Agarwala, Sanjiv S; Lee, Sandra J; Yip, Waiki; Rao, Uma N; Tarhini, Ahmad A; Cohen, Gary I; Reintgen, Douglas S; Evans, Terry L; Brell, Joanna M; Albertini, Mark R; Atkins, Michael B; Dakhil, Shaker R; Conry, Robert M; Sosman, Jeffrey A; Flaherty, Lawrence E; Sondak, Vernon K; Carson, William E; Smylie, Michael G; Pappo, Alberto S; Kefford, Richard F; Kirkwood, John M

    2017-03-10

    Purpose To test the efficacy of 4 weeks of intravenous (IV) induction with high-dose interferon (IFN) as part of the Eastern Cooperative Oncology Group regimen compared with observation (OBS) in patients with surgically resected intermediate-risk melanoma. Patients and Methods In this intergroup international trial, eligible patients had surgically resected cutaneous melanoma in the following categories: (1) T2bN0, (2) T3a-bN0, (3) T4a-bN0, and (4) T1-4N1a-2a (microscopic). Patients were randomly assigned to receive IFN α-2b at 20 MU/m(2)/d IV for 5 days (Monday to Friday) every week for 4 weeks (IFN) or OBS. Stratification factors were pathologic lymph node status, lymph node staging procedure, Breslow depth, ulceration of the primary lesion, and disease stage. The primary end point was relapse-free survival. Secondary end points included overall survival, toxicity, and quality of life. Results A total of 1,150 patients were randomly assigned. At a median follow-up of 7 years, the 5-year relapse-free survival rate was 0.70 (95% CI, 0.66 to 0.74) for OBS and 0.70, (95% CI, 0.66 to 0.74) for IFN ( P = .964). The 5-year overall survival rate was 0.83 (95% CI, 0.79 to 0.86) for OBS and 0.83 (95% CI, 0.80 to 0.86) for IFN ( P = .558). Treatment-related grade 3 and higher toxicity was 4.6% versus 57.9% for OBS and IFN, respectively ( P < .001). Quality of life was worse for the treated group. Conclusion Four weeks of IV induction as part of the Eastern Cooperative Oncology Group high-dose IFN regimen is not better than OBS alone for patients with intermediate-risk melanoma as defined in this trial.

  18. A Study of Layered Learning in Oncology

    PubMed Central

    Buie, Larry W.; Lyons, Kayley; Rao, Kamakshi; Pinelli, Nicole R.; McLaughlin, Jacqueline E.; Roth, Mary T.

    2016-01-01

    Objective. To explore use of pharmacy learners as a means to expand pharmacy services in a layered learning practice model (LLPM), to examine whether an LLPM environment precludes achievement of knowledge-based learning objectives, and to explore learner perception of the experience. Design. An acute care oncology pharmacy practice experience was redesigned to support the LLPM. Specifically, the redesign focused on micro discussion, standardized feedback (eg, rubrics), and cooperative learning to enhance educational gain through performing clinical activities. Assessment. Posttest scores evaluating knowledge-based learning objectives increased in mean percentage compared to pretest values. Learners viewed the newly designed practice experience positively with respect to perceived knowledge attainment, improved clinical time management skills, contributions to patient care, and development of clinical and self-management skills. A fifth theme among students, comfort with learning, was also noted. Conclusion. Layered learning in an oncology practice experience was well-received by pharmacy learners. Data suggest a practice experience in the LLPM environment does not preclude achieving knowledge-based learning objectives and supports further studies of the LLPM. PMID:27293235

  19. Clinical trials of interventional oncology.

    PubMed

    Arai, Yasuaki

    2012-08-01

    Interventional oncology has great potential to be a good treatment modality in the field of oncology, because its procedures are minimally invasive and fairly quick. However, except for a few procedures such as percutaneous radiofrequency ablation and trans-catheter arterial chemo-embolization that have been recognized as standard treatments for hepatocellular carcinoma, most procedures have not been established as the standard treatment modality due to the limited number of clinical trials with compelling evidence. There are several common problems when performing clinical trials of interventional oncology. The first is that the outcomes of clinical trials are greatly influenced by the level of technical skill of the physicians. The second is that equipment and devices vary widely in countries and regions, and they also influence the outcomes. The third is that the methodology of clinical trials for techniques such as interventional oncology has not yet been established. The fourth is the difficulty of setting appropriate endpoints; quality of life is suitable for evaluating interventional oncology in palliative care, but it is not easy to set as the endpoint. The fifth is the difficulty of employing a blinded design, because the procedure cannot be performed without the physician's awareness. Despite such difficult situations, many multi-institutional clinical trials of interventional oncology have been carried out in Japan, with some challenging results. Establishing evidence is critical to making interventional oncology the standard treatment. Interventional radiologists should know the importance of clinical trials, and should move ahead in this direction in a step-by-step manner.

  20. Perceived roles of oncology nursing.

    PubMed

    Lemonde, Manon; Payman, Naghmeh

    2015-01-01

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

  1. Outpatient therapeutic nuclear oncology.

    PubMed

    Turner, J Harvey

    2012-05-01

    In the beginning, nuclear medicine was radionuclide therapy, which has evolved into molecular tumour-targeted control of metastatic cancer. Safe, efficacious, clinical practice of therapeutic nuclear oncology may now be based upon accurate personalised dosimetry by quantitative gamma SPECT/CT imaging to prescribe tumoricidal activities without critical organ toxicity. Preferred therapy radionuclides possess gamma emission of modest energy and abundance to enable quantitative SPECT/CT imaging for calculation of the beta therapy dosimetry, without radiation exposure risk to hospital personnel, carers, family or members of the public. The safety of outpatient radiopharmaceutical therapy of cancer with Iodine-131, Samarium-153, Holmium-166, Rhenium-186, Rhenium-188, Lutetium-177 and Indium-111 is reviewed. Measured activity release rates and radiation exposure to carers and the public are all within recommendations and guidelines of international regulatory agencies and, when permitted by local regulatory authorities allow cost-effective, safe, outpatient radionuclide therapy of cancer without isolation in hospital.

  2. Radiation oncology (Vol. 2)

    SciTech Connect

    Phillips, T.L.; Wara, W.

    1987-01-01

    This volume of the Radiation Oncology series features update reports on the current status of primary therapy for lung cancer and the role of radiation therapy in the treatment of hepatomas. Other articles describe the use of stereotaxic interstitial implantation in the treatment of malignant brain tumors and discuss the indications for and results of radiation as the primary or adjuvant treatment of large bowel cancer. Reports on new technological developments examine the biological basis and clinical potential of local-regional hyperthermia and photodynamic therapy. Included are reviews of the role of magnetic resonance imaging in the diagnostic evaluation of cancer and of three-dimensional treatment planning for high energy external beam radiotherapy.

  3. [Dermato-oncological rehabilitation].

    PubMed

    Buhles, N; Sander, C

    2005-07-01

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

  4. Nuclear medicine in oncology

    SciTech Connect

    Murphy, J.

    1996-12-31

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

  5. Computed Tomography Imaging in Oncology.

    PubMed

    Forrest, Lisa J

    2016-05-01

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

  6. [Oncologic gynecology and the Internet].

    PubMed

    Gizler, Robert; Bielanów, Tomasz; Kulikiewicz, Krzysztof

    2002-11-01

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

  7. Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update.

    PubMed

    Recht, Abram; Comen, Elizabeth A; Fine, Richard E; Fleming, Gini F; Hardenbergh, Patricia H; Ho, Alice Y; Hudis, Clifford A; Hwang, E Shelley; Kirshner, Jeffrey J; Morrow, Monica; Salerno, Kilian E; Sledge, George W; Solin, Lawrence J; Spears, Patricia A; Whelan, Timothy J; Somerfield, Mark R; Edge, Stephen B

    A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT).

  8. Imaging Opportunities in Radiation Oncology

    SciTech Connect

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

    2011-02-01

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

  9. Imaging opportunities in radiation oncology.

    PubMed

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

    2011-02-01

    Interdisciplinary efforts may significantly affect the way that clinical knowledge and scientific research related to imaging impact the field of Radiation Oncology. This report summarizes the findings of an intersociety workshop held in October 2008, with the express purpose of exploring "Imaging Opportunities in Radiation Oncology." Participants from the American Society for Radiation Oncology (ASTRO), National Institutes of Health (NIH), Radiological Society of North America (RSNA), American Association of physicists in Medicine (AAPM), American Board of Radiology (ABR), Radiation Therapy Oncology Group (RTOG), European Society for Therapeutic Radiology and Oncology (ESTRO), and Society of Nuclear Medicine (SNM) discussed areas of education, clinical practice, and research that bridge disciplines and potentially would lead to improved clinical practice. Findings from this workshop include recommendations for cross-training opportunities within the allowed structured of Radiology and Radiation Oncology residency programs, expanded representation of ASTRO in imaging related multidisciplinary groups (and reciprocal representation within ASTRO committees), increased attention to imaging validation and credentialing for clinical trials (e.g., through the American College of Radiology Imaging Network (ACRIN)), and building ties through collaborative research as well as smaller joint workshops and symposia. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Haemato-oncology and burnout: an Italian survey

    PubMed Central

    Bressi, C; Manenti, S; Porcellana, M; Cevales, D; Farina, L; Felicioni, I; Meloni, G; Milone, G; Miccolis, I R; Pavanetto, M; Pescador, L; Poddigue, M; Scotti, L; Zambon, A; Corrao, G; Lambertenghi-Deliliers, G; Invernizzi, G

    2008-01-01

    This cross-sectional survey aimed to evaluate the prevalence of burnout and estimated psychiatric disorders among haemato-oncology healthcare professionals in Italy. The aspects of work that respondents perceive as stressful and satisfying have also been examined. The assessments were made using the Maslach Burnout Inventory (MBI), General Health Questionnaire and a study-specific questionnaire. Logistic regression models were applied to show associations between different sources of work-related stress and burnout. Three hundred and eighty-seven out of 440 (87.95%) returned their questionnaires. The scores on MBI subscales indicate a high level of emotional exhaustion in 32.2% of the physicians and 31.9% of the nurses; a high level of Depersonalisation in 29.8 and 23.6%, respectively; and a low level of personal accomplishment in 12.4 and 15.3% respectively. The estimated prevalence of psychiatric disorders was 36.4% in physicians and 28.8% in nurses. Statistical analysis confirmed age, sex, personal dissatisfaction, physical tiredness and working with demanding patients to be associated with burnout. In conclusion, haemato-oncology healthcare professionals report a level of burnout and estimated psychiatric morbidity comparable to other oncological areas. Knowledge of the mechanisms of burnout and preventing and dealing with them is therefore a fundamental requirement for the improvement of quality in health services and job satisfaction. PMID:18283310

  11. The actual citation impact of European oncological research.

    PubMed

    López-Illescas, Carmen; de Moya-Anegón, Félix; Moed, Henk F

    2008-01-01

    This study provides an overview of the research performance of major European countries in the field Oncology, the most important journals in which they published their research articles, and the most important academic institutions publishing them. The analysis was based on Thomson Scientific's Web of Science (WoS) and calculated bibliometric indicators of publication activity and actual citation impact. Studying the time period 2000-2006, it gives an update of earlier studies, but at the same time it expands their methodologies, using a broader definition of the field, calculating indicators of actual citation impact, and analysing new and policy relevant aspects. Findings suggest that the emergence of Asian countries in the field Oncology has displaced European articles more strongly than articles from the USA; that oncologists who have published their articles in important, more general journals or in journals covering other specialties, rather than in their own specialist journals, have generated a relatively high actual citation impact; and that universities from Germany, and--to a lesser extent--those from Italy, the Netherlands, UK, and Sweden, dominate a ranking of European universities based on number of articles in oncology. The outcomes illustrate that different bibliometric methodologies may lead to different outcomes, and that outcomes should be interpreted with care.

  12. Micronutrients in Oncological Intervention

    PubMed Central

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

    2016-01-01

    Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%–90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that treatment is tolerated better—with an increase in patient compliance and a lower rate of treatment discontinuations—when micronutrients, such as selenium, are added as appropriate to the patient’s medication. Nutritional supplementation tailored to an individual’s background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician. PMID:26985904

  13. Micronutrients in Oncological Intervention.

    PubMed

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

    2016-03-12

    Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%-90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that treatment is tolerated better-with an increase in patient compliance and a lower rate of treatment discontinuations-when micronutrients, such as selenium, are added as appropriate to the patient's medication. Nutritional supplementation tailored to an individual's background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician.

  14. [Unproven methods in oncology].

    PubMed

    Jallut, O; Guex, P; Barrelet, L

    1984-09-08

    As in some other chronic diseases (rheumatism, multiple sclerosis, etc.), unproven methods of diagnosis and treatment have long been current in cancer. Since 1960 the American Cancer Society has published an abundant literature on these "unproven methods", which serves as a basis for a historical review: some substances (Krebiozen, Laetrile) have enjoyed tremendous if shortlived success. The present trend is back to nature and "mild medicine". The proponents of this so-called natural medicine are often disciples of a pseudoscientific religion using irrational arguments. Direct attacks on these erroneous theories and their public refutation fail to convince the adepts, who trust in these methods and are not amenable to a scientific approach. Study of their psychological motivations reveals that in fact they seek something more reassuring than plain medical explanation which is aware of its limits. They feel reassured by theories which often bear some resemblance to the old popular medicine. To protect patients against these dangerous methods and all the disillusionment they entail, the Swiss Society of Oncology and the Swiss Cancer League have decided to gather information and draw up a descriptive list of the commonest unproven methods in Switzerland (our File No. 2, "Total anti-cancer cure", is given as an example). The files are published in French, German and English and are available to physicians, nursing teams, and also patients who wish to have more objective information on these methods.

  15. [Economic limits in oncology].

    PubMed

    Hellriegel, K P

    2000-12-01

    Economic aspects require consideration even in oncology. However, they have to be seen in context with open questions concerning especially the evaluation of therapeutic effectiveness, of methodology, and particularly of ethics. Medical procedures and achievements should primarily be measured against objective results, against effectiveness and benefits. Consequently, the suitability of diagnostic and therapeutic strategies has to be evaluated. Overall objective of medical achievements should be their optimalization, not their maximization. For a physician being aware of his responsibility, the optimal care for his patients always has highest priority. Medical guidelines for diagnosis, treatment and follow-up are the basis for effective and economic patient care. They have to undergo economic evaluation and permanent updating. For systematic collection, documentation and evaluation, the clinical register is the appropriate instrument. For the assessment of medical care, a continuous monitoring of its processes has to be established. The documentation of medical care processes should lead to sustainable cost reductions together with an optimalization of the quality of care.

  16. Counseling in Italy

    ERIC Educational Resources Information Center

    Remley, Theodore P.; Bacchini, Eugenio; Krieg, Paul

    2010-01-01

    The counseling profession in Italy is in an early stage of development. No university preparation programs exist, and counselors are not employed in schools. Counselors maintain private practices, work in agencies, and are employed by the government. Counselors receive their preparation in Italy from professional associations in programs that…

  17. Knowledge and attitudes about cancer pain management: a national survey of Italian oncology nurses.

    PubMed

    Bernardi, Matteo; Catania, Gianluca; Lambert, Annie; Tridello, Gloria; Luzzani, Massimo

    2007-07-01

    The purpose of this study was to obtain information about the knowledge and attitudes of Italian oncology nurses concerning cancer pain management and to determine the predictors of nurses' pain management knowledge. The study was a nationwide descriptive survey and included 287 nurses in Italy from 21 oncology wards in the north, center and south of Italy. The Nurses' Knowledge and Attitudes Survey (Italian version) and a background information form were used to collect the data. Knowledge and attitudes regarding cancer pain were the main research variables. Among the 39 pain knowledge questions assessed, the mean number of correctly answered question was 21.4 (SD=5.5), with a range of 6-35. The correct answer rate for the entire scale, on average, was 55% (SD=25.9). Further analysis of items showed that more than 50% of oncology nurses underestimated the patients' pain and they did not treat it in the correct way; they also had an incorrect self-evaluation about their pain management knowledge. Results from stepwise regression showed that nurses with higher mean correct answer scores had attended more courses about pain education. There are still significant knowledge deficits and erroneous beliefs that may hamper treatment of oncology patients in pain. The results of this study could be useful to institutions involved in patient care and teaching of pain management.

  18. The Globalization of Cooperative Groups.

    PubMed

    Valdivieso, Manuel; Corn, Benjamin W; Dancey, Janet E; Wickerham, D Lawrence; Horvath, L Elise; Perez, Edith A; Urton, Alison; Cronin, Walter M; Field, Erica; Lackey, Evonne; Blanke, Charles D

    2015-10-01

    The National Cancer Institute (NCI)-supported adult cooperative oncology research groups (now officially Network groups) have a longstanding history of participating in international collaborations throughout the world. Most frequently, the US-based cooperative groups work reciprocally with the Canadian national adult cancer clinical trial group, NCIC CTG (previously the National Cancer Institute of Canada Clinical Trials Group). Thus, Canada is the largest contributor to cooperative groups based in the United States, and vice versa. Although international collaborations have many benefits, they are most frequently utilized to enhance patient accrual to large phase III trials originating in the United States or Canada. Within the cooperative group setting, adequate attention has not been given to the study of cancers that are unique to countries outside the United States and Canada, such as those frequently associated with infections in Latin America, Asia, and Africa. Global collaborations are limited by a number of barriers, some of which are unique to the countries involved, while others are related to financial support and to US policies that restrict drug distribution outside the United States. This article serves to detail the cooperative group experience in international research and describe how international collaboration in cancer clinical trials is a promising and important area that requires greater consideration in the future.

  19. The Globalization of Cooperative Groups

    PubMed Central

    Valdivieso, Manuel; Corn, Benjamin W.; Dancey, Janet E.; Wickerham, D. Lawrence; Horvath, L. Elise; Perez, Edith A.; Urton, Alison; Cronin, Walter M.; Field, Erica; Lackey, Evonne; Blanke, Charles D.

    2015-01-01

    The National Cancer Institute-supported adult cooperative oncology research groups (now officially Network groups) have a long-standing history of participating in international collaborations throughout the world. Most frequently, the U.S. based cooperative groups work reciprocally with the Canadian national adult cancer clinical trial group, NCIC CTG (previously the National Cancer Institute of Canada Clinical Trials Group). Thus, Canada is the largest contributor to cooperative groups based in the U.S., and vice versa. Although international collaborations have many benefits, they are most frequently utilized to enhance patient accrual to large phase III trials originating in the U.S. or Canada. Within the cooperative group setting, adequate attention has not been given to the study of cancers that are unique to countries outside the U.S. and Canada, such as those frequently associated with infections in Latin America, Asia and Africa. Global collaborations are limited by a number of barriers, some of which are unique to the countries involved, while others are related to financial support and to U.S. policies that restrict drug distribution outside the U.S. This manuscript serves to detail the cooperative group experience in international research and describe how international collaboration in cancer clinical trials is a promising and important area that requires greater consideration in the future. PMID:26433551

  20. Oocyte cryopreservation in oncological patients.

    PubMed

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

    2004-04-05

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

  1. Integrative oncology imperative for nurses.

    PubMed

    Bauer-Wu, Susan; Decker, Georgia M

    2012-02-01

    To provide an overview of key issues and resources related to complementary and alternative medical (CAM) and integrative approaches in cancer care. Peer-reviewed publications and web sites of professional, federal, and academic institutions and organizations. The field of integrative oncology is growing and research evidence in this area is burgeoning. Many cancer patients are using and can benefit from CAM. There are many resources and educational opportunities available to oncology nurses to enhance their CAM knowledge and skills. Nurses must keep abreast of the growing evidence in integrative oncology that documents the safety and efficacy of different CAM approaches for cancer patients. It is critical that nurses be aware of reputable resources and legal implications related to use of CAM. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Ethical issues in integrative oncology.

    PubMed

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

    2008-08-01

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

  3. Emergencies in Hematology and Oncology.

    PubMed

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

    2017-04-01

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

  4. Tissue Microarrays in Clinical Oncology

    PubMed Central

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

    2008-01-01

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

  5. Comprehensive Oncologic Emergencies Research Network (CONCERN)

    Cancer.gov

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

  6. Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists.

    PubMed

    Jonker, J M; Smorenburg, C H; Schiphorst, A H; van Rixtel, B; Portielje, J E A; Hamaker, M E

    2014-11-01

    To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel.

  7. Reconstruction of Peripelvic Oncologic Defects.

    PubMed

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

    2017-10-01

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

  8. [Vitamins and Minerals in Oncology].

    PubMed

    Holch, Julian Walter; Michl, Marlies; Heinemann, Volker; Erickson, Nicole

    2017-06-01

    The use of vitamins and minerals to prevent cancer as well as their supportive use in oncological patients is widespread and often occurs without the knowledge of the treating physician. Beyond general recommendations with regard to a balanced and healthy diet, no evidence exists supporting the use of vitamins and minerals in the prevention of cancer. Furthermore, the diet of oncological patients should contain vitamins and minerals of the same quantity as for healthy individuals. In particular, there is currently no rationale for a high-dosage administration of antioxidants. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Design of oncology clinical trials: a review.

    PubMed

    Ananthakrishnan, Revathi; Menon, Sandeep

    2013-10-01

    Cancer is a disease that occurs due to the uncontrolled multiplication of cells that invade nearby tissues and can spread to other parts of the body. An increased incidence of cancer in the world has led to an increase in oncology research and in the number of oncology trials. Well designed oncology clinical trials are a key part of developing effective anti-cancer drugs. This review focuses on statistical considerations in the design and analysis of oncology clinical trials.

  10. Advances in Statistical Approaches Oncology Drug Development

    PubMed Central

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

    2014-01-01

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

  11. Area Handbook Series: Italy, A Country Study,

    DTIC Science & Technology

    1985-09-01

    Italian alliance system. After the collapse of the Medici seigniory. the allies in the Italian League renewed their incessant fighting, leaving Italy...extinction (i’ the Medici f’aily [it 1737T. I i had becomne a tributary of the con~sort of’ thle A uitrini elip r--. 111, D~uchy of’ IlaI now under anl...that have been formed to fight pollution, drugs , or destruction of monu- ments and of cooperatives in villages that had no ,uch problems 14 years

  12. Influenza vaccination among the elderly in Italy.

    PubMed Central

    Pregliasco, F.; Sodano, L.; Mensi, C.; Selvaggi, M. T.; Adamo, B.; D'Argenio, P.; Giussani, F.; Simonetti, A.; Carosella, M. R.; Simeone, R.; Dentizi, C.; Montanaro, C.; Ponzio, G.

    1999-01-01

    This article surveys the attitudes and perceptions of a random sample of the elderly population in three regions of Italy on the use and efficacy of influenza vaccine. The data were collected by direct interviews using a standard questionnaire. The results show that vaccination coverage against influenza is inadequate (26-48.6%). The major reasons for nonvaccination were lack of faith in the vaccine and disbelief that influenza is a dangerous illness. These data emphasize the need for a systematic education programme targeted at the elderly and the provision of influenza vaccination, with the increased cooperation of general practitioners. PMID:10083710

  13. Cooperative Networks

    DTIC Science & Technology

    2009-02-23

    than the traditional direct transmission and full cooperation schemes. B. OFDM-Based Cooperation Relay and Subchannel Assignment and Combining We... subchannel assignment and combining schemes. Based on the amount of CSI, resources, such as subchannels , can be allocated to relays to improve the end-to-end...relay node uses the same subchannel to relay the information transmitted by the source node. To further improve the performance gain, subchannel

  14. [Knowledge, experience and attitudes of laymen in oncological health services].

    PubMed

    Feith, Helga Judit; Szőke, Andrea; Ábrám, Boróka; Tóth, Erika

    2016-08-01

    There is much less emphasis on the survey of the laymen's attitudes towards their awareness of patients' rights and organization of care, and cooperation. The most important goal of this niche study was to explore how much laymen know about the organization of care and to assess their attitudes when they are under oncological care. Data collection was completed in outpatient oncology departments in two different hospitals treating high number of patients (n = 271). 26.1% of the respondents did not collect further information about their supposed disease. 69.0% thought that the pathologist deals exclusively with the dead or did not know what their duties are. Only 39.7% of the respondents indicated that the pathologist plays a role in the diagnostic process of cancers. The latter two findings were not influenced by the respondents' level of education. There is a clear evidence that the majority of the respondents were not familiar with the organisationof the care in oncology and, depending on the level of their education, a high percentage does not even want to learn about it at all. The authors propose that informing the layman would lead to a higher quality of patient care, and consequently to greater patient safety. Orv. Hetil., 2016, 157(33), 1314-1319.

  15. Charting the Future of Cancer Health Disparities Research: A Position Statement from the American Association of Cancer Research, the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute

    Cancer.gov

    The American Association for Cancer Research, American Cancer Society, American Society of Clinical Oncology, and NCI present a unified strategy to promote cooperation in all areas of the cancer health disparities research community.

  16. Pulkovo cooperation of optical observers

    NASA Astrophysics Data System (ADS)

    Molotov, I.; Abalakin, V. K.; Titenko, V.; , Pozanenko A.; Dorokhova, T. N.; Guseva, I.; Ibragimov, M.; Sukhov, P. P.; Rozales, R.; Mukhamednazarov, S.; Gulyamov, M.; Lupishko, D.; Kiladze, R.; Sochilina, A.; Marshalkina, A.; Khutorovskiy, Z.; Arkharov, A. A.; Korniyenko, G.; Yerofeyeva, A.

    2005-01-01

    Under the new organization is the cooperation of optical observatory space debris, asteroids and gamma-ray bursts. Currently, with the cooperation of the Pulkovo optical observers (PulKON) collaborate 14 points in Russia, Ukraine, Uzbekistan, Tajikistan, Turkmenistan, Italy, Spain and Bolivia. Regular observations are in Pulkovo, Ussuriisk, Nauchnom, Mayaki and Chuguev. Test observations commenced or will commence in 2005 in Campo Imperatore, Tarija, Maidanak Abastumani Dushak, Kislovodsk and Hissar. For two grants (Ministry of Education and Science of the Russian Federation and INTAS) in step 8 is planned to purchase modern CCDs for re telescopes operating at target indications PulKON and the Centre for collecting and processing information on Space Debris at IPM of Keldysh RAS.

  17. Biogerontology in Italy.

    PubMed

    Odetti, Patrizio; Bergamini, Ettore

    2011-02-01

    In this paper experimental gerontology in Italy is reviewed on the basis of research developed in Academic and non Academic Centres. There are several groups across Italy working actively on basic science of aging producing high impact papers with a significant contribution to biogerontology. Some distinguished Italian scientist working abroad is also mentioned. Interesting issues on longevity and interventions on aging (including caloric restriction) and on aging brain are quoted. Relevant studies encompass the (glyco-)oxidative stress as direct damage mechanism and main process of theory of aging, other research lines include IGF-1, mitochondria DNA, obesity/sarcopenia and exercise and also an animal model for aging studies is reported. Notwithstanding financial restrictions and structure deficit the biogerontology research in Italy could be judged as good, but additional resources are necessary to keep this good rank.

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

    PubMed

    Riskó, Ágnes

    2015-09-01

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

  19. Future of oncologic photodynamic therapy.

    PubMed

    Allison, Ron R; Bagnato, Vanderlei S; Sibata, Claudio H

    2010-06-01

    Photodynamic therapy (PDT) is a tumor-ablative and function-sparing oncologic intervention. The relative simplicity of photosensitizer application followed by light activation resulting in the cytotoxic and vasculartoxic photodynamic reaction has allowed PDT to reach a worldwide audience. With several commercially available photosensitizing agents now on the market, numerous well designed clinical trials have demonstrated the efficacy of PDT on various cutaneous and deep tissue tumors. However, current photosensitizers and light sources still have a number of limitations. Future PDT will build on those findings to allow development and refinement of more optimal therapeutic agents and illumination devices. This article reviews the current state of the art and limitations of PDT, and highlight the progress being made towards the future of oncologic PDT.

  20. [Oncological data elements in histopathology].

    PubMed

    Haroske, G; Kramm, T; Mörz, M; Oberholzer, M

    2010-09-01

    In order to cope with increasing demands to supply information to a variety of documentation systems outside pathology, pathologists need to set standards both for the content and the use of the information they generate. Oncological datasets based on a set vocabulary are urgently required for use both in pathology and in further processing. Data elements were defined according to German pathology report guidelines for colorectal cancers in line with ISO 11179 requirements for the relations between data element concepts and value domains, as well as for further formal conditions, which can be exported in XML together with metadata information. Tests on 100 conventionally written diagnoses showed their principal usability and an increasing degree of guideline conformity in diagnoses commensurate with training time. This set of oncological data elements is a valuable checklist tool for pathologists, enabling formatted information export for further use and saving documentation effort.

  1. Oncology pain and complementary therapy.

    PubMed

    Running, Alice; Turnbeaugh, Elizabeth

    2011-08-01

    Half of all patients with cancer experience some level of pain, so pain management is an important topic for oncology nurses. Pharmacologic measures traditionally are the primary intervention for bone, visceral, neuropathic, and procedural pain; however, many patients are turning to an integrative approach of Western and complementary therapies for pain and symptom management. The authors explored the current evidence concerning the effectiveness of complementary therapies in relation to cancer pain and symptom control.

  2. Mentoring future Kenyan oncology researchers

    PubMed Central

    2013-01-01

    This is a summary of the 1st Academic Model Providing Access to Healthcare (AMPATH) Oncology Institute research grant writing workshop organized in collaboration with the Kenya Medical Research Institute (KEMRI) and held in Kisumu, Kenya from January 16th to 18th, 2013. The goal of this meeting was to mentor future Kenyan scientists and prioritize research topics that would lead to improved cancer care and survival for the citizens of Kenya. PMID:24099090

  3. Religious slaughter in Italy.

    PubMed

    Cenci-Goga, B T; Mattiacci, C; De Angelis, G; Marini, P; Cuccurese, A; Rossi, R; Catanese, B

    2010-06-01

    This research aims to understand the prevalence of religious slaughter practices in Italy. Two different ways of slaughtering animals are identified. Conventional slaughter is performed with prior stunning; kosher slaughter is practiced without stunning. Halal slaughter is performed for most animals without stunning. Halal slaughter with prior stunning is acceptable for 5.90% of small ruminants. For Halal slaughter in Italy, the terms "religious slaughter with stunning" and "religious slaughter without stunning" should be used to differentiate religious slaughter practices, keeping animal welfare in perspective.

  4. Integrative oncology in North America.

    PubMed

    Sagar, Stephen M

    2006-01-01

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

  5. Advancing performance measurement in oncology.

    PubMed

    Campion, Francis X; Larson, Leanne R; Kadlubek, Pamela J; Earle, Craig C; Neuss, Michael N

    2011-05-01

    The American healthcare system, including the cancer care system, is under pressure to improve patient outcomes and lower the cost of care. Government payers have articulated an interest in partnering with the private sector to create learning communities to measure quality and improve the value of healthcare. In 2006, the American Society of Clinical Oncology (ASCO) unveiled the Quality Oncology Practice Initiative (QOPI), which has become a key component of the measurement system to promote quality cancer care. QOPI is a physician-led, voluntary, practice-based, quality-improvement program, using performance measurement and benchmarking among oncology practices across the United States. Since its inception, ASCO's QOPI has grown steadily to include 973 practices as of November 2010. One key area that QOPI has addressed is end-of-life care. During the most recent data collection cycle in the fall of 2010, those practices completing multiple data collection cycles had better performance on care of pain compared with sites participating for the first time (62.61% vs 46.89%). Similarly, repeat QOPI participants demonstrated meaningfully better performance than their peers in the rate of documenting discussions of hospice and palliative care (62.42% vs 54.65%) and higher rates of hospice enrollment. QOPI demonstrates how a strong performance measurement program can lead to improved quality and value of care for patients.

  6. Oncological resource allocation in Germany.

    PubMed

    Hartmann, Michael; Kath, Roland; Gundermann, Christin

    2008-03-01

    Oncology is a resource-intensive medical discipline where, so far, effectiveness rather than efficiency of a treatment has stood in the foreground. The aim of our study was, therefore, to determine the resource allocation and to assess the efficiency of oncology in Germany for the period of 2002-2004. With the aid of the official German Health Report, the expenditures for health in 2004 and the gain in years of life according to ICD 10 disease categories were analyzed. Based on the incremental costs and years of life gained, the cost calculation per year of life gained was made. Malignant neoplasms appear in 5th place in health expenditures at a cost of 15 billion 1. With costs per year of life gained of 140,750 1, malignant neoplasms range ahead of respiratory diseases (52,500 1)digestive diseases (27,455 1), and injuries (14,538 1). Costs involving malignant neoplasm per year of life gained range between 39,000 1(malignancies of the lip, oral cavity, and the pharynx), and 126,000 1(digestive organ cancer). In Germany, oncology incurs higher costs per year of life gained as compared to several other diseases. Also, in malignant neoplasm considerable differences can be observed regarding resource allocation and efficiency. (c) 2008 S. Karger AG, Basel.

  7. Orthodontic treatment in oncological patients.

    PubMed

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

    2015-01-01

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

  8. Making Cooperative Learning Work.

    ERIC Educational Resources Information Center

    Johnson, David W.; Johnson, Roger T.

    1999-01-01

    Discusses the importance of cooperative learning, focusing on what is and is not a cooperative effort; types of cooperative learning; an example of integrated use of cooperative learning; cooperative schools; basic elements of cooperation; and what is known about cooperative efforts (related to achievement, interpersonal relationship, and…

  9. [Definition and outline on geriatric oncology].

    PubMed

    Terret, C; Droz, J-P

    2009-11-01

    Geriatric oncology is the concept for management of elderly cancer patients. It is an equal approach of the health status problems and of cancer in a patient considered as a whole. Therefore it is not a subspecialty but a practice which can be translated in the elderly cancer patient's care. The treatment of cancer is based on the same principles than this of younger patients; recommendations used are those of the scientific oncological societies. Health problems of elderly patients are screened by specific tools. Patients without major health problems are managed by the oncological team in the routine; those for whom screening have demonstrated problems are first evaluated in the geriatrics setting and then oncological decisions are adapted to the patient situation. Decisions are made in specific geriatric oncology conferences. Specific clinical trials are required to build an Evidence Based Medicine background. Geriatric oncology teaching programs are warranted.

  10. World gynecologic oncology publications and the Turkish contribution to the literature between 2000 and 2007.

    PubMed

    Dursun, Polat; Gultekin, Murat; Ayhan, Ali

    2011-01-01

    To investigate the number of publications and the contribution from top-ranking countries, institutions, and authors in 3 gynecologic oncology journals (Gynecologic Oncology [GO], International Journal of Gynecological Cancer [IJGC], and European Journal of Gynaecological Oncology [EJGO]),as well as the degree of Turkish contribution between 2000 and 2007. Articles published between 2000 and 2007 in 3 gynecologic oncology journals indexed by the Science Citation Index were accessed via the ISI-Thomson website. Additionally, PubMed, Sciencedirect, and Blackwell-Synergy databases were used to identify the originating countries and institutions of the published articles. The types of articles, originating countries, and names of the institutions and authors were determined. Furthermore, the number of articles affiliated with Turkish institutions and the publication year were also determined. We located 6,851 articles published in the 3 journals. During this period 36.1%, 7.7%, 7.2%, 5.8% and 4.8% of the papers originated from the USA, Japan, Italy, Turkey, and England, respectively. The 5 most productive institutions were the University of Texas, Memorial Sloan-Kettering Cancer Center, Roswell Park Cancer Institute, University of Alabama, and University of Athens. The 5 most productive authors were Markman (USA), Chi (USA), Ayhan (Turkey), Barakat (USA), and Vergote (Belgium), respectively. In all, 36.1% of the papers originated from the USA, while 44% originated from 17 European countries. The USA was the first-ranked country of origin in GO and IJGC, while Turkey was the first-ranked country of origin in EJGO. Overall, 399 (5.8%) papers originated from Turkish institutions. Most of the gynecologic oncology publications originated from the USA and Western European countries, where gynecologic oncology training is available and surgical and research traditions are well established. On the other hand, Turkish researchers made an important contribution to gynecologic

  11. Teacher Cooperatives

    ERIC Educational Resources Information Center

    Hawkins, Beth

    2009-01-01

    Twenty years ago, when the late Albert Shanker endorsed the notion of innovative schools operating outside conventional district bureaucracies, his aim was to put teachers at the helm. Today there are nearly 80 teacher-governed charter schools around the country. Although most are legally constituted as worker cooperatives, they better resemble…

  12. Teacher Cooperatives

    ERIC Educational Resources Information Center

    Hawkins, Beth

    2009-01-01

    Twenty years ago, when the late Albert Shanker endorsed the notion of innovative schools operating outside conventional district bureaucracies, his aim was to put teachers at the helm. Today there are nearly 80 teacher-governed charter schools around the country. Although most are legally constituted as worker cooperatives, they better resemble…

  13. Cooperative Education.

    ERIC Educational Resources Information Center

    Brown, Robert L.

    Cooperative education involves on-campus instruction and off-campus work experience. These programs can be referred to as work study, field work, or work experience. The student has the advantage of applying his knowledge in a work situation; the college gains financial benefits; and the employer has the opportunity to influence the student to…

  14. Nursing's presence in the changing cooperative group setting.

    PubMed

    Kottschade, Lisa A; Bell, Jennifer; Klinger, Kathy; Smith, Ellen M Lavoie

    2014-02-01

    To describe the history of nurse-led contributions within three legacy cancer cooperative groups and the challenges and new opportunities faced by nurses with the merger of these three groups. Journal articles, government and special health reports. Recent changes in the cancer cooperative group have significantly altered the way cancer clinical trials will be conducted in the future. With recent federal funding cuts, three cooperative groups have merged in an effort to improve efficiency, while maintaining the quality and availability of clinical trials for patients with cancer. The group merger presented a unique opportunity to maintain and advance nursing's contribution to education, research, and practice within the cooperative group setting. As a result of merger, cooperative group nurses will expand their work to integrate oncology nursing practice within the alliance cooperative group's infrastructure, facilitating research and high-quality patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. African Trypanosomiasis Gambiense, Italy

    PubMed Central

    Beltrame, Anna; Monteiro, Geraldo; Arzese, Alessandra; Marocco, Stefania; Rorato, Giada; Anselmi, Mariella; Viale, Pierluigi

    2005-01-01

    African trypanosomiasis caused by Trypanosoma brucei gambiense has not been reported in Italy. We report 2 cases diagnosed in the summer of 2004. Theses cases suggest an increased risk for expatriates working in trypanosomiasis-endemic countries. Travel medicine clinics should be increasingly aware of this potentially fatal disease. PMID:16318728

  16. Personal Identity in Italy

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Rabaglietti, Emanuela; Sica, Luigia Simona

    2012-01-01

    This chapter discusses specifics of identity formation in Italian adolescents and emerging adults. We review consistent evidence illustrating that, in Italy, a progressive deferral of transition to adulthood strongly impacts youth identity development by stimulating identity exploration and postponement of identity commitments. We also consider…

  17. Personal Identity in Italy

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Rabaglietti, Emanuela; Sica, Luigia Simona

    2012-01-01

    This chapter discusses specifics of identity formation in Italian adolescents and emerging adults. We review consistent evidence illustrating that, in Italy, a progressive deferral of transition to adulthood strongly impacts youth identity development by stimulating identity exploration and postponement of identity commitments. We also consider…

  18. Occupational cancer in Italy.

    PubMed Central

    Merler, E; Vineis, P; Alhaique, D; Miligi, L

    1999-01-01

    This article is a discussion of occupational cancer in Italy. The introduction provides the necessary context of Italian industrialization and occupational health regulation. This is followed by a review of Italian epidemiologic studies of occupational cancer risks considered in terms of relative measures of risk and attributable risk of carcinogenic agents or exposure circumstances. We attempt to establish the number of workers exposed to carcinogens in Italy and the intensity of their exposures. Finally, the Italian system of compensation for occupational cancer is discussed. Several cohort and case-control studies have addressed the issue of occupational risks, mostly among male workers. The results of these studies suggest that the growing incidence of and mortality by mesothelioma is explained by the widespread and intense exposure to asbestos in some Italian industrial settings. A high attributable risk of lung tumors among male populations in industrial areas of northern Italy is explained by occupational exposures. However, insufficient data are available for clear definition of the extent and intensity of occupational exposure to carcinogenic substances. In Italy, we must prioritize and maximize resources in occupational cancer epidemiology and revitalize the role of national institutions. Recent legislation has established new regulations on the handling of carcinogenic substances in industrial settings, a new list of occupational diseases, and a national registry of mesothelioma linked to asbestos exposure. These legislative changes are expected to have positive effects. PMID:10350509

  19. Beginning Reading in Italy.

    ERIC Educational Resources Information Center

    Tutolo, Daniel

    Teaching practices in Italy, where teachers combine three different methods for teaching reading, may provide insight into ways to improve methodologies in the United States. The first method is the natural method, which, unlike American methods, teaches reading and writing simultaneously with the emphasis on writing. The teacher writes as…

  20. Bay of Naples, Italy

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The modern city of Naples (41.0N, 14.5E) and the ancient volcano of Mount Vesuvius on the shores of the Bay of Naples, Italy are the most striking features in this scene. The Roman city of Pompei, buried in the AD 79 volcano eruption can be seen on the coast just to the south of Vesuvius.

  1. Usutu Virus, Italy, 1996

    PubMed Central

    Bakonyi, Tamás; Rossi, Giacomo; Mani, Paolo; Nowotny, Norbert

    2013-01-01

    Retrospective analysis of archived tissue samples from bird deaths in the Tuscany region of Italy in 1996 identified Usutu virus. Partial sequencing confirmed identity with the 2001 Vienna strain and provided evidence for a much earlier introduction of this virus into Europe than previously assumed. PMID:23347844

  2. Beginning Reading in Italy.

    ERIC Educational Resources Information Center

    Tutolo, Daniel

    Teaching practices in Italy, where teachers combine three different methods for teaching reading, may provide insight into ways to improve methodologies in the United States. The first method is the natural method, which, unlike American methods, teaches reading and writing simultaneously with the emphasis on writing. The teacher writes as…

  3. Organisational design for an integrated oncological department

    PubMed Central

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

    2001-01-01

    Abstract Objective The outcomes of a Strength, Weakness, Opportunities and Threat (SWOT) analysis of three Integrated Oncological Departments were compared with their present situation three years later to define factors that can influence a successful implementation and development of an Integrated Oncological Department in- and outside (i.e. home care) the hospital. Research design Comparative Qualitative Case Study. Methods Auditing based on care-as-usual norms by an external, experienced auditing committee. Research setting Integrated Oncological Departments of three hospitals. Results Successful multidisciplinary care in an integrated, oncological department needs broad support inside the hospital and a well-defined organisational plan. PMID:16896411

  4. Imported leprosy in Italy.

    PubMed

    Massone, C; Brunasso, A M G; Noto, S; Campbell, T M; Clapasson, A; Nunzi, E

    2012-08-01

    Leprosy is far from being eliminated with more than 200,000 new cases detected (NCD)/year. Retrospective analysis between 2003 and 2009 to compare the New Case Detected Rate (NCDR) observed in Italy in the immigrant population with the NCDR of the same population in their country of origin to verify if the cases observed are those expected or not. Leprosy statistics were retrieved from the Italian leprosy register and from official WHO data. The NCD in Italy were lower than expected, from 2003 when the expected number of NCD was 40.5 between the legally resident immigrants, but only one case was diagnosed (98% of lower from the expected), to 2009 when four NCD were diagnosed and 41 were expected (90% lower from expected). This study points out a discrepancy between the observed and the expected cases of leprosy in Italy. Specifically, the number of NCD was less than expected for each studied year. Of course our data do not represent a validation, but only an indication of the leprosy diagnosis in Italy. Difficulty in accessing the health systems, fear of segregation, ignorance and illegal immigrant status with consequent fear of police arrest are possible explaining factors. The critical issue anyhow is the medical expertise. The role of the dermatologist is fundamental. For these reasons, there is still a need for wide spread leprosy teaching programmes. Although with few limitations, this study represents a first approach to validate the accuracy in leprosy diagnosis in Italy. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

  5. 76 FR 58520 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... products (products to suppress clotting of blood) in children. Issues for discussion will...

  6. 78 FR 63222 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... ] (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... (Pub. L. 108-155) and the Best Pharmaceuticals for Children Act (Pub. L. 107-109) and their...

  7. 77 FR 57095 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... will receive a presentation on pediatric provisions mandated by the Food and Drug Administration Safety...

  8. Seroprevalence of hepatitis B and C among oncology patients in Turkey.

    PubMed

    Kose, Sukran; Olmezoglu, Ali; Gozaydin, Ayhan; Ece, Gulfem

    2011-12-01

    Hepatitis B virus (HBV) is one of the public-health issues worldwide. Approximately two billion people are infected with HBV, and about 350 million people are chronic carriers globally. About 3% of the world population is infected with hepatitis C virus (HCV). Oncology patients receiving packed red blood cell suspensions and other blood products usually are in the high-risk group for infections due to these viruses. The aim of the study was to detect the seroprevalence of hepatitis B and hepatitis C among chemotherapy patients at the Oncology Department of the Tepecik Education and Research Hospital. HBsAg, anti-HBs, anti-HBcIgM, anti-HBc total and anti-HCV assays were studied by enzyme immunoassay method (Diasorin, Italy) in serum samples of patients (n = 448) referred to the Department of Oncology of the Tepecik Education and Research Hospital during 1 June 2006-1 January 2007. Of the 448 patients, 19 (4.2%) were HBsAg-positive, and three (0.7%) had anti-HCV positivity. In this study, the seroprevalence of HBV was similar to previous data in Turkey. This could be due to widespread vaccination programmes. The seroprevalence of low anti-HCV may be because of controlled blood transfusion. Oncology patients should be monitored for their protective antibody levels against HBV, and they must be included in the vaccination programme. Their anti-HCV status should also be checked as well.

  9. The characteristics of oncology social work in Australia: Implications for workforce planning in integrated cancer care.

    PubMed

    Pockett, Rosalie; Peate, Michelle; Hobbs, Kim; Dzidowska, Monika; L Bell, Melanie; Baylock, Brandi; Epstein, Irwin

    2016-12-01

    To describe the demographics, professional characteristics, self-reported professional development needs and research involvement of oncology social workers in Australia and to describe perceived barriers to provision of quality psychosocial care. A cross-sectional online survey was administered to social workers working in the oncology field who were contacted through three professional organizations; the Australian Association of Social Workers, Oncology Social Work Australia and the Psycho-oncology Co-operative Research Group, the University of Sydney. A snowball recruitment method was adopted to maximize the sample size. Two thirds of respondents had over 10 years professional practice experience but with lesser experience in oncology settings. Twenty-eight percent had post-graduate qualifications. Professional development needs were reported as moderate or high by 68% of respondents. No association between professional needs and work setting was found. Years of experience in oncology practice and living in an urban area increased the likelihood of involvement in research. Barriers to psychosocial care included poor understandings of the social work role, time constraints and an inadequate number of social work positions. In this first Australian study of the social work oncology workforce, the results demonstrated active, well-qualified and experienced social workers providing frontline services to people with cancer and their caregivers in geographically diverse locations across Australia. Inadequate resources and a lack of integrated psychosocial care were identified as barriers to comprehensive cancer care. The need for Aboriginal and Torres Strait Islander social workers was identified as an urgent workforce priority. © 2016 John Wiley & Sons Australia, Ltd.

  10. Symposium: "Oncology Leadership in Asia".

    PubMed

    Noh, Dong-Young; Roh, Jae Kyung; Kim, Yeul Hong; Yoshida, Kazuhiro; Baba, Hideo; Samson-Fernando, Marie Cherry Lynn; Misra, Sanjeev; Aziz, Zeba; Umbas, Rainy; P Singh, Yogendra; Shu Kam Mok, Tony; Yang, Han-Kwang; Akaza, Hideyuki

    2017-03-09

    The Symposium on "Oncology Leadership in Asia" was held as part of the official program of the 42nd Annual Meeting of the Korean Cancer Association. Given the increasing incidence of cancer in all countries and regions of Asia, regardless of developmental stage, and also in light of the recognized need for Asian countries to enhance collaboration in cancer prevention, research, treatment and follow-up, the symposium was held with the aim of bringing together oncology specialists from eight countries and regions in Asia to present the status in their own national context and discuss the key challenges and requirements in order to establish a greater Asian presence in the area of cancer control and research. The task of bringing together diverse countries and regions is made all the more urgent in that while Asia now accounts for more than half of all new cancer cases globally, clinical guidelines are based predominantly on practices adopted in western countries, which may not be optimized for unique ethnic, pharmacogenomic and cultural characteristics in Asia. Recognizing the need for Asia to better gather information and data for the compilation of Asia-specific clinical guidelines, the participants discussed the current status in Asia in the national and regional contexts and identified future steps towards integrated and collaborative initiatives in Asia. A key outcome of the symposium was a proposal to combine and integrate the activities of existing pan-Asian societies, including the Asia Pacific Federation of Organizations for Cancer Research and Control (APFOCC) and Asian Clinical Oncology Society (ACOS). Further proposals included the expansion of pan-Asian society membership to include individuals and the essential need to encourage the participation of young researchers in order to ensure self-sustainability of cancer control efforts in the future.

  11. Recovery- Cooper

    NASA Image and Video Library

    1963-05-16

    S63-07853 (16 May 1963) --- Astronaut L. Gordon Cooper Jr., pilot of the Mercury-Atlas 9 (MA-9) mission, stands supported by strong hands after climbing out of his spacecraft "Faith 7" after a 600,000-mile, 22-orbit journey around Earth. He elected to remain in the spacecraft until it was hoisted to the deck of the USS Kearsarge, as did astronaut Walter Schirra during the previous mission. Photo credit: NASA

  12. Economics of new oncology drug development.

    PubMed

    DiMasi, Joseph A; Grabowski, Henry G

    2007-01-10

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

  13. Molecular profiles in foregut oncology.

    PubMed

    Sukharamwala, Prashant; Hennessey, Daniel; Wood, Thomas; Singh, Shelly; Ryan, Carrie; Rosemurgy, Alexander

    2016-12-01

    Oncology is and will continue to evolve resulting from a better understanding of the biology and intrinsic genetic profile of each cancer. Tumor biomarkers and targeted therapies are the new face of precision medicine, so it is essential for all physicians caring for cancer patients to understand and assist patients in understanding the role and importance of such markers and strategies to target them. This review was initiated in an attempt to identify, characterize, and discuss literature supporting clinically relevant molecular markers and interventions. The efficacy of targeting specific markers will be examined with data from clinical trials focusing on treatments for esophageal, gastric, liver, gallbladder, biliary tract, and pancreatic cancers.

  14. Introduction to veterinary clinical oncology

    SciTech Connect

    Weller, R.E.

    1991-10-01

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

  15. [The second opinion in oncology].

    PubMed

    Cifaldi, Luciano; Felicetti, Viviana; Cristina, Giuseppe

    2010-01-01

    The medical second opinion (MSO) means the process through which it is possible to consult any available medical institution or a single physician, to compare, confirm and/or review a first diagnosis and/or a proposed treatment. The MSO is of the utmost importance when patients are suffering serious and disabling diseases or when risking their lives. Oncology is a really complex discipline in which, daily, doctors and patients have to deal with new clinical, managerial and sociological problems. Most patients are now better informed-often having gathered information from the Web, newspapers, magazines.This information is often very mixed and confusing and the number of MSO is increasing.

  16. Report from the OECI Oncology Days 2014

    PubMed Central

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

    2014-01-01

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

  17. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

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

  18. Clinical Oncology Assistantship Program for Medical Students.

    ERIC Educational Resources Information Center

    Neilan, Barbara A.; And Others

    1985-01-01

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

  19. Perceptions of Oncology as a Medical Specialty.

    ERIC Educational Resources Information Center

    Cassileth, Barrie R.; And Others

    1980-01-01

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

  20. Art Therapy with an Oncology Care Team

    ERIC Educational Resources Information Center

    Nainis, Nancy A.

    2005-01-01

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

  1. Perceptions of Oncology as a Medical Specialty.

    ERIC Educational Resources Information Center

    Cassileth, Barrie R.; And Others

    1980-01-01

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

  2. Clinical Oncology Assistantship Program for Medical Students.

    ERIC Educational Resources Information Center

    Neilan, Barbara A.; And Others

    1985-01-01

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

  3. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

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

  4. Conscientious objection in Italy.

    PubMed

    Minerva, Francesca

    2015-02-01

    The law regulating abortion in Italy gives healthcare practitioners the option to make a conscientious objection to activities that are specific and necessary to an abortive intervention. Conscientious objectors among Italian gynaecologists amount to about 70%. This means that only a few doctors are available to perform abortions, and therefore access to abortion is subject to constraints. In 2012 the International Planned Parenthood Federation European Network (IPPF EN) lodged a complaint against Italy to the European Committee of Social Rights, claiming that the inadequate protection of the right to access abortion implies a violation of the right to health. In this paper I will discuss the Italian situation with respect to conscientious objection to abortion and I will suggest possible solutions to the problem.

  5. Mount Vesuvius, Italy

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) image of Mt. Vesuvius, Italy was acquired September 26, 2000. The full-size false-color image covers an area of 36 by 45 km. Vesuvius overlooks the city of Naples and the Bay of Naples in central Italy. (Popocatepetl and Mount Fuji are other volcanos surrounded by dense urban areas.) In 79 AD, Vesuvius erupted cataclysmically, burying all of the surrounding cites with up to 30 m of ash. The towns of Pompeii and Herculanaeum were rediscovered in the 18th century, and excavated in the 20th century. They provide a snapshot of Roman life from 2000 years ago: perfectly preserved are wooden objects, food items, and the casts of hundreds of victims. Vesuvius is intensively monitored for potential signs of unrest that could signal the beginning of another eruption. Image courtesy NASA/GSFC/MITI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team

  6. Mt. Vesuvius, Italy

    NASA Technical Reports Server (NTRS)

    2001-01-01

    This ASTER image of Mt. Vesuvius Italy was acquired September 26, 2000, and covers an area of 36 by 45 km. Vesuvius overlooks the city of Naples and the Bay of Naples in central Italy. In 79 AD, Vesuvius erupted cataclysmically, burying all of the surrounding cites with up to 30 m of ash. The towns of Pompeii and Herculanaeum were rediscovered in the 18th century, and excavated in the 20th century. They provide a snapshot of Roman life from 2000 years ago: perfectly preserved are wooden objects, food items, and the casts of hundreds of victims. Vesuvius is intensively monitored for potential signs of unrest that could signal the beginning of another eruption. The image is centered at 40.8 degrees north latitude, 14.4 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  7. Mt. Vesuvius, Italy

    NASA Technical Reports Server (NTRS)

    2001-01-01

    This ASTER image of Mt. Vesuvius Italy was acquired September 26, 2000, and covers an area of 36 by 45 km. Vesuvius overlooks the city of Naples and the Bay of Naples in central Italy. In 79 AD, Vesuvius erupted cataclysmically, burying all of the surrounding cites with up to 30 m of ash. The towns of Pompeii and Herculanaeum were rediscovered in the 18th century, and excavated in the 20th century. They provide a snapshot of Roman life from 2000 years ago: perfectly preserved are wooden objects, food items, and the casts of hundreds of victims. Vesuvius is intensively monitored for potential signs of unrest that could signal the beginning of another eruption. The image is centered at 40.8 degrees north latitude, 14.4 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  8. Mt. Vesuvius, Italy

    NASA Image and Video Library

    2001-10-22

    This ASTER image of Mt. Vesuvius Italy was acquired September 26, 2000, and covers an area of 36 by 45 km. Vesuvius overlooks the city of Naples and the Bay of Naples in central Italy. In 79 AD, Vesuvius erupted cataclysmically, burying all of the surrounding cites with up to 30 m of ash. The towns of Pompeii and Herculanaeum were rediscovered in the 18th century, and excavated in the 20th century. They provide a snapshot of Roman life from 2000 years ago: perfectly preserved are wooden objects, food items, and the casts of hundreds of victims. Vesuvius is intensively monitored for potential signs of unrest that could signal the beginning of another eruption. The image is centered at 40.8 degrees north latitude, 14.4 degrees east longitude. http://photojournal.jpl.nasa.gov/catalog/PIA11091

  9. Mount Vesuvius, Italy

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) image of Mt. Vesuvius, Italy was acquired September 26, 2000. The full-size false-color image covers an area of 36 by 45 km. Vesuvius overlooks the city of Naples and the Bay of Naples in central Italy. (Popocatepetl and Mount Fuji are other volcanos surrounded by dense urban areas.) In 79 AD, Vesuvius erupted cataclysmically, burying all of the surrounding cites with up to 30 m of ash. The towns of Pompeii and Herculanaeum were rediscovered in the 18th century, and excavated in the 20th century. They provide a snapshot of Roman life from 2000 years ago: perfectly preserved are wooden objects, food items, and the casts of hundreds of victims. Vesuvius is intensively monitored for potential signs of unrest that could signal the beginning of another eruption. Image courtesy NASA/GSFC/MITI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team

  10. Visceral Leishmaniasis Treatment, Italy

    PubMed Central

    Gramiccia, Marina; Scalone, Aldo

    2003-01-01

    First-line drug treatment was recorded in 573 immunocompetent patients with visceral leishmaniasis in Italy. In the past 12 years, the proportion of antimonial treatments decreased from 100% to 2.8%, while the proportion of amphotericin B treatments increased from 0% to 97.2%. The countrywide change in therapy is a response to both disease reemergence and increasing antimonial failure. PMID:14720406

  11. [Therapeutic Aggressiveness and Liquid Oncology].

    PubMed

    Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

    2017-01-01

    Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

  12. Optical imaging probes in oncology.

    PubMed

    Martelli, Cristina; Lo Dico, Alessia; Diceglie, Cecilia; Lucignani, Giovanni; Ottobrini, Luisa

    2016-07-26

    Cancer is a complex disease, characterized by alteration of different physiological molecular processes and cellular features. Keeping this in mind, the possibility of early identification and detection of specific tumor biomarkers by non-invasive approaches could improve early diagnosis and patient management.Different molecular imaging procedures provide powerful tools for detection and non-invasive characterization of oncological lesions. Clinical studies are mainly based on the use of computed tomography, nuclear-based imaging techniques and magnetic resonance imaging. Preclinical imaging in small animal models entails the use of dedicated instruments, and beyond the already cited imaging techniques, it includes also optical imaging studies. Optical imaging strategies are based on the use of luminescent or fluorescent reporter genes or injectable fluorescent or luminescent probes that provide the possibility to study tumor features even by means of fluorescence and luminescence imaging. Currently, most of these probes are used only in animal models, but the possibility of applying some of them also in the clinics is under evaluation.The importance of tumor imaging, the ease of use of optical imaging instruments, the commercial availability of a wide range of probes as well as the continuous description of newly developed probes, demonstrate the significance of these applications. The aim of this review is providing a complete description of the possible optical imaging procedures available for the non-invasive assessment of tumor features in oncological murine models. In particular, the characteristics of both commercially available and newly developed probes will be outlined and discussed.

  13. Vascular access in oncology patients.

    PubMed

    Gallieni, Maurizio; Pittiruti, Mauro; Biffi, Roberto

    2008-01-01

    Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications. Vascular access management has considerably improved after the publication of effective guidelines for the appropriate nursing of the vascular device, which has reduced the risk of late complications, such as catheter-related bloodstream infection. However, many areas of clinical practice are still lacking an evidence-based background, such as the choice of the most appropriate vascular access device in each clinical situation, as well as prevention and treatment of thrombosis. We suggest an approach to the choice of the most appropriate vascular access device for the oncology patient, based on the literature available to date.

  14. Big data in oncologic imaging.

    PubMed

    Regge, Daniele; Mazzetti, Simone; Giannini, Valentina; Bracco, Christian; Stasi, Michele

    2017-06-01

    Cancer is a complex disease and unfortunately understanding how the components of the cancer system work does not help understand the behavior of the system as a whole. In the words of the Greek philosopher Aristotle "the whole is greater than the sum of parts." To date, thanks to improved information technology infrastructures, it is possible to store data from each single cancer patient, including clinical data, medical images, laboratory tests, and pathological and genomic information. Indeed, medical archive storage constitutes approximately one-third of total global storage demand and a large part of the data are in the form of medical images. The opportunity is now to draw insight on the whole to the benefit of each individual patient. In the oncologic patient, big data analysis is at the beginning but several useful applications can be envisaged including development of imaging biomarkers to predict disease outcome, assessing the risk of X-ray dose exposure or of renal damage following the administration of contrast agents, and tracking and optimizing patient workflow. The aim of this review is to present current evidence of how big data derived from medical images may impact on the diagnostic pathway of the oncologic patient.

  15. Psychiatric oncology: Cancer in mind

    PubMed Central

    Chaturvedi, Santosh K.

    2012-01-01

    Psychosocial oncology is an upcoming area of interest, which deals with numerous psychiatric, psychological, and social aspects of malignancies. Psychiatric oncology relates to some of the common psychological and emotional problems encountered in persons with malignancy and their formal and informal caregivers. This oration will discuss the importance of this field of Consultation Liaison Psychiatry, with a focus on the research and practice in the Indian setting. This presentation will also share the findings and researches of the presenter. All these range from studies on cancer pain and palliative care, screening for psychiatric morbidity, quality of life, communication skills for health professionals in breaking bad news and handling difficult questions, and counseling. The findings on researches on somatization and illness behavior in cancer patients would highlight newer challenges in this field. Caregivers of persons with cancer are as important as the patient, but usually ignored. The stress, strain, burden, positive emotions, and coping in the context of care giving for persons with cancer are being increasingly realized. Professional caregivers should be aware of caregiver difficulties and support them through their ordeal. Lastly, the importance of dealing with staff stress and burnout among health professionals looking after families with cancer patients and survivors will be emphasized. PMID:22988317

  16. Decision making in surgical oncology.

    PubMed

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

    2011-09-01

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

  17. Oncology and pharmacogenetics in 2007.

    PubMed

    Stebbing, Justin

    2007-01-01

    Justin Stebbing is a member of the Royal College of Physicians, American Board of Internal Medicine and the Royal College of Pathologists. Originally, Justin trained in medicine at Trinity College Oxford (Oxford, UK), obtaining a triple first class degree. After completion of junior doctor posts in Oxford, he undertook a residency (junior doctor) training at The Johns Hopkins Hospital (MD, USA), before returning to London to continue his training in oncology at The Royal Marsden. Justin then undertook a PhD, funded by the medical research council, investigating the interplay between the immune system and cancer. Specifically, the role of heat shock proteins in tumorigenesis was examined, leading to the development of a cancer vaccine that is currently in clinical trials. Justin has published over 200 papers and book chapters, in journals such as the Lancet, New England Journal, Blood, the Journal of Clinical Oncology and Annals of Internal Medicine, the majority as first or last author. They mainly focus on early and late stage trials of new drugs, mechanisms of disease and prognostic indicators. He is on the editorial board of a number of journals and regularly serves as a referee. Justin's main focus is now in breast cancer, and helping patients with early and late stage disease get better.

  18. Optical imaging probes in oncology

    PubMed Central

    Martelli, Cristina; Dico, Alessia Lo; Diceglie, Cecilia; Lucignani, Giovanni; Ottobrini, Luisa

    2016-01-01

    Cancer is a complex disease, characterized by alteration of different physiological molecular processes and cellular features. Keeping this in mind, the possibility of early identification and detection of specific tumor biomarkers by non-invasive approaches could improve early diagnosis and patient management. Different molecular imaging procedures provide powerful tools for detection and non-invasive characterization of oncological lesions. Clinical studies are mainly based on the use of computed tomography, nuclear-based imaging techniques and magnetic resonance imaging. Preclinical imaging in small animal models entails the use of dedicated instruments, and beyond the already cited imaging techniques, it includes also optical imaging studies. Optical imaging strategies are based on the use of luminescent or fluorescent reporter genes or injectable fluorescent or luminescent probes that provide the possibility to study tumor features even by means of fluorescence and luminescence imaging. Currently, most of these probes are used only in animal models, but the possibility of applying some of them also in the clinics is under evaluation. The importance of tumor imaging, the ease of use of optical imaging instruments, the commercial availability of a wide range of probes as well as the continuous description of newly developed probes, demonstrate the significance of these applications. The aim of this review is providing a complete description of the possible optical imaging procedures available for the non-invasive assessment of tumor features in oncological murine models. In particular, the characteristics of both commercially available and newly developed probes will be outlined and discussed. PMID:27145373

  19. Surgical Oncology Nursing: Looking Back, Looking Forward.

    PubMed

    Crane, Patrick C; Selanders, Louise

    2017-02-01

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

  20. Expanding the role of the oncology nurse

    PubMed Central

    Quinn, A

    2008-01-01

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

  1. Group Psychotherapy in Italy.

    PubMed

    Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria

    2015-10-01

    This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

  2. The Cooperative Groups: past and future.

    PubMed

    Comis, R L

    1998-01-01

    The Cooperative Group system of the National Cancer Institute (NCI) has been in existence since the 1950s and has evolved to comprise 11 groups, the membership of which includes universities, Community Clinical Oncology Programs, and Cooperative Group Outreach Programs. The Cooperative Groups serve as models for cancer clinical trials throughout the world. However, in today's changing healthcare environment in the USA the Cooperative Groups need to adjust how they operate to ensure the continuation of their leadership role in cancer clinical trials. Government funds, the main source of support for the Cooperative Groups' activities, are shrinking and currently funding is only 50% of the recommended level. If the Cooperative Groups are to remain at the forefront, adjustments must be made in several areas: the Cooperative Groups need to provide an efficient and rapid scientific and legal mechanism to execute large phase III studies of the increasingly important portfolio of compounds being developed by industry more effectively. Industry has come to rely on contract research organizations for expedited testing of their products due to perceived inefficiency in these areas in the Cooperative Group mechanism. The Cooperative Groups are uniquely situated to provide in-depth evaluation of the newest therapies for regulatory agencies and interested health insurers, as well as provide health outcomes data, which are now much sought after by the healthcare industry. Managed care is shaping medical practice, including cancer care, throughout the USA. Finally, the Cooperative Groups need to foster greater international cooperation to speed technology transfers. The leaders of the Cooperative Groups are discussing new approaches to address these deficiencies, while complementing the existing NCI structure and recognizing the independence of each group. The objectives of these new approaches would be: to establish a structure whereby better contracts with industry for

  3. Children's Oncology Group's 2013 blueprint for research: behavioral science.

    PubMed

    Noll, Robert B; Patel, Sunita K; Embry, Leanne; Hardy, Kristina K; Pelletier, Wendy; Annett, Robert D; Patenaude, Andrea; Lown, E Anne; Sands, Stephen A; Barakat, Lamia P

    2013-06-01

    Behavioral science has long played a central role in pediatric oncology clinical service and research. Early work focused on symptom relief related to side effects of chemotherapy and pain management related to invasive medical procedures. As survival rates improved, the focused has shifted to examination of the psychosocial impact, during and after treatment, of pediatric cancer and its treatment on children and their families. The success of the clinical trials networks related to survivorship highlights an even more critical role in numerous domains of psychosocial research and care. Within the cooperative group setting, the field of behavioral science includes psychologists, social workers, physicians, nurses, and parent advisors. The research agenda of this group of experts needs to focus on utilization of psychometrically robust measures to evaluate the impact of treatment on children with cancer and their families during and after treatment ends. Over the next 5 years, the field of behavioral science will need to develop and implement initiatives to expand use of standardized neurocognitive and behavior batteries; increase assessment of neurocognition using technology; early identification of at-risk children/families; establish standards for evidence-based psychosocial care; and leverage linkages with the broader behavioral health pediatric oncology community to translate empirically supported research clinical trials care to practice.

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

    PubMed

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

    2007-10-01

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

  5. Music therapy research and applications in pediatric oncology treatment.

    PubMed

    Standley, J M; Hanser, S B

    1995-01-01

    Music therapy is a profession which meets multiple physical, social, and psychological needs. Music therapists can facilitate health objectives by reducing the intensity or duration of pain, alleviating anxiety, and decreasing the amount of analgesic medication needed. Rehabilitative objectives can include activities which incorporate exercise, range of motion therapy, or gait training. Reduction of fear, anxiety, stress, or grief are common psychological objectives. Music therapy is particularly effective in promoting social objectives such as increased interaction, verbalization, independence, and cooperation; enhanced relationships with health care personnel and family members; and increased stimulation during long-term hospitalization or isolation. Counseling techniques are often paired with music to achieve emotional objectives such as expression, adjustment, stability, or locus of control. The purpose of this article is to synthesize the extant music/medical research literature and clarify how music therapy can provide a quintessential combination of physical, social, and psychological benefits to enhance the health care of pediatric oncology patients.

  6. Nutrition support in surgical oncology.

    PubMed

    Huhmann, Maureen B; August, David A

    2009-01-01

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

  7. Integrated telemedicine applications and services for oncological positron emission tomography.

    PubMed

    Kontaxakis, George; Visvikis, Dimitris; Ohl, Roland; Sachpazidis, Ilias; Suarez, Juan Pablo; Selby, Peter; Cheze-Le Rest, Catherine; Santos, Andres; Ortega, Fernando; Diaz, Javier; Pan, Leyun; Strauss, Ludwig; Dimitrakopoulou-Strauss, Antonia; Sakas, Georgios; Pozo, Miguel Angel

    2006-01-01

    TENPET (Trans European Network for Positron Emission Tomography) aims to evaluate the provision of integrated teleconsultation and intelligent computer supported cooperative work services for clinical positron emission tomography (PET) in Europe at its current stage, as it is a multi-centre project financially supported by the European Commission (Information Society, eTEN Program). It addresses technological challenges by linking PET centres and developing supporting services that permit remote consultation between professionals in the field. The technological platform (CE-marked) runs on Win2000/NT/XP systems and incorporates advanced techniques for image visualization, analysis and fusion, as well as for interactive communication and message handling for off-line communications. Four PET Centres from Spain, France and Germany participate to the pilot system trials. The performance evaluation of the system is carried out via log files and user-filled questionnaires on the frequency of the teleconsultations, their duration and efficacy, quality of the images received, user satisfaction, as well as on privacy, ethical and security issues. TENPET promotes the co-operation and improved communication between PET practitioners that are miles away from their peers or on mobile units, offering options for second opinion and training and permitting physicians to remotely consult patient data if they are away from their centre. It is expected that TENPET will have a significant impact in the development of new skills by PET professionals and will support the establishment of peripheral PET units. To our knowledge, TENPET is the first telemedicine service specifically designed for oncological PET. This report presents the technical innovations incorporated in the TENPET platform and the initial pilot studies at real and diverse clinical environments in the field of oncology.

  8. Psychological factors affecting oncology conditions.

    PubMed

    Grassi, Luigi; Biancosino, Bruno; Marmai, Luciana; Rossi, Elena; Sabato, Silvana

    2007-01-01

    The area of psychological factors affecting cancer has been the object of research starting from the early 1950s and consolidating from the 1970s with the development of psychooncology. A series of problems in the DSM and ICD nosological systems, such as the difficult application of the criteria for psychiatric diagnoses (i.e. major depression, adjustment disorders) and the scarce space dedicated to the rubric of psychosocial implications of medical illness (i.e. Psychological Factors Affecting a Medical Condition under 'Other Conditions That May Be a Focus of Clinical Attention' in the DSM-IV) represent a major challenge in psycho-oncology. The application of the Diagnostic Criteria for Psychosomatic Research (DCPR) has been shown to be useful in a more precise identification of several psychological domains in patients with cancer. The DCPR dimensions of health anxiety, demoralization and alexithymia have been shown to be quite frequent in cancer patient (37.7, 28.8 and 26%, respectively). The overlap between a formal DSM-IV diagnosis and the DCPR is low, with 58% of patients being categorized as non-cases on the DSM-IV having at least one DCPR syndrome. The specific quality of the DCPR in characterizing psychosocial aspects secondary to cancer is also confirmed by the fact that some dimensions of coping (e.g. Mini-Mental Adjustment to Cancer subscale hopelessness) correlate with the DCPR dimension of demoralization, while a quantitative approach on symptom assessment (e.g. stress symptoms on the Brief Symptom Inventory) is not useful in discriminating the patients with and without DCPR syndromes. More research is needed in order to understand the relationship between DCPR constructs (e.g. alexithymia) and psychosocial factors which have been shown to be significant in oncology (e.g. emotional repression and avoidance). The role of specific DCPR constructs in influencing the course of illness is also an area that should be investigated.

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

    ERIC Educational Resources Information Center

    Cersosimo, Robert J.

    1989-01-01

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

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

    ERIC Educational Resources Information Center

    Cersosimo, Robert J.

    1989-01-01

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

  11. Turin, Italy 2006

    NASA Image and Video Library

    2017-09-27

    City lights at night along the France-Italy border, Europe are featured in this image photographed by an Expedition 23 crew member on the International Space Station (ISS). The brightly lit metropolitan areas of Torino (Italy), Lyon, and Marseille (both in France) stand out amidst numerous smaller urban areas in this dramatic photograph. The image captures the night time appearance of the France-Italy border area between the mountainous Alps to the north (not shown) and the island of Corsica in the Ligurian Sea to the south (top). The full moon reflects brightly on the water surface and also illuminates the tops of low patchy clouds over the border (center). This image was taken by an ISS crew member at approximately 11:55 p.m. local time when the station was located over the France-Belgium border near Luxembourg. Crew members orbiting Earth frequently collect images that include sunglint, or sunlight that reflects off a water surface at such an angle that it travels directly back towards the observer. Sunglint typically lends a mirror-like appearance to the water surface. During clear sky conditions reflected light from the moon can produce the same effect (moon glint) as illustrated in this view. The observer was looking towards the southeast at an oblique viewing angle at the time the image was taken; in other words, looking outwards from the ISS, not straight down towards Earth. Credit: NASA NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  12. PET-Based Thoracic Radiation Oncology.

    PubMed

    Simone, Charles B; Houshmand, Sina; Kalbasi, Anusha; Salavati, Ali; Alavi, Abass

    2016-07-01

    Fluorodeoxyglucose-PET is increasingly being integrated into multiple aspects of oncology. PET/computed tomography (PET/CT) has become especially important in radiation oncology. With the increasing use of advanced techniques like intensity-modulated radiation therapy and proton therapy, PET/CT scans have played critical roles in the target delineation of tumors for radiation oncologists delivering conformal treatment techniques. Use of PET/CT is well established in lung cancer and several other thoracic malignancies. This article details the current uses of PET/CT in thoracic radiation oncology with a focus on lung cancer and describes expected future roles of PET/CT for thoracic tumors.

  13. [The national union for private hospital oncology].

    PubMed

    Parmentier, Gérard

    2013-06-01

    In the French health system, social security is the same for both public and private hospitals regardless of their status. In terms of number of patients screened, diagnosed, or treated, independant medicine is the most important sector in the French oncology. The multitude of organizations representing private hospitals or independant oncologists, physicians, radiologists or pathologists have a common organization, the National Union for Private Hospital Oncology (UNHPC). It bases its action on two founding postulates to ensure the quality of the oncology practice : the medical and managerial cultures are complementary and should be articulated ; the quality of organizations is as important as professional competence.

  14. The impact of genomics on oncology nursing.

    PubMed

    Beamer, Laura Curr; Linder, Lauri; Wu, Bohua; Eggert, Julia

    2013-12-01

    Since 2003, genetics and genomics information has led to exciting new diagnostics, prognostics, and treatment options in oncology practice. Profiling of cancers offers providers insight into treatment and prognostic factors. Germline testing provides an individual with information for surveillance or therapy that may help them prevent cancer in their lifetime and options for family members as yet untouched by malignancy. This offers a challenge for oncology nurses and other oncology health care providers to become comfortable with incorporating education about genetics/genomics into their clinical practice and patient education.

  15. Bay of Naples, Italy

    NASA Image and Video Library

    1981-04-14

    STS001-13-442 (14 April 1981) --- This photograph showing much of Italy was taken with a handheld 70mm camera from 276 kilometers above Earth as the NASA space shuttle Columbia and its crew were marking their last few hours in space on the historic first space mission utilizing a reusable vehicle. Included in the area of the frame are Golfo de Napoli, Napoli (Naples), Castellammare, Amalfi, Capri, Sorrento, Mt. Vesuvius and the ruins of Pompei. Astronauts John W. Young and Robert L. Crippen exposed eight magazines of color 70mm film during their two and one-third days in Earth orbit. Photo credit: NASA

  16. The Bologna Process in Italy

    ERIC Educational Resources Information Center

    Ballarino, Gabriele; Perotti, Loris

    2012-01-01

    Italy was among the promoters of the Bologna Process and the early adopters of the reform. If one looks at its impact on the formal structure of curricula and study programmes, the reform undertaken under the Bologna banner seems to have been one of the major educational reforms ever achieved in Italy. This article describes how the Bologna…

  17. The Language Situation in Italy

    ERIC Educational Resources Information Center

    Tosi, Arturo

    2004-01-01

    This monograph provides an overview of the language situation in Italy, within the framework of language policy and language planning. It presents an account of multilingualism, linguistic diversity, social variation, educational issues and phenomena of language contact both within and outside Italy. The four main threads are (1) the current…

  18. Report on First International Workshop on Robotic Surgery in Thoracic Oncology.

    PubMed

    Veronesi, Giulia; Cerfolio, Robert; Cingolani, Roberto; Rueckert, Jens C; Soler, Luc; Toker, Alper; Cariboni, Umberto; Bottoni, Edoardo; Fumagalli, Uberto; Melfi, Franca; Milli, Carlo; Novellis, Pierluigi; Voulaz, Emanuele; Alloisio, Marco

    2016-01-01

    A workshop of experts from France, Germany, Italy, and the United States took place at Humanitas Research Hospital Milan, Italy, on February 10 and 11, 2016, to examine techniques for and applications of robotic surgery to thoracic oncology. The main topics of presentation and discussion were robotic surgery for lung resection; robot-assisted thymectomy; minimally invasive surgery for esophageal cancer; new developments in computer-assisted surgery and medical applications of robots; the challenge of costs; and future clinical research in robotic thoracic surgery. The following article summarizes the main contributions to the workshop. The Workshop consensus was that since video-assisted thoracoscopic surgery (VATS) is becoming the mainstream approach to resectable lung cancer in North America and Europe, robotic surgery for thoracic oncology is likely to be embraced by an increasing numbers of thoracic surgeons, since it has technical advantages over VATS, including intuitive movements, tremor filtration, more degrees of manipulative freedom, motion scaling, and high-definition stereoscopic vision. These advantages may make robotic surgery more accessible than VATS to trainees and experienced surgeons and also lead to expanded indications. However, the high costs of robotic surgery and absence of tactile feedback remain obstacles to widespread dissemination. A prospective multicentric randomized trial (NCT02804893) to compare robotic and VATS approaches to stages I and II lung cancer will start shortly.

  19. Report on First International Workshop on Robotic Surgery in Thoracic Oncology

    PubMed Central

    Veronesi, Giulia; Cerfolio, Robert; Cingolani, Roberto; Rueckert, Jens C.; Soler, Luc; Toker, Alper; Cariboni, Umberto; Bottoni, Edoardo; Fumagalli, Uberto; Melfi, Franca; Milli, Carlo; Novellis, Pierluigi; Voulaz, Emanuele; Alloisio, Marco

    2016-01-01

    A workshop of experts from France, Germany, Italy, and the United States took place at Humanitas Research Hospital Milan, Italy, on February 10 and 11, 2016, to examine techniques for and applications of robotic surgery to thoracic oncology. The main topics of presentation and discussion were robotic surgery for lung resection; robot-assisted thymectomy; minimally invasive surgery for esophageal cancer; new developments in computer-assisted surgery and medical applications of robots; the challenge of costs; and future clinical research in robotic thoracic surgery. The following article summarizes the main contributions to the workshop. The Workshop consensus was that since video-assisted thoracoscopic surgery (VATS) is becoming the mainstream approach to resectable lung cancer in North America and Europe, robotic surgery for thoracic oncology is likely to be embraced by an increasing numbers of thoracic surgeons, since it has technical advantages over VATS, including intuitive movements, tremor filtration, more degrees of manipulative freedom, motion scaling, and high-definition stereoscopic vision. These advantages may make robotic surgery more accessible than VATS to trainees and experienced surgeons and also lead to expanded indications. However, the high costs of robotic surgery and absence of tactile feedback remain obstacles to widespread dissemination. A prospective multicentric randomized trial (NCT02804893) to compare robotic and VATS approaches to stages I and II lung cancer will start shortly. PMID:27822454

  20. An interprofessionally developed geriatric oncology curriculum for hematology-oncology fellows.

    PubMed

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2015-03-01

    Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies' publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows' evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. An interprofessional team approach was a successful method for identifying areas of learners' educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. An interprofessionally developed geriatric oncology curriculum for hematology–oncology fellows

    PubMed Central

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2016-01-01

    Objective Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. Methods A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies’ publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows’ evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Results Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. Conclusion An interprofessional team approach was a successful method for identifying areas of learners’ educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. PMID:25487037

  2. Lake Garda, Italy

    NASA Image and Video Library

    2001-07-21

    This ASTER image was acquired on July 29, 2000 and covers an area of 30 by 57 km in northern Italy. Lake Garda was formed by glaciers during the last Ice Age, and is Italy's largest lake. Lago di Garda lies in the provinces of Verona, Brescia, and Trento, and is 51 kilometers (32 miles) long and from 3 to 18 kilometers (2 to 11 miles) wide. The Sarca is its chief affluent, and the lake is drained southward by the Mincio, which discharges into the Po River. Many villas are situated on its shores. On the peninsula of Sirmione, at the southern end of the lake, are the ruins of a Roman villa and a castle of the Scaligers, an Italian family of the 16th century. The RIGHT image has the land area masked out, and a harsh stretch was applied to the lake values to display variations in sediment load. Also visible are hundreds of boats and their wakes, criss-crossing the lake. The image is centered at 45.6 degrees north latitude, 10.6 degrees east longitude. http://photojournal.jpl.nasa.gov/catalog/PIA02671

  3. American Society of Pediatric Hematology/Oncology

    MedlinePlus

    ... Policies Advertising Sponsorship Support of CME Committee Policies, Responsibilities, and Resources Conflict of Interest and Disclosure for ... toward Equity Children's Oncology Group (COG) Outcomes Research Social Media: The Good, The Bad, and Beyond Sickle ...

  4. The Role of the Social Partners in Vocational Training in Italy.

    ERIC Educational Resources Information Center

    Catalano, N.; And Others

    This document studies the role of unions, management, government, and education agencies (the social partners) in vocational training in Italy. Through an analysis of existing and historical structures governing cooperation and coordination between the social partners and the public bodies responsible for vocational education and training, an…

  5. [Interests of applied anthropology to oncology].

    PubMed

    Soum-Pouyalet, Fanny; Hubert, Annie; Dilhuydy, Jean-Marie

    2008-01-01

    From now on the introduction of social and human sciences studies in the field of oncology has not always been conclusive. This article aims to analyze the bounds that border the meeting and the understanding between physicians, patients and anthropologists. It also treats the problems due to the introduction of applied anthropology in the field of oncology and points up the interests and practical contributions that this disciplinary bring and could bring.

  6. [Information technology in gynecological oncology today].

    PubMed

    Kupka, M S; Richter, O; Tutschek, B

    2003-11-01

    Information technology has been integrated in gynecological oncology treatment. Therefore, new software has been established in hospitals and out-patient clinics. A German law concerning data collection in oncology has attempted to unify different strategies. All intentions to establish new documentation systems for tumor diseases need a standardized basic data set. Nevertheless, local governmental health organizations are not yet prepared to implement a global information system such as prenatal and perinatal care databases. Financial support and political work is therefore needed.

  7. Medicare coverage for oncology services.

    PubMed

    Bagley, G P; McVearry, K

    1998-05-15

    Medicare's mission is to assure health care security for our beneficiaries. Title XVIII of the Social Security Act (the Act) provides the Health Care Financing Administration (HCFA) with the authority to fulfill this mission. Although Medicare is considered a defined benefit program, the Act vested Medicare with the discretionary authority to make specific policy decisions when necessary. HCFA's discretionary authority, which is found at section 1862(a)(1)(A) of the Act, enables HCFA to provide coverage for services that are reasonable and necessary for the treatment and diagnosis of illness or injury or to improve the functioning of a malformed body member. To determine whether a service is reasonable and necessary, HCFA relies on authoritative evidence. This evidence includes, but is not limited to, approvals from appropriate federal agencies, such as the Food and Drug Administration, and systematic evaluations of scientific literature via technology assessments. HCFA also may decide that a service warrants a unique type of coverage policy, which is referred to as coverage with conditions. This form of coverage is a middle ground between strict noncoverage and general coverage for a medical service that appears promising, but still is evolving. All these policy specifications effect Medicare coverage of oncology services. This means that reasonable and necessary diagnostic and therapeutic cancer-related services that are not otherwise prohibited by Medicare's statute, regulations, and manual instructions are covered and paid for by the program. Prior to the Balanced Budget Act of 1997 (BBA '97), Medicare provided coverage for some beneficiaries to undergo mammography and Papanicolaou smear screening. As a result of BBA '97, Congress has mandated expanding coverage for these services as well as adding coverage for pelvic examinations, prostate cancer screening, colorectal screening, and antiemetic drugs used as part of an anticancer chemotherapy regimen. Other

  8. Current management of surgical oncologic emergencies.

    PubMed

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

    2015-01-01

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

  9. Secondary traumatic stress in oncology staff.

    PubMed

    Quinal, Leonida; Harford, Stephanie; Rutledge, Dana N

    2009-01-01

    As empathetic caregivers, oncology staff may be prone to secondary traumatic stress (STS). Secondary traumatic stress results from exposure to persons who have experienced trauma and from giving care to such persons. The presence of STS among oncology staff has not been documented. This correlational descriptive study examined STS among oncology staff at a 500-bed Magnet-designated community hospital by determining the presence of individual symptoms and frequency with which diagnostic criteria for STS are met. Also determined were associations between STS demographic characteristics and specific stress-reduction activities.In this study, 43 staff members from an inpatient oncology unit completed mailed surveys. The Secondary Traumatic Stress Scale assessed the frequency of intrusion, avoidance, and arousal symptoms associated with STS; also assessed were use/helpfulness of stress-reduction activities. In this first study to document the prevalence of STS among oncology staff, prevalence ranged from 16% (Bride's method) to 37% (cutoff-score method). Most common symptoms were difficulty sleeping, intrusive thoughts about patients, and irritability. Least common were avoidance of people, places, and things and disturbing dreams about patients. Current use of massage was significantly predictive of not having STS. Ethnicity of staff member was related to having STS. Further research is warranted evaluating STS prevalence in different groups of oncology staff along with the effect of STS on burnout and job retention.

  10. The art of pediatric oncology nursing practice.

    PubMed

    Cantrell, Mary Ann

    2007-01-01

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

  11. Exploring resilience in paediatric oncology nursing staff.

    PubMed

    Zander, Melissa; Hutton, Alison; King, Lindy

    2013-01-01

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

  12. Evolutionary explanations for cooperation.

    PubMed

    West, Stuart A; Griffin, Ashleigh S; Gardner, Andy

    2007-08-21

    Natural selection favours genes that increase an organism's ability to survive and reproduce. This would appear to lead to a world dominated by selfish behaviour. However, cooperation can be found at all levels of biological organisation: genes cooperate in genomes, organelles cooperate to form eukaryotic cells, cells cooperate to make multicellular organisms, bacterial parasites cooperate to overcome host defences, animals breed cooperatively, and humans and insects cooperate to build societies. Over the last 40 years, biologists have developed a theoretical framework that can explain cooperation at all these levels. Here, we summarise this theory, illustrate how it may be applied to real organisms and discuss future directions.

  13. Food and Drug Administration process for development and approval of drugs and radiopharmaceuticals: treatments in urologic oncology.

    PubMed

    Ning, Yang-Min; Maher, V Ellen

    2015-03-01

    Regulatory advice and assessment play an important role in the successful development of new drugs and radiopharmaceuticals for the treatment of urologic malignancies. Cooperation between the US Food and Drug Administration (FDA) and the pharmaceutical industry has led to the approval of more than 20 new urologic oncology products in the last 2 decades. Despite these advances, more effective treatments need to be developed and approved for the treatment of urologic malignancies. This review provides general information about the FDA's role in the development of investigational new drugs, with an emphasis on the regulatory process and the requirements for marketing approval. In addition, this review summarizes the products for the treatment of urologic malignancies that were approved by the FDA in the last 30 years and the key issues concerning urologic oncology products that were discussed publicly at Oncologic Drug Advisory Committee meetings in the past 10 years.

  14. Clinical ethics consultation in oncology.

    PubMed

    Shuman, Andrew G; Montas, Sacha M; Barnosky, Andrew R; Smith, Lauren B; Fins, Joseph J; McCabe, Mary S

    2013-09-01

    There is limited empirical research exploring the nature of clinical ethical consultations within the oncology population. Our objective was to review and describe clinical ethics consultations at two National Cancer Institute-designated comprehensive cancer centers to identify opportunities for systems improvement in clinical care and opportunities for staff education. This case series is derived from two institutional prospectively maintained clinical ethics consultation databases. All ethics consultations from 2007 through 2011 that related to adult patients with cancer were included. A total of 208 eligible patient cases were identified. The most common primary issues leading to ethics consultation were code status and advance directives (25%), surrogate decision making (17%), and medical futility (13%). Communication lapses were identified in 45% of patient cases, and interpersonal conflict arose in 51%. Before ethics consultation, 26% of patients had do-not-resuscitate orders, which increased to 60% after ethics consultation. Palliative care consultation occurred in 41% of patient cases. Ethics consultations among patients with cancer reflect the complexities inherent to their clinical management. Appropriately honoring patients' wishes within the context of overall goals of care is crucial. Thoughtful consideration of the role of and relationship with palliative care experts, communication barriers, sources of interpersonal conflict, symptom control, and end-of-life care is paramount to optimal management strategies in this patient population.

  15. Spirituality and religion in oncology.

    PubMed

    Peteet, John R; Balboni, Michael J

    2013-01-01

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

  16. Oncology information on the Internet.

    PubMed

    Goto, Yasushi; Nagase, Takahide

    2012-05-01

    Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

  17. Oncologic imaging: kidney and ureter

    SciTech Connect

    McClennan, B.L.; Balfe, D.M.

    1983-11-01

    Malignant cancers of the kidney and ureter account for only 2 to 3% of all neoplasms in man. However, early diagnosis and treatment can have a profound effect on patient prognosis and survival. This article seeks to amalgamate a large body of information related to the pathology of primary renal tumors and metastatic disease with current imaging strategies to assist the clinician and enhance his understanding of the wide variety of modern imaging techniques available. Current tumor staging classifications are presented and the various imaging strategies are keyed to detection, definition and treatment options for tumors of the renal parenchyma and ureter. The strengths and limitations of all available imaging modalities are reviewed. An optimal approach to the imaging workup is developed with regard to availability, evolving technology and most importantly, cost efficacy. The controversies and conflicts in imaging and treatment options are explored while constructing a step by step approach that will be both flexible and utilitarian for the clinician faced with daily oncologic management choices.

  18. Nanotechnology Applications in Surgical Oncology

    PubMed Central

    Singhal, Sunil; Nie, Shuming; Wang, May D.

    2010-01-01

    Surgery is currently the most effective and widely used procedure in treating human cancers, and the single most important predictor of patient survival is a complete surgical resection. Major opportunities exist to develop new and innovative technologies that could help the surgeon to delineate tumor margins, to identify residual tumor cells and micrometastases, and to determine if the tumor has been completely removed. Here we discuss recent advances in nanotechnology and optical instrumentation, and how these advances can be integrated for applications in surgical oncology. A fundamental rationale is that nanometer-sized particles such as quantum dots and colloidal gold have functional and structural properties that are not available from either discrete molecules or bulk materials. When conjugated with targeting ligands such as monoclonal antibodies, peptides, or small molecules, these nanoparticles can be used to target malignant tumor cells and tumor microenvironments with high specificity and affinity. In the “mesoscopic” size range of 10–100 nm, nanoparticles also have large surface areas for conjugating to multiple diagnostic and therapeutic agents, opening new possibilities in integrated cancer imaging and therapy. PMID:20059343

  19. Emerging therapeutic aspects in oncology

    PubMed Central

    MacEwan, David J

    2013-01-01

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

  20. Comparative Effectiveness Research in Oncology

    PubMed Central

    2013-01-01

    Although randomized controlled trials represent the gold standard for comparative effective research (CER), a number of additional methods are available when randomized controlled trials are lacking or inconclusive because of the limitations of such trials. In addition to more relevant, efficient, and generalizable trials, there is a need for additional approaches utilizing rigorous methodology while fully recognizing their inherent limitations. CER is an important construct for defining and summarizing evidence on effectiveness and safety and comparing the value of competing strategies so that patients, providers, and policymakers can be offered appropriate recommendations for optimal patient care. Nevertheless, methodological as well as political and social challenges for CER remain. CER requires constant and sophisticated methodological oversight of study design and analysis similar to that required for randomized trials to reduce the potential for bias. At the same time, if appropriately conducted, CER offers an opportunity to identify the most effective and safe approach to patient care. Despite rising and unsustainable increases in health care costs, an even greater challenge to the implementation of CER arises from the social and political environment questioning the very motives and goals of CER. Oncologists and oncology professional societies are uniquely positioned to provide informed clinical and methodological expertise to steer the appropriate application of CER toward critical discussions related to health care costs, cost-effectiveness, and the comparative value of the available options for appropriate care of patients with cancer. PMID:23697601

  1. Gestalt psychology in Italy.

    PubMed

    Verstegen, I

    2000-01-01

    Graz gestalt psychology was introduced into Italy after World War I with Vittorio Benussi's emigration to Padua. His earliest adherent, Cesare Musatti, defended Graz theory, but after Benussi's premature death became an adherent of the Berlin gestalt psychology of Wertheimer-Köhler-Koffka. He trained his two most important students, Fabio Metelli and Gaetano Kanizsa, in orthodox Berlin theory. They established rigid "schools" in Padua and Trieste. The structure of Italian academics allowed for such strict orthodoxy, quite unlike the situation in America, where scientific objectivity mitigated against schools. In the 1960s, some of the students of Metelli and Kanizsa (above all Bozzi) initiated a realist movement-felt in Kanizsa's late work-that was quite independent of that of J. J. Gibson. Finally, more recently, Benussi and Graz theorizing have been embraced again, sentimentally, as a predecedent to Kanizsa-Bozzi.

  2. Cardiotoxicity of Anticancer Drugs: The Need for Cardio-Oncology and Cardio-Oncological Prevention

    PubMed Central

    Pennesi, Giuseppina; Donatelli, Francesco; Cammarota, Rosaria; De Flora, Silvio; Noonan, Douglas M.

    2010-01-01

    Due to the aging of the populations of developed countries and a common occurrence of risk factors, it is increasingly probable that a patient may have both cancer and cardiovascular disease. In addition, cytotoxic agents and targeted therapies used to treat cancer, including classic chemotherapeutic agents, monoclonal antibodies that target tyrosine kinase receptors, small molecule tyrosine kinase inhibitors, and even antiangiogenic drugs and chemoprevention agents such as cyclooxygenase-2 inhibitors, all affect the cardiovascular system. One of the reasons is that many agents reach targets in the microenvironment and do not affect only the tumor. Combination therapy often amplifies cardiotoxicity, and radiotherapy can also cause heart problems, particularly when combined with chemotherapy. In the past, cardiotoxic risk was less evident, but it is increasingly an issue, particularly with combination therapy and adjuvant therapy. Today's oncologists must be fully aware of cardiovascular risks to avoid or prevent adverse cardiovascular effects, and cardiologists must now be ready to assist oncologists by performing evaluations relevant to the choice of therapy. There is a need for cooperation between these two areas and for the development of a novel discipline, which could be termed cardio-oncology or onco-cardiology. Here, we summarize the potential cardiovascular toxicities for a range of cancer chemotherapeutic and chemopreventive agents and emphasize the importance of evaluating cardiovascular risk when patients enter into trials and the need to develop guidelines that include collateral effects on the cardiovascular system. We also discuss mechanistic pathways and describe several potential protective agents that could be administered to patients with occult or overt risk for cardiovascular complications. PMID:20007921

  3. Plant cooperation.

    PubMed

    Dudley, Susan A

    2015-09-25

    The study of plant behaviour will be aided by conceptual approaches and terminology for cooperation, altruism and helping. The plant literature has a rich discussion of helping between species while the animal literature has an extensive and somewhat contentious discussion of within-species helping. Here, I identify and synthesize concepts, terminology and some practical methodology for speaking about helping in plant populations and measuring the costs and benefits. I use Lehmann and Keller's (2006) classification scheme for animal helping and McIntire and Fajardo's (2014) synthesis of facilitation to provide starting points for classifying the mechanisms of how and why organisms help each other. Contextual theory is discussed as a mechanism for understanding and measuring the fitness consequences of helping. I synthesize helping into four categories. The act of helping can be costly to the helper. If the helper gains indirect fitness by helping relatives but loses direct fitness, this is altruism, and it only occurs within species. Helpers can exchange costly help, which is called mutualism when between species, and reciprocation when within a species. The act of helping can directly benefit the helper as well as the recipient, either as an epiphenomenon resulting from behaviours under natural selection for other reasons, or because the helper is creating a mutual benefit, such as satiating predators or supporting a mutualism. Facilitation between species by stress amelioration, creation of novel ecosystems and habitat complexity often meets the definition of epiphenomenon helping. Within species, this kind of helping is called by-product mutualism. If the helping is under selection to create a mutual benefit shared by others, between species this is facilitation with service sharing or access to resources and within species, direct benefits by mutual benefits. These classifications provide a clear starting point for addressing the subject of helping behaviours.

  4. Plant cooperation

    PubMed Central

    Dudley, Susan A.

    2015-01-01

    The study of plant behaviour will be aided by conceptual approaches and terminology for cooperation, altruism and helping. The plant literature has a rich discussion of helping between species while the animal literature has an extensive and somewhat contentious discussion of within-species helping. Here, I identify and synthesize concepts, terminology and some practical methodology for speaking about helping in plant populations and measuring the costs and benefits. I use Lehmann and Keller's (2006) classification scheme for animal helping and McIntire and Fajardo's (2014) synthesis of facilitation to provide starting points for classifying the mechanisms of how and why organisms help each other. Contextual theory is discussed as a mechanism for understanding and measuring the fitness consequences of helping. I synthesize helping into four categories. The act of helping can be costly to the helper. If the helper gains indirect fitness by helping relatives but loses direct fitness, this is altruism, and it only occurs within species. Helpers can exchange costly help, which is called mutualism when between species, and reciprocation when within a species. The act of helping can directly benefit the helper as well as the recipient, either as an epiphenomenon resulting from behaviours under natural selection for other reasons, or because the helper is creating a mutual benefit, such as satiating predators or supporting a mutualism. Facilitation between species by stress amelioration, creation of novel ecosystems and habitat complexity often meets the definition of epiphenomenon helping. Within species, this kind of helping is called by-product mutualism. If the helping is under selection to create a mutual benefit shared by others, between species this is facilitation with service sharing or access to resources and within species, direct benefits by mutual benefits. These classifications provide a clear starting point for addressing the subject of helping behaviours

  5. Multi-institutional implementation and evaluation of a curriculum for the medical student clerkship in radiation oncology

    PubMed Central

    Golden, Daniel W.; Braunstein, Steve; Jimenez, Rachel B.; Mohindra, Pranshu; Spektor, Alexander; Ye, Jason C.; Bradley, Kristin A.; Chmura, Steven J.; Currey, Adam; Das, Prajnan; Du, Kevin; Haas-Kogan, Daphne; Howard, Andrew R.; Higgins, Susan A.; Hung, Arthur Y.; Kharofa, Jordan; Krishnan, Monica S.; MacDonald, Shannon M.; Mancini, Brandon R.; Parashar, Bhupesh; Thaker, Nikhil G.; Thomas, Charles R.; Viswanathan, Akila N.; Wheatley, Matt

    2015-01-01

    Purpose/Objective(s) Radiation oncology curriculum development is challenging due to limited numbers of trainees at any single institution. The goal of this project is to implement and evaluate a standardized medical student clerkship curriculum following the multi-institutional cooperative group research model. Methods and Materials During the 2013 academic year, a standardized curriculum was implemented at 11 academic medical centers consisting of three one-hour lectures and a hands-on radiation treatment planning workshop. Post-curriculum, students completed anonymous evaluations using Likert scales (1 = "not at all" to 5 = "extremely"; reported as median [interquartile range]) and free responses. Evaluations asked students to rate their pre/post-comfort with radiation oncology as a specialty, knowledge of radiotherapy planning methods, and ability to function as a radiation oncology resident. Non-parametric statistical tests were used in analysis. Results 88 students at 11 academic medical centers completed the curriculum de-novo with 72.7% (64/88) survey response rate. 57/64 (89.1%) reported intent to pursue radiation oncology as their specialty. Median student ratings of the importance of curricular content were: Overview 4[4-5]; Radiation Biology/Physics 5[4-5]; Practical Aspects/Emergencies 5[4-5]; Planning Workshop 4[4-5]. Students reported the curriculum helped them to better understand radiation oncology as a specialty (5[4-5]), increased specialty decision comfort (4[3-5]), and would help the transition to radiation oncology residency (4[4-5]). Students rated their specialty decision comfort significantly higher after completing the curriculum (4[4-5] vs. 5[5-5], p<0.001). Conclusions A national standardized curriculum was successfully implemented at 11 academic medical centers, providing proof-of-principle that curriculum development can follow the multi-institutional cooperative group research model. PMID:26410347

  6. Multi-Institutional Implementation and Evaluation of a Curriculum for the Medical Student Clerkship in Radiation Oncology.

    PubMed

    Golden, Daniel W; Braunstein, Steve; Jimenez, Rachel B; Mohindra, Pranshu; Spektor, Alexander; Ye, Jason C

    2016-02-01

    Radiation oncology curriculum development is challenging because of limited numbers of trainees at any single institution. The goal of this project is to implement and evaluate a standardized medical student clerkship curriculum following the multi-institutional cooperative group research model. During the 2013 academic year, a standardized curriculum was implemented at 11 academic medical centers consisting of three 1-hour lectures and a hands-on radiation treatment planning workshop. After the curriculum, students completed anonymous evaluations using Likert-type scales (1 = "not at all" to 5 = "extremely") and free responses. Evaluations asked students to rate their comfort, before and after the curriculum, with radiation oncology as a specialty, knowledge of radiotherapy planning methods, and ability to function as a radiation oncology resident. Nonparametric statistical tests were used in the analysis. Eighty-eight students at 11 academic medical centers completed the curriculum de novo, with a 72.7% (64 of 88) survey response rate. Fifty-seven students (89.1%) reported intent to pursue radiation oncology as their specialty. Median (interquartile range) student ratings of the importance of curricular content were as follows: overview, 4 (4-5); radiation biology/physics, 5 (4-5); practical aspects/emergencies, 5 (4-5); and planning workshop, 4 (4-5). Students reported that the curriculum helped them better understand radiation oncology as a specialty (5 [4-5]), increased specialty decision comfort (4 [3-5]), and would help the transition to radiation oncology residency (4 [4-5]). Students rated their specialty decision comfort significantly higher after completing the curriculum (4 [4-5] versus 5 [5-5]; P < .001). A national standardized curriculum was successfully implemented at 11 academic medical centers, providing proof of principle that curriculum development can follow the multi-institutional cooperative group research model. Copyright © 2016 American

  7. Gastric cancer in Italy.

    PubMed

    Cipriani, F; Buiatti, E; Palli, D

    1991-01-01

    Although Gastric Cancer (GC) death rates are decreasing worldwide, in high risk areas GC is still a major public health problem. Italy is one of the European countries with the highest mortality rates for GC (males: 17.3; females: 8.2 x 100,000 inhabitants in 1987) which represents the third cause of death due to cancer in 1987, accounting for over 14,000 deaths per year (10% of cancer deaths). Reasons for the geographic variability in GC occurrence within the country are reviewed, discussing the results of two recent analytical epidemiological studies carried out in Italy. These large case-control studies focused on dietary factors, involving high and low-risk areas for GC (Florence, Siena, Forlì, Imola, Cremona, Genoa, Cagliari, and Milan). Low socio-economic status, family history of GC, residence in rural areas were associated to GC risk, while migration from southern areas and body mass index were inversely related to GC. Consumption of traditional soups, meat, salted and dried fish, cold cuts and seasoned cheeses, as well as the intake of animal proteins and nitrites were related to an increased GC risk. On the contrary consumption of fresh fruit, citrus fruit, raw vegetables, spices, garlic and olive oil, and vitamin C, E and beta-carotene intake were found to be protective factors. Among diet-related factors, preference for salty foods and frequent broiling were positively related to GC, while the longstanding availbility of a refrigerator or freezer and the habits of consuming frozen foods were associated with decreased GC risk. These results are discussed in detail, considering the main hypotheses on GC carcinogenesis.

  8. Italy: health system review.

    PubMed

    Ferre, Francesca; de Belvis, Antonio Giulio; Valerio, Luca; Longhi, Silvia; Lazzari, Agnese; Fattore, Giovanni; Ricciardi, Walter; Maresso, Anna

    2014-01-01

    Italy is the sixth largest country in Europe and has the second highest average life expectancy, reaching 79.4 years for men and 84.5 years for women in 2011. There are marked regional differences for both men and women in most health indicators, reflecting the economic and social imbalance between the north and south of the country. The main diseases affecting the population are circulatory diseases, malignant tumours and respiratory diseases. Italy's health care system is a regionally based national health service that provides universal coverage largely free of charge at the point of delivery. The main source of financing is national and regional taxes, supplemented by copayments for pharmaceuticals and outpatient care. In 2012, total health expenditure accounted for 9.2 percent of GDP (slightly below the EU average of 9.6 percent). Public sources made up 78.2 percent of total health care spending. While the central government provides a stewardship role, setting the fundamental principles and goals of the health system and determining the core benefit package of health services available to all citizens, the regions are responsible for organizing and delivering primary, secondary and tertiary health care services as well as preventive and health promotion services. Faced with the current economic constraints of having to contain or even reduce health expenditure, the largest challenge facing the health system is to achieve budgetary goals without reducing the provision of health services to patients. This is related to the other key challenge of ensuring equity across regions, where gaps in service provision and health system performance persist. Other issues include ensuring the quality of professionals managing facilities, promoting group practice and other integrated care organizational models in primary care, and ensuring that the concentration of organizational control by regions of health-care providers does not stifle innovation. World Health

  9. [Primary care in Italy].

    PubMed

    Sánchez-Sagrado, T

    2017-05-25

    Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

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

    SciTech Connect

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

    2012-10-01

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

  11. Perspective View, Mt. Etna, Italy

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Italy's Mount Etna is the focus of this perspective view made from an Advanced Spaceborne Thermal and Emission Radiometer (ASTER) image from NASA's Terra spacecraft overlaid on Shuttle Radar Topography Mission (SRTM) topography. The image is looking south with dark lava flows from the 1600's (center) to 1981 (long flow at lower right) visible in the foreground and the summit of Etna above. The city of Catania is barely visible behind Etna on the bay at the upper left. In late October 2002, Etna erupted again, sending lava flows down the north and south sides of the volcano. The north flows are near the center of this view, but the ASTER image is from before the eruption.

    In addition to the terrestrial applications of these data for understanding active volcanoes and hazards associated with them such as lava flows and explosive eruptions, geologists studying Mars find these data useful as an analog to martian landforms and geologic processes. In late September 2002, a field conference with the theme of Terrestrial Analogs to Mars focused on Mount Etna, allowing Mars geologists to see in person the types of features they can only sample remotely.

    Elevation data used in this image was acquired by SRTM aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Earth Science Enterprise

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2010-04-01

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

  14. Pediatric oncology in Morocco: achievements and challenges.

    PubMed

    Hessissen, Laila; Madani, Abdellah

    2012-03-01

    Cancer in children is quickly becoming one of the leading causes of non traumatic death among children. In pediatric oncology, palliative care is a primary component of the cancer control plan. In low income countries also known as emerging nations or developing countries access to adequate care remains a challenge for most pediatric oncology patients. In Morocco the situation has dramatically improved in the last few years as both the government and NGOs have become more aware of the importance and urgency of the issue. The incidence of cancer in patients under 15 years of age in Morocco is estimated to be 1000 new cases per year and the incidence of leukemia to be 100 new cases diagnosed per year. Pediatric cancer patients are mostly managed by public hospitals. Thus they are highly influenced by the Moroccan public health system, which is now considering cancer management a priority. Since health cover is very limited, most chemotherapy drugs were purchased by local parent associations. Recently, a new large Moroccan NGO (ALSC) provides anti-cancer drugs to all government-run oncology units. Despite all the progress, Morocco has witnessed in the pediatric oncology field, the palliative aspect of the care is not yet organized. Pediatric oncology is supported by the work of the National Society of Pediatric Oncolgy. The opioide therapy is available. However its use is strongly limited by the current restrictive and obsolete legislation which represents a major barrier to care. Despite the latest progress, pediatric oncology in Morocco still needs to improve in order to achieve performances comparable to those of the developed world. These improvements include better survival rates, less treatment abandonment, developing new techniques, improving quality of life and creating data collection teams. In order for this action to succeed all the stakeholders (government, NGOs, medical societies, oncology teams) must work together and coordinate their efforts.

  15. Prevalence and treatment of cancer pain in Italian oncological wards centres: a cross-sectional survey.

    PubMed

    Mercadante, Sebastiano; Roila, Fausto; Berretto, Oscar; Labianca, Roberto; Casilini, Stefania

    2008-11-01

    The aim of this national cross-sectional survey was to draw information on pain prevalence and intensity from a large sample of patients who were admitted to oncologic centres for different reasons and to evaluate the pain treatment and possible influencing factors. A total of 2,655 patients completed the study. Nine hundred and one patients (34%) reported pain. Higher pain levels were observed in inpatients, in the presence of bone metastases, and with low levels of Eastern Cooperative Oncology Group status. The number of patients receiving strong opioids increased with the highest levels of pain. However, a significant part of patients with moderate-severe pain were not receiving appropriate medication, patients being predominantly administered non-opioid drugs. General practitioners' attitudes did not negatively influence the opioid prescription. The results of this survey indicate a need for continuing educational and informative program in pain management for oncologists and more generally for any physician dealing with cancer patients.

  16. The Evolution of Cooperation.

    ERIC Educational Resources Information Center

    Dugatkin, Lee Alan

    1997-01-01

    Outlines the four paths to the evolution and maintenance of cooperative behavior and provides two stories highlighting each path. Discusses reciprocity, byproduct mutualism, kin-selected cooperation, and group-selected cooperation. Presents some thoughts on where the study of animal cooperation might head in the future. Contains 67 references.…

  17. Italy INAF Data Center Report

    NASA Technical Reports Server (NTRS)

    Negusini, M.; Sarti, P.

    2013-01-01

    This report summarizes the activities of the Italian INAF VLBI Data Center. Our Data Center is located in Bologna, Italy and belongs to the Institute of Radioastronomy, which is part of the National Institute of Astrophysics.

  18. Rice Cultivation in Northwest Italy

    NASA Image and Video Library

    2005-06-08

    The lowlands of Lombardy and Piedmont in northwest Italy are some of the most highly developed irrigation areas in the world. These views of the region were acquired on May 8, 2005, by NASA Terra spacecraft.

  19. [Clinical prediction in medical oncology].

    PubMed

    González Barón, Manuel

    2003-01-01

    Predictive factors (PF) are variables that give information about survival, treatment response or toxicity and future complications on cancer patients. The foremost utility of PF takes root in the possibility to furnish an individualized treatment schedule with higher succeeding options. They include clinical characteristics of the patient, tumour features, treatment administrated, classical pathological and new molecular data obtained from patients clinical samples. Clinical parameters comprise age, sex, underlying diseases and performance status among others, and in concurrence with tumour pathology and clinical stage (TNM) usually define the best treatment options. Also, chemotherapy response can modify natural history of several tumours, and thus is a PF. Modifications in evolving PF typically induce a variation in patient outcome. Hence, surgical tumour size reduction or neoadjuvant down-staging improve survival in several cancers. In the other side, treatment adjustment to steady PF should offers better outcome than "standard therapies". Recent advances on cancer research have generated a great deal of biological data that help us to search new treatment and diagnostic modalities. Biotechnology offers a great amount of possibilities in the next future and probably a true individualized therapy. Conversely, there are a small amount of molecular evidences that imply a creal variation in current clinical practice. Hence, more scientific and financial efforts are necessary to exploit to the full knowledge spurting up from basic science. In summary, the prediction in oncology is a hard task derived from clinical observation, tumour behaviour, treatment schedules and biological evidences that must offer realistic predictions on a concrete cancer patient. Oncologists have a duty to know all these variables to accomplish this thorny assignment. This review will focus on classical and recent biological PF in cancer.

  20. PREFACE: Cooperative dynamics Cooperative dynamics

    NASA Astrophysics Data System (ADS)

    Gov, Nir

    2011-09-01

    The dynamics within living cells are dominated by non-equilibrium processes that consume chemical energy (usually in the form of ATP, adenosine triphosphate) and convert it into mechanical forces and motion. The mechanisms that allow this conversion process are mostly driven by the components of the cytoskeleton: (i) directed (polar) polymerization of filaments (either actin or microtubules) and (ii) molecular motors. The forces and motions produced by these two components of the cytoskeleton give rise to the formation of cellular shapes, and drive the intracellular transport and organization. It is clear that these systems present a multi-scale challenge, from the physics of the molecular processes to the organization of many interacting units. Understanding the physical nature of these systems will have a large impact on many fundamental problems in biology and break new grounds in the field of non-equilibrium physics. This field of research has seen a rapid development over the last ten years. Activities in this area range from theoretical and experimental work on the underlying fundamental (bio)physics at the single-molecule level, to investigations (in vivo and in vitro) of the dynamics and patterns of macroscopic pieces of 'living matter'. In this special issue we have gathered contributions that span the whole spectrum of length- and complexity-scales in this field. Some of the works demonstrate how active forces self-organize within the polymerizing cytoskeleton, on the level of cooperative cargo transport via motors or due to active fluxes at the cell membrane. On a larger scale, it is shown that polar filaments coupled to molecular motors give rise to a huge variety of surprising dynamics and patterns: spontaneously looping rings of gliding microtubules, and emergent phases of self-organized filaments and motors in different geometries. All of these articles share the common feature of being out-of-equilibrium, driven by metabolism. As demonstrated here

  1. Creating a unique, multi-stakeholder Paediatric Oncology Platform to improve drug development for children and adolescents with cancer.

    PubMed

    Vassal, Gilles; Rousseau, Raphaël; Blanc, Patricia; Moreno, Lucas; Bode, Gerlind; Schwoch, Stefan; Schrappe, Martin; Skolnik, Jeffrey; Bergman, Lothar; Bradley-Garelik, Mary Brigid; Saha, Vaskar; Pearson, Andy; Zwierzina, Heinz

    2015-01-01

    Seven years after the launch of the European Paediatric Medicine Regulation, limited progress in paediatric oncology drug development remains a major concern amongst stakeholders - academics, industry, regulatory authorities, parents, patients and caregivers. Restricted increases in early phase paediatric oncology trials, legal requirements and regulatory pressure to propose early Paediatric Investigation Plans (PIPs), missed opportunities to explore new drugs potentially relevant for paediatric malignancies, lack of innovative trial designs and no new incentives to develop drugs against specific paediatric targets are some unmet needs. Better access to new anti-cancer drugs for paediatric clinical studies and improved collaboration between stakeholders are essential. The Cancer Drug Development Forum (CDDF), previously Biotherapy Development Association (BDA), with Innovative Therapy for Children with Cancer Consortium (ITCC), European Society for Paediatric Oncology (SIOPE) and European Network for Cancer Research in Children and Adolescents (ENCCA) has created a unique Paediatric Oncology Platform, involving multiple stakeholders and the European Union (EU) Commission, with an urgent remit to improve paediatric oncology drug development. The Paediatric Oncology Platform proposes to recommend immediate changes in the implementation of the Regulation and set the framework for its 2017 revision; initiatives to incentivise drug development against specific paediatric oncology targets, and repositioning of drugs not developed in adults. Underpinning these changes is a strategy for mechanism of action and biology driven selection and prioritisation of potential paediatric indications rather than the current process based on adult cancer indications. Pre-competitive research and drug prioritisation, early portfolio evaluation, cross-industry cooperation and multi-compound/sponsor trials are being explored, from which guidance for innovative trial designs will be

  2. Precision oncology: origins, optimism, and potential.

    PubMed

    Prasad, Vinay; Fojo, Tito; Brada, Michael

    2016-02-01

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

  3. 2003 survey of Canadian radiation oncology residents

    SciTech Connect

    Yee, Don . E-mail: donyee@cancerboard.ab.ca; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-06-01

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

  4. Psycho-oncology: Searching for practical wisdom?

    PubMed

    Butlin, Helen

    2015-10-01

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

  5. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    PubMed

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

    2016-12-01

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

  6. Lake Garda, Italy

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This ASTER image was acquired on July 29, 2000 and covers an area of 30 by 57 km in northern Italy. Lake Garda was formed by glaciers during the last Ice Age, and is Italy's largest lake. Lago di Garda lies in the provinces of Verona, Brescia, and Trento, and is 51 kilometers (32 miles) long and from 3 to 18 kilometers (2 to 11 miles) wide. The Sarca is its chief affluent, and the lake is drained southward by the Mincio, which discharges into the Po River. Many villas are situated on its shores. On the peninsula of Sirmione, at the southern end of the lake, are the ruins of a Roman villa and a castle of the Scaligers, an Italian family of the 16th century. The RIGHT image has the land area masked out, and a harsh stretch was applied to the lake values to display variations in sediment load. Also visible are hundreds of boats and their wakes, criss-crossing the lake.

    The image is centered at 45.6 degrees north latitude, 10.6 degrees east longitude.

    Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. Dr. Anne Kahle at NASA's Jet Propulsion Laboratory, Pasadena, Calif., is the U.S. Science team leader; Moshe Pniel of JPL is the project manager. ASTER is the only high resolution imaging sensor on Terra. The primary goal of the ASTER mission is to obtain high-resolution image data in 14 channels over the entire land surface, as well as black and white stereo images. With revisit time of between 4 and 16 days, ASTER will provide the capability for repeat coverage of changing areas on Earth's surface.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for

  7. Snow in Italy

    NASA Image and Video Library

    2017-09-28

    NASA image acquired February 24, 2012 By late February, 2012, the great European cold wave had begun to loosen its frigid grip, but significant snow still remained in the region. The Moderate Resolution Imaging Spectroradiometer (MODIS) aboard the Aqua satellite captured this true-color image of snow in Italy on February 24 at 12:35 UTC (1:30 p.m. local time). In the north of the image, bright white clouds blanket the region in a broad arc. Snow, which tends to be generally less bright that clouds, covers the Alps in the north of Italy. The Apennine Mountains, which form the backbone of the Italian peninsula, also carry a blanket of snow. Although clouds and snow can, at times, be distinguished visually in a true-color image, sometimes they can appear very similar. When it is important to clearly define snow from cloud, false color images are often helpful. Rome, which can be seen as a gray smudge on the southwestern coast of the peninsula, recorded highs of a spring-like 50°F the day this image was captured, but earlier in the month the temperatures dove as low as 26°F on February 5. During that cold snap a rare intense snowfall blanketed Rome, causing the closure of the Colosseum, the Roman Forum and the Palatine Hill due to concerns of the risk of icy footing for tourists, and roads became impassible. Further north, temperatures plummeted to −21 °C (−6 °F) on 7 February. On February 11, news media reported over 2 meters (6.5 feet) of snow had fallen in Urbino, a walled town situated on a high sloping hillside on the eastern side of the Apennine Mountains. That same snowfall cut access to many remote towns in the Apennines, blocking roads and trapping some people in the homes. Credit: NASA/GSFC/Jeff Schmaltz/MODIS Land Rapid Response Team NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA

  8. Italy of censuses.

    PubMed

    Rey, G M

    1983-06-01

    To supplement census data on Italy's economy, Istat conducted a sample survey of 2% of households. This paper reports survey findings in 3 areas: age structure of the population, employment and unemployment patterns by region, and structure of the productive system. Those over age 65 years have increased from 11% of the population in 1971 to 13% in 1981 and are forecast to constitute 14.5% in 1991. Women accounted for 51.3% of the total population in 1981 but 58.5% of those over age 65. 12% of households have a member over age 75. The 0-14 year age group has declined from 24.4% of the population in 1971 to 21.5% in 1981 and is projected to comprise 17.4% in 1991. The labor force activity rate was 39.8% in 1981. Unemployment was set at 14.7% in the census sample compared with 9.1% in Istat's quarterly survey of the labor force. 60% of the difference between these 2 figures was accounted for by Campania, Sicily, Puglia, Calabria, and Latium. These 5 regions, which account for only 30% of total employment, are the areas with the most acute employment problems and highest proportions of casual employment in agriculture and traditional services. Agriculture accounted for 22% of total unemployment, construction for 18.5%, and traditional industry for 14%--percentages that are higher than the share of total employment represented by these sectors. In the South, 20.4% of employment is in agriculture, 18.1% in industry, 12.6% in construction, and 48.9% in services. The average worker in the South supports 3.3 persons compared with 2.5 persons in the North. Survey results indicate a substantial shift in the sectoral composition of employment as well as a change in the size of productive units. There has been an increase in the highly specialized components of the economy, including services to firms. The average size of factories has declined, with a proliferation of small and medium sized units. These findings suggest a need to broaden and deepen Italy's industrial base

  9. Lake Garda, Italy

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This ASTER image was acquired on July 29, 2000 and covers an area of 30 by 57 km in northern Italy. Lake Garda was formed by glaciers during the last Ice Age, and is Italy's largest lake. Lago di Garda lies in the provinces of Verona, Brescia, and Trento, and is 51 kilometers (32 miles) long and from 3 to 18 kilometers (2 to 11 miles) wide. The Sarca is its chief affluent, and the lake is drained southward by the Mincio, which discharges into the Po River. Many villas are situated on its shores. On the peninsula of Sirmione, at the southern end of the lake, are the ruins of a Roman villa and a castle of the Scaligers, an Italian family of the 16th century. The RIGHT image has the land area masked out, and a harsh stretch was applied to the lake values to display variations in sediment load. Also visible are hundreds of boats and their wakes, criss-crossing the lake.

    The image is centered at 45.6 degrees north latitude, 10.6 degrees east longitude.

    Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of International Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. Dr. Anne Kahle at NASA's Jet Propulsion Laboratory, Pasadena, Calif., is the U.S. Science team leader; Moshe Pniel of JPL is the project manager. ASTER is the only high resolution imaging sensor on Terra. The primary goal of the ASTER mission is to obtain high-resolution image data in 14 channels over the entire land surface, as well as black and white stereo images. With revisit time of between 4 and 16 days, ASTER will provide the capability for repeat coverage of changing areas on Earth's surface.

    The broad spectral coverage and high spectral resolution of ASTER will provide scientists in numerous disciplines with critical information for

  10. Soft budget constraints in health care: evidence from Italy.

    PubMed

    Levaggi, Rosella; Menoncin, Francesco

    2013-10-01

    The reforms that have reshaped the public health care systems have often been coupled with devolution. However, this process has frequently been accompanied by widespread soft budget constraint policies. In this paper we argue that the soft budget constraint arises from a cooperative game between local authorities that force Central Government to bail them out. Our theoretical model is tested using data for Italian regions for the period 2002-2006 and our hypothesis is verified. Although the model uses Italy as a benchmark, we believe that the framework we propose could be extended to other federal contexts where resources are distributed unevenly and preferences are asymmetric.

  11. Life's final journey: the oncology nurse's role.

    PubMed

    Fairbrother, Cheryl A; Paice, Judith A

    2005-10-01

    Despite advances in technology and science, many people diagnosed with cancer are likely to die from the disease. Because of the long-term relationships that oncology nurses develop with patients and their families during lengthy treatment periods, they are the most appropriate clinicians to provide care across the continuum and through the final journey. Care of patients in the final days of life requires a comprehensive knowledge of common syndromes, skillful assessment, and adept clinical management. Nurses cannot focus solely on the needs of patients; family members often are unaware of the dying process. Oncology nurses are uniquely qualified to provide education and support to families at the bedside witnessing the final days and hours of their loved ones. Finally, oncology nurses involved in the care of dying patients are at risk for burnout and need to provide care for their own needs to find balance between their professional and personal lives.

  12. The Servier oncology pipeline in 2017.

    PubMed

    Therasse, Patrick; Perron, Beatrice; Novack, Sarah A; Abastado, Jean-Pierre

    2017-07-01

    Cancer is a complex, multifactorial disease that for years has been the focus of intensive research efforts to explore both the molecular and biological mechanisms involved and the development of novel agents to target these pathways. Servier is an independent French pharmaceutical company with a focus on oncology. Currently, Servier's commercial portfolio includes agents used to treat non-Hodgkin's lymphoma and metastatic colorectal cancer; Servier's oncology pipeline involves agents for the treatment of both solid and hematological tumors. The main areas of future research focus on the development of therapeutics targeting apoptosis or the active immune components involved in tumour development/maintenance. Servier intends to continue its focus on cutting-edge oncology innovation by collaborating with both industry and academia, and maintaining its strong patient-centered approach.

  13. [Acute dysphagia of oncological origin. Therapeutic management].

    PubMed

    Arias, F; Manterola, A; Domínguez, M A; Martínez, E; Villafranca, E; Romero, P; Vera, R

    2004-01-01

    Dysphagia is one of the most frequent syndromes in patients with tumours of the head and neck, and the oesophagus. This can be the initial symptom or, more frequently, related to the oncological treatment. We review the most important therapeutic and physio-pathological aspects of acute dysphagia of oncological origin. Deglutition is a complex process in which numerous muscular-skeletal structures intervene under the neurological control of different cranial nerves. The complex neuro-muscular coordination needed for a correct deglutition can be affected by numerous situations, both from the effect of the tumours and from their treatment, basically surgery or radiotherapy. In conclusion, it can be affirmed that for a suitable treatment of oncological dysphagia, a correct initial evaluation and an active treatment are required, since not only the patient's quality of life but, on numerous occasions, the possibility of continuing the treatment and thus maintaining the possibilities of a cure depend on control of the dysphagia.

  14. [Imaging in oncology: terms and definitions].

    PubMed

    Brader, P; Menu, Y; Kreuzer, S; Polanec, S; Mayerhoefer, M; Herold, C J

    2013-04-01

    Oncologic imaging includes the morphological description of the primary tumor region for an accurate classification of the tumor and lymph node stage and whether distant metastases have occurred according to the TNM staging system. Knowing the stage of the disease helps to plan the treatment and to estimate the prognosis. In clinical routine this is accomplished by conventional imaging techniques, such as ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Additionally, oncologic imaging is essential in treatment monitoring to visualize and quantify the effect of cancer therapy according to response evaluation criteria in solid tumors (RECIST) and World Health Organization (WHO) criteria. The tremendous development in oncology and technical innovations in imaging represent a particular challenge for radiology.

  15. [Bipolar disorders in oncology: Characteristics and management].

    PubMed

    Reich, Michel; Kotecki, Nuria

    2017-05-01

    Bipolar disorders belong to the spectrum of mood disorders and represent a serious psychiatric comorbidity. Behaviors adopted by bipolar patients can foster cancer occurrence but also impact its management, especially during acute depressive or manic episode. Oncologists must adapt their protocols in order to obtain the best compliance for treatment and avoid any possible mood destabilization, with the inherent risk of suicidal attempt. Potential interactions between mood-stabilizing agents (lithium, divalproate, atypical antipsychotics, and anticonvulsivants) and oncologic treatment (chemotherapy, targeted therapy, immunotherapy, corticotherapy) will be particularly watched. To do so, a closely collaboration with the oncopsychiatrist but also with the referent or liaison psychiatry team is necessary during the patient's oncologic care. Some clinical vignettes will illustrate the modalities of care of bipolar disorders in oncology. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  16. The Evolution of Gero-Oncology Nursing

    PubMed Central

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

    2016-01-01

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

  17. Nardo Ring, Italy

    NASA Technical Reports Server (NTRS)

    2008-01-01

    The Nardo Ring is a striking visual feature from space, and astronauts have photographed it several times. The Ring is a race car test track; it is 12.5 kilometers long and steeply banked to reduce the amount of active steering needed by drivers. The Nardo Ring lies in a remote area on the heel of Italy's 'boot,' 50 kilometers east of the naval port of Taranto. The Ring encompasses a number of active (green) and fallow (brown to dark brown) agricultural fields. In this zone of intensive agriculture, farmers gain access to their fields through the Ring via a series of underpasses. Winding features within the southern section of the Ring appear to be smaller, unused race tracks.

    The image covers an area of 18.8 x 16.4 km, was acquired on August 17. 2007, and is located at 49.3 degrees north latitude, 17.8 degrees east longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  18. Biodemography in Siena, Italy.

    PubMed

    Vienna, A; De Stefano, G F; Bastianini, A; Biondi, G

    1998-10-01

    Data were obtained on surnames of the parents and places of birth of the parents and grandparents of children in Siena, Italy. Isonymy and total inbreeding coefficient, and their random and non-random components, are 0.005, 0.00125, 0.00019 and 0.00106, respectively. Isonymy and inbreeding figures are similar to those of other medium-sized Italian towns, while higher values have been reported for Italian villages and Italian ethnic minorities. City endogamy, and endogamy of Contrada for grandparents have the same values (44.1 and 44.8%, respectively), but for parents, endogamy of Contrada is lower than city endogamy (15.2 and 33.4%, respectively). The difference between the extent of Contrada endogamy expected at random and observed in the parents' generation does not seem to affect the genetic structure of the present population. However, the bulk of marriage migration (more than 70%) is short range, with people coming from Tuscany. There is no statistical difference in marital migration between males and females.

  19. Current Management of Surgical Oncologic Emergencies

    PubMed Central

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

    2015-01-01

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

  20. Contemporary Trends in Radiation Oncology Resident Research.

    PubMed

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

    2016-11-15

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

  1. Safety in radiation oncology: the role of international initiatives by the International Atomic Energy Agency.

    PubMed

    Abdel-Wahab, May; Rosenblatt, Eduardo; Holmberg, Ola; Meghzifene, Ahmed

    2011-11-01

    The International Atomic Energy Agency (IAEA) has a wide range of initiatives that address the issue of safety. Quality assurance initiatives and comprehensive audits of radiotherapy services, such as the Quality Assurance Team for Radiation Oncology, are available through the IAEA. Furthermore, the experience of the IAEA in thermoluminescence dosimetric audits has been transferred to the national level in various countries and has contributed to improvements in the quality and safety of radiotherapy. The IAEA is also involved in the development of a safety reporting and analysis system (Safety in Radiation Oncology). In addition, IAEA publications describe and analyze factors contributing to safety-related incidents around the world. The lack of sufficient trained, qualified staff members is addressed through IAEA programs. Initiatives include national, regional, and interregional technical cooperation projects, educational workshops, and fellowship training for radiation oncology professionals, as well as technical assistance in developing and initiating local radiation therapy, safety education, and training programs. The agency is also active in developing staffing guidelines and encourages advanced planning at a national level, aided by information collection systems such as the Directory of Radiotherapy Centers and technical cooperation project personnel planning, to prevent shortages of staff. The IAEA also promotes the safe procurement of equipment for radiation therapy centers within a comprehensive technical cooperation program that includes clinical, medical physics, and radiation safety aspects and review of local infrastructure (room layout, shielding, utilities, and radiation safety), the availability of qualified staff members (radiation oncologists, medical physicists, and radiation technologists and therapists), as well as relevant imaging, treatment planning, dosimetry, and quality control items. The IAEA has taken the lead in developing a

  2. Integrated biophotonics in endoscopic oncology

    NASA Astrophysics Data System (ADS)

    Muguruma, Naoki; DaCosta, Ralph S.; Wilson, Brian C.; Marcon, Norman E.

    2009-02-01

    endoscopic diagnosis is likely to be impacted by a combination of biomarkers and technology, and 'endoscopic molecular imaging' should be defined as "visualization of molecular characteristics with endoscopy". These innovations will allow us not only to locate a tumor or dysplastic lesion but also to visualize its molecular characteristics (e.g., DNA mutations and polymorphisms, gene and/or protein expression), and the activity of specific molecules and biological processes that affect tumor behavior and/or its response to therapy. In the near future, these methods should be promising technologies that will play a central role in gastrointestinal oncology.

  3. Genetics in neuro-oncology.

    PubMed

    Martuza, R L

    1983-01-01

    could be identified and studied in the meningioma, the findings could be important not only in the treatment of patients with this tumor but also in the treatment of tumors of other hormonally modulated tissues such as breast and uterus. Finally, neurofibromatosis was chosen as the most common of the phakomatoses and as one which can offer significant insights into many areas of neuro-oncology. The NF gene occurs in at least two forms (VRNF, BANF), and it can be associated with virtually all of the tumors known to neurosurgeons--gliomas, neurofibromas, schwannomas, and meningiomas.(ABSTRACT TRUNCATED AT 400 WORDS)

  4. Oncological emergencies associated with gastrointestinal tumors

    PubMed Central

    Prenen, Klaas; Prenen, Hans

    2015-01-01

    Oncological emergencies are defined as acute life-threatening conditions in cancer patients either as a result of the malignancy or as a result of its treatment. In this review, we focus on oncological emergencies associated with gastrointestinal tumors. They can be categorized by their system of origin as hematologic, neurologic or metabolic. Furthermore, we discuss mechanical emergencies such as intestinal obstruction and vena cava superior syndrome as well as acute gastrointestinal bleeding and pulmonary embolism. The patients’ performance status as well as prognosis are essential during decision making for optimal treatment. PMID:26424367

  5. [Role of laparoscopy in uro-oncology].

    PubMed

    Safarík, L; Novák, K; Dvorácek, J

    2005-01-01

    The article reviews problems of laparoscopic surgery in uro-oncology. Examples supporting and opposing the laparoscopic alternative are given. Original objections against the use of the method for the treatment of malignancies are discussed from the retrospective position. According to the predominant views it looks that laparoscopic treatment by a highly educated team with good technical background, respecting oncologic and functional aspects, does not have worse short-term and long-lasting results. The improving diagnostics and possibility to identify malignancies in early stage of development will enable wider use of the laparoscopic surgery.

  6. Fish Oncology: Diseases, Diagnostics, and Therapeutics.

    PubMed

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

    2017-01-01

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

  7. Managing oncology agents: an HMO's perspective.

    PubMed

    Jaramillo, Robert

    2007-03-01

    The only way to accomplish the goals discussed is for health plans to collaborate more constructively with the oncologist community. We have reached out to providers, but there is still plenty of room for improvement. It is critical for both our success and that of the oncology community, because no one benefits from an adversarial relationship. We have not really sat down as partners with care providers to talk about what both parties see as emerging issues and how to best address them. We are at a point in oncology where we have this opportunity.

  8. Integrative Oncology in Indian Subcontinent: An Overview

    PubMed Central

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

    2015-01-01

    Integrative oncology is a combination of one where complementary and alternative medicine (CAM) with conventional cancer treatment modalities is used to manage symptoms, control side-effects and improve the state of mental wellbeing. The ancient Indian medicinal approach in cancer treatment and management has a wide array of herbs and practices. There is an increasing demand for traditional and natural medicine by the cancer patients. The conventional oncologic surgeons and physicians should be aware of the role of cCAM that are available in Indian subcontinent and provide a treatment that focuses on the physical and mental state of wellness in combating cancer. PMID:25954692

  9. Immunotherapy Administration: Oncology Nursing Society Recommendations
.

    PubMed

    Wiley, Kathleen; LeFebvre, Kristine B; Wall, Lisa; Baldwin-Medsker, Abigail; Nguyen, Kim; Marsh, Lisa; Baniewicz, Diane

    2017-04-01

    As the use of immunotherapeutic agents increases in single-agent and multimodality treatment regimens, oncology nurses face the challenge of administering and caring for patients receiving new and unique agents. Oncology Nursing Society clinical staff and clinical nurses collaborated to produce a set of recommendations to educate nurses involved with the monitoring of patients receiving immunotherapy on administration procedures and safe handling of these agents to ensure patient and staff safety and to reduce risk of error. The recommendations are meant to provide clinical nurses with a framework on which to build policies and procedures for administering new treatment modalities.
.

  10. Oncology of Reptiles: Diseases, Diagnosis, and Treatment.

    PubMed

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

    2017-01-01

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

  11. Potential role for metformin in urologic oncology

    PubMed Central

    Sayyid, Rashid Khalid

    2016-01-01

    Metformin is one of the most commonly used drugs worldwide. It is currently considered first-line pharmacological agent for management of diabetes mellitus type 2. Recent studies have suggested that metformin may have further benefits, especially in the field of urologic oncology. Use of metformin has been shown to be associated with decreased incidence and improved outcomes of prostate, bladder, and kidney cancer. These studies suggest that metformin does have a future role in the prevention and management of urologic malignancies. In this review, we will discuss the latest findings in this field and its implications on the management of urologic oncology patients. PMID:27195314

  12. The virtual slide in the promotion of cytologic and hystologic quality in oncologic screenings.

    PubMed

    Bondi, Arrigo; Pierotti, Paola; Crucitti, Paola; Lega, Stefania

    2010-01-01

    A regional experience environment in virtual microscopy and digital pathology comprehending the digital cytology is presented. The project has been conducted in Emilia-Romagna and it has been planned for the promotion and the quality assessment in screening cytology and histology for the prevention of the tumors of uterine cervix, breast and colon-rectum cancers. During the project it has been envisaged the design of a dedicated picture archive and communication system (PACS) for cooperative diagnosis, didactics and training, teleconsulting, documentation of rare cases and pilot experiences; furthermore selected cases are catalogued in the PACS with the aim of the check of the diagnostic concordance in the oncologic screening.

  13. 75 FR 81283 - Oncologic Drugs Advisory Committee; Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... HUMAN SERVICES Food and Drug Administration Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory... of December 6, 2010 (75 FR 75680). On February 9, 2011, the Oncologic Drugs Advisory Committee...

  14. Graviquakes in Italy

    NASA Astrophysics Data System (ADS)

    Petricca, P.; Barba, S.; Carminati, E.; Doglioni, C.; Riguzzi, F.

    2015-08-01

    We discuss the mechanics of crustal normal fault-related earthquakes, and show that they represent dissipation of gravitational potential energy (graviquakes) and their magnitude increases with the involved volume (delimited by the seismogenic fault and an antithetic dilated wedge in its hangingwall), and the fault dip. The magnitude increases with the deepening of the brittle-ductile transition (BDT), which in turn enlarges the involved volume. The fault dip seems rather controlled by the static friction of the involved crustal layers. We apply the model to the extensional area of the Italian peninsula, whose geodynamics is controlled by the Alpine and Apennines subduction zones. The latter has a well-developed backarc basin and a large part of the accretionary prism is affected by on-going extensional tectonics, which is responsible for most of peninsular Italy seismicity. Analyzing the seismic record of the Apennines, the length of seismogenic normal faults tends to be at most about 3 times the hypocenter depth. We compile a map of the brittle-ductile transition depth and, assuming a fixed 45° or 60° fault dip and a dilated wedge developed during the interseismic period almost perpendicular to the fault plane, we compute the maximum volume of the hangingwall collapsing at the coseismic stage, and estimate the maximum expected magnitude. Lower magnitude values are obtained in areas with thinner brittle layer and higher heat flow. Moreover, lower magnitude relative to those theoretically expected may occur in areas of higher strain rate where faults may creep faster due to lower frictional values.

  15. Natural Language Processing in Oncology: A Review.

    PubMed

    Yim, Wen-Wai; Yetisgen, Meliha; Harris, William P; Kwan, Sharon W

    2016-06-01

    Natural language processing (NLP) has the potential to accelerate translation of cancer treatments from the laboratory to the clinic and will be a powerful tool in the era of personalized medicine. This technology can harvest important clinical variables trapped in the free-text narratives within electronic medical records. Natural language processing can be used as a tool for oncological evidence-based research and quality improvement. Oncologists interested in applying NLP for clinical research can play pivotal roles in building NLP systems and, in doing so, contribute to both oncological and clinical NLP research. Herein, we provide an introduction to NLP and its potential applications in oncology, a description of specific tools available, and a review on the state of the current technology with respect to cancer case identification, staging, and outcomes quantification. More automated means of leveraging unstructured data from daily clinical practice is crucial as therapeutic options and access to individual-level health information increase. Research-minded oncologists may push the avenues of evidence-based research by taking advantage of the new technologies available with clinical NLP. As continued progress is made with applying NLP toward oncological research, incremental gains will lead to large impacts, building a cost-effective infrastructure for advancing cancer care.

  16. Ethical problems experienced by oncology nurses1

    PubMed Central

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

    2015-01-01

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

  17. Major Oncologic Surgery at a Community Hospital

    PubMed Central

    Loui, Hollyann; Benyamini, Pouya

    2017-01-01

    There is a national trend to refer patients requiring complex oncologic surgery to tertiary high-volume cancer centers. However, this presents major access challenges to Hawai‘i patients seeking care. The purpose of this study is to demonstrate that complex oncologic surgery can be safely performed at community hospitals like those in Hawai‘i. From July 2007 to December 2014, 136 patients underwent complex oncologic procedures at a community hospital in Hawai'i by a single general surgeon. Cases included esophagogastric, hepatobiliary, pancreatic, rectal, and retroperitoneal resections. A database of patients was created from information extracted from the EPIC database. Complications were evaluated using the Clavien-Dindo grading system. There was 0.7% mortality rate (grade V complication). The major morbidity rate was 12.5%, including 10.3% grade III complications and 2.2% grade IV complications. The median length of stay for all operations was 8 days. The mean estimated blood loss for all operations was 708 cc. There was a 2.9% hospital readmission rate within 30 days of initial discharge, and a 5.1% reoperation rate. Complex oncologic procedures can be safely performed at a low-volume community hospital, with outcomes similar to those from high-volume cancer centers. PMID:28210527

  18. Direct-to-consumer advertising in oncology.

    PubMed

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

    2006-02-01

    Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to patients and support to caregivers while encouraging the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum in which caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Increasingly, cancer patients are subjected to advertisements related to oncologic therapies and other cancer-related products in the popular media. Such direct-to-consumer advertising is controversial: while it may inform, educate, and perhaps even empower patients, it also has the ability to misinform patients, and strain their relationships with oncology providers. The U.S. Food and Drug Administration requires that direct-to-consumer advertising provide a balanced presentation of a product's benefits, risks, and side effects, but this can be difficult to achieve. Through a discussion of this topic by an oncology fellow, ethicist, cancer survivor, and senior oncologist, the role of direct-to-consumer advertising and its often subtle effects on clinical practice in oncology are explored. Although sparse, the medical literature on this increasingly prevalent type of medical communication is also reviewed.

  19. [Analysis of hepato-digestive oncology practices].

    PubMed

    Guillemot, Florence; Cornu, Chloé; Marterer, Justine; Thegarid, Héléne

    2014-09-01

    Help nursing students and new professionals to understand the different facets of care is at the heart of the managerial and pedagogical process coordinated by the health framework. The formalisation and use of learning situations promote the identification of opportunities for learning, modelling and the assessment of practices. Feedback from the hepato-digestive oncology service.

  20. Origins of the quality oncology practice initiative.

    PubMed

    Simone, Joseph V

    2009-11-01

    In 2002, the ASCO Board of Directors reviewed a proposal for a new approach to promoting high-quality cancer care. Today, the Quality Oncology Practice Initiative has 500 participating practices that report data on approximately 35,000 medical records annually.

  1. Generic oncology drugs: are they all safe?

    PubMed

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

    2016-11-01

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

  2. Tobacco control policies of oncology nursing organizations.

    PubMed

    Sarna, Linda; Bialous, Stella Aguinaga

    2004-05-01

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

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

    PubMed

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

    2016-07-15

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

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

    PubMed

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

    2016-12-01

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

  5. American Society of Clinical Oncology National Census of Oncology Practices: preliminary report.

    PubMed

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

    2013-01-01

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

  6. Choosing the cooperative option

    SciTech Connect

    English, G. )

    1999-06-01

    Cooperatives do not ask to be exempted from the law. They do ask that laws and regulations be designed to allow them to meet the needs of their consumer-owners in accordance with cooperative principles, at a time that the marginal consumers being abandoned by for-profit utilities may be ready to gravitate toward cooperatives. The cooperative principles are worth reviewing because they explain the focus on the consumer and the cooperative concept of service: cooperatives are voluntary organizations, open to all persons able to use their services and willing to accept the responsibilities of membership; cooperatives are democratic organizations controlled by their members, who actively participate in setting policies and making decisions, the elected representatives are accountable to the membership; members contribute equitably to, and democratically control, the capital of their cooperative; cooperatives are autonomous, self-help organizations controlled by their members, if they enter into agreements with other organizations, including governments, they do so on terms that ensure democratic control by their members and maintain their cooperative autonomy; cooperatives provide education and training for their members, elected representatives, managers, and employees so they can contribute effectively to the development of their cooperatives, they inform the general public, particularly young people and opinion leaders, about the nature and benefits of cooperation; cooperatives serve their members most effectively and strength the cooperative movement by working together through local, national, regional, and international structures; and while focusing on member needs, cooperatives work for the sustainable development of their communities through policies accepted by their members.

  7. Technology for Innovation in Radiation Oncology.

    PubMed

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

    2015-11-01

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

  8. Is disease management right for oncology?

    PubMed

    Kash, Kathryn M; Sharma, Smiriti; Goldfarb, Neil I

    2009-12-01

    The disease management (DM) model for the treatment of chronic conditions has been around for many years and has been found to be effective for diseases of high prevalence and high cost (eg, diabetes, asthma, heart disease). With an increasing number of people living with cancer and the continual escalation of treatment costs, DM vendors have begun to implement DM concepts into cancer care. However, the multitude of cancer types, treatment options, and adverse effects have all presented barriers to oncology DM, and data reflecting the effectiveness of oncology DM have remained scarce. Oncology costs, the lack of congruence between provider and patient expectations of treatment, the lack of prevention and early detection for many cancers, and, most importantly, the inability of people to adhere to healthy lifestyles are additional obstacles that must be overcome. Moreover, when designing an oncology DM program, it is imperative to look at cancers individually as the etiology, treatment, and impact of cancer can be markedly different from one patient to the next. An effective oncology DM program is one that acts to decrease fatigue, reduces nosocomial infections, deals with dehydration and pain, manages anemia, identifies and treats skin infections, recognizes and treats depression and other psychological distress, provides patients access to palliative care services, facilitates informed decision making and end-of-life transitions, and promotes communication between patients and their providers as well as between physicians. Moving forward, DM vendors and health insurance companies capable of incorporating DM with medical management will be in the best position to provide optimal cancer care.

  9. Drug development in oncology: a regulatory perspective.

    PubMed

    Augustus, Stella

    2011-07-01

    The ultimate goal of any drug development, including that in oncology, is to register the new medicinal product. A number of challenges remain in this field, primarily in demonstrating the efficacy of the new oncology products to the satisfaction of the regulatory authorities worldwide. Key aspects of clinical trial design, conduct, and analysis that require careful consideration by the sponsors before initiation of drug development programs in oncology include the choice of primary and secondary end points, the choice of comparators, the necessity for independent radiologic review of a disease-related end point such as progression-free survival and tumor response, and the relative value of the independently reviewed and investigator-assessed clinical end points. Many of these aspects, including the choice of comparators and choice of primary/secondary end points, may have a crucial impact on both the eventual registrability of the new medicine and on the feasibility of conducting the clinical trials in the first place. Although both the industry and the regulators share a common goal of developing promising new oncology products that make a tangible contribution to the care of patients with cancer, more harmonized expectations for "proof of efficacy" and more pragmatic, clinically driven decision-making approaches from regulatory authorities would go a long way in making oncology drug development process less fraught with uncertainties and will result in a more efficient path from clinical trials to the clinic for new medicines. An open dialogue and greater collaboration between the industry and the regulators may help in achieving clarity around these goals and in bringing these to fruition.

  10. Oncology patients overwhelmingly support tissue banking.

    PubMed

    Bryant, Jamie; Sanson-Fisher, Rob; Fradgley, Elizabeth; Regan, Timothy; Hobden, Breanne; Ackland, Stephen P

    2015-05-17

    Translational biomedical research relies on the availability of human tissue to explore disease aetiology and prognostic factors, with the objective of developing better targeted treatments. The establishment of biobanks poses ongoing ethical considerations in relation to donors. This is a quantitative study exploring medical oncology patients' preferences for contributing to tissue biobanks. The objectives of this study were to explore oncology patients' preferences about tissue banking, including: 1) willingness to donate; 2) factors influencing donation decisions; 3) preferences about the use of donated tissue including permission systems, data linkage, and communication about research findings to donors. A cross-sectional survey was conducted in two tertiary oncology outpatient clinics. Eligible patients were approached by volunteers to complete a touchscreen survey in waiting rooms or while receiving intravenous therapy. Consenting participants completed demographic questions and received up to 12 previously validated items exploring preferences for donating tissue. 224 oncology outpatients participated over a ten month period (69.1 % consent rate; 64.4 % completion rate). Most participants were female (54 %), were a mean age of 62 years, and diagnosed with breast (26 %) and bowel (20 %) cancer. Most participants indicated willingness to donate tissue (84 %) and for their sample to be stored for future use (96 %). Participants preferred a blanket consent approach (71 %), samples to be linked to medical records (62 %) and for general results of the research (79 %) to be provided to them. Factors influencing willingness to donate tissue included personal (85 %) or familial health benefits (88 %) and a sense of duty to future patients (82 %). The overwhelming majority of oncology patients are willing to participate in a tissue bank, providing some support to explore 'opt-out' models of consent. To enhance patient acceptability, tissue banking programs should: (i

  11. Evaluation of burnout syndrome in oncology employees.

    PubMed

    Demirci, Senem; Yildirim, Yasemin Kuzeyli; Ozsaran, Zeynep; Uslu, Ruchan; Yalman, Deniz; Aras, Arif B

    2010-09-01

    Burnout is an important occupational problem for health care workers. We aimed to assess the burnout levels among oncology employees and to evaluate the sociodemographic and occupational factors contributing to burnout levels. The Maslach Burnout Inventory, which is designed to measure the three stages of burnout-emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), was used. The study sample consisted of 90 participants with a median age of 34 (range 23-56). The mean levels of burnout in EE, DP and PA stages were 23.80 +/- 10.98, 5.21 +/- 4.99, and 36.23 +/- 8.05, respectively, for the entire sample. Among the 90 participants, 42, 20, and 35.6% of the employees had high levels of burnout in the EE, DP, and PA substage, respectively. Sociodemographic and occupational factors associated with higher levels of burnout included age of less than 35, being unmarried, being childless, >40 work hours per week, working on night shifts, and <10 years experience in the medicine/oncology field. Within all oncology clinics, medical oncology employees had the highest levels of burnout. Furthermore, employees who are not pleased with working in oncology field, who would like to change their specialty if they have an opportunity, and whose family and social lives have been negatively affected by their work experienced higher levels of burnout. Burnout syndrome may influence physical and mental health of the employee and affects the quality of health care as well. Therefore, several individual or organizational efforts should be considered for dealing with burnout.

  12. What is a cooperative?

    Treesearch

    Kimberly Zeuli

    2006-01-01

    Groups of individuals throughout time have worked together in pursuit of common goals. The earliest forms of hunting and agriculture required a great deal of cooperation among humans. Although the word "cooperative" can be applied to many different types of group activities, in this publication it refers to a formal business model. Cooperative businesses are...

  13. Cooperative Learning: Professional's Guide.

    ERIC Educational Resources Information Center

    Grisham, Dana L.; Molinelli, Paul M.

    Noting that since the 1970s cooperative learning has been widely investigated regarding its implementation and efficacy, this booklet is designed to introduce the teaching strategy of cooperative learning to classroom teachers. The booklet first provides an overview and supplies a context for cooperative learning and then defines cooperative…

  14. Learning to Learn Cooperatively

    ERIC Educational Resources Information Center

    Byrd, Anne Hammond

    2009-01-01

    Cooperative learning, put quite simply, is a type of instruction whereby students work together in small groups to achieve a common goal. Cooperative learning has become increasingly popular as a feature of Communicative Language Teaching (CLT) with benefits that include increased student interest due to the quick pace of cooperative tasks,…

  15. Advising People about Cooperatives.

    ERIC Educational Resources Information Center

    Kirkman, C. H., Jr.; Mohn, Paul O.

    This document provides background and references for educational programs on cooperatives. Seven major topics are covered: Cooperatives Are Distinctive Business Corporations, Types of Cooperatives (such as agricultural, credit, housing, crafts, health, memorial association, fishing, forestry, recreation, labor, buying clubs, consumer, student, and…

  16. Interlibrary Cooperation. Final Report.

    ERIC Educational Resources Information Center

    Olson, Edwin E.

    The major dimensions of interlibrary cooperation which have implications for manpower development in librarianship are identified, categorized and described. These dimensions include: (1) the "power budget" of a cooperative; that is, the capability of a cooperative as represented by its structure, resources, and decision-making processes to…

  17. Cooperation Among State Agencies

    ERIC Educational Resources Information Center

    Wattenbarger, James L.; Hansen, Dean M.

    1975-01-01

    Most states have separate agencies to deal with vocational education, adult education, and community colleges. Because current procedures for interagency cooperation are inadequate and often nonproductive, there is a need for a national or extra-state catalyst to encourage cooperation in a positive way. Five strategies for cooperation are…

  18. Progress in Childhood Cancer: 50 Years of Research Collaboration, A Report from the Children's Oncology Group

    PubMed Central

    O'Leary, Maura; Krailo, Mark; Anderson, James R.; Reaman, Gregory H.

    2009-01-01

    The Children's Oncology Group (COG) recently celebrated the milestone of 50 years of pediatric clinical trials and collaborative research in oncology. Our group had its origins in the four legacy pediatric clinical trials groups: the Children's Cancer Group, the Pediatric Oncology Group, the National Wilms' Tumor Study Group and the Intergroup Rhabdomyosarcoma Study Group which merged in 2000 to form the COG. Over the last 50 years, the survival rates for childhood cancer have risen from 10% to almost 80%. Outcome in Acute Lymphoblastic Leukemia (ALL) has gone from a six month median survival to an 85% overall cure rate. We have modified therapies in most major diseases to induce remission with the least amount of long term sequelae. Here we look back on our advances but also look forward to the next 50 years which will produce even more successful treatments that will be tailored to the specific patient translating the tools of molecular genetics. Experience has clearly proven that everything we know about the diagnosis and management of childhood cancer is a result of research and the dramatic historical decrease in mortality from childhood cancer is directly related to cooperative group clinical research. PMID:18929147

  19. Establishing a Global Radiation Oncology Collaboration in Education (GRaCE): Objectives and priorities.

    PubMed

    Turner, Sandra; Eriksen, Jesper G; Trotter, Theresa; Verfaillie, Christine; Benstead, Kim; Giuliani, Meredith; Poortmans, Philip; Holt, Tanya; Brennan, Sean; Pötter, Richard

    2015-10-01

    Representatives from countries and regions world-wide who have implemented modern competency-based radiation- or clinical oncology curricula for training medical specialists, met to determine the feasibility and value of an ongoing international collaboration. In this forum, educational leaders from the ESTRO School, encompassing many European countries adopting the ESTRO Core Curriculum, and clinician educators from Canada, Denmark, the United Kingdom, Australia and New Zealand considered the training and educational arrangements within their jurisdictions, identifying similarities and challenges between programs. Common areas of educational interest and need were defined, which included development of new competency statements and assessment tools, and the application of the latter. The group concluded that such an international cooperation, which might expand to include others with similar goals, would provide a valuable vehicle to ensure training program currency, through sharing of resources and expertise, and enhance high quality radiation oncology education. Potential projects for the Global Radiation Oncology Collaboration in Education (GRaCE) were agreed upon, as was a strategy designed to maintain momentum. This paper describes the rationale for establishing this collaboration, presents a comparative view of training in the jurisdictions represented, and reports early goals and priorities.

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

    PubMed

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

    2009-01-01

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

  1. The National Centre for Oncological Hadrontherapy (CNAO): Status and perspectives.

    PubMed

    Rossi, Sandro

    2015-06-01

    The National Centre for Oncological Hadrontherapy (CNAO, sited in Pavia, Italy) completed at the end of 2013 the clinical trial phase achieving the CE label from the notified body of the Italian Health Ministry and obtained the authorisation to treat patients within the national health system. Nowadays more than 400 patients completed the treatments, two thirds of them with carbon ions, and recently started the treatment of pathologies located within moving organs. For the first time in the world carbon ions delivered with active scanning, coupled with breathing synchronisation and rescanning modalities have been applied to treat patients affected by tumours of the liver and by pancreatic cancers. The path to reach the final CE label required a wide-ranging experimental activity that went through dosimetry measurements of the hadron beams, in-vitro and in-vivo radiobiology essays and treatments of 150 patients, all enrolled in one of the 23 clinical trials approved by the Ethical Committee of CNAO and then authorized by the Italian Ministry of Health. The results of the trials were very positive in terms of safety and reliability of the procedures. The follow-up period is still short, but preliminary good results are observed in particular in terms of limited toxicity, that on the whole is less than expected. The paper gives a status report on the experimental phase that completed the CE certification process and then outlines the ongoing activities with also indications on the future trends and the most interesting R&D programmes pursued at CNAO.

  2. Assessing the Eventual Publication of Clinical Trial Abstracts Submitted to a Large Annual Oncology Meeting.

    PubMed

    Massey, Paul R; Wang, Ruibin; Prasad, Vinay; Bates, Susan E; Fojo, Tito

    2016-03-01

    Despite the ethical imperative to publish clinical trials when human subjects are involved, such data frequently remain unpublished. The objectives were to tabulate the rate and ascertain factors associated with eventual publication of clinical trial results reported as abstracts in the Proceedings of the American Society of Clinical Oncology (American Society of Clinical Oncology). Abstracts describing clinical trials for patients with breast, lung, colorectal, ovarian, and prostate cancer from 2009 to 2011 were identified by using a comprehensive online database (http://meetinglibrary.asco.org/abstracts). Abstracts included reported results of a treatment or intervention assessed in a discrete, prospective clinical trial. Publication status at 4-6 years was determined by using a standardized search of PubMed. Primary outcomes were the rate of publication for abstracts of randomized and nonrandomized clinical trials. Secondary outcomes included factors influencing the publication of results. A total of 1,075 abstracts describing 378 randomized and 697 nonrandomized clinical trials were evaluated. Across all years, 75% of randomized and 54% of nonrandomized trials were published, with an overall publication rate of 61%. Sample size was a statistically significant predictor of publication for both randomized and nonrandomized trials (odds ratio [OR] per increase of 100 participants = 1.23 [1.11-1.36], p < .001; and 1.64 [1.15-2.34], p = .006, respectively). Among randomized studies, an industry coauthor or involvement of a cooperative group increased the likelihood of publication (OR 2.37, p = .013; and 2.21, p = .01, respectively). Among nonrandomized studies, phase II trials were more likely to be published than phase I (p < .001). Use of an experimental agent was not a predictor of publication in randomized (OR 0.76 [0.38-1.52]; p = .441) or nonrandomized trials (OR 0.89 [0.61-1.29]; p = .532). This is the largest reported study examining why oncology trials are

  3. Medication Reconciliation in Oncological Patients: A Randomized Clinical Trial.

    PubMed

    Vega, Triana González-Carrascosa; Sierra-Sánchez, Jesús Francisco; Martínez-Bautista, María José; García-Martín, Fátima; Suárez-Carrascosa, Francisco; Baena-Cañada, Jose Manuel

    2016-06-01

    Medication reconciliation is considered to be an important strategy for increasing the safety of medication use. However, few studies have been carried out showing the effect of a medication reconciliation program on the incidence of reconciliation errors (REs) in oncological patients treated in the outpatient setting. To measure the effect of a medication reconciliation program on the incidence of reconciliation error that reached the patient (RERP) in cancer patients receiving chemotherapy as outpatients. A randomized, prospective, controlled study was carried out to identify the proportion of patients with at least 1 RERP. Medication reconciliation (intervention group) was compared with standard practice (control group) in patients starting new chemotherapy and who were receiving at least 1 home medication before the start of chemotherapy. A prespecified analysis of factors capable of influencing the occurrence of RE in oncological patients was also carried out. A total of 147 patients were included (76 in the intervention group and 71 controls) in this study. There were 3 (4%) patients with RERP (primary endpoint) in the intervention group and 21 (30%) patients in the control group (relative risk [RR] = 0.13, 95% CI = 0.04-0.43; P = 0.0009). The prespecified analysis of the effects of the Eastern Cooperative Oncology Group performance status (ECOG), Charlson Comorbidity Index score, and degree of poly-medication upon the number of patients with RE showed the Charlson Comorbidity Index to be unrelated to RE occurrence. However, the risk of RE was greater in patients with ECOG ≥ 2 (RR = 2.18, 95% CI = 1.4-3.4; P = 0.018) and among patients with major poly-medication (RR = 2.49, 95% CI = 1.52-4.09; P <0.001). Medication reconciliation results in a marked decrease in RERP in cancer patients. The factors that may influence RE occurrence in oncological patients have not been fully established, although parameters such as the degree of poly-medication and

  4. Dilemmas of partial cooperation.

    PubMed

    Stark, Hans-Ulrich

    2010-08-01

    Related to the often applied cooperation models of social dilemmas, we deal with scenarios in which defection dominates cooperation, but an intermediate fraction of cooperators, that is, "partial cooperation," would maximize the overall performance of a group of individuals. Of course, such a solution comes at the expense of cooperators that do not profit from the overall maximum. However, because there are mechanisms accounting for mutual benefits after repeated interactions or through evolutionary mechanisms, such situations can constitute "dilemmas" of partial cooperation. Among the 12 ordinally distinct, symmetrical 2 x 2 games, three (barely considered) variants are correspondents of such dilemmas. Whereas some previous studies investigated particular instances of such games, we here provide the unifying framework and concisely relate it to the broad literature on cooperation in social dilemmas. Complementing our argumentation, we study the evolution of partial cooperation by deriving the respective conditions under which coexistence of cooperators and defectors, that is, partial cooperation, can be a stable outcome of evolutionary dynamics in these scenarios. Finally, we discuss the relevance of such models for research on the large biodiversity and variation in cooperative efforts both in biological and social systems.

  5. Standardizing Naming Conventions in Radiation Oncology

    SciTech Connect

    Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa; Vliet-Vroegindeweij, Corine van; Brame, Scott; Straube, William; Galvin, James; Tripuraneni, Prabhakar; Michalski, Jeff; Bosch, Walter

    2012-07-15

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

  6. Nardò Ring, Italy

    NASA Image and Video Library

    2008-04-08

    The Nardò Ring is a striking visual feature from space, and astronauts have photographed it several times. The Ring is a race car test track in Italy. This image was acquired by NASA Terra satellite on August 17. 2007.

  7. Fatal Naegleria fowleri Meningoencephalitis, Italy

    PubMed Central

    Scaglia, Massimo; Gatti, Simonetta; Rossetti, Flavio; Alaggio, Rita; Laverda, Anna Maria; Zhou, Ling; Xiao, Lihua; Visvesvara, Govinda S.

    2004-01-01

    We report the first case of primary amebic meningoencephalitis in Italy, in a 9-year-old boy. Clinical course was fulminant, and diagnosis was made by identifying amebas in stained brain sections and by indirect immunofluorescence analysis. Naegleria fowleri was characterized as genotype I on the basis of polymerase chain reaction test results. PMID:15504272

  8. Southern Italy, Instrument Pointing Subsystem

    NASA Image and Video Library

    1985-08-06

    51F-32-024 (29 July - 6 August 1985) --- Italy's “boot heel" surrounded by waters of the Ionian Sea/Golfo di Taranto and the Adriatic Sea is very clearly visible in this scene made with a handheld 70mm camera. Spacelab 2's versatile instrument pointing system (IPS) protrudes from the cargo bay.

  9. The Radio Phenomenon in Italy.

    ERIC Educational Resources Information Center

    Faenza, Roberto

    One in a series of studies of experiments in new audiovisual techniques in Europe and the situations in some member countries, this paper traces the development of radio in Italy. Opposing views about radio broadcasting (public monopoly vs. freedom of broadcasting) are examined, and the various political and legal aspects of communications in…

  10. [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.

  11. Analysis of user-satisfaction with the use of a teleconsultation system in oncology.

    PubMed

    Larcher, B; Arisi, E; Berloffa, F; Demichelis, F; Eccher, C; Galligioni, E; Galvagni, M; Martini, G; Sboner, A; Tomio, L; Zumiani, G; Graiff, A; Forti, S

    2003-06-01

    There is an increasing interest in assessing telemedicine as alternative method of delivering high quality cancer treatment to patients living in rural areas. In the Province of Trento (north-east Italy) a tele-oncology system was implemented to provide non-surgical oncological consultation to district general hospitals. The aim of this study was to explore user-satisfaction with the system after 6 months of experimentation. During the on-field validation two questionnaires with open and closed-response questions were distributed to 80 physicians and nurses 6 months apart to investigate the users' expected benefits vs. perceived ones. The two questionnaires were compared to assess how perceived benefits differed from expected ones. Significant differences were found regarding improvements in: the standardization of diagnostic-therapeutic procedures using the Electronic Patient Record (EPR)]; information sharing; data updating; consultation speed; and the possibility to diminish patients' travels through the use of teleconsultation (TC). Physicians' responses showed a significant difference regarding the EPR's effects on relationship with patient, the nurses' responses with regards to its effects on care quality. Physicians felt that both modalities of teleconsultation were useful in enhancing communication with colleagues (86% for the synchronous TC, 80% for the asynchronous TC). Responses indicated that the major difficulties encountered were in the introduction of the system into the daily routine. Despite this, user expectations for its future use in clinical field were considerably high.

  12. [Development and Evaluation of the Work-Related Intervention "Perspective Job" for the Oncological Rehabilitation].

    PubMed

    Kähnert, H; Exner, A-K; Brand, S; Leibbrand, B

    2016-06-01

    The knowledge about contents and arrangement of work-related measures in oncological rehabilitation is limited. The aim of the study was to develop a multimodal work-related module called Perspective Job for the oncological rehabilitation as well as to evaluate the process of development and the module itself. Perspective Job was developed within a rehabilitation team. For an examination of the process of development and of the module expert interviews with clinic employees and group interviews with patients were conducted. Group interviews were conducted before as well as after the implementation of Perspective Job to demonstrate changes in the rehabilitation from the patients point of view. Participants were oncological patients with substantial work-related problems. The module Perspective Job consists of work-related therapies as well as job trainings. The expert interviews illustrates: The process of development is valued as positive and meaningful by the rehabilitation team. Furthermore synergetic effects were used and the exchange of information and the communication within the team were promoted. The interviews with the patient emphasized that most perspective job therapies were classified as work-related and that an individual occupation-oriented care took place. The promoting exchanges of experience between the participants has been positively evaluated. In addition, they seemed to be well-prepared for the return to work. The development of a work-related module in the rehabilitation team is possible. The process was valued by the team members positively and promoted the multiprofessional cooperation. An occupationally oriented arrangement of the rehabilitation was solely perceived by the participants of Perspective Job, which felt better prepared to reintegrate into working life. The results emphasize the importance of teamwork for the development and implementation of work-related therapy modules for the oncological rehabilitation. © Georg Thieme

  13. Cooperative Group Trials in the Community Setting

    PubMed Central

    Wade, James Lloyd; Petrelli, Nicholas J.; McCaskill-Stevens, Worta

    2015-01-01

    Over the last 40 years the National Cancer Institute (NCI) has created a vibrant public-private partnership for the implementation of NCI sponsored cooperative group (Network) clinical trials throughout the United States and Canada. Over these four decades, the cancer clinical trials process has become more complex more precise and more resource intensive. During this same time period, financial resources to support the NCI community research initiative have become more constrained. The newest manifestation of NCI sponsored community based cancer clinical trial research, known as the National Community Oncology Research Program (NCORP) began initial operation August 1st, 2014. This paper describes several key strategies that community sites may use to not only be successful, but to thrive in this new financially austere research environment. PMID:26433550

  14. Cooperative Group Trials in the Community Setting.

    PubMed

    Lloyd Wade, James; Petrelli, Nicholas J; McCaskill-Stevens, Worta

    2015-10-01

    Over the last 40 years the National Cancer Institute (NCI) has created a vibrant public-private partnership for the implementation of NCI-sponsored cooperative group (Network) clinical trials throughout the United States and Canada. Over these four decades, the cancer clinical trials process has become more complex more precise and more resource intensive. During this same time period, financial resources to support the NCI community research initiative have become more constrained. The newest manifestation of NCI-sponsored community based cancer clinical trial research, known as the National Community Oncology Research Program (NCORP) began initial operation August 1, 2014. We describe several key strategies that community sites may use to not only be successful but to thrive in this new financially austere research environment. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Breakthrough Cancer Pain: Preliminary Data of The Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS).

    PubMed

    Mercadante, Sebastiano; Marchetti, Paolo; Cuomo, Arturo; Caraceni, Augusto; Mediati, Rocco Domenico; Mammucari, Massimo; Natoli, Silvia; Lazzari, Marzia; Dauri, Mario; Airoldi, Mario; Azzarello, Giuseppe; Bandera, Mauro; Blasi, Livio; Cartenì, Giacomo; Chiurazzi, Bruno; Costanzo, Benedetta Veruska Pierpaola; Degiovanni, Daniela; Fusco, Flavio; Guardamagna, Vittorio; Iaffaioli, Vincenzo; Liguori, Simeone; Lorusso, Vito; Mameli, Sergio; Mattioli, Rodolfo; Mazzei, Teresita; Melotti, Rita Maria; Menardo, Valentino; Miotti, Danilo; Moroso, Stefano; De Santis, Stefano; Orsetti, Remo; Papa, Alfonso; Ricci, Sergio; Sabato, Alessandro Fabrizio; Scelzi, Elvira; Sofia, Michele; Tonini, Giuseppe; Aielli, Federica; Valle, Alessandro

    2017-01-01

    An ongoing national multicenter survey [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] is evaluating the characteristics of breakthrough cancer pain (BTP) in different clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here. Thirty-two clinical centers are involved in the survey. A diagnosis of BTP was performed by a standard algorithm. Epidemiological data, Karnofsky index, stage of disease, presence and sites of metastases, ongoing oncologic treatment, and characteristics of background pain and BTP and their treatments were recorded. Background pain and BTP intensity were measured. Patients were also questioned about BTP predictability, BTP onset (≤10 or >10 min), BTP duration, background and BTP medications and their doses, time to meaningful pain relief after BTP medication, and satisfaction with BTP medication. The occurrence of adverse reactions was also assessed, as well as mucosal toxicity. Background pain was well controlled with opioid treatment (numerical rating scale 3.0 ± 1.1). Patients reported 2.5 ± 1.6 BTP episodes/day with a mean intensity of 7.5 ± 1.4 and duration of 43 ± 40 min; 977 patients (65.1%) reported non-predictable BTP, and 1076 patients (71.7%) reported a rapid onset of BTP (≤10 min). Higher patient satisfaction was reported by patients treated with fast onset opioids. These preliminary data underline that the standard algorithm used is a valid tool for a proper diagnosis of BTP in cancer patients. Moreover, rapid relief of pain is crucial for patients' satisfaction. The final IOPS-MS data are necessary to understand relationships between BTP characteristics and other clinical variables in oncologic patients. Molteni Farmaceutici, Italy.

  16. Quantitatively and qualitatively augmenting medical student knowledge of oncology and radiation oncology: an update on the impact of the oncology education initiative.

    PubMed

    Hirsch, Ariel E; Handal, Roxane; Daniels, Janeen; Levin-Epstein, Rebecca; Denunzio, Nicholas J; Dillon, Johanne; Shaffer, Kitt; Bishop, Pauline Mulleady

    2012-02-01

    The Oncology Education Initiative was established in 2007 in an effort to advance oncology and radiation oncology education at the undergraduate level. As a continuation of the initiative, the aim of this study was to determine whether these structured didactics would continue to increase overall medical student knowledge about oncologic topics. Preclerkship and postclerkship tests examining concepts in general oncology, radiation oncology, breast cancer, and prostate cancer were administered. The 21-question, multiple-choice examination was administered at the beginning and end of the radiology clerkship, during which a 1.5-hour didactic session was given by an attending radiation oncologist. Changes in individual question responses, student responses, and overall categorical responses were analyzed. All hypothesis tests were two tailed with a significance level of .05. In the 2009-2010 academic year, 155 third-year and fourth-year students had average examination score improvements from 62% to 68.9% (P < .0001). Every topic (100%) showed improvement in scores, with the largest absolute improvement seen in the radiation oncology category, which increased from 56.5% to 71.8% (P < .0001). As the year proceeded, average examination scores increased among third-year students and decreased among fourth-year students. In the successive years since its inception, the Oncology Education Initiative continues to show a significant improvement in medical students' knowledge of cancer. The initiative has also succeeded in providing radiation oncology education to all graduating medical students at the authors' institution. Dedicated oncology education in the undergraduate medical curriculum provides students with a better understanding of multidisciplinary oncology management. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Mind-body therapies in integrative oncology.

    PubMed

    Elkins, Gary; Fisher, William; Johnson, Aimee

    2010-12-01

    There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care.

  18. Value: a framework for radiation oncology.

    PubMed

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

    2014-09-10

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

  19. Treatment of bladder cancer. Oncology overview

    SciTech Connect

    Not Available

    1982-10-01

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Surgical treatment of common bladder cancers; Radiation therapy of common bladder cancers; Chemotherapy of common bladder cancers; Immunotherapy of common bladder cancers; Multimodal treatment of common bladder cancers; Other treatment modalities of common bladder cancers; Treatment of less common bladder cancers; Reviews of treatment of bladder cancers.

  20. Veterinary oncology clinical trials: design and implementation.

    PubMed

    Thamm, Douglas H; Vail, David M

    2015-08-01

    There has been a recent increase in interest among veterinarians and the larger biomedical community in the evaluation of novel cancer therapies in client-owned (pet) animals with spontaneous cancer. This includes novel drugs designed to be veterinary therapeutics, as well as agents for which data generated in animals with tumors may inform human clinical trial design and implementation. An understanding of the process involved in moving a therapeutic agent through the stages of clinical evaluation is critical to the successful implementation of clinical investigations, as well as interpretation of the veterinary oncology literature. This review outlines considerations in the design and conduct of the various phases of oncology clinical trials, along with recent adaptations/modifications of these basic designs that can enhance the generation of timely and meaningful clinical data. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Limb salvage in musculoskeletal oncology: Recent advances

    PubMed Central

    Puri, Ajay

    2014-01-01

    The treatment of musculoskeletal sarcomas has made vast strides in the last few decades. From an era where amputation was the only option to the current day function preserving resections and complex reconstructions has been a major advance. The objectives of extremity reconstruction after oncologic resection include providing skeletal stability where necessary, adequate wound coverage to allow early subsequent adjuvant therapy, optimising the aesthetic outcome and preservation of functional capability with early return to function. This article highlights the concepts of surgical margins in oncology, discusses the principles governing safe surgical resection in these tumors and summarises the current modalities and recent developments relevant to reconstruction after limb salvage. The rationale of choice of a particular resection modality, the unique challenges of reconstruction in skeletally immature individuals and the impact of adjuvant modalities like chemotherapy and radiotherapy on surgical outcomes are also discussed. PMID:25190911

  2. Value: A Framework for Radiation Oncology

    PubMed Central

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

    2014-01-01

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

  3. Radiolabeled antibodies in cancer. Oncology Overview

    SciTech Connect

    Not Available

    1984-11-01

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories through the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Radiolabeled antibodies--labeling and imaging techniques; Radiolabeled antibodies--carcinoembryonic antigen; Radiolabeled antibodies--alpha-fetoprotein; Radiolabeled antibodies--human chorionic gonadotropin; Radiolabeled antibodies--ferritin; Radiolabeled antibodies--imaging of colorectal tumors; Radiolabeled antibodies--imaging of malignant melanoma; Radiolabeled antibodies--imaging of urogenital tumors; Radiolabeled antibodies--imaging of thyroid tumors; Radiolabeled antibodies--other clinical studies; Radiolabeled antibodies--selected preclinical studies; Radiolabeled antibodies--reviews.

  4. 2015 SNMMI Highlights Lecture: Oncology, Part I

    PubMed Central

    Mahmood, Umar

    2016-01-01

    From the Newsline Editor: The Highlights Lecture, presented at the closing session of each SNMMI Annual Meeting, was originated and delivered for more than 30 years by Henry N. Wagner, Jr., MD. Beginning in 2010, the duties of summarizing selected significant presentations at the meeting were divided annually among 4 distinguished nuclear and molecular medicine subject matter experts. The 2015 Highlights Lectures were delivered on June 10 at the SNMMI Annual Meeting in Baltimore, MD. Umar Mahmood, MD, PhD, a professor of radiology at Massachusetts General Hospital (Boston, MA), spoke on oncology highlights from the meeting’s sessions. Because of its length, the oncology presentation will be divided between 2 Newsline issues. Note that in the following summary, numerals in brackets represent abstract numbers as published in The Journal of Nuclear Medicine [2015;56:suppl 3). PMID:26526798

  5. Informatics Enabled Behavioral Medicine in Oncology

    PubMed Central

    Hesse, Bradford W.; Suls, Jerry M.

    2011-01-01

    For the practicing physician, the behavioral implications of preventing, diagnosing, and treating cancer are many and varied. Fortunately, an enhanced capacity in informatics may help create a redesigned ecosystem in which applying evidence-based principles from behavioral medicine will become a routine part of care. Innovation to support this evolution will be spurred by the “meaningful use” criteria stipulated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and by focused research and development efforts within the broader health information ecosystem. The implications for how to better integrate evidence-based principles in behavioral medicine into oncology care through both spheres of development are discussed within the framework of the cancer control continuum. The promise of using the data collected through these tools to accelerate discovery in psycho-oncology is also discussed. If nurtured appropriately, these developments should help accelerate successes against cancer by altering the behavioral milieu. PMID:21799329

  6. Mass Spectrometry Imaging in Oncology Drug Discovery.

    PubMed

    Goodwin, R J A; Bunch, J; McGinnity, D F

    2017-01-01

    Over the last decade mass spectrometry imaging (MSI) has been integrated in to many areas of drug discovery and development. It can have significant impact in oncology drug discovery as it allows efficacy and safety of compounds to be assessed against the backdrop of the complex tumour microenvironment. We will discuss the roles of MSI in investigating compound and metabolite biodistribution and defining pharmacokinetic -pharmacodynamic relationships, analysis that is applicable to all drug discovery projects. We will then look more specifically at how MSI can be used to understand tumour metabolism and other applications specific to oncology research. This will all be described alongside the challenges of applying MSI to industry research with increased use of metrology for MSI. © 2017 Elsevier Inc. All rights reserved.

  7. [Methodology of economic assessment: example in oncology].

    PubMed

    Jaisson-Hot, Isabelle; Schott, Anne-Marie; Clippe, Christine; Ganne, Christell; Hajri, Touria; Poncet, Bénédicte; Trillet-Lenoir, Véronique; Colin, Cyrille

    2003-11-01

    The increasing costs of care make it important to identify those strategies of greatest value from both an effectiveness and cost perspective. Economic analysis is characterized by a simultaneous consideration of alternatives costs and outcomes, and can provide useful data for managerial decision making. In this paper, methods of economic evaluations in general and in cancer in particular is reviewed. In cancer treatment, preventive, curative or palliative strategies can be concerned. Economic evaluation have become increasingly important in oncology because of the proliferation of expensive new treatments. Furthermore, considering quality of life effects is particularly important in oncology, where many treatments obtain modest improvements in response or survival. Quality of life measurements are also reviewed.

  8. Incidence of colonization and bloodstream infection with carbapenem-resistant Enterobacteriaceae in children receiving antineoplastic chemotherapy in Italy.

    PubMed

    Caselli, Desiree; Cesaro, Simone; Fagioli, Franca; Carraro, Francesca; Ziino, Ottavio; Zanazzo, Giulio; Meazza, Cristina; Colombini, Antonella; Castagnola, Elio

    2016-02-01

    Few data are available on the incidence of carbapenemase-producing Enterobacteriaceae (CPE) infection or colonization in children receiving anticancer chemotherapy. We performed a nationwide survey among centers participating in the pediatric hematology-oncology cooperative study group (Associazione Italiana Ematologia Oncologia Pediatrica, AIEOP). During a 2-year observation period, we observed a threefold increase in the colonization rate, and a fourfold increase of bloodstream infection episodes, caused by CPE, with a 90-day mortality of 14%. This first nationwide Italian pediatric survey shows that the circulation of CPE strains in the pediatric hematology-oncology environment is increasing. Given the mortality rate, which is higher than for other bacterial strains, specific monitoring should be applied and the results should have implications for health-care practice in pediatric hematology-oncology.

  9. Technology for Innovation in Radiation Oncology

    PubMed Central

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

    2015-01-01

    Radiotherapy is an effective, personalized cancer treatment that has benefited from technological advances associated with growing ability to identify and target tumors with accuracy and precision. As these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society of Therapeutic Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM) and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology”, which took place at the National Institutes of Health (NIH) in Bethesda, MD, on June 13-14, 2013. The purpose of this workshop was to discuss emerging technology for the field and recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how they are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, as well as information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically-advanced nature of radiation therapy treatments pre-disposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research were clearly identified as synergistic. PMID:26460989

  10. The Role of Inhibitory Control in Children's Cooperative Behaviors during a Structured Puzzle Task

    ERIC Educational Resources Information Center

    Giannotta, Fabrizia; Burk, William J.; Ciairano, Silvia

    2011-01-01

    This study examined the role of inhibitory control (measured by Stroop interference) in children's cooperative behaviors during a structured puzzle task. The sample consisted of 250 8-, 10-, and 12-year-olds (117 girls and 133 boys) attending classrooms in three primary schools in Northern Italy. Children individually completed an elaborated…

  11. African American Women Scholars and International Research: Dr. Anna Julia Cooper's Legacy of Study Abroad

    ERIC Educational Resources Information Center

    Evans, Stephanie Y.

    2009-01-01

    EIn this article, the author presents a little-known but detailed history of Black women's tradition of study abroad. Specifically, she situates Dr. Anna Julia Cooper within the landscape of historic African American students who studied in Japan, Germany, Jamaica, England, Italy, Haiti, India, West Africa, and Thailand, in addition to France. The…

  12. Uptake Carriers and Oncology Drug Safety

    PubMed Central

    Sprowl, Jason A.

    2014-01-01

    Members of the solute carrier (SLC) family of transporters are responsible for the cellular influx of a broad range of endogenous compounds and xenobiotics in multiple tissues. Many of these transporters are highly expressed in the gastrointestinal tract, liver, and kidney and are considered to be of particular importance in governing drug absorption, elimination, and cellular sensitivity of specific organs to a wide variety of oncology drugs. Although the majority of studies on the interaction of oncology drugs with SLC have been restricted to the use of exploratory in vitro model systems, emerging evidence suggests that several SLCs, including OCT2 and OATP1B1, contribute to clinically important phenotypes associated with those agents. Recent literature has indicated that modulation of SLC activity may result in drug-drug interactions, and genetic polymorphisms in SLC genes have been described that can affect the handling of substrates. Alteration of SLC function by either of these mechanisms has been demonstrated to contribute to interindividual variability in the pharmacokinetics and toxicity associated with several oncology drugs. In this report, we provide an update on this rapidly emerging field. PMID:24378324

  13. Oncology Nurse Participation in Survivorship Care

    PubMed Central

    Grant, Marcia; Economou, Denice; Ferrell, Betty

    2011-01-01

    Oncology nurses are playing an important role in the provision of survivorship care. Their involvement includes educating and coordinating multidiscipline teams to initiate and provide care to patients and families. Oncology nurses participate in this evolving model of care in a variety of ways. Using the IOM report recommendations for the provision of quality cancer care nurses provide care based on the specific characteristics of individual health care settings and the populations they serve. Evaluating the settings resources and goals for desired survivorship activities as part of the planning process can be the difference between success and failure. Collaborating with local and national resources for cancer survivors can help expand services for a setting in an efficient and cost effective manner. Models of care vary and resources and communication differs among cancer care settings. Survivorship care differs as a result, across different models. Nurses are key to the dissemination and coordination of survivorship activities and are critical in facilitating communication between health care providers, the patients and caregivers. Nurses have a significant role in the dissemination and coordination of information between the patient and other health care providers. Oncology care does not end when treatment ends. PMID:21112849

  14. Workplace Bullying in Radiology and Radiation Oncology.

    PubMed

    Parikh, Jay R; Harolds, Jay A; Bluth, Edward I

    2017-08-01

    Workplace bullying is common in health care and has recently been reported in both radiology and radiation oncology. The purpose of this article is to increase awareness of bullying and its potential consequences in radiology and radiation oncology. Bullying behavior may involve abuse, humiliation, intimidation, or insults; is usually repetitive; and causes distress in victims. Workplace bullying is more common in health care than in other industries. Surveys of radiation therapists in the United States, student radiographers in England, and physicians-in-training showed that substantial proportions of respondents had been subjected to workplace bullying. No studies were found that addressed workplace bullying specifically in diagnostic radiology or radiation oncology residents. Potential consequences of workplace bullying in health care include anxiety, depression, and health problems in victims; harm to patients as a result of victims' reduced ability to concentrate; and reduced morale and high turnover in the workplace. The Joint Commission has established leadership standards addressing inappropriate behavior, including bullying, in the workplace. The ACR Commission on Human Resources recommends that organizations take steps to prevent bullying. Those steps include education, including education to ensure that the line between the Socratic method and bullying is not crossed, and the establishment of policies to facilitate reporting of bullying and support victims of bullying. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Current challenges in European oncology pharmacy practice.

    PubMed

    Hoppe-Tichy, Torsten

    2010-03-01

    The demand for pharmacy cancer services is expected to at least double over the next 10 years, as the population ages and new treatments are introduced. Safe and efficient handling of cytotoxic products minimises risks to staff and reduces medication errors. To identify and describe strategies for coping safely and effectively with heavier workloads in the hospital oncology pharmacy, currently and in the future. The PubMed database was searched for literature on approaches to safe handling of antineoplastic agents and to decreasing medication errors in the hospital pharmacy. Articles that were judged to be of prime importance to the hospital oncologist were reviewed. These safety concepts are put into the context of contemporary hospital oncology pharmacy practice through discussion of key issues, including increased demand, the role of the pharmacist in determining the hospital formulary, and growth in patient preferences for oral chemotherapy. Recommendations on best practices are also provided, based on relevant literature and author experience. Efficient, safe hospital pharmacy operations can be aided by capacity planning, dose banding, and knowledge of novel products and procedures that can reduce risks to health while increasing the number of patients who are safely treated. Consideration may also be given to the economic role of oncology pharmacists in formulary development.

  16. Moral justification of Phase 1 oncology trials.

    PubMed

    Dubov, Alex

    2014-06-01

    This article attempts to answer the following normative questions: Can one consider the design of Phase 1 trials ethically appropriate due to the unfavorable ratio of risks and benefits? What are some ethical safeguards for Phase 1 oncology research? A comparative review of literature contributed to the consolidation of the proposed ethical framework for Phase 1 oncology trials. This framework gives a special attention to issues of therapeutic misconception and vulnerability. The benefits and dangers associated with the enrollment in trials are described as well as the absence of alternatives, treatment-specific optimism, and vagueness in factual presentation during the informed consent process. The notion of therapeutic misconception is contrasted with optimism despite realism that stems from psychological, cultural, and religious factors and not necessarily from the lack of information. Close attention is given to the possible ways in which the inherent uncertainty and resulting cognitive biases may affect the informed consent process and the definition of therapeutic misconception. The article ends with recommendations for an ethical way of enrolling palliative patients in early stages of oncology research, giving special attention to provision of adequate consent, protection of vulnerability, and avoidance of therapeutic misconception.

  17. [The role of emotional labour in oncology].

    PubMed

    Szluha, Kornélia; Lazányi, Kornélia; Molnár, Péter

    2007-01-01

    Oncologists and related health care professionals (HCPs) do not only have to follow professional protocols in their everyday work, but also have to communicate proper attitudes towards patients suffering from malignant diseases. This task is often a heavier load than the implementation of professional activities themselves. The present article is based on a survey on HCP work motivation, employment parameters and correlations with emotional labour. Fifty oncology HCPs at Debrecen University Medical Health Sciences Centre volunteered to participate in this survey containing 20 simple-choice questions. More than 90 percent of HCPs make an effort to hide their emotional state, giving way to possible negative side effects. The survey showed significant differences between the level of emotional labour of those working in the field of oncology longer or shorter than ten years. Surface and deep emotional labour is more frequent among professionals already working in oncology for a longer period of time. This can serve us with explanation to the burn-out syndrome so frequent in this profession. To diminish the load of emotional labour, healthcare institutes have to aim at hiring employees that spontaneously fit the emotional and behavioural norms facing them, and do not need officially prescribed behavioural norms for everyday work. Their constant need for respect and appreciation of their values must be kept in mind, because the capability of genuine emotional labour diminishes parallel to the number of years spent in work.

  18. Update on genomics in veterinary oncology.

    PubMed

    Breen, Matthew

    2009-08-01

    The release of an annotated human genome sequence assembly and the emergence of genomics technologies have led to significant advances in our understanding of many human diseases including cancers. As DNA sequencing technology has become less costly, the field of comparative genomics has progressed rapidly and attention has turned now to generating whole genome assemblies and dedicated genomics resources for veterinary species. Such progress brings a whole new series of opportunities to advance veterinary medicine. Many human and animal diseases share a pathogenetic basis, and although veterinary species need advances in biomedical research in their own right, the consideration of companion animals also as good comparative models for human disease saw the emergence of the "one medicine" concept. The future of many areas of human and veterinary biomedical research is very much interdependent, with one of the closest associations being in oncology. It is inevitable that veterinary oncology will benefit enormously from data derived from genomics and that this era will see a huge shift in the ways in which companion animal cancer patients are evaluated and subsequently treated. Here, we will review some of the advancements of genomics as they relate to veterinary oncology.

  19. [Oncologic pathology at an internal medicine service].

    PubMed

    de Miranda, M I; da Luz, R; Gonçalves, F M; Monteiro, J S; da Costa, J N

    1990-01-01

    A retrospective survey of the patients with oncological disease admitted to our Department of Internal Medicine in 1987 was conducted to determine its prevalence and to draw a descriptive profile of these patients' admissions. The results show that oncological diseases were the second cause of hospital admissions that year (12%) only exceeded by cardiovascular diseases. About 60% of the patients had neoplasms already diagnosed elsewhere and were admitted for complications or with therapeutic purposes; in 40% of cases the disease was diagnosed in our Department. A wide variety of hematological and non-hematological tumors was found. There were some difficulties in interdisciplinary coordination in the diagnostic and therapeutic approach. More than 50% of the patients had advanced disease, limiting medical intervention to supportive measures. In about 60% of them were oriented to primary care physicians after physicians after discharged from Hospital. These results suggest the dispersion of the available resources for the diagnosis, treatment and follow-up of oncological diseases in our population. A better cancer patients' assistance in Portugal will depend on the promotion of national cancer registers as well as the improvement of cancer prevention and early detection programs, according to the directives of EEC and WHO. We also emphasize the need of investment on undergraduate and postgraduate education programs, specially for primary care physicians.

  20. The Danish Neuro-Oncology Registry

    PubMed Central

    Hansen, Steinbjørn

    2016-01-01

    Aim of database The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. Study population DNOR has registered clinical data on diagnostics and treatment of all adult patients diagnosed with glioma since January 1, 2009, which numbers approximately 400 patients each year. Main variables The database contains information about symptoms, presurgical magnetic resonance imaging (MRI) characteristics, performance status, surgical procedures, residual tumor on postsurgical MRI, postsurgical complications, diagnostic and histology codes, radiotherapy, and chemotherapy. Descriptive data DNOR publishes annual reports on descriptive data. During the period of registration, postoperative MRI is performed in a higher proportion of the patients (Indicator II), and a higher proportion of patients have no residual tumor after surgical resection of the primary tumor (Indicator IV). Further data are available in the annual reports. The indicators reflect only minor elements of handling brain tumor patients. Another advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. Conclusion The establishment of DNOR has optimized the quality in handling primary brain tumor patients in Denmark by reporting indicators and facilitating a better multidisciplinary collaboration at a national level. DNOR provides a valuable resource for research. PMID:27822109

  1. Synthetic Yeast Cooperation

    NASA Astrophysics Data System (ADS)

    Shou, Wenying; Burton, Justin

    2010-03-01

    Cooperation is wide-spread and has been postulated to drive major transitions in evolution. However, Darwinian selection favors ``cheaters'' that consume benefits without paying a fair cost. How did cooperation evolve against the threat of cheaters? To investigate the evolutionary trajectories of cooperation, we created a genetically tractable system that can be observed as it evolves from inception. The system consists of two engineered yeast strains -- a red-fluorescent strain that requires adenine and releases lysine and a yellow-fluorescent strain that requires lysine and releases adenine. Cells that consume but not supply metabolites would be cheaters. From the properties of two cooperating strains, we calculated and experimentally verified the minimal initial cell densities required for the viability of the cooperative system in the absence of exogenously added adenine and lysine. Strikingly, evolved cooperative systems were viable at 100-fold lower initial cell densities than their ancestors. We are investigating the nature and diversity of pro-cooperation changes, the dynamics of cooperator-cheater cocultures, and the effects of spatial environment on cooperation and cheating.

  2. Futures for energy cooperatives

    SciTech Connect

    1981-01-01

    A listing of Federal agencies and programs with potential funding for community-scale cooperatives using conservation measures and solar technologies is presented in Section 1. Section 2 presents profiles of existing community energy cooperatives describing their location, history, membership, services, sources of finance and technical assistance. A condensed summary from a recent conference on Energy Cooperatives featuring notes on co-op members' experiences, problems, and opportunities is presented in Section 3. Section 4 lists contacts for additional information. A National Consumer Cooperative Bank Load Application is shown in the appendix.

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

    SciTech Connect

    Dennis, Kristopher E.B.; Duncan, Graeme

    2010-03-01

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

  4. Republic of Italy (country profile).

    PubMed

    Hakkert, R

    1986-02-01

    This discussion of Italy focuses on the following: cities and regions; population growth; households and families; housing and construction; ethnicity and religion; education; economy and labor force; consumption; and transport and communications. Italy, with its total area of 116,374 square miles, is about the size of Florida and Georgia combined. Its 56.6 million people form the 2nd largest population in Western Europe, after West Germany, but slightly larger than Great Britain and France. The main administrative divisions are 20 regions, subdivided into 95 provinces. The provinces in turn are divided into 8090 "comuni" or municipalities. The 6 cities with more than 500,000 people are Roma, Milano, Napoli, Torino, Genova, and Palermo. They account for 14% of the population. The 43 cities with between 100,000-500,000 account for another 13%. There are 373 middle-sized communities with between 20,000 and 100,000 people, accounting for 26% of population. Italy has a regional problem. The line separating the regions of Emilia Romagna, Toscana, Umbria, and Lazio from the regions to the south and east is important. The regions north of it hold 62% of the population but are responsible for 73% of the gross national product (GNP) and 78% of the industrial product. The regions to the south are economically much weaker. At the time of the last Italian census on October 25, 1981, the country counted 56.6 million inhabitants. Compared to 33.5 million at the turn of the century, this implies an average annual growth rate of .61%. Between 1900-70, nearly 20 million Italians left their country. Most settled in the US, Argentina, and Brazil. Beginning in the 1960s, a new sort of migration was added as young Italians temporarily left to work in the more prosperous countries of northern Europe. The birthrate, which had declined slowly to 18/1000 during the 1960s, fell more rapidly during the 1970s, to 10.9/1000 in 1981 and 10.3 in 1984. The death rate in Italy has changed little

  5. Renaissance Neurosurgery: Italy's Iconic Contributions.

    PubMed

    Nanda, Anil; Khan, Imad Saeed; Apuzzo, Michael L

    2016-03-01

    Various changes in the sociopolitical milieu of Italy led to the increasing tolerance of the study of cadavers in the late Middle Ages. The efforts of Mondino de Liuzzi (1276-1326) and Guido da Vigevano (1280-1349) led to an explosion of cadaver-centric studies in centers such as Bologna, Florence, and Padua during the Renaissance period. Legendary scientists from this era, including Leonardo Da Vinci, Andreas Vesalius, Bartolomeo Eustachio, and Costanzo Varolio, furthered the study of neuroanatomy. The various texts produced during this period not only helped increase the understanding of neuroanatomy and neurophysiology but also led to the formalization of medical education. With increased understanding came new techniques to address various neurosurgical problems from skull fractures to severed peripheral nerves. The present study aims to review the major developments in Italy during the vibrant Renaissance period that led to major progress in the field of neurosurgery.

  6. Neuro-oncology: a selected review of ASCO 2016 abstracts.

    PubMed

    Chamberlain, Marc C

    2016-10-01

    ASCO 2016, 29 May-2 June 2016, Chicago, IL, USA The largest annual clinical oncology conference the American Society of Clinical Oncology is held in the USA and gives researchers and other key opinion leaders the opportunity to present new cancer clinical trials and research data. The CNS tumors section of the American Society of Clinical Oncology 2016 covered various aspects of neuro-oncology including metastatic CNS diseases and primary brain tumors, presented via posters, oral talks and over 100 abstracts. This brief review selectively highlights presentations from this meeting in an organizational manner that reflects clinically relevant aspects of a large and multifaceted meeting.

  7. Southern Italy, Instrument Pointing Subsystem

    NASA Technical Reports Server (NTRS)

    1985-01-01

    This view of the 'heel' of the 'boot' of Southern Italy (40.5N, 18.0E) shows the rich an varied detail of the Salentina peninsula. This southern promontory, projecting into the Mediterranean Sea, is known for its year round mild climate and agricultural produce. The typical European cluster city and town plan wherein the farming population lives in communities and commutes to the fields can be observed throughout the peninsula.

  8. Italy INAF Analysis Center Report

    NASA Technical Reports Server (NTRS)

    Negusini, M.; Sarti, P.

    2013-01-01

    This report summarizes the activity of the Italian INAF VLBI Analysis Center. Our Analysis Center is located in Bologna, Italy and belongs to the Institute of Radioastronomy, which is part of the National Institute of Astrophysics. IRA runs the observatories of Medicina and Noto, where two 32-m VLBI AZ-EL telescopes are situated. This report contains the AC's VLBI data analysis activities and shortly outlines the investigations into the co-locations of space geodetic instruments.

  9. Seismic risk perception in Italy

    NASA Astrophysics Data System (ADS)

    Crescimbene, Massimo; La Longa, Federica; Camassi, Romano; Pino, Nicola Alessandro; Peruzza, Laura

    2014-05-01

    Risk perception is a fundamental element in the definition and the adoption of preventive counter-measures. In order to develop effective information and risk communication strategies, the perception of risks and the influencing factors should be known. This paper presents results of a survey on seismic risk perception in Italy conducted from January 2013 to present . The research design combines a psychometric and a cultural theoretic approach. More than 7,000 on-line tests have been compiled. The data collected show that in Italy seismic risk perception is strongly underestimated; 86 on 100 Italian citizens, living in the most dangerous zone (namely Zone 1), do not have a correct perception of seismic hazard. From these observations we deem that extremely urgent measures are required in Italy to reach an effective way to communicate seismic risk. Finally, the research presents a comparison between groups on seismic risk perception: a group involved in campaigns of information and education on seismic risk and a control group.

  10. Cellular cooperation: insights from microbes.

    PubMed

    Celiker, Hasan; Gore, Jeff

    2013-01-01

    Cooperation between cells is a widespread phenomenon in nature, found across diverse systems ranging from microbial populations to multicellular organisms. For cooperation to evolve and be maintained within a population of cells, costs due to competition have to be outweighed by the benefits gained through cooperative actions. Because cooperation generally confers a cost to the cooperating cells, defector cells that do not cooperate but reap the benefits of cooperation can thrive and eventually drive the cooperating phenotypes to extinction. Here we summarize recent advances made in understanding how cooperation and multicellularity can evolve in microbial populations in the face of such conflicts and discuss parallels with cell populations within multicellular organisms.

  11. Cooperative Learning Strategies.

    ERIC Educational Resources Information Center

    Barnes, Buckley; O'Farrell, Gail

    1990-01-01

    Presents essential characteristics and types of cooperative learning strategies for use in elementary social studies. Outlines exercises for forming teams and building team spirit. Points out such methods promote group interdependence and student responsibility for learning and teaching others. Highlights two cooperative group strategies, Jigsaw…

  12. Helping Children Cooperate

    ERIC Educational Resources Information Center

    Pica, Rae

    2011-01-01

    There are occasions in life when the competitive process is appropriate. But when people consider the relationships in their lives--with friends, family members, coworkers, and the larger community--they realize the value of cooperation. When adults give children the chance to cooperate, to work together toward a solution or a common goal like…

  13. Educational Cooperatives. PREP-23

    ERIC Educational Resources Information Center

    National Center for Educational Communication (DHEW/OE), Washington, DC.

    Dr. Larry W. Hughes and Dr. C. M. Achilles of the University of Tennessee, Knoxville, conducted a national survey for the Office of Education on educational cooperatives--studying and reporting on the nature and kind of cooperative endeavors, their organization, governance, financial arrangements, services, and personnel. Their study focused upon…

  14. Cooperative Learning and Technology.

    ERIC Educational Resources Information Center

    Denning, Rebecca; Smith, Philip J.

    1997-01-01

    Cooperative learning has been used as an educational technique for some time, and recently researchers have been exploring technology as a mechanism to further this educational method. Presents several examples of the use of technology to support cooperative learning episodes and examines the underlying design concepts and principles embedded in…

  15. Testimony: Writing Cooperatively.

    ERIC Educational Resources Information Center

    Sasser, Linda; Cromwell, Carole

    A lesson plan and supportive materials for an exercise in reading comprehension and cooperative writing are presented. The exercise is based on a story entitled "Testimony," in which a writer expresses feelings about a boxing match. The lesson plan outlines procedures for presentation of the exercise to the class, for the cooperative teams to…

  16. Achieving cooperative success

    Treesearch

    Kimberly Zeuli

    2006-01-01

    Success of a cooperative depends on the foundation built during its organization. Successful businesses are not started overnight. Careful and deliberate planning must be started long before the co-op opens its doors. This chapter begins with an outline of six fundamental steps that should be followed when organizing any cooperative. From initial concept to the start...

  17. Making Cooperative Learning Powerful

    ERIC Educational Resources Information Center

    Slavin, Robert E.

    2014-01-01

    Just about everyone loves the "idea" of cooperative learning, children working productively and excitedly in groups, everyone getting along and enthusiastically helping one another learn. This article presents five strategies that teachers can use to get the greatest benefit possible from cooperative learning and ensure that…

  18. Cooperative Learning Strategies.

    ERIC Educational Resources Information Center

    Barnes, Buckley; O'Farrell, Gail

    1990-01-01

    Presents essential characteristics and types of cooperative learning strategies for use in elementary social studies. Outlines exercises for forming teams and building team spirit. Points out such methods promote group interdependence and student responsibility for learning and teaching others. Highlights two cooperative group strategies, Jigsaw…

  19. Cooperative Vocational Education Programs.

    ERIC Educational Resources Information Center

    Bureau of Adult, Vocational, and Technical Education (DHEW/OE), Washington, DC. Div. of Vocational and Technical Education.

    Cooperative education, said to be a "sleeping giant" in vocational education, received special authorization in Public Law 90 576 and was made a priority in vocational education. This publication summarizes information to assist the states in planning development of cooperative vocational education: definitions, funding sources, program…

  20. Montana Cooperative Education Handbook.

    ERIC Educational Resources Information Center

    Harris, Ron, Ed.

    This revised handbook was developed to help teachers and administrators in Montana conduct cooperative education programs. The handbook is organized in 13 sections. In narrative style, the first 11 sections cover the following topics: introduction to cooperative education, advisory committees, related instruction, coordination of activities,…

  1. Cooperative Science Lesson Plans.

    ERIC Educational Resources Information Center

    Cooperative Learning, 1991

    1991-01-01

    Offers several elementary level cooperative science lesson plans. The article includes a recipe for cooperative class learning, instructions for making a compost pile, directions for finding evidence of energy, experiments in math and science using oranges to test density, and discussions of buoyancy using eggs. (SM)

  2. Distinguished Cooperating Teacher Program.

    ERIC Educational Resources Information Center

    Chicago State Univ., IL.

    The Distinguished Cooperating Teacher Program at Chicago State University was developed to train cooperating teachers to supervise student teachers. The program departs from traditional practice by changing the roles of the classroom teacher and the university field supervisor. The supervisor's role becomes that of coordinator while the teacher…

  3. Cooperative Science Lesson Plans.

    ERIC Educational Resources Information Center

    Cooperative Learning, 1991

    1991-01-01

    Offers several elementary level cooperative science lesson plans. The article includes a recipe for cooperative class learning, instructions for making a compost pile, directions for finding evidence of energy, experiments in math and science using oranges to test density, and discussions of buoyancy using eggs. (SM)

  4. Making Cooperative Learning Powerful

    ERIC Educational Resources Information Center

    Slavin, Robert E.

    2014-01-01

    Just about everyone loves the "idea" of cooperative learning, children working productively and excitedly in groups, everyone getting along and enthusiastically helping one another learn. This article presents five strategies that teachers can use to get the greatest benefit possible from cooperative learning and ensure that…

  5. An increase in medical student knowledge of radiation oncology: a pre-post examination analysis of the oncology education initiative.

    PubMed

    Hirsch, Ariel E; Mulleady Bishop, Pauline; Dad, Luqman; Singh, Deeptej; Slanetz, Priscilla J

    2009-03-15

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

  6. Culture and cooperation.

    PubMed

    Gächter, Simon; Herrmann, Benedikt; Thöni, Christian

    2010-09-12

    Does the cultural background influence the success with which genetically unrelated individuals cooperate in social dilemma situations? In this paper, we provide an answer by analysing the data of Herrmann et al. (2008a), who studied cooperation and punishment in 16 subject pools from six different world cultures (as classified by Inglehart & Baker (2000)). We use analysis of variance to disentangle the importance of cultural background relative to individual heterogeneity and group-level differences in cooperation. We find that culture has a substantial influence on the extent of cooperation, in addition to individual heterogeneity and group-level differences identified by previous research. The significance of this result is that cultural background has a substantial influence on cooperation in otherwise identical environments. This is particularly true in the presence of punishment opportunities.

  7. Culture and cooperation

    PubMed Central

    Gächter, Simon; Herrmann, Benedikt; Thöni, Christian

    2010-01-01

    Does the cultural background influence the success with which genetically unrelated individuals cooperate in social dilemma situations? In this paper, we provide an answer by analysing the data of Herrmann et al. (2008a), who studied cooperation and punishment in 16 subject pools from six different world cultures (as classified by Inglehart & Baker (2000)). We use analysis of variance to disentangle the importance of cultural background relative to individual heterogeneity and group-level differences in cooperation. We find that culture has a substantial influence on the extent of cooperation, in addition to individual heterogeneity and group-level differences identified by previous research. The significance of this result is that cultural background has a substantial influence on cooperation in otherwise identical environments. This is particularly true in the presence of punishment opportunities. PMID:20679109

  8. Oncologic Outcomes After Nipple-Sparing Mastectomy.

    PubMed

    Moo, Tracy Ann; Pinchinat, Tiffany; Mays, Simone; Landers, Alyssa; Christos, Paul; Alabdulkareem, Hanan; Tousimis, Eleni; Swistel, Alexander; Simmons, Rache

    2016-10-01

    Nipple-sparing mastectomy (NSM) is increasingly used as an alternative to traditional mastectomy because it provides improved aesthetic results. The data on its oncologic safety are limited. The authors' institution has performed NSM during the past 10 years for both oncologic and prophylactic indications. This study aimed to examine oncologic outcomes after NSM for breast cancer. The study retrospectively examined all NSM cases managed between July 2007 and July 2013. Descriptive statistics were used to characterize the study cohort. Kaplan-Meier survival analysis was performed to estimate recurrence-free survival, specifically the 36-month recurrence-free survival proportion. A total of 721 nipple-sparing mastectomies were performed for 413 patients: 45 (10.9 %) to reduce risk and 368 (89.1 %) for breast cancer. In the breast cancer group, 29.8 % of the patients had ductal carcinoma in situ, and 70.2 % had invasive cancer. The mean follow-up time was 32 months (range 0.01-90.2 months). In the breast cancer group, the Kaplan-Meier 3-year recurrence-free survival rate was 93.6 % (95 % confidence interval, 89.9-96.0 %). Eight patients (2.2 %) had locoregional recurrences, including one in the nipple. Nine patients (2.4 %) had distant recurrence, and six patients (1.6 %) had a diagnosis of both local and distant recurrences. The findings showed a locoregional recurrence rate of 2.2 %, with an overall recurrence rate of 6.3 % for patients undergoing NSM for the treatment of breast cancer. The majority of these recurrences were distant, with one recurrence at the nipple. These results are promising, but a longer follow-up evaluation of this cohort is necessary.

  9. [Donatori di Musica: when oncology meets music].

    PubMed

    Graiff, Claudio

    2014-10-01

    Donatori di Musica is a network of musicians - both physicians and volunteers - that was initially founded in 2009 with the aim to set up and coordinate classical music concerts in hospitals. This activity was initially started and led by the Oncology Departments at Carrara and Bolzano Hospitals, where high profile professional musicians make themselves available for concerts in support of Oncological in/out-patients of that specific Hospital. A live classical music performance is a deeply touching experience - particularly for those who live a critical condition like cancer. Main characteristics of Donatori di Musica concerts are: continuity (concerts are part of a regular and non-stopping music season); quality (concerts are held by well-established professional musicians); philanthropic attitude (musicians do not wear a suit and usually chat with patients; they also select an easy-to-listen program; a convivial event is usually organized after the performance with the aim of overcoming distinctions and barriers between physician and patient); no profit: musicians perform for free - travel expenses and/or overnight staying only can be claimed; concerts have free access for patients, their families and hospital staff.Patients and musicians therefore do get in close contact and music is able to merge each other experiences - with patients being treated by the beauty of music and musicians being treated theirselves by patients daily-life feedback. The Donatori di Musica experience is therefore able to help Medicine to retrieve its very first significance - the medical act regain that human and cultural dimension that seems to be abandoned in the last decades in favour of a mere technicism. This is the spirit and the deep significance of Donatori di Musica - «[…] the hope that Music can become a key support to medical treatments in every Oncology department» (by Gian Andrea Lodovici).

  10. [Proposal for radio-oncologic needs planning].

    PubMed

    Sauer, R

    1986-10-01

    The demand planning for radio-oncologic treatment considers the population density and structure of the region served by the hospital, the geographic conditions of this region, the medical prescriptions of the hospital institution, the incidence of cancer, the part of radiotherapy in the treatment of the tumor, hospital-specific factors and, finally, the minimum requirements for technical equipment and staff of a radiotherapeutic functional unit. The most important factors are certainly the incidence of cancer and the number of tumor patients actually receiving a radiotherapy. For the Federal Republic of Germany, an incidence of annually 300 to 320 new cancers per 100,000 inhabitants is determined, based on the mortality statistics of the Federal Republic of Germany, England, Wales and Norway as well as the cancer incidence statistics of Hamburg, Baden-Württemberg, Saarland and the very reliable registers of Scandinavia and the German Democratic Republic. The part of radiotherapy is probably between 32 and 35% of primary treatments, repeated treatments must be added. With respect to technical equipment and staff, some minimum requirements have to be fulfilled by a radiotherapeutic functional unit if its work shall be satisfactory in the medical and economical domain. A concentration of radiotherapeutic resources is recommended. The number of beds required for a radio-oncologic hospital applying modern techniques and combined methods is 40 to 45% of the number of patients irradiated per day. A three-category system for radio-oncologic treatment is presented. Future planning, however, should only be based on two categories.

  11. Advance care planning in the oncology settings.

    PubMed

    Samara, Juliane; Larkin, David; Chan, Choi Wan; Lopez, Violeta

    2013-06-01

    Self-determination and patient choice of end-of-life care are emphasised in palliative care. Advance care planning (ACP) is an approach to enabling patients' choices. The use of ACP has not been extensively studied in our current context. Little is known about oncology care nurses' views and the barriers they face in the implementation of ACP. The aims of this study were to assess the uptake of ACP by health professionals and explore nurses' perceived barriers for implementing ACP. This study employed a pre- and post-implementation audit design using the Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRIP) programs. An education programme on ACP was provided between pre-and post-implementation audits. Nurses and medical professionals (pre-audit, n = 32; post-audit, n = 30) working in oncology departments were invited to complete a questionnaire based on the audit criteria. A convenience sample of 25 nurses participated in the focus group interview. Interview data were analysed by content analysis. The post-audit results were lower than the pre-audit results with a range of decreased compliance from 1% for criterion 5 to 14% for criterion 6. Lack of time to implement ACP was the most frequently raised barrier by oncology nurses. The study findings were disappointing, but this first audit is significant to provide insights for future dissemination and implementation of ACP interventions. An ongoing mandatory professional development programme in ACP for healthcare staff is promising to promote the uptake of ACP in healthcare settings. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

  12. Symposium: “Oncology Leadership in Asia”

    PubMed Central

    Noh, Dong-Young; Roh, Jae Kyung; Kim, Yeul Hong; Yoshida, Kazuhiro; Baba, Hideo; Samson-Fernando, Marie Cherry Lynn; Misra, Sanjeev; Aziz, Zeba; Umbas, Rainy; P. Singh, Yogendra; Shu Kam Mok, Tony; Yang, Han-Kwang; Akaza, Hideyuki

    2017-01-01

    The symposium on “Oncology Leadership in Asia” was held as part of the official program of the 42nd Annual Meeting of the Korean Cancer Association with International Cancer Conference. Given the increasing incidence of cancer in all countries and regions of Asia, regardless of developmental stage, and also in light of the recognized need for Asian countries to enhance collaboration in cancer prevention, research, treatment and follow-up, the symposium was held with the aim of bringing together oncology specialists from eight countries and regions in Asia to present the status in their own national context and discuss the key challenges and requirements in order to establish a greater Asian presence in the area of cancer control and research. The task of bringing together diverse countries and regions is made all the more urgent in that while Asia now accounts for more than half of all new cancer cases globally, clinical guidelines are based predominantly on practices adopted in Western countries, which may not be optimized for unique ethnic, pharmacogenomic and cultural characteristics in Asia. Recognizing the need for Asia to better gather information and data for the compilation of Asia-specific clinical guidelines, the participants discussed the current status in Asia in the national and regional contexts and identified future steps towards integrated and collaborative initiatives in Asia. A key outcome of the symposium was a proposal to combine and integrate the activities of existing pan-Asian societies, including the Asian Pacific Federation of Organizations for Cancer Research and Control (APFOCC) and Asian Clinical Oncology Society (ACOS). Further proposals included the expansion of pan-Asian society membership to include individuals and the essential need to encourage the participation of young researchers in order to ensure self-sustainability of cancer control efforts in the future. PMID:28279063

  13. [Induced drug prescription in oncology patients].

    PubMed

    Mas Arcas, C; Pascual Plá, F; Escrivá Muñz, J J; Boscas Mayans, R

    2004-01-01

    To study drug prescription generated by cancer patients treated at the Emergency Service (ES) of the Instituto Valenciano de Oncología (IVO) in their Primary Health Care Centre (PHCC). A descriptive prospective study has been carried out with patients treated and discharged from the ES of the IVO in November (n=207) and December (n=239) of 2001. 446 patients were treated and discharged; one out of five patients was contacted by telephone 48 hours after discharge to confirm drug prescriptions from the ES. In November, drug prescription was based on brand-name products, while, in December, generic drugs were prescribed. All patients were discharged with a detailed report that included: patient's medical records, consultation reason, physical exploration performed, diagnostic test results, discharge diagnosis and prescribed treatment. When a brand-name drug was prescribed, the majority of patients received the same product at the PHCC (92.5%), while the rest of them received the same active drug with a different brand name. When a generic drug was prescribed, patients received a prescription for the same active substance at the PHCC in 98% of cases (46% generic drug and 54% brand-name). As to length of treatment, 96% were short treatments (less than 2 weeks), while the rest of them were on-going. 80% needed one prescription; 15%, two, and 5% three or more prescriptions. In terms of therapeutic groups, the most commonly prescribed drugs were anti-infectious, analgesics, digestive-metabolism, respiratory, cardiovascular, neurological and miscellaneous. 1. There is a high level of induced drug prescription at PHCC in cancer patients, since primary care physicians usually maintain active substances prescribed by the ES of IVO, with few variations. 2. Promoting a good relationship between Hospital Care and Primary Health Care Centres helps control and reduce pharmaceutical costs. 3. A high correlation can be found between most frequently prescribed drugs in oncological

  14. Metastatic Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline

    PubMed Central

    Sohal, Davendra P.S.; Mangu, Pamela B.; Khorana, Alok A.; Shah, Manish A.; Philip, Philip A.; O’Reilly, Eileen M.; Uronis, Hope E.; Ramanathan, Ramesh K.; Crane, Christopher H.; Engebretson, Anitra; Ruggiero, Joseph T.; Copur, Mehmet S.; Lau, Michelle; Urba, Susan; Laheru, Daniel

    2016-01-01

    Purpose To provide evidence-based recommendations to oncologists and others for the treatment of patients with metastatic pancreatic cancer. Methods American Society of Clinical Oncology convened an Expert Panel of medical oncology, radiation oncology, surgical oncology, gastroenterology, palliative care, and advocacy experts to conduct a systematic review of the literature from April 2004 to June 2015. Outcomes were overall survival, disease-free survival, progression-free survival, and adverse events. Results Twenty-four randomized controlled trials met the systematic review criteria. Recommendations A multiphase computed tomography scan of the chest, abdomen, and pelvis should be performed. Baseline performance status and comorbidity profile should be evaluated. Goals of care, patient preferences, treatment response, psychological status, support systems, and symptom burden should guide decisions for treatments. A palliative care referral should occur at first visit. FOLFIRINOX (leucovorin, fluorouracil, irinotecan, and oxaliplatin; favorable comorbidity profile) or gemcitabine plus nanoparticle albumin-bound (NAB) -paclitaxel (adequate comorbidity profile) should be offered to patients with Eastern Cooperative Oncology Group performance status (ECOG PS) 0 to 1 based on patient preference and support system available. Gemcitabine alone is recommended for patients with ECOG PS 2 or with a comorbidity profile that precludes other regimens; the addition of capecitabine or erlotinib may be offered. Patients with an ECOG PS ≥ 3 and poorly controlled comorbid conditions should be offered cancer-directed therapy only on a case-by-case basis; supportive care should be emphasized. For second-line therapy, gemcitabine plus NAB-paclitaxel should be offered to patients with first-line treatment with FOLFIRINOX, an ECOG PS 0 to 1, and a favorable comorbidity profile; fluorouracil plus oxaliplatin, irinotecan, or nanoliposomal irinotecan should be offered to patients with

  15. Nanopharmacology in translational hematology and oncology

    PubMed Central

    Tomuleasa, Ciprian; Braicu, Cornelia; Irimie, Alexandra; Craciun, Lucian; Berindan-Neagoe, Ioana

    2014-01-01

    Nanoparticles have displayed considerable promise for safely delivering therapeutic agents with miscellaneous therapeutic properties. Current progress in nanotechnology has put forward, in the last few years, several therapeutic strategies that could be integrated into clinical use by using constructs for molecular diagnosis, disease detection, cytostatic drug delivery, and nanoscale immunotherapy. In the hope of bringing the concept of nanopharmacology toward a viable and feasible clinical reality in a cancer center, the present report attempts to present the grounds for the use of cell-free nanoscale structures for molecular therapy in experimental hematology and oncology. PMID:25092977

  16. Assessment of comorbidities in surgical oncology outcomes.

    PubMed

    Sinha, Parul; Kallogjeri, Dorina; Piccirillo, Jay F

    2014-10-01

    The impact of comorbidities on treatment, postoperative complications, survival, prognosis, and quality of life, makes comorbidities' assessment essential in surgically managed cancer patients. Multiple indices exist to measure the presence and severity of comorbidities, of which the Charlson Comorbidity Index and the Adult Comorbidity Evaluation-27 are the most widely employed. Incorporation of comorbidity data in cancer registries facilitates surgical oncology research conduct with an objective to improve cancer care through better-informed patient counseling and treatment planning. © 2014 Wiley Periodicals, Inc.

  17. Nuclear oncology: From genotype to patient care

    SciTech Connect

    1997-12-31

    Nuclear medicine is the medical specialty best suited to translate the exploding body of knowledge obtained from research in genetics and molecular biology into the care of patients. This fourth annual nuclear oncology conference will address how this can be done and how positron emission tomography (PET) and single photon emission tomography (SPECT) can be used in the care of patients with cancer or with increased genetic risk of developing cancer. The course will include illustrative patient studies showing how PET and SPECT can help in diagnosis, staging and treatment planning and monitoring of patients with cancer.

  18. Psychosocial Impact of Personalized Therapies in Oncology.

    PubMed

    Schilling, Georgia; Schulz-Kindermann, Frank

    2018-01-01

    Personalized medicine is a keyword in modern oncology summarizing biomarker-driven targeted therapies. Those novel agents enhance our therapeutic portfolio and offer new options for our patients. But the term is often misleading and implicates a tailored therapy to the individual person, but it rather means a treatment stratified on genetic characteristics of the tumor. Molecular therapies raise expectations of curability or long-term treatments making former life-threatening diseases to more chronic ones but this is true only for some patients. So we have to carefully communicate with our patients about the options and limitations of those modern therapies not to trigger disappointments.

  19. [The problems of informing oncological patients].

    PubMed

    Pietschmann, H

    1979-01-01

    The "phase-model" of Kübler-Ross represents useful auxiliary means, which however prove correct only in a portion of the cases. The information of the diagnosis of a malign disease constitutes one of the most difficult medical problems and requires certain basic conditions. As a rule it cannot be delegated but must be solved within the realm of oncology. In the future it will be necessary to inform the patients concerning their malign disease very much more than is is presently done.

  20. The Johns Hopkins Oncology Clinical Information System

    PubMed Central

    Lenhard, Raymond E.; Blum, Bruce I.; Sunderland, Jeffery M.; Braine, Hayden G.; Saral, Rein

    1982-01-01

    The Johns Hopkins Oncology Center has developed and maintains a clinical information system to support patient care, education, research and administrative functions. It operates on a dedicated mini-computer (PDP-11) programmed in MUMPS. Clinical information collelcted includes patient medical status and laboratory values. Data are used daily in patient care and also in support of retrospective and prospective research. The use of the system to manage a large blood product pheresis program and to study and treat infectious disease is described. Administrative functions include patient and personnel scheduling, program evaluation and projects directed toward control of costs.

  1. Advanced MR Imaging in Neuro-oncology.

    PubMed

    Radbruch, A; Bendszus, M

    2015-10-01

    The value of magnetic resonance (MR) imaging for the clinical management of brain tumour patients has greatly increased in recent years through the introduction of functional MR sequences. Previously, MR imaging for brain tumours relied for the most part on contrast-enhanced T1-weighted MR sequences but today with the help of advanced functional MR sequences, the pathophysiological aspects of tumour growth can be directly visualised and investigated. This article will present the pathophysiological background of the MR sequences relevant to neuro-oncological imaging as well as potential clinical applications. Ultimately, we take a look at possible future developments for ultra-high-field MR imaging.

  2. Rabbit Oncology: Diseases, Diagnostics, and Therapeutics.

    PubMed

    van Zeeland, Yvonne

    2017-01-01

    Neoplasia has long been reported as a rare finding in rabbits, but over the past decades the number of reports on neoplastic disease in rabbits has risen considerably. Similar to other animals, neoplastic changes may occur in any organ system, but the rate in which the organ systems are affected differs considerably. In rabbits, tumors have predominantly been found in the urogenital, hemolymphatic, and integumentary systems. This article discusses current insights on the etiopathogenesis, clinical signs, diagnosis, and treatment of the commonest neoplastic diseases in rabbits and offer guidelines for the correct diagnosis and treatment of the rabbit oncologic patient. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Lymphadenectomy in urologic oncology: pathologic considerations.

    PubMed

    Alexander, Riley E; Sung, Ming-Tse; Cheng, Liang

    2011-11-01

    Lymphadenectomy (LAD) is an important staging and treatment modality of oncologic surgery. LAD in genitourinary malignancies presents inherent difficulties to the urologist and pathologist because of the differences in anatomic sites and primary histologic type. This review focuses on pathologic evaluation and how communication between urologist and pathologist is necessary to provide optimal care. Recommendations covering general specimen submission and processing are discussed, as well as more specific recommendations concerning the kidney, upper urinary tract, urinary bladder, prostate, testes, and penis. Emerging areas of prognostic significance and the impact that improved molecular techniques are contributing to diagnostic interpretation are highlighted.

  4. Evidence-based paediatric surgical oncology.

    PubMed

    Losty, Paul D

    2016-10-01

    Surgeons play a pivotal role in the decision-making and multidisciplinary management of childhood solid tumours.(1) Evidence-based medicine-"aims to optimise decision making by emphasising on the use of best evidence from well-designed conducted research." This article offers a brief overview in an effort to demonstrate how a selection of well-conducted, recently published studies can help address some topical and controversial themes in paediatric surgical oncology practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Bioinformatics: a key role in oncology].

    PubMed

    Olivier, Timothée; Chappuis, Pierre; Tsantoulis, Petros

    2016-05-18

    Bioinformatics is essential in clinical oncology and research. Combining biology, computer science and mathematics, bioinformatics aims to derive useful information from clinical and biological data, often poorly structured, at a large scale. Bioinformatics approaches have reclassified certain cancers based on their molecular and biological presentation, improving treatment selection. Many molecular signatures have been developed and, after validation, some are now usable in clinical practice. Other applications could facilitate daily practice, reduce the risk of error and increase the precision of medical decision-making. Bioinformatics must evolve in accordance with ethical considerations and requires multidisciplinary collaboration. Its application depends on a sound technical foundation that meets strict quality requirements.

  6. Applied Nanotechnology and Nanoscience in Orthopedic Oncology.

    PubMed

    Savvidou, Olga D; Bolia, Ioanna K; Chloros, George D; Goumenos, Stavros D; Sakellariou, Vasileios I; Galanis, Evanthia C; Papagelopoulos, Panayiotis J

    2016-09-01

    Nanomedicine is based on the fact that biological molecules behave similarly to nanomolecules, which have a size of less than 100 nm, and is now affecting most areas of orthopedics. In orthopedic oncology, most of the in vitro and in vivo studies have used osteosarcoma or Ewing sarcoma cell lineages. In this article, tumor imaging and treatment nanotechnology applications, including nanostructure delivery of chemotherapeutic agents, gene therapy, and the role of nano-selenium-coated implants, are outlined. Finally, the potential role of nanotechnology in addressing the challenges of drug and radiotherapy resistance is discussed. [Orthopedics. 2016; 39(5):280-286.].

  7. The Essential Elements of Cooperative Learning.

    ERIC Educational Resources Information Center

    Watson, Scott B.

    1992-01-01

    Discusses four elements of cooperative learning in science classrooms: cooperative task structures; cooperative incentive structures; individual accountability; and heterogeneous grouping. Presents and describes seven cooperative learning methods. (MDH)

  8. [Reconstructive surgery in head and neck oncology: indication and technic].

    PubMed

    Kolb, F; Julieron, M

    2005-02-01

    Oncologic cervicofacial surgery and plastic surgery have had a common evolution over the last 50 years where progress erasing from one was beneficial to the other one. We review here the historical evolution of these specialties and present the state of the art of plastic surgery in the field of cervicofacial oncology.

  9. Effects of Age Expectations on Oncology Social Workers' Clinical Judgment

    ERIC Educational Resources Information Center

    Conlon, Annemarie; Choi, Namkee G.

    2014-01-01

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

  10. Effects of Age Expectations on Oncology Social Workers' Clinical Judgment

    ERIC Educational Resources Information Center

    Conlon, Annemarie; Choi, Namkee G.

    2014-01-01

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

  11. 75 FR 71450 - Oncologic Drugs Advisory Committee; Amendment of Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-23

    ... HUMAN SERVICES Food and Drug Administration Oncologic Drugs Advisory Committee; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing an amendment to the notice of a meeting of the Oncologic Drugs Advisory Committee....

  12. 77 FR 37911 - Oncologic Drugs Advisory Committee; Amendment of Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... HUMAN SERVICES Food and Drug Administration Oncologic Drugs Advisory Committee; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. The Food and Drug Administration (FDA) is announcing an amendment to the notice of meeting of the Oncologic Drugs Advisory Committee. This meeting...

  13. 77 FR 63839 - Oncologic Drugs Advisory Committee; Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... HUMAN SERVICES Food and Drug Administration Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory... committee have been resolved. FOR FURTHER INFORMATION CONTACT: Caleb Briggs, Center for Drug Evaluation...

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

    PubMed Central

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

    2014-01-01

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

  15. What drives cooperative breeding?

    PubMed

    Koenig, Walter D

    2017-06-01

    Cooperative breeding, in which more than a pair of conspecifics cooperate to raise young at a single nest or brood, is widespread among vertebrates but highly variable in its geographic distribution. Particularly vexing has been identifying the ecological correlates of this phenomenon, which has been suggested to be favored in populations inhabiting both relatively stable, productive environments and in populations living under highly variable and unpredictable conditions. Griesser et al. provide a novel approach to this problem, performing a phylogenetic analysis indicating that family living is an intermediate step between nonsocial and cooperative breeding birds. They then examine the ecological and climatic conditions associated with these different social systems, concluding that cooperative breeding emerges when family living is favored in highly productive environments, followed secondarily by selection for cooperative breeding when environmental conditions deteriorate and within-year variability increases. Combined with recent work addressing the fitness consequences of cooperative breeding, Griesser et al.'s contribution stands to move the field forward by demonstrating that the evolution of complex adaptations such as cooperative breeding may only be understood when each of the steps leading to it are identified and carefully integrated.

  16. Maintenance of Certification for Radiation Oncology

    SciTech Connect

    Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

    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 of 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.

  17. [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.

  18. Apps for Radiation Oncology. A Comprehensive Review.

    PubMed

    Calero, J J; Oton, L F; Oton, C A

    2017-02-01

    Software applications executed on a smart-phone or mobile device ("Apps") are increasingly used by oncologists in their daily work. A comprehensive critical review was conducted on Apps specifically designed for Radiation Oncology, which aims to provide scientific support for these tools and to guide users in choosing the most suited to their needs. A systematic search was conducted in mobile platforms, iOS and Android, returning 157 Apps. Excluding those whose purpose did not match the scope of the study, 31 Apps were methodically analyzed by the following items: Objective Features, List of Functionalities, Consistency in Outcomes and Usability. Apps are presented in groups of features, as Dose Calculators (7 Apps), Clinical Calculators (4), Tools for Staging (7), Multipurpose (7) and Others (6). Each App is presented with the list of attributes and a brief comment. A short summary is provided at the end of each group. There are numerous Apps with useful tools at the disposal of radiation oncologists. The most advisable Apps do not match the more expensive. Three all-in-one apps seem advisable above all: RadOnc Reference (in English), Easy Oncology (in German) and iOncoR (in Spanish). Others recommendations are suggested for specific tasks: dose calculators, treatment-decision and staging. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Extremely high-frequency therapy in oncology.

    PubMed

    Teppone, Mikhail; Avakyan, Romen

    2010-11-01

    This article represents a review of the literature, mainly from Russian sources, dealing with the therapeutic application of low-intensity electromagnetic radiation in the millimeter band applied to experimental and clinical oncology. At the early stage of these studies, efficacy and safety of millimeter electromagnetic radiation (extremely high frequency [EHF]) was proved for various types of malignant tumors. The majority of the further studies demonstrated the high efficacy and safety of millimeter wave radiation in treating patients suffering from both benign and malignant tumors. Developments led to treatment on skin melanoma, cancer of the ear-nose-throat, bowel and breast cancer, cancer of the uterus, lung, and stomach, solid tumors, as well as lymphoma. The main indications for this therapy are (1) preparation prior to radical treatment; (2) prevention and treatment of side-effects and complications from chemotherapy and radiotherapy; (3) prevention of metastases, relapses, and dissemination of the tumor; (4) treatment of the paraneoplastic syndrome; and (5) palliative therapy of incurable patients. In spite of the fact that not all mechanisms underlying effects of EHF therapy are known as yet, this therapeutic modality has been shown to have great potential in clinical oncology from studies performed in Eastern Europe and Russia.

  20. Towards standardized robotic surgery in gastrointestinal oncology.

    PubMed

    Knab, Lawrence M; Zureikat, Amer H; Zeh, Herbert J; Hogg, Melissa E

    2017-09-27

    Minimally invasive techniques have revolutionized the field of surgery over the past several decades. Specifically, robotic surgery is increasingly being used for complex operations, although the appreciable learning curve required to become proficient has deterred many surgeons. We describe how use of a proficiency-based training program can decrease the learning curve and lead to standardized robotic surgery. The steps of a proficiency-based robotic training program are described, including (1) a proficiency-based virtual reality simulation curriculum, (2) an inanimate biotissue curriculum, (3) a video library training, (4) intraoperative evaluation, and (5) skill maintenance with ongoing assessment. The learning curve for robotic gastrointestinal surgery is explored, as well as outcomes compared to laparoscopic and open techniques. The implementation of a proficiency-based robotic training program is feasible. Surgical oncology fellows who participated in the program demonstrated improvement in both the simulation and biotissue curricula. Analyzed as a group, the participants improved in time and errors after the biotissue curriculum. Published outcomes from robotic gastrointestinal surgery have demonstrated safety, feasibility, and preserved oncologic resections. A proficiency-based robotic curriculum is ideal to enable surgeons to achieve mastery in robotic surgery while minimizing the learning curve required.

  1. Technological challenges of theranostics in oncology.

    PubMed

    Warenius, Hilmar M

    2009-07-01

    Although the term theranostics has been coined only fairly recently, attempts to relate the level of biomarkers to therapeutic response in the oncology clinic go back several decades. After a long period in which a limited number of individual theranostic molecular biomarkers gained general clinical acceptance, extremely powerful genomic and proteomic technologies have now emerged. These technologies, reviewed here, promise a potential revolution in our ability to predict therapeutic response in cancer, and by so doing, guide new anticancer drugs more successfully into clinical oncology practice. A full understanding of the detailed molecular nature of clinical cancer is, however, still evolving. The need for appropriate models of the highly complex disease, against which we are attempting to direct effective therapy more accurately, is also addressed. These should include an understanding of genomic and proteomic heterogeneity, genetic instability and systems biology models of cancer that take into account recent demonstrations of the vastly increased mutational state of the average clinical cancer as compared with the normal cell(s) from which it arose. The way forward in theranostics is, arguably, less dependent on further improvements in the already powerful genomic and proteomic technologies themselves than on our improved understanding of how we should apply them to the complex reality of the average clinical cancer.

  2. Computer-assisted surgery in orthopedic oncology

    PubMed Central

    Gerbers, Jasper G; Stevens, Martin; Ploegmakers, Joris JW; Bulstra, Sjoerd K; Jutte, Paul C

    2014-01-01

    Background and purpose — In orthopedic oncology, computer-assisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore describe possible applications of CAS and report preliminary results in 130 procedures. Patients and methods — We conducted a retrospective cohort study of all oncological CAS procedures in a single institution from November 2006 to March 2013. Mean follow-up time was 32 months. We categorized and analyzed 130 procedures for clinical parameters. The categories were image-based intralesional treatment, image-based resection, image-based resection and reconstruction, and imageless resection and reconstruction. Results — Application to intralesional treatment showed 1 inadequate curettage and 1 (other) recurrence in 63 cases. Image-based resections in 42 cases showed 40 R0 margins; 16 in 17 pelvic resections. Image-based reconstruction facilitated graft creation with a mean reconstruction accuracy of 0.9 mm in one case. Imageless CAS was helpful in resection planning and length- and joint line reconstruction for tumor prostheses. Interpretation — CAS is a promising new development. Preliminary results show a high number of R0 resections and low short-term recurrence rates for curettage. PMID:25140984

  3. Lessons Learned from Radiation Oncology Clinical Trials

    PubMed Central

    Liu, Fei-Fei; Okunieff, Paul; Bernhard, Eric J.; Stone, Helen B.; Yoo, Stephen; Coleman, C. Norman; Vikram, Bhadrasain; Brown, Martin; Buatti, John; Guha, Chandan

    2014-01-01

    A Workshop entitled “Lessons Learned from Radiation Oncology Trials” was held on December 7–8th, 2011 in Bethesda, MD, to present and discuss some of the recently conducted Radiation Oncology clinical trials with a focus on those that failed to refute the null hypothesis. The objectives of this Workshop were to summarize and examine the questions that these trials provoked, to assess the quality and limitations of the pre-clinical data that supported the hypotheses underlying these trials, and to consider possible solutions to these challenges for the design of future clinical trials. Several themes emerged from the discussions, including the: a) opportunities to learn from null-hypothesis trials through tissue and imaging studies; b) value of pre-clinical data supporting the design of combinatorial therapies; c) significance of validated biomarkers; d) necessity of quality assurance in radiotherapy delivery; e) conduct of sufficiently-powered studies to address the central hypothesis; and f) importance of publishing results of the trials regardless of the outcome. The fact that well-designed hypothesis-driven clinical trials produce null or negative results is expected given the limitations of trial design, and complexities of cancer biology. It is important to understand the reasons underlying such null results however, in order to effectively merge the technological innovations with the rapidly evolving biology for maximal patient benefit, through the design of future clinical trials. PMID:24043463

  4. Social Interaction and Collaboration among Oncology Nurses.

    PubMed

    Moore, Jane; Prentice, Dawn; McQuestion, Maurene

    2015-01-01

    Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

  5. Safety and efficacy of biosimilars in oncology.

    PubMed

    Schellekens, Huub; Smolen, Josef S; Dicato, Mario; Rifkin, Robert M

    2016-11-01

    Biosimilars are considered to be one of the solutions to combat the substantially increasing costs of cancer treatment, and its imminent introduction is expected to expand affordability worldwide. However, biosimilar monoclonal antibodies provide many challenges compared with first-generation biosimilars, growth factors, and hormones, because they have shown only a modest clinical effect, and are often used in combination with other more toxic therapies, making it difficult to design studies that allow appropriate efficacy and safety assessments compared with the original products. The value of comparative clinical trials for showing clinical equivalence of biosimilars that demonstrate a high degree of similarity in physical, chemical, structural, and biological characteristics with the original product is increasingly being questioned, and advances in analytical methods that provide robust non-clinical data might reduce the need for extensive clinical comparisons. In this Series paper, the third of three papers on drug safety in oncology, we review the safety and efficacy of biosimilars in oncology, assessing biosimilar monoclonal antibodies in relation to first-generation biosimilars, the issues surrounding interchangeability and extrapolation of biosimilars to other disease and patient indications, and reassessing the safety approval pathway in light of 10 years worth of biosimilar experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Antisense therapeutics in oncology: current status

    PubMed Central

    Farooqi, Ammad Ahmad; Rehman, Zia ur; Muntane, Jordi

    2014-01-01

    There is increasing progress in translational oncology and tremendous breakthroughs have been made as evidenced by preclinical and clinical trials. Data obtained from high-throughput technologies are deepening our understanding about the molecular and gene network in cancer cells and rapidly emerging in vitro and in vivo evidence is highlighting the role of antisense agents as specific inhibitors of the expression of target genes, thus modulating the response of cancer cells to different therapeutic strategies. Much information is continuously being added into various facets of molecular oncology and it is now understood that overexpression of antiapoptotic proteins, oncogenes, oncogenic microRNAs (miRNA), and fusion proteins make cancer cells difficult to target. Delivery of antisense oligonucleotides has remained a challenge and technological developments have helped in overcoming hurdles by improving the ability to penetrate cells, effective and targeted binding to gene sequences, and downregulation of target gene function. Different delivery systems, including stable nucleic acid lipid particles, have shown potential in enhancing the delivery of cargo to the target site. In this review, we attempt to summarize the current progress in the development of antisense therapeutics and their potential in medical research. We partition this multicomponent review into introductory aspects about recent breakthroughs in antisense therapeutics. We also discuss how antisense therapeutics have shown potential in resensitizing resistant cancer cells to apoptosis by targeted inhibition of antiapoptotic proteins, oncogenic miRNAs, and BCR-ABL. PMID:25395862

  7. [Introduction of emotional labour into oncology].

    PubMed

    Lazányi, Kornélia; Molnár, Péter; Szluha, Kornélia

    2007-06-03

    Health care professionals do not have emotional labour obligations in their employment contract. However, in everyday work it is often inevitable for them to change their true feelings. This is critically true for professionals treating chronic or cancer patients. The suitable emotional state of the treatment staff does not only influence the practitioner-patient relationship but the process of recovery as well. Depending on the way one might get into the appropriate emotional state, the literature distinguishes between surface, deep and genuine acting. While surface and deep emotional labour has numerous negative psychological consequences genuine acting is usually accompanied by positive side effects. For those working in the field of oncology, emotional labour is a part of the role expectations of the professionals. This is how the appropriate attitude is a fundamental part of the professionals' essence. For the in depth analysis of subjects related to emotional labour, the authors adopted ideas from L. Festinger 's cognitive dissonance theory. The best way to alleviate cognitive dissonance and the negative side effects of emotional labour is to prevent the emergence of them. Oncology professionals should fit their role expectations genuinely, without particular efforts. If this was impossible, or the particular life situations did not allow genuine acting, it is the employer's and the workmates' common duty to help professionals, to ease the load of emotional labour, to diminish the occurring cognitive dissonance with the help of appropriate recompense.

  8. Radiation Oncology Physics and Medical Physics Education

    NASA Astrophysics Data System (ADS)

    Bourland, Dan

    2011-10-01

    Medical physics, an applied field of physics, is the applications of physics in medicine. Medical physicists are essential professionals in contemporary healthcare, contributing primarily to the diagnosis and treatment of diseases through numerous inventions, advances, and improvements in medical imaging and cancer treatment. Clinical service, research, and teaching by medical physicists benefits thousands of patients and other individuals every day. This talk will cover three main topics. First, exciting current research and development areas in the medical physics sub-specialty of radiation oncology physics will be described, including advanced oncology imaging for treatment simulation, image-guided radiation therapy, and biologically-optimized radiation treatment. Challenges in patient safety in high-technology radiation treatments will be briefly reviewed. Second, the educational path to becoming a medical physicist will be reviewed, including undergraduate foundations, graduate training, residency, board certification, and career opportunities. Third, I will introduce the American Association of Physicists in Medicine (AAPM), which is the professional society that represents, advocates, and advances the field of medical physics (www.aapm.org).

  9. Minimally Invasive Surgery in Gynecologic Oncology

    PubMed Central

    Mori, Kristina M.; Neubauer, Nikki L.

    2013-01-01

    Minimally invasive surgery has been utilized in the field of obstetrics and gynecology as far back as the 1940s when culdoscopy was first introduced as a visualization tool. Gynecologists then began to employ minimally invasive surgery for adhesiolysis and obtaining biopsies but then expanded its use to include procedures such as tubal sterilization (Clyman (1963), L. E. Smale and M. L. Smale (1973), Thompson and Wheeless (1971), Peterson and Behrman (1971)). With advances in instrumentation, the first laparoscopic hysterectomy was successfully performed in 1989 by Reich et al. At the same time, minimally invasive surgery in gynecologic oncology was being developed alongside its benign counterpart. In the 1975s, Rosenoff et al. reported using peritoneoscopy for pretreatment evaluation in ovarian cancer, and Spinelli et al. reported on using laparoscopy for the staging of ovarian cancer. In 1993, Nichols used operative laparoscopy to perform pelvic lymphadenectomy in cervical cancer patients. The initial goals of minimally invasive surgery, not dissimilar to those of modern medicine, were to decrease the morbidity and mortality associated with surgery and therefore improve patient outcomes and patient satisfaction. This review will summarize the history and use of minimally invasive surgery in gynecologic oncology and also highlight new minimally invasive surgical approaches currently in development. PMID:23997959

  10. The role of inhibitory control in children's cooperative behaviors during a structured puzzle task.

    PubMed

    Giannotta, Fabrizia; Burk, William J; Ciairano, Silvia

    2011-11-01

    This study examined the role of inhibitory control (measured by Stroop interference) in children's cooperative behaviors during a structured puzzle task. The sample consisted of 250 8-, 10-, and 12-year-olds (117 girls and 133 boys) attending classrooms in three primary schools in Northern Italy. Children individually completed an elaborated Stroop task, were paired with classmates into 125 dyads, and were observed during a 10-min puzzle task. Results confirmed that interaction partners exhibited similar levels of cooperative behaviors, and the cooperative behaviors of children predicted changes in the cooperative behaviors of their partners throughout the puzzle task. Cooperative behaviors of each interaction partner were predicted by the child's own inhibitory control as well as the inhibitory control of the partner. Findings are discussed within a developmental contextual framework.

  11. Oncology and medical education—past, present and future

    PubMed Central

    Cave, Judith

    2016-01-01

    Oncologists should contribute to the undergraduate curriculum whenever they can, and should teach communication skills, acute oncology, prescribing, and other transferable skills. Newly qualified doctors will care for many patients with cancer in their first years of work, and all doctors need to know when an urgent oncology referral is required and to be aware of the pace of change in oncology. Oncologists should involve their patients in teaching whenever it is appropriate. We should aim to inspire junior doctors to consider a career in oncology. The oncology education community should adopt new teaching methods, for example simulation, mock MDTs and student led clinics. CPD provided by honorable organisations, including online learning, is becoming more important for oncologists to keep up to date. PMID:27350792

  12. Medical oncology, history and its future in Iran.

    PubMed

    Mirzania, Mehrzad; Ghavamzadeh, Ardeshir; Asvadi Kermani, Iraj; Ashrafi, Farzaneh; Allahyari, Abolghasem; Rostami, Nematollah; Razavi, Seyed Mohsen; Ramzi, Mani; Nemanipour, Gholamreza

    2015-11-01

    Systemic therapy is one of the cornerstones of cancer treatment. In 1972, following representations by American Society of Clinical Oncology (ASCO), the American Board of Internal Medicine (ABIM) recognized medical oncology as a new subspecialty of internal medicine. Subspecialty of Hematology and Medical Oncology was emerged in Iran in 1983. In the past, modern medical treatments and education were started in Dar Al-fonun school and then in Tehran University; now six universities in Iran are training in Subspecialty of Hematology and Medical Oncology. There are also ten active hematopoietic stem cell transplantation centers, thirty-one provincial medical schools use their specialized services. Future goals for Hematology and Medical Oncology in Iran include expansion and reinforcement of multidisciplinary teams across the country, early detection and prevention of cancer, providing educational program and conducting cancer researches. To achieve these goals, it is necessary to establish Cancer Hospitals in each province that link together through a network.

  13. Student Perspectives on Oncology Curricula at United States Medical Schools.

    PubMed

    Neeley, Brandon C; Golden, Daniel W; Brower, Jeffrey V; Braunstein, Steve E; Hirsch, Ariel E; Mattes, Malcolm D

    2017-08-07

    Delivering a cohesive oncology curriculum to medical students is challenging due to oncology's multidisciplinary nature, predominantly outpatient clinical setting, and lack of data describing effective approaches to teaching it. We sought to better characterize approaches to oncology education at US medical schools by surveying third and fourth year medical students who serve on their institution's curriculum committee. We received responses from students at 19 schools (15.2% response rate). Key findings included the following: (1) an under-emphasis of cancer in the curriculum relative to other common diseases; (2) imbalanced involvement of different clinical subspecialists as educators; (3) infrequent requirements for students to rotate through non-surgical oncologic clerkships; and (4) students are less confident in their knowledge of cancer treatment compared to basic science/natural history or workup/diagnosis. Based on these findings, we provide several recommendations to achieve robust multidisciplinary curriculum design and implementation that better balances the clinical and classroom aspects of oncology education.

  14. Clinical oncology practice 2015: preparing for the future.

    PubMed

    Kosty, Michael P; Acheson, Anupama Kurup; Tetzlaff, Eric D

    2015-01-01

    The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

  15. Italy: An Open Air Museum

    NASA Astrophysics Data System (ADS)

    Pizzorusso, Ann

    2016-04-01

    Imagine if you could see the River Styx, bathe in the Fountain of Youth, collect water which enhances fertility, wear a gem that heals bodily ailments, understand how our health is affected by geomagnetic fields, venture close to the flames of Hell on Earth and much, much, more. Know something? These things exist - on Earth - today - in Italy and you can visit them because Italy is an open air museum. Ann C. Pizzorusso, in her recent book, reveals how Italy's geology has affected its art, literature, architecture, religion, medicine and just about everything else. She explores the geologic birth of the land, describing the formation of the Alps and Apennines, romantic bays of Tuscany and Lazio, volcanoes of the south and Caribbean-like beaches of Puglia. But that's not all, from the first pages of this visually stunning book, the reader has the impression of being in an art museum, where one can wander from page to page to satisfy one's curiosity-- guided from time to time by the Etruscan priests, Virgil, Dante, Goethe or Leonardo da Vinci himself. Pizzorusso stitches together widely diverse topics - such as gemology, folk remedies, grottoes, painting, literature, physics and religion - using geology as a thread. Quoting everyone from Pliny the Elder to NASA physicist Friedemann Freund, the work is solidly backed scholarship that reads as easily as a summer novel. Wonderfully illustrated with many photos licensed from Italian museums, HRH Elizabeth II and the Ministero Beni Culturali the book highlights the best works in Italian museums and those outside in the "open air museums." This approach can be used in any other country in the world and can be used for cultural tourism (a tour following the book has been organized for cultural and university groups), an ideal way of linking museums to the surrounding landscape.

  16. Assessing the Eventual Publication of Clinical Trial Abstracts Submitted to a Large Annual Oncology Meeting

    PubMed Central

    Wang, Ruibin; Prasad, Vinay; Bates, Susan E.; Fojo, Tito

    2016-01-01

    Background. Despite the ethical imperative to publish clinical trials when human subjects are involved, such data frequently remain unpublished. The objectives were to tabulate the rate and ascertain factors associated with eventual publication of clinical trial results reported as abstracts in the Proceedings of the American Society of Clinical Oncology (American Society of Clinical Oncology). Materials and Methods. Abstracts describing clinical trials for patients with breast, lung, colorectal, ovarian, and prostate cancer from 2009 to 2011 were identified by using a comprehensive online database (http://meetinglibrary.asco.org/abstracts). Abstracts included reported results of a treatment or intervention assessed in a discrete, prospective clinical trial. Publication status at 4−6 years was determined by using a standardized search of PubMed. Primary outcomes were the rate of publication for abstracts of randomized and nonrandomized clinical trials. Secondary outcomes included factors influencing the publication of results. Results. A total of 1,075 abstracts describing 378 randomized and 697 nonrandomized clinical trials were evaluated. Across all years, 75% of randomized and 54% of nonrandomized trials were published, with an overall publication rate of 61%. Sample size was a statistically significant predictor of publication for both randomized and nonrandomized trials (odds ratio [OR] per increase of 100 participants = 1.23 [1.11–1.36], p < .001; and 1.64 [1.15–2.34], p = .006, respectively). Among randomized studies, an industry coauthor or involvement of a cooperative group increased the likelihood of publication (OR 2.37, p = .013; and 2.21, p = .01, respectively). Among nonrandomized studies, phase II trials were more likely to be published than phase I (p < .001). Use of an experimental agent was not a predictor of publication in randomized (OR 0.76 [0.38–1.52]; p = .441) or nonrandomized trials (OR 0.89 [0.61–1.29]; p = .532). Conclusion

  17. Updates from the 2013 Society for Neuro-Oncology annual and World Federation for Neuro-Oncology quadrennial meeting.

    PubMed

    Lukas, Rimas V; Amidei, Christina

    2014-01-01

    We present an overview of a number of key clinical studies in infiltrating gliomas presented at the 2013 Society for Neuro-Oncology and World Federation of Neuro-Oncology joint meeting. This review focuses on efficacy results, including quality of life studies, from larger clinical trials in both high- and low-grade infiltrating gliomas.

  18. Integration in Italy: A Dynamic Movement.

    ERIC Educational Resources Information Center

    Berrigan, Carol

    The result of trips by American special educators to Italy in 1984 and 1986, this paper reviews laws, public policy, and events in Italy's recent history leading to widespread desegregation of the disabled special schools and other institutions. The review of legislation focuses on National Law 517 (1977) with such specified strategies for pupil…

  19. Cooperative Learning Strategies.

    ERIC Educational Resources Information Center

    Pratt, Sandra

    2003-01-01

    Describes the effectiveness of cooperative learning on discipline problems, interdependence between students, and teacher-student interactions. Explains how to group students and introduces a laboratory activity on covalent and ionic bonds. (YDS)

  20. Cooperative processing data bases

    NASA Technical Reports Server (NTRS)

    Hasta, Juzar

    1991-01-01

    Cooperative processing for the 1990's using client-server technology is addressed. The main theme is concepts of downsizing from mainframes and minicomputers to workstations on a local area network (LAN). This document is presented in view graph form.

  1. How Myxobacteria Cooperate.

    PubMed

    Cao, Pengbo; Dey, Arup; Vassallo, Christopher N; Wall, Daniel

    2015-11-20

    Prokaryotes often reside in groups where a high degree of relatedness has allowed the evolution of cooperative behaviors. However, very few bacteria or archaea have made the successful transition from unicellular to obligate multicellular life. A notable exception is the myxobacteria, in which cells cooperate to perform group functions highlighted by fruiting body development, an obligate multicellular function. Like all multicellular organisms, myxobacteria face challenges in how to organize and maintain multicellularity. These challenges include maintaining population homeostasis, carrying out tissue repair and regulating the behavior of non-cooperators. Here, we describe the major cooperative behaviors that myxobacteria use: motility, predation and development. In addition, this review emphasizes recent discoveries in the social behavior of outer membrane exchange, wherein kin share outer membrane contents. Finally, we review evidence that outer membrane exchange may be involved in regulating population homeostasis, thus serving as a social tool for myxobacteria to make the cyclic transitions from unicellular to multicellular states.

  2. Cooperative Learning in Statistics.

    ERIC Educational Resources Information Center

    Keeler, Carolyn M.; And Others

    1994-01-01

    Formal use of cooperative learning techniques proved effective in improving student performance and retention in a freshman level statistics course. Lectures interspersed with group activities proved effective in increasing conceptual understanding and overall class performance. (11 references) (Author)

  3. Cooperative Learning Strategies.

    ERIC Educational Resources Information Center

    Pratt, Sandra

    2003-01-01

    Describes the effectiveness of cooperative learning on discipline problems, interdependence between students, and teacher-student interactions. Explains how to group students and introduces a laboratory activity on covalent and ionic bonds. (YDS)

  4. Cooperative Education: Industry Involvement.

    ERIC Educational Resources Information Center

    Davies, Geoffrey; McClelland, Alan L.

    1980-01-01

    Contains information from three large chemical companies having a long-standing interest in cooperative education with chemistry students. Questions and answers are provided for specific information regarding DuPont, 3M, and Dow Chemical. (CS)

  5. Cooperative Purchasing Reduces Costs.

    ERIC Educational Resources Information Center

    Kula, Edwin J.

    1981-01-01

    Several suburban Chicago (Illinois) school districts are members of the South Suburban School Purchasing Cooperative, which serves as a conduit for volume purchases of educational supplies. (Author/MLF)

  6. American Society of Clinical Oncology Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce.

    PubMed

    Winkfield, Karen M; Flowers, Christopher R; Patel, Jyoti D; Rodriguez, Gladys; Robinson, Patricia; Agarwal, Amit; Pierce, Lori; Brawley, Otis W; Mitchell, Edith P; Head-Smith, Kimberly T; Wollins, Dana S; Hayes, Daniel F

    2017-08-01

    In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves.

  7. Cooperating mobile robots

    DOEpatents

    Harrington, John J.; Eskridge, Steven E.; Hurtado, John E.; Byrne, Raymond H.

    2004-02-03

    A miniature mobile robot provides a relatively inexpensive mobile robot. A mobile robot for searching an area provides a way for multiple mobile robots in cooperating teams. A robotic system with a team of mobile robots communicating information among each other provides a way to locate a source in cooperation. A mobile robot with a sensor, a communication system, and a processor, provides a way to execute a strategy for searching an area.

  8. Cooperation and depressive symptoms.

    PubMed

    Brendan Clark, C; Thorne, Christopher B; Hardy, Sonya; Cropsey, Karen L

    2013-09-25

    Deficits in pro-social cooperation are common in many individuals with mental illnesses such as depression. For decades, researchers have used economic game paradigms to compare cross-cultural cooperative behavior. However, research using economic games to assess cooperative behavior in clinical populations is in the early stages. We hypothesized that individuals with greater depressive symptoms would struggle to maintain reciprocity in iterative games, but not in single-iteration games measuring personal values. Participants (n=41) played four computer-based economic games (prisoner's dilemma, the public goods game, the ultimatum game, and the trust game) measuring different aspects of cooperation. Participants completed the Depression Anxiety and Stress Scale (DASS) and other measures of personality and demographics. Analyses assessed the relationships between game performance and psychological distress as measured by the DASS. Significant correlations were found between game performance and depressive symptoms, but not symptoms of anxiety or stress. Performance in the prisoner's dilemma and public goods game was significantly related to depression in a linear regression even when known associations with depressive affect such as age, gender, race, education, marital status, and neuroticism were controlled for. Depressive symptoms were associated with an inability to sustain reciprocal cooperation. Participants showed the predicted deficits in cooperation in these economic games. Economic games show the potential for assessing the social deficits associated with depressive symptoms. © 2013 Elsevier B.V. All rights reserved.

  9. Fixed Dosing of Monoclonal Antibodies in Oncology.

    PubMed

    Hendrikx, Jeroen J M A; Haanen, John B A G; Voest, Emile E; Schellens, Jan H M; Huitema, Alwin D R; Beijnen, Jos H

    2017-07-28

    Most monoclonal antibodies in oncology are administered in body-size-based dosing schedules. This is believed to correct for variability in both drug distribution and elimination between patients. However, monoclonal antibodies typically distribute to the blood plasma and extracellular fluids only, which increase less than proportionally with the increase in body weight. Elimination takes place via proteolytic catabolism, a nonspecific immunoglobulin G elimination pathway, and intracellular degradation after binding to the target. The latter is the primary route of elimination and is related to target expression levels rather than body size. Taken together, the minor effects of body size on distribution and elimination of monoclonal antibodies and their usually wide therapeutic window do not support body-size-based dosing. We evaluated effects of body weight on volume of distribution and clearance of monoclonal antibodies in oncology and show that a fixed dose for most of these drugs is justified based on pharmacokinetics. A survey of the savings after fixed dosing of monoclonal antibodies at our hospital showed that fixed dosing can reduce costs of health care, especially when pooling of preparations is not possible (which is often the case in smaller hospitals). In conclusion, based on pharmacokinetic parameters of monoclonal antibodies, there is a rationale for fixed dosing of these drugs in oncology. Therefore, we believe that fixed dosing is justified and can improve efficiency of the compounding. Moreover, drug spillage can be reduced and medication errors may become less likely. The currently available knowledge of elimination of monoclonal antibodies combined with the publicly available data from clinical trials and extensive population pharmacokinetic (PopPK) modeling justifies fixed dosing. Interpatient variation in exposure is comparable after body weight and fixed dosing and most monoclonal antibodies show relatively flat dose-response relationships

  10. Augmented reality in laparoscopic surgical oncology.

    PubMed

    Nicolau, Stéphane; Soler, Luc; Mutter, Didier; Marescaux, Jacques

    2011-09-01

    Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient's medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon's intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering. But better results are obtained with surface rendering after organ and pathology delineations and 3D modelling. Registration can be performed interactively or automatically. Several interactive systems have been developed and applied to humans, demonstrating the benefit of AR in surgical oncology. It also shows the current limited interactivity due to soft organ movements and interaction between surgeon instruments and organs. If the current automatic AR systems show the feasibility of such system, it is still relying on specific and expensive equipment which is not available in clinical routine. Moreover, they are not robust enough due to the high complexity of developing a real-time registration taking organ deformation and human movement into account. However, the latest results of automatic AR systems are extremely encouraging and show that it will become a standard requirement for future computer-assisted surgical oncology. In this article, we will explain the concept of AR and its principles. Then, we

  11. Prevalence in the use of complementary medicine among cancer patients in Tuscany, Italy.

    PubMed

    Johannessen, Helle; von Bornemann Hjelmborg, Jacob; Pasquarelli, Elisa; Fiorentini, Giammaria; Di Costanzos, Francesco; Miccinesi, Guido

    2008-01-01

    A previous survey by Molassiotis et al. (Ann Oncol, 16: 655-663, 2005) on the use of complementary and alternative medicines (CAM) among cancer patients in Europe reported that 73% of the Italian cancer patients had used CAM, a number well above the European average of 36%. Some national variation in preference of CAM was reported, and Italian cancer patients were reported to have high use of homeopathy, herbal medicine, and spiritual therapies. The difference between CAM use in Italy and other European countries intrigued a further investigation of CAM use among Italian cancer patients. A survey using the same questionnaire as Molassiotis et al. was conducted at two oncology day hospitals in Tuscany and included 132 patients (55% male, 45% female, with various forms of cancer) on chemotherapy. The response rate was 71%. The incidence of CAM use after cancer diagnosis among Tuscan cancer patients was 17%. The most widely used forms were herbal medicine (52%), homeopathy (30%) and acupuncture (13%). Use was higher in the urban area and among women, breast cancer patients, and persons with a higher education. These results agree with results of other studies on the use of CAM among Italians and Europeans in general, as well as among cancer patients in Italy. The high prevalence of CAM use among Italians reported by Molassiotis et al. cannot be regarded a national estimate on the use of CAM for cancer in Italy. Rather it may reflect a relatively high use of CAM in palliative care, in Northern Italy and in urban areas. CAM use among Italians in general as well as among Tuscan cancer patients in chemotherapy is modest compared with the overall European use and reflects a general high use of CAM among urbanites, women and those with a higher education. Most commonly used forms of CAM are herbal medicine and homeopathy.

  12. Implementation of the American Society of Clinical Oncology and Oncology Nursing Society chemotherapy safety standards.

    PubMed

    Vioral, Anna N; Kennihan, Heather K

    2012-12-01

    Chemotherapy involves an intricate, high-risk, multidisciplinary process of prescribing, dispensing, and administering complex multimedication regimens with narrow therapeutic indices. Chemotherapeutic agents also require safe-handling precautions for patients and healthcare providers. In addition, a number of chemotherapy and targeted therapies have expanded to nononcology populations. This complexity demands standardization of chemotherapy practice for all healthcare providers to ensure safe outcomes. This article describes one organization's multidisciplinary effort to standardize chemotherapy practice according to the American Society of Clinical Oncology and Oncology Nursing Society's 31 safety standards for chemotherapy administration. The article also describes how the organization integrated and developed standards of practice using interdisciplinary approaches. The educational processes used during implementation and the lessons learned are discussed to assist healthcare providers involved in standardizing chemotherapy administration. The article equips healthcare professionals with a multidisciplinary process for high-quality clinical standards of practice that may reduce errors and ensure safety.

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

    PubMed Central

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

    1994-01-01

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

  14. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study--Milan-Paris-Lyon experience of 646 lipofilling procedures.

    PubMed

    Petit, Jean Yves; Lohsiriwat, Visnu; Clough, Krishna B; Sarfati, Isabelle; Ihrai, Tarik; Rietjens, Mario; Veronesi, Paolo; Rossetto, Fabio; Scevola, Anna; Delay, Emmanuel

    2011-08-01

    Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment. The authors included three institutions specializing in both breast cancer treatment and breast reconstruction (European Institute of Oncology, Milan, Italy; Paris Breast Center, Paris, France; and Leon Berard Centre, Lyon, France) for a multicenter study. A collective chart review of all lipofilling procedures after breast cancer treatment was performed. From 2000 to 2010, the authors reviewed 646 lipofilling procedures from 513 patients. There were 370 mastectomy patients and 143 breast-conserving surgery patients. There were 405 patients (78.9 percent) with invasive carcinoma and 108 (21.1 percent) with carcinoma in situ. The average interval between oncologic surgical interventions and lipofilling was 39.7 months. Average follow-up after lipofilling was 19.2 months. The authors observed a complication rate of 2.8 percent (liponecrosis, 2.0 percent). Twelve radiologic images appeared after lipofilling in 119 breast-conserving surgery cases (10.1 percent). The overall oncologic event rate was 5.6 percent (3.6 percent per year). The locoregional event rate was 2.4 percent (1.5 percent per year). Lipofilling after breast cancer treatment leads to a low complication rate and does not affect radiologic follow-up after breast-conserving surgery. A prospective clinical registry including high-volume multicenter data with a long follow-up is warranted to demonstrate the oncologic safety. Until then, lipofilling should be performed in experienced hands, and a cautious oncologic follow-up protocol is advised. Therapeutic, IV [corrected].

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

    PubMed

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

    2005-01-01

    We compared clinical characteristics and outcomes for dogs with various digital tumors. Medical records and histology specimens of affected dogs from 9 veterinary institutions were reviewed. Risk factors examined included age, weight, sex, tumor site (hindlimb or forelimb), local tumor (T) stage, metastases, tumor type, and treatment modality. The Kaplan-Meier product limit method was used to determine the effect of postulated risk factors on local disease-free interval (LDFI), metastasis-free interval (MFI), and survival time (ST). Outcomes were thought to differ significantly between groups when P < or = .003. Sixty-four dogs were included. Squamous cell carcinoma (SCC) accounted for 33 (51.6%) of the tumors. Three dogs presented with or developed multiple digital SCC. Other diagnoses included malignant melanoma (MM) (n = 10; 15.6%), osteosarcoma (OSA) (n = 4; 6.3%), hemangiopericytoma (n = 3; 4.7%), benign soft tissue tumors (n = 5; 7.8%), and malignant soft tissue tumors (n = 9; 14%). Fourteen dogs with malignancies had black hair coats, including 5 of the 10 dogs with MM. Surgery was the most common treatment and, regardless of the procedure, had a positive impact on survival. None of the patient variables assessed, including age, sex, tumor type, site, and stage, had a significant impact on ST. Both LDFI and MFI were negatively affected by higher T stage, but not by type of malignancy. Although metastasis at diagnosis correlated with a shorter LDFI, it did not have a significant impact on ST. On the basis of these findings, early surgical intervention is advised for the treatment of dogs with digital tumors, regardless of tumor type or the presence of metastatic disease.

  16. Development of a telemedicine model for emerging countries: a case study on pediatric oncology in Brazil.

    PubMed

    Hira, A Y; Nebel de Mello, A; Faria, R A; Odone Filho, V; Lopes, R D; Zuffo, M K

    2006-01-01

    This article discusses a telemedicine model for emerging countries, through the description of ONCONET, a telemedicine initiative applied to pediatric oncology in Brazil. The ONCONET core technology is a Web-based system that offers health information and other services specialized in childhood cancer such as electronic medical records and cooperative protocols for complex treatments. All Web-based services are supported by the use of high performance computing infrastructure based on clusters of commodity computers. The system was fully implemented on an open-source and free-software approach. Aspects of modeling, implementation and integration are covered. A model, both technologically and economically viable, was created through the research and development of in-house solutions adapted to the emerging countries reality and with focus on scalability both in the total number of patients and in the national infrastructure.

  17. Italy

    Atmospheric Science Data Center

    2013-04-17

    ... surface texture, which is influenced by terrain, vegetation structure, soil type and surface wetness. Wet surfaces or areas with standing ... MD. The MISR data were obtained from the NASA Langley Research Center Atmospheric Science Data Center in Hampton, VA. Image ...

  18. Cooperative Learning in the Classroom.

    ERIC Educational Resources Information Center

    James, Cecile Burnett

    1989-01-01

    Discusses the rationale for cooperative learning and examines the teacher's role in creating groups. Provides examples of cooperative learning experiences in an integrated unit and as applied to computer education. Lists the advantages of using cooperative learning, while noting its pitfalls. Cautions that cooperative learning should be used in…

  19. Attitudes of Chinese Oncology Physicians Toward Death with Dignity.

    PubMed

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

    2016-08-01

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

  20. [Quality assurance in head and neck medical oncology].

    PubMed

    Digue, Laurence; Pedeboscq, Stéphane

    2014-05-01

    In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology.

  1. Actionable data analytics in oncology: are we there yet?

    PubMed

    Barkley, Ronald; Greenapple, Rhonda; Whang, John

    2014-03-01

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

  2. Status of oncologic specialties: global survey of physicians treating cancer.

    PubMed

    Komiya, Takefumi; Mackay, Christine B; Chalise, Prabhakar

    2017-04-01

    In the United States, medical oncologists play a central role in the management of systemic therapy for cancer patients. Medical oncology as a specialty is not as established in Japan and several other European nations according to recent surveys, and little is known about this specialty in developing nations. We aimed to identify global differences in the roles of physicians treating cancer; specifically, how the management of advanced disease differs among nations. In March 2016, a self-administered internet survey was conducted with degreed physicians who prescribed systemic agents for adult cancer treatment within the past 5 years. Physicians were identified from the American Society of Clinical Oncology active member online directory. Among 3907 members in 55 nations, 376 (9.6%) responded to the survey. The 310 respondents who provided an answer to the recognition of medical oncology were dominated by male MDs that have practiced for more than 5 years at academic centers, and ~60% were medical oncologists. A majority of the respondents in all four regions reported that medical oncology was established in their corresponding nations. However, there are several outlying nations where oncologic specialties play a minimal role in the management of systemic therapy. Despite general recognition of medical oncology, the role is not globally established as the primary point of care for delivery of systemic therapy. Nations lacking this specialty should be assisted by the international community to develop medical oncology.

  3. Advancing performance measurement in oncology: quality oncology practice initiative participation and quality outcomes.

    PubMed

    Campion, Francis X; Larson, Leanne R; Kadlubek, Pamela J; Earle, Craig C; Neuss, Michael N

    2011-05-01

    The American health care system, including the cancer care system, is under pressure to improve patient outcomes and lower the cost of care. Government payers have articulated an interest in partnering with the private sector to create learning communities to measure quality and improve the value of health care. In 2006, the American Society for Clinical Oncology (ASCO) unveiled the Quality Oncology Practice Initiative (QOPI), which has become a key component of the measurement system to promote quality cancer care. QOPI is a physician-led, voluntary, practice-based, quality-improvement program, using performance measurement and benchmarking among oncology practices across the United States. Since its inception, ASCO's QOPI has grown steadily to include 973 practices as of November 2010. One key area that QOPI has addressed is end-of-life care. During the most recent data collection cycle in the Fall of 2010, those practices completing multiple data collection cycles had better performance on care of pain compared with sites participating for the first time (62.61% v 46.89%). Similarly, repeat QOPI participants demonstrated meaningfully better performance than their peers in the rate of documenting discussions of hospice and palliative care (62.42% v 54.65%) and higher rates of hospice enrollment. QOPI demonstrates how a strong performance measurement program can lead to improved quality and value of care for patients.

  4. Robotic oncologic complexity score - a new tool for predicting complications in computer-enhanced oncologic surgery.

    PubMed

    Sgarbura, Olivia; Tomulescu, Victor; Popescu, Irinel

    2016-06-01

    While there is little doubt that robotic interventions have already opened new horizons in surgery due to its inherent complexity, there is still an unmet need for tools allowing center-to-center performance comparisons. A complexity score could be a valuable instrument for further research. The items of the robotic oncologic complexity score (ROCS) were based on risk factors identified in previous studies. We attempt to build the score and validate it on 400 consecutive cases of robotic oncologic surgery. The primary endpoint is to assess the value of ROCS in predicting major complications. The mean ROCS in the group was 3.3(+/-1.4). Different correlations were calculated: the score and the complications (r=0.38), the major complications (r=0.42), Clavien grade (r=0.5), the operating time (r=0.35), and the length of stay (r=0.47). On the ROC-curve a score >4 has the best specificity and sensibility for predicting major complications (P<0.05). ROCS has potential in predicting complications and hospital length of stay, as well as a role in classifying oncologic robotic surgical interventions. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Integrating the Healthcare Enterprise in Radiation Oncology Plug and Play-The Future of Radiation Oncology?

    SciTech Connect

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

    2010-02-01

    Purpose: To describe the processes and benefits of the integrating healthcare enterprises in radiation oncology (IHE-RO). Methods: 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. Results: 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. Conclusions: IHE-RO serves an important purpose for the radiation oncology community at large.

  6. Targeted mesoporous silica nanocarriers in oncology.

    PubMed

    Baeza, Alejandro; Vallet-Regí, Maria

    2016-06-02

    Cancer is one of the major leading causes of death worldwide and its prevalence will be higher in the coming years due to the progressive aging of the population. The development of nanocarriers in oncology has provided a new hope in the fight against this terrible disease. Among the different types of nanoparticles which have been described, mesoporous silica nanoparticles (MSNs) constitute a very promising material due to their inherent properties as high loading capacity of many different drugs, excellent biocompatibility and easiness functionalization. This review presents the current state of the art related with the development of mesoporous silica nanocarriers for antitumoral therapy paying special attention on targeted MSN able to selectively destroy tumoral cells reducing the side damage in healthy ones, and the basic principles of targeting tumoral tissues and cells.

  7. Music therapy in adult oncology: research issues.

    PubMed

    Hanser, Suzanne

    2006-01-01

    The article reviews the effects of music and music therapy with adult oncology patients, summarizes major findings, discusses the difficulties inherent in research methodologies, and explores directions for future research. Although there is more qualitative than quantitative research, empiric investigations have found that music techniques are effective in managing pain and other physical symptoms, psychological distress, and mood. Health-related outcomes and quality of life have also been improved. Recommendations for future research include collaborative projects that (1) test established music therapy clinical protocols; (2) control for the presence of a music therapist; (3) identify the characteristics of patients who will potentially benefit most; (4) examine physiologic, psychological, behavioral, neurologic, immunologic, and spiritual outcomes; and (5) detect and control extraneous variability.

  8. Side effects of chemotherapy in musculoskeletal oncology.

    PubMed

    Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Romantini, Matteo; Angelini, Andrea; Ruggieri, Pietro

    2010-01-01

    With recent advances in medical and orthopedic oncology, radiation therapy and single- or multiple-agent perioperative chemotherapy are currently applied as an essential part of the multidisciplinary treatment to improve disease-free and overall survival of patients with primary and metastatic bone and soft tissue tumors. However, these treatments have led to unwanted complications. A better understanding of the effects of various antineoplastic agents on bone, soft tissue, and organs may provide the basis for the more efficacious use of antiproliferative drugs when fracture healing or allograft incorporation is required. This knowledge may also provide a rationale for concurrent treatment with drugs that protect against or compensate for adverse effects in osseous repair resulting from chemotherapy.

  9. Intervention patterns of pivot nurses in oncology.

    PubMed

    Skrutkowski, Myriam; Saucier, Andréanne; Ritchie, Judith A; Tran, Ngoc; Smith, Kevin

    2011-01-01

    The Pivot Nurse in Oncology (PNO) is a health care professional dedicated to providing patients with cancer and their families with continuing and consistent supportive care throughout the care trajectory. The purpose of this paper is to describe the variation and frequency of nursing interventions delivered by 12 PNOs at our health centre. An administrative analysis over a three-year period revealed a total of 43,906 interventions that were grouped into 10 categories. This analysis provided a description of the intervention frequency and these interventions were further collapsed into the four role functions of the PNO. Coordination/continuity of care and the assessment of needs and symptoms were identified as the dominant practice domains of the PNO in the professional cancer navigator role.

  10. Adaptive clinical trial designs in oncology

    PubMed Central

    Zang, Yong; Lee, J. Jack

    2015-01-01

    Adaptive designs have become popular in clinical trial and drug development. Unlike traditional trial designs, adaptive designs use accumulating data to modify the ongoing trial without undermining the integrity and validity of the trial. As a result, adaptive designs provide a flexible and effective way to conduct clinical trials. The designs have potential advantages of improving the study power, reducing sample size and total cost, treating more patients with more effective treatments, identifying efficacious drugs for specific subgroups of patients based on their biomarker profiles, and shortening the time for drug development. In this article, we review adaptive designs commonly used in clinical trials and investigate several aspects of the designs, including the dose-finding scheme, interim analysis, adaptive randomization, biomarker-guided randomization, and seamless designs. For illustration, we provide examples of real trials conducted with adaptive designs. We also discuss practical issues from the perspective of using adaptive designs in oncology trials. PMID:25811018

  11. [Adaptogens as agents for prophylactic oncology].

    PubMed

    Bocharova, O A

    1999-01-01

    The paper considers whether it is advisable to use the new acting preparations adaptogens, including phytoadaptogens, in oncological care for prevention of cancer. The adaptogens are shown to have a regulating action, to be able to activate the protective properties of the body, to protect it from extreme exposures and to stimulate regenerative processes. The author associates the antitumor effect of adaptogens with the immunomodulating (they can activate macrophages, natural killer cells, antigen-dependent T lymphocytes) and interferonogenic actions and with the their ability to suppress experimental tumor growth, to enhance tissue differentiation, to improve intercellular adhesion, to reduce the likelihood of metastasis spreading. Furthermore, the use of adaptogens, and phytoadaptogens in particular, decreases the toxic effects of chemotherapy and improves drug tolerance.

  12. Preclinical imaging in oncology: advances and perspectives.

    PubMed

    Iommelli, Francesca; DE Rosa, Viviana; Terlizzi, Cristina; Del Vecchio, Silvana

    2017-03-01

    Preclinical imaging with radiolabeled probes became an integral part of the complex translational process that moves a newly developed compound from laboratory to clinical application. Imaging studies in animal tumor models may be undertaken to test a newly synthesized tracer, a newly developed drug or to interrogate, in the living organism, specific molecular and biological processes underlying tumor growth and progression. The aim of the present review is to outline the current knowledge and future perspectives of preclinical imaging in oncology by providing examples from recent literature. Among the biological processes and molecular targets that can be visualized with radiolabeled probes in animal tumor models, we focused on proliferation, expression of targets suitable for therapy, glycolytic phenotype, metastatic dissemination, tumor angiogenesis and survival. The major contribution of preclinical imaging emerging from these studies is the development and validation of imaging biomarkers that can be translated into the clinical context for patient selection and evaluation of tumor response to molecularly targeted agents.

  13. Microfluidics for research and applications in oncology.

    PubMed

    Chaudhuri, Parthiv Kant; Ebrahimi Warkiani, Majid; Jing, Tengyang; Kenry; Lim, Chwee Teck

    2016-01-21

    Cancer is currently one of the top non-communicable human diseases, and continual research and developmental efforts are being made to better understand and manage this disease. More recently, with the improved understanding in cancer biology as well as the advancements made in microtechnology and rapid prototyping, microfluidics is increasingly being explored and even validated for use in the detection, diagnosis and treatment of cancer. With inherent advantages such as small sample volume, high sensitivity and fast processing time, microfluidics is well-positioned to serve as a promising platform for applications in oncology. In this review, we look at the recent advances in the use of microfluidics, from basic research such as understanding cancer cell phenotypes as well as metastatic behaviors to applications such as the detection, diagnosis, prognosis and drug screening. We then conclude with a future outlook on this promising technology.

  14. [PET/CT tomography. Usefulness in oncology].

    PubMed

    Martínez-Villaseñor, David; Gerson-Cwilich, Raquel

    2006-01-01

    In order to have optimum results in oncological patients, precise evaluation, diagnosis and staging of the patient is necessary. Positron emission tomography (PET) yields a high negative predictive value through exploration of the entire body. It diagnoses the benign or malignant state of a neoplasm that has been detected by other imaging methods and establishes an extensive diagnosis previous to therapeutic treatment of a known cancer. It identifies residual tumor and changes produced after surgery, chemotherapy or radiotherapy and locates suspicious residual tumor clinically or by elevation of the tumor markers. It allows for a new extension study or re-staging after diagnosis of recurrence and permits early evaluation of response to a therapeutic regime and permits the search for a primary tumor in patients with metastasis of unknown origin. PET leads to a molecular functional imaging of cancer in the entire body.

  15. Improving the outcomes in oncological colorectal surgery

    PubMed Central

    van Vugt, Jeroen LA; Reisinger, Kostan W; Derikx, Joep PM; Boerma, Djamila; Stoot, Jan HMB

    2014-01-01

    During the last several decades, colorectal cancer surgery has experienced some major perioperative improvements. Preoperative risk-assessment of nutrition, frailty, and sarcopenia followed by interventions for patient optimization or an adapted surgical strategy, contributed to improved postoperative outcomes. Enhanced recovery programs or fast-track surgery also resulted in reduced length of hospital stay and overall complications without affecting patient safety. After an initially indecisive start due to uncertainty about oncological safety, the most significant improvement in intraoperative care was the introduction of laparoscopy. Laparoscopic surgery for colon and rectal cancer is associated with better short-term outcomes, whereas long-term outcomes regarding survival and recurrence rates are comparable. Nevertheless, long-term results in rectal surgery remain to be seen. Early recognition of anastomotic leakage remains a challenge, though multiple improvements have allowed better management of this complication. PMID:25253944

  16. Advances and trends in dermato-oncology.

    PubMed

    Dessinioti, Clio; Gogas, Helen; Stratigos, Alexander J

    2010-11-01

    The 6th Congress of the European Association of Dermato-Oncology, held in Athens, Greece (16-19 June 2010), focused on the most recent advances in the field of melanoma, epithelial skin cancers and other malignant skin tumors. Under the theme 'transforming care through personalized medicine', the scientific program reviewed and discussed the significant changes that are currently taking place in many aspects of skin cancer care, from risk prediction and prevention to the use of targeted treatments. This article highlights the key messages from selected presentations that feature the remarkable progress in our understanding of the pathogenesis of skin malignancies and the rapid 'translation' of this knowledge into new effective treatments in clinical practice.

  17. Clinical oncology in Malaysia: 1914 to present

    PubMed Central

    2006-01-01

    A narration of the development of staff, infrastructure and buildings in the various parts of the country is given in this paper. The role of universities and other institutions of learning, public health, palliative care, nuclear medicine and cancer registries is described together with the networking that has been developed between the government, non-governmental organisations and private hospitals. The training of skilled manpower and the commencement of the Master of Clinical Oncology in the University of Malaya is highlighted. Efforts taken to improve the various aspects of cancer control which includes prevention of cancer, early detection, treatment and palliative care are covered. It is vital to ensure that cancer care services must be accessible and affordable throughout the entire health system, from the primary care level up to the centres for tertiary care, throughout the whole country. PMID:21614216

  18. Lack of timely accrual information in oncology clinical trials: a cross-sectional analysis.

    PubMed

    Mitchell, Aaron P; Hirsch, Bradford R; Abernethy, Amy P

    2014-03-25

    Poor accrual is a significant barrier to the successful completion of oncology clinical trials; half of all phase 3 oncology trials close due to insufficient accrual. Timely access to accrual data fosters an understanding of successful trial design and can be used to inform the design of new clinical trials prospectively. Accrual statistics are available within research networks, such as the cancer cooperative groups, but comprehensive data reflecting the overall portfolio of cancer clinical trials are lacking. As a demonstration case, the purpose of this study was to quantify the public availability of accrual data across all recent renal cell carcinoma (RCC) trials. The database for the Aggregate Analysis of ClinicalTrials.gov (AACT) summarizes all trials registered between October 2007 and September 2010. In total, 108 trials of pharmacologic therapy for RCC were included. Accrual data on these trials were gathered via ClinicalTrials.gov (CTG), a manual review of resulting publications, and online surveys sent to principle investigators or trial coordinators. In total, 26% (20 of 76) of trials listing a government, academic, or cooperative group (GAC) sponsor responded to the survey vs 0% (0 of 32) of those listing only industry sponsors. Across all methods, accrual data were available for only 40% (43 of 108) of trials, including 37% (28 of 76) of GAC trials and 47% (15 of 32) of industry trials. Moreover, 87% (66 of 76) of GAC trials were ongoing (open, actively recruiting, or of unknown status) vs 75% (24 of 32) of industry trials, while 9% (10 of 108) of trials were terminated or suspended. Despite extensive efforts (surveys, phone calls, CTG abstraction, publication searches), accurate accrual data remained inaccessible for 60% of the RCC trial cohort. While CTG reports trial results, ongoing accrual data are also critically needed. Poor access to accrual data will continue to limit attempts to develop a national summary of clinical trials metrics and to

  19. E-oncology and health portals: instructions and standards for the evaluation, production organisation and use.

    PubMed

    Cognetti, G; Cecere, L

    2003-12-01

    In 2002 the Italian Ministry of Health promoted the institution of a network and a web portal, E-oncology (2), for the seven NHS research institutions specialising in oncology (Istituti di Ricovero e Cura a Carattere Scientifico-IRCCS). One of the aims was to gather and provide information on tumoral pathologies to operators and the public. For an optimum organisation of a health web site it is necessary to comply with the standards internationally used. The World Wide Web Consortium (W3C) has developed guidelines for accessibility and usability of the sites, implemented in Italy through governmental issues. Many international organisations adopt rules and codes of conduct to validate biomedical information and have organised quality portals such as NLM, OMNI, MEDCIRCLE, HON etc. Some terminological standards, such as the MESH thesaurus and UMLS, have been produced by the libraries for a correct management and an effective information retrieval, and are currently used by the most important biomedical web sites. The Dublin Core, metadata standard for the integration of information deriving from heterogeneous archives, has also been developed by the libraries. The easy access to information dims the complex architecture necessary for the construction of a web site. The contribution of different professionals is necessary to guarantee the production of quality medical/health web sites, among them librarians have always been involved with the management of knowledge and their skills are extremely valuable. Furthermore, the libraries' network is essential in order to guarantee universal access to health information, mostly still against payment, and to contribute to overcoming the 'digital divide' and 'second-level digital divide'.

  20. It takes chutzpah: oncology nurse leaders.

    PubMed

    Green, E

    1999-01-01

    Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.

  1. Pediatric hematology and oncology in Iran.

    PubMed

    Alebouyeh, Mardawig

    2005-01-01

    Pediatric hematology and oncology (PHO) is a rapidly expandingfield. It has been our goal to meet the needs and increasing demands for comprehensive medical care of children suffering from chronic blood diseases and malignancies. In the past decade we have been able expand and optimize the PHO services throughout Iran, in general and in respect to their prevalence and clinical importance, by trained pediatric hematologist-oncologists, pediatric surgeons and improved para clinical facilities. Major beta-thalassemics receive blood transfusion and chelation therapy according to the current standards mostly at regional blood banks centers. To curb major beta-thalassemia a premarital screening program has been enacted and abortion has been legitimized if major thalassemia is diagnosed by CVS. Hemophiliacs are supervised and treated as indicated by Iranian Hemophilia Comprehensive Care Centers (IHCCC). Screening for transfusion related complications and transmitted viral diseases (HBV, HCV and HIV) in both cohorts are carried out in regular intervals and necessary management will be then carried out as indicated at respective specialized units. Childhood malignancies are treated according to protocols adopted from accredited institutions in the USA and Europe, with almost comparable results. BMT is available for selected patients with beta-thalassemia or malignancies. By going to public we have been able to rise general awareness about chronic blood diseases and childhood malignancies and have initiated establishment of parents groups and formation of NGOs to support these children and their families. Foundation of Iranian Society of Pediatric Hamatology and Oncology (ISPHO) in the year 2000 has been another step forward to consolidate and coordinate the available manpower and facilities. By evaluation of the country's main problems and shortcomings and conduction of collaborative studies and operation planning one will succeed to get the expected feedback and

  2. Essential Genetic and Genomic Nursing Competencies for the Oncology Nurse

    PubMed Central

    Jenkins, Jean

    2010-01-01

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

  3. How to Develop a Cardio-Oncology Clinic.

    PubMed

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

    2017-04-01

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

  4. Exploring Oncology Nurses’ Grief: A Self-study

    PubMed Central

    Barbour, Lisa C.

    2016-01-01

    Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release. PMID:27981166

  5. Requirements for radiation oncology physics in Australia and New Zealand.

    PubMed

    Oliver, L; Fitchew, R; Drew, J

    2001-03-01

    This Position Paper reviews the role, standards of practice, education, training and staffing requirements for radiation oncology physics. The role and standard of practice for an expert in radiation oncology physics, as defined by the ACPSEM, are consistent with the IAEA recommendations. International standards of safe practice recommend that this physics expert be authorised by a Regulatory Authority (in consultation with the professional organization). In order to accommodate the international and AHTAC recommendations or any requirements that may be set by a Regulatory Authority, the ACPSEM has defined the criteria for a physicist-in-training, a base level physicist, an advanced level physicist and an expert radiation oncology physicist. The ACPSEM shall compile separate registers for these different radiation oncology physicist categories. What constitutes a satisfactory means of establishing the number of physicists and support physics staff that is required in radiation oncology continues to be debated. The new ACPSEM workforce formula (Formula 2000) yields similar numbers to other international professional body recommendations. The ACPSEM recommends that Australian and New Zealand radiation oncology centres should aim to employ 223 and 46 radiation oncology physics staff respectively. At least 75% of this workforce should be physicists (168 in Australia and 35 in New Zealand). An additional 41 registrar physicist positions (34 in Australia and 7 in New Zealand) should be specifically created for training purposes. These registrar positions cater for the present physicist shortfall, the future expansion of radiation oncology and the expected attrition of radiation oncology physicists in the workforce. Registrar physicists shall undertake suitable tertiary education in medical physics with an organised in-house training program. The rapid advances in the theory and methodology of the new technologies for radiation oncology also require a stringent approach

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

    PubMed

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

    2017-10-01

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

  7. Inconsistent labeling of food effect for oral agents across therapeutic areas: differences between oncology and non-oncology products

    PubMed Central

    Kang, Soonmo Peter; Ratain, Mark J.

    2010-01-01

    Purpose Several recent oral oncology drug labels were labeled to be administered in fasted states despite the fact that food increases their bioavailability. Since this was inconsistent with principles of oral drug delivery, we hypothesized that there were inconsistencies across therapeutic areas. Experimental Design Oral agents approved by US FDA from January 2000 to May 2009 were included in our study. Comparison of the food labeling patterns between oncology and non-oncology drugs was made using Fisher's exact test. Results Of 99 drugs evaluated, 34 showed significant food effects on bioavailability. When food markedly enhanced bioavailability, 8 out of 9 non-oncology drugs were labeled “fed” to take advantage of the food-drug interaction while all oncology drugs (n=3) were labeled to be administered in “fasted” states (Fisher's exact; p= 0.01). Conclusions Drug labeling pattern with respect to food-drug interactions observed with oncology drugs is in contradiction to fundamental pharmacological principles, as exemplified in the labeling of non-oncology drugs. PMID:20736327

  8. International Cooperation at NASA

    NASA Astrophysics Data System (ADS)

    Tawney, Timothy; Feldstein, Karen

    International cooperation is a cornerstone principle of NASA’s activities, especially within the activities of the Science Mission Directorate. Nearly two thirds of the flight missions in which NASA leads or participates involve international cooperation. Numerous ground based activities also rely on international cooperation, whether because of unique expertise, unique geography, or the need for a global response. Going forward, in an era of tighter budgets and a more integrated global perspective, NASA and the rest of the space agencies around the world will be forced to work more closely together, in a broader array of activities than ever before, in order to be able to afford to push the boundaries of space exploration. The goal of this presentation is to provide an overview of NASA’s current international science cooperative activities. It will include a discussion of why NASA conducts international cooperation and look at the mechanisms through which international cooperation can occur at NASA, including peer-to-peer development of relationships. It will also discuss some of the limiting factors of international cooperation, such as export control, and ways in which to manage those constraints. Finally, the presentation would look at some of the present examples where NASA is working to increase international cooperation and improve coordination. Case studies will be used to demonstrate these mechanisms and concepts. For example, NASA continues to participate in international coordination groups such as the International Mars Exploration Working Group (IMEWG) and International Space Exploration Coordination Group (ISECG), but is expanding into new areas as well. NASA is one of the leaders in expanding and improving international coordination in the area of Near-Earth Object detection, characterization, and mitigation. Having participated in the first meetings of such groups as the International Asteroid Warning Network (IAWN) and Space Missions Planning

  9. Cooper Pair Insulators

    NASA Astrophysics Data System (ADS)

    Valles, James

    One of the recent advances in the field of the Superconductor to Insulator Transition (SIT) has been the discovery and characterization of the Cooper Pair Insulator phase. This bosonic insulator, which consists of localized Cooper pairs, exhibits activated transport and a giant magneto-resistance peak. These features differ markedly from the weakly localized transport that emerges as pairs break at a ``fermionic'' SIT. I will describe how our experiments on films nano-patterned with a nearly triangular array of holes have enabled us to 1) distinguish bosonic insulators from fermionic insulators, 2) show that Cooper pairs, rather than quasi-particles dominate the transport in the Cooper Pair insulator phase, 3) demonstrate that very weak, sub nano-meter thickness inhomogeneities control whether a bosonic or fermionic insulator forms at an SIT and 4) reveal that Cooper pairs disintegrate rather than becoming more tightly bound deep in the localized phase. We have also developed a method, using a magnetic field, to tune flux disorder reversibly in these films. I will present our latest results on the influence of magnetic flux disorder and random gauge fields on phenomena near bosonic SITs. This work was performed in collaboration with M. D. Stewart, Jr., Hung Q. Nguyen, Shawna M. Hollen, Jimmy Joy, Xue Zhang, Gustavo Fernandez, Jeffrey Shainline and Jimmy Xu. It was supported by NSF Grants DMR 1307290 and DMR-0907357.

  10. Video-assisted thoracic lobectomy for lung cancer in Italy: the 'VATS Group' Project.

    PubMed

    Crisci, Roberto; Droghetti, Andrea; Migliore, Marcello; Bertani, Alessandro; Gonfiotti, Alessandro; Solli, Piergiorgio

    2016-12-01

    As part of the third Mediterranean Symposium in Thoracic Surgical Oncology, we introduce the Italian VATS Group ( http://vatsgroup.org/sito/index.php ). This national collaborative initiative was established in 2013 and started to recruit patients in January 2014; as of July 2016, 3680 patients have been enrolled in the database. Three different video-assisted thoracic surgery approaches have been predominantly used by Italian thoracic surgery centers, 71% of them preferentially adopting a multi-portal approach, with a 20% recorded morbidity. The majority of the cases were stage I adenocarcinomas of the lung. Conversion to open surgery occurred in 9% of the cases. The study suggests video-assisted thoracic surgery lobectomy as a 'gold standard' for the surgical treatment of early-stage lung cancer in Italy.

  11. [The strategy of the Czech Society for Oncology of the Czech Medical Association of J. E. Purkyně for the organisation of oncological care in the Czech Republic].

    PubMed

    Vorlíček, J

    2013-08-01

    The Czech Society for Oncology of the Czech Medical Association of J. E. Purkyně (ČOS ČLS JEP) builds on intensive collaboration at all levels of medical care during the organisation of oncological care. Over 77,000 malignant neoplasms are diagnosed in the Czech Republic annually. Every year, over 27,000 patients with a malignant tumour die in the Czech Republic. A total of over 450,000 patients with malignant tumours or patients with a history of an oncological disease are living in the Czech Republic. The specialised society analyses available data about the treatment history and offers them to the individual regions; it also plans population based treatment costs which are then discussed with the healthcare payers. The Czech National Cancer Control Programme (NOP) presents a strategic outline for the management and development of the treatment, and facilitates the communication with all stakeholders and the public. The ČOS ČLS JEP Society includes a specialised section responsible for data analysis, which provides a complex agenda of population based data, estimated numbers of treated patients, standards for reference of survival analysis and a system of collecting required clinical data. Even with a growing incidence, the Czech Republic shows a stabilised mortality in all cancer diagnoses. Screening programmes for breast, colorectal and cervical carcinoma are ongoing. We have a consolidated and cooperating network of oncology centres. We are able to actively plan diagnostic and treatment needs and we have a system of data collection that is able to respond to the needs of evaluation of cost efficiency. We are currently introducing a hospital care quality assessment.

  12. Rites of passage in Italy.

    PubMed

    Field, Carol

    2010-01-01

    Unlike the vast number of public celebrations in Italy that are almost always associated with specific foods, rites of passage in that country are focused on pivotal private moments after the ceremonial crossing of a threshold; and food may or may not be a primary focus of the event. Recognition of birth, marriage, and death—the three major turning points in the intimate life of a family—may still be observed with dishes or ingredients traceable to the Renaissance, but many older traditions have been modified or forgotten entirely in the last thirty years. Financial constraints once preserved many customs, especially in the south, but regional borders have become porous, and new food trends may no longer reflect the authentic tradition. Can new movements, such as Slow Food, promote ancient values as the form and food of traditional events continue to change?

  13. Italy: old problems, new books.

    PubMed

    Agazzi, Evandro

    1989-01-01

    Agazzi's bibliographic essay of recent titles in Italian on biomedical issues also discusses the Catholic versus the secular approaches to bioethics in Italy. Among the publications mentioned are several of a philosophical or theological nature: M. Mori's volume on artificial insemination, and second editions of well-established textbooks on biomedical ethics by S. Leone, E. Sgreccia, S. Spinsanti, and D. Tettamanzi. Legal issues in reproductive technologies are addressed in the Santosuosso Commission's report on regulating artificial procreation, and in a book discussing the report. Secular writings on ethical issues have appeared in issues cited here of the journals Prospettive Settanta and Biblioteca della Libertà. Also mentioned in Agazzi's essay are a critique of the Vatican Congregation for the Doctrine of the Faith's Instruction on Respect for Human Life, and a booklet of articles related to the 20th anniversary of the encyclical Humanae Vitae.

  14. Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

    PubMed Central

    Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan

    2014-01-01

    Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring

  15. [What is the future for the galvanic industry in Italy and Europe].

    PubMed

    Cavallotti, P L

    2012-01-01

    A number of European directives and burocratic constraints give difficulties to the galvanic Italian industries: The situation of the Galvanic industry in Italy is examined, with special care about the innovation perspectives needed to maintain an important role for the Italian surface treatment processes in Italy. Alternatives are already present for zinc cyanic alkaline plating and for the passivation with chromates of zinc. Difficult instead is the substitution of bright nickel and of electroless autocatalytic nickel An important process is Plating On Plastics POP and on other non conducting materials with electroless nickel The substitution of colloidal Palladium for surface activation is proposed. New innovative processes are proposed, regarding composite depositions with powders of micron or nano size, pulsed current deposition and deposition of layers with structure controlled at nanometric level. A strict cooperation among Research centres, Universities and Industries can start the renewal of a production of fundamental importance for the Italian future.

  16. Emilia Earthquake: VLF Transmitters and ELF Signal from the Central Italy Electromagnetic Network (CIEN)

    NASA Astrophysics Data System (ADS)

    Fidani, C.; Albarello, D.; Arcaleni, M.; Martinelli, G.; Siciliani, P. M.; Tardioli, S.; Vannucchi, A.

    2012-10-01

    Use of a VLF (1-25 kHz) transmitter monitoring in connection with strong earthquakes has been studied by several authors over the last two decades. This has recently led to international cooperation which includes a network covering the whole of Europe (Hayakawa, 1994;Biagi, 2011). Its aim is to monitor the sub-ionospheric channels between VLF radio transmitters and receivers. In fact, sub-ionospheric channels, which are above the preparation zone of a future strong earthquake, have been observed in several cases preventing transmissions many days before the main shocks. To study this kind of phenomena, a network devoted to seismic monitoring of VLF transmitters and ELF signals ELF (4 Hz-1 kHz) was established in central Italy (Central Italy Electromagnetic Network, CIEN) was operating since 2006 and progressively extended to include 6 stations. The features of CIEN are described at first

  17. Cooper Pairs in Insulators?!

    ScienceCinema

    James Valles

    2016-07-12

    Nearly 50 years elapsed between the discovery of superconductivity and the emergence of the microscopic theory describing this zero resistance state. The explanation required a novel phase of matter in which conduction electrons joined in weakly bound pairs and condensed with other pairs into a single quantum state. Surprisingly, this Cooper pair formation has also been invoked to account for recently uncovered high-resistance or insulating phases of matter. To address this possibility, we have used nanotechnology to create an insulating system that we can probe directly for Cooper pairs. I will present the evidence that Cooper pairs exist and dominate the electrical transport in these insulators and I will discuss how these findings provide new insight into superconductor to insulator quantum phase transitions. 

  18. Synchrony and cooperation.

    PubMed

    Wiltermuth, Scott S; Heath, Chip

    2009-01-01

    Armies, churches, organizations, and communities often engage in activities-for example, marching, singing, and dancing-that lead group members to act in synchrony with each other. Anthropologists and sociologists have speculated that rituals involving synchronous activity may produce positive emotions that weaken the psychological boundaries between the self and the group. This article explores whether synchronous activity may serve as a partial solution to the free-rider problem facing groups that need to motivate their members to contribute toward the collective good. Across three experiments, people acting in synchrony with others cooperated more in subsequent group economic exercises, even in situations requiring personal sacrifice. Our results also showed that positive emotions need not be generated for synchrony to foster cooperation. In total, the results suggest that acting in synchrony with others can increase cooperation by strengthening social attachment among group members.

  19. Evolution, epigenetics and cooperation.

    PubMed

    Bateson, Patrick

    2014-04-01

    Explanations for biological evolution in terms of changes in gene frequencies refer to outcomes rather than process. Integrating epigenetic studies with older evolutionary theories has drawn attention to the ways in which evolution occurs. Adaptation at the level of the gene is givingway to adaptation at the level of the organism and higher-order assemblages of organisms. These ideas impact on the theories of how cooperation might have evolved. Two of the theories, i.e. that cooperating individuals are genetically related or that they cooperate for self-interested reasons, have been accepted for a long time. The idea that adaptation takes place at the level of groups is much more controversial. However, bringing together studies of development with those of evolution is taking away much of the heat in the debate about the evolution of group behaviour.

  20. Comparison of oncologic outcomes for open and laparoscopic nephroureterectomy: a multi-institutional analysis of 1249 cases.

    PubMed

    Capitanio, Umberto; Shariat, Shahrokh F; Isbarn, Hendrik; Weizer, Alon; Remzi, Mesut; Roscigno, Marco; Kikuchi, Eiji; Raman, Jay D; Bolenz, Christian; Bensalah, Karim; Koppie, Theresa M; Kassouf, Wassim; Fernández, Mario I; Ströbel, Philipp; Wheat, Jeffrey; Zigeuner, Richard; Langner, Cord; Waldert, Matthias; Oya, Mototsugu; Guo, Charles C; Ng, Casey; Montorsi, Francesco; Wood, Christopher G; Margulis, Vitaly; Karakiewicz, Pierre I

    2009-07-01

    Data regarding the oncologic efficacy of laparoscopic nephroureterectomy (LNU) compared to open nephroureterectomy (ONU) are scarce. We compared recurrence and cause-specific mortality rates of ONU and LNU. Thirteen centers from three continents contributed data on 1249 patients with nonmetastatic upper tract urothelial carcinoma (UTUC). Univariable and multivariable survival models tested the effect of procedure type (ONU [n=979] vs LNU [n=270]) on cancer recurrence and cancer-specific mortality. Covariables consisted of institution, age, Eastern Cooperative Oncology Group (ECOG) performance status score, pT stage, pN stage, tumor grade, lymphovascular invasion, tumor location, concomitant carcinoma in situ, ureteral cuff management, previous urothelial bladder cancer, and previous endoscopic treatment. Median follow-up for censored cases was 49 mo (mean: 62). Relative to ONU, LNU patients had more favorable pathologic stages (pT0/Ta/Tis: 38.1% vs 20.8%, p<0.001) and less lymphovascular invasion (14.8% vs 21.3%, p=0.02) and less frequently had tumors located in the ureter (64.5 vs 71.1%, p=0.04). In univariable recurrence and cancer-specific mortality models, ONU was associated with higher cancer recurrence and mortality rates compared to LNU (hazard ratio [HR]: 2.1 [p<0.001] and 2.0 [p=0.008], respectively). After adjustment for all covariates, ONU and LNU had no residual effect on cancer recurrence and mortality (p=0.1 for both). Short-term oncologic data on LNU are comparable to ONU. Since LNU was selectively performed in favorable-risk patients, we cannot state with certainty that ONU and LNU have the same oncologic efficacy in poor-risk patients. Long-term follow-up data and morbidity data are necessary before LNU can be considered as the standard of care in patients with muscle-invasive or high-grade UTUC.