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Sample records for medical oncology basic

  1. Medical oncology: Basic principles and clinical management of cancer

    SciTech Connect

    Calabresi, P.; Schein, P.S.; Rosenberg, S.A.

    1985-01-01

    This book consists of three section, each containing several papers. The sections are: Basic Principles, Specific Neoplasmas, and Supportive Care. Some of the paper titles are: Pharmacology of Antineoplastic Agents, Hodgkin's Disease, Myeloma, Melanoma, Neoplasms of the Lung, Sarcomas, Pediatric Neoplasms, Infectious Consideration in Cancer, Nursing Considerations in Cancer, and Rehabilitation of the Patient with Cancer.

  2. 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.

  3. 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…

  4. 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…

  5. 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)

  6. 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)

  7. [Basic principles for the development of biomarkers in oncology].

    PubMed

    Seijas, Raquel; Herranz, Jesús; Malats, Nuria

    2013-06-01

    The accelerated expansion of the knowledge of genetic and molecular basics of cancer, together with the recent development of molecular biology techniques, have had a significant impact in the field of oncology, among other medical disciplines. So, over the last few years, we are crossing from an empiricism-based model to an evidence-based model in which drugs are adapted depending of the molecular alterations which result crucial for tumor development (both for carcinogenesis and acquisition of an aggressive phenotype leading to tumor invasion and resistance to therapy). The molecular alterations /variations offer the possibility of being detected and used as biomarkers in clinical practice. Biomarkers may have multiple applications in the field of oncology, from determining the risk to suffer the disease to prediction of response to therapy, including diagnosis, prognosis and disease monitoring, with the final aim of performing a more personalized medicine and achieving greater efficacy for the therapies selected, diminishing each therapy's own adverse events. Considering the importance biomarkers may get to have in clinical decision making, it is basic that their development is performed under straight evaluation and validation rules. In this article we review the various types of biomarkers and the basic methodological principles for their development, validation and subsequent clinical application.

  8. A Nationwide Medical Student Assessment of Oncology Education.

    PubMed

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

    2016-12-01

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

  9. [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.

  10. [Medical oncology: is it a new medical speciality in Africa?

    PubMed

    Brahmi, Sami Aziz; Ziani, Fatima Zahra; Seddik, Youssef; Afqir, Said

    2017-01-01

    Cancer is a major public health problem in Africa. Advances in the treatment of cancers over the last decade are undeniable. Multidisciplinary approach is essential for improved patient's management. Medical oncology is a recently-recognized speciality in Africa Indeed, many African countries do not have doctors or a sufficient number of doctors qualified to practice in this medical specialty. The fight against cancer in Africa involves oncology speciality training and the development of curricula in order to ensure optimum patient management.

  11. 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.

  12. 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).

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

    ERIC Educational Resources Information Center

    Elkort, Richard; Mozden, Peter J.

    1975-01-01

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

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

    ERIC Educational Resources Information Center

    Elkort, Richard; Mozden, Peter J.

    1975-01-01

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

  15. 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.

  16. 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

  17. Basic medical legal principles.

    PubMed

    Martello, J

    1999-01-01

    A contract exists, either expressed or implied, between the physician and the patient. If a duty of care was owed by the physician to the patient and the standard of care was violated, resulting in the patients' injury, then the damages, injury, or loss the patient suffered can be compensated. This article reviews the elements of a medical malpractice claim and the factors that may lead to such a claim.

  18. 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.

  19. Medical Computing: Another Basic Science?

    PubMed Central

    Shortliffe, Edward H.

    1980-01-01

    Medical computing is frequently viewed as the application of established computer science techniques in medical domains. However, it is the thesis of this paper that many clinical computing tasks demand techniques that are as yet undeveloped. As a result, medical computing research should logically be closely tied to basic research in computer science. Failure to recognize that this developing discipline often requires fundamental investigation has tended to foster unrealistic expectations of the field.

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

    PubMed

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

    2017-04-01

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

  2. Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum

    SciTech Connect

    Golden, Daniel W.; Spektor, Alexander; Rudra, Sonali; Ranck, Mark C.; Krishnan, Monica S.; Jimenez, Rachel B.; Viswanathan, Akila N.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.

    2014-01-01

    Purpose: To develop and evaluate a structured didactic curriculum to complement clinical experiences during radiation oncology clerkships at 2 academic medical centers. Methods and Materials: A structured didactic curriculum was developed to teach fundamentals of radiation oncology and improve confidence in clinical competence. Curriculum lectures included: (1) an overview of radiation oncology (history, types of treatments, and basic clinic flow); (2) fundamentals of radiation biology and physics; and (3) practical aspects of radiation treatment simulation and planning. In addition, a hands-on dosimetry session taught students fundamentals of treatment planning. The curriculum was implemented at 2 academic departments in 2012. Students completed anonymous evaluations using a Likert scale to rate the usefulness of curriculum components (1 = not at all, 5 = extremely). Likert scores are reported as (median [interquartile range]). Results: Eighteen students completed the curriculum during their 4-week rotation (University of Chicago n=13, Harvard Longwood Campus n=5). All curriculum components were rated as extremely useful: introduction to radiation oncology (5 [4-5]); radiation biology and physics (5 [5-5]); practical aspects of radiation oncology (5 [4-5]); and the treatment planning session (5 [5-5]). Students rated the curriculum as “quite useful” to “extremely useful” (1) to help students understand radiation oncology as a specialty; (2) to increase student comfort with their specialty decision; and (3) to help students with their future transition to a radiation oncology residency. Conclusions: A standardized curriculum for medical students completing a 4-week radiation oncology clerkship was successfully implemented at 2 institutions. The curriculum was favorably reviewed. As a result of completing the curriculum, medical students felt more comfortable with their specialty decision and better prepared to begin radiation oncology residency.

  3. Impact of a 3-Day Introductory Oncology Course on First-Year International Medical Students.

    PubMed

    Granek, Leeat; Mizrakli, Yuval; Ariad, Samuel; Jotkowitz, Alan; Geffen, David B

    2016-02-05

    Although only some medical students will choose cancer as their specialty, it is essential that all students have a basic understanding of cancer and its treatment. The purpose of this study was to evaluate the impact of an introductory clinical oncology course on first-year international medical students. Evaluation of the course involved a quantitative survey designed for this study that was given pre- and post-course completion. Participants included 29 first-year international medical students. Students reported that the course affected them emotionally more than they anticipated it would prior to beginning the course. By the end of the course, students felt more comfortable focusing on how to live with cancer, felt less afraid of dealing with death, and were better able to cope with uncomfortable emotional situations. The course had no significant effect on students' interest in specializing in oncology in the future. Our study provides evidence that an introductory oncology course can increase student comfort with issues related to living with cancer, with confronting and dealing with death and dying, and with coping with uncomfortable emotional situations as related to cancer care. In anticipation of growing shortages in oncology specialists in the coming years, the ability of an early course in oncology to attract more students to the field is of interest. Future research should examine ethnic and cultural differences in uptake of the clinical oncology courses across continents and should use direct observation in addition to self-report in evaluating outcomes.

  4. Variability of physics education in radiation oncology medical residency programs.

    PubMed

    Das, Indra J; Moskvin, Vadim

    2012-11-01

    The aim of this study was to compare the quality of medical physics education for radiation oncology medical residents. An independent survey regarding physics education was carried out using e-mail. The survey contained 12 questions addressing the duration, length, and quality of education. Responses were tabulated and compared with the recommended educational scheme. Nearly 56% of institutions participated in this survey. Educational patterns were found to be significantly variable among institutions. Some have minimum physics education (10 lectures), and some have 90 lectures per year. In general, two-thirds of the institutions require residents to attend classes up to the third year. Significant variability of physics education for radiation oncology medical residents was observed, contrary to the national recommendations. With advanced treatment techniques, physics education should be given more importance, and the number of lectures should be increased to accommodate every aspect of radiation oncology practice. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    PubMed

    McRae, Robert J

    2016-12-01

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

  6. Medical Student–Reported Outcomes of a Radiation Oncologist–Led Preclinical Course in Oncology: A Five-Year Analysis

    SciTech Connect

    Agarwal, Ankit; Koottappillil, Brian; Shah, Bhartesh; Ahuja, Divya; Hirsch, Ariel E.

    2015-07-15

    Purpose: There is a recognized need for more robust training in oncology for medical students. At our institution, we have offered a core dedicated oncology block, led by a radiation oncologist course director, during the second year of the medical school curriculum since the 2008-2009 academic year. Herein, we report the outcomes of the oncology block over the past 5 years through an analysis of student perceptions of the course, both immediately after completion of the block and in the third year. Methods and Materials: We analyzed 2 separate surveys. The first assessed student impressions of how well the course met each of the course's learning objectives through a survey that was administered to students immediately after the oncology block in 2012. The second was administered after students completed the oncology block during the required radiology clerkship in the third year. All questions used a 5-level Likert scale and were analyzed by use of a Wilcoxon signed-rank test. Results: Of the 169 students who took the oncology course in 2012, 127 (75.1%) completed the course feedback survey. Over 73% of students agreed or strongly agreed that the course met its 3 learning objectives. Of the 699 medical students who took the required radiology clerkship between 2010 and 2013, 538 participated in the second survey, for a total response rate of 77%. Of these students, 368 (68.4%) agreed or strongly agreed that the course was effective in contributing to their overall medical education. Conclusion: Student perceptions of the oncology block are favorable and have improved across multiple categories since the inception of the course. Students self-reported that a dedicated preclinical oncology block was effective in helping identify the basics of cancer therapy and laying the foundation for clinical electives in oncology, including radiation oncology.

  7. 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.

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

    SciTech Connect

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

    2014-07-01

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

  9. POLYPHARMACY AND POTENTIALLY INAPPROPRIATE MEDICATION USE IN GERIATRIC ONCOLOGY

    PubMed Central

    Sharma, Manvi; Loh, Kah Poh; Nightingale, Ginah; Mohile, Supriya G.; Holmes, Holly M.

    2016-01-01

    Polypharmacy is a highly prevalent problem in older persons, and is challenging to assess and improve due to variations in definitions of the problem and the heterogeneous methods of medication review and reduction. The purpose of this review is to summarize evidence regarding the prevalence and impact of polypharmacy in geriatric oncology patients and to provide recommendations for assessment and management. Polypharmacy has somewhat variably been incorporated into geriatric assessment studies in geriatric oncology, and polypharmacy has not been consistently evaluated as a predictor of negative outcomes in patients with cancer. Once screened, interventions for polypharmacy are even more uncertain. There is a great need to create standardized interventions to improve polypharmacy in geriatrics, and particularly in geriatric oncology. The process of deprescribing is aimed at reducing medications for which real or potential harm outweighs benefit, and there are numerous methods to determine which medications are candidates for deprescribing. However, deprescribing approaches have not been evaluated in older patients with cancer. Ultimately, methods to identify polypharmacy will need to be clearly defined and validated, and interventions to improve medication use will need to be based on clearly defined and standardized methods. PMID:27498305

  10. 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.

  11. Trends in medical oncology outreach clinics in rural areas.

    PubMed

    Gruca, Thomas S; Nam, Inwoo; Tracy, Roger

    2014-09-01

    To examine the long-term trends in medical oncology outreach in Iowa, a state with a high proportion of rural residents, and to assess the involvement of the 2011 Iowa oncology workforce in visiting consultant clinics using a unique data source. Outreach locations and clinic frequencies are tracked annually in the Visiting Medical Consultant Database (Carver College of Medicine) along with the physicians' primary practice locations. Growth in the number of cities served and number of clinic days from 1989 to 2011 was analyzed using joinpoint analysis. Data from 2011 were used to estimate the trip length for participating oncologists. The number of rural cities served by medical oncology outreach increased significantly between 1989 and 1996. Clinic days grew significantly in two periods: 1989 to 1998 and 2003 to 2005. In 2011, more than 2,100 clinic days were provided in 66 sites (95% of clinic days in rural areas). Almost half of all Iowa-based oncologists regularly participate in outreach. Oncologists staffing visiting consultant clinics in Iowa drive an estimated 21,000 miles per month. For more than 20 years, visiting medical oncologists have brought cancer care to rural patients in Iowa. Access to cancer care in rural Iowa (ie, clinic days) increased significantly in the post-Medicare Modernization Act period (after 2005). High participation rates and travel burdens may influence oncologist training and retention strategies. Because the Affordable Care Act seeks to expand access for vulnerable populations (eg, rural elderly), it is critical to better understand the existing system of rural cancer care delivery. Copyright © 2014 by American Society of Clinical Oncology.

  12. Bacteriophages and medical oncology: targeted gene therapy of cancer.

    PubMed

    Bakhshinejad, Babak; Karimi, Marzieh; Sadeghizadeh, Majid

    2014-08-01

    Targeted gene therapy of cancer is of paramount importance in medical oncology. Bacteriophages, viruses that specifically infect bacterial cells, offer a variety of potential applications in biomedicine. Their genetic flexibility to go under a variety of surface modifications serves as a basis for phage display methodology. These surface manipulations allow bacteriophages to be exploited for targeted delivery of therapeutic genes. Moreover, the excellent safety profile of these viruses paves the way for their potential use as cancer gene therapy platforms. The merge of phage display and combinatorial technology has led to the emergence of phage libraries turning phage display into a high throughput technology. Random peptide libraries, as one of the most frequently used phage libraries, provide a rich source of clinically useful peptide ligands. Peptides are known as a promising category of pharmaceutical agents in medical oncology that present advantages such as inexpensive synthesis, efficient tissue penetration and the lack of immunogenicity. Phage peptide libraries can be screened, through biopanning, against various targets including cancer cells and tissues that results in obtaining cancer-homing ligands. Cancer-specific peptides isolated from phage libraries show huge promise to be utilized for targeting of various gene therapy vectors towards malignant cells. Beyond doubt, bacteriophages will play a more impressive role in the future of medical oncology.

  13. [Basic features of medical liability].

    PubMed

    Niksić, Sasa

    2008-01-01

    Medical liability is one of the most important parts of law that regulates health services. Although there are different types of liability in the field of medicine (criminal responsibility, disciplinary proceedings) civil law liability holds central position. Civil law liability in medicine (medical liability) is probably more important than criminal responsibility and disciplinary proceedings because of the number of cases in comparison to the criminal responsibility and impact of the consequences in comparison to the disciplinary proceedings. Medical liability is governed by a (general) tort law. Therefore medical liability exists only if conditions for civil law liability are met. When considering medical liability it is necessary to emphasize that tortfeasor will not be liable only because victim sustained the damage, but if all conditions for liability are met. Medical liability will arise if actions of physician are not conducted lege artis or in a breach of the duty of care. In some cases of medical liability legal sources are directly applicable (informed consent). General tort law is also applicable on decisions in the respect of the damages.

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

    PubMed

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

    2017-07-01

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

  15. 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

  16. Medical Student Oncology Congress: Designed and Implemented by Brazilian Medical Students.

    PubMed

    de Camargo, Celeste Rodovalho Soares; Schoueri, Jean Henri Maselli; Neto, Felippe Lazar; Segalla, Paola Boaro; Del Giglio, Auro; Cubero, Daniel I G

    2017-03-30

    Oncology is an essential field of medicine; however, its teaching is occasionally underemphasized and uncoordinated during medical school. An alternative method of providing additional oncological information to medical students is through extracurricular activities, such as congresses and medical student associations. The aim of this paper is to describe a Medical Student Oncology Congress entirely designed and organized by medical students. Three medical students from oncology study and research groups identified the gap in oncology training at universities and decided to organize a congress for students. They selected representatives from 26 universities in Brazil for onsite registration and created a website for online registration and promotion of the congress. To determine the topics of the lectures, they searched the medical literature for the most commonly occurring cancers in adults and children. Extrapolating the academic content of oncology, they organized lectures by non-governmental organizations (NGOs), talks on career guidance and research in this field as well as a role-playing workshop to train future doctors on how to deliver news to patients. There were a total of 609 attendees, with 590 students from 26 different universities in Brazil. Approximately 82% were medical students, and among the participants there were also 15 medical educators. A total of 80.75% of the participants were extremely satisfied with the congress, and 99.17% would recommend it to a colleague. Most of the overall cost of the congress, 96%, was covered by registration fees. There was a 6% positive net balance, which was donated to the NGOs participating in the congress. This successful experience proves that it is possible to have a congress fully designed, organized and managed by students. It demonstrates how students can be active participants in their own education, as opposed to a classic approach through which only professors are responsible for instruction.

  17. [Challenges of basical sciences in medical education].

    PubMed

    Rodríguez Carranza, Rodolfo

    2014-12-01

    The relevance of basic sciences in medical education has been recognized for centuries, and the importance of exposing medical students to science was acknowledged and reinforced by the recommendations of Flexner in 1910. Since then, traditional medical education has been divided into preclinical and clinical subjects; within this scheme, the first terms of undergraduate medical education usually concentrate on basic sciences, while subsequent ones focus on clinical sciences and clinical training. Since 1956, this educational scheme has been questioned and, in some schools, the medical curriculum has undergone significant structural changes; some of these reforms, especially integrated curricula, are associated with important reductions in the time allotted to individual basic science courses or even with their removal. The removal of basic science subjects from the medical curriculum is paradoxical because nowadays the value of biomedical knowledge and the scientific reasoning to make medical decisions is more appreciated than ever. To maintain its relevance in medical education, basic sciences have to confront three challenges: a) increasing its presence in clinical education; b) developing nuclear programs; and c) renewing laboratory instruction.

  18. [Basic problems of medical ethics].

    PubMed

    Herms, E

    1988-03-01

    The discussion on ethical problems in reproductive medicine that has been going on for quite a decade, is of an exemplary nature; it is mainly focussed on extracorporeal fertilisation, prenatal diagnosis with a view to abortion, and post partum diagnosis and treatment of genetic diseases. The fundamental problems of medical ethics in general come to the fore particularly clearly in this discussion. The following article deals with these fundamental problems, whereas a subsequent article will be concerned in greater detail with the three special disciplines I have just mentioned.

  19. [Systemic learning planification for medical students during oncology clinical rotation].

    PubMed

    Gonçalves, Anthony; Viens, Patrice; Gilabert, Marine; Turrini, Olivier; Lambaudie, Eric; Prebet, Thomas; Farnault, Bertrand; Eisinger, François; Gorincour, Guillaume; Bertucci, François

    2011-12-01

    The expected increase in cancer incidence emphasizes the need for specific training in this area, including either family physician or specialized oncologists. In France, the fourth to sixth years of medical teaching include both theoretical classes at the university and daily actual practice at the hospital. Thus, clinical rotations are thought to play a major role in the training of medical students and also largely participate to the choice of the student of his/her final specialty. Pedagogic quality of these rotations is dependent on multiple parameters, including a rigorous planification of the expected learning. Here, we reported a systemic planification of learning activities for medical students during an oncology rotation at the Paoli-Calmettes Institute in Marseille, France, a regional comprehensive cancer center. This planification includes an evaluation of learning requirements, definition of learning objectives, selection of learning methods and choice of methods of assessment of the students' achievement of these objectives as well as the learning activity itself.

  20. Basics in Clinical Medical Nutrition.

    PubMed

    Meier, Rémy F; Forbes, Alastair

    2015-01-01

    Nutrition is a basic requirement for life and plays an important role in health and in disease prevention, but malnutrition is a common event and a cause of increased morbidity and mortality, particularly in patients with disease-related malnutrition showing inflammation and a catabolic state. Malnutrition is often overlooked, and deterioration in the nutritional status following admission to hospital is common. It should be actively pursued by a ubiquitous system of nutrition screening, and full nutritional assessment is required for those found to be at risk. There are simple screening tools which can be used by all health care professionals. Assessment considers body composition, inflammatory status and other aspects of underlying diseases and their functional consequences; it is a more specialist process. It is important to determine the energy and protein needs of each individual patient. Appropriate nutritional intervention can often be offered by the oral route, using food with or without special supplements. When this is insufficient, enteral tube feeding will normally be sufficient, but there is an important subgroup of patients in whom enteral feeding is contraindicated or unsuccessful, and in these patients parenteral nutrition (either total or supplemental) is required. A number of immunonutrients and other special substrates have been shown to be helpful in specific circumstances, but their use is not without potential hazards, and therefore adherence to international guidelines is recommended.

  1. The Impact of a Radiation Oncologist led Oncology Curriculum on Medical Student Knowledge.

    PubMed

    Agarwal, Ankit; Shah, Aishwarya; Shah, Bhartesh; Koottappillil, Brian; Hirsch, Ariel E

    2017-05-09

    Medical students at our institution all take a pre-clinical oncology course as well as a clinical radiation oncology didactic session during their clinical curriculum. The objective of this analysis is to demonstrate the impact of the radiation oncology didactic on medical student knowledge of core oncology concepts. All students received a standardized didactic lecture introducing students to core concepts of general oncology and radiation. We administered an 18-question pretest and a posttest examining student knowledge between 2012 and 2015. Changes in student responses between pre-test and post-tests were analyzed to evaluate the effectiveness of the didactic session. Over the course of three years, 319 (64.4%) of 495 students who completed the Radiology block completed both the pre-test and post-test. The average student test grade improved from 62.0% on the pretest to 69.6% on the posttest (p < 0.001). By category, students increased their score from 81.4% to 89.8% (p < 0.001) in general oncology, from 59.9% to 69.9% (p < 0.001) in breast oncology, from 43.0% to 51.0% (p < 0.001) in prostate oncology, and from 71.3% to 75.7% (p = 0.003) in radiation oncology. Students showed increases in knowledge across general oncology, prostate oncology, breast oncology, and radiation oncology.

  2. [Basic principles and results of brachytherapy in gynecological oncology].

    PubMed

    Kanaev, S V; Turkevich, V G; Baranov, S B; Savel'eva, V V

    2014-01-01

    The fundamental basics of contact radiation therapy (brachytherapy) for gynecological cancer are presented. During brachytherapy the principles of conformal radiotherapy should be implemented, the aim of which is to sum the maximum possible dose of radiation to the tumor and decrease the dose load in adjacent organs and tissues, which allows reducing the frequency of radiation damage at treatment of primary tumors. It is really feasible only on modern technological level, thanks to precision topometry preparation, optimal computer dosimetrical and radiobiological planning of each session and radiotherapy in general. Successful local and long-term results of the contact radiation therapy for cancer of cervix and endometrium are due to optimal anatomical and topometrical ratio of the tumor localization, radioactive sources, and also physical and radiobiological laws of distribution and effects of ionizing radiation, the dose load accounting rules.

  3. Basic Workshops for Medical Record Clerical Personnel.

    ERIC Educational Resources Information Center

    Intermountain Regional Medical Program, Salt Lake City, UT.

    This curriculum guide is an outline of the content for basic workshop training sessions of hospital medical record personnel. Following a two-page topical outline of five content areas, there is a detailed presentation of this content as follows: (1) the medical record and its contribution to patient care (Joint Commission for Accreditation of…

  4. Basic Workshops for Medical Record Clerical Personnel.

    ERIC Educational Resources Information Center

    Intermountain Regional Medical Program, Salt Lake City, UT.

    This curriculum guide is an outline of the content for basic workshop training sessions of hospital medical record personnel. Following a two-page topical outline of five content areas, there is a detailed presentation of this content as follows: (1) the medical record and its contribution to patient care (Joint Commission for Accreditation of…

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

    ERIC Educational Resources Information Center

    Cersosimo, Robert J.

    1989-01-01

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

  6. 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.…

  7. 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

  8. Clinical neuro-oncology formal education opportunities for medical students in the United States and Canada.

    PubMed

    Dixit, Karan S; Nicholas, Martin Kelly; Lukas, Rimas V

    2014-12-01

    To develop an understanding of the availability of the formal clinical neuro-oncology educational opportunities for medical students. The curriculum websites of all medical schools accredited by the Liaison Committee on Medical Education were reviewed for the presence of clinical neuro-oncology electives as well as other relevant data. Ten (6.8%) of medical schools accredited by the Liaison Committee on Medical Education offer formal neuro-oncology electives. Half are clustered in the Midwest. Forty percent are at institutions with neuro-oncology fellowships. All are at institutions with neurosurgery and neurology residency programs. Formal clinical neuro-oncology elective opportunities for medical students in the United States and Canada are limited. Additional such opportunities may be of value in the education of medical students. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Radiation oncology: postgraduate medical education in the United States, 1988.

    PubMed

    Cox, J D; Flynn, D F; Pittman, D D; Brady, L W; del Regato, J A

    1989-06-01

    The fourteenth survey of postgraduate medical education in radiation oncology in the United States was conducted in the first three months of 1988. It revealed stability in the number of approved programs, positions offered, and physicians in training compared with 1986. The proportion of trainees who were U.S. citizens by birth rose to an all-time high of 88%, and the proportion of foreign medical graduates decreased to 9%. The proportion of women in residency has remained unchanged (24%) over the past 6 years. At present, approximately 150 physicians complete residency and enter practice each year, one-third of whom commence in an academic setting. A high proportion of recent graduates of approved programs successfully completes the examinations and becomes certified by the American Board of Radiology.

  10. Preclinical Medical Student Hematology/Oncology Education Environment.

    PubMed

    Zumberg, Marc S; Broudy, Virginia C; Bengtson, Elizabeth M; Gitlin, Scott D

    2015-12-01

    To better prepare medical students to care for patients in today's changing health-care environment as they transition to continuing their education as residents, many US medical schools have been reviewing and modifying their curricula and are considering integration of newer adult learning techniques, including team-based learning, flipped classrooms, and other active learning approaches (Assoc Am Med Coll. 2014). Directors of hematology/oncology (H/O) courses requested an assessment of today's H/O education environment to help them respond to the ongoing changes in the education content and environment that will be necessary to meet this goal. Several recommendations for the improvement of cancer education resulted from American Association for Cancer Education's (ACCE's) "Cancer Education Survey II" including a call for medical schools to evaluate the effectiveness of current teaching methods in achieving cancer education objectives (Chamberlain et al. J Cancer Educ 7(2):105-114.2014). To understand the current environment and resources used in medical student preclinical H/O courses, an Internet-based, Survey Monkey®-formatted, questionnaire focusing on nine topic areas was distributed to 130 United States Hematology/Oncology Course Directors (HOCDs). HOCDs represent a diverse group of individuals who work in variably supportive environments and who are variably satisfied with their position. Several aspects of these courses remain relatively unchanged from previous assessments, including a predominance of traditional lectures, small group sessions, and examinations that are either written or computer-based. Newer technology, including web-based reproduction of lectures, virtual microscopes, and availability of additional web-based content has been introduced into these courses. A variety of learner evaluation and course assessment approaches are used. The ultimate effectiveness and impact of these changes needs to be determined.

  11. Medication prior authorization in pediatric hematology and oncology.

    PubMed

    Dickens, David S; Pollock, Brad H

    2017-06-01

    Medication prior authorization (PA) is a commonly occurring requirement, particularly for medications used for rare conditions. Based on standard definitions, cancer and many blood disorders affecting children are rare. The study aims were to describe the relative frequency of PA requests and their association with payers and medications in order to identify opportunities to improve system efficiency. Requests for medication PA were logged prospectively for patients seen at a single institution over a 7-month period. Period prevalence was used to estimate the relative frequency of PA requests. Descriptive statistics summarized the relationship among payers, medications, and approvals relative to the frequency of PA requests. For the study duration of 150 clinic days, there were 5,583 patient visits. A total of 142 medication PA requests were received resulting in a period prevalence rate of 2.5% patient visits. Of the 137 medication PA requests with available outcome data, 135 (98.5%) were ultimately approved with additional provider efforts. The median clinic staff time spent per request was 46 min with an interquartile range of 25-80 min. There was striking process heterogeneity among different payers. Virtually no medication PA request in pediatric hematology and oncology (PHO) leads to alterations in care. Medication utilization management strategies in PHO fail to provide benefits reported in other areas of medicine and have unmeasured negative effects on timeliness of care and parenteral psychological/emotional health. There is opportunity for increasing efficiency through payer and provider collaboration on the creation of prescribing standards for PHO patients. © 2016 Wiley Periodicals, Inc.

  12. Web-based Oncology Educational Tool for Medical Trainees on Oncology Rotation-Results of a Pilot Study.

    PubMed

    Haq, Rashida; Li, Benjamin; Jovicic, Aleksandra; Dastur, Daisy; Trinkaus, Martina; Kong, Amy

    2017-01-03

    Oncology education for post-graduate medical trainees is mostly clinic-based with didactic lectures. However, a 3-4-week rotation lacks full exposure to the vast field of oncology, resulting in an educational gap. We felt there is a need for a standard curriculum to educate trainees on common oncology topics and encourage self-directed learning. This study aims to improve knowledge of oncology in trainees through the use of an oncology educational tool (consisting of a handbook and website) that we developed and evaluated. Fifty-three post-graduate trainees (years 1, 2, and 3) consented to participate at the start of their oncology rotation. In phase I, four participants took part in a usability evaluation of the tool. In phase II, 39 trainees underwent a knowledge assessment with use of the tool. Baseline and post-intervention test results were compared using paired t tests. In the qualitative study (phase III), 10 trainees provided feedback on the updated tool and overall rotation experience. Issues identified from phase I were addressed prior to subsequent phases. Phase II analysis of complete sets of data found the mean post-intervention scores (9.44/10) were significantly higher (p < 0.001) than the mean baseline scores (7.47/10). In the qualitative study, feedback strongly supported the integration of the tool for improving knowledge of trainees. To our knowledge, this is the first study to show that an oncology educational tool for medical trainees improves oncology knowledge by providing a standard curriculum. Future work involves evaluating this tool to determine if effects are from the education tool or rotation experience.

  13. A Basic Camera Unit for Medical Photography

    PubMed Central

    Smialowski, Arthur; Currie, Donald J.

    1964-01-01

    A camera unit suitable for most medical photographic purposes is described. The unit comprises a single-lens reflex camera, an electronic flash unit and supplementary lenses. Simple instructions for use of th's basic unit are presented. The unit is entirely suitable for taking fine-quality photographs of most medical subjects by persons who have had little photographic training. ImagesFig. 1 PMID:14179542

  14. Mapping the future: towards oncology curriculum reform in undergraduate medical education at a Canadian medical school.

    PubMed

    Kwan, Jennifer Y Y; Nyhof-Young, Joyce; Catton, Pamela; Giuliani, Meredith E

    2015-03-01

    To evaluate (1) the quantity and quality of current undergraduate oncology teaching at a major Canadian medical school; and (2) curricular changes over the past decade, to enhance local oncology education and provide insight for other educators. Relevant 2011-2012 undergraduate curricular sessions were extracted from the University of Toronto curriculum mapping database using keywords and database identifiers. Educational sessions were analyzed according to Medical Council of Canada objectives, discussion topics, instructor qualifications, teaching format, program year, and course subject. Course-related oncology research projects performed by students during 2000 to 2012 were extracted from another internal database. Elective choices of clerks during 2008-2014 were retrieved from the institution. The 2011-2012 and 2000-2001 curricula were compared using common criteria. The 2011-2012 curriculum covers 5 major themes (public health, cancer biology, diagnosis, principles of care, and therapy), which highlight 286 oncology teaching topics within 80 sessions. Genitourinary (10, 12.5%), gynecologic (8, 10.0%), and gastrointestinal cancers (7.9, 9.8%) were the most commonly taught cancers. A minority of sessions were taught by surgical oncologists (6.5, 8.1%), medical oncologists (2.5, 3.1%), and radiation oncologists (1, 1.2%). During 2000-2012, 9.0% of students (233 of 2578) opted to complete an oncology research project. During 2008-2014, oncology electives constituted 2.2% of all clerkship elective choices (209 of 9596). Compared with pre-2001 curricula, the 2012 oncology curriculum shows notable expansion in the coverage of epidemiology (6:1 increase), prevention (4:1), screening (3:1), and molecular biology (6:1). The scope of the oncology curriculum has grown over the past decade. Nevertheless, further work is needed to improve medical student knowledge of cancers, particularly those relevant to public health needs. Defining minimum curricular content

  15. Mapping the Future: Towards Oncology Curriculum Reform in Undergraduate Medical Education at a Canadian Medical School

    SciTech Connect

    Kwan, Jennifer Y.Y.; Nyhof-Young, Joyce; Catton, Pamela; Giuliani, Meredith E.

    2015-03-01

    Purpose: To evaluate (1) the quantity and quality of current undergraduate oncology teaching at a major Canadian medical school; and (2) curricular changes over the past decade, to enhance local oncology education and provide insight for other educators. Methods and Materials: Relevant 2011-2012 undergraduate curricular sessions were extracted from the University of Toronto curriculum mapping database using keywords and database identifiers. Educational sessions were analyzed according to Medical Council of Canada objectives, discussion topics, instructor qualifications, teaching format, program year, and course subject. Course-related oncology research projects performed by students during 2000 to 2012 were extracted from another internal database. Elective choices of clerks during 2008-2014 were retrieved from the institution. The 2011-2012 and 2000-2001 curricula were compared using common criteria. Results: The 2011-2012 curriculum covers 5 major themes (public health, cancer biology, diagnosis, principles of care, and therapy), which highlight 286 oncology teaching topics within 80 sessions. Genitourinary (10, 12.5%), gynecologic (8, 10.0%), and gastrointestinal cancers (7.9, 9.8%) were the most commonly taught cancers. A minority of sessions were taught by surgical oncologists (6.5, 8.1%), medical oncologists (2.5, 3.1%), and radiation oncologists (1, 1.2%). During 2000-2012, 9.0% of students (233 of 2578) opted to complete an oncology research project. During 2008-2014, oncology electives constituted 2.2% of all clerkship elective choices (209 of 9596). Compared with pre-2001 curricula, the 2012 oncology curriculum shows notable expansion in the coverage of epidemiology (6:1 increase), prevention (4:1), screening (3:1), and molecular biology (6:1). Conclusions: The scope of the oncology curriculum has grown over the past decade. Nevertheless, further work is needed to improve medical student knowledge of cancers, particularly those relevant to public health

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

    SciTech Connect

    Grover, Surbhi; Swisher-McClure, Samuel; Sosnowicz, Stasha; Li, Jiaqi; Mitra, Nandita; Berman, Abigail T.; Baffic, Cordelia; Vapiwala, Neha; Freedman, Gary M.

    2015-07-15

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

  17. The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO).

    PubMed

    Popescu, R A; Schäfer, R; Califano, R; Eckert, R; Coleman, R; Douillard, J-Y; Cervantes, A; Casali, P G; Sessa, C; Van Cutsem, E; de Vries, E; Pavlidis, N; Fumasoli, K; Wörmann, B; Samonigg, H; Cascinu, S; Cruz Hernández, J J; Howard, A J; Ciardiello, F; Stahel, R A; Piccart, M

    2014-01-01

    The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.

  18. Basic Emergency Medical Technician Skills Manual.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This manual was developed to help students preparing to become emergency medical technicians (EMTs) learn standardized basic skills in the field. The manual itemizes the steps and performance criteria of each required skill and uses an accompanying videotape series (not included) to enhance the educational experience. The five units of the manual,…

  19. Basic Emergency Medical Technician Skills Manual.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This manual was developed to help students preparing to become emergency medical technicians (EMTs) learn standardized basic skills in the field. The manual itemizes the steps and performance criteria of each required skill and uses an accompanying videotape series (not included) to enhance the educational experience. The five units of the manual,…

  20. [Medical equipment product lines in basic pharmacies].

    PubMed

    Macesková, B; Lipská, J

    2003-07-01

    Medical appliances dispensed in basic type pharmacies for cash or vouchers for medical or orthopedic appliances require expertise of pharmacists and laboratory assistants concerning the assortment, payment, construction of prices, conditions for prescription, ordering, properties, and functions of individual appliances. Using the method of frequency analysis, the analysis of data from five pharmacies within a period of three months (more than 17,000 records) revealed how individual subgroups of medical appliances and their concrete items are represented in both types of dispensation. The method of the semistructured questionnaire (10 respondents) was used to find what problems are encountered in dispensation, and which medical appliances and their subgroups are the sources of the problems. The respondents regard the contemporary level of knowledge concerning medical appliances gained in pregradual studies as insufficient.

  1. [Computational medical imaging (radiomics) and potential for immuno-oncology].

    PubMed

    Sun, R; Limkin, E J; Dercle, L; Reuzé, S; Zacharaki, E I; Chargari, C; Schernberg, A; Dirand, A S; Alexis, A; Paragios, N; Deutsch, É; Ferté, C; Robert, C

    2017-10-01

    The arrival of immunotherapy has profoundly changed the management of multiple cancers, obtaining unexpected tumour responses. However, until now, the majority of patients do not respond to these new treatments. The identification of biomarkers to determine precociously responding patients is a major challenge. Computational medical imaging (also known as radiomics) is a promising and rapidly growing discipline. This new approach consists in the analysis of high-dimensional data extracted from medical imaging, to further describe tumour phenotypes. This approach has the advantages of being non-invasive, capable of evaluating the tumour and its microenvironment in their entirety, thus characterising spatial heterogeneity, and being easily repeatable over time. The end goal of radiomics is to determine imaging biomarkers as decision support tools for clinical practice and to facilitate better understanding of cancer biology, allowing the assessment of the changes throughout the evolution of the disease and the therapeutic sequence. This review will develop the process of computational imaging analysis and present its potential in immuno-oncology. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  2. Quantitative imaging features: extension of the oncology medical image database

    NASA Astrophysics Data System (ADS)

    Patel, M. N.; Looney, P. T.; Young, K. C.; Halling-Brown, M. D.

    2015-03-01

    Radiological imaging is fundamental within the healthcare industry and has become routinely adopted for diagnosis, disease monitoring and treatment planning. With the advent of digital imaging modalities and the rapid growth in both diagnostic and therapeutic imaging, the ability to be able to harness this large influx of data is of paramount importance. The Oncology Medical Image Database (OMI-DB) was created to provide a centralized, fully annotated dataset for research. The database contains both processed and unprocessed images, associated data, and annotations and where applicable expert determined ground truths describing features of interest. Medical imaging provides the ability to detect and localize many changes that are important to determine whether a disease is present or a therapy is effective by depicting alterations in anatomic, physiologic, biochemical or molecular processes. Quantitative imaging features are sensitive, specific, accurate and reproducible imaging measures of these changes. Here, we describe an extension to the OMI-DB whereby a range of imaging features and descriptors are pre-calculated using a high throughput approach. The ability to calculate multiple imaging features and data from the acquired images would be valuable and facilitate further research applications investigating detection, prognosis, and classification. The resultant data store contains more than 10 million quantitative features as well as features derived from CAD predictions. Theses data can be used to build predictive models to aid image classification, treatment response assessment as well as to identify prognostic imaging biomarkers.

  3. Are future medical oncologists sufficiently trained to communicate about palliative care? The medical oncology curriculum in Flanders, Belgium.

    PubMed

    Horlait, M; Van Belle, S; Leys, M

    2017-10-01

    Palliative care is considered an integral part of oncology and communicating this with patients is an unavoidable task for oncologists. This contribution investigated to what extent communication skills for communicating palliative care with patients are trained in the formal academic training program in medical oncology in Flanders, Belgium. The programme is based on the recommendations for a Global Core Curriculum in Medical Oncology, developed by The American Society of Clinical Oncology (ASCO) together with the European Society for Medical Oncology (ESMO). For this qualitative study, data were collected using document analysis from the ESMO/ASCO recommendations and the documents of the Flanders' medical oncology programme complemented with interviews with Flemish medical oncology trainees. Few recommendations for training communication skills to communicate about palliative care were found in the ASMO/ASCO recommendations and even less in the Flanders' programme documents. Trainees are mainly exposed to palliative care communication during the clinical practice of their training. Only very few lectures or seminars are devoted to palliative care and even less on communication about palliative care. They reported several barriers to communicate about palliative care. This study revealed promising developments for the training of Flemish medical oncologists to discuss palliative care. However, there is still a need for more theoretical training on palliative care complemented with communication skills trainings. Communication training in general needs to be fully integrated as a core skill within the medical curriculum at large and should be promoted as lifelong learning and competency development.

  4. [NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

    PubMed

    Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

    2017-08-01

    Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

  5. 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

  6. The Impact of an Oncology Course on Attitudes of Freshman Medical Students.

    ERIC Educational Resources Information Center

    Appel, Marilyn H.; And Others

    1981-01-01

    A course in oncology for freshman medical students at the Medical College of Pennsylvania is discussed. It is thought that appropriate training of medical students appears to lead to more positive attitudes toward cancer, but many of these efforts have been directed to groups at later stages of medical education. (MLW)

  7. The Impact of an Oncology Course on Attitudes of Freshman Medical Students.

    ERIC Educational Resources Information Center

    Appel, Marilyn H.; And Others

    1981-01-01

    A course in oncology for freshman medical students at the Medical College of Pennsylvania is discussed. It is thought that appropriate training of medical students appears to lead to more positive attitudes toward cancer, but many of these efforts have been directed to groups at later stages of medical education. (MLW)

  8. Establishing an international baseline for medication safety in oncology: Findings from the 2012 ISMP International Medication Safety Self Assessment® for Oncology.

    PubMed

    Greenall, Julie; Shastay, Ann; Vaida, Allen J; U, David; Johnson, Philip E; O'Leary, Joe; Chambers, Carole

    2015-02-01

    In 2012, the Institute for Safe Medication Practices (ISMP) and the Institute for Safe Medication Practices Canada (ISMP Canada) collaborated with an international panel of oncology practitioners to develop the ISMP International Medication Safety Self Assessment® for Oncology. This self-assessment was designed to assist oncology practitioners in hospitals, ambulatory care centers, and office practice settings throughout the world to evaluate safe practices related to medication use in the oncology setting and to identify opportunities for improvement. The self-assessment consists of 175 items organized into 10 key elements subdivided into 18 core characteristics of safe medication use. Assessment results were submitted via a secure online portal. The online program allows participants to print and graph their results and to compare their findings with those of similar organizations both nationally and internationally. Complimentary access to the self-assessment was made available for a seven-month "snapshot" period in 2012. A total of 352 organizations from 13 countries submitted assessment results. Key opportunities for improvement were identified in five areas: implementation of the World Health Organization recommendations for management of vinCRIStine and other vinca alkaloids, safe management of oral chemotherapy, labeling of distal ends of intravenous tubing, implementation of technology-based safeguards, and patient education. This international snapshot provides important data about the level of implementation of system-based safeguards in oncology practice, key improvement opportunities, and represents a baseline for future improvement efforts. A collaborative approach to identifying vulnerabilities and developing solutions for safe medication use in oncology will enhance the care of patients with cancer internationally. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Review of 40-year MD theses in medical oncology.

    PubMed

    Zeeneldin, Ahmed; Diyaa, Amira; Moneer, Manar; Elgammal, Mosaad; Buhoush, Wafa

    2014-09-01

    It is almost 40 years since the foundation of the Medical Oncology (MO) Department. We aimed to appraise the clinical research to fulfill the Medical Doctorate (MD) degree in MO at the National Cancer Institute, Cairo University (NCI, CU). This review included 62 MD theses containing 66 studies. They were reviewed regarding aims, type of study, clinical trial phase, design and methodology, statistical tests, results, limitations, consent and IRB approval. Theses were grouped into 3 periods: 1970-1989, 1990-1999 and 2000-2008. Almost 76% of the studies were interventional and 24% were observational. Informed consent and Institutional Review Board approval were mentioned in 18 and 2 studies, respectively. While all studies mentioned the aims, none, clearly mentioned the research question. Outcomes were mainly efficacy followed by safety. Study design was inadequately considered, especially in 70's-80's period (p=0.038). Median sample size and study duration were almost stable through the three periods (p=0.441, 0.354, respectively). Most of the studies used both descriptive and analytical statistical methods. In a descending order, researched cancers were lymphoma, breast, leukemia, liver, urinary bladder, lung and colorectal. The commonest stages researched were IV and III. The number of studies focused on assessing biomarkers, biomarkers plus drugs/procedures, drugs and procedures are 20, 20, 16 and 6, respectively. With time, research within MD theses in MO increased quantitatively and qualitatively. Improvements were noticeable in documentation of study design. Copyright © 2014. Production and hosting by Elsevier B.V.

  10. 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.

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

    PubMed

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

    2014-02-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Beyond the Standard Curriculum: A Review of Available Opportunities for Medical Students to Prepare for a Career in Radiation Oncology

    SciTech Connect

    Agarwal, Ankit; DeNunzio, Nicholas J.; Ahuja, Divya; Hirsch, Ariel E.

    2014-01-01

    Purpose: To review currently available opportunities for medical students to supplement their standard medical education to prepare for a career in radiation oncology. Methods and Materials: Google and PubMed were used to identify existing clinical, health policy, and research programs for medical students in radiation oncology. In addition, results publicly available by the National Resident Matching Program were used to explore opportunities that successful radiation oncology applicants pursued during their medical education, including obtaining additional graduate degrees. Results: Medical students can pursue a wide variety of opportunities before entering radiation oncology. Several national specialty societies, such as the American Society for Radiation Oncology and the Radiological Society of North America, offer summer internships for medical students interested in radiation oncology. In 2011, 30% of allopathic senior medical students in the United States who matched into radiation oncology had an additional graduate degree, including PhD, MPH, MBA, and MA degrees. Some medical schools are beginning to further integrate dedicated education in radiation oncology into the standard 4-year medical curriculum. Conclusions: To the authors' knowledge, this is the first comprehensive review of available opportunities for medical students interested in radiation oncology. Early exposure to radiation oncology and additional educational training beyond the standard medical curriculum have the potential to create more successful radiation oncology applicants and practicing radiation oncologists while also promoting the growth of the field. We hope this review can serve as guide to radiation oncology applicants and mentors as well as encourage discussion regarding initiatives in radiation oncology opportunities for medical students.

  14. [Conceptual issues of standartization of the special medical care rendered to oncological patients].

    PubMed

    Shalimov, S O; Lishchyshyna, O M

    2005-01-01

    Legislative documents of Ukraine as well as manuals of international organizations dealing with state regulation and social guaranties in Health Care have been analyzed. The use of standards in oncology institution in Ukraine has been studied. It was established that there is discrepancy in standards being used, lack of financing directed to oncology institutions. Controversial points concerning theoretical aspects were found as follows: the regulation of negative figures and selection of the complex of diagnostic and treatment procedures. The requirements to branch standards and principles of standardization of medical care provided to oncological patients.

  15. Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study.

    PubMed

    Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E

    2016-01-01

    Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to

  16. Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study

    PubMed Central

    Tam, Vincent C.; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E.

    2016-01-01

    Background: Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. Methods: In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Results: Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Interpretation: Through a systematic process, we created a comprehensive, consensus

  17. Medical Oncology Pharmacy: A New Role for the Clinical Pharmacist

    ERIC Educational Resources Information Center

    Morris, Carl R.; Hickman, Mary Johne

    1977-01-01

    The University of Tennessee has established a training program for clinical pharmacists dealing with cancer chemotherapy patients. Health-care settings are described in which these individuals can contribute as unique health-care team members in oncology. (Author/LBH)

  18. Medical Oncology Pharmacy: A New Role for the Clinical Pharmacist

    ERIC Educational Resources Information Center

    Morris, Carl R.; Hickman, Mary Johne

    1977-01-01

    The University of Tennessee has established a training program for clinical pharmacists dealing with cancer chemotherapy patients. Health-care settings are described in which these individuals can contribute as unique health-care team members in oncology. (Author/LBH)

  19. Assessing Interprofessional Teamwork in Inpatient Medical Oncology Units.

    PubMed

    Weaver, A Charlotta; Callaghan, Mary; Cooper, Abby L; Brandman, James; O'Leary, Kevin J

    2015-01-01

    Teamwork is important to providing safe and effective care for hospitalized patients with cancer; however, few studies have evaluated teamwork in this setting. We surveyed all nurses, residents, hospitalists, and oncology physicians in oncology units at a large urban teaching hospital from September to November 2012. Respondents rated teamwork using a validated instrument (Safety Attitudes Questionnaire; scale, 0 to 100) and rated the quality of collaboration they had experienced with other professionals using a 5-point ordinal response scale (1, very low quality; 5, very high quality). Respondents also rated potential barriers to collaboration using a 4-point ordinal response scale (1, not at all a barrier; 4, major barrier). We compared ratings by professionals using analysis of variance (ANOVA). Overall, 129 (67%) of 193 eligible participants completed the survey. Teamwork scores differed across professional types, with nurses providing the lowest ratings (69.7) and residents providing the highest (81.9; ANOVA P = .01). Ratings of collaboration with nurses were high across all types of professionals. Ratings of collaboration with physicians varied significantly by professional type (P ≤ .02), with nurses giving lower ratings of collaboration with all physician types. Similarly, perceived barriers to collaboration differed by professional type, with nurses perceiving the biggest barrier to be negative attitudes regarding the importance of communication. Oncologists did not perceive any of the listed options as major barriers to collaboration. In inpatient oncology units, discrepancies exist between nurses' and physicians' ratings of teamwork and collaboration. Oncologists seem to be unaware that teamwork is suboptimal in this setting. Copyright © 2015 by American Society of Clinical Oncology.

  20. Pediatric Oncology Branch - training- medical student rotations | Center for Cancer Research

    Cancer.gov

    Medical Student Rotations Select 4th-year medical students may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The student is supervised directly by the Branch’s attending physician and clinical fellows. Students attend daily in-patient and out-patient rounds and multiple weekly Branch conferences, and are expected to research relevant topics and present a 30-minute talk near the end of their rotation.

  1. Look-alike, sound-alike oncology medications.

    PubMed

    Schulmeister, Lisa

    2006-02-01

    Confusing medication names and packaging may cause or contribute to potentially harmful medication errors. The names of several chemotherapy and supportive agents can look or sound like the names of other chemotherapy agents or unrelated medications and can be inadvertently interchanged, or mixed up. Poor handwriting, abbreviations of medication names, unclear verbal medication orders, memory lapses, and the large volume of medications currently in use are risk factors for look-alike, sound-alike medication errors. Risk reduction strategies include being aware of medications that look or sound like other medications, installing pop-up alerts in computer systems, prescribing medications by their generic and trade names, placing eye-catching labels and warning stickers on storage bins, storing medications in nonadjacent areas, and advising patients to be alert for potential mix-ups with look-alike, sound-alike medications.

  2. Implementation of a Novel Medical School Multidisciplinary and Interprofessional Oncology Curriculum: a Mixed Method Study.

    PubMed

    McKillip, Ryan P; Hahn, Olwen M; Bartkowiak, Bartlomiej; Rosenberg, Carol A; Olopade, Olufunmilayo I; Arora, Vineet M; Golden, Daniel W

    2017-08-22

    As the population of patients with cancer and survivors grows, physician knowledge of oncology clinical care and research is increasingly important. Despite this patient population growth, medical students and non-oncology physicians report insufficient oncologic and survivorship care training. First-year students at a single US medical school completing a summer research experience were invited to participate in integrated Scholars in Oncology-Associated Research (SOAR) program. SOAR seeks to broaden students' understanding of multidisciplinary and interprofessional oncology clinical care and research. SOAR consists of three components: structured didactics, multidisciplinary tumor board attendance, and interprofessional shadowing. A mixed-methods approach investigated whether student knowledge improved after SOAR. Thirty-three students enrolled in SOAR (20 in 2015, 13 in 2016) and completed pre-assessments. Twenty-five (75.8%) students completed SOAR and post-assessments. Self-reported understanding of clinical (2[2, 3] vs. 4[4], p < 0.01) and research oncology (2[2, 3] vs. 4[4], p < 0.01) improved after SOAR. Understanding of individual disciplines also significantly improved. When describing clinical oncology, responses written post-SOAR were more comprehensive, averaging 3.7 themes per response vs. 2.8 on pre-assessments (p = 0.03). There were more references to "survivorship" as a component of oncology on post-assessments (0[0.0%] vs. 7[28.0%], p < 0.01) and "screening/prevention" (2[6.1%] vs. 7[28.0%], p = 0.03). Additionally, students more often described cancer care as a continuum on post-assessments (4[12.1%] vs. 11[44.0%], p = 0.01). A structured didactic and experiential introduction to oncology, SOAR, was successfully piloted. SOAR improved participant understanding of oncology and its distinct clinical and research disciplines. Future work will focus on expanding SOAR into a longitudinal oncology curriculum.

  3. Medical Malpractice Claims in Radiation Oncology: A Population-Based Study 1985-2012

    SciTech Connect

    Marshall, Deborah C.; Punglia, Rinaa S.; Fox, Dov; Recht, Abram; Hattangadi-Gluth, Jona A.

    2015-10-01

    Purpose: The purpose of this study was to determine trends in radiation oncology malpractice claims and expenses during the last 28 years and to compare radiation oncology malpractice claims to those of other specialties. Methods and Materials: We performed a retrospective analysis of closed malpractice claims filed from 1985 to 2012, collected by a nationwide medical liability insurance trade association. We analyzed characteristics and trends among closed claims, indemnity payments (payments to plaintiff), and litigation expenses. We also compared radiation oncology malpractice claims to those of 21 other medical specialties. Time series dollar amounts were adjusted for inflation (2012 was the index year). Results: There were 1517 closed claims involving radiation oncology, of which 342 (22.5%) were paid. Average and median indemnity payments were $276,792 and $122,500, respectively, ranking fifth and eighth, respectively, among the 22 specialty groups. Linear regression modeling of time trends showed decreasing total numbers of claims (β = −1.96 annually, P=.003), increasing average litigation expenses paid (β = +$1472 annually, P≤.001), and no significant changes in average indemnity payments (β = −$681, P=.89). Conclusions: Medical professional liability claims filed against radiation oncologists are not common and have declined in recent years. However, indemnity payments in radiation oncology are large relative to those of many other specialties. In recent years, the average indemnity payment has been stable, whereas litigation expenses have increased.

  4. [Burnout effect on academic progress of Oncology medical residents].

    PubMed

    González-Ávila, Gabriel; Bello-Villalobos, Herlinda

    2014-01-01

    Introducción: en el periodo formativo de los cursos de especializaciones médicas se asumen nuevas y grandes responsabilidades en el ámbito profesional y personal. La interacción de diferentes factores que envuelven el ejercicio de estos médicos puede llegar a sobrepasar su capacidad de afrontamiento y ocasionarles niveles elevados de estrés y desgaste profesional, lo cual afectará su desarrollo académico. El objetivo es determinar si el estrés laboral presente en los médicos residentes afecta su aprovechamiento académico. Métodos: se aplicó el cuestionario de Maslach a 52 médicos residentes de tres especialidades oncológicas que aceptaron participar voluntariamente el día que acudieron a su tercer examen ordinario del área cognoscitiva. Resultados: la prevalencia de burnout fue del 13.5 % con una frecuencia mayor en el primer año de la especialidad. En sus dimensiones, se encontró un mayor agotamiento emocional y baja realización personal en Oncología Médica. El aprovechamiento académico fue mayor para el tercer año de la residencia, con una diferencia significativa para Cirugía Oncológica y Oncología Médica (p = 0.026 y 0.015, respectivamente). No obstante, no se observó relación alguna con la presencia de burnout, ni tampoco con sexo (p = 0.437), estado civil (p = 0.329), número de hijos (p = 0.467) o escolaridad de la pareja (p = 0.784). Conclusión: la presencia de burnout no afecta el aprovechamiento académico de los médicos residentes en oncología.

  5. Oncological image analysis: medical and molecular image analysis

    NASA Astrophysics Data System (ADS)

    Brady, Michael

    2007-03-01

    This paper summarises the work we have been doing on joint projects with GE Healthcare on colorectal and liver cancer, and with Siemens Molecular Imaging on dynamic PET. First, we recall the salient facts about cancer and oncological image analysis. Then we introduce some of the work that we have done on analysing clinical MRI images of colorectal and liver cancer, specifically the detection of lymph nodes and segmentation of the circumferential resection margin. In the second part of the paper, we shift attention to the complementary aspect of molecular image analysis, illustrating our approach with some recent work on: tumour acidosis, tumour hypoxia, and multiply drug resistant tumours.

  6. Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.

    PubMed

    Weinstein, Aurélie G; Henrich, Christopher C

    2013-12-01

    This study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective. A web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis. Pediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%). This work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. [Basic areas of medical science in Uzbekistan].

    PubMed

    Abdullakhodzhaeva, M S

    2016-01-01

    The paper considers the issues of medicine development in the Republic of Uzbekistan and the contribution made by prominent scientists developing effective methods for diagnosing and treating different diseases in medical science. A great part is assigned to medical science advances in our country. To solve the urgent problems of public health, much attention is given to the training of scientific manpower, the setting up of specialized research and practical medical centers of different profile, research laboratories of medical higher educational establishments as a base for conducting researches and investigations, which will be able to improve the quality of medical care to the population and corresponds to a health care reform program.

  8. Assessing the Value of an Optional Radiation Oncology Clinical Rotation During the Core Clerkships in Medical School

    SciTech Connect

    Zaorsky, Nicholas G.; Malatesta, Theresa M.; Den, Robert B.; Wuthrick, Evan; Ahn, Peter H.; Werner-Wasik, Maria; Shi, Wenyin; Dicker, Adam P.; Anne, P. Rani; Bar-Ad, Voichita; Showalter, Timothy N.

    2012-07-15

    Purpose: Few medical students are given proper clinical training in oncology, much less radiation oncology. We attempted to assess the value of adding a radiation oncology clinical rotation to the medical school curriculum. Methods and Materials: In July 2010, Jefferson Medical College began to offer a 3-week radiation oncology rotation as an elective course for third-year medical students during the core surgical clerkship. During 2010 to 2012, 52 medical students chose to enroll in this rotation. The rotation included outpatient clinics, inpatient consults, didactic sessions, and case-based presentations by the students. Tests of students' knowledge of radiation oncology were administered anonymously before and after the rotation to evaluate the educational effectiveness of the rotation. Students and radiation oncology faculty were given surveys to assess feedback about the rotation. Results: The students' prerotation test scores had an average of 64% (95% confidence interval [CI], 61-66%). The postrotation test scores improved to an average of 82% (95% CI, 80-83%; 18% absolute improvement). In examination question analysis, scores improved in clinical oncology from 63% to 79%, in radiobiology from 70% to 77%, and in medical physics from 62% to 88%. Improvements in all sections but radiobiology were statistically significant. Students rated the usefulness of the rotation as 8.1 (scale 1-9; 95% CI, 7.3-9.0), their understanding of radiation oncology as a result of the rotation as 8.8 (95% CI, 8.5-9.1), and their recommendation of the rotation to a classmate as 8.2 (95% CI, 7.6-9.0). Conclusions: Integrating a radiation oncology clinical rotation into the medical school curriculum improves student knowledge of radiation oncology, including aspects of clinical oncology, radiobiology, and medical physics. The rotation is appreciated by both students and faculty.

  9. Difficult Conversations: Teaching Medical Oncology Trainees Communication Skills One Hour at a Time

    PubMed Central

    Baile, Walter F.

    2014-01-01

    Difficult conversations about prognosis, end of life, and goals of care arise commonly in medical oncology practice. These conversations are often highly emotional. Medical oncologists need outstanding, patient-centered communication skills to build trust and rapport with their patients and help them make well-informed decisions. Key skills include exploring patients’ perspectives, responding to emotion with empathy, and maintaining mindfulness during highly charged conversations. These skills can be taught and learned. Most previously described communication skills training curricula for oncology providers involve multiday retreats, which are costly and can disrupt busy clinical schedules. Many curricula involve a variety of oncology providers, such as physicians and nurses, at various stages of their careers. The authors developed a monthly, one-hour communication skills training seminar series exclusively for physicians in their first year of medical oncology subspecialty training. The curriculum involved a variety of interactive and engaging educational methods, including sociodramatic techniques, role-play, reflective writing, and Balint-type case discussion groups. Medical oncologists in their second and third years of training served as teaching assistants and peer mentors. Learners had the opportunity to practice skills during sessions and with patients between sessions. Learners acquired important skills and found the curriculum to be clinically relevant, judging by anonymous surveys and anonymous responses on reflective writing exercises. Results from the current curriculum are preliminary but lay the foundation for enhanced and expanded communication skills training programs in the future. PMID:24556763

  10. Difficult conversations: teaching medical oncology trainees communication skills one hour at a time.

    PubMed

    Epner, Daniel E; Baile, Walter F

    2014-04-01

    Difficult conversations about prognosis, end of life, and goals of care arise commonly in medical oncology practice. These conversations are often highly emotional. Medical oncologists need outstanding, patient-centered communication skills to build trust and rapport with their patients and help them make well-informed decisions. Key skills include exploring patients' perspectives, responding to emotion with empathy, and maintaining mindfulness during highly charged conversations. These skills can be taught and learned. Most previously described communication skills training curricula for oncology providers involve multiday retreats, which are costly and can disrupt busy clinical schedules. Many curricula involve a variety of oncology providers, such as physicians and nurses, at various stages of their careers. The authors developed a monthly, one-hour communication skills training seminar series exclusively for physicians in their first year of medical oncology subspecialty training. The curriculum involved a variety of interactive and engaging educational methods, including sociodramatic techniques, role-play, reflective writing, and Balint-type case discussion groups. Medical oncologists in their second and third years of training served as teaching assistants and peer mentors. Learners had the opportunity to practice skills during sessions and with patients between sessions. Learners acquired important skills and found the curriculum to be clinically relevant, judging by anonymous surveys and anonymous responses on reflective writing exercises. Results from the current curriculum are preliminary but lay the foundation for enhanced and expanded communication skills training programs in the future.

  11. Reimbursement versus effort in medical physics practice in radiation oncology.

    PubMed

    Herman, Michael G; Mills, Michael D; Gillin, Michael T

    2003-01-01

    The changes in health care reimbursement have the potential to affect the availability of quality medical physicist service in patient care. A survey was conducted by the AAPM Professional Council and the ACMP to collect cost information for special medical physics consultation, CPT4-77370 and continuing medical physics, CPT4-77336. The data collected from the survey was compared to current reimbursement schemes for a number of special procedures. Under varying reimbursement schemes, the costs of the medical physics services provided cannot be recaptured by the institution. It remains important for medical physicists to assess our utilization of resources and allocation to each of the services we provide and to understand the implications of policy changes at the federal and local levels.

  12. Content Analysis of Oncology-Related Pharmaceutical Advertising in a Peer-Reviewed Medical Journal

    PubMed Central

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

    2012-01-01

    Background The oncology market represents one of the largest pharmaceutical markets in any medical field, and printed advertising in medical journals is an important channel by which pharmaceutical companies communicate with healthcare professionals. The aim of the present study was to analyze the volume and content of and trends and changes in oncology-related advertising intended for healthcare professionals in a peer-reviewed medical journal. Information that could be included in advertisements to promote drug development and improve treatment strategies for cancer patients is discussed on the basis of the results of the analysis. Methods/Principal Findings Overall, 6,720 advertisements covering 13,039 pages in a leading oncology medical journal published (by the American Society of Clinical Oncology) between January 2005 and December 2009 were analyzed. The advertisements targeting pharmaceuticals and clinical trials, in particular, were reviewed. A total of 6,720 advertisements covering 13,039 pages were included in the analysis. For the years 2005–2009, the percentages of total journal pages dedicated to advertising were 24.0%, 45.7%, 49.8%, 46.8%, and 49.8%, respectively. Package insert information and efficacy and safety explanations appeared in more than 80% of advertisements intended for pharmaceutical promotion. From 2005 to 2009, the overall quantity of drug advertisements decreased by approximately 13%, whereas advertisements calling for the enrollment of patients into registration trials increased by approximately 11%. Conclusion/Significance Throughout the study period, oncology-related pharmaceutical advertisements occupied a considerable number of pages relative to other journal content. The proportion of advertisements on ongoing clinical trials increased progressively throughout the study period. PMID:22952970

  13. [Flipped classroom in basic medical education].

    PubMed

    Merenmies, Jussi; Niemi-Murola, Leila; Pyörälä, Eeva

    2015-01-01

    Medical education is facing changes in order to improve young doctors' competency to respond better to current needs of the patients and the society. Both curriculum content and teaching methods are revised. In addition to vibrant research in academic medical education, teachers are supported by the improved web-based learning environments and novel technical tools. Flipped classroom, a new paradigm that benefits from technical development, provides many opportunities for medical education. This teaching method always consists of two mutually complementary parts. The first part of the learning action takes place independently off classroom with video lectures or other stimuli for learning. The second part takes place in conjunction with the teacher and other students, and requires student group interactions.

  14. Basic methods for the assessment of health-related quality of life in uro-oncological patients.

    PubMed

    Sosnowski, Roman; Kulpa, Marta; Kosowicz, Mariola; Presicce, Fabrizio; Porpiglia, Francesco; Tubaro, Andrea; DE Nunzio, Cosimo; Demkow, Tomasz

    2017-10-01

    The evaluation of patients' expectations and quality of life in uro-oncology is considered an important outcome of treatment efficacy and satisfaction. Aim of this systematic review was to evaluate the most frequently adopted tools in uro-oncology to assess Health Related Quality of Life (HRQoL). A systematic literature search until October 2015 was performed on MEDLINE, Cochrane Library, PubMed combining the following terms: "quality of life," "health-related quality of life," "kidney cancer," "bladder cancer," "prostate cancer." Additional references were obtained from the reference list of full-text manuscripts. Data were synthesized using meta-analytic methods conformed to the PRISMA statement. HRQoL is a fundamental step in evaluating treatment outcome in patients with urological cancers. HRQoL is mostly measured through several questionnaires, which are generally categorized in generic questionnaires, exploring the patient's well-being en bloc; specific questionnaires, assessing each single domain of health status; and uro-oncological specific questionnaires, mainly characterized by a modular approach. Although different questionnaires have been proposed and validated, the standard method to be adopted in urology is far from the solution and further studies should investigate the strength and weakness of the different questionnaires. HRQoL questionnaires should become a standard method to evaluate medical/surgical outcomes in uro-oncology. Their implementation may significantly improve patients' satisfaction and help physicians in the decision-making process and possibly reduce health care costs.

  15. Pain medication management processes used by oncology outpatients and family caregivers part I: health systems contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. The aim was to describe day-to-day pain medication management from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management by patients and family caregivers in the context of multiple complex health systems. We qualitatively analyzed audio-recorded intervention sessions that included extensive dialogue between patients, family caregivers, and nurses about pain medication management during the 10-week intervention. The health systems context for pain medication management included multiple complex systems for clinical care, reimbursement, and regulation of analgesic prescriptions. Pain medication management processes particularly relevant to this context were getting prescriptions and obtaining medications. Responsibilities that fell primarily to patients and family caregivers included facilitating communication and coordination among multiple clinicians, overcoming barriers to access, and serving as a final safety checkpoint. Significant effort was required of patients and family caregivers to insure safe and effective pain medication management. Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and health-care reform initiatives. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  16. Medical Imaging with Ultrasound: Some Basic Physics.

    ERIC Educational Resources Information Center

    Gosling, R.

    1989-01-01

    Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

  17. Medical Imaging with Ultrasound: Some Basic Physics.

    ERIC Educational Resources Information Center

    Gosling, R.

    1989-01-01

    Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

  18. Basic Reference Aids for Small Medical Libraries *

    PubMed Central

    Blair, Edith D.

    1967-01-01

    Selected primarily for the small medical library, this list is compiled to serve as a practical guide for the librarian in developing and utilizing an effective reference collection. Arrangement is by broad subject groups; titles chosen are chiefly in English with geographic coverage limited to the United States and Canada. Texts in subject fields have been omitted since these are adequately covered in several comprehensive guides to the literature. PMID:6041827

  19. Thirty year celebration of journal publications on radiation oncology medical physics.

    PubMed

    Oliver, L D

    2007-03-01

    The Australasian Physical & Engineering Sciences in Medicine Journal (APESM) is an avenue for the profession to report scientific work in medicine; provide a facility for the publication of current work, new research and new techniques developed or reviewed; report on professional news from elsewhere and; publish the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) policies and protocols. The journal is a vital instrument within the ACPSEM organisation with a worldwide circulation. This review of APESM on medical physics in radiation oncology is meant to be a progress summary of work in that specialty. Even so, it has become a lengthy appraisal due to the many years involved. In considering publications related to medical physics in radiation oncology, this review has shown the progression of the College journal to an international journal. There is an increase in the number of papers contributed from Asia and other countries world wide for this discipline. Growth in the number of contributions should continue to rise. In order to provide some appreciation of where the present medical physics activity arose from, this article commences its discussion in 1959 and progresses towards the present, describing along the way, from radiation oncology papers published in APESM, the use of linear accelerators, brachytherapy, the medical physics workforce, the formation of the ACPSEM, and the more modern developments in radiotherapy such as 3-D treatment planning and IMRT.

  20. The relevance of basic sciences in undergraduate medical education.

    PubMed

    Lynch, C; Grant, T; McLoughlin, P; Last, J

    2016-02-01

    Evolving and changing undergraduate medical curricula raise concerns that there will no longer be a place for basic sciences. National and international trends show that 5-year programmes with a pre-requisite for school chemistry are growing more prevalent. National reports in Ireland show a decline in the availability of school chemistry and physics. This observational cohort study considers if the basic sciences of physics, chemistry and biology should be a prerequisite to entering medical school, be part of the core medical curriculum or if they have a place in the practice of medicine. Comparisons of means, correlation and linear regression analysis assessed the degree of association between predictors (school and university basic sciences) and outcomes (year and degree GPA) for entrants to a 6-year Irish medical programme between 2006 and 2009 (n = 352). We found no statistically significant difference in medical programme performance between students with/without prior basic science knowledge. The Irish school exit exam and its components were mainly weak predictors of performance (-0.043 ≥ r ≤ 0.396). Success in year one of medicine, which includes a basic science curriculum, was indicative of later success (0.194 ≥ r (2) ≤ 0.534). University basic sciences were found to be more predictive than school sciences in undergraduate medical performance in our institution. The increasing emphasis of basic sciences in medical practice and the declining availability of school sciences should mandate medical schools in Ireland to consider how removing basic sciences from the curriculum might impact on future applicants.

  1. ESMO / ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2016

    PubMed Central

    Dittrich, Christian; Kosty, Michael; Jezdic, Svetlana; Pyle, Doug; Berardi, Rossana; Bergh, Jonas; El-Saghir, Nagi; Lotz, Jean-Pierre; Österlund, Pia; Pavlidis, Nicholas; Purkalne, Gunta; Awada, Ahmad; Banerjee, Susana; Bhatia, Smita; Bogaerts, Jan; Buckner, Jan; Cardoso, Fatima; Casali, Paolo; Chu, Edward; Close, Julia Lee; Coiffier, Bertrand; Connolly, Roisin; Coupland, Sarah; De Petris, Luigi; De Santis, Maria; de Vries, Elisabeth G E; Dizon, Don S; Duff, Jennifer; Duska, Linda R; Eniu, Alexandru; Ernstoff, Marc; Felip, Enriqueta; Fey, Martin F; Gilbert, Jill; Girard, Nicolas; Glaudemans, Andor W J M; Gopalan, Priya K; Grothey, Axel; Hahn, Stephen M; Hanna, Diana; Herold, Christian; Herrstedt, Jørn; Homicsko, Krisztian; Jones, Dennie V; Jost, Lorenz; Keilholz, Ulrich; Khan, Saad; Kiss, Alexander; Köhne, Claus-Henning; Kunstfeld, Rainer; Lenz, Heinz-Josef; Lichtman, Stuart; Licitra, Lisa; Lion, Thomas; Litière, Saskia; Liu, Lifang; Loehrer, Patrick J; Markham, Merry Jennifer; Markman, Ben; Mayerhoefer, Marius; Meran, Johannes G; Michielin, Olivier; Moser, Elizabeth Charlotte; Mountzios, Giannis; Moynihan, Timothy; Nielsen, Torsten; Ohe, Yuichiro; Öberg, Kjell; Palumbo, Antonio; Peccatori, Fedro Alessandro; Pfeilstöcker, Michael; Raut, Chandrajit; Remick, Scot C; Robson, Mark; Rutkowski, Piotr; Salgado, Roberto; Schapira, Lidia; Schernhammer, Eva; Schlumberger, Martin; Schmoll, Hans-Joachim; Schnipper, Lowell; Sessa, Cristiana; Shapiro, Charles L; Steele, Julie; Sternberg, Cora N; Stiefel, Friedrich; Strasser, Florian; Stupp, Roger; Sullivan, Richard; Tabernero, Josep; Travado, Luzia; Verheij, Marcel; Voest, Emile; Vokes, Everett; Von Roenn, Jamie; Weber, Jeffrey S; Wildiers, Hans; Yarden, Yosef

    2016-01-01

    The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) thanks to contribution of 64 ESMO-appointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to provide state-of-the-art cancer care to all patients wherever they live. Recent progress in the field of cancer research has indeed resulted in diagnostic and therapeutic innovations such as targeted therapies as a standard therapeutic approach or personalised cancer medicine apart from the revival of immunotherapy, requiring specialised training for medical oncology trainees. Thus, several new chapters on technical contents such as molecular pathology, translational research or molecular imaging and on conceptual attitudes towards human principles like genetic counselling or survivorship have been integrated in the GC. The GC edition 2016 consists of 12 sections with 17 subsections, 44 chapters and 35 subchapters, respectively. Besides renewal in its contents, the GC underwent a principal formal change taking into consideration modern didactic principles. It is presented in a template-based format that subcategorises the detailed outcome requirements into learning objectives, awareness, knowledge and skills. Consecutive steps will be those of harmonising and implementing teaching and assessment strategies. PMID:27843641

  2. The patient-centered medical home in oncology: from concept to reality.

    PubMed

    Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

    2015-01-01

    In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future.

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

    PubMed

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

    2017-08-01

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

  4. Evaluation of Internet-based oncologic teaching for medical students.

    PubMed

    Mehta, M P; Sinha, P; Kanwar, K; Inman, A; Albanese, M; Fahl, W

    1998-01-01

    Electronic tools with substantial educational applications are now widely available. In a prospective, randomized study, the value of Web-based educational tools for teaching second-year medical students was evaluated. The 35-hour, image-intensive multifaculty neoplasia course was selected for the experiment, with 103 students assigned to the control group (C) and 61 to the experimental group (E). Representative password-controlled multimedia course modules, accessible via the Internet, were developed. The E cohort was exposed to both classroom and Web-aided materials, whereas the C group had access to the Web modules only after the experiment was concluded (but before the final examination). Pre- and post-exposure questionnaires assessed computer knowledge, familiarity with the Internet, availability of computer access, and the value of Web-based education for both cohorts. Additionally, pre-and post-exposure tests were administered to both cohorts based on educational materials presented in the Web modules. The overall participation rate was 64% (E = 69%; C = 60%). The post-test showed no major performance difference between the two groups. The questionnaires revealed that: less than 1% of the students had not accessed the Internet previously; less than 5% had not used the Internet for medical education before; 34% felt that computer resources on campus were inadequate; and over 75% found Web-based education to be an important additional educational resource. The major negative aspect was the slow pace of data transfer for modem-based home access. Only 1% of students felt that Web-based education could completely replace traditional teaching. The potential for incorporating Web-based education in the medical curriculum is considerable.

  5. Career opportunities and benefits for young oncologists in the European Society for Medical Oncology (ESMO)

    PubMed Central

    Morgan, Gilberto; Lambertini, Matteo; Kourie, Hampig Raphael; Amaral, Teresa; Argiles, Guillem; Banerjee, Susana; Cardone, Claudia; Corral, Jesus; De Mattos-Arruda, Letticia; Öztürk, Akif; Petrova, Mila; Poulsen, Laurids; Strijbos, Michiel; Tyulyandina, Alexandra; Vidra, Radu; Califano, Raffaele; de Azambuja, Evandro; Garrido Lopez, Pilar; Guarneri, Valentina; Reck, Martin; Moiseyenko, Vladimir; Martinelli, Erika; Douillard, Jean-Yves; Stahel, Rolf; Voest, Emile; Arnold, Dirk; Cardoso, Fatima; Casali, Paolo; Cervantes, Andrés; Eggermont, Alexander M M; Eniu, Alexandru; Jassem, Jacek; Pentheroudakis, George; Peters, Solange; McGregor, Keith; Rauh, Stefan; Zielinski, Christoph C; Ciardiello, Fortunato; Tabernero, Josep; Preusser, Matthias

    2016-01-01

    The European Society for Medical Oncology (ESMO) is one of the leading societies of oncology professionals in the world. Approximately 30% of the 13 000 ESMO members are below the age of 40 and thus meet the society's definition of young oncologists (YOs). ESMO has identified the training and development of YOs as a priority and has therefore established a comprehensive career development programme. This includes a leadership development programme to help identify and develop the future leaders in oncology. Well-trained and highly motivated future generations of multidisciplinary oncologists are essential to ensure the optimal evolution of the field of oncology with the ultimate goal of providing the best possible care to patients with cancer. ESMO's career development portfolio is managed and continuously optimised by several dedicated committees composed of ESMO officers and is directly supervised by the ESMO Executive Board and the ESMO President. It offers unique resources for YOs at all stages of training and includes a broad variety of fellowship opportunities, educational courses, scientific meetings, publications and resources. In this article, we provide an overview of the activities and career development opportunities provided by ESMO to the next generation of oncologists. PMID:28255451

  6. Career opportunities and benefits for young oncologists in the European Society for Medical Oncology (ESMO).

    PubMed

    Morgan, Gilberto; Lambertini, Matteo; Kourie, Hampig Raphael; Amaral, Teresa; Argiles, Guillem; Banerjee, Susana; Cardone, Claudia; Corral, Jesus; De Mattos-Arruda, Letticia; Öztürk, Akif; Petrova, Mila; Poulsen, Laurids; Strijbos, Michiel; Tyulyandina, Alexandra; Vidra, Radu; Califano, Raffaele; de Azambuja, Evandro; Garrido Lopez, Pilar; Guarneri, Valentina; Reck, Martin; Moiseyenko, Vladimir; Martinelli, Erika; Douillard, Jean-Yves; Stahel, Rolf; Voest, Emile; Arnold, Dirk; Cardoso, Fatima; Casali, Paolo; Cervantes, Andrés; Eggermont, Alexander M M; Eniu, Alexandru; Jassem, Jacek; Pentheroudakis, George; Peters, Solange; McGregor, Keith; Rauh, Stefan; Zielinski, Christoph C; Ciardiello, Fortunato; Tabernero, Josep; Preusser, Matthias

    2016-01-01

    The European Society for Medical Oncology (ESMO) is one of the leading societies of oncology professionals in the world. Approximately 30% of the 13 000 ESMO members are below the age of 40 and thus meet the society's definition of young oncologists (YOs). ESMO has identified the training and development of YOs as a priority and has therefore established a comprehensive career development programme. This includes a leadership development programme to help identify and develop the future leaders in oncology. Well-trained and highly motivated future generations of multidisciplinary oncologists are essential to ensure the optimal evolution of the field of oncology with the ultimate goal of providing the best possible care to patients with cancer. ESMO's career development portfolio is managed and continuously optimised by several dedicated committees composed of ESMO officers and is directly supervised by the ESMO Executive Board and the ESMO President. It offers unique resources for YOs at all stages of training and includes a broad variety of fellowship opportunities, educational courses, scientific meetings, publications and resources. In this article, we provide an overview of the activities and career development opportunities provided by ESMO to the next generation of oncologists.

  7. Basic Training Program for Emergency Medical Technician Ambulance: Course Guide.

    ERIC Educational Resources Information Center

    Fucigna, Joseph T.; And Others

    In an effort to upgrade or further develop the skills levels of all individuals involved in the emergency medical care service, this training program was developed for the National Highway Safety Bureau. This specific course is an attempt to organize, conduct, and standardize a basic training course for emergency medical technicians (EMTs). The…

  8. Basic science right, not basic science lite: medical education at a crossroad.

    PubMed

    Fincher, Ruth-Marie E; Wallach, Paul M; Richardson, W Scott

    2009-11-01

    This perspective is a counterpoint to Dr. Brass' article, Basic biomedical sciences and the future of medical education: implications for internal medicine. The authors review development of the US medical education system as an introduction to a discussion of Dr. Brass' perspectives. The authors agree that sound scientific foundations and skill in critical thinking are important and that effective educational strategies to improve foundational science education should be implemented. Unfortunately, many students do not perceive the relevance of basic science education to clinical practice.The authors cite areas of disagreement. They believe it is unlikely that the importance of basic sciences will be diminished by contemporary directions in medical education and planned modifications of USMLE. Graduates' diminished interest in internal medicine is unlikely from changes in basic science education.Thoughtful changes in education provide the opportunity to improve understanding of fundamental sciences, the process of scientific inquiry, and translation of that knowledge to clinical practice.

  9. Analysis and practical use: the Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services--round II.

    PubMed

    Mills, Michael D

    2005-09-01

    The initial Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services was published in October 1995. That study measured qualified medical physicist (QMP) work associated only with routine radiation oncology procedures. In the intervening years, medical physics practice has changed dramatically. Three-dimensional treatment planning, once considered a special procedure, is the standard of care for many patient presentations. Prostate seed brachytherapy, stereotactic procedures, and intensity-modulated radiation therapy now constitute a large portion of the time medical physicists devote to clinical duties. Special procedures now dominate radiation oncology, leading to the request for an updated work and staffing study for qualified medical physicists. The updated Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services: Round II was published in June 2003. Round II measures and reports QMP work associated with both routine and most contemporary special procedures. Additionally, staffing patterns are reported for a variety of practice settings. A work model is created to allow medical physicists to defend QMP work on the basis of both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The work and cost justification models may in turn be used to defend medical physicist staffing and compensation. The updated Abt study empowers medical physicists to negotiate service or employment contracts with providers on the basis of measured national QMP work force and staffing data.

  10. European Society for Medical Oncology (ESMO) Program for the integration of oncology and Palliative Care: a 5-year review of the Designated Centers' incentive program.

    PubMed

    Cherny, N; Catane, R; Schrijvers, D; Kloke, M; Strasser, F

    2010-02-01

    In 1999, the National Representatives of European Society for Medical Oncology (ESMO) created a Palliative Care Working Group to improve the delivery of supportive and palliative care (S + PC) by oncologists, oncology departments and cancer centers. They have addressed this task through initiatives in policy, education, research and incentives. As an incentive program for oncology departments and centers, ESMO developed a program of Designated Centers (DCs) for programs meeting predetermined targets of service development and delivery of a high level of S + PC. The history, accreditation criteria and implementation of the DC incentive program is described. Since 2004, 75 centers have applied for designation and 48 have been accredited including 34 comprehensive cancer centers (CCCs) in general hospitals and seven freestanding CCCs. Perceived benefits accrued from the accreditation included the following: improved status and role identification of the center, positive impact on daily work, positive impact on business activity and positive impact on funding for projects. The accreditation of DCs has been a central to the ESMO initiative to improve the palliative care provided by oncologists and oncology centers. It is likely that many other oncology departments and cancer centers already meet the criteria and ESMO strongly encourages them to apply for accreditation.

  11. "Green Oncology": the Italian medical oncologists' challenge to reduce the ecological impact of their clinical activity.

    PubMed

    Bretti, Sergio; Porcile, Gianfranco; Romizi, Roberto; Palazzo, Salvatore; Oliani, Cristina; Crispino, Sergio; Labianca, Roberto

    2014-01-01

    For decades Western medicine has followed a biomedical model based on linear thinking and an individualized, disease-oriented doctor-patient relationship. Today this framework must be replaced by a biopsychosocial model based on complexity theory and a person-oriented medical team-patient relationship, taking into account the psychological and social determinants of health and disease. However, the new model is already proving no longer adequate or appropriate, and current events are urging us to develop an ecological model in which the medical team takes into account both individual illness and population health as a whole, since we are all part of the biosphere. In recent years, the rising costs of cancer treatment have raised a serious issue of economic sustainability. As the population of our planet, we now need to rapidly address this issue, and everyone of us must try to reduce their ecological footprint, measured as CO2 production. Medical oncologists need to reduce the ecological footprint of their professional activity by lowering the consumption of economic resources and avoiding environmental damage as much as possible. This new paradigm is endorsed by the Italian College of Hospital Medical Oncology Directors (CIPOMO). A working group of this organization has drafted the "Green Oncology Position Paper": a proposal of Italian medical oncology (in accordance with international guidelines) that oncologists, while aiming for the same end results, make a commitment toward the more appropriate management of health care and the careful use of resources in order to protect the environment and the ecosphere during the daily exercise of their professional activities.

  12. An assessment of radiation oncology medical physicists' perspectives on undertaking research.

    PubMed

    Ebert, Martin A; Halkett, Georgia K B; Berg, Melissa; Cutt, David; Davis, Michael; Hegney, Desley; House, Michael; Krawiec, Michele; Kearvell, Rachel; Lester, Leanne; Maresse, Sharon; McLoone, Peter; McKay, Jan

    2017-03-01

    As part of a study of the radiation oncology workforce, radiation oncology medical physicists (ROMPs) who had worked in Australia were surveyed regarding their attitudes to participating in research. Responses from 88 ROMPs were available for analysis, representing a broad mix of employment situations and research experience. Greater than 70% of ROMPs described their involvement in research as "liking it" or "loving it", with associated identified benefits including skills development, job satisfaction and career progression. Over half of respondents agreed that involvement in research inspired them to stay in their profession. However, lack of time, support and motivation were all identified as barriers to participation in research. Areas of research interest were identified. This study highlights the importance of a research culture for job satisfaction and staff retention.

  13. Pre-internship Nigerian medical graduates lack basic musculoskeletal competency.

    PubMed

    Nottidge, Timothy Eyo; Ekrikpo, Udeme; Ifesanya, Adeleke Olusegun; Nnabuko, Richard E; Dim, Edwin Maduakonam; Udoinyang, Clement Inyang

    2012-04-01

    Our aim was to assess the basic musculoskeletal competency of pre-internship graduates from Nigerian medical schools. We administered the Freedman and Bernstein basic musculoskeletal competency examination to 113 pre-internship graduates from seven Nigerian medical schools over a three year period from 2008 to 2010 at the University of Uyo Teaching Hospital. Five specialist residents took the examination to test criteria relevance. All graduates failed this test, obtaining scores ranging from 7% to 67%. The duration of the orthopaedic posting, and observation of operative fracture fixation, were not significant determinants of the score. The two final-year specialist residents each had a marginal pass in the examination. Basic musculoskeletal competency among pre-internship Nigerian medical-school graduates is inadequate.

  14. [Basic principles of computational chemistry for medical biologists].

    PubMed

    Ivanov, A S

    2005-01-01

    The lecture describes the basic principles of computational chemistry underlying the methods of molecular modelling used in bioinformatics area. The basic positions, methods of molecular and quantum mechanics and combined approaches are considered. This lecture is from theoretical cycle "Bioinformatics and Computer-Aided Drug Design" for fourth year students of Medico-Biological Department of Russian State Medical University (specialty--biochemistry, biophysics and medical cybernetics). It can also be advised for all students and post-graduate students of medico-biological specialties.

  15. Hereditary Colorectal Cancer Syndromes: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guidelines

    PubMed Central

    Stoffel, Elena M.; Mangu, Pamela B.; Gruber, Stephen B.; Hamilton, Stanley R.; Kalady, Matthew F.; Lau, Michelle Wan Yee; Lu, Karen H.; Roach, Nancy; Limburg, Paul J.

    2015-01-01

    Purpose To provide recommendations on prevention, screening, genetics, treatment, and management for people at risk for hereditary colorectal cancer (CRC) syndromes. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. Methods The Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guideline published in 2013 on behalf of the European Society for Medical Oncology (ESMO) Guidelines Working Group in Annals of Oncology was reviewed for developmental rigor by methodologists, with content and recommendations reviewed by an ASCO endorsement panel. Results The ASCO endorsement panel determined that the recommendations of the ESMO guidelines are clear, thorough, and based on the most relevant scientific evidence. The ASCO panel endorsed the ESMO guidelines and added a few qualifying statements. Recommendations Approximately 5% to 6% of patient cases of CRC are associated with germline mutations that confer an inherited predisposition for cancer. The possibility of a hereditary cancer syndrome should be assessed for every patient at the time of CRC diagnosis. A diagnosis of Lynch syndrome, familial adenomatous polyposis, or another genetic syndrome can influence clinical management for patients with CRC and their family members. Screening for hereditary cancer syndromes in patients with CRC should include review of personal and family histories and testing of tumors for DNA mismatch repair deficiency and/or microsatellite instability. Formal genetic evaluation is recommended for individuals who meet defined criteria. PMID:25452455

  16. Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology.

    PubMed

    Limkin, E J; Sun, R; Dercle, L; Zacharaki, E I; Robert, C; Reuzé, S; Schernberg, A; Paragios, N; Deutsch, E; Ferté, C

    2017-06-01

    Medical image processing and analysis (also known as Radiomics) is a rapidly growing discipline that maps digital medical images into quantitative data, with the end goal of generating imaging biomarkers as decision support tools for clinical practice. The use of imaging data from routine clinical work-up has tremendous potential in improving cancer care by heightening understanding of tumor biology and aiding in the implementation of precision medicine. As a noninvasive method of assessing the tumor and its microenvironment in their entirety, radiomics allows the evaluation and monitoring of tumor characteristics such as temporal and spatial heterogeneity. One can observe a rapid increase in the number of computational medical imaging publications-milestones that have highlighted the utility of imaging biomarkers in oncology. Nevertheless, the use of radiomics as clinical biomarkers still necessitates amelioration and standardization in order to achieve routine clinical adoption. This Review addresses the critical issues to ensure the proper development of radiomics as a biomarker and facilitate its implementation in clinical practice. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Medical waste management at the Oncology Institute of Vojvodina: possibilities of successful implementation of medical waste regulation in Serbia.

    PubMed

    Gavrancic, Tatjana; Simic, Aleksandar; Gavrancic, Brane

    2012-06-01

    Implementation of National waste management strategy, which included most of Healthcare facilities (HCF) in Serbia, began in 2009. The present study aimed to evaluate the medical waste management strategy protocol at Oncology Institute of Vojvodina, which is the first institution in Vojvodina and one of the first institutions in Serbia which has implemented the recomended medical waste management protocol. Segregation, storage, transportation and treatment were all evaluated and that was all performed according to National strategy. Biohazard generation rate was 0,17 kg/bed/day, which correspods with values in the HCF in Eastern Europe. The results show that the methods for safe management of medical waste are acceptable, affordable, and economically justifable to accomplish the reduction in the financial costs in HCF business, and can serve as representative of proper medical waste management practice for other HCF.

  18. Basic skills for outpatient surgery in medical graduation.

    PubMed

    Purim, Kátia Sheylla Malta; Skinovsky, James; Fernandes, Júlio Wilson

    2015-01-01

    Medical students must have domain of basic surgery skills before starting more advanced stages of surgical learning. The authors present a practical and reproducible system of operative techniques circuit, idealized and often applied to the fourth year medical students of a private educational institution. This method has enabled accurate assessment of students' skills, improving their performance and preparing them for more advanced stages of the surgical learning.

  19. Utilization patterns for oral oncology medications in a specialty pharmacy cycle management program.

    PubMed

    Deutsch, Sarah; Koerner, Pamela; Miller, Richard T; Craft, Zoie; Fancher, Karen

    2016-02-01

    The cycle management program (CMP) was implemented in 2008 at a national specialty pharmacy with a focus on providing specialized counseling and monitoring for patients on select oral oncology medications. The program now includes nine medications: bexarotene, dasatinib, erlotinib, everolimus, nilotinib, pazopanib, sorafenib, sunitinib, and vorinostat. Patients receive frequent assessments to encourage adherence, identify adverse events, and track discontinuations through a pharmacist outreach at the initiation of therapy, day 10 and 20 of the first month, then monthly thereafter. The use of oral agents is increasing in cancer patients, shifting away from regimens exclusively involving intravenous chemotherapy. This offers advantages for patients in terms of convenience, but introduces risk as patients become more responsible for the administration and monitoring of the medications. To evaluate utilization patterns of the oral oncology medications in the CMP including adverse event occurrence, medication discontinuations, and adherence markers. This study is a retrospective review of patient-reported data from the CMP assessments completed in 2013. Data collected include adverse events and grades, adherence markers, and discontinuation rates. A total of 1163 assessments were reviewed from 557 patients. The assessments included in the analysis were the initial assessment, 10-day assessment, 20-day assessment, and the first monthly follow-up assessment, which encompasses the first two months of therapy. A total of 1453 adverse events were reported. Adverse events were cited as the reason for 39% of discontinuations and 28% of missed/held doses. A total of 101 discontinuations were reported across the nine CMP medications based on the first two months of data. Missed or held doses were reported in 130 assessments. Patient engagement and pharmacist interventions, through programs such as the CMP, are important to help patients manage these complex, high

  20. A focused curriculum in surgical oncology for the third-year medical students.

    PubMed

    Wisniewski, William R; Fournier, Keith F; Ling, Yan K; Slack, Rebecca S; Babiera, Gildy; Grubbs, Elizabeth G; Moore, Laura J; Fleming, Jason B; You, Y Nancy

    2013-12-01

    Educating medical students in surgical subspecialty fields can be challenging, and the optimal timing and curriculum remain unknown. Despite advocacy for earlier exposure, competing core clerkship rotations often leave little time for subspecialty fields. We report our experience with a novel, short, and focused curriculum in surgical oncology for the third-year medical students. A 2-wk (2009-2010) and a 4-wk (2010-2011) curriculum in surgical oncology were developed for the third-year students at a tertiary-referral cancer center, including formal didactics, rotation in clinical service of students' choosing (breast, gastrointestinal, endocrine, or melanoma), and case-based learning and presentation. Paired pre- and postrotation questionnaires were prospectively completed, including 20 items assessing knowledge and four items assessing experience. Grading was anonymous, and change in score was assessed by Wilcoxon signed-rank test. Paired questionnaires from 47 students (2-wk rotation, n = 26; 4-wk rotation, n = 21) showed a median improvement of three points (21.4%) from pre- to posttests (P < 0.001). The improvement did not differ by the length of rotation or by the specific clinical service. Nearly all (93%) reported a positive and inspiring experience. The most valuable avenue of learning was reported as the time spent with resident or fellow or attending (92%), followed by self-directed reading (62%) and didactic lectures (28%). A short and focused curriculum in surgical oncology, including structured didactics and clinical rotation, had positive impact for the third-year students. Given the increasing work-hour limits, it is important to note that the time spent in the clinical setting continues to be ranked as the most educationally valuable by medical students. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Social Media Use Among Physicians and Trainees: Results of a National Medical Oncology Physician Survey.

    PubMed

    Adilman, Rachel; Rajmohan, Yanchini; Brooks, Edward; Urgoiti, Gloria Roldan; Chung, Caroline; Hammad, Nazik; Trinkaus, Martina; Naseem, Madiha; Simmons, Christine; Adilman, Rachel; Rajmohan, Yanchini; Brooks, Edward; Roldan Urgoiti, Gloria; Chung, Caroline; Hammad, Nazik; Trinkaus, Martina; Naseem, Madiha; Simmons, Christine

    2016-01-01

    Cancer management requires coordinated care from many health care providers, and its complexity requires physicians be up to date on current research. Web-based social media support physician collaboration and information sharing, but the extent to which physicians use social media for these purposes remains unknown. The complex field of oncology will benefit from increased use of online social media to enhance physician communication, education, and mentorship. To facilitate this, patterns of social media use among oncologists must be better understood. A nine-item survey investigating physician social media use, designed using online survey software, was distributed via e-mail to 680 oncology physicians and physicians in training in Canada. Responses were analyzed using descriptive statistics. A total of 207 responses (30%) were received; 72% of respondents reported using social media. Social media use was highest, at 93%, in respondents age 25 to 34 years and lowest, at 39%, in those age 45 to 54 years. This demonstrates a significant gap in social media use between younger users and mid- to late-career users. The main barrier to use was lack of free time. The identified gap in social media use between age cohorts may have negative implications for communication in oncology. Despite advancements in social media and efforts to integrate social media into medical education, most oncologists and trainees use social media rarely, which, along with the age-related gap in use, may have consequences for collaboration and education in oncology. Investigations to further understand barriers to social media use should be undertaken to enhance physician collaboration and knowledge sharing through social media.

  2. AFOMP POLICY STATEMENT No. 2: recommended clinical radiation oncology medical physicist staffing levels in AFOMP countries.

    PubMed

    Round, W H; Tay, Y K; Ng, K H; Cheung, K Y; Fukuda, S; Han, Y; Huang, Y X; Kim, H J; Krisanachinda, A; Liu, H L

    2010-03-01

    This document is the second of a series of policy statements being issued by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP). The document was developed by the AFOMP Professional Development Committee (PDC) and was released by the AFOMP Council in 2009. The main purpose of the document is to give guidance as to how many medical physicists are required to staff a radiation oncology department. Strict guidelines are difficult to define as work practices vary from country-to-country and from hospital-to-hospital. A calculation scheme is presented to aid in estimating medical physics staffing requirements that is primarily based on equipment levels and patient numbers but also with allowances for staff training, professional development and leave requirements.

  3. [Patient-centered care. Improvement of communication between university medical centers and general practitioners for patients in neuro-oncology].

    PubMed

    Renovanz, M; Keric, N; Richter, C; Gutenberg, A; Giese, A

    2015-12-01

    Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular. Questionnaires were sent to1000 GPs and the response rate was 15 %. The mean scored evaluation of the university medical center in general was 2.62 and of the neuro-oncological outpatient clinic 2.28 (range 1-6). The most often mentioned issues to be improved were easier/early telephone information (44 %) and a constantly available contact person (49 %). Interestingly, > 60 % of the GPs indicated they would support web-based tumor boards for interdisciplinary and palliative neuro-oncological care. As interdisciplinary care for neuro-oncology patients is an essential part of therapy, improvement of communication between GPs and university medical centers is indispensable. Integrating currently available electronic platforms under data protection aspects into neuro-oncological palliative care could be an interesting tool in order to establish healthcare networks and could find acceptance with GPs.

  4. Demand for voluntary basic medical insurance in urban China: panel evidence from the Urban Resident Basic Medical Insurance scheme.

    PubMed

    Chen, Gang; Yan, Xiao

    2012-12-01

    This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Two waves of longitudinal household survey data are used, and a three-level random-intercept logit model is used for the analysis. Two different sets of explanatory variables were identified for adults and children, separately. Results suggest for both the adult and the child samples that income, health status, age and health risk behaviours are key influencing factors for basic medical insurance demand. The household head's characteristics are also significantly related to other household members' medical insurance demands. Specifically, household heads who are more educated or retired are more likely to purchase medical insurance for their children. These findings suggest that an expansion of the special subsidy to the poor or, probably more important, a risk-adjusted benefit package may be needed for voluntary basic medical insurance in China. In addition, adverse selection consistently exists and is a major challenge for the sustainability of medical insurance financing. To expand insurance coverage for children, especially those under school age, special efforts (possibly through health education or health promotion) should be focused on the household head, particularly those engaging in risky health behaviours.

  5. Japanese medical students' interest in basic sciences: a questionnaire survey of a medical school in Japan.

    PubMed

    Yamazaki, Yuka; Uka, Takanori; Shimizu, Haruhiko; Miyahira, Akira; Sakai, Tatsuo; Marui, Eiji

    2013-02-01

    The number of physicians engaged in basic sciences and teaching is sharply decreasing in Japan. To alleviate this shortage, central government has increased the quota of medical students entering the field. This study investigated medical students' interest in basic sciences in efforts to recruit talent. A questionnaire distributed to 501 medical students in years 2 to 6 of Juntendo University School of Medicine inquired about sex, grade, interest in basic sciences, interest in research, career path as a basic science physician, faculties' efforts to encourage students to conduct research, increases in the number of lectures, and practical training sessions on research. Associations between interest in basic sciences and other variables were examined using χ(2) tests. From among the 269 medical students (171 female) who returned the questionnaire (response rate 53.7%), 24.5% of respondents were interested in basic sciences and half of them considered basic sciences as their future career. Obstacles to this career were their original aim to become a clinician and concerns about salary. Medical students who were likely to be interested in basic sciences were fifth- and sixth-year students, were interested in research, considered basic sciences as their future career, considered faculties were making efforts to encourage medical students to conduct research, and wanted more research-related lectures. Improving physicians' salaries in basic sciences is important for securing talent. Moreover, offering continuous opportunities for medical students to experience research and encouraging advanced-year students during and after bedside learning to engage in basic sciences are important for recruiting talent.

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

    PubMed

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

    2015-02-01

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

  7. Medical Knowledge Assessment by Hematology and Medical Oncology In-Training Examinations Are Better Than Program Director Assessments at Predicting Subspecialty Certification Examination Performance.

    PubMed

    Collichio, Frances A; Hess, Brian J; Muchmore, Elaine A; Duhigg, Lauren; Lipner, Rebecca S; Haist, Steven; Hawley, Janine L; Morrison, Carol A; Clayton, Charles P; Raymond, Marilyn J; Kayoumi, Karen M; Gitlin, Scott D

    2017-09-01

    The Accreditation Council for Graduate Medical Education's Next Accreditation System requires training programs to demonstrate that fellows are achieving competence in medical knowledge (MK), as part of a global assessment of clinical competency. Passing American Board of Internal Medicine (ABIM) certification examinations is recognized as a metric of MK competency. This study examines several in-training MK assessment approaches and their ability to predict performance on the ABIM Hematology or Medical Oncology Certification Examinations. Results of a Hematology In-Service Examination (ISE) and an Oncology In-Training Examination (ITE), program director (PD) ratings, demographic variables, United States Medical Licensing Examination (USMLE), and ABIM Internal Medicine (IM) Certification Examination were compared. Stepwise multiple regression and logistic regression analyses evaluated these assessment approaches as predictors of performance on the Hematology or Medical Oncology Certification Examinations. Hematology ISE scores were the strongest predictor of Hematology Certification Examination scores (β = 0.41) (passing odds ratio [OR], 1.012; 95 % confidence interval [CI], 1.008-1.015), and the Oncology ITE scores were the strongest predictor of Medical Oncology Certification Examination scores (β = 0.45) (passing OR, 1.013; 95 % CI, 1.011-1.016). PD rating of MK was the weakest predictor of Medical Oncology Certification Examination scores (β = 0.07) and was not significantly predictive of Hematology Certification Examination scores. Hematology and Oncology ITEs are better predictors of certification examination performance than PD ratings of MK, reinforcing the effectiveness of ITEs for competency-based assessment of MK.

  8. Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics.

    PubMed

    Studnek, Jonathan R

    2016-12-01

    The objective of this paper is to identify factors associated with compensation for Emergency Medical Technician (EMT)-Basics and Paramedics and assess whether these associations have changed over the period 1999-2008. Data obtained from the Longitudinal EMT Attributes and Demographic Study (LEADS) surveys, a mail survey of a random, stratified sample of nationally certified EMT-Basics and Paramedics, were analyzed. For the 1999-2003 period, analyses included all respondents providing Emergency Medical Services (EMS). With the addition of a survey in 2004 about volunteers, it was possible to exclude volunteers from these analyses. Over 60% of EMT-Basics reported being either compensated or noncompensated volunteers in the 2004-2008 period. This was substantially and significantly greater than the proportion of EMT-Paramedic volunteers (<25%). The EMT-Paramedics earned significantly more than EMT-Basics, with differentials of $11,000-$18,000 over the course of the study. The major source of earnings disparity was type of organization: respondents employed by fire-based EMS agencies reported significantly higher earnings than other respondents, at both the EMT-Basic and EMT-Paramedic levels. Males also earned significantly more than females, with annual earnings differentials ranging from $7,000 to $15,000. There are a number of factors associated with compensation disparities within the EMS profession. These include type of service (ie, fire-based vs. other types of agencies) and gender. The reasons for these disparities warrant further investigation. Studnek JR . Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s87-s95.

  9. The Impact of Curriculum Design in the Acquisition of Knowledge of Oncology: Comparison Among Four Medical Schools.

    PubMed

    Cecilio-Fernandes, Dario; Aalders, Wytze S; Bremers, André J A; Tio, René A; de Vries, Jakob

    2017-04-03

    Over the past 5 years, cancer has replaced coronary heart disease as the leading cause of death in the Netherlands. It is thus paramount that medical doctors acquire a knowledge of cancer, since most of them will face many patients with cancer. Studies, however, have indicated that there is a deficit in knowledge of oncology among medical students, which may be due not only to the content but also to the structure of the curriculum. In this study, we compared students' knowledge acquisition in four different undergraduate medical programs. Further, we investigated possible factors that might influence students' knowledge growth as related to oncology. The participants comprised 1440 medical students distributed over four universities in the Netherlands. To measure students' knowledge of oncology, we used their progress test results from 2007 to 2013. The progress test consists of 200 multiple-choice questions; this test is taken simultaneously four times a year by all students. All questions regarding oncology were selected. We first compared the growth of knowledge of oncology using mixed models. Then, we interviewed the oncology coordinator of each university to arrive at a better insight of each curriculum. Two schools showed similar patterns of knowledge growth, with a slight decrease in the growth rate for one of them in year 6. The third school had a faster initial growth with a faster decrease over time compared to other medical schools. The fourth school showed a steep decrease in knowledge growth during years 5 and 6. The interviews showed that the two higher-scoring schools had a more focused semester on oncology, whereas in the others, oncology was scattered throughout the curriculum. Furthermore, the absence of a pre-internship training program seemed to hinder knowledge growth in one school. Our findings suggest that curricula have an influence on students' knowledge acquisition. A focused semester on oncology and a pre-internship preparatory training

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

    PubMed

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

    2011-07-01

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

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

    PubMed Central

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

    2011-01-01

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

  12. Compulsory Licenses for Cancer Drugs: Does Circumventing Patent Rights Improve Access to Oncology Medications?

    PubMed Central

    Bognar, Cinthia Leite Frizzera Borges; Bychkovsky, Brittany L.

    2016-01-01

    Worldwide, there are enormous inequities in cancer control that cause poor outcomes among patients with cancer who live in low- and middle-income countries (LMICs). One of the biggest challenges that oncology faces today is how to increase patient access to expensive, but life-saving, therapies in LMICs. Access to cancer medications in LMICs is a major problem, especially in recent years, as the costs of these therapies continue to rise exponentially. One mechanism available to LMICs to improve access to cancer medications allows a country to pursue a compulsory license for a given drug. Here, we will review how the legal framework in the World Trade Organization's Trade-Related Aspects of Intellectual Property Rights Agreement and the Doha Declaration supports countries to circumvent patent laws and acquire compulsory licenses for essential medicines. We will also discuss the current and future role of compulsory licenses in oncology and how compulsory licenses may improve access to cancer drugs in LMICs. PMID:28717715

  13. Evaluation of the Theoretical Teaching of Postgraduate Radiation Oncology Medical Residents in France: a Cross-Sectional Study.

    PubMed

    Faivre, Jean-Christophe; Bibault, Jean-Emmanuel; Leroy, Thomas; Agopiantz, Mikaël; Salleron, Julia; Wack, Maxime; Janoray, Guillaume; Roché, Henri; Culine, Stéphane; Rivera, Sofia

    2017-01-30

    This study's purpose was to have residents evaluate Radiation Oncology (RO) theoretical teaching practices in France. An anonymous electronically cross-functional survey on theoretical teaching practices in the RO residents was conducted by (i) collecting data from residents in the medical faculties in France, (ii) comparing the data across practices when possible and (iii) suggesting means of improvement. A total of 103 out of 140 RO residents responded to the survey (73.5% response rate). National, inter-university, university and internships courses do not exist in 0% (0), 16.5% (17), 53.4% (55) and 40.8% (42) of residents, respectively. Residents need additional training due to the shortage of specialised postgraduate degree training (49.5% (51)), CV enhancement to obtain a post-internship position (49.5% (51)) or as part of a career plan (47.6% (49)). The topics covered in teaching to be improved were the following: basic concept 61.2% (63), advanced concept 61.2 (63) and discussion of frequent clinical cases 50.5% (52). The topics not covered in teaching to be improved were the following: the development of career (66.0% (68)), medical English (56.3% (58)), the organisation of RO speciality (49.5% (51)) and the hospital management of RO department (38.8% (40)). This is the first national assessment of theoretical teaching of RO residents in France.

  14. The Negative Impact of Stark Law Exemptions on Graduate Medical Education and Health Care Costs: The Example of Radiation Oncology

    SciTech Connect

    Anscher, Mitchell S.; Anscher, Barbara M.; Bradley, Cathy J.

    2010-04-15

    Purpose: To survey radiation oncology training programs to determine the impact of ownership of radiation oncology facilities by non-radiation oncologists on these training programs and to place these findings in a health policy context based on data from the literature. Methods and Materials: A survey was designed and e-mailed to directors of all 81 U.S. radiation oncology training programs in this country. Also, the medical and health economic literature was reviewed to determine the impact that ownership of radiation oncology facilities by non-radiation oncologists may have on patient care and health care costs. Prostate cancer treatment is used to illustrate the primary findings. Results: Seventy-three percent of the surveyed programs responded. Ownership of radiation oncology facilities by non-radiation oncologists is a widespread phenomenon. More than 50% of survey respondents reported the existence of these arrangements in their communities, with a resultant reduction in patient volumes 87% of the time. Twenty-seven percent of programs in communities with these business arrangements reported a negative impact on residency training as a result of decreased referrals to their centers. Furthermore, the literature suggests that ownership of radiation oncology facilities by non-radiation oncologists is associated with both increased utilization and increased costs but is not associated with increased access to services in traditionally underserved areas. Conclusions: Ownership of radiation oncology facilities by non-radiation oncologists appears to have a negative impact on residency training by shifting patients away from training programs and into community practices. In addition, the literature supports the conclusion that self-referral results in overutilization of expensive services without benefit to patients. As a result of these findings, recommendations are made to study further how physician ownership of radiation oncology facilities influence graduate

  15. The negative impact of stark law exemptions on graduate medical education and health care costs: the example of radiation oncology.

    PubMed

    Anscher, Mitchell S; Anscher, Barbara M; Bradley, Cathy J

    2010-04-01

    To survey radiation oncology training programs to determine the impact of ownership of radiation oncology facilities by non-radiation oncologists on these training programs and to place these findings in a health policy context based on data from the literature. A survey was designed and e-mailed to directors of all 81 U.S. radiation oncology training programs in this country. Also, the medical and health economic literature was reviewed to determine the impact that ownership of radiation oncology facilities by non-radiation oncologists may have on patient care and health care costs. Prostate cancer treatment is used to illustrate the primary findings. Seventy-three percent of the surveyed programs responded. Ownership of radiation oncology facilities by non-radiation oncologists is a widespread phenomenon. More than 50% of survey respondents reported the existence of these arrangements in their communities, with a resultant reduction in patient volumes 87% of the time. Twenty-seven percent of programs in communities with these business arrangements reported a negative impact on residency training as a result of decreased referrals to their centers. Furthermore, the literature suggests that ownership of radiation oncology facilities by non-radiation oncologists is associated with both increased utilization and increased costs but is not associated with increased access to services in traditionally underserved areas. Ownership of radiation oncology facilities by non-radiation oncologists appears to have a negative impact on residency training by shifting patients away from training programs and into community practices. In addition, the literature supports the conclusion that self-referral results in overutilization of expensive services without benefit to patients. As a result of these findings, recommendations are made to study further how physician ownership of radiation oncology facilities influence graduate medical education, treatment patterns and utilization

  16. Patient participation in the medical decision-making process in haemato-oncology--a qualitative study.

    PubMed

    Ernst, J; Berger, S; Weißflog, G; Schröder, C; Körner, A; Niederwieser, D; Brähler, E; Singer, S

    2013-09-01

    Cancer patients are showing increased interest in shared decision-making. Patients with haematological illnesses, however, express considerably less desire for shared decision-making as compared with other oncological patient groups. The goal of the current project was to identify the reasons for the lower desire for shared decision-making among patients with haematological illness. We conducted qualitative, semi-structured interviews with 11 haematological patients (39-70 years old) after the beginning of therapy concerning the course and evaluation of medical shared decision-making. The patients were often overwhelmed by the complexity of the illness and the therapy and did not want to assume any responsibility in medical decision-making. They reported a great deal of distress and very traditional paternalistic role expectations with regards to their health care providers, which limited the patients' ability to partake in the decision-making process. In contrast to the socio-cultural support for many other oncological diseases, haematological diseases are not as well supported, e.g. there is a lack of self-help materials, systematic provision of information and support groups for patients, which may be related to a lower empowerment of this patient population. Results show the limits of patient participation in the context of highly complicated medical conditions. In addition to already researched preferences of the physicians and patients for shared decision-making, future research should pay greater attention to the process and other variables relevant to this aspect of the doctor-patient relationship. © 2013 John Wiley & Sons Ltd.

  17. 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

  18. 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

  19. What Medical Oncologist Residents Think about the Italian Speciality Schools: A Survey of the Italian Association of Medical Oncology (AIOM) on Educational, Clinical and Research Activities.

    PubMed

    Moretti, Anna; Ghidini, Michele; De Angelis, Carmine; Lambertini, Matteo; Cremolini, Chiara; Imbimbo, Martina; Berardi, Rossana; Di Maio, Massimo; Cascinu, Stefano; La Verde, Nicla

    2016-01-01

    Relevant heterogeneity exists among Postgraduate Schools in Medical Oncology, also within the same country. In order to provide a comprehensive overview of the landscape of Italian Postgraduate Schools in Medical Oncology, the Italian Association of Medical Oncology (AIOM) undertook an online survey, inviting all the residents to describe their daily activities and to express their overall satisfaction about their programs. A team composed of five residents and three consultants in medical oncology prepared a 38 items questionnaire that was published online in a reserved section, accessible through a link sent by e-mail. Residents were invited to anonymously fill in the questionnaire that included the following sub-sections: quality of teaching, clinical and research activity, overall satisfaction. Three-hundred and eleven (57%) out of 547 invited residents filled in the questionnaire. Two-hundred and twenty-three (72%) participants declared that attending lessons was frequently difficult and 153 (49%) declared they did not gain substantial improvement in their knowledge from them. Fifty-five percent stated that they did not receive lessons on palliative care. Their overall judgment about didactic activity was low in 63% of the interviewed. The satisfaction for clinical activity was in 86% of cases good: 84% recognized that, during the training period, they acquired a progressive independence on patients' management. About research activity, the majority (79%) of participants in the survey was actively engaged in managing patients included in clinical trials but the satisfaction level for the involvement in research activities was quite low (54%). Overall, 246 residents (79%) gave a positive global judgment of their Medical Oncology Schools. The landscape of Italian Postgraduate Schools in Medical Oncology is quite heterogeneous across the country. Some improvements in the organization of teaching and in the access to research opportunity are needed; the perception

  20. What Medical Oncologist Residents Think about the Italian Speciality Schools: A Survey of the Italian Association of Medical Oncology (AIOM) on Educational, Clinical and Research Activities

    PubMed Central

    Moretti, Anna; De Angelis, Carmine; Lambertini, Matteo; Cremolini, Chiara; Imbimbo, Martina; Berardi, Rossana; Di Maio, Massimo; Cascinu, Stefano; La Verde, Nicla

    2016-01-01

    Background and objectives Relevant heterogeneity exists among Postgraduate Schools in Medical Oncology, also within the same country. In order to provide a comprehensive overview of the landscape of Italian Postgraduate Schools in Medical Oncology, the Italian Association of Medical Oncology (AIOM) undertook an online survey, inviting all the residents to describe their daily activities and to express their overall satisfaction about their programs. Methods A team composed of five residents and three consultants in medical oncology prepared a 38 items questionnaire that was published online in a reserved section, accessible through a link sent by e-mail. Residents were invited to anonymously fill in the questionnaire that included the following sub-sections: quality of teaching, clinical and research activity, overall satisfaction. Results Three-hundred and eleven (57%) out of 547 invited residents filled in the questionnaire. Two-hundred and twenty-three (72%) participants declared that attending lessons was frequently difficult and 153 (49%) declared they did not gain substantial improvement in their knowledge from them. Fifty-five percent stated that they did not receive lessons on palliative care. Their overall judgment about didactic activity was low in 63% of the interviewed. The satisfaction for clinical activity was in 86% of cases good: 84% recognized that, during the training period, they acquired a progressive independence on patients' management. About research activity, the majority (79%) of participants in the survey was actively engaged in managing patients included in clinical trials but the satisfaction level for the involvement in research activities was quite low (54%). Overall, 246 residents (79%) gave a positive global judgment of their Medical Oncology Schools. Conclusions The landscape of Italian Postgraduate Schools in Medical Oncology is quite heterogeneous across the country. Some improvements in the organization of teaching and in the

  1. [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.

  2. 78 FR 12762 - Joint Meeting of the Medical Imaging Drugs Advisory Committee and the Oncologic Drugs Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Joint Meeting of the Medical Imaging Drugs Advisory Committee and the Oncologic Drugs Advisory Committee; Notice of Meeting. AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a...

  3. 76 FR 59167 - Siemens Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ..., Concord, CA; Siemens Medical Solutions USA, Inc., Global Services/Supply Chain Management Including.../Supply Chain Management. These employees provided support for the supply of information technology...,158) and Siemens Medical Solutions USA, Inc., Global Services/Supply Chain Management, including...

  4. New Advanced Technologies to Provide Decentralised and Secure Access to Medical Records: Case Studies in Oncology

    PubMed Central

    Quantin, Catherine; Coatrieux, Gouenou; Allaert, François André; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

    2009-01-01

    The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology make it feasible to gain access to medical records anywhere and anytime, allowing the physician or the patient to gather information from an “ephemeral electronic patient record”. However, this easy access to data is accompanied by the requirement for improved security (confidentiality, traceability, integrity, ...) and this issue needs to be addressed. In this paper we propose and discuss a decentralised approach based on recent advances in information sharing and protection: Grid technologies and watermarking methodologies. The potential impact of these technologies for oncology is illustrated by the examples of two experimental cases: a cancer surveillance network and a radiotherapy treatment plan. It is expected that the proposed approach will constitute the basis of a future secure “google-like” access to medical records. PMID:19718446

  5. A Balint-inspired reflective forum in oncology for medical residents: main themes during seven years.

    PubMed

    Salander, Pär; Sandström, Maria

    2014-10-01

    Reflection groups for clinicians, often called Balint groups, are a way of refining professional competence in health care. This study presents a model for reflective practice in a group setting and describes the kinds of troublesome cases that medical residents are concerned about. From 2005 to 2012 a Balint-inspired reflective forum has been a part of the academic seminar program for physicians in training in a Department of Oncology at a Swedish university. The present study is focused on all 63 cases presented in the forum. The cases were categorized into three kinds of challenges: Communication challenges in the patient-physician relationship, Communication challenges in organizational matters, and Communication challenges with close relatives of the patient. The study tells us something about the vulnerability of being a medical resident and the identified challenges have bearings on medical education curricula as well as on how the training of junior physicians is organized. The cases are contextual and multifaceted, and a forum of this kind might therefore be regarded as a potential way to develop professional competence and to refine communication in clinical practice. A structured evaluation of the forum would be valuable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Attitude of Basic Science Medical Students Toward Interprofessional Collaboration.

    PubMed

    Shankar, P Ravi; Dwivedi, Neelam R; Nandy, Atanu; Balasubramanium, Ramanan

    2015-09-25

    Interprofessional collaboration (IPC) and interprofessional education (IPE) are increasingly emphasized in the education of health professions. Xavier University School of Medicine, a Caribbean medical school admits students from the United States, Canada, and other countries to the undergraduate medical course. The present study was carried out to obtain information about the attitude toward IPC among basic science medical students and note differences, if any, among different subgroups. The study was conducted among first to fifth semester students during July 2015 using the previously validated Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). Gender, age, semester, and nationality were noted. Participants' agreement with a set of 20 statements was studied. Mean total scores, working relationship, and accountability scores were calculated and compared among different subgroups of respondents (p<0.05). Sixty-seven of the 71 students (94.4%) participated. Cronbach's alpha value of the questionnaire was 0.827, indicating good internal consistency. The mean total score was 104.48 (maximum score 140) while the working relationship and accountability scores were 63.51 (maximum score 84) and 40.97 (maximum score 56), respectively. Total scores were significantly higher among third-semester students and students of Canadian nationality. Working relationship and accountability scores were higher among first and third-semester students. The total working relationship and accountability scores were lower compared to those obtained in a previous study. Opportunities for IPE and IPC during the basic science years should be strengthened. Longitudinal studies in the institution may be helpful. Similar studies in other Caribbean medical schools are required.

  7. Attitude of Basic Science Medical Students Toward Interprofessional Collaboration

    PubMed Central

    Dwivedi, Neelam R; Nandy, Atanu; Balasubramanium, Ramanan

    2015-01-01

    Purpose: Interprofessional collaboration (IPC) and interprofessional education (IPE) are increasingly emphasized in the education of health professions. Xavier University School of Medicine, a Caribbean medical school admits students from the United States, Canada, and other countries to the undergraduate medical course. The present study was carried out to obtain information about the attitude toward IPC among basic science medical students and note differences, if any, among different subgroups. Methods: The study was conducted among first to fifth semester students during July 2015 using the previously validated Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). Gender, age, semester, and nationality were noted. Participants’ agreement with a set of 20 statements was studied. Mean total scores, working relationship, and accountability scores were calculated and compared among different subgroups of respondents (p<0.05). Results: Sixty-seven of the 71 students (94.4%) participated. Cronbach’s alpha value of the questionnaire was 0.827, indicating good internal consistency. The mean total score was 104.48 (maximum score 140) while the working relationship and accountability scores were 63.51 (maximum score 84) and 40.97 (maximum score 56), respectively. Total scores were significantly higher among third-semester students and students of Canadian nationality. Working relationship and accountability scores were higher among first and third-semester students. Conclusion: The total working relationship and accountability scores were lower compared to those obtained in a previous study. Opportunities for IPE and IPC during the basic science years should be strengthened. Longitudinal studies in the institution may be helpful. Similar studies in other Caribbean medical schools are required. PMID:26543691

  8. [Basic assessment of trust level in medical apparatus and instruments sales systems by medical organization].

    PubMed

    Ge, Y; Wang, M; Li, X J

    2001-03-01

    Purchase of medical apparatus and instruments is a strict work of taking the patient as a consuming objection. To analyze the trust level in medical apparatus and instruments sales systems and to set up the method of trust level assessment before the purchase, is an important link of ensuring the reality of medical products and consumerism. According to the principle mentioned about, the present article analyses the basic content of assessing factors and their inter-relationship, summarizes their expressions, studies and sets up the mathematical modal and it method. All these are of some value to medical organization in choosing factory owners and their products while the purchasing.

  9. Biosimilars: a position paper of the European Society for Medical Oncology, with particular reference to oncology prescribers.

    PubMed

    Tabernero, Josep; Vyas, Malvika; Giuliani, Rosa; Arnold, Dirk; Cardoso, Fatima; Casali, Paolo G; Cervantes, Andres; Eggermont, Alexander Mm; Eniu, Alexandru; Jassem, Jacek; Pentheroudakis, George; Peters, Solange; Rauh, Stefan; Zielinski, Christoph C; Stahel, Rolf A; Voest, Emile; Douillard, Jean-Yves; McGregor, Keith; Ciardiello, Fortunato

    2016-01-01

    Biosimilars present a necessary and timely opportunity for physicians, patients and healthcare systems. If suitably developed clinically, manufactured to the correct standards and used appropriately, they can positively impact on the financial sustainability of healthcare systems. A critical consideration regarding the introduction of biosimilars into the clinic centres on the required information concerning all the respective procedures. This position paper aims to describe the issues revolving around biosimilars that are relevant to the field of oncology, especially the prescribers. More specifically, we discuss aspects related to definition, forms of biosimilars, labelling, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, responsibilities among prescribers and pharmacists, potential impact on financial burden in healthcare and the current scenario and future prospects of biosimilars in Europe and the rest of the world.

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

    SciTech Connect

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

    2014-01-01

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

  11. Oncological outcomes of metastatic testicular cancers under centralized management through regional medical network.

    PubMed

    Inai, Hiromu; Kawai, Koji; Kojima, Takahiro; Joraku, Akira; Shimazui, Toru; Yamauchi, Atsushi; Miyagawa, Tomoaki; Endo, Tsuyoshi; Fukuhara, Yoshiharu; Miyazaki, Jun; Uchida, Katsunori; Nishiyama, Hiroyuki

    2013-12-01

    To investigate the dose intensity of induction chemotherapy and oncological outcomes of metastatic testicular cancer under centralized management through a regional medical network. We retrospectively analyzed the outcomes of 86 metastatic testicular cancer patients who were given induction chemotherapy at Tsukuba University Hospital and four branch hospitals between January 2000 and November 2010. Principally, management of patients with poor-prognosis disease and patients having risk factors for bleomycin, etoposide and cisplatin were referred to Tsukuba University Hospital before chemotherapy. For high-risk groups, etoposide and cisplatin or etoposide, ifosfamide and cisplatin was used as an alternative to bleomycin, etoposide and cisplatin. Overall, 56 and 30 patients were treated at Tsukuba University Hospital and branch hospitals, respectively. Forty-seven, 18 and 21 patients were classified with good-, intermediate- and poor-prognosis disease, respectively, according to the International Germ Cell Cancer Collaborative Group criteria. Eighteen of the 21 patients (86%) with poor-prognosis disease were treated at Tsukuba University Hospital from the beginning of induction chemotherapy. Induction chemotherapy with a high relative dose intensity was possible in most patients. The average relative dose intensity of each drug was >0.96. Treatment procedures other than induction chemotherapy were efficiently centralized; 74% of post-chemotherapy surgery and all second-line or subsequent chemotherapies were performed at Tsukuba University Hospital. The 5-year overall survival rates of the good-, intermediate- and poor-prognosis groups were 97, 93 and 84%, respectively. Induction chemotherapy with high relative dose intensity, post-chemotherapy surgery and salvage chemotherapy was accomplished efficiently through centralization of management. Oncological outcomes were excellent, especially in patients with poor-prognosis disease, whose 5-year OS reached 84%.

  12. The Oncologic Safety of Breast Fat Grafting and Contradictions Between Basic Science and Clinical Studies: A Systematic Review of the Recent Literature.

    PubMed

    Charvet, Heath J; Orbay, Hakan; Wong, Michael S; Sahar, David E

    2015-10-01

    Fat grafting is increasingly popular and is becoming a common practice in plastic surgery for postmastectomy breast reconstruction and aesthetic breast augmentation; however, concerns over the oncologic safety remains a controversial and hot topic among scientists and surgeons. Basic science and laboratory research repeatedly show a potentially dangerous effect of adipose-derived stem cells on breast cancer cells; however, clinical research, although limited, continually fails to show an increase in breast cancer recurrence after breast fat grafting, with the exception of 1 small study on a subset patient population with intraepithelial neoplasm of the breast. The aim of this review is to summarize the recent conflicting basic science and clinical data to better understand the safety of breast fat grafting from an oncological perspective.

  13. Preparing medical students for future learning using basic science instruction.

    PubMed

    Mylopoulos, Maria; Woods, Nicole

    2014-07-01

    The construct of 'preparation for future learning' (PFL) is understood as the ability to learn new information from available resources, relate new learning to past experiences and demonstrate innovation and flexibility in problem solving. Preparation for future learning has been proposed as a key competence of adaptive expertise. There is a need for educators to ensure that opportunities are provided for students to develop PFL ability and that assessments accurately measure the development of this form of competence. The objective of this research was to compare the relative impacts of basic science instruction and clinically focused instruction on performance on a PFL assessment (PFLA). This study employed a 'double transfer' design. Fifty-one pre-clerkship students were randomly assigned to either basic science instruction or clinically focused instruction to learn four categories of disease. After completing an initial assessment on the learned material, all participants received clinically focused instruction for four novel diseases and completed a PFLA. The data from the initial assessment and the PFLA were submitted to independent-sample t-tests. Mean ± standard deviation [SD] scores on the diagnostic cases in the initial assessment were similar for participants in the basic science (0.65 ± 0.11) and clinical learning (0.62 ± 0.11) conditions. The difference was not significant (t[42] = 0.90, p = 0.37, d = 0.27). Analysis of the diagnostic cases on the PFLA revealed significantly higher mean ± SD scores for participants in the basic science learning condition (0.72 ± 0.14) compared with those in the clinical learning condition (0.63 ± 0.15) (t[42] = 2.02, p = 0.05, d = 0.62). Our results show that the inclusion of basic science instruction enhanced the learning of novel related content. We discuss this finding within the broader context of research on basic science instruction, development of adaptive expertise and assessment

  14. SIMMEON-Prep study: SIMulation of Medication Errors in ONcology: prevention of antineoplastic preparation errors.

    PubMed

    Sarfati, L; Ranchon, F; Vantard, N; Schwiertz, V; Gauthier, N; He, S; Kiouris, E; Gourc-Berthod, C; Guédat, M G; Alloux, C; Gustin, M-P; You, B; Trillet-Lenoir, V; Freyer, G; Rioufol, C

    2015-02-01

    Medication errors (ME) in oncology are known to cause serious iatrogenic complications. However, MEs still occur at each step in the anticancer chemotherapy process, particularly when injections are prepared in the hospital pharmacy. This study assessed whether a ME simulation program would help prevent ME-associated iatrogenic complications. The 5-month prospective study, consisting of three phases, was undertaken in the centralized pharmaceutical unit of a university hospital of Lyon, France. During the first simulation phase, 25 instruction sheets each containing one simulated error were inserted among various instruction sheets issued to blinded technicians. The second phase consisted of activity aimed at raising pharmacy technicians' awareness of risk of medication errors associated with antineoplastic drugs. The third phase consisted of re-enacting the error simulation process 3 months after the awareness campaign. The rate and severity of undetected medication errors were measured during the two simulation (first and third) phases. The potential seriousness of the ME was assessed using the NCC MERP(®) index. The rate of undetected medication errors decreased from 12 in the first simulation phase (48%) to five in the second simulation phase (20%, P = 0.04). The number of potential deaths due to administration of a faulty preparation decreased from three to zero. Awareness of iatrogenic risk through error simulation allowed pharmacy technicians to improve their ability to identify errors. This study is the first demonstration of the successful application of a simulation-based learning tool for reducing errors in the preparation of injectable anticancer drugs. Such a program should form part of the continuous quality improvement of risk management strategies for cancer patients. © 2014 John Wiley & Sons Ltd.

  15. 78 FR 54731 - Update to the List of Basic Medical Supplies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... reexportation to Iran pursuant to Sec. 560.530(a)(3)(i), to include additional items. DATES: Effective Date... basic medical supplies to Iran. The term basic medical supplies is defined in paragraph (a)(3)(ii) to... List of Basic Medical Supplies on the OFAC Web site ( www.treasury.gov/ofac ) on the Iran Sanctions...

  16. Medical expertise and patient involvement: a multiperspective qualitative observation study of the patient's role in oncological decision making.

    PubMed

    Salloch, Sabine; Ritter, Peter; Wäscher, Sebastian; Vollmann, Jochen; Schildmann, Jan

    2014-06-01

    Decision making in oncology poses intricate ethical questions because treatment decisions should account not only for evidence-based standards but also for the patient's individual values and preferences. However, there is a scarcity of empirical knowledge about patient involvement in oncological decision making. Direct, nonparticipant observation was used as a qualitative research method to gain an understanding of the interplay between medical expertise and patient participation in oncological decision making. Based on a multiperspective approach, observations were performed in three settings (tumor conference, ward round, and outpatient clinic) in the oncology department of a German university hospital. The observation transcripts were analyzed using central features of qualitative data analysis. Major differences were identified regarding the decision-making processes in the three settings related to the patient's presence or absence. When the patient was absent, his or her wishes were cited only irregularly; however, patients actively advanced their wishes when present. Preselection of treatments by physicians was observed, narrowing the scope of options that were finally discussed with the patient. Dealing with decisions about risky treatments was especially regarded as part of the physician's professional expertise. The study reveals aspects of decision making for cancer patients that have been underexposed in the empirical and theoretical literature so far. Among these are the relevance of structural aspects for the decisions made and the practice of preselection of treatment options. It should be further discussed how far medical expertise reaches and whether therapeutic decisions can be made without consulting the patient. ©AlphaMed Press.

  17. Surveying trends in radiation oncology medical physics in the Asia Pacific Region.

    PubMed

    Kron, Tomas; Healy, Brendan; Ng, Kwan Hoong

    2016-07-01

    Our study aims to assess and track work load, working conditions and professional recognition of radiation oncology medical physicists (ROMPs) in the Asia Pacific Region over time. A structured questionnaire was mailed in 2008, 2011 and 2014 to senior medical physicists representing 23 countries. The questionnaire covers 7 themes: education and training including certification; staffing; typical tasks; professional organisations; resources; research and teaching; job satisfaction. Across all surveys the response rate was >85% with the replies representing practice affecting more than half of the world's population. The expectation of ROMP qualifications (MSc and between 1 and 3years of clinical experience) has not changed much over the years. However, compared to 2008, the number of medical physicists in many countries has doubled. Formal professional certification is only available in a small number of countries. The number of experienced ROMPs is small in particular in low and middle income countries. The increase in staff numbers from 2008 to 2014 is matched by a similar increase in the number of treatment units which is accompanied by an increase in treatment complexity. Many ROMPs are required to work overtime and not many find time for research. Resource availability has only improved marginally and ROMPs still feel generally overworked, but professional recognition, while varying widely, appears to be improving slowly. While number of physicists and complexity of treatment techniques and technologies have increased significantly, ROMP practice remains essentially unchanged over the last 6years in the Asia Pacific Region. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Relations between Policy for Medical Teaching and Basic Need Satisfaction in Teaching

    ERIC Educational Resources Information Center

    Engbers, Rik; Fluit, Cornelia R. M. G.; Bolhuis, Sanneke; Sluiter, Roderick; Stuyt, Paul M. J.; Laan, Roland F. J. M.

    2015-01-01

    Policy initiatives that aim to elevate the position of medical teaching to that of medical research could influence the satisfaction of three basic psychological needs related to motivation for medical teaching. To explore relations between the satisfaction of three basic psychological needs towards medical teaching and two policy initiatives for…

  19. Relations between Policy for Medical Teaching and Basic Need Satisfaction in Teaching

    ERIC Educational Resources Information Center

    Engbers, Rik; Fluit, Cornelia R. M. G.; Bolhuis, Sanneke; Sluiter, Roderick; Stuyt, Paul M. J.; Laan, Roland F. J. M.

    2015-01-01

    Policy initiatives that aim to elevate the position of medical teaching to that of medical research could influence the satisfaction of three basic psychological needs related to motivation for medical teaching. To explore relations between the satisfaction of three basic psychological needs towards medical teaching and two policy initiatives for…

  20. Referral to Medical Oncology: A Crucial Step in the Treatment of Older Patients with Stage III Colon Cancer

    PubMed Central

    Luo, RuiLi; Giordano, Sharon H.; Freeman, Jean L.; Zhang, Dong; Goodwin, James S.

    2007-01-01

    Purpose Adjuvant chemotherapy for stage III colon cancer produces a substantial survival benefit, but many older patients do not receive chemotherapy. This study examines factors associated with medical oncology consultation and evaluates the impact of such consultation on chemotherapy use. Patients and Methods We used the Surveillance Epidemiology and End Results–Medicare linked database and identified 7,569 patients, aged 66–99, with stage III colon cancer diagnosed from 1992–1999. Modified Poisson regression was used to assess the relative risk for seeing a medical oncologist and for receiving chemotherapy as a function of individual characteristics. Results 78.08% of patients saw a medical oncologist within 6 months of diagnosis. Patients who were female, white, married, had low comorbidity scores, were diagnosed in more recent years, or had four or more positive lymph nodes were more likely to see a medical oncologist. Patients seeing a medical oncologist were 10 times more likely to receive chemotherapy (odds ratio, 9.98; 95% confidence interval, 8.21–12.14), after controlling for demographic and tumor characteristics. Chemotherapy use increased over time, but was substantially lower among older, black, and unmarried patients. Conclusions Referral to medical oncology is one of the most important factors associated with receipt of chemotherapy among older patients with stage III colon cancer. Comorbidity decreases the likelihood of receiving chemotherapy, but its effect is the same for those who see a medical oncologist and all patients combined. Ensuring that high-risk patients are referred to medical oncology is a crucial step in quality care for patients with colon cancer. PMID:17030645

  1. Turkish Ministry of Health, 2nd Turkish Medical General Assembly Clinical Oncology Study Group Report

    PubMed Central

    Özmen, Vahit; Dağoğlu, Nergiz; Dede, İsmet; Akçakaya, Adem; Kerem, Mustafa; Göksel, Fatih; Özgür, Enver; Başkan, Emel; Yaylacı, Mustafa; Ceydeli, Adil; Baykara, Meltem; Kızıltan, Huriye Şenay; Kömürcü, Şeref; Gümüş, Mahmut; Türk, H. Mehmet; Demirhan, Recep; Akgün, Ali; Kadoglou, Naim; Yatman, Emre; Elbi, Cem Cüneyt; Güleç, Seza; Soran, Atilla; Özet, Ahmet; Keleştimur, Fahrettin

    2016-01-01

    Objective There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems. Developments on palliative care were also evaluated. Materials and Methods The current situation in the practice of clinical oncology, related drawbacks, problems encountered during multidisciplinary approach and their solutions were discussed under several sub-headings during a 3-day meeting organized by the Turkish Ministry of Health (Türkiye Cumhuriyeti Sağlık Bakanlığı-TCSB) with participation of 16 scientists from Turkey and 6 from abroad, and the conclusions were reported. Results It is expected that the newly established Turkish Health Institutes Association (Türkiye Sağlık Enstitüleri Başkanlığı-TÜSEB) and the National Cancer Institute (Ulusal Kanser Enstitüsü) will provide a new framework in the field of oncology. The current positive findings include the increase in the number of scientists who carry out successful trials in oncology both in Turkey and abroad, the implementation of the national cancer registry program by the Cancer Control Department and the breast cancer registry program by the Turkish Federation of Breast Diseases Societies (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF), and introduction of Cancer Early Diagnosis, Screening, and Training Centers (Kanser Erken Tanı, Tarama ve Eğitim Merkezi-KETEM) for the application of community-based cancer screening programs. In addition to these, obvious shortcomings related to education, implementation, management and

  2. Current opinions on medical radiation: a survey of oncologists regarding radiation exposure and dose reduction in oncology patients.

    PubMed

    Burke, Lauren M B; Bashir, Mustafa R; Neville, Amy M; Nelson, Rendon C; Jaffe, Tracy A

    2014-05-01

    The aim of this study was to evaluate oncologists' opinions about the use of ionizing radiation in medical imaging of oncology patients. An electronic survey was e-mailed to 2,725 oncologists at the top 50 National Cancer Institute-funded cancer centers. The survey focused on opinions on CT dose reduction in oncology patients and current philosophies behind long-term imaging in these patients. The response rate was 15% (415 of 2,725). Eighty-two percent of respondents stated that their patients or families have expressed anxiety regarding radiation dose from medical imaging. Although fewer than half of oncologists (48%) did not know whether CT dose reduction techniques were used at their institutions, only 25% were concerned that small lesions may be missed with low-dose CT techniques. The majority of oncologists (63%) follow National Comprehensive Cancer Network guidelines for imaging follow-up, while the remainder follow other national guidelines such as those of the Children's Oncology Group, the American Society of Clinical Oncology, or clinical trials. Ninety percent of respondents believe that long-term surveillance in oncology patients is warranted, particularly in patients with breast cancer, melanoma, sarcoma, and pediatric malignancies. The majority of oncologists would consider the use of low-dose CT imaging in specific patient populations: (1) children and young women, (2) those with malignancies that do not routinely metastasize to the liver, and (3) patients undergoing surveillance imaging. Cumulative radiation exposure is a concern for patients and oncologists. Among oncologists, there is support for long-term imaging surveillance despite lack of national guidelines. Published by Elsevier Inc.

  3. The European Society for Medical Oncology Magnitude of Clinical Benefit Scale in daily practice: a single institution, real-life experience at the Medical University of Vienna

    PubMed Central

    Kiesewetter, Barbara; Raderer, Markus; Steger, Günther G; Bartsch, Rupert; Pirker, Robert; Zöchbauer-Müller, Sabine; Prager, Gerald; Krainer, Michael; Preusser, Matthias; Schmidinger, Manuela; Zielinski, Christoph C

    2016-01-01

    Background The European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) has been designed to stratify the therapeutic benefit of a certain drug registered for the treatment of cancer. However, though internally validated, this tool has not yet been evaluated for its feasibility in the daily practice of a major center of medical oncology. Methods The practicability of the MCBS for advanced oncological diseases at the Clinical Division of Oncology, Medical University of Vienna, which constitutes one of the largest oncological centres in Europe, was analysed in a three-step approach. First, retrospectively collected data were analysed to gain an overview of treatments in regular use. Second, data were scored by using the MCBS. Third, the ensuing results were evaluated within corresponding programme directorships to assess feasibility in a real-life clinical context. Results In the majority of tumour entities, the MCBS results reported earlier are consistent with daily clinical practice. Thus, in metastatic breast cancer or advanced lung cancer, there was a high level of clinical benefit for first-line treatment standards, and these results reflected well real-life experience. However, analyses based on the first version of the MCBS are limited if it comes to salvage treatment in tumour entities in which optimal sequencing of potential treatment options is of major importance, as in metastatic colorectal or renal cell cancer. In contrast to this, it is remarkable that certain novel therapies such as nivolumab assessed for heavily pretreated advanced renal cancer reached the highest level of clinical benefit due to prolongation in survival and a favourable toxicity profile. The MCBS clearly underlines the potential benefit of these compounds. Conclusions The MCBS is an excellent tool for daily clinical practice of a tertiary referral centre. It supports treatment decisions based on the clinical benefit to be expected from a novel approach

  4. Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School

    PubMed Central

    Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi

    2016-01-01

    The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the “old” curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations. PMID:27486351

  5. Developing a competency-based medical education curriculum for the core basic medical sciences in an African Medical School.

    PubMed

    Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi

    2016-01-01

    The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the "old" curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations.

  6. The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

    PubMed

    Viale, Pamela Hallquist; Sanchez Yamamoto, Deanna

    2004-07-01

    To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. Exploratory survey. Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. 221 of 376 ONPs completed the survey (58%). Researcher-developed 12-question postal survey. Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

  7. A survey of medical school teachers to identify basic biomedical concepts medical students should understand.

    PubMed

    Dawson-Saunders, B; Feltovich, P J; Coulson, R L; Steward, D E

    1990-07-01

    Insights from the cognitive sciences indicate a continuing need for physicians to understand conceptual knowledge from the basic sciences, despite recent concerns regarding the increasing amount of information in medicine and the growing emphasis on performance skills. A 1987 survey of selected basic science and clinical teachers in North American medical schools was undertaken to identify basic biomedical concepts that are important in the practice of medicine and to specify how difficult these are for students to learn, apply, or both. Responses from faculty (nominated by their deans to answer the survey) from 82% of the medical schools indicated considerable agreement between the basic science teachers and clinical teachers on the relative importance of a set of biomedical concepts, and showed relatively minor levels of disagreement on how difficult these concepts are. The judgments of these teachers could prove extremely useful in (1) determining concepts that--because of their importance--should receive special attention in curriculum efforts, and (2) determining concepts that--because of their difficulty--need "special handling."

  8. The impact of a palliative medicine consultation service in medical oncology.

    PubMed

    Homsi, Jade; Walsh, Declan; Nelson, Kristine A; LeGrand, Susan B; Davis, Mellar; Khawam, Elias; Nouneh, Chadi

    2002-05-01

    This prospective study of consecutive patients describes the palliative medicine consult service in a tertiary level cancer center and its impact on patient care. All inpatients/outpatients referred to the Palliative Medicine Program in a 4-month period were enrolled. Data were collected at the initial consultation using standardized forms with spaces for: reason for the consultation, referring service, demographics and history, ECOG performance status, symptoms, prognosis and diagnostic tests, treatment, and care plan. In all, 240 patients were seen: 79% were referred for symptom management; 53% were referred from medical oncology; and 50% were women. Median patient age was 67 years (range 18-96). Median performance status was 2 (1-4). Most (84%) of the patients had cancer. The cancer sites were: lung in 26% of cases, colorectal in 8%, and breast in 7%. Inpatients accounted for 53% and outpatients, for 47% of the study population. The median number of symptoms per patient was 13 (2-30). The estimated survival was <2 weeks in 15%, 2-8 weeks in 38%, 2-6 months in 37%, and >6 months in 10%. The patients' goals were: improve symptoms for 84%, return home for 55%, and no further admissions for 5%. The support systems named by patients were: family in 89%, friends in 13%, and the community in 5%. Hospice care was discussed at the consultation with 38% of the patients, would have been inappropriate for 31%, was not discussed with 22%, and had been discussed before with 9%. In response to questions about psychosocial care, a caregiver was identified by 78%, a spokesperson by 75%, and durable power of attorney was referred to by 21%. The DNR status was discussed on consult by 57%, had already been discussed with 30%, and was not discussed with 13%. Plan of care foresaw outpatient follow-up for 40%, inpatient follow-up for 32%, and transfer to palliative medicine for 27%. In 39% of cases the consults were considered late referrals. New medications suggested were opioids for

  9. Nurses Exploring the Spirituality of Their Patients With Cancer: Participant Observation on a Medical Oncology Ward.

    PubMed

    van Meurs, Jacqueline; Smeets, Wim; Vissers, Kris C P; Groot, Marieke; Engels, Yvonne

    2017-07-19

    Attention for spirituality should be an integral part of professionals' caregiving. Particularly, nurses caring for patients with cancer might have opportunities to give attention to this dimension. The aim of this study was to gain insight in the way and extent to which nurses during daily caregiving observe and explore spiritual issues of hospitalized patients with cancer. We performed an ethnographic study with participant observation. Data were collected in 2015 during 4 shifts at the medical oncology department of a university hospital. The researcher, a spiritual care provider (chaplain) wearing the same kind of uniform as the nurses, observed the nurses, participated in their actions, and interviewed them after the shift. Although the patients did send many implicit and explicit messages concerning spiritual issues, the nurses did not explore them. If noticed, 3 barriers for exploring spiritual issues were mentioned by the nurses: lack of time, conflict with their mindset, and being reserved to talk about such issues. During their daily caregiving to patients with a life-threatening illness, nurses have many opportunities to explore spiritual issues, but they do not often recognize them. If they do, they tend not to explore the spiritual issues. Communication training for nurses is necessary to develop skills for exploring the spiritual dimension in patients with cancer. In such training, attention to the misconception that such a conversation requires a lot of time and for recognizing signals from patients inviting an exploration of their concerns is necessary.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  10. [Oncology medications prescription in a cancer service: appropriateness to clinical practice guidelines].

    PubMed

    Palchik, Valeria; Traverso, María Luz; Colautti, Marisel; Bianchi, Mariela; Dolza, Lucía; Catena, José María; Salamano, Mercedes

    2016-11-01

    Objetivo: Evaluar la prescripción de medicamentos oncológicos de la Red de Salud Pública Municipal de Rosario según su adecuación las guías de práctica clínica. Método: Estudio farmacoepidemiológico descriptivo en pacientes adultos en un Servicio Oncológico. Enero-junio 2012. Se evaluó la adecuación de las prescripciones a las guías de práctica clínica de referencia. Resultados: El 51,8 % de los diagnósticos tuvo al menos un medicamento prescripto que no coincidía con lo recomendado por al menos una de las guías consideradas. Las prescripciones de doxorrubicina e ifosfamida no coincidieron con lo recomendado por ninguna guía. El 5,4% de las prescripciones no estaban consideradas en las guías locales, el 7,7% no lo estaban en las nacionales y, respecto de las internacionales, el 4,2 % no estaban consideradas en la European Society for Medical Oncology, el 2,3% por el American Cancer Society y solo el 1,9% por la National Comprehensive Cancer Network. Conclusiones: La prescripción de oncológicos se adecúa más a las guías internacionales. Podría deberse a que no existe aún una definición estándar en el manejo de las patologías tumorales por parte del Estado Nacional.

  11. Burnout and occupational stress in the medical residents of Oncology, Haematology and Radiotherapy: a prevalence and predictors study in Portugal.

    PubMed

    Joaquim, Ana; Custódio, Sandra; Savva-Bordalo, Joana; Chacim, Sérgio; Carvalhais, Inês; Lombo, Liliana; Lopes, Heitor; Araújo, António; Gomes, Rui

    2017-06-29

    Burnout is a professional syndrome associated with stress caused by overwork. Our aim was to calculate the prevalence of burnout and stress on medical residents of Oncology, Haematology and Radiotherapy in Portugal, as well as to determine predictors of burnout and stress. An anonymous questionnaire was applied (n = 118). Statistical analysis consisted of a descriptive and inferential analysis. The prevalence of burnout and stress was calculated to be 45.2 and 50%, respectively. The dimensions that generated higher levels of stress were 'dealing with patients' and 'overwork'. Burnout was directly related with stress dimension 'overwork'. The prevalence of burnout in Portuguese oncological residents is high as in other European countries and in the U.S. Therefore, interventional strategies can be designed.

  12. Pain medication management processes used by oncology outpatients and family caregivers part II: home and lifestyle contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. Reducing Unplanned Medical Oncology Readmissions by Improving Outpatient Care Transitions: A Process Improvement Project at the Cleveland Clinic.

    PubMed

    Montero, Alberto J; Stevenson, James; Guthrie, Amy E; Best, Carolyn; Goodman, Lindsey Martin; Shrotriya, Shiva; Azzouqa, Abdel-Ghani; Parala, Armida; Lagman, Ruth; Bolwell, Brian J; Kalaycio, Matt E; Khorana, Alok A

    2016-05-01

    Reducing 30-day unplanned hospital readmissions is a national policy priority. We examined the impact of a quality improvement project focused on reducing oncology readmissions among patients with cancer who were admitted to palliative and general medical oncology services at the Cleveland Clinic. Baseline rates of readmissions were gathered during the period from January 2013 to April 2014. A quality improvement project designed to improve outpatient care transitions was initiated during the period leading to April 1, 2014, including: (1) provider education, (2) postdischarge nursing phone calls within 48 hours, and (3) postdischarge provider follow-up appointments within 5 business days. Nursing callback components included symptom management, education, medication review/compliance, and follow-up appointment reminder. During the baseline period, there were 2,638 admissions and 722 unplanned 30-day readmissions for an overall readmission rate of 27.4%. Callbacks and 5-day follow-up appointment monitoring revealed a mean monthly compliance of 72% and 78%, respectively, improving over time during the study period. Readmission rates declined by 4.5% to 22.9% (P < .01; relative risk reduction, 18%) during the study period. The mean direct cost of one readmission was $10,884, suggesting an annualized cost savings of $1.04 million with the observed reduction in unplanned readmissions. Modest readmission reductions can be achieved through better systematic transitions to outpatient care (including follow-up calls and early provider visits), thereby leading to a reduction in use of inpatient resources. These data suggest that efforts focused on improving outpatient care transition were effective in reducing unplanned oncology readmissions. Copyright © 2016 by American Society of Clinical Oncology.

  14. Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences

    PubMed Central

    Pfeiffer, Yvonne; Taxis, Katja

    2016-01-01

    Background Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied. Objective To study the practice of different double-checking procedures in chemotherapy administration and to explore nurses' experiences, for example, how often they actually find errors using a certain procedure. General evaluations regarding double-checking, for example, frequency of interruptions during and caused by a check, or what is regarded as its essential feature was assessed. Methods In a cross-sectional survey, qualified nurses working in oncology departments of 3 hospitals were asked to rate 5 different scenarios of double-checking procedures regarding dimensions such as frequency of use in practice and appropriateness to prevent medication errors; they were also asked general questions about double-checking. Results Overall, 274 nurses (70% response rate) participated in the survey. The procedure of jointly double-checking (read-read back) was most commonly used (69% of respondents) and rated as very appropriate to prevent medication errors. Jointly checking medication was seen as the essential characteristic of double-checking—more frequently than ‘carrying out checks independently’ (54% vs 24%). Most nurses (78%) found the frequency of double-checking in their department appropriate. Being interrupted in one's own current activity for supporting a double-check was reported to occur frequently. Regression analysis revealed a strong preference towards checks that are currently implemented at the responders' workplace. Conclusions Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be

  15. Basic Training Program in Medical Pedagogy: a 1-year program for medical faculty.

    PubMed Central

    Des Marchais, J E; Jean, P; Delorme, P

    1990-01-01

    In 1979 université de Montréal developed the Basic Training Program in Medical Pedagogy; the program has since been offered at two other Canadian medical schools. The learning activities are spread over an academic year so that the teachers are able to continue their clinical or research duties. The program, which follows a model of systematic instruction, comprises 17 self-instructional modules on basic educational topics adapted to medical teaching. The topics are related to four components of an integrated system: student needs and learning objectives, instructional methods, student evaluation and program evaluation. The instructional format is aimed at three levels--understanding, analysis and application--to which assignments and assessments are related. In addition to the modules, the program offers 15 half-day sessions for small groups (five participants and one instructor) to discuss aspects of the program, especially home assignments and the application of personal educational projects. A minimum of 100 hours of personal time is requested. The program's main goal is that students be placed at the centre of the educational process. Of 215 participants since 1979, 171 (80%) have completed the program and reported high satisfaction. Issues related to any faculty development program are discussed. PMID:2317704

  16. The Integration of Emotional, Physiologic, and Communication Responses to Medical Oncology Surveillance Appointments During Breast Cancer Survivorship.

    PubMed

    Clayton, Margaret F; Dingley, Catherine; Donaldson, Gary

    Breast cancer survivors regularly interact with providers during routine surveillance medical oncology visits, discussing uncertainty and anxiety about potential cancer recurrence for many years after treatment. Physiologic alteration can also occur as a stress response, triggered by an upcoming surveillance visit. Survivor-provider communication can theoretically allay emotional distress. The aim of this study was to evaluate associations between emotional (uncertainty, anxiety, concerns about recurrence) and physiologic responses (cytokine levels, lymphocyte counts), and survivor-provider communication (women's plans for their visit, negotiation of decision-making roles). Twenty-seven community-dwelling breast cancer survivors participated. Blood specimens, and self-reported data focusing on the previous month, were collected immediately before and the morning after a regularly scheduled medical oncology visit. Global concerns about cancer recurrence and acute anxiety and uncertainty were associated with changes in immune status before and after the visit. Postvisit natural killer cells increased in 70% of women, and uncertainty/anxiety decreased. Thirty-three percent of women reported a previous minor illness. Most women had a visit plan; 66% successfully negotiated decision-making roles with providers. Triggered by an upcoming medical oncology visit, women experience uncertainty, anxiety, and altered immunity, potentially placing them at risk of disease exacerbations. Not all women respond similarly to a routine surveillance visit; thus, providers must determine who may be at increased risk of emotional distress and physiologic alteration. Survivor-provider communication facilitates immediate resolution of concerns. Explanations of symptom meaning reduce anxiety and uncertainty and by extension may help resolve immune alteration. Between visits, this could be done by nurse-operated telephone-based "help lines."

  17. One more chemo or one too many? Defining the limits of treatment and innovation in medical oncology.

    PubMed

    Baszanger, Isabelle

    2012-09-01

    During the past few years, debates have frequently erupted in oncology journals regarding the question of whether to prolong or end treatment. These debates have been informed by developments from both within and outside the field. Within Bioethics, some writers have put forward a number of principles for judging the legitimacy of medical interventions, notably that of patient autonomy. Broad social and political developments have also profoundly affected medical practices at the end of life. Though therapeutic options have evolved, whether to stop or to pursue treatment in the face of certain death has been a central issue in medical oncology since the early 1950s. A critical appraisal of the history of this issue can help us to better understand the tangled relationship(s) between innovation, "cure," death, and the symptoms and subjective experiences of sufferers. This paper addresses an aspect of this complex problem, namely how limits are established regarding both treatment and therapeutic innovation near the end of life. Utilizing a grounded theory and situational analysis approach it traces how the issues at stake were defined and the ways in which the dilemma was progressively transformed as a result of the combined effects of a proliferating number of stakeholders, molecules, instruments, and techniques. It discusses three different moments, as they epitomize how the links between chemotherapy and palliation were construed through the evolving forms of clinical research and innovative therapies. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Radiation exposure received by the medical radiation workers in Lithuania at the Institute of Oncology, Vilnius University, 2004-2011.

    PubMed

    Samerdokiene, Vitalija; Atkocius, Vydmantas; Ofomala, Renata

    2013-11-01

    The occupational radiation exposure of medical radiation workers at the Institute of Oncology, Vilnius University (IOVU) was analysed. Quartile dose measurements were collected and routinely analysed for a period of 8 y from 1 January 2004 to 31 December 2011. A total of 193 medical radiation workers were monitored, comprising 34 % physicians (radiologists and radiotherapists), 8 % physicists, 42 % radiological technologists and 16 % ancillary staff. A statistically significant decrease by 18 % has been detected when comparing the annual average effective doses (AAEDs) received by medical radiation workers at the IOVU during periods 2004-2007 and 2008-2011 (p < 0.0001). The main occupation categories responsible for this reduction were of Nuclear Medicine (p < 0.028) and Radiology (p < 0.0001) departments. The values of AAED in Radiology, Radiotherapy and Nuclear Medicine departments are quite low and well below the annual limit of 20 mSv, averaged over a period of 5 consecutive years.

  19. The Use of Art in the Medical Decision-Making Process of Oncology Patients

    ERIC Educational Resources Information Center

    Czamanski-Cohen, Johanna

    2012-01-01

    The introduction of written informed consent in the 1970s created expectations of shared decision making between doctors and patients that has led to decisional conflict for some patients. This study utilized a collaborative, intrinsic case study approach to the decision-making process of oncology patients who participated in an open art therapy…

  20. The Use of Art in the Medical Decision-Making Process of Oncology Patients

    ERIC Educational Resources Information Center

    Czamanski-Cohen, Johanna

    2012-01-01

    The introduction of written informed consent in the 1970s created expectations of shared decision making between doctors and patients that has led to decisional conflict for some patients. This study utilized a collaborative, intrinsic case study approach to the decision-making process of oncology patients who participated in an open art therapy…

  1. SU-F-E-14: Global Radiation Oncology Education and Training in Medical Physics Powered by Information and Communication Technologies

    SciTech Connect

    Ngwa, W; Sajo, E; Ngoma, T; Dachi, J; Julius Mwaiselage, J; Kenton, O; Avery, S

    2016-06-15

    Purpose: Recent publications have highlighted the potential of Information and Communication Technologies (ICTs) to catalyze collaborations in cancer care, research and education in global radiation oncology. This work reports on the use of ICTs for global Medical Physics education and training across three countries: USA, Tanzania and Kuwait Methods: An online education platform was established by Radiation Oncology Faculty from Harvard Medical School, and the University of Pennsylvania with integrated Medical Physics Course modules accessible to trainees in Tanzania via partnership with the Muhimbili University of Health and Allied Sciences, and the Ocean Road Cancer Institute. The course modules incorporated lectures covering Radiation Therapy Physics with videos, discussion board, assessments and grade center. Faculty at Harvard Medical School and the University of Massachusetts Lowell also employed weekly Skype meetings to train/mentor three graduate students, living out-of-state and in Kuwait for up to 9 research credits per semester for over two semesters towards obtaining their graduate degrees Results: Students were able to successfully access the Medical Physics course modules and participate in learning activities, online discussion boards, and assessments. Other instructors could also access/co-teach the course modules from USA and Tanzania. Meanwhile all three graduate students with remote training via Skype and email made major progress in their graduate training with each one of them submitting their research results as abstracts to be presented at the 2016 AAPM conference. One student has also published her work already and all three are developing these abstracts for publication in peer-reviewed journals. Conclusion: Altogether, this work highlights concrete examples/model on how ICTs can be used for capacity building in Medical Physics across continents, for both education and research training needed for Masters/PhD degrees. The developed modules

  2. [Medical students' reactions to their experience in oncology and its contribution to their training].

    PubMed

    Notzer, Netta; Tur-Kaspa, Ran

    2006-01-01

    The need to deepen the teaching of oncology was recognized by the Sackler Faculty of Medicine. In 2004, a weekly short clerkship was introduced into the 6th year curriculum, aiming to expose students to a variety of cancer diseases and treatments and to internalize the comprehensive approach to the patient and his family by the multi-professional team. To present students' reactions to their experiences in oncology in order to learn about the clerkship's contribution and to find ways to improve the training. A questionnaire was circulated to students at the end of their experiences. The response rate was 87% (out of 83), of which 55% were women. The answers were summarized by qualitative and quantitative methods. The students perceived the change in their attitude to cancer patients as a result of the acquisition of knowledge and their exposure to treatments of the diseases and patients (75%). They highly appreciated the implementation of the patient-doctor relationship and the multi-disciplinary teamwork (over 50%), transforming the oncologist into a different physician from his colleagues (70%), and more optimistic as to the prognosis. Twenty-five percent of the students expressed their interest in becoming involved with oncology in the future. While women noted the behavioral aspects of oncology significantly more than men, men indicated a greater appreciation of the knowledge and technologies they encountered. No relationship was found with the occurrence of cancer in the students' families. With the growing need to deepen physicians' empathy with patients and their families, especially with long-term diseases and health problems, oncology departments were found to serve as a unique site, suitable for training students. This was asserted by the students' reactions to the clerkship, as expressed in this study. The students furthermore expressed their preference for broader training exposure to palliative care and pain relief, and increased involvement in

  3. Teaching Medical Students Basic Neurotransmitter Pharmacology Using Primary Research Resources

    ERIC Educational Resources Information Center

    Halliday, Amy C.; Devonshire, Ian M.; Greenfield, Susan A.; Dommett, Eleanor J.

    2010-01-01

    Teaching pharmacology to medical students has long been seen as a challenge, and one to which a number of innovative approaches have been taken. In this article, we describe and evaluate the use of primary research articles in teaching second-year medical students both in terms of the information learned and the use of the papers themselves. We…

  4. Teaching Medical Students Basic Neurotransmitter Pharmacology Using Primary Research Resources

    ERIC Educational Resources Information Center

    Halliday, Amy C.; Devonshire, Ian M.; Greenfield, Susan A.; Dommett, Eleanor J.

    2010-01-01

    Teaching pharmacology to medical students has long been seen as a challenge, and one to which a number of innovative approaches have been taken. In this article, we describe and evaluate the use of primary research articles in teaching second-year medical students both in terms of the information learned and the use of the papers themselves. We…

  5. [Priorities of German Oncologists. Results of the "choosing wisely" survey of the German Society of Hematology and Medical Oncology (DGHO)].

    PubMed

    Krause, Stefan W; Oldenburg, Michael; Hallek, Michael; Neubauer, Andreas

    2017-09-01

    Background During the preparation of "choosing wisely" recommendations, the German Society of Hematology and Medical Oncology (DGHO) had performed a member survey. The large body of replies was systematically and quantitatively analyzed for this report. Methods Replies to the draft recommendations are quantified. Free text replies were iteratively categorized in three levels according to medical categories and additionally, according to their general target of necessary action. Results 492 members completed the survey within the given limit of 2 weeks. Draft recommendations against oversupply were widely supported (77 %-88 %). 1598 free text replies were analyzed. Unnecessary use of resources was requested in several fields in accordance with our recommendations. Strong demand was put forward regarding soft factors: "talking medicine", individually tailored therapy, supportive medicine and palliative care (51 % together) and social resources (11 %). Possible under-supply was less frequently described in fields of expensive measures (17 % of replies). Conclusion In the replies to our survey, we found a strong statement for a plus in talking medicine in oncology. Every physician caring for these patients can contribute to this demand. Structural improvements in continuing education and reimbursement in this field are desirable. © Georg Thieme Verlag KG Stuttgart · New York.

  6. ASTRO APEx(®) and RO-ILS™ are applicable to medical malpractice in radiation oncology.

    PubMed

    Zaorsky, Nicholas G; Ricco, Anthony G; Churilla, Thomas M; Horwitz, Eric M; Den, Robert B

    2016-11-01

    To analyze malpractice trials in radiation oncology and assess how ASTRO APEx(®) and RO-ILS™ apply to such cases. The Westlaw database was reviewed using PICOS/PRISMA methods. Fisher's exact and Mann-Whitney U tests were used to find factors associated with outcomes. Of 34 cases identified, external beam was used in 26 (77%). The most common factors behind malpractice were excessive toxicity (80%) and lack of informed consent (66%). ASTRO APEx pillars and ROI-LS had applicability to all but one case. Factors favoring the defendant included statute of limitations (odds ratio: 8.1; 95% CI: 1.3-50); those favoring the plaintiff included patient death (odds ratio: 0.7; 95% CI: 0.54-0.94). APEx and RO-ILS are applicable to malpractice trials in radiation oncology.

  7. An upcoming program for medical humanities education in Fudan University's School of Basic Medical Sciences.

    PubMed

    Liu, Ye; Cheng, Xunjia

    2017-05-23

    Ideal medical care requires professional skills as well as appropriate communication skills. However, traditional medical education in medical schools mostly emphasizes the former. To remedy this situation, medical humanities education will be incorporated into education for medical students at Fudan University. Comprehensive medical education that includes both medical skills and humanities may greatly improve medical care.

  8. Clinical and basic science teachers' opinions about the required depth of biomedical knowledge for medical students.

    PubMed

    Koens, Franciska; Custers, Eugène J F M; ten Cate, Olle T J

    2006-05-01

    The aim of the present study was to investigate whether basic scientists and physicians agree on the required depth of biomedical knowledge of medical students at graduation. A selection of basic science and clinical teachers rated the relevance of biomedical topics for students at graduation, illustrated by 80 example items. The items were derived from ten organ systems and designed at four levels: clinical, organ, cellular and molecular. Respondents were asked to identify for each item to what extent recently graduated medical students should have knowledge about it. In addition, they were asked to indicate whether the content of the item should be included in the medical curriculum. Analysis showed that basic scientists and physicians do not diverge at the clinical level. At the organ, cellular and molecular levels however, basic scientists judge that medical students should have more active knowledge. As expected, basic scientists also indicate that more deep level content should be included. Explanations for this phenomenon will be discussed.

  9. Restoration of medical oncology services at LSU Interim Public Hospital in New Orleans after Hurricane Katrina: a two-year experience of LSUHSC.

    PubMed

    Harmon, Rachael E; Boulmay, Brian C

    2011-01-01

    Oncology services at Charity Hospital were discontinued following Hurricane Katrina in August 2005. Medical oncology and chemotherapy services resumed at the Louisiana State University Interim Public Hospital in 2007. Demographic, clinical, and displacement data of the re-established patient cohort were reviewed. Patients evaluated in the Louisiana State University Health Sciences Center (LSUHSC) Oncology Clinics from September 1, 2007, to August 31, 2009, were identified and data collected included time from diagnosis of malignancy to initial oncology evaluation, insurance status, percentage displaced for six months or more due to Hurricane Katrina, ethnicity, referrals for radiation oncology, and the number of outpatient clinical encounters (OCE). 464 patients were evaluated in the study time period. Sixty-five percent of the patients had new cancer diagnoses and 35% re-established cancer care in the Charity System and a substantial proportion were either unfunded or had Medicaid coverage. Thirty-four percent were confirmed to be displaced from New Orleans for greater than six months and the majority of patients were black. The majority of new cancer diagnoses were breast, lung, and colon cancer. Human immunodeficiency virus (HIV) positive patients made up 7.5% of the patient cohort. There was a 70% decline in patient volumes following Hurricane Katrina. Oncology services for a minority-based, underinsured patient population were severely impacted by Hurricane Katrina. Following the storm, persistent systemwide resource limitations led to suboptimal timeliness of medical oncology evaluations. Health care systems serving underinsured patients require a disaster plan to minimize interruption of oncology care. Our experience illustrates the need for resources to ensure rapid re-establishment of care for economically disadvantaged patients following natural disasters.

  10. Introduction of Basic Dermatologic Ultrasound in Undergraduate Medical Education.

    PubMed

    Alfageme, F; Cerezo, E; Fernandez, I S; Aguilo, R; Vilas-Sueiro, A; Roustan, G

    2016-11-01

    Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students' theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students' understanding of the technique and the quality of medical education in dermatology.

  11. Introduction of Basic Dermatologic Ultrasound in Undergraduate Medical Education

    PubMed Central

    Alfageme, F.; Cerezo, E.; Fernandez, I. S.; Aguilo, R.; Vilas-Sueiro, A.; Roustan, G.

    2016-01-01

    Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students’ theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students’ understanding of the technique and the quality of medical education in dermatology. PMID:27933321

  12. Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences.

    PubMed

    Schwappach, D L B; Pfeiffer, Yvonne; Taxis, Katja

    2016-06-13

    Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied. To study the practice of different double-checking procedures in chemotherapy administration and to explore nurses' experiences, for example, how often they actually find errors using a certain procedure. General evaluations regarding double-checking, for example, frequency of interruptions during and caused by a check, or what is regarded as its essential feature was assessed. In a cross-sectional survey, qualified nurses working in oncology departments of 3 hospitals were asked to rate 5 different scenarios of double-checking procedures regarding dimensions such as frequency of use in practice and appropriateness to prevent medication errors; they were also asked general questions about double-checking. Overall, 274 nurses (70% response rate) participated in the survey. The procedure of jointly double-checking (read-read back) was most commonly used (69% of respondents) and rated as very appropriate to prevent medication errors. Jointly checking medication was seen as the essential characteristic of double-checking-more frequently than 'carrying out checks independently' (54% vs 24%). Most nurses (78%) found the frequency of double-checking in their department appropriate. Being interrupted in one's own current activity for supporting a double-check was reported to occur frequently. Regression analysis revealed a strong preference towards checks that are currently implemented at the responders' workplace. Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be transferred more actively into clinical practice. The

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

    SciTech Connect

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

    2015-07-15

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

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

    PubMed

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

    2015-07-15

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

  15. "Burnout in Medical Oncology Fellows: a Prospective Multicenter Cohort Study in Brazilian Institutions".

    PubMed

    Cubero, Daniel I G; Fumis, Renata Rego Lins; de Sá, Thiago Hérick; Dettino, Aldo; Costa, Felipe Osório; Van Eyll, Brigitte M R H Adam; Beato, Carlos; Peria, Fernanda Maris; Mota, Augusto; Altino, José; Azevedo, Sérgio Jobim; da Rocha Filho, Duílio Reis; Moura, Melba; Lessa, Álvaro Edson Ramos; Del Giglio, Auro

    2016-09-01

    Burnout syndrome is a common occurrence among oncologists. Doctors enrolled in residency programs in clinical oncology are exposed to similar risk factors; however, few data are available in this population. This study assessed the occurrence of burnout and associated factors among first-year residents at Brazilian institutions. The present prospective, multicenter, cohort study was conducted with doctors enrolled in residency programs in clinical oncology at Brazilian institutions affiliated with the public health system. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), Lipp's Stress Inventory, and the Beck Depression Inventory (BDI), upon admission to the program and 6 and 12 months later. Of 37 eligible residency programs in 2009, 11 (30.6 %) agreed to participate in the study. Fifty-four residents, representing 100 % of new admissions to the participating institutions, were included. Most of the participants met the criteria for severe burnout upon admission to the residency programs (emotional exhaustion in 49.0 % and depersonalization in 64.7 %). The scores on MBI domains emotional exhaustion and depersonalization increased significantly (p < 0.01) during the first year of residency, and the prevalence of burnout increased to 88 % at the end of that first year. The present study found a high prevalence of burnout among doctors enrolled in residency programs in clinical oncology at Brazilian institutions. A large fraction of the participants met the criteria for burnout syndrome upon admission to the program, which suggests that the problem began during the course of the previous residency program in internal medicine.

  16. Internet-Based Survey Evaluating Use of Pain Medications and Attitudes of Radiation Oncology Patients Toward Pain Intervention

    SciTech Connect

    Simone, Charles B. Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M.

    2008-09-01

    Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.

  17. Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

    PubMed Central

    2011-01-01

    This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies, and not only on demand of the patient, in the field of gynecologic oncology with the use of drugs, devices and surgical-medical techniques. PMID:22051161

  18. Radiation therapists' and radiation oncology medical physicists' perceptions of work and the working environment in Australia: a qualitative study.

    PubMed

    Halkett, G K B; McKay, J; Hegney, D G; Breen, Lauren J; Berg, M; Ebert, M A; Davis, M; Kearvell, R

    2016-05-05

    Workforce recruitment and retention are issues in radiation oncology. The working environment is likely to have an impact on retention; however, there is a lack of research in this area. The objectives of this study were to: investigate radiation therapists' (RTs) and radiation oncology medical physicists' (ROMPs) perceptions of work and the working environment; and determine the factors that influence the ability of RTs and ROMPs to undertake their work and how these factors affect recruitment and retention. Semi-structured interviews were conducted and thematic analysis was used. Twenty-eight RTs and 21 ROMPs participated. The overarching themes were delivering care, support in work, working conditions and lifestyle. The overarching themes were mostly consistent across both groups; however, the exemplars reflected the different roles and perspectives of RTs and ROMPs. Participants described the importance they placed on treating patients and improving their lives. Working conditions were sometimes difficult with participants reporting pressure at work, large workloads and longer hours and overtime. Insufficient staff numbers impacted on the effectiveness of staff, the working environment and intentions to stay. Staff satisfaction is likely to be improved if changes are made to the working environment. We make recommendations that may assist departments to support RTs and ROMPs.

  19. Teaching medical students basic neurotransmitter pharmacology using primary research resources.

    PubMed

    Halliday, Amy C; Devonshire, Ian M; Greenfield, Susan A; Dommett, Eleanor J

    2010-12-01

    Teaching pharmacology to medical students has long been seen as a challenge, and one to which a number of innovative approaches have been taken. In this article, we describe and evaluate the use of primary research articles in teaching second-year medical students both in terms of the information learned and the use of the papers themselves. We designed a seminar where small groups of students worked on different neurotransmitters before contributing information to a plenary session. Student feedback suggested that when the information was largely novel, students learned considerably more. Crucially, this improvement in knowledge was seen even when they had not directly studied a particular transmitter in their work groups, suggesting a shared learning experience. Moreover, the majority of students reported that using primary research papers was easy and useful, with over half stating that they would use them in future study.

  20. Doctor-patient dialogue--basic aspect of medical consultation.

    PubMed

    Murariu-Brujbu, Isabella Cristina; Macovei, Luana Andreea

    2013-01-01

    Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

  1. Improving neuro-oncological patients care: basic and practical concepts for nurse specialist in neuro-rehabilitation.

    PubMed

    Bartolo, Michelangelo; Zucchella, Chiara; Pace, Andrea; De Nunzio, Alessandro Marco; Serrao, Mariano; Sandrini, Giorgio; Pierelli, Francesco

    2012-10-02

    Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding.The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course. A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics. The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questions were developed in order to evaluate the participants' level of knowledge, while a semi-structured interview was prepared to investigate students' satisfaction. Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education programmes for graduate nurses. Developing expertise in neuro

  2. Improving neuro-oncological patients care: basic and practical concepts for nurse specialist in neuro-rehabilitation

    PubMed Central

    2012-01-01

    Background Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding. The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course. Methods A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics. Results The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questions were developed in order to evaluate the participants’ level of knowledge, while a semi-structured interview was prepared to investigate students’ satisfaction. Conclusions Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education programmes for graduate nurses

  3. The Reorganization of Basic Science Departments in U.S. Medical Schools, 1980-1999.

    ERIC Educational Resources Information Center

    Mallon, William T.; Biebuyck, Julien F.; Jones, Robert F.

    2003-01-01

    Constructed a longitudinal database to examine how basic science departments have been reorganized at U.S. medical schools. Found that there were fewer basic science departments in the traditional disciplines of anatomy, biochemistry, microbiology, pharmacology, and physiology in 1999 than in 1980. But as biomedical science has developed in an…

  4. The Reorganization of Basic Science Departments in U.S. Medical Schools, 1980-1999.

    ERIC Educational Resources Information Center

    Mallon, William T.; Biebuyck, Julien F.; Jones, Robert F.

    2003-01-01

    Constructed a longitudinal database to examine how basic science departments have been reorganized at U.S. medical schools. Found that there were fewer basic science departments in the traditional disciplines of anatomy, biochemistry, microbiology, pharmacology, and physiology in 1999 than in 1980. But as biomedical science has developed in an…

  5. Refresher Training Program for the Basic Emergency Medical Technician. Course Guide, 1979.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This guide for a refresher training program for basic Emergency Medical Technicians (EMTs) is designed to assure continuance of a uniformly high level of knowledge and skills among EMTs who have completed the U.S. Department of Transportation's basic training for EMTs. The first of four sections presents the purposes of the course, the role of the…

  6. [Medical transfers in pediatric oncology. Reflections apropos of economic, technical and ethical problems (Oran 1977-1983)].

    PubMed

    Aguercif, M; Meziane, F; Taleb-Bendiab, R; Bouhass, R; Bendouma, M; Borsali, T

    1986-02-01

    In an underdeveloped country such as Algeria [20 million inhabitants, 2,140 US Dollars per capita gross national product (GNP)], satisfying a high level of health demand is difficult both in primary care and hospital. Limited facilities (hospital beds 2.3%; physicians 1:2,500; public health expenditure: 2% of GNP) combined with demographic pressure (population under 15 years of age: 47%) further compromise medical benefits. Qualitatively severe diseases such as pediatric cancers cannot be wholly managed locally. Thus administrative regulations permit sending patients with such situations abroad. We tested the feasibility of managing locally to a great extent (radiotherapy excepted) pediatric cancers. For leukemias and lymphomas, actuarial life expectancies corresponded to middle values of internationally published data. Cost-benefit estimations seemed good compared with other severe diseases managed both locally and abroad. Our present problem deals with balancing oncologic activity (more than 100 new cases a year) within a general pediatric department practice.

  7. Continuing professional development needs of Australian radiation oncology medical physicists--an analysis of applications for CPD funding.

    PubMed

    Perkins, A; Kron, T

    2007-09-01

    In November 2004, the Australian federal government allocated $775,000 to individual Australian radiation oncology medical physicists (ROMPs) to access continuing professional development (CPD) activities. The funding was administered by the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM). In order to receive funding, individuals had to submit an application to ACPSEM, which assessed each application and distributed funds to successful applicants. 248 separate applications were received from 143 individuals in two rounds of applications. Information from the applications was collated and analysed, with the aim of identifying patterns that will be of use in future planning for CPD. This paper presents a summary of the information extracted from the analysis.

  8. Some sociodemographic and diagnostic characteristics of military patients treated in the Department of Medical Oncology, Gülhane Military Medical Academy.

    PubMed

    Acikel, Cengiz Han; Kir, Tayfun; Komurcu, Seref; Kilic, Selim; Ozett, Ahmet; Rzayev, Maharet; Arpaci, Fikret; Ozturk, Bekir; Ogur, Recai; Ataergin, Selmin; Kuzhan, Okan; Hasde, Metin

    2006-05-01

    Today, chronic diseases have increased importance. Cancer, for which 10 million new cases are diagnosed around the world each year, is in the lead of such diseases. This study included military personnel with cancer who applied to the Department of Medical Oncology, Gülhane Military Medical Academy, in the period between 1998 and 2003, and it aims to describe some sociodemographic and diagnostic characteristics of the patients. The total number of cases was 938, which included both active duty and retired military personnel with diagnoses of cancer who were given medical care between 1998 and 2003 in the Department of Medical Oncology. For the study group, the five most common diagnoses were lung cancer, colorectal cancer, testicular cancer, non-Hodgkin's lymphoma, and Hodgkin's disease. Although the first three diagnoses among officers were lung cancer, testicular cancer, and Hodgkin's disease, those among retired officers were colorectal cancer, lung cancer, and prostate cancer. Among noncommissioned officers, the first three diagnoses were colorectal cancer, testicular cancer, and Hodgkin's disease for active duty patients and lung cancer, colorectal cancer, and gastric cancer for retired patients. In the group of privates, testicular cancer, Hodgkin's disease, and non-Hodgkin's lymphoma were the first three diagnoses. When we consider the characteristics of cancers, such as high costs of treatment, loss of manpower, and high mortality rates, prevention of cancers and early diagnosis are very important. Because the frequent types of cancers differed for groups according to age and occupation, those characteristics should be considered when cancer screening programs are being developed for the Armed Forces.

  9. Some Basic Determinants of Medical Care and Health Policy

    PubMed Central

    Somers, Anne R.

    1966-01-01

    Long-term trends in our economy and social structure are radically affecting the supply and demand for health services. Population increases, both generally and in the over-65-years-of-age bracket, growing ratio of nonwhites to whites, increasing proportion of women, increasing urbanization, industrialization, educational levels and per capita income are only some of the major factors affecting the demand for health services. Major developments in the science, technology and organization of medical care are and will continue breaking traditional patterns in rendering such care, and definitely point in the direction of multidisciplinary and institutional makeup in the delivery of health services. Changes in the financing of medical care are bringing in a foray of public programs sponsored by all levels of the government, contributing to the unique American pluralistic health care economy with its “mix” of public and private activities. Questions, intended to point up some of the more far-reaching issues, are appended to each section of the paper. PMID:5971547

  10. SU-F-P-13: NRG Oncology Medical Physics Manpower Survey Quantifying Support Demands for Multi Institutional Clinical Trials

    SciTech Connect

    Monroe, J; Boparai, K; Xiao, Y; Followill, D; Galvin, J; Sohn, J

    2016-06-15

    Purpose: A survey was taken by NRG Oncology to assess Full Time Equivalent (FTE) contributions to multi institutional clinical trials by medical physicists.No current quantification of physicists’ efforts in FTE units associated with clinical trials is available. The complexity of multi-institutional trials increases with new technologies and techniques. Proper staffing may directly impact the quality of trial data and outcomes. The demands on physics time supporting clinical trials needs to be assessed. Methods: The NRG Oncology Medical Physicist Subcommittee created a sixteen question survey to obtain this FTE data. IROC Houston distributed the survey to their list of 1802 contact physicists. Results: After three weeks, 363 responded (20.1% response). 187 (51.5%) institutions reporting external beam participation were processed. There was a wide range in number of protocols active and supported at each institution. Of the 187 clinics, 134 (71.7%) participate in 0 to 10 trials, 28 (15%) in 11 to 20 trials, 10 (5.3%) in 21 to 30 trials, 9 (4.8%) had 40 to 75 trials. On average, physicist spent 2.7 hours (SD: 6.0) per week supervising or interacting with clinical trial staff. 1.25 hours (SD: 3.37), 1.83 hours (SD: 4.13), and 0.64 hours(SD: 1.13) per week were spent on patient simulation, reviewing treatment plans, and maintaining a DICOM server, respectively. For all protocol credentialing activities, physicist spent an average of 37.05 hours (SD: 96.94) yearly. To support dosimetrists, clinicians, and therapists, physicist spend on average 2.07 hours (SD: 3.52) per week just reading protocols. Physicist attended clinical trial meetings for on average 1.13 hours (SD: 1.85) per month. Conclusion: Responding physicists spend a nontrivial amount of time: 8.8 hours per week (0.22 FTE) supporting, on average, 9 active multi-institutional clinical trials.

  11. Asthma Medications: Basic Pharmacology and Use in the Athlete

    PubMed Central

    Houglum, Joel E.

    2000-01-01

    Objective: Asthma is a chronic disease that affects athletes at all levels of sport. Several categories of drugs, including relatively new agents, are available to treat the asthmatic patient. By understanding the appropriate uses and effects of these drugs, the athletic trainer can assist the asthmatic athlete in improving therapeutic outcomes from the asthma therapy. The appropriate use of these medications includes not only the use of the appropriate drug(s), but also appropriate technique for administration, compliance with the prescribed dosing intervals, and sufficient care to avoid side effects. Data Sources: I searched MEDLINE and CINAHL from 1982 to 1999 and International Pharmaceutical Abstracts from 1990 to 1999. Terms searched were “asthma,” “athlete,”“athletic,” “exercise-induced,” “exercise,” “performance,” “therapy,” and “treatment.” Data Synthesis: Bronchodilators include β2 agonists, anticholinergics, and methylxanthines. Of these, the β2 agonists used by inhalation are the drugs of choice to treat an acute asthma attack or to prevent an anticipated attack (such as before exercise). Anti-inflammatory agents include corticosteroids mast cell-stabilizing agents, and antileukotrienes. Corticosteroids by inhalation are the drugs of choice for long-term treatment to curb the inflammatory process in the lung. Each of these drug categories has a unique mechanism of action. The athletic trainer who understands the appropriate use of these medications can help the athlete to obtain optimal results from drug therapy. Encouraging the athlete to comply with appropriate therapy, monitoring the effectiveness of the therapy, and recognizing the stimuli that initiate asthmatic attacks can improve the patient's therapeutic outcomes. Conclusions/Recommendations: The athletic trainer has an opportunity to play a key role in ensuring that the asthmatic athlete achieves the desired outcomes from treatment. The athletic trainer can help

  12. LncRNAs: From Basic Research to Medical Application

    PubMed Central

    Wu, Tao; Du, Yantao

    2017-01-01

    This review aimed to summarize the current research contents about long noncoding RNAs (lncRNAs) and some related lncRNAs as molecular biomarkers or therapy strategies in human cancer and cardiovascular diseases. Following the development of various kinds of sequencing technologies, lncRNAs have become one of the most unknown areas that need to be explored. First, the definition and classification of lncRNAs were constantly amended and supplemented because of their complexity and diversity. Second, several methods and strategies have been developed to study the characteristic of lncRNAs, including new species identifications, subcellular localization, gain or loss of function, molecular interaction, and bioinformatics analysis. Third, based on the present results from basic researches, the working mechanisms of lncRNAs were proved to be different forms of interactions involving DNAs, RNAs, and proteins. Fourth, lncRNA can play different important roles during the embryogenesis and organ differentiations. Finally, because of the tissue-specific expression of lncRNAs, they could be used as biomarkers or therapy targets and effectively applied in different kinds of diseases, such as human cancer and cardiovascular diseases. PMID:28367094

  13. Assessing the need for improved strategies and medication-related education to increase adherence for oral anticancer medications in the young adult oncology population.

    PubMed

    Divakaruni, Anupama; Saylor, Elizabeth; Duffy, Alison P

    2017-01-01

    Rationale Oral anticancer medication adherence is a critical factor in optimizing cancer treatment outcomes and minimizing toxicity. Although potential adherence barriers exist, it is not well understood how these factors impact adherence. Methods This is a prospective, single-center, patient survey-based study conducted at the University of Maryland Greenebaum Comprehensive Cancer Center including 18- to 39-year-old patients who have been actively taking an oral anticancer medication for at least one month from 1 April 2013 to 1 April 2016. The primary objective of this study is to describe institutional practices for medication education and adherence monitoring practices as perceived by young adult patients at the University of Maryland Greenebaum Comprehensive Cancer Center and to describe practice consistency with recommendations from the American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards. The secondary objectives include patient-reported facilitators and barriers to oral anticancer medication adherence. Results Seventeen patients completed the survey; 24% ( n = 4) of patients denied receiving information about what to do in case of a missed dose. The most common facilitators of adherence include understanding of disease and treatment (88%, n = 15), perceived severity of illness (82%, n = 14), and use of oral anticancer medications (82%, n = 14). The most common barriers to adherence are side effects (59% n = 10), forgetfulness (47%, n = 8), and depressive symptoms (35%, n = 6). Conclusion Based on patient-reported guideline adherence, improvement is needed in including family, caregivers, and others in the education process as well as providing education about plan for missed doses and drug-drug and drug-food interactions. The strengths of the current medication education and adherence monitoring practices as perceived by the young adult patient population include education

  14. Medication Therapy Management for Patients Receiving Oral Chemotherapy Agents at a Community Oncology Center: A Pilot Study.

    PubMed

    Bertsch, Nathan S; Bindler, Ross J; Wilson, Poppy L; Kim, Anne P; Ward, Beverly

    2016-10-01

    Purpose: To determine the impact of a pharmacist-driven medication therapy management (MTM) program for patients receiving oral chemotherapy agents. Methods: We assessed the impact of MTM consultations with a pharmacist for patients who were receiving a new prescription for an oral chemotherapy agent. Data were assessed for outcomes including (1) number of medication errors identified in electronic medical records (EMRs), (2) number of interventions performed by the pharmacist, (3) time spent on the MTM process, and (4) patient satisfaction. Data were compared between patients who received their oral chemotherapy agents from the onsite specialty pharmacy or from a mail-order pharmacy. The data were also examined for correlations, and logistic regression was utilized to determine the largest variant cofactor to create an equation for estimating the number of errors in a patient's EMR. Results: Fifteen patients received an MTM consultation, and the pharmacists identified an average of 6 medication EMR errors per patient. There was an average of 3 pharmacist-led interventions per patient. Multiple significant correlations were noted between the variables: (1) total number of prescriptions a patient was taking, (2) total number of medication errors identified, (3) time spent on the MTM process, and (4) total number of interventions performed by the pharmacist. Patient satisfaction was favorable for the program. Conclusion: The implementation of a pharmacist-driven MTM program for patients receiving a prescription for an oral chemotherapy agent had a significant impact on patient care by improving medication reconciliation, identifying drug-related problems, and strengthening pharmacist-patient interactions in the oncology clinic.

  15. Peer-Assisted Learning: Filling the Gaps in Basic Science Education for Preclinical Medical Students

    ERIC Educational Resources Information Center

    Sammaraiee, Yezen; Mistry, Ravi D.; Lim, Julian; Wittner, Liora; Deepak, Shantal; Lim, Gareth

    2016-01-01

    In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United…

  16. Peer-Assisted Learning: Filling the Gaps in Basic Science Education for Preclinical Medical Students

    ERIC Educational Resources Information Center

    Sammaraiee, Yezen; Mistry, Ravi D.; Lim, Julian; Wittner, Liora; Deepak, Shantal; Lim, Gareth

    2016-01-01

    In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United…

  17. Basic Training Course/Emergency Medical Technician (Second Edition). Instructor's Lesson Plan.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document containing instructor lesson plans is one of three prepared to update a basic training program for emergency medical technicians (EMTs). (A course guide containing planning and management information and a study guide are available separately.) Material covers all emergency medical techniques currently considered to be within the…

  18. Course Guide and Course Coordinator Orientation Program. Basic Training Program for Emergency Medical Technician. Ambulance.

    ERIC Educational Resources Information Center

    Dunlap and Associates, Inc., Darien, CT.

    To assist the States in implementing Federal standards for emergency medical services (under the Highway Safety Act of 1966), this guide has been prepared to aid in organizing, conducting, and standardizing a basic training course for emergency medical technicians (EMT's). Part I is a guide for a course designed to develop or upgrade the skill…

  19. Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: a report from the Children's Oncology Group.

    PubMed

    Turcotte, Lucie M; Georgieff, Michael K; Ross, Julie A; Feusner, James H; Tomlinson, Gail E; Malogolowkin, Marcio H; Krailo, Mark D; Miller, Nicole; Fonstad, Rachel; Spector, Logan G

    2014-11-01

    Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Incident hepatoblastoma cases who were born <2,500 g (N = 60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N = 51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. This study presents the largest case series of hepatoblastoma in <2,500 g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology. © 2014 Wiley Periodicals, Inc.

  20. Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

    PubMed

    Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel

    2012-01-01

    Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.

  1. Relations between policy for medical teaching and basic need satisfaction in teaching.

    PubMed

    Engbers, Rik; Fluit, Cornelia R M G; Bolhuis, Sanneke; Sluiter, Roderick; Stuyt, Paul M J; Laan, Roland F J M

    2015-10-01

    Policy initiatives that aim to elevate the position of medical teaching to that of medical research could influence the satisfaction of three basic psychological needs related to motivation for medical teaching. To explore relations between the satisfaction of three basic psychological needs towards medical teaching and two policy initiatives for medical teaching: (Junior) Principal Lecturer positions [(J)PL positions] and Subsidized Innovation and Research Projects in Medical Education (SIRPMEs). An online questionnaire was used to collect data about medical teaching in the setting of a university hospital. We adapted the Work-related Basic Need Satisfaction scale (Van den Broeck et al. in J Occup Organ Psychol, 83(4):981-1002, 2010), in order to measure feelings of autonomy, competence, and relatedness in teaching. We examined the relations between (J)PL positions and SIRPMEs and the satisfaction of three basic psychological needs. A total of 767 medical teachers participated. The initiatives appear to be related to different beneficial outcomes in terms of feelings of autonomy, competence, and relatedness in medical teaching. Either a (J)PL position is obtained by teachers who feel competent and related towards medical teaching, or obtaining a (J)PL position makes teachers feel more competent and related towards teaching, or these relations could be interacting. Also, either a SIRPME is obtained by teachers who feel competent and autonomous towards medical teaching, or obtaining a SIRPME makes teachers feel more competent and autonomous towards teaching, or these relations could be interacting. Additional research needs to scrutinize the causal or interacting relations further and to determine optimal conditions for these policy initiatives more specifically. Implications for future research are discussed.

  2. Impact of an Oncology Course on the Attitudes of Freshman Medical Students.

    ERIC Educational Resources Information Center

    Appel, Marilyn H.; And Others

    Previous attempts to change the prevailing negative attitudes of health professionals toward cancer and cancer patients have consisted mainly of elective courses for small groups of students at advanced levels of medical training. In order to develop more positive attitudes, the Cancer Coordinating Committee at the Medical College of Pennsylvania…

  3. Impact of an Oncology Course on the Attitudes of Freshman Medical Students.

    ERIC Educational Resources Information Center

    Appel, Marilyn H.; And Others

    Previous attempts to change the prevailing negative attitudes of health professionals toward cancer and cancer patients have consisted mainly of elective courses for small groups of students at advanced levels of medical training. In order to develop more positive attitudes, the Cancer Coordinating Committee at the Medical College of Pennsylvania…

  4. The Pocketable Electronic Devices in Radiation Oncology (PEDRO) Project: How the Use of Tools in Medical Decision Making is Changing?

    PubMed

    De Bari, Berardino; Franco, Pierfrancesco; Niyazi, Maximilian; Cornetto, Andrea Peruzzo; Qvortrup, Camilla; Martin, Arturo Navarro; Cacicedo, Jon; Fernandez, Gonçalo; Louro, Luís Vasco; Lestrade, Laëtitia; Ciammella, Patrizia; Greto, Daniela; Checkrine, Tarik; Youssef, Elkholti; Filippi, Andrea Riccardo; Poulsen, Laurids Østergaard; Alongi, Filippo

    2016-04-01

    To analyze the impact of mobile electronic devices (MEDs) and apps in the daily clinical activity of young radiation or clinical oncologists in 5 Western European countries (Italy, Germany, Spain, Portugal, and Denmark). A web-based questionnaire was sent to 462 young (≤40 years) members of the national radiation or clinical oncology associations of the countries involved in the study. The 15 items investigated diffusion of MEDs (smartphones and/or tablets), their impact on daily clinical activity, and the differences perceived by participants along time. A total of 386 (83.5%) of the 462 correctly filled questionnaires were statistically evaluated. Up to 65% of respondents declared to use an electronic device during their clinical activity. Conversely, 72% considered low to moderate impact of smartphones/tables on their daily practice. The daily use significantly increased from 2009 to 2012: users reporting a use ≥6 times/d raised from 5% to 39.9%. Professional needs fulfillment was declared by less than 68% of respondents and compliance to apps indications by 66%. Significant differences were seen among the countries, in particular concerning the feeling of usefulness of MEDs in the daily clinical life. The perception of the need of a comprehensive Web site containing a variety of applications (apps) for clinical use significantly differed among countries in 2009, while it was comparable in 2012. This survey showed a large diffusion of MEDs in young professionals working in radiation oncology. Looking at these data, it is important to verify the consistency of information found within apps, in order to avoid potential errors eventually detrimental for patients. "Quality assurance" criteria should be specifically developed for medical apps and a comprehensive Web site gathering all reliable applications and tools might be useful for daily clinical practice. © The Author(s) 2015.

  5. [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.

  6. [Training requirements, expertise and basic conditions of committed medical educators in Germany].

    PubMed

    Huwendiek, Sören; Dern, Peter; Hahn, Eckhart G; Pediaditakis, Daphne; Tönshoff, Burkhard; Nikendei, Christoph

    2008-01-01

    Despite an increasing interest in undergraduate, postgraduate and continuing medical education, little is known about the training requirements, expertise and basic conditions of medical educators. Against this backdrop, we initiated a web-based survey amongst members of the "Gesellschaft für Medizinische Ausbildung" (German Section of the Association for Medical Education in Europe) e.V. (GMA). We conducted a web-based survey designed to answer the following questions: How do medical educators judge (1) their training requirements, (2) their expertise and (3) basic conditions. 147 out of 373 members of the GMA e-mailing list responded to the questionnaire (overall response rate: 39%). The following were rated as high-priority training needs: development in medical education research methodology (56% of survey participants), student assessment (37%), supporting self-directed learning (35%), and computer-based training (32%). The highest level of expertise [Likert Scale: 1 = very low to 5 = very high] was perceived in: general teaching principles (3.76 +/- 0.74), curriculum development (3.74 +/- 0.95), student assessment (3.65 +/- 0.97] and evaluation of courses and curricula [3.65 +/- 0.9]. Regarding basic conditions, respondents noted a particular need for more funding in medical education [4.26 +/- 0.88] and more recognition of merits in medical education [4.20 +/- 0.92]. The survey respondents identified more training in research methodology and more academic recognition and funding as important challenges in the field of medical education.

  7. Characteristics of physicians engaged in basic science: a questionnaire survey of physicians in basic science departments of a medical school in Japan.

    PubMed

    Yamazaki, Yuka; Uka, Takanori; Shimizu, Haruhiko; Miyahira, Akira; Sakai, Tatsuo; Marui, Eiji

    2012-01-01

    The number of physicians engaged in basic science and teaching is sharply decreasing in Japan. To alleviate this shortage, central government has increased the quota of medical students entering the field. This study aimed to determine the characteristics of physicians who are engaged in basic science in efforts to recruit talent. A questionnaire was distributed to all 30 physicians in the basic science departments of Juntendo University School of Medicine. Question items inquired about sex, years since graduation, years between graduation and time entering basic science, clinical experience, recommending the career to medical students, expected obstacles to students entering basic science, efforts to inspire students in research, increased number of lectures and practical training sessions on research, and career choice satisfaction. Correlations between the variables were examined using χ(2) tests. Overall, 26 physicians, including 7 female physicians, returned the questionnaire (response rate 86.7%). Most physicians were satisfied with their career choice. Medical students were deemed not to choose basic science as their future career, because they aimed to become clinicians and because they were concerned about salary. Women physicians in basic science departments were younger than men. Women physicians also considered themselves to make more efforts in inspiring medical students to be interested in research. Moreover, physicians who became basic scientists earlier in their career wanted more research-related lectures in medical education. Improving physicians' salaries in basic science is important to securing talent. In addition, basic science may be a good career path for women physicians to follow.

  8. Basic practical skills teaching and learning in undergraduate medical education – a review on methodological evidence

    PubMed Central

    Vogel, Daniela; Harendza, Sigrid

    2016-01-01

    Objective: Practical skills are an essential part of physicians’ daily routine. Nevertheless, medical graduates’ performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students’ learning of these skills. Methods: Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. Results: 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students’ performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. Conclusion: A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills. PMID:27579364

  9. Perspectives of medical oncologists regarding music therapy for patients with cancer in Turkey - can musicology be integrated into psycho-oncology?

    PubMed

    Tanriverdi, Ozgur; Aydemir, Nil Fatma

    2014-01-01

    Music therapy is a common complementary and alternative therapy in addition to medical treatment for patients with cancer. If music therapy, which is known has a positive effect on human emotions and behaviors, is a useful additional therapy, it should be more integrated into pyscho-oncology. In this study, we aimed to determine medical oncologist attitudes to music therapy for patients with cancer and knowledge about musicology and music therapy in Turkey. This survey study included questions about participant attitudes and knowledge regarding music therapy as well as demographic characteristics. The population of the study were 402 physicians working in medical oncology in Turkey and the sample covered 112 participants in the the survey. For statistical analyses the chi-square test, Fischer exact test, and Mann-Whitney U analysis are applied. In our study the rate for medical oncologists who were interested in music therapy was 28% (n=112). Some 30% (n=34) of medical oncologists recommended music therapy for their patients and 55% (n=61) recommended music therapy to prevent anxiety in patients with cancer. In this study, for more harmony with patients and in order to ensure management of adverse effect, it was concluded that music therapy should be regrded as an additional therapy in oncology clinics.

  10. The dinosaur is extinct: the demise of solo medical oncology practice in the United States.

    PubMed

    Keech, John A

    2010-09-01

    Evolution is brought about by subtle environmental pressures over time or by a cataclysmic extinction event. The latter is the case for the solo medical oncologist, with the event being the Medicare Modernization Act of 2003.

  11. Necessity of Accreditation Standards for Quality Assurance of Medical Basic Sciences

    PubMed Central

    Rezaeian, M; Jalili, Z; Nakhaee, N; Shirazi, J Jahroomi; Jafari, AR

    2013-01-01

    Background: The present article reviews the significance of accreditation standards while emphasizing the necessity of implementation of such standards by basic medical science council, with an eye on such international standards as those published by WFME. This review article had to decide on the key words and expressions, data bases, to review relevant literature, review higher and medical education journals at GOOGLE, ELSEVIER, PUBMED, and such web sites as those of WFME and WMA’s. Accreditation is a powerful leverage for institutional change and improvement and must be actively supported by academic and national health authorities worldwide. Considering the mission of the Basic Medical Science, Health and Post grad. Education, Ministry of Health and Medical Education, Tehran, Iran as accountable medical education, all specialists of the spectrum of disciplines agreed on the necessity of formulating the medical education standards for all disciplines of their interest. It is important that all efforts be joined in the endeavor to create effective and reliable instruments for quality assurance of Basic Medical Sciences Education. PMID:23865033

  12. Is basic science disappearing from medicine? The decline of biomedical research in the medical literature.

    PubMed

    Steinberg, Benjamin E; Goldenberg, Neil M; Fairn, Gregory D; Kuebler, Wolfgang M; Slutsky, Arthur S; Lee, Warren L

    2016-02-01

    Explosive growth in our understanding of genomics and molecular biology have fueled calls for the pursuit of personalized medicine, the notion of harnessing biologic variability to provide patient-specific care. This vision will necessitate a deep understanding of the underlying pathophysiology in each patient. Medical journals play a pivotal role in the education of trainees and clinicians, yet we suspected that the amount of basic science in the top medical journals has been in decline. We conducted an automated search strategy in PubMed to identify basic science articles and calculated the proportion of articles dealing with basic science in the highest impact journals for 8 different medical specialties from 1994 to 2013. We observed a steep decline (40-60%) in such articles over time in almost all of the journals examined. This rapid decline in basic science from medical journals is likely to affect practitioners' understanding of and interest in the basic mechanisms of disease and therapy. In this Life Sciences Forum, we discuss why this decline may be occurring and what it means for the future of science and medicine.

  13. Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation

    PubMed Central

    Denadai, Rafael; Toledo, Andréia Padilha; Martinhão Souto, Luis Ricardo

    2012-01-01

    Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed. PMID:23326659

  14. The challenge for basic science education in problem-based medical curricula.

    PubMed

    Sweeney, G

    1999-02-01

    There has been intense debate about medical curriculum reform since the early 1950s. The last 25 years have seen a steady shift ward problem-based learning curriculum design in schools of medicine and allied health sciences. This trend has been less challenging for clinical departments than for departments of basic science, where it has often evoked anxiety, antipathy, lack of cooperation, and general mistrust. This appears paradoxical, as problem-based learning (PBL) is promoted as an improved method of integrating scientific concepts, and the advances that drive much of modern medical practice are advances in the basic sciences. While proponents of PBL argue that the approach promotes better integration and use of scientific concepts, the evidence, such as it is, is against this. As well, other evidence suggests that clinicians do not use basic science concepts extensively in their practice. This then questions the utility of scientific knowledge in a medical curriculum. This article examines this notion of utility (the quality or state of being useful), to establish some ground rules for what does, and does not, possess utility, and to present strategies to develop specific objectives from general statements concerning utility. Understanding of biologic and pathologic processes becomes of central importance and arguably possesses utility. If it is both required and evaluated, such understanding necessitates mastery of basic science concepts. Previously, the presentation of the basic sciences in medical curricula has emphasized the acquisition of knowledge rather than its use. Such learning has been perceived to lack utility; strategies to enhance the value of studying basic science concepts are suggested. If the importance of objectives in the basic medical sciences is accepted, these objectives should be achieved early in training, maintained at exit from medical school, and revisited in continuing medical education. The process of change in medical education

  15. How do medical students in their clinical years perceive basic sciences courses at King Saud University?

    PubMed

    Alam, Awatif

    2011-01-01

    The inclusion of detailed basic science courses in medical school curricula has been a concern of students. The main objective of this study was to explore the attitudes of medical students towards basic sciences courses taught to them in the preclinical years and the applicability of these courses to current clinical practice. A cross-sectional survey was conducted during 2008-2009 among medical students in their clinical years at King Saud University, Riyadh, Saudi Arabia. Thirty percent of all students (n=314) were randomly selected to receive a questionnaire designed to evaluate their opinions about course load, ability to recall information, value of practical sessions, availability of references and course guidelines, and the applicability of individual courses to clinical practice. Students identified anatomy and pathology as the courses most overloaded with content (76% and 70%, respectively). Half of the students felt they retained the most knowledge of physiology (50%), while less than a quarter of students (19%) felt they retained the most information from biochemistry coursework. The role of practical sessions in facilitating theoretical understanding was more evident in anatomy (69%). Physiology was perceived as the subject with the highest applicability to clinical practice (66%), while pathology (29%) was identified as the subject with the least practical application. Students became increasingly negative in their opinions about basic science courses as they progressed through their medical education. Current attitudes of medical students towards their basic science courses indicate a need to reform the curricula so as to maximize the benefit of these courses.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  18. Back to the basic sciences: an innovative approach to teaching senior medical students how best to integrate basic science and clinical medicine.

    PubMed

    Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L

    2008-07-01

    Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.

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

    PubMed

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

    2012-01-05

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

  20. 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.

  1. Evaluation of a Basic Science, Peer Tutorial Program for First- and Second-Year Medical Students.

    ERIC Educational Resources Information Center

    Trevino, Fernando M.; Eiland, D. C., Jr.

    1980-01-01

    A peer tutorial program in the basic sciences implemented at the University of Texas Medical Branch at Galveston is evaluated. The grades of students receiving peer tutorials were analyzed and questionnaires were mailed to each participant soliciting their evaluation of services received. Future cost-benefit evaluations are planned. (Author/MLW)

  2. Evaluation of a Basic Science, Peer Tutorial Program for First- and Second-Year Medical Students.

    ERIC Educational Resources Information Center

    Trevino, Fernando M.; Eiland, D. C., Jr.

    1980-01-01

    A peer tutorial program in the basic sciences implemented at the University of Texas Medical Branch at Galveston is evaluated. The grades of students receiving peer tutorials were analyzed and questionnaires were mailed to each participant soliciting their evaluation of services received. Future cost-benefit evaluations are planned. (Author/MLW)

  3. Selecting Students for Medical School: What Predicts Success during Basic Science Studies? A Cognitive Approach.

    ERIC Educational Resources Information Center

    Lindblom-Ylanne, Sari; And Others

    1996-01-01

    A study with 503 applicants to the University of Helsinki (Finland) medical school compared the predictive validity of multiple-choice science tests and a "learning-from-text" test (LFT) designed to measure deep-level text processing. Results indicated the LFT was the best predictor of student academic progress in basic science courses.…

  4. Basic Training Course/Emergency Medical Technician (Second Edition). Course Guide.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    Intended to aid the course coordinator in planning and managing a basic training program for emergency medical technicians (EMTs), this course guide is divided into four sections. The introductory section provides a brief overview of the coordinator's responsibilities and identifies the twenty-five lessons included in the course. Section 2…

  5. A Basic Instructional Unit in Ophthalmology for Medical Students: Conceptualization, Development, Validation and Implementation. Final Report.

    ERIC Educational Resources Information Center

    Spivey, Bruce E.; And Others

    A systems approach has been used to develop and validate instructional materials in medical education. Seven self-instructional units, currently in various stages of completion, form the basis of a basic curriculum in opthamology. Performance objectives for the units were derived from the results of a questionnaire responded to by 1,600…

  6. Basic Training Course/Emergency Medical Technician. (1977 Edition). Student Study Guide.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    Developed to aid students enrolled in an emergency medical technician (EMT) training course, this document accompanies a course guide and a set of instructor lesson plans which update a basic training program for EMTs. The course consists of twenty-five lessons involving a minimum of seventy-one hours of classroom and field training plus ten hours…

  7. Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

    PubMed

    Malamed, Stanley F

    2015-12-01

    Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

  8. Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce over the past quarter century.

    PubMed

    Deville, Curtiland; Chapman, Christina H; Burgos, Ramon; Hwang, Wei-Ting; Both, Stefan; Thomas, Charles R

    2014-09-01

    To assess the medical oncology (MO) physician workforce diversity by race, Hispanic ethnicity, and sex, with attention to trainees. Public registries were used to assess 2010 differences among MO practicing physicians, academic faculty, and fellows; internal medicine (IM) residents; and the US population, using binomial tests with P < .001 significance adjusting for multiple comparisons. Significant changes in fellow representation from 1986 to 2011 were assessed. Female representation as MO fellows (45.0%) was significantly increased compared with faculty (22.4%) and practicing physicians (27.4%); was no different than IM residents (44.7%, P = .853); and increased significantly, by 1.0% per year. Women were significantly underrepresented as practicing physicians, faculty, and fellows compared with the US population (50.8%). Traditionally underrepresented minorities in medicine (URM) were significantly underrepresented as practicing physicians (7.8%), faculty (5.7%), and fellows (10.9%), versus US population (30.0%). Hispanic MO fellows (7.5%) were increased compared with faculty (3.9%) and practicing physicians (4.1%); Black fellows (3.1%) were no different than faculty (1.8%, P = .0283) or practicing physicians (3.5%, P = .443). When comparing MO fellows versus IM residents, there were no differences for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (0.3%, 0.6%, respectively, P = .137) and Hispanics (7.5%, 8.7%, P = .139), unlike Blacks (3.1%, 5.6%, P < .001). There has been no significant change in URM representation, with negligible changes every 5 years for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (-0.1%), Blacks (-0.3%), and Hispanics (0.3%). Female fellow representation increased 1% per year over the quarter century indicating historical gains, whereas URM diversity remains unchanged. For Blacks alone, representation as MO fellows is decreased compared with IM residents, suggesting greater disparity in MO

  9. Patients With Advanced Non-Small Cell Lung Cancer Requiring Inpatient Medical Oncology Consultation: Characteristics, Referral Patterns, and Outcomes.

    PubMed

    Gotfrit, Joanna; Zhang, Tinghua; Zanon-Heacock, Silvia; Wheatley-Price, Paul

    2016-07-01

    Patients with advanced non-small cell lung cancer (NSCLC) occasionally are hospitalized at the time of initial medical oncology consultation. We investigated the characteristics and outcomes of this population. With ethics approval, we performed a retrospective analysis of patients with advanced NSCLC at our institution whose initial consult occurred while hospitalized from 2007 to 2012. This was an exploratory analysis. Multivariate survival analysis was performed using Cox regression models. A total of 223 patients were included. Baseline demographics were as follows: median age, 65 years; 52% were female; median Charlson Comorbidity Index of 10; 69% performance status (PS) 3 to 4; 49% were current smokers; 90% had stage IV disease; and 52% had ≥ 5% weight loss. Only 24% received chemotherapy. Among those treated, the median time from diagnosis to chemotherapy was 43 days. Common reasons for not receiving chemotherapy included poor PS (72%) and patient choice (9%). Factors associated with receiving chemotherapy in multivariate analysis were good PS (odds ratio [OR], 9.01; 95% confidence interval [CI], 3.55-23.26; P < .001), no leukocytosis (OR, 3.56; 95% CI, 1.35-9.35; P = .01), and age < 70 years (OR, 6.80; 95% CI, 1.78-26.32; P = .005). Factors associated with shorter overall survival in multivariate analysis were not receiving chemotherapy (hazard ratio [HR], 2.11; 95% CI, 1.28-3.48; P = .003), PS 3 to 4 (HR, 1.51; 95% CI, 1.01-2.26; P = .045), leukocytosis (HR, 2.13; 95% CI, 1.44-3.13; P < .001), and thrombocytosis (HR, 1.46; 95% CI, 1.03-2.09; P = .036). Patients whose first consultation with medical oncologists occurs while hospitalized are an inherently sick population. Earlier diagnosis and referral would give more patients access to treatment options before a terminal functional decline. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Designing an evaluation framework for WFME basic standards for medical education.

    PubMed

    Tackett, Sean; Grant, Janet; Mmari, Kristin

    2016-01-01

    To create an evaluation plan for the World Federation for Medical Education (WFME) accreditation standards for basic medical education. We conceptualized the 100 basic standards from "Basic Medical Education: WFME Global Standards for Quality Improvement: The 2012 Revision" as medical education program objectives. Standards were simplified into evaluable items, which were then categorized as inputs, processes, outputs and/or outcomes to generate a logic model and corresponding plan for data collection. WFME standards posed significant challenges to evaluation due to complex wording, inconsistent formatting and lack of existing assessment tools. Our resulting logic model contained 244 items. Standard B 5.1.1 separated into 24 items, the most for any single standard. A large proportion of items (40%) required evaluation of more than one input, process, output and/or outcome. Only one standard (B 3.2.2) was interpreted as requiring evaluation of a program outcome. Current WFME standards are difficult to use for evaluation planning. Our analysis may guide adaptation and revision of standards to make them more evaluable. Our logic model and data collection plan may be useful to medical schools planning an institutional self-review and to accrediting authorities wanting to provide guidance to schools under their purview.

  11. Program evaluation of an Integrated Basic Science Medical Curriculum in Shiraz Medical School, Using CIPP Evaluation Model.

    PubMed

    Rooholamini, Azadeh; Amini, Mitra; Bazrafkan, Leila; Dehghani, Mohammad Reza; Esmaeilzadeh, Zohreh; Nabeiei, Parisa; Rezaee, Rita; Kojuri, Javad

    2017-07-01

    In recent years curriculum reform and integration was done in many medical schools. The integrated curriculum is a popular concept all over the world. In Shiraz medical school, the reform was initiated by stablishing the horizontal basic science integration model and Early Clinical Exposure (ECE) for undergraduate medical education. The purpose of this study was to provide the required data for the program evaluation of this curriculum for undergraduate medical students, using CIPP program evaluation model. This study is an analytic descriptive and triangulation mixed method study which was carried out in Shiraz Medical School in 2012, based on the views of professors of basic sciences courses and first and second year medical students. The study evaluated the quality of the relationship between basic sciences and clinical courses and the method of presenting such courses based on the Context, Input, Process and Product (CIPP) model. The tools for collecting data, both quantitatively and qualitatively, were some questionnaires, content analysis of portfolios, semi- structured interview and brain storming sessions. For quantitative data analysis, SPSS software, version 14, was used. In the context evaluation by modified DREEM questionnaire, 77.75%of the students believed that this educational system encourages them to actively participate in classes. Course schedule and atmosphere of class were reported suitable by 87.81% and 83.86% of students. In input domain that was measured by a researcher made questionnaire, the facilities for education were acceptable except for shortage of cadavers. In process evaluation, the quality of integrated modules presentation and Early Clinical Exposure (ECE) was good from the students' viewpoint. In product evaluation, students' brain storming, students' portfolio and semi-structured interview with faculties were done, showing some positive aspects of integration and some areas that need improvement. The main advantage of assessing

  12. Ototoxicity monitoring through the eyes of the treating physician: Perspectives from pulmonology and medical oncology.

    PubMed

    Garinis, Angela C; Cornell, Alexandra; Allada, Gopal; Fennelly, Kevin P; Maggiore, Ronald J; Konrad-Martin, Dawn

    2017-10-05

    Integrating audiological management into the care pathways of clinical specialties that prescribe ototoxic medications for essential, often life-preserving medical care that is critical for early hearing loss identification and remediation. Research shows that successful implementation of a new health service or intervention requires alignment of goals among provider groups, institutional leadership and patients. Thoughtful consideration of the physician's viewpoints about ototoxicity and its implications for treatment planning is, therefore, important for the implementation and enduring success of an ototoxicity monitoring programme (OMP). This discussion paper uses qualitative methods to explore the perspectives of four physicians on OMP provision in their patient populations. Three pulmonologists and one oncologist completed the written survey or survey-based interview described in this report. Each physician indicated that (i) ototoxicity is a potential problem for their patients; (ii) monitoring hearing is important to ensure good quality of life among their patients and (iii) treatment modification would be considered if an alternative treatment option were available. The physicians differed in their approaches to ototoxicity monitoring, from routine referrals to audiology, to relying on patient self-referral. Physician provider input is needed to optimise monitoring schedules and OMP care coordination with audiology.

  13. Interconnections of basic science research and product development in medical device design.

    PubMed

    Privitera, Mary Beth; Design, M; Johnson, Jeffrey

    2009-01-01

    The relationship between basic science research and product design/development are intertwined. This paper explores the definition of basic science and design as it relates to medical device development. It is intended to serve as a reference for both researchers and device developers to assist in trans-disciplinary collaborative efforts in improving patient care as each are of equal importance. The definition of a medical device is broad and varied. This paper is aimed towards those devices which interact with tissue and are rooted in the tenets of science. Both the scientific method and the design process are compared with similarities and opposites identified. The paper concludes identifying fundamental principles of medical device development and highlights the importance of both entities.

  14. BASIC RADIATION PROTECTION EDUCATION AND TRAINING FOR MEDICAL PROFESSIONALS; GEORGIAN EXPERIENCE AND FUTURE PERSPECTIVE.

    PubMed

    Todua, F; Nadareishvili, D; Ormotsadze, G; Sanikidze, T

    2016-06-01

    The level of knowledge provided by the Tbilisi State Medical University (TSMU) standard curriculum modules in 'Medical physics' and 'Radiation risk estimates' was assessed as was the learning outcome of modern standards elective course in 'Radiation protection'. Two groups of medical students were examined: Group 1: 5 y students, participants in elective course 'Radiobiology and radiogenic health risk' and Group 2: 1-2 y students, participants in winter and summer schools. Students were tested before and after training courses with the same tests questionnaire. The results of the tests showed the necessity for improvement of the educational curriculum. The changes needed are the inclusion of a basic radiobiological course in the curricula of the faculty of medicine and expansion of the medical physics course through a more detailed presentation of medical imaging methods. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Phenomenographic study of basic science understanding-senior medical students' conceptions of fatigue.

    PubMed

    Wilhelmsson, Niklas; Dahlgren, Lars Owe; Hult, Håkan; Wirell, Staffan; Ledin, Torbjörn; Josephson, Anna

    2013-01-01

    Helping students learn to apply their newly learned basic science knowledge to clinical situations is a long-standing challenge for medical educators. This study aims to describe how medical students' knowledge of the basic sciences is construed toward the end of their medical curriculum, focusing on how senior medical students explain the physiology of a given scenario. Methods A group of final-year medical students from two universities was investigated. Interviews were performed and phenomenographic analysis was used to interpret students' understanding of the physiology underlying the onset of fatigue in an individual on an exercise bicycle. Three categories of description depict the qualitatively different ways the students conceptualized fatigue. A first category depicts well integrated physiological and bio-chemical knowledge characterized by equilibrium and causality. The second category contains conceptions of finite amount of substrate and juxtaposition of physiological concepts that are not fully integrated. The third category exhibits a fragmented understanding of disparate sections of knowledge without integration of basic science and clinical knowledge. Distinctive conceptions of fatigue based with varying completeness of students' understanding characterized the three identified categories. The students' conceptions of fatigue were based on varying understanding of how organ systems relate and of the thresholds that determine physiological processes. Medical instruction should focus on making governing steps in biological processes clear and providing opportunity for causal explanations of clinical scenarios containing bio-chemical as well as clinical knowledge. This augments earlier findings by adding descriptions in terms of the subject matter studied about how basic science is applied by students in clinical settings.

  16. An international basic science and clinical research summer program for medical students.

    PubMed

    Ramjiawan, Bram; Pierce, Grant N; Anindo, Mohammad Iffat Kabir; Alkukhun, Abedalrazaq; Alshammari, Abdullah; Chamsi, Ahmad Talal; Abousaleh, Mohannad; Alkhani, Anas; Ganguly, Pallab K

    2012-03-01

    An important part of training the next generation of physicians is ensuring that they are exposed to the integral role that research plays in improving medical treatment. However, medical students often do not have sufficient time to be trained to carry out any projects in biomedical and clinical research. Many medical students also fail to understand and grasp translational research as an important concept today. In addition, since medical training is often an international affair whereby a medical student/resident/fellow will likely train in many different countries during his/her early training years, it is important to provide a learning environment whereby a young medical student experiences the unique challenges and value of an international educational experience. This article describes a program that bridges the gap between the basic and clinical research concepts in a unique international educational experience. After completing two semester curricula at Alfaisal University in Riyadh, Kingdom of Saudi Arabia, six medical students undertook a summer program at St. Boniface Hospital Research Centre, in Winnipeg, MB, Canada. The program lasted for 2 mo and addressed advanced training in basic science research topics in medicine such as cell isolation, functional assessment, and molecular techniques of analysis and manipulation as well as sessions on the conduct of clinical research trials, ethics, and intellectual property management. Programs such as these are essential to provide a base from which medical students can decide if research is an attractive career choice for them during their clinical practice in subsequent years. An innovative international summer research course for medical students is necessary to cater to the needs of the medical students in the 21st century.

  17. Analysis of medical-decision making and the use of standards of care in oncology.

    PubMed Central

    Holzer, S.; Fremgen, A. M.; Hundahl, S. A.; Dudeck, J.

    2000-01-01

    Guidelines in medicine have been proposed as a way to assist physicians in the clinical decision-making process. Increasingly, they form the basis for assessing accountability in the delivery of healthcare services. However, experiences with their evaluation, as the most important step in the continuous guidelines process, are rare. Patient Care Evaluation Studies have been developed by the Commission on Cancer in the United States. As they reflect the "real-world" medical practice they are helpful in evaluating the quality of diagnosis, therapy and follow-up of tumor diseases in hospitals and cancer center and the compliance with current standards of care. In this context, they can provide an infrastructure for the analysis of the decision-making process. PMID:11079906

  18. 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

  19. Recruitment and Retention of New Emergency Medical Technician (EMT)-Basics and Paramedics.

    PubMed

    Chapman, Susan A; Crowe, Remle P; Bentley, Melissa A

    2016-12-01

    The purpose of this paper is to describe factors important for the recruitment and retention of Emergency Medical Technician (EMT)-Basics and EMT-Paramedics new to the Emergency Medical Services (EMS) field (defined as two years or less of EMS employment) through an analysis of 10 years of Longitudinal EMT Attributes and Demographic Study (LEADS) data. Data were obtained from 10 years of LEADS surveys (1999-2008). Individuals new to the profession were identified through responses to a survey item. Their responses were analyzed using weights reflecting each individual's probability of selection. Means, proportions, and 95% confidence intervals (CIs) were determined and used to identify statistically significant differences. There were few changes in the demographic characteristics of new EMT-Basics and Paramedics across survey years. New EMT-Basics tended to be older and less likely to have a college degree than new EMT-Paramedics. More new EMT-Basics than EMT-Paramedics worked in rural areas and small towns and reported that they were working as a volunteer. There were differences between new EMT-Basics and EMT-Paramedics in several of the reasons for entering the profession and in facets of job satisfaction. The findings provide guidance for recruiters, educators, employers, and governmental EMS policy organizations and will provide better insight into how to attract and retain new entrants to the field. Chapman SA , Crowe RP , Bentley MA . Recruitment and retention of new Emergency Medical Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s70-s86.

  20. [Development of guide to clinical performance and basic clinical skills for medical students].

    PubMed

    Roh, HyeRin; Lee, KeunMi; Eo, Eunkyung; Hong, Young Sun; Lee, Hakseung; Jang, Byung Woo; Rhee, Byoung Doo

    2015-12-01

    The aim of this report was to discuss the development and content of a guide on clinical performance and basic clinical skills for medical students. We published the first edition of this guide in 2010 and will publish the second edition in 2016. Initially, we took a survey on important clinical presentations and fundamental clinical and technical skills in 41 medical schools in Korea. Ultimately, we chose 80 core clinical presentations and 56 clinical skills. In the guide to basic clinical skills, we described the physical examination and technical skills according to the preprocedural preparation, procedure, and postprocedural process. In the guide on clinical performance, we reviewed patient encounters-from history taking and the physical examination to patient education. We included communication skills, principles of patient safety, and clinical reasoning schemes into the guides. In total, 43 academic faculty members helped develop the basic clinical skills guide, 75 participated in establishing the clinical performance guide, and 16 advisors from 14 medical specialty societies contributed to the guide. These guides can help medical students approach patients holistically and safely.

  1. [Turnover of Non-medical Staff in Outpatient Oncology Practices: Is Building Social Capital a Solution?].

    PubMed

    Gloede, T D; Ernstmann, N; Baumann, W; Groß, S E; Ansmann, L; Nitzsche, A; Neumann, M; Wirtz, M; Schmitz, S; Schulz-Nieswandt, F; Pfaff, H

    2015-11-01

    While a lot is known about potential and actual turnover of non-medical hospital staff, only few data exist for the outpatient setting. In addition, little is known about actual instruments which leaders can use to influence staff turnover in physician practices. In the literature, the social capital of an organisation, which means the amount of trust, common values and reciprocal behaviour in the organisation, has been discussed as a possible field of action. In the present study, staff turnover as perceived by outpatient haematologists and oncologists is presented and analysed as to whether social capital is associated with that staff turnover. In conclusion, measures to increase the social capital of a practice are presented. The present study is based on data gathered in a questionnaire-based survey with members of the Professional Organisation of -Office-Based Haematologists and Oncologists (N=551). The social capital of the practice was captured from the haematologists and oncologists using an existing and validated scale. To analyse the impact of the practice's social capital on staff turnover, as perceived by the physicians, bivariate correlations and linear regression analyses were calculated. In total, 152 haematologists and oncologists participated in the study which represents a response rate of 28%. In the regression analyses, social capital appears as a significant and strong predictor of staff turnover (beta=-0.34; p<0.001). Building social capital within the practice may be an important contribution to reducing staff turnover although the underlying study design does not allow for drawing causal conclusions regarding this relationship. To create social capital in their practice, outpatient physicians may apply measures that facilitate social interaction among staff, foster trust and facilitate cooperation. Such measures may already be applied when hiring and training new staff, but also continuously when leading employees and when organising work

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

    SciTech Connect

    Mills, M.

    2015-06-15

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

  3. The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes.

    PubMed

    Huang, Feng; Gan, Li

    2017-02-01

    At the end of 1998, China launched a government-run mandatory insurance program, the urban employee basic medical insurance (UEBMI), to replace the previous medical insurance system. Using the UEBMI reform in China as a natural experiment, this study identifies variations in patient cost sharing that were imposed by the UEBMI reform and examines their effects on the demand for healthcare services. Using data from the 1991-2006 waves of the China Health and Nutrition Survey, we find that increased cost sharing is associated with decreased outpatient medical care utilization and expenditures but not with decreased inpatient care utilization and expenditures. Patients from low-income and middle-income households or with less severe medical conditions are more sensitive to prices. We observe little impact on patient's health, as measured by self-reported health status. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Awareness of basic life support among medical, dental, nursing students and doctors.

    PubMed

    Chandrasekaran, Shanta; Kumar, Sathish; Bhat, Shamim Ahamed; Saravanakumar; Shabbir, P Mohammed; Chandrasekaran, Vp

    2010-03-01

    To study the awareness of Basic Life Support (BLS) among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19%) had secured 80 - 89% marks, 10 out of 1054 (0.95%) had secured 70 - 79% marks, 40 of 1054 (4.08%) had secured 60 - 69% marks and 105 of 1054 (9.96%) had secured 50 - 59% marks. A majority of them, that is, 894 (84.82%) had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor.

  5. Awareness of basic life support among medical, dental, nursing students and doctors

    PubMed Central

    Chandrasekaran, Shanta; Kumar, Sathish; Bhat, Shamim Ahamed; Saravanakumar; Shabbir, P Mohammed; Chandrasekaran, VP

    2010-01-01

    To study the awareness of Basic Life Support (BLS) among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19%) had secured 80 – 89% marks, 10 out of 1054 (0.95%) had secured 70 – 79% marks, 40 of 1054 (4.08%) had secured 60 – 69% marks and 105 of 1054 (9.96%) had secured 50 – 59% marks. A majority of them, that is, 894 (84.82%) had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor. PMID:20661349

  6. [Formal sample size calculation and its limited validity in animal studies of medical basic research].

    PubMed

    Mayer, B; Muche, R

    2013-01-01

    Animal studies are highly relevant for basic medical research, although their usage is discussed controversially in public. Thus, an optimal sample size for these projects should be aimed at from a biometrical point of view. Statistical sample size calculation is usually the appropriate methodology in planning medical research projects. However, required information is often not valid or only available during the course of an animal experiment. This article critically discusses the validity of formal sample size calculation for animal studies. Within the discussion, some requirements are formulated to fundamentally regulate the process of sample size determination for animal experiments.

  7. [The role of next of kin in medical decision-making--empirical findings from haemato-oncological diseases].

    PubMed

    Ernst, J; Schwarz, R; Schwarzer, A; Aldaoud, A; Niederwieser, D; Mantovani-Löffler, L; Schröder, C

    2009-08-01

    Models of shared decision making in the patient-doctor relationship are attracting increasing attention. A recent study focuses on the so far inadequate attention paid to the role of next of kin. It was examined in which decision areas next of kin of haematological cancer patients were included, further what support next of kin could provided and finally which factors encouraged the participation of next of kin in that process. From 2006-2008 empirical data were collected from hemato-oncological patients undergoing treatment as well as from their families. The participating family members of patients were mailed questionnaires based on the patient sample (designation of a family member by the patient: 118/177 or 66.7%) on average half of a year following the patient's (in- or outpatient) treatment. The response rate of the participants was 67.8% (80/118). Of the respondents, 65% were spouses or partners of the patients, the average age was 53.9 years, and 66.3% were female. Family members think it makes sense for them to take an active part in medical decisions affecting their loved ones and a majority of them reported having participated in decision-making processes concerning a variety of issues. Being involved in their loved one's discussions with their doctors has a significant influence on this. Family members' level of education was the only clear predictor for participation in discussions with doctors that could be isolated. It is clear that family members, especially spouses and partners, consider it meaningful to participate in medical decisions affecting their loved ones, and that they want to be able to do this in the clinical context. One limitation that must be mentioned is that due to the small size of the sample and an approach that focused on initial exploration, the results should be interpreted as a point of orientation. Further studies should look in more detail at how inner family structures play a role in patient-doctor shared decision

  8. Integrative cases for preclinical medical students: connecting clinical, basic science, and public health approaches.

    PubMed

    Schapiro, Renie; Stickford-Becker, Amy E; Foertsch, Julie A; Remington, Patrick L; Seibert, Christine S

    2011-10-01

    Healthcare and public health systems are each transforming, resulting in a need for better integration between clinical and population-based approaches to improve the health of populations. These changes also demand substantial transformations in the curriculum for medical students. Integrative Cases were designed for all first- and second-year medical students to provide them with more awareness, knowledge, and skills in integrating public health into clinical medicine. Each case examines basic science factors, clinical approaches, and public health determinants, including risk factors and direct and indirect contributing factors. This study was designed to evaluate the effectiveness of Integrative Cases in the medical student curriculum. Integrative Cases were formatively evaluated using standardized online post-event questionnaires emailed to students after each case. The questionnaires focused on goals specific to each case, ratings of particular sessions and facilitators, general impressions of the case, and student suggestions for improvement. Student evaluations indicate that Integrative Cases achieved their goals, especially providing experiences that offer a more expansive view of medicine and public health, stimulating interest and questions that anticipate future learning and making connections across basic science, medicine, and health. Students also indicated that these cases added to their understanding of public health issues and how to apply what they had learned to patient care. Integrative Cases demonstrate the effectiveness of a comprehensive approach that integrates clinical medicine with basic science and public health perspectives. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students

    PubMed Central

    Chamberlain, Neal R.; Stuart, Melissa K.; Singh, Vineet K.; Sargentini, Neil J.

    2012-01-01

    Background Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) Methods Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Results Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Conclusion Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians. PMID:22435014

  10. Quality of Basic Life Support – A Comparison between Medical Students and Paramedics

    PubMed Central

    Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido

    2016-01-01

    Introduction Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. Aim This study aimed to assess quality of basic life support in medical students and paramedics. Materials and Methods We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. Results In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Conclusion Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS. PMID:27630885

  11. Use of the National Board of Medical Examiners(®) Comprehensive Basic Science Exam: survey results of US medical schools.

    PubMed

    Wright, William S; Baston, Kirk

    2017-01-01

    The National Board of Medical Examiners(®) (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination(®) (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME(®)) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated "yes" or "no" to the initial question "Does your institution administer the NBME CBSE prior to the USMLE Step 1?". A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools.

  12. Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology.

    PubMed

    Shibata, H; Kato, S; Sekine, I; Abe, K; Araki, N; Iguchi, H; Izumi, T; Inaba, Y; Osaka, I; Kato, S; Kawai, A; Kinuya, S; Kodaira, M; Kobayashi, E; Kobayashi, T; Sato, J; Shinohara, N; Takahashi, S; Takamatsu, Y; Takayama, K; Takayama, K; Tateishi, U; Nagakura, H; Hosaka, M; Morioka, H; Moriya, T; Yuasa, T; Yurikusa, T; Yomiya, K; Yoshida, M

    2016-01-01

    Diagnosis and treatment of bone metastasis requires various types of measures, specialists and caregivers. To provide better diagnosis and treatment, a multidisciplinary team approach is required. The members of this multidisciplinary team include doctors of primary cancers, radiologists, pathologists, orthopaedists, radiotherapists, clinical oncologists, palliative caregivers, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, occupational therapists, medical social workers, etc. Medical evidence was extracted from published articles describing meta-analyses or randomised controlled trials concerning patients with bone metastases mainly from 2003 to 2013, and a guideline was developed according to the Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Multidisciplinary team meetings are helpful in diagnosis and treatment. Clinical benefits such as physical or psychological palliation obtained using the multidisciplinary team approaches are apparent. We established a guideline describing each specialty field, to improve understanding of the different fields among the specialists, who can further provide appropriate treatment, and to improve patients' outcomes.

  13. Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology

    PubMed Central

    Shibata, H; Kato, S; Sekine, I; Abe, K; Araki, N; Iguchi, H; Izumi, T; Inaba, Y; Osaka, I; Kato, S; Kawai, A; Kinuya, S; Kodaira, M; Kobayashi, E; Kobayashi, T; Sato, J; Shinohara, N; Takahashi, S; Takamatsu, Y; Takayama, K; Takayama, K; Tateishi, U; Nagakura, H; Hosaka, M; Morioka, H; Moriya, T; Yuasa, T; Yurikusa, T; Yomiya, K; Yoshida, M

    2016-01-01

    Diagnosis and treatment of bone metastasis requires various types of measures, specialists and caregivers. To provide better diagnosis and treatment, a multidisciplinary team approach is required. The members of this multidisciplinary team include doctors of primary cancers, radiologists, pathologists, orthopaedists, radiotherapists, clinical oncologists, palliative caregivers, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, occupational therapists, medical social workers, etc. Medical evidence was extracted from published articles describing meta-analyses or randomised controlled trials concerning patients with bone metastases mainly from 2003 to 2013, and a guideline was developed according to the Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Multidisciplinary team meetings are helpful in diagnosis and treatment. Clinical benefits such as physical or psychological palliation obtained using the multidisciplinary team approaches are apparent. We established a guideline describing each specialty field, to improve understanding of the different fields among the specialists, who can further provide appropriate treatment, and to improve patients’ outcomes. PMID:27843593

  14. A prescription that addresses the decline of basic science education in medical school.

    PubMed

    Miller, Daniel; Thornton, Christina S; Keough, Michael B; Roberts, Jodie I; Yipp, Bryan; Hollenberg, Morley; Bau, Jason T; Peplowski, Michael A; Beck, Paul L

    2014-10-04

    Over 30 years ago a cry rang out through the proverbial halls of academia; "The clinician scientist is an endangered species." These prophetic words have been reverberated in the ears of every specialty and every general medical organization in deafening tones. Why is the role of the clinician scientist or clinician investigator so important that this phrase has been repeated subsequently in medical and educational journals? Simply put, the clinician scientist bridges the ravine between the ever-growing mountain of scientific knowledge and the demanding patient centered clinical care. Here, we describe the current educational model established by the University of Calgary, Leaders in Medicine Program. Our program seeks to train future physicians and clinician scientists by incorporating training in basic science, translational and clinical research with clinical and medical education in a longitudinal program to students of traditional MD/PhD, MD/MSc or MD/MBA stream as well as interested Doctor of Medicine students.

  15. A medical oncologist's perspective on communication skills and burnout syndrome with psycho-oncological approach (to die with each patient one more time: the fate of the oncologists).

    PubMed

    Tanriverdi, Ozgur

    2013-06-01

    The increasing incidence of cancer is at the same time one of the leading causes of death all over the world. Many clinical studies show that the psychological disorders are more frequent in cancer patients than the normal population. That is the reason why "psycho-oncology" is getting popular each day. On the other hand, clinical studies about psychological status of the oncologists who are in contact with cancer patients ceaselessly and who are mostly responsible to give the "bad news" to the cancer patients are very limited. In fact, if the clinical studies which show that the frequency of depression and burnout syndrome are increasing among physicians are taken into consideration, one can say that psycho-oncology must cover all the medical personnel who are dealing with cancer patients. It is determined that the rate of depression and burnout syndrome is high among oncologists when referred to the literature. Several solutions are proposed for the psychological conditions of the oncologists and other related personnel who empathize with the patients and deliver "bad news" and also try to adopt ideal "patient-physician" communication model. The knowledge on the psychological conditions of oncology professionals and their behaviour and the results of the clinical studies on this subject will be discussed and the personal opinion will also be presented in this paper.

  16. Peer-assisted learning: filling the gaps in basic science education for preclinical medical students.

    PubMed

    Sammaraiee, Yezen; Mistry, Ravi D; Lim, Julian; Wittner, Liora; Deepak, Shantal; Lim, Gareth

    2016-09-01

    In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United Kingdom medical school. Twenty tutorials were delivered by senior students throughout the year to first- and second-year students. A baseline questionnaire was delivered to inform the development of the program followed by an end-point questionnaire the next year (n = 122). Quizzes were administered before and after five separate tutorials to assess changes in mean student scores. Additionally, each tutorial was evaluated via a questionnaire for participants (n = 949). All five posttutorial quizzes showed a significant improvement in mean student score (P < 0.05). Questionnaires showed students found the program to be relevant and useful for revision purposes and appreciated how tutorials contextualized basic science to clinical medicine. Students appreciated the interactive nature of the sessions and found receiving personalized feedback about their learning and consolidating information with someone familiar with the material to be useful. With the inclusion of the program, students felt there were now an adequate number of tutorials during the year. In conclusion, this study shows that senior medical students can design and deliver a program that adds value to the mostly lecture-based formal preclinical curriculum. We hope that our study can prompt further work to explore the effect of PAL on the teaching of basic sciences during preclinical studies.

  17. A pilot study designed to acquaint medical educators with basic pedagogic principles.

    PubMed

    McLeod, P J; Brawer, J; Steinert, Y; Chalk, C; McLeod, A

    2008-02-01

    Faculty development activities in medical schools regularly target teaching behaviours but rarely address basic pedagogic principles underlying those behaviours. Although many teachers have an intuitive or tacit knowledge of basic pedagogic principles, overt knowledge of fundamental educational principles is rare. We conducted a short-term pilot study designed to transform teachers' tacit knowledge into explicit knowledge of pedagogic principles. We hypothesized that conscious awareness of these principles will positively influence their teaching effectiveness. The intervention included a workshop, provision of a workbook on pedagogic principles and free access to educational consultants. For the intervention, we chose a purposive sample of experienced teachers at our medical school. Evaluation of the impact of the intervention using questionnaires and semi-structured interviews revealed three notable findings; 1. Participants were surprised to discover the existence of an extensive body of pedagogic science underlying teaching and learning. 2. They were enthusiastic about the intervention and expressed interest in learning more about basic pedagogic principles. 3. The knowledge acquired had an immediate impact on their teaching.

  18. Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: an integrative review.

    PubMed

    Landier, Wendy; Tse, Alice M

    2010-12-01

    This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind-body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Use of Complementary and Alternative Medical Interventions for the Management of Procedure-Related Pain, Anxiety, and Distress in Pediatric Oncology: An Integrative Review

    PubMed Central

    Landier, Wendy; Tse, Alice M.

    2016-01-01

    This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind–body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology. PMID:21035021

  20. Right-to-try laws and individual patient "compassionate use" of experimental oncology medications: A call for improved provider-patient communication.

    PubMed

    Hoerger, Michael

    2016-01-01

    The U.S. Food and Drug Administration's Expanded Access program allows patients with life-threatening diagnoses, such as advanced cancer, to use experimental medications without participating in clinical research (colloquially, "Compassionate Use"). Sixteen U.S. states recently passed "right-to-try" legislation aimed at promoting Expanded Access. Acknowledging popular support, Expanded Access could undermine clinical trials that benefit public health. Moreover, existing norms in oncologic care, for example, often lead patients to pursue intense treatments near the end of life, at the expense of palliation, and improved communication about the risks and benefits of Expanded Access would more often discourage its use.

  1. [Internet: a fundamental tool for the retrieval of the information useful for medical research and health care in oncology].

    PubMed

    Bianciardi, L; D'Agata, A

    2002-02-01

    Internet represents an essential aid for the professional updating of physicians and researches. Also for the research and therapy in oncology, Internet provides important such as bibliographic data, trials and guidelines with full text, as well as epidemiologic and statistical data. Some of the most authoritative sites are indicated.

  2. [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.

  3. [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.

  4. Assessment of knowledge and perceptions toward generic medicines among basic science undergraduate medical students at Aruba

    PubMed Central

    Shankar, P. Ravi; Herz, Burton L.; Dubey, Arun K.; Hassali, Mohamed A.

    2016-01-01

    Objective: Use of generic medicines is important to reduce rising health-care costs. Proper knowledge and perception of medical students and doctors toward generic medicines are important. Xavier University School of Medicine in Aruba admits students from the United States, Canada, and other countries to the undergraduate medical (MD) program. The present study was conducted to study the knowledge and perception about generic medicines among basic science MD students. Materials and Methods: The cross-sectional study was conducted among first to fifth semester students during February 2015. A previously developed instrument was used. Basic demographic information was collected. Respondent’s agreement with a set of statements was noted using a Likert-type scale. The calculated total score was compared among subgroups of respondents. One sample Kolmogorov–Smirnov test was used to study the normality of distribution, Independent samples t-test to compare the total score for dichotomous variables, and analysis of variance for others were used for statistical analysis. Results: Fifty-six of the 85 students (65.8%) participated. Around 55% of respondents were between 20 and 25 years of age and of American nationality. Only three respondents (5.3%) provided the correct value of the regulatory bioequivalence limits. The mean total score was 43.41 (maximum 60). There was no significant difference in scores among subgroups. Conclusions: There was a significant knowledge gap with regard to the regulatory bioequivalence limits for generic medicines. Respondents’ level of knowledge about other aspects of generic medicines was good but could be improved. Studies among clinical students in the institution and in other Caribbean medical schools are required. Deficiencies were noted and we have strengthened learning about generic medicines during the basic science years. PMID:28031604

  5. Assessment of knowledge and perceptions toward generic medicines among basic science undergraduate medical students at Aruba.

    PubMed

    Shankar, P Ravi; Herz, Burton L; Dubey, Arun K; Hassali, Mohamed A

    2016-10-01

    Use of generic medicines is important to reduce rising health-care costs. Proper knowledge and perception of medical students and doctors toward generic medicines are important. Xavier University School of Medicine in Aruba admits students from the United States, Canada, and other countries to the undergraduate medical (MD) program. The present study was conducted to study the knowledge and perception about generic medicines among basic science MD students. The cross-sectional study was conducted among first to fifth semester students during February 2015. A previously developed instrument was used. Basic demographic information was collected. Respondent's agreement with a set of statements was noted using a Likert-type scale. The calculated total score was compared among subgroups of respondents. One sample Kolmogorov-Smirnov test was used to study the normality of distribution, Independent samples t-test to compare the total score for dichotomous variables, and analysis of variance for others were used for statistical analysis. Fifty-six of the 85 students (65.8%) participated. Around 55% of respondents were between 20 and 25 years of age and of American nationality. Only three respondents (5.3%) provided the correct value of the regulatory bioequivalence limits. The mean total score was 43.41 (maximum 60). There was no significant difference in scores among subgroups. There was a significant knowledge gap with regard to the regulatory bioequivalence limits for generic medicines. Respondents' level of knowledge about other aspects of generic medicines was good but could be improved. Studies among clinical students in the institution and in other Caribbean medical schools are required. Deficiencies were noted and we have strengthened learning about generic medicines during the basic science years.

  6. Vertical integration of basic science in final year of medical education.

    PubMed

    Rajan, Sudha Jasmine; Jacob, Tripti Meriel; Sathyendra, Sowmya

    2016-01-01

    Development of health professionals with ability to integrate, synthesize, and apply knowledge gained through medical college is greatly hampered by the system of delivery that is compartmentalized and piecemeal. There is a need to integrate basic sciences with clinical teaching to enable application in clinical care. To study the benefit and acceptance of vertical integration of basic science in final year MBBS undergraduate curriculum. After Institutional Ethics Clearance, neuroanatomy refresher classes with clinical application to neurological diseases were held as part of the final year posting in two medical units. Feedback was collected. Pre- and post-tests which tested application and synthesis were conducted. Summative assessment was compared with the control group of students who had standard teaching in other two medical units. In-depth interview was conducted on 2 willing participants and 2 teachers who did neurology bedside teaching. Majority (>80%) found the classes useful and interesting. There was statistically significant improvement in the post-test scores. There was a statistically significant difference between the intervention and control groups' scores during summative assessment (76.2 vs. 61.8 P < 0.01). Students felt that it reinforced, motivated self-directed learning, enabled correlations, improved understanding, put things in perspective, gave confidence, aided application, and enabled them to follow discussions during clinical teaching. Vertical integration of basic science in final year was beneficial and resulted in knowledge gain and improved summative scores. The classes were found to be useful, interesting and thought to help in clinical care and application by majority of students.

  7. 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.

  8. [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.

  9. Medication-Related Osteonecrosis of the Jaw: Basic and Translational Science Updates.

    PubMed

    Allen, Matthew R

    2015-11-01

    In the late 1990s and the early 2000s, bisphosphonates had become the clinical pillar of excellence for treating metabolic bone disease, and thus their connection with osteonecrosis of the jaw (ONJ) caused significant concern. Over the past decade, progress has been made in understanding what is now referred to as medication-related ONJ (MRONJ), because of its connections to agents other than bisphosphonates, although in many respects the progress has been slow. This review highlights the key basic science and translational (animal) studies in the area of MRONJ and suggests areas of focus as the field moves into the next decade. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Medical Individualism or Medical Familism? A Critical Analysis of China's New Guidelines for Informed Consent: The Basic Norms of the Documentation of the Medical Record.

    PubMed

    Bian, Lin

    2015-08-01

    Modern Western medical individualism has had a significant impact on health care in China. This essay demonstrates the ways in which such Western-style individualism has been explicitly endorsed in China's 2010 directive: The Basic Norms of the Documentation of the Medical Record. The Norms require that the patient himself, rather than a member of his family, sign each informed consent form. This change in clinical practice indicates a shift toward medical individualism in Chinese healthcare legislation. Such individualism, however, is incompatible with the character of Chinese familism that is deeply rooted in the Chinese ethical tradition. It also contradicts family-based patterns of health care in China. Moreover, the requirement for individual informed consent is incompatible with numerous medical regulations promulgated in the past two decades. This essay argues that while Chinese medical legislation should learn from relevant Western ideas, it should not simply copy such practices by importing medical individualism into Chinese health care. Chinese healthcare policy is properly based on Chinese medical familist resources. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools

    PubMed Central

    Wright, William S; Baston, Kirk

    2017-01-01

    Purpose The National Board of Medical Examiners® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. Methods A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME®) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated “yes” or “no” to the initial question “Does your institution administer the NBME CBSE prior to the USMLE Step 1?”. Results A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Conclusion Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools. PMID

  12. Knowledge, Attitude and Practice of Self-Medication Among Basic Science Undergraduate Medical Students in a Medical School in Western Nepal.

    PubMed

    Gyawali, Sudesh; Shankar, P Ravi; Poudel, Phanindra Prasad; Saha, Archana

    2015-12-01

    Studies have shown self-medication to be common among medical students. These studies are however, few in Nepal. The present study assessed knowledge, attitude, and practice of self-medication among second and fourth semesters' undergraduate medical students and studied differences in knowledge and attitude (if any) among different subgroups of the respondents. A cross-sectional survey was conducted using a questionnaire among basic science medical students of Manipal College of Medical Sciences, Nepal. Semester of study, gender, age, nationality, and the profession of their parents were noted. Students' knowledge and attitude about self-medication was studied by noting their degree of agreement with a set of 40 statements using a Likert-type scale. The average scores and frequency of occurrence of particular behaviors among different categories of respondents were compared using appropriate statistical tests. Two hundred and seventy-six of the 295 (93.6%) students participated. The mean (SD) knowledge, attitude, and total scores were 74.54 (6.92), 67.18 (5.68), and 141.73 (10.76) with maximum possible scores 100, 100 and 200, respectively. There was no significant difference in scores according to respondents' gender, age, and the profession of their parents. However, the mean knowledge, attitude and total scores were significantly different among students of different nationalities. Mean scores of fourth semester students were significantly higher compared to second semester students. There were differences in knowledge and total scores among students of different nationalities. Eighty two percent of respondents had self-medicated during the one year period preceding the study; 149 respondents (54%) shared that previous experience with the medicine was one of the information sources for self-medication. Prevalence of self-medication among respondents according to semester of study, gender, age, and profession of the parents was not significantly different. The

  13. [The research of basic medical education with clinical practice and culturing of discovering and creative ability for students].

    PubMed

    Yang, Kang-Juan; Jin, Ying-Zi; Zhang, Zi-Bo; Jin, Yan-Hua; Jin, Xiong-Ji; Xiu, Jing-Hui; Sun, Lian-Ping; Liu, Yang; Sheng, Tian-Xin

    2008-05-01

    In order to explore the educational model of combined research aidding basic medical education and clinical practice, the educational form of combined research, teaching and clinical practice was adopted and brought into the education of medical genetics for medical students. The consequence of five-year educational practice has revealed that the educational effects and quality have been obviously increased, and the deeply activated studying initiative, self-studying ability, ability of cooperation, discovering and creative ability have been achieved in culturing practical general medical students with in-depth basic knowledge, great ability and high quality.

  14. Pre-training evaluation and feedback improve medical students' skills in basic life support.

    PubMed

    Li, Qi; Ma, Er-Li; Liu, Jin; Fang, Li-Qun; Xia, Tian

    2011-01-01

    Evaluation and feedback are two factors that could influence simulation-based medical education and the time when they were delivered contributes their different effects. To investigate the impact of pre-training evaluation and feedback on medical students' performance in basic life support (BLS). Forty 3rd-year undergraduate medical students were randomly divided into two groups, C group (the control) and pre-training evaluation and feedback group (E&F group), each of 20. After BLS theoretical lecture, the C group received 45 min BLS training and the E&F group was individually evaluated (video-taped) in a mock cardiac arrest (pre-training evaluation). Fifteen minutes of group feedback related with the students' BLS performance in pre-training evaluation was given in the E&F group, followed by a 30-min BLS training. After BLS training, both groups were evaluated with one-rescuer BLS skills in a 3-min mock cardiac arrest scenario (post-training evaluation). The score from the post-training evaluation was converted to a percentage and was compared between the two groups. The score from the post-training evaluation was higher in the E&F group (82.9 ± 3.2% vs. 63.9 ± 13.4% in C group). In undergraduate medical students without previous BLS training, pre-training evaluation and feedback improve their performance in followed BLS training.

  15. Back from basics: integration of science and practice in medical education.

    PubMed

    Bandiera, Glen; Kuper, Ayelet; Mylopoulos, Maria; Whitehead, Cynthia; Ruetalo, Mariela; Kulasegaram, Kulamakan; Woods, Nicole N

    2017-10-10

    In 1988, the Edinburgh Declaration challenged medical teachers, curriculum designers and leaders to make an organised effort to change medical education for the better. Among a series of recommendations was a call to integrate training in science and clinical practice across a breadth of clinical contexts. The aim was to create physicians who could serve the needs of all people and provide care in a multitude of contexts. In the years since, in the numerous efforts towards integration, new models of curricula have been proposed and implemented with varying levels of success. In this paper, we examine the evolution of curricular integration since the Edinburgh Declaration, and discuss theoretical advances and practical solutions. In doing so, we draw on recent consensus reports on the state of medical education, emblematic initiatives reported in the literature, and developments in education theory pertinent to the role of integrated curricula. Interest in integration persists despite 30 years of efforts to respond to the Edinburgh Declaration. We argue, however, that a critical shift has taken place with respect to the conception of integration, whereby empirical models support a view of integration as pertaining to both cognitive activity and curricular structure. In addition, we describe a broader definition of 'basic science' relevant to clinical practice that encompasses social and behavioural sciences, as well as knowledge derived from biomedical science. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  16. Medical Device Recalls in Radiation Oncology: Analysis of US Food and Drug Administration Data, 2002-2015.

    PubMed

    Connor, Michael J; Tringale, Kathryn; Moiseenko, Vitali; Marshall, Deborah C; Moore, Kevin; Cervino, Laura; Atwood, Todd; Brown, Derek; Mundt, Arno J; Pawlicki, Todd; Recht, Abram; Hattangadi-Gluth, Jona A

    2017-06-01

    To analyze all recalls involving radiation oncology devices (RODs) from the US Food and Drug Administration (FDA)'s recall database, comparing these with non-radiation oncology device recalls to identify discipline-specific trends that may inform improvements in device safety. Recall data on RODs from 2002 to 2015 were sorted into 4 product categories (external beam, brachytherapy, planning systems, and simulation systems). Outcomes included determined cause of recall, recall class (severity), quantity in commerce, time until recall termination (date FDA determines recall is complete), and time since 510(k) approval. Descriptive statistics were performed with linear regression of time-series data. Results for RODs were compared with those for other devices by Pearson χ(2) test for categorical data and 2-sample Kolmogorov-Smirnov test for distributions. There were 502 ROD recalls and 9534 other class II device recalls during 2002 to 2015. Most recalls were for external beam devices (66.7%) and planning systems (22.9%), and recall events peaked in 2011. Radiation oncology devices differed significantly from other devices in all recall outcomes (P≤.04). Recall cause was commonly software related (49% vs 10% for other devices). Recall severity was more often moderate among RODs (97.6% vs 87.2%) instead of severe (0.2% vs 4.4%; P<.001). Time from 510(k) market approval to recall was shorter among RODs (P<.001) and progressively shortened over time. Radiation oncology devices had fewer recalled devices in commerce than other devices (P<.001). Compared with other class II devices, RODs experience recalls sooner after market approval and are trending sooner still. Most of these recalls were moderate in severity, and software issues are prevalent. Comprehensive analysis of recall data can identify areas for device improvement, such as better system design among RODs. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Can the referring surgeon enhance accrual of breast cancer patients to medical and radiation oncology trials? The ENHANCE study

    PubMed Central

    Arnaout, A.; Kuchuk, I.; Bouganim, N.; Pond, G.; Verma, S.; Segal, R.; Dent, S.; Gertler, S.; Song, X.; Kanji, F.; Clemons, M.

    2016-01-01

    Introduction The accrual rate to clinical trials in oncology remains low. In this exploratory pilot study, we prospectively assessed the role that engaging a referring surgeon plays in enhancing nonsurgical oncologic clinical trial accrual. Methods Newly diagnosed breast cancer patients were seen by a surgeon who actively introduced specific patient-and physician-centred strategies to increase clinical trial accrual. Patient-centred strategies included providing patients, before their oncology appointment, with information about specific clinical trials for which they might be eligible, as evaluated by the surgeon. The attitudes of the patients about clinical trials and the interventions used to improve accrual were assessed at the end of the study. The primary outcome was the clinical trial accrual rate during the study period. Results Overall clinical trial enrolment during the study period among the 34 participating patients was 15% (5 of 34), which is greater than the institution’s historical average of 7%. All patients found the information delivered by the surgeon before the oncology appointment to be very helpful. Almost three quarters of the patients (73%) were informed about clinical trials by their oncologist. The top reasons for nonparticipation reported by the patients who did not participate in clinical trials included lack of interest (35%), failure of the oncologist to mention clinical trials (33%), and inconvenience (19%). Conclusions Accrual of patients to clinical trials is a complex multistep process with multiple potential barriers. The findings of this exploratory pilot study demonstrate a potential role for the referring surgeon in enhancing nonsurgical clinical trial accrual. PMID:27330365

  18. Recent advances of basic materials to obtain electrospun polymeric nanofibers for medical applications

    NASA Astrophysics Data System (ADS)

    Manea, L. R.; Hristian, L.; Leon, A. L.; Popa, A.

    2016-08-01

    The most important applications of electrospun polymeric nanofibers are by far those from biomedical field. From the biological point of view, almost all the human tissues and organs consist of nanofibroas structures. The examples include the bone, dentine, cartilage, tendons and skin. All these are characterized through different fibrous structures, hierarchically organized at nanometer scale. Electrospinning represents one of the nanotechnologies that permit to obtain such structures for cell cultures, besides other technologies, such as selfassembling and phase separation technologies. The basic materials used to produce electrospun nanofibers can be natural or synthetic, having polymeric, ceramic or composite nature. These materials are selected depending of the nature and structure of the tissue meant to be regenerated, namely: for the regeneration of smooth tissues regeneration one needs to process through electrospinning polymeric basic materials, while in order to obtain the supports for the regeneration of hard tissues one must mainly use ceramic materials or composite structures that permit imbedding the bioactive substances in distinctive zones of the matrix. This work presents recent studies concerning basic materials used to obtain electrospun polymeric nanofibers, and real possibilities to produce and implement these nanofibers in medical bioengineering applications.

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

    PubMed

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

    2014-03-01

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

  20. Establishing a minority-based community clinical oncology program: the University of Medicine and Dentistry of New Jersey, New Jersey Medical School-university Hospital Cancer Center experience.

    PubMed

    Wieder, Robert; Teal, Randall; Saunders, Tracie; Weiner, Bryan J

    2013-03-01

    The Minority-Based Community Clinical Oncology Program (MB-CCOP) at University of Medicine and Dentistry of New Jersey, New Jersey Medical School-University Hospital Cancer Center was established to serve an unmet need in a medically, educationally, and socioeconomically underserved community of primarily African American and Latino patients in Newark and Essex County, New Jersey. The MB-CCOP was built on an existing infrastructure of multidisciplinary teams of cancer specialists who collaborated in patient care and an existing clinical research program, which included multilingual staff and a breast cancer navigator. This article highlights some of the unique opportunities and challenges involved in the startup of an MB-CCOP specifically relevant to an academic setting. We present a guide to the necessary infrastructure and institutional support that must be in place before considering such a program and some of the steps an institution can take to overcome barriers preventing successful enrollment of patients onto clinical trials.

  1. Retention of first aid and basic life support skills in undergraduate medical students

    PubMed Central

    de Ruijter, Pim A.; Biersteker, Heleen A.; Biert, Jan; van Goor, Harry; Tan, Edward C.

    2014-01-01

    Background Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students. Methods One hundred and twenty students were randomly selected from first year (n=349) medical students who successfully followed a compulsory FA and BLS course. From these 120 students, 94 (78%) and 69 (58%) participated in retention tests of FA and BLS skills after 1 and 2 years, respectively. The assessment consisted of two FA stations and one BLS station. Results After 1 year, only 2% passed both FA and BLS stations and 68% failed both FA and BLS stations. After 2 years, 5% passed and 50% failed both FA and BLS stations. Despite the high failure rate at the stations, 90% adequately checked vital signs and started cardiopulmonary resuscitation appropriately. Conclusions The long-term retention of FA and BLS skills after a compulsory course in the first year is poor. Adequate check of vital signs and commencing cardiopulmonary resuscitation retained longer. PMID:25382803

  2. Evaluation of Multiple Choice and Short Essay Question items in Basic Medical Sciences

    PubMed Central

    Baig, Mukhtiar; Ali, Syeda Kauser; Ali, Sobia; Huda, Nighat

    2014-01-01

    Objectives: To evaluate Multiple Choice and Short Essay Question items in Basic Medical Sciences by determining item writing flaws (IWFs) of MCQs along with cognitive level of each item in both methods. Methods: This analytical study evaluated the quality of the assessment tools used for the first batch in a newly established medical college in Karachi, Pakistan. First and sixth module assessment tools in Biochemistry during 2009-2010 were analyzed. Cognitive level of MCQs and SEQs, were noted and MCQ item writing flaws were also evaluated. Results: A total of 36 SEQs and 150 MCQs of four items were analyzed. The cognitive level of 83.33% of SEQs was at recall level while remaining 16.67% were assessing interpretation of data. Seventy six percent of the MCQs were at recall level while remaining 24% were at the interpretation. Regarding IWFs, 69 IWFs were found in 150 MCQs. The commonest among them were implausible distracters (30.43%), unfocused stem (27.54%) and unnecessary information in the stem (24.64%). Conclusion: There is a need to review the quality including the content of assessment tools. A structured faculty development program is recommended for developing improved assessment tools that align with learning outcomes and measure competency of medical students. PMID:24639820

  3. Evaluation of Retention of Knowledge and Skills Imparted to First-Year Medical Students through Basic Life Support Training

    ERIC Educational Resources Information Center

    Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam

    2014-01-01

    Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which…

  4. Evaluation of Retention of Knowledge and Skills Imparted to First-Year Medical Students through Basic Life Support Training

    ERIC Educational Resources Information Center

    Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam

    2014-01-01

    Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which…

  5. Commentary on 19th annual scientific meeting of the Society for Neuro-Oncology

    PubMed Central

    Jalali, Rakesh

    2015-01-01

    The Society for Neuro-Oncology (SNO) is the premier organization dedicated to the cause of central nervous system (CNS) tumors. Although it is primarily located in North America, it attracts considerable memberships from all over the world with truly multi-disciplinary representations from not only neuro-oncology, neurosurgery, radiation oncology, medical oncology and basic scientists, but also in recent years from imaging, psychology, epidemiology, public health and industry, etc. SNO annual meetings are very much looked forward to with presentations of the latest cutting edge data as well as several educational sessions for trainees and updates for senior members too. The meeting is unique in the way that almost the entire scientific agenda is based on submitted abstracts with very few invited lectures. PMID:25810579

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

    PubMed

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

    2014-01-01

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

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

    SciTech Connect

    Wallner, Paul E.; Anscher, Mitchell S.; Barker, Christopher A.; Bassetti, Michael; Bristow, Robert G.; Dicker, Adam P.; Formenti, Silvia C.; Graves, Edward E.; Hahn, Stephen M.; Hei, Tom K.; Kimmelman, Alec C.; Kirsch, David G.; Kozak, Kevin R.; Lawrence, Theodore S.; Marples, Brian; and others

    2014-01-01

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

  8. Impacts of regulated competition on pricing in Chinese pharmaceutical market under urban employee basic medical insurance.

    PubMed

    Zhao, Mingyue; Wu, Jing

    2017-06-01

    Examine the effects of regulated competition on the drug pricing in China. Based on product-level data, a regression method was employed for pricing by using data from Tianjin Urban Employee Basic Medical Insurance (UEBMI) database. The market competition measures distinguished generic competition within the same molecule from therapeutic competition within the same therapeutic class. The increases in pricing are inversely related to the number of generic competitions. The generic sub-group results vary from the originator sub-group. For the generics, generic competition has a significantly reduced effect on the price; however, only therapeutic competition has a significantly reduced effect on the originator price. Regulated competition has a positive role in shaping the pharmaceutical market. Furthermore, regulated competition affects the price differently for the sub-groups. The promotion of competition between generic and originator in order to reap full competition benefit and reduce frictions among policies are necessary.

  9. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    PubMed

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Laser-driven electron beam and radiation sources for basic, medical and industrial sciences.

    PubMed

    Nakajima, Kazuhisa

    2015-01-01

    To date active research on laser-driven plasma-based accelerators have achieved great progress on production of high-energy, high-quality electron and photon beams in a compact scale. Such laser plasma accelerators have been envisaged bringing a wide range of applications in basic, medical and industrial sciences. Here inheriting the groundbreaker's review article on "Laser Acceleration and its future" [Toshiki Tajima, (2010)],(1)) we would like to review recent progress of producing such electron beams due to relativistic laser-plasma interactions followed by laser wakefield acceleration and lead to the scaling formulas that are useful to design laser plasma accelerators with controllability of beam energy and charge. Lastly specific examples of such laser-driven electron/photon beam sources are illustrated.

  11. Laser-driven electron beam and radiation sources for basic, medical and industrial sciences

    PubMed Central

    NAKAJIMA, Kazuhisa

    2015-01-01

    To date active research on laser-driven plasma-based accelerators have achieved great progress on production of high-energy, high-quality electron and photon beams in a compact scale. Such laser plasma accelerators have been envisaged bringing a wide range of applications in basic, medical and industrial sciences. Here inheriting the groundbreaker’s review article on “Laser Acceleration and its future” [Toshiki Tajima, (2010)],1) we would like to review recent progress of producing such electron beams due to relativistic laser-plasma interactions followed by laser wakefield acceleration and lead to the scaling formulas that are useful to design laser plasma accelerators with controllability of beam energy and charge. Lastly specific examples of such laser-driven electron/photon beam sources are illustrated. PMID:26062737

  12. Teaching population health as a basic science at Harvard Medical School.

    PubMed

    Finkelstein, Jonathan A; McMahon, Graham T; Peters, Antoinette; Cadigan, Rebecca; Biddinger, Paul; Simon, Steven R

    2008-04-01

    In 2006-2007, Harvard Medical School implemented a new, required course for first-year medical and dental students entitled Clinical Epidemiology and Population Health. Conceived of as a "basic science" course, its primary goal is to allow students to develop an understanding of caring for individuals and promoting the health of populations as a continuum of strategies, all requiring the engagement of physicians. In the course's first iteration, topical content accessible to first-year students was selected to exemplify physicians' roles in addressing current threats to population health. Methodological areas included domains of clinical epidemiology, decision sciences, population-level prevention and health promotion, physicians' roles in the public health system, and population-level surveillance and intervention strategies. Large-group settings were selectively used to frame the relevance of each topic, and conceptual learning of statistical and epidemiologic methods occurred in conference groups of 24 students. Finally, tutorials of eight students and one or two faculty were used for critical reading of published studies, review of problem sets, and group discussion of population health issues. To help students appreciate the structure and function of the public health system and physicians' role in public health emergencies, the course included a role-playing exercise simulating response to an influenza pandemic. The first iteration of the course was well received, and assessment of students suggested mastery of basic skills. Preclinical courses represent a progressive step in developing a workforce of physicians who embrace their responsibility to improve the health of the population as a whole, as well as the health of the patient in front of them.

  13. Knowledge loss of medical students on first year basic science courses at the University of Saskatchewan.

    PubMed

    D'Eon, Marcel F

    2006-01-14

    Many senior undergraduate students from the University of Saskatchewan indicated informally that they did not remember much from their first year courses and wondered why we were teaching content that did not seem relevant to later clinical work or studies. To determine the extent of the problem a course evaluation study that measured the knowledge loss of medical students on selected first year courses was conducted. This study replicates previous memory decrement studies with three first year medicine basic science courses, something that was not found in the literature. It was expected that some courses would show more and some courses would show less knowledge loss. In the spring of 2004 over 20 students were recruited to retake questions from three first year courses: Immunology, physiology, and neuroanatomy. Student scores on the selected questions at the time of the final examination in May 2003 (the 'test') were compared with their scores on the questions 10 or 11 months later (the 're-test') using paired samples t -tests. A repeated-measures MANOVA was used to compare the test and re-test scores among the three courses. The re-test scores were matched with the overall student ratings of the courses and the student scores on the May 2003 examinations. A statistically significant main effect of knowledge loss (F = 297.385; p < .001) and an interaction effect by course (F = 46.081; p < .001) were found. The students' scores in the Immunology course dropped 13.1%, 46.5% in Neuroanatomy, and 16.1% in physiology. Bonferroni post hoc comparisons showed a significant difference between Neuroanatomy and Physiology (mean difference of 10.7, p = .004). There was considerable knowledge loss among medical students in the three basic science courses tested and this loss was not uniform across courses. Knowledge loss does not seem to be related to the marks on the final examination or the assessment of course quality by the students.

  14. Screening for basic social needs at a medical home for low-income children.

    PubMed

    Garg, Arvin; Butz, Arlene M; Dworkin, Paul H; Lewis, Rooti A; Serwint, Janet R

    2009-01-01

    The goals of this cross-sectional study were to (a) describe the prevalence of 5 basic social needs in a cohort of parents attending an urban teaching hospital-based pediatric clinic, (b) assess parental attitudes toward seeking assistance from their child's provider, and (c) examine resident providers' attitudes and behaviors toward addressing these needs. Parents (n = 100) reported a median of 2 basic needs at the pediatric visit. The most common was employment (52%), followed by education (34%), child care (19%), food (16%), and housing (10%). Most parents (67%) had positive attitudes toward requesting assistance from their child's pediatrician. The majority of resident providers (91%) believed in the importance of addressing social needs; however, few reported routinely screening for these needs (range, 11% to 18%). There is great potential for assisting low-income parents within the medical home. Further practice-based interventions are needed to enhance providers' self-efficacy to screen and address low-income families' needs at pediatric visits.

  15. 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.

  16. [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.

  17. The impact of the urban resident basic medical insurance on health services utilisation in China.

    PubMed

    Chen, Gang; Liu, Gordon G; Xu, Fei

    2014-03-01

    The Urban Resident Basic Medical Insurance (URBMI), launched in 2007 by the State Council, aims to cover around 420 million urban residents in China. This study aimed to assess the impact of URBMI on health services access (especially inpatient utilisation) in urban China. Data was drawn from the recent four-wave URBMI Survey (2008-2011). Probit and recursive bivariate probit models have been adopted to handle the possible endogeneity of medical insurance in the utilisation equations. Based on the preferred results from the unbalanced four-wave panel data, we found that the URBMI had significantly increased the likelihood of receiving inpatient treatment in the past year. However, the insurance effect on reducing the refused hospitalisation was insignificant. Finally, the URBMI had also increased the probability of using outpatient services in the past 2 weeks, although the insurance reimburses mainly against critical outpatient care. Given that it is still early days for the URBMI scheme, the positive effect on health services utilisation is appreciable.

  18. Pilot program to assess proposed basic quality assurance requirements in the medical use of byproduct materials

    SciTech Connect

    Kaplan, E.; Nelson, K.; Meinhold, C.B. )

    1991-10-01

    In January 1990, the Nuclear Regulatory Commission (NRC) proposed amendments to 10 CFR Part 35 that would require medical licensees using byproduct material to establish and implement a basic quality assurance program. A 60-day real-world trial of the proposed rules was initiated to obtain information beyond that generally found through standard public comment procedures. Volunteers from randomly selected institutions had opportunities to review the details of the proposed regulations and to implement these rules on a daily basis during the trial. The participating institutions were then asked to evaluate the proposed regulations based on their personal experiences. The pilot project sought to determine whether medical institutions could develop written quality assurance programs that would meet the eight performance-based objectives of proposed Section 35.35. In addition, the NRC wanted to learn from these volunteers if they had any recommendations on how the rule could be revised to minimized its cost and to clarify its objectives without decreasing its effectiveness. It was found that licensees could develop acceptable QA programs under a performance-based approach, that most licensee programs did meet the proposed objectives, and that most written QA plans would require consultations with NRC or Agreement State personnel before they would fully meet all objectives of proposed Section 35.35. This report describes the overall pilot program. The methodology used to select and assemble the group of participating licensees is presented. The various workshops and evaluation questionnaires are discussed, and detailed findings are presented. 7 refs.

  19. [Invitation to be basic medical research doctors; current status and efforts at Kurume University School of Medicine].

    PubMed

    Nakamura, Kei-ichiro; Kimura, Iori; Fujita, Kazuaki; Takano, Yoko; Saga, Tsuyoshi; Ohta, Keisuke; Yamaki, Kouichi

    2013-03-01

    Many medical students are interested in basic medical researches. However, to make a decision to get into the research position throughout the life is not easy. In Kurume University, although shortage of clinicians, partly due to the atmosphere that senior doctors consider experiences of basic research is favorable as well as a re-evaluation of PhD degree, staffs and PhD students with MD or DDS are not very rare in the departments of basic medical sciences including the anatomy department. Some, not many though, MDs once lead clinical experience return to basic research in order to solve problems they encountered at clinical scenes or for enthusiasms for spirit of further inquiry for life sciences. Those might be lead by the push of senior doctors or through "admission course for medical sciences" and "laboratory experience training" in the initial curriculum of the medical course. Open spaces where students and researchers can enjoy free scientific talking are hopefully expected to facilitate establishing students' incentive to participate in basic studies.

  20. A newly introduced comprehensive consultation fee in the national health insurance system in Japan: a promotive effect of multidisciplinary medical care in the field of radiation oncology--results from a questionnaire survey.

    PubMed

    Igaki, Hiroshi; Onishi, Hiroshi; Nakagawa, Keiichi; Dokiya, Takushi; Nemoto, Kenji; Shigematsu, Naoyuki; Nishimura, Yasumasa; Hiraoka, Masahiro

    2013-12-01

    The consultation fee for outpatient radiotherapy was newly introduced in the national health insurance system in Japan in April 2012. We conducted a survey on the use of this consultation fee and its effect on clinical practices. The health insurance committee of the Japanese Society of Therapeutic Radiology and Oncology conducted a questionnaire survey. The questionnaire form was mailed to 160 councilors of the Society, the target questionees. A total of 94 answers (58% of the target questionees) sent back were used for analyses. The analyses revealed that 75% of the hospitals charged most of the patients who receive radiotherapy in an outpatient setting a consultation fee. The introduction of the consultation fee led to some changes in radiation oncology clinics, as evidenced by the response of 'more careful observations by medical staff' in 37% of questionees and a 12% increase in the number of full-time radiation oncology nurses. It was also shown that the vast majority (92%) of radiation oncologists expected a positive influence of the consultation fee on radiation oncology clinics in Japan. Our questionnaire survey revealed the present status of the use of a newly introduced consultation fee for outpatient radiotherapy, and the results suggested its possible effect on promoting a multidisciplinary medical care system in radiation oncology departments in Japan.

  1. Obesity as a risk factor in cancer: A national consensus of the Spanish Society for the Study of Obesity and the Spanish Society of Medical Oncology.

    PubMed

    Goday, A; Barneto, I; García-Almeida, J M; Blasco, A; Lecube, A; Grávalos, C; Martínez de Icaya, P; de las Peñas, R; Monereo, S; Vázquez, L; Palacio, J E; Pérez-Segura, P

    2015-10-01

    In the last few years, many prospective studies have demonstrated a clear association between obesity and cancers of the colon and rectum, breast in post-menopausal women, endometrium, kidney, oesophagus and pancreas. Obesity is also associated with a high risk of recurrence and cancer-related death. The pathophysiology of obesity involves various changes that may be implicated in the relationship between obesity and cancer, such as excess inflammatory cytokines and chronic inflammation, hyperinsulinaemia, insulin resistance, and raised leptin and oestrogens. The Spanish Society for the Study of Obesity and the Spanish Society of Medical Oncology have signed a cooperation agreement to work together towards reducing the impact of obesity in cancer. Preventing obesity prevents cancer.

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

    PubMed

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

    2014-11-01

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

  3. Biomarkers come of age: PD1 in the frontline and cell cycle therapy swells the ranks of personalised therapy in the European Society of Medical Oncology (ESMO) congress, Copenhagen, 7–10 October 2016

    PubMed Central

    Davies, Will

    2016-01-01

    After years of trials, Programmed Death Ligand and Receptor targeting finally debuts as a firstline therapy in combination and as a single agent regimen at the 2016 European Society of Medical Oncology (ESMO) Congress. The meeting brought together 20,522 attendees, from over 120 countries, to share updates and novel technologies from a wide swathe of oncology research. This year’s theme, From Disease Treatment to Patient Care, was matched by abstract presentations starting from inception of care regimens to new standards of care in high-risk patient subgroups, to wellbeing of care providers, and finally the funding obstacles at each continental level. PMID:28105074

  4. Biomarkers come of age: PD1 in the frontline and cell cycle therapy swells the ranks of personalised therapy in the European Society of Medical Oncology (ESMO) congress, Copenhagen, 7-10 October 2016.

    PubMed

    Davies, Will

    2016-01-01

    After years of trials, Programmed Death Ligand and Receptor targeting finally debuts as a firstline therapy in combination and as a single agent regimen at the 2016 European Society of Medical Oncology (ESMO) Congress. The meeting brought together 20,522 attendees, from over 120 countries, to share updates and novel technologies from a wide swathe of oncology research. This year's theme, From Disease Treatment to Patient Care, was matched by abstract presentations starting from inception of care regimens to new standards of care in high-risk patient subgroups, to wellbeing of care providers, and finally the funding obstacles at each continental level.

  5. Knowledge loss of medical students on first year basic science courses at the university of Saskatchewan

    PubMed Central

    D'Eon, Marcel F

    2006-01-01

    Background Many senior undergraduate students from the University of Saskatchewan indicated informally that they did not remember much from their first year courses and wondered why we were teaching content that did not seem relevant to later clinical work or studies. To determine the extent of the problem a course evaluation study that measured the knowledge loss of medical students on selected first year courses was conducted. This study replicates previous memory decrement studies with three first year medicine basic science courses, something that was not found in the literature. It was expected that some courses would show more and some courses would show less knowledge loss. Methods In the spring of 2004 over 20 students were recruited to retake questions from three first year courses: Immunology, physiology, and neuroanatomy. Student scores on the selected questions at the time of the final examination in May 2003 (the 'test') were compared with their scores on the questions 10 or 11 months later (the 're-test') using paired samples t -tests. A repeated-measures MANOVA was used to compare the test and re-test scores among the three courses. The re-test scores were matched with the overall student ratings of the courses and the student scores on the May 2003 examinations. Results A statistically significant main effect of knowledge loss (F = 297.385; p < .001) and an interaction effect by course (F = 46.081; p < .001) were found. The students' scores in the Immunology course dropped 13.1%, 46.5% in Neuroanatomy, and 16.1% in physiology. Bonferroni post hoc comparisons showed a significant difference between Neuroanatomy and Physiology (mean difference of 10.7, p = .004). Conclusion There was considerable knowledge loss among medical students in the three basic science courses tested and this loss was not uniform across courses. Knowledge loss does not seem to be related to the marks on the final examination or the assessment of course quality by the students

  6. [Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology].

    PubMed

    Ferreirós, J; Cabeza, B; Gayete, Á; Sánchez, M; Torres, M I; Cobo, M; Isla, D; Puente, J; Reguart, N; de Castro, J

    2015-01-01

    The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM) have therefore produced a national consensus statement in order to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography (MDCT) as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only Response Evaluation Criteria in Solid Tumours (RECIST 1.1) but also Immune-Related Response Criteria (irRC).

  7. 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.

  8. Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies

    PubMed Central

    Sanghavi, Prachi; Jena, Anupam B.; Newhouse, Joseph P.; Zaslavsky, Alan M.

    2016-01-01

    Background Most Medicare patients seeking emergency medical transport are treated by ambulance providers trained in advanced life support (ALS). Evidence supporting the superiority of ALS over basic life support (BLS) is limited, but some studies suggest ALS may harm patients. Objective To compare outcomes after ALS and BLS in out-of-hospital medical emergencies. Design Observational study with adjustment for propensity score weights and instrumental variable analyses based on county-level variations in ALS use. Setting Traditional Medicare. Patients 20% random sample of Medicare beneficiaries from nonrural counties between 2006 and 2011 with major trauma, stroke, acute myocardial infarction (AMI), or respiratory failure. Measurements Neurologic functioning and survival to 30 days, 90 days, 1 year, and 2 years. Results Except in cases of AMI, patients showed superior unadjusted outcomes with BLS despite being older and having more comorbidities. In propensity score analyses, survival to 90 days among patients with trauma, stroke, and respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI, 5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7 percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8 percentage points] for respiratory failure). Patients with AMI did not exhibit differences in survival at 30 days but had better survival at 90 days with ALS (1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic functioning favored BLS for all diagnoses. Results from instrumental variable analyses were broadly consistent with propensity score analyses for trauma and stroke, showed no survival differences between BLS and ALS for respiratory failure, and showed better survival at all time points with BLS than ALS for patients with AMI. Limitation Only Medicare beneficiaries from nonrural counties were studied. Conclusion Advanced life support is associated with substantially higher mortality

  9. Methodological issues in the choice among different drugs approved for the same therapeutic indication: a position paper by the Italian Association of Medical Oncology (AIOM)

    PubMed Central

    Bruzzi, Paolo; Perrone, Francesco; Torri, Valter; Montemurro, Filippo; Tiseo, Marcello; Vasile, Enrico

    2016-01-01

    In oncology, as in other clinical fields, different treatments are often approved for the same therapeutic indication. In many cases, no direct comparisons are available to inform the choice in clinical practice. In 2015, the Italian Association of Medical Oncology (AIOM) instructed a working group, including both clinicians and methodologists, to discuss the issue of the best choice among different treatments available for the same indication. The working group discussed 3 different scenarios: (1) biosimilar drugs; (2) different drugs with same mechanism of action; (3) different drugs with different mechanism of action. For each scenario, methodological issues were discussed, along with the priority for investment of resources in the conduct of clinical trials testing direct comparison. As for biosimilar drugs, the panel recommended that, following comparability exercise and approval by regulatory agencies, they should be widely used, considered that their use allows financial savings. As for different drugs (with either the same or a different mechanism of action), the panel agreed that indirect comparisons and network meta-analyses are associated with relevant risk of bias and imprecision, and direct comparisons should be encouraged. The priority of these direct comparisons should be higher when the potential differences in efficacy and/or toxicity are clinically relevant. The choice of the study design (superiority vs non-inferiority) depends on the toxicity profiles and also on the presumed difference in efficacy. Scientific societies should put pressure on public bodies to identify all the administrative and financial mechanisms useful to facilitate the conduct of trials testing direct comparisons, when needed. Decision about therapeutic equivalence can have important consequences on innovation: the availability of drugs characterised by the same effectiveness, but at a lower cost, could enable non-negligible savings of economic resources that could be used

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

    SciTech Connect

    Shakespeare, Thomas P. . E-mail: ThomasShakespeare@gmail.com; Back, Michael F.; Lu, Jiade J.; Lee, Khai Mun; Mukherjee, Rahul K.

    2006-03-01

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

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

    PubMed

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

    2015-03-01

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

  12. 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.

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

    PubMed Central

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

    1995-01-01

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

  14. Opinions concerning euthanasia, life-sustaining treatment and acceleration of death: results of an Italian Association of Medical Oncology (AIOM) survey.

    PubMed

    Catania, C; Zagonel, V; Fosser, V; La Verde, N; Bertetto, O; Iacono, C; Venturini, M; Radice, D; Adamoli, L; Boccardo, F

    2008-11-01

    Advance directives, acceleration of death, euthanasia and 'life-sustaining treatment' have sparked much heated debate among the media, the public, doctors and political leaders. We evaluate the personal opinions of Italian Association of Medical Oncology (AIOM) members. A 30-item questionnaire was developed and delivered to all 1,832 AIOM members. Six-hundred and eighty-five (37%) oncologists completed and returned the questionnaires. Sixty-three per cent felt culturally and psychologically prepared to face these issues. Fifty-four per cent believed that what had been decided while the patient enjoyed good health is no longer applicable in an advanced state of terminal illness. Thirty-nine per cent believed that doctors should abide by these directives, while 49% believed that this should be discussed on a case-by-case basis. Fourteen per cent of oncologists were favourable towards euthanasia and 42% only in particular circumstances. Fifty-six per cent had received at least one request for accelerating death: 15% consented, 50% discussed it with the patient and 31% refused. Advance directives, euthanasia, accelerated death and life-sustaining treatment represent considerable challenges for Italian oncologists. Although prepared to face these issues, AIOM members ask for a debate within the medical world and for a shared judicial regulation.

  15. The Effect of Urban Basic Medical Insurance on Health Service Utilisation in Shaanxi Province, China: A Comparison of Two Schemes

    PubMed Central

    Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Background Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Methods Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Conclusion Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. PMID:24740282

  16. The effect of urban basic medical insurance on health service utilisation in Shaanxi Province, China: a comparison of two schemes.

    PubMed

    Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

  17. Development and Evaluation of an Integrated Basic Combat/Advanced Individual Training Program for Medical Corpsmen (MOS 91A10).

    ERIC Educational Resources Information Center

    Ward, Joseph S.; And Others

    The Human Resources Research Organization undertook this study to determine experimentally the effect of integrating the Basic Combat Training (BCT) and the Advanced Individual Training (AIT) sequence of instruction for conscientious objector (CO) being trained as a Medical Corpsman (MOS 91A10). Other objectives were to develop an improved AIT…

  18. The Use of Self-Learning Modules to Facilitate Learning of Basic Science Concepts in an Integrated Medical Curriculum

    ERIC Educational Resources Information Center

    Khalil, Mohammed K.; Nelson, Loren D.; Kibble, Jonathan D.

    2010-01-01

    This study used qualitative and quantitative approaches to evaluate the effectiveness of self-learning modules (SLMs) developed to facilitate and individualize students' learning of basic medical sciences. Twenty physiology and nineteen microanatomy SLMs were designed with interactive images, animations, narrations, and self-assessments. Of 41…

  19. The Use of Self-Learning Modules to Facilitate Learning of Basic Science Concepts in an Integrated Medical Curriculum

    ERIC Educational Resources Information Center

    Khalil, Mohammed K.; Nelson, Loren D.; Kibble, Jonathan D.

    2010-01-01

    This study used qualitative and quantitative approaches to evaluate the effectiveness of self-learning modules (SLMs) developed to facilitate and individualize students' learning of basic medical sciences. Twenty physiology and nineteen microanatomy SLMs were designed with interactive images, animations, narrations, and self-assessments. Of 41…

  20. Changes in Study Strategies of Medical Students between Basic Science Courses and Clerkships Are Associated with Performance

    ERIC Educational Resources Information Center

    Ensminger, David C.; Hoyt, Amy E.; Chandrasekhar, Arcot J.; McNulty, John A.

    2013-01-01

    We tested the hypothesis that medical students change their study strategies when transitioning from basic science courses to clerkships, and that their study practices are associated with performance scores. Factor scores for three approaches to studying (construction, rote, and review) generated from student (n = 150) responses to a…

  1. [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.

  2. Importance of basic life support training for first and second year medical students--a personal statement.

    PubMed

    Tipa, Raluca Oana; Bobirnac, George

    2010-01-01

    Current studies show that there is a significant lack of knowledge regarding the typical signs and risk factors associated with serious medical conditions among medical students and laypersons. Basic life support consists of a number of medical procedures provided to patients with life threatening conditions of the body that cause pain or dysfunction to the person. In spite of the fact that this programme is not included in the curricula, students might receive this information from various persons, even though these persons are not specialized in the domain of giving first aid. Learning medicine without placing patients at an increased risk of complications is of utmost importance in the medical profession. High-fidelity patient simulators can potentially achieve this, and, therefore they are increasingly used in the training of medical students. Recent studies regarding simulation training show that the simulation-based intervention offers a positively evaluated possibility to enhance students' skills in recognizing and handling emergencies improving the ability to manage medical emergencies. Understanding BLS courses and more than that, practicing these techniques is by far the most challenging task confronting first aid. Taking everything into consideration, we believe that an adequate education in first aid and basic life support should be considered an essential aspect of the medical curriculum.

  3. Design and construction of translational medicine platform for urologic oncology.

    PubMed

    Xu, Yong; Yang, Kuo

    2012-03-01

    Translational medicine is a new medical model which focus on overcoming the serious imbalance among the basic research, its clinical and public health application. Its core is to establish effective ties among basic medical researchers, public health workers and doctors who know the needs of patients, particularly translating the molecular medical research results to suitable disease prevention, diagnosis, treatment and prevention methods effectively. This paper discusses the design and construction of the translational medicine platform for urologic system tumors. However, there is no draw on the precedent, it is a challenging project to create such a complicated platform and make it running smoothly and effectively. Based on the Tianjin Translational Medicine Platform for Urologic Oncology (TTMPUO) which had been established in support of Tianjin Science and Technology Commission, this paper will focus on describing the design ideas and the essential parts of the platform.

  4. 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

  5. Paradoxes in Advance Care Planning: The Complex Relationship of Oncology Patients, Their Physicians, and Advance Medical Directives

    PubMed Central

    Dow, Lindsay A.; Matsuyama, Robin K.; Ramakrishnan, V.; Kuhn, Laura; Lamont, Elizabeth B.; Lyckholm, Laurel; Smith, Thomas J.

    2010-01-01

    Purpose Many seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or unwanted aggressive care at the end of life. Ten years ago, patients with cancer said they would not like to discuss ADs with their oncologist but would be willing to discuss them with an admitting physician. We assessed whether this point of view still held. Patients and Methods Semi-structured interviews were conducted with 75 consecutively admitted patients with cancer in the cancer inpatient service. Results Of those enrolled, 41% (31 of 75) had an AD. Nearly all (87%, 65 of 75) thought it acceptable to discuss ADs with the admitting physician with whom they had no prior relationship, and 95% (62 of 65) thought that discussing AD issues was very or somewhat important. Only 7% (5 of 75) had discussed ADs with their oncologist, and only 23% (16 of 70) would like to discuss ADs with their oncologist. When specifically asked which physician they would choose, 48% (36 of 75) of patients would prefer their oncologist, and 35% (26 of 75) would prefer their primary care physician. Conclusion Fewer than half of seriously ill patients with cancer admitted to an oncology service have an AD. Only 23% (16 of 70) would like to discuss their ADs with their oncologist but nearly all supported a policy of discussing ADs with their admitting physician. However, fully 48% (36 of 75) actually preferred to discuss advance directives with their oncologist if AD discussion was necessary. We must educate patients on why communicating their ADs is beneficial and train primary care physicians, house staff, hospitalists, and oncologists to initiate these difficult discussions. PMID:19933909

  6. Prospective, Observational Study of Pain and Analgesic Prescribing in Medical Oncology Outpatients With Breast, Colorectal, Lung, or Prostate Cancer

    PubMed Central

    Fisch, Michael J.; Lee, Ju-Whei; Weiss, Matthias; Wagner, Lynne I.; Chang, Victor T.; Cella, David; Manola, Judith B.; Minasian, Lori M.; McCaskill-Stevens, Worta; Mendoza, Tito R.; Cleeland, Charles S.

    2012-01-01

    Purpose Pain is prevalent among patients with cancer, yet pain management patterns in outpatient oncology are poorly understood. Patients and Methods A total of 3,123 ambulatory patients with invasive cancer of the breast, prostate, colon/rectum, or lung were enrolled onto this prospective study regardless of phase of care or stage of disease. At initial assessment and 4 to 5 weeks later, patients completed a 25-item measure of pain, functional interference, and other symptoms. Providers recorded analgesic prescribing. The pain management index was calculated to assess treatment adequacy. Results Of the 3,023 patients we identified to be at risk for pain, 2,026 (67%) reported having pain or requiring analgesics at initial assessment; of these 2,026 patients, 670 (33%) were receiving inadequate analgesic prescribing. We found no difference in treatment adequacy between the initial and follow-up visits. Multivariable analysis revealed that the odds of a non-Hispanic white patient having inadequate pain treatment were approximately half those of a minority patient after adjusting for other explanatory variables (odds ratio, 0.51; 95% CI, 0.37 to 0.70; P = .002). Other significant predictors of inadequate pain treatment were having a good performance status, being treated at a minority treatment site, and having nonadvanced disease without concurrent treatment. Conclusion Most outpatients with common solid tumors must confront issues related to pain and the use of analgesics. There is significant disparity in pain treatment adequacy, with the odds of undertreatment twice as high for minority patients. These findings persist over 1 month of follow-up, highlighting the complexity of these problems. PMID:22508819

  7. [Experimental intervention study of safe injection in basic-level hospitals in Hunan by medical staff].

    PubMed

    Li, Li; Li, Yinglan; Long, Yanfang; Zhou, Yang; Lu, Jingmei; Wu, Ying

    2013-07-01

    To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect after the intervention and to provide practical measures to improve safe injection. We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups after the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8% to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0% to 27.9%, with significant difference (P<0.01). Six months after the intervention, the unsafe injection rate in the experimental group declined to 18.4% while the unsafe injection rate in the control group also dropped to 22.4%, with significant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with significant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01); the experimental group got higher scores after the intervention (P<0.01). Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners' behaviors in unsafe injections and it is worth promoting.

  8. Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India.

    PubMed

    Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra

    2017-01-01

    This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences (P<0.05) between assessed knowledge and anxiety. Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983). There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

  9. Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India

    PubMed Central

    Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra

    2017-01-01

    BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences (P<0.05) between assessed knowledge and anxiety. RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983). CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures. PMID:28458758

  10. Protection of quality and innovation in radiation oncology: the prospective multicenter trial the German Society of Radiation Oncology (DEGRO-QUIRO study). Evaluation of time, attendance of medical staff, and resources during radiotherapy with IMRT.

    PubMed

    Vorwerk, H; Zink, K; Schiller, R; Budach, V; Böhmer, D; Kampfer, S; Popp, W; Sack, H; Engenhart-Cabillic, R

    2014-05-01

    A number of national and international societies published recommendations regarding the required equipment and manpower assumed to be necessary to treat a number of patients with radiotherapy. None of these recommendations were based on actual time measurements needed for specific radiotherapy procedures. The German Society of Radiation Oncology (DEGRO) was interested in substantiating these recommendations by prospective evaluations of all important core procedures of radiotherapy in the most frequent cancers treated by radiotherapy. The results of the examinations of radiotherapy with intensity-modulated radiation therapy (IMRT) in patients with different tumor entities are presented in this manuscript. Four radiation therapy centers [University Hospital of Marburg, University Hospital of Giessen, University Hospital of Berlin (Charité), Klinikum rechts der Isar der Technischen Universität München] participated in this prospective study. The workload of the different occupational groups and room occupancies for the core procedures of radiotherapy were prospectively documented during a 2-month period per center and subsequently statistically analyzed. The time needed per patient varied considerably between individual patients and between centers for all the evaluated procedures. The technical preparation (contouring of target volume and organs at risk, treatment planning, and approval of treatment plan) was the most time-consuming process taking 3 h 54 min on average. The time taken by the medical physicists for this procedure amounted to about 57%. The training part of the preparation time was 87% of the measured time for the senior physician and resident. The total workload for all involved personnel comprised 74.9 min of manpower for the first treatment, 39.7 min for a routine treatment with image guidance, and 22.8 min without image guidance. The mean room occupancy varied between 10.6 min (routine treatment without image guidance) and 23.7 min (first

  11. Case method teaching: an effective approach to integrate the basic and clinical sciences in the preclinical medical curriculum.

    PubMed

    Bowe, Constance M; Voss, John; Thomas Aretz, H

    2009-09-01

    Recent efforts to identify the essential skills and competencies required for medical practice have resulted in an expansion of the educational outcomes for which medical schools are accountable. Teachers in the preclinical years, formerly focused on the transmission of biomedical principles and factual information, are now charged with presenting discipline-specific concepts with an emphasis on clinical relevance while advancing active learning, critical thinking, communication skills, and other professional competencies. Problem-based learning has been widely introduced to support these educational goals but other, less resource-intensive, discussion methodologies have not been extensively explored. To examine the feasibility of case-method teaching (CMT) during the preclinical curricula to integrate basic science concepts in the management of clinical problems. CMT sessions were conducted with students during the first- and second-year of hybrid curricula at two US medical schools. First- and second-year medical classes of 40-95 students prepared for and actively engaged in single session case discussions and were able to productively apply basic science principles in clinical problem-solving. CMT represents a feasible and resource-conservative pedagogical format to promote critical thinking and to integrate basic science principles during the preclinical curriculum.

  12. Integrated case studies and medical decision making: a novel, computer-assisted bridge from the basic sciences to the clinics.

    PubMed

    Schor, N F; Troen, P; Adler, S; Williams, J G; Kanter, S L; Mahling, D E; Sorrows, B; Skogseid, I; Bernier, G M

    1995-09-01

    This article describes a novel course that was designed to bridge the gap between the basic science years and clinical experiences in medical school by using information science and computer technology as major components of problem-based learning (PBL) sessions. The course, Integrated Case Studies and Medical Decision Making, was first given to second-year students at the University of Pittsburgh School of Medicine in the spring of 1994. It consists of 13 PBL exercises, each of which explores a clinical case. The cases, including images and gated access to information, are housed on a computer. Using one of 16 networked terminals in specially designed small-group rooms, groups of nine students progress through the cases with a faculty facilitator. The responses of students and faculty to the initial year of the course were favorable. In comparison with traditional PBL sessions, enhanced quality of and access to images and accountability for accessing case information in sequential fashion were cited as major strengths of the course. Juxtaposition of basic science and clinical material and utility in reviewing for the United States Medical Licensing Examination were also cited as strengths. The diversity of the basic science material involved in completing the cases drew overwhelming enthusiasm from students and facilitators alike. In conclusion, the course successfully employs computer and information science technology, which will be of increasing importance to future physicians. The course also serves as an effective bridge to the clinical years of medical school and as a study adjunct for the USMLE.

  13. An International Basic Science and Clinical Research Summer Program for Medical Students

    ERIC Educational Resources Information Center

    Ramjiawan, Bram; Pierce, Grant N.; Anindo, Mohammad Iffat Kabir; AlKukhun, Abedalrazaq; Alshammari, Abdullah; Chamsi, Ahmad Talal; Abousaleh, Mohannad; Alkhani, Anas; Ganguly, Pallab K.

    2012-01-01

    An important part of training the next generation of physicians is ensuring that they are exposed to the integral role that research plays in improving medical treatment. However, medical students often do not have sufficient time to be trained to carry out any projects in biomedical and clinical research. Many medical students also fail to…

  14. An International Basic Science and Clinical Research Summer Program for Medical Students

    ERIC Educational Resources Information Center

    Ramjiawan, Bram; Pierce, Grant N.; Anindo, Mohammad Iffat Kabir; AlKukhun, Abedalrazaq; Alshammari, Abdullah; Chamsi, Ahmad Talal; Abousaleh, Mohannad; Alkhani, Anas; Ganguly, Pallab K.

    2012-01-01

    An important part of training the next generation of physicians is ensuring that they are exposed to the integral role that research plays in improving medical treatment. However, medical students often do not have sufficient time to be trained to carry out any projects in biomedical and clinical research. Many medical students also fail to…

  15. [Ambulatory palliative treatment in oncology. Medical and psychosocial care of tumor patients in the advanced stadium of the disease].

    PubMed

    Böning, L

    1999-03-30

    Many patients with terminal cancer would prefer to receive care at home. Frequently, however, socio-economic or familial constraints make this impossible, although from the medical point of view there might be no objections, even when the late stage of the disease is associated with certain complications. However, the preconditions must first be defined and agreed when the patient and relatives are making the necessary preparations--as far as possible jointly with a team comprising family doctor, oncologist and nursing service. Binding agreements among all those involved are required to ensure that in difficult situations the patient and his family receive the support they need. A number of common medical problems met with during palliative treatment, such as diarrhea, constipation, pleural effusion, etc. are described.

  16. Guidelines for biomarker testing in metastatic melanoma: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology.

    PubMed

    Martín-Algarra, S; Fernández-Figueras, M T; López-Martín, J A; Santos-Briz, A; Arance, A; Lozano, M D; Berrocal, A; Ríos-Martín, J J; Espinosa, E; Rodríguez-Peralto, J L

    2014-04-01

    This consensus statement, conceived as a joint initiative of the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM), makes diagnostic and treatment recommendations for the management of patients with advanced or metastatic melanoma based on the current scientific evidence on biomarker use. This document thus provides an opportunity to improve healthcare efficiency and resource use, which will benefit these patients. Based on the data available so far, this expert group recommends routinely testing patients with metastatic melanoma for BRAF mutation status, as the result affects the subsequent therapeutic management of these patients. The analysis of genetic alterations in KIT may be reasonable in patients with primary tumours in acral or mucosal sites or on chronically sun-exposed skin, in an advanced condition, but not in patients with other types of melanomas. This panel believes that testing for other genetic alterations, such as NRAS mutation status in patients not carrying BRAF mutations, GNAQ/GNA11 mutational analysis or genetic alterations in PTEN, is not currently indicated as routine clinical practice, because the results do not influence treatment planning in these patients at the present time. Other important issues addressed in this document are the organisational requirements and quality controls needed for proper testing of these biomarkers, and the legal implications to be borne in mind.

  17. Guidelines for biomarker testing in colorectal carcinoma (CRC): a national consensus of the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM).

    PubMed

    García-Alfonso, Pilar; Salazar, Ramón; García-Foncillas, Jesús; Musulén, Eva; García-Carbonero, Rocío; Payá, Artemio; Pérez-Segura, Pedro; Ramón y Cajal, Santiago; Navarro, Samuel

    2012-10-01

    This consensus statement, conceived as a joint initiative of the Spanish Society of Pathology and the Spanish Society of Medical Oncology, makes diagnostic and treatment recommendations for the management of patients with hereditary, localised and advanced CRC based on the current scientific evidence on biomarker use. This consensus statement thus provides an opportunity to improve healthcare efficiency and resource use, which will benefit these patients. Based on the currently available data on this subject, this expert group recommends testing for microsatellite instability (MSI) in patients with localised CRC, as this is a strong predictive factor for deciding on adjuvant treatment. However, although the ColoPrint(®) and Oncotype Dx(®) gene expression signatures have been shown to have prognostic value, no consensus yet exists concerning their use in clinical practice. For advanced CRC, it is essential to test for KRAS mutation status before administering an anti-EGFR treatment, such as cetuximab or panitumumab. However, testing for other biomarkers, such as BRAF, EGFR, PI3K and PTEN mutations, should not be done routinely, because this does not influence treatment planning at the present time. Other important issues addressed include organisational requirements and the quality controls needed for proper testing of these biomarkers as well as the legal implications to be borne in mind when testing some biomarkers.

  18. Guidelines for HER2 testing in breast cancer: a national consensus of the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM).

    PubMed

    Albanell, Joan; Andreu, Xavier; Calasanz, María José; Concha, Angel; Corominas, José María; García-Caballero, Tomás; López, José Antonio; López-Ríos, Fernando; Ramón y Cajal, Santiago; Vera-Sempere, Francisco J; Colomer, Ramón; Martín, Miguel; Alba, Emilio; González-Martín, Antonio; Llombart, Antonio; Lluch, Ana; Palacios, José

    2009-06-01

    Identifying breast cancers with HER2 overexpression or amplification is critical as these usually imply the use of HER2-targeted therapies. DNA (amplification) and protein (overexpression) HER2 abnormalities usually occur simultaneously and both in situ hybridisation and immunohistochemistry may be accurate methods for the evaluation of these abnormalities. However, recent studies, including those conducted by the Association for Quality Assurance of the Spanish Society of Pathology, as well as the experience of a number of HER2 testing National Reference Centres have suggested the existence of serious reproducibility issues with both techniques. To address this issue, a joint committee from the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM) was established to review the HER2 testing guidelines. Consensus recommendations are based not only on the panellists' experience, but also on previous consensus guidelines from several countries, including the USA, the UK and Canada. These guidelines include the minimal requirements that pathology departments should fulfil in order to guarantee proper HER2 testing in breast cancer. Pathology laboratories not fulfilling these standards should make an effort to meet them and, until then, are highly encouraged to submit to reference laboratories breast cancer samples for which HER2 determination has clinical implications for the patients.

  19. Dunno if you've any plans for the future: medical student indirect questioning in simulated oncology interviews.

    PubMed

    Bourquin, Céline; Stiefel, Friedrich; Berney, Alexandre; Singy, Pascal

    2012-03-02

    This exploratory study investigated the motives of medical students (N = 63) for using indirect questions of the type I don't know if [you have already heard about chemotherapies], I don't know how [you are], or I don't know what [you do for a living] in simulated patient interviews during a communication skills course. I don't know questions (IDK-Qs) were observed during the initial evaluation of students' communication skills; they were systematically identified through video screening and subjected to a qualitative content and discourse analysis considering their context, their content, their intent and their effect on the simulated patients. To evaluate the specificity of medical students' IDK-Qs, the data were compared with a data set of oncologists (N = 31) conducting simulated patient interviews in the context of a Communication Skills Training (CST). During the interviews, 41.3% of the students asked 1-6 IDK-Qs. The IDK-Qs were attributed to three content categories: medical/treatment questions (N = 24); lifestyle/psychosocial questions (N = 18); and "inviting questions" questions (N = 11). Most of the IDK-Qs had an exploratory function (46/53), with simulated patients providing detailed responses or asking for more information (36/53). IDK-Qs were rare in the oncologist sample compared to the student sample (5 vs. 53 occurrences). IDK-Qs showed a question design difference between medical students and oncologists in simulated patient interviews. Among other reasons for this difference, the possible function of IDK-Qs as a protective linguistic strategy and marker for psychological discomfort is discussed.

  20. Medical Physics Panel Discussion

    NASA Astrophysics Data System (ADS)

    Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew

    2006-03-01

    The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.

  1. Basic results of medical studies during prolonged manned flights on-board the Salyut-7/Soyuz-T orbital complex

    NASA Technical Reports Server (NTRS)

    1988-01-01

    From 1982 through 1986 six extended flights (from 65 to 237 days) were carried out in the Salyut-7/Soyuz-T orbital complex by the principal crews, and five short-term flights (8 to 12 days) by visiting crews. During these flights, a broad series of medical studies was performed, their greatest extent during the longest flight (237 days), with the participation of a cosmonaut-doctor. The medical studies were aimed at obtaining additional information and new data on the reactions of the body's basic systems during a prolonged state of weightlessness.

  2. Basic results of medical studies during prolonged manned flights on-board the Salyut-7/Soyuz-T orbital complex

    NASA Technical Reports Server (NTRS)

    1988-01-01

    From 1982 through 1986 six extended flights (from 65 to 237 days) were carried out in the Salyut-7/Soyuz-T orbital complex by the principal crews, and five short-term flights (8 to 12 days) by visiting crews. During these flights, a broad series of medical studies was performed, their greatest extent during the longest flight (237 days), with the participation of a cosmonaut-doctor. The medical studies were aimed at obtaining additional information and new data on the reactions of the body's basic systems during a prolonged state of weightlessness.

  3. Developing a complex systems perspective for medical education to facilitate the integration of basic science and clinical medicine.

    PubMed

    Aron, David C

    2017-04-01

    The purpose of medical education is to produce competent and capable professional practitioners who can combine the art and science of medicine. Moreover, this process must prepare individuals to practise in a field in which knowledge is increasing and the contexts in which that knowledge is applied are changing in unpredictable ways. The 'basic sciences' are important in the training of a physician. The goal of basic science training is to learn it in a way that the material can be applied in practice. Much effort has been expended to integrate basic science and clinical training, while adding many other topics to the medical curriculum. This effort has been challenging. The aims of the paper are (1) to propose a unifying conceptual framework that facilitates knowledge integration among all levels of living systems from cell to society and (2) illustrate the organizing principles with two examples of the framework in action - cybernetic systems (with feedback) and distributed robustness. Literature related to hierarchical and holarchical frameworks was reviewed. An organizing framework derived from living systems theory and spanning the range from molecular biology to health systems management was developed. The application of cybernetic systems to three levels (regulation of pancreatic beta cell production of insulin, physician adjustment of medication for glycaemic control and development and action of performance measures for diabetes care) was illustrated. Similarly distributed robustness was illustrated by the DNA damage response system and principles underlying patient safety. Each of the illustrated organizing principles offers a means to facilitate the weaving of basic science and clinical medicine throughout the course of study. The use of such an approach may promote systems thinking, which is a core competency for effective and capable medical practice. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  4. In defense of basic science funding: today's scientific discovery is tomorrow's medical advance.

    PubMed

    Tessier-Lavigne, Marc

    2013-06-01

    In this address, I will discuss the importance of basic science in tackling our health problems. I will also describe how the funding cuts are damaging our economic competitiveness and turning our young people away from science.

  5. The attitudes and perceptions of medical students towards basic science subjects during their clinical years: A cross-sectional survey.

    PubMed

    Gupta, Shalini; Gupta, Ashwani K; Verma, Minni; Kaur, Harpreet; Kaur, Amandeep; Singh, Kamaljit

    2014-01-01

    In the conventional system of medical education, basic subjects are taught in the 1(st) year with least interdisciplinary interaction. The objective of this study was to explore the students' perception about content, need and application of basic science subjects during the clinical years of their medical education. A total of 300 questionnaires were distributed among students randomly after taking their written consent for participation in the study. About 265 completely filled questionnaires were received back and the response was analyzed. Students identified anatomy as the subject with overloaded syllabus (75.4%) and also with maximum clinical application with 50.1% of them considering it the most important basic subject. Students were satisfied with the practical integration of subjects to impart clinical skills, but considered problem based learning a better method of teaching. According to 37%, 43.8% and 33.2% of respondents respectively; anatomy, biochemistry and physiology curriculum should only cover the general concepts to give the working knowledge of the subject. Approximately, 65% of the respondents were able to recall the knowledge of anatomy and physiology while biochemistry was retained by 40%. Overall, the attitudes of students toward basic science subjects were positive. The learning experience for them can be improved significantly by better clinical integration of the subjects.

  6. The attitudes and perceptions of medical students towards basic science subjects during their clinical years: A cross-sectional survey

    PubMed Central

    Gupta, Shalini; Gupta, Ashwani K; Verma, Minni; Kaur, Harpreet; Kaur, Amandeep; Singh, Kamaljit

    2014-01-01

    Introduction: In the conventional system of medical education, basic subjects are taught in the 1st year with least interdisciplinary interaction. The objective of this study was to explore the students’ perception about content, need and application of basic science subjects during the clinical years of their medical education. Materials and Methods: A total of 300 questionnaires were distributed among students randomly after taking their written consent for participation in the study. About 265 completely filled questionnaires were received back and the response was analyzed. Results: Students identified anatomy as the subject with overloaded syllabus (75.4%) and also with maximum clinical application with 50.1% of them considering it the most important basic subject. Students were satisfied with the practical integration of subjects to impart clinical skills, but considered problem based learning a better method of teaching. According to 37%, 43.8% and 33.2% of respondents respectively; anatomy, biochemistry and physiology curriculum should only cover the general concepts to give the working knowledge of the subject. Approximately, 65% of the respondents were able to recall the knowledge of anatomy and physiology while biochemistry was retained by 40%. Conclusions: Overall, the attitudes of students toward basic science subjects were positive. The learning experience for them can be improved significantly by better clinical integration of the subjects. PMID:24600572

  7. 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.

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

    SciTech Connect

    Gutierrez, A

    2016-06-15

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

  9. Japanese Society of Medical Oncology Clinical Guidelines: RAS (KRAS/NRAS) mutation testing in colorectal cancer patients11

    PubMed Central

    Taniguchi, Hiroya; Yamazaki, Kentaro; Yoshino, Takayuki; Muro, Kei; Yatabe, Yasushi; Watanabe, Toshiaki; Ebi, Hiromichi; Ochiai, Atsushi; Baba, Eishi; Tsuchihara, Katsuya

    2015-01-01

    The Japanese guidelines for the testing of KRAS mutations in colorectal cancer have been used for the past 5 years. However, new findings of RAS (KRAS/NRAS) mutations that can further predict the therapeutic effects of anti-epidermal growth factor receptor (EGFR) antibody therapy necessitated a revision of the guidelines. The revised guidelines included the following five basic requirements for RAS mutation testing to highlight a patient group in which anti-EGFR antibody therapy may be ineffective: First, anti-EGFR antibody therapy may not offer survival benefit and/or tumor shrinkage to patients with expanded RAS mutations. Thus, current methods to detect KRAS exon 2 (codons 12 and 13) mutations are insufficient for selecting appropriate candidates for this therapy. Additional testing of extended KRAS/NRAS mutations is recommended. Second, repeated tests are not required for the detection; tissue materials of either primary or metastatic lesions are applicable for RAS mutation testing. Evaluating RAS mutations prior to anti-EGFR antibody therapy is recommended. Third, direct sequencing with manual dissection or allele-specific PCR-based methods is currently applicable for RAS mutation testing. Fourth, thinly sliced sections of formalin-fixed, paraffin-embedded tissue blocks are applicable for RAS mutation testing. One section stained with H&E should be provided to histologically determine whether the tissue contains sufficient amount of tumor cells for testing. Finally, RAS mutation testing must be performed in laboratories with appropriate testing procedures and specimen management practices. PMID:25800101

  10. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that the...

  11. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that the...

  12. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... was filed. In situations where the occupational illness or covered illness is a secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying...

  13. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying primary cancer under these circumstances does not constitute a determination by OWCP that the...

  14. 20 CFR 30.400 - What are the basic rules for obtaining medical treatment?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer; however, payment for medical treatment of the underlying... treatment? 30.400 Section 30.400 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...

  15. [Discussion forum on medical ethics. A1. Basic forms in ethics].

    PubMed

    Löw, R

    1990-05-01

    Medical ethics should not be subsumed under the classical types of ethical reasoning (e.g. Aristotle, Kant) nor the modern ethical versions of utilitarianism, deontology or ethics of discourse. All of them may contribute to medical ethics; but these should be goaled by general ethics in the meaning of how to lead a senseful life in its whole.

  16. Integration of basic clinical skills training in medical education: an interprofessional simulated teaching experience.

    PubMed

    Hale, Janet Fraser; Cahan, Mitchell A; Zanetti, Mary L

    2011-01-01

    A 2004 survey reveals that the implementation of the 1998 AAMC report on medical student clinical skills training is slow. Given the importance of intravenous catheter placement, a creative approach evolved to educate medical students on this important skill. As part of a community service learning initiative, six graduate nursing students developed, implemented, and evaluated a pilot IV Cannulation Education Module taught to medical students. Data analysis of 63 participants reveals improved knowledge and confidence in medical students' ability to place an intravenous catheter. The objectives were met and the process enjoyed by students of both professions. Opportunities for interprofessional teaching and learning include clinical skills training. Medical students learned an important skill taught by graduate nursing students who developed and evaluated a curriculum that met their own graduate course objectives. Both professions appreciated the opportunity to work collaboratively to achieve their respective programmatic goals.

  17. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland

    PubMed Central

    Nieminen, Pentti; Sipilä, Kirsi; Takkinen, Hanna-Mari; Renko, Marjo; Risteli, Leila

    2007-01-01

    Background Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. Methods A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. Results A high proportion of the theses (69.5%) were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%). Only 61 theses (23.8%) had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. Conclusion The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved. PMID:18053247

  18. Medical theses as part of the scientific training in basic medical and dental education: experiences from Finland.

    PubMed

    Nieminen, Pentti; Sipilä, Kirsi; Takkinen, Hanna-Mari; Renko, Marjo; Risteli, Leila

    2007-12-05

    Teaching the principles of scientific research in a comprehensive way is important at medical and dental schools. In many countries medical and dental training is not complete until the candidate has presented a diploma thesis. The objective of this study was to evaluate the nature, quality, publication pattern and visibility of Finnish medical diploma theses. A total of 256 diploma theses presented at the University of Oulu from 2001 to 2003 were analysed. Using a standardised questionnaire, we extracted several characteristics from each thesis. We used the name of the student to assess whether the thesis resulted in a scientific publication indexed in medical article databases. The number of citations received by each published thesis was also recorded. A high proportion of the theses (69.5%) were essentially statistical in character, often combined with an extensive literature review or the development of a laboratory method. Most of them were supervised by clinical departments (55.9%). Only 61 theses (23.8%) had been published in indexed scientific journals. Theses in the fields of biomedicine and diagnostics were published in more widely cited journals. The median number of citations received per year was 2.7 and the range from 0 to 14.7. The theses were seldom written according to the principles of scientific communication and the proportion of actually published was small. The visibility of these theses and their dissemination to the scientific community should be improved.

  19. Evaluation of doctors’ performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

    PubMed Central

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Background Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students’ perceptions regarding lecture quality in a new medical school. Methods This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012–2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. Results The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Conclusion Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning. PMID:25878516

  20. Evaluation of doctors' performance as facilitators in basic medical science lecture classes in a new Malaysian medical school.

    PubMed

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students' perceptions regarding lecture quality in a new medical school. This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012-2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning.

  1. Review of basic medical results of the Salyut-7-Soyuz-T 8-month manned flight

    NASA Astrophysics Data System (ADS)

    Gazenko, O. G.; Schulzhenko, E. B.; Grigoriev, A. I.; Atkov, O. Yu.; Egorov, A. D.

    This paper presents the results of medical investigations performed in the Salyut-7 8-month mission in which a professional physician took part. The paper contains anthropometric measurements, results of investigating the vestibular function, cardiovascular function at rest and in response to multi-step tests (with emphasis on echocardiographic measurements), metabolic parameters and hormonal status. It also discusses medical aspects of the extravehicular activity. The medical investigations, although some new methods were applied, provided the continuity of methodical approaches and data accumulated in previous missions.

  2. 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.

  3. 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.

  4. Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey.

    PubMed

    Banerjee, S; Califano, R; Corral, J; de Azambuja, E; De Mattos-Arruda, L; Guarneri, V; Hutka, M; Jordan, K; Martinelli, E; Mountzios, G; Ozturk, M A; Petrova, M; Postel-Vinay, S; Preusser, M; Qvortrup, C; Volkov, M N M; Tabernero, J; Olmos, D; Strijbos, M H

    2017-07-01

    Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.

  5. Timely access to specialist medical oncology services closer to home for rural patients: experience from the Townsville Teleoncology Model.

    PubMed

    Sabesan, Sabe; Roberts, Lynden J; Aiken, Peter; Joshi, Abhishek; Larkins, Sarah

    2014-08-01

    Prior to 2009, the teleoncology model of the Townsville Cancer Centre (TCC) did not achieve its aims of equal waiting times for rural and urban patients and the provision of reliable, local acute cancer care. From 2007-2009, 60 new patients from Mt Isa travelled to TCC for their first consultation and their first dose of chemotherapy. Six of these patients required inter-hospital transfers and eight required urgent flights to attend outpatient clinics. Only 50% these rural patients (n = 30) were reviewed within one week of their referral, compared with 90% of Townsville patients. A descriptive study. TCC provides teleoncology services to 21 rural towns; the largest is Mt Isa, Qld. Specialist review of 90% of urgent cases within 24 hours, and 90% of non-urgent cases within one week of referral via videoconferencing. A 50% reduction in inpatient inter-hospital transfers from Mt Isa to Townsville. Employment of a half-time medical officer and a half-time cancer care coordinator, and implementation of new policies. Between 2009 and 2011, TCC provided cancer care to 70 new patients from Mt Isa. Of these new patients, 93% (65/70) were seen within one week of referral. All 17 patients requiring urgent reviews were seen within 24 hours of referral and managed locally thus eliminating the need for inpatient inter-hospital transfers. Provision of timely acute cancer care closer to home requires an increase in the rural case complexity and human resources. © 2014 National Rural Health Alliance Inc.

  6. 20 CFR 10.310 - What are the basic rules for obtaining medical care?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... physicians' assistants, nurse practitioners and physical therapists may also provide authorized services for... § 10.800. OWCP may also utilize the services of a field nurse to facilitate and coordinate medical care...

  7. 20 CFR 10.310 - What are the basic rules for obtaining medical care?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... physicians' assistants, nurse practitioners and physical therapists may also provide authorized services for... § 10.800. OWCP may also utilize the services of a field nurse to facilitate and coordinate medical care...

  8. 20 CFR 10.310 - What are the basic rules for obtaining medical care?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... physicians' assistants, nurse practitioners and physical therapists may also provide authorized services for... § 10.800. OWCP may also utilize the services of a field nurse to facilitate and coordinate medical care...

  9. Integrating Basic Science and Clinical Teaching for Third-Year Medical Students.

    ERIC Educational Resources Information Center

    Croen, Lila G.; And Others

    1986-01-01

    A 2-month program for third-year students at Yeshiva's Albert Einstein College of Medicine that provides a model for integrating basic sciences and clinical training is described. It demonstrates the importance of lifelong learning in a field that constantly changes. (Author/MLW)

  10. Integrating Basic Science and Clinical Teaching for Third-Year Medical Students.

    ERIC Educational Resources Information Center

    Croen, Lila G.; And Others

    1986-01-01

    A 2-month program for third-year students at Yeshiva's Albert Einstein College of Medicine that provides a model for integrating basic sciences and clinical training is described. It demonstrates the importance of lifelong learning in a field that constantly changes. (Author/MLW)

  11. Bioethical aspects of basic research and medical applications of human stem cells.

    PubMed

    Santos, Manuel J; Ventura-Juncá, Patricio

    2012-01-01

    The new discoveries, the extraordinary dynamism in human stem cell (SC) research, and the great expectations of the benefits in clinical treatment of many diseases are on the edge of unparalleled advances in both: 1) the understanding of basic mechanisms of cell differentiation and development and 2) the translation from basic research to new clinical therapies. Human stem cells are obtained from different sources, such as embryo, fetal, and adult tissues, in vitro induction (iPS cells) or transdifferentiation. The evidence that these cells are pluripotent (or multipotent), meaning they have the ability to differentiate into all body tissues or tissues of the same lineage, raises the possibility that they could regenerate diseased or damaged tissue in diseases that until now have had no effective treatments. Human stem cell research and therapy raise important bioethical considerations because of the human nature of these cells and their peculiar characteristics. Here we discuss the bioethical aspects of basic human SC research and the conditions necessary for the translation of basic preclinical research into clinical use of SC.

  12. Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study.

    PubMed

    Visser, Leonie N C; Tollenaar, Marieke S; Bosch, Jos A; van Doornen, Lorenz J P; de Haes, Hanneke C J M; Smets, Ellen M A

    2017-01-01

    Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r = 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative

  13. Definition of medical event is to be based on the total source strength for evaluation of permanent prostate brachytherapy: A report from the American Society for Radiation Oncology.

    PubMed

    Nag, Subir; Demanes, D Jeffrey; Hagan, Michael; Rivard, Mark J; Thomadsen, Bruce R; Welsh, James S; Williamson, Jeffrey F

    2011-10-01

    The Nuclear Regulatory Commission deems it to be a medical event (ME) if the total dose delivered differs from the prescribed dose by 20% or more. A dose-based definition of ME is not appropriate for permanent prostate brachytherapy as it generates too many spurious MEs and thereby creates unnecessary apprehension in patients, and ties up regulatory bodies and the licensees in unnecessary and burdensome investigations. A more suitable definition of ME is required for permanent prostate brachytherapy. The American Society for Radiation Oncology (ASTRO) formed a working group of experienced clinicians to review the literature, assess the validity of current regulations, and make specific recommendations about the definition of an ME in permanent prostate brachytherapy. The working group found that the current definition of ME in §35.3045 as "the total dose delivered differs from the prescribed dose by 20 percent or more" was not suitable for permanent prostate brachytherapy since the prostate volume (and hence the resultant calculated prostate dose) is dependent on the timing of the imaging, the imaging modality used, the observer variability in prostate contouring, the planning margins used, inadequacies of brachytherapy treatment planning systems to calculate tissue doses, and seed migration within and outside the prostate. If a dose-based definition for permanent implants is applied strictly, many properly executed implants would be improperly classified as an ME leading to a detrimental effect on brachytherapy. The working group found that a source strength-based criterion, of >20% of source strength prescribed in the post-procedure written directive being implanted outside the planning target volume is more appropriate for defining ME in permanent prostate brachytherapy. ASTRO recommends that the definition of ME for permanent prostate brachytherapy should not be dose based but should be based upon the source strength (air-kerma strength) administered.

  14. 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.

  15. Are Belgian senior medical students ready to deliver basic medical care in case of a H5N1 pandemic?

    PubMed

    Mortelmans, Luc J M; De Cauwer, Harald G; Van Dyck, Evi; Monballyu, Pieter; Van Giel, Roel; Van Turnhout, Ellen

    2009-01-01

    Medical care systems will be overwhelmed if a human H5N1 pandemic should occur. Several national disaster plans, including that of Belgium, focus on maximal treatment at home with senior medical students supporting frontline care. To evaluate the knowledge and preparedness of Belgian senior medical students, an e-mail survey of senior medical students (last two years of education) attending Flemish universities was conducted. A total of 243 students (30%) replied. Only 21.8% of them were aware of the possibility of being involved in this planning. A total of 77.4% estimated H5N1 to be a possible threat to national health. Seventy percent of respondents reacted positively towards the idea of being involved in implementing primary care, and only 9.5% were absolutely opposed to the idea. A total of 82.3% would care for pandemic patients if necessary, but only 41.2% would do so if these patients were children. Only 18.9% estimated themselves to be sufficiently educated regarding H5N1. Ninety-one percent were convinced that care for H5N1-influenza patients should be incorporated into their regular curriculum. Several antiviral products were reported by the students to be efficient for treating H5N1, but only 34.6% correctly chose oseltamavir and/or zanamavir and 35.4% replied "I don't know". A total of 95.5% correctly answered that the regular influenza vaccination doesn't protect against H5N1. The risk for human-to-human transmission was rated to be small by 50.6% (none 21%, high 27.6%). The human infection risk was rated to be small by 74.1% (none 1.6%, high 23%). There is a high level of willingness to participate among senior medical students. However, in the case of pediatric patients they're more reserved. It would be useful to incorporate a focused session on preparedness in the regular teaching program. A legal base for their actions should also be provided. Ethical guidelines on rights and duties in case of a pandemic should be prepared by an international

  16. Improved knowledge gain and retention for third-year medical students during surgical journal club using basic science review: A pilot study.

    PubMed

    Williams, Austin D; Mann, Barry D

    2017-02-01

    As they enter the clinical years, medical students face large adjustments in the acquisition of medical knowledge. We hypothesized that basic science review related to the topic of journal club papers would increase the educational benefit for third-year medical students. Students were randomized either to participation in a review session about basic science related to the journal club paper, or to no review. After one day, and after three months, students were given a 10-question quiz encompassing the basic science and the clinical implications of the paper. Twenty-six of 50 students were randomized to basic science review. These students scored better on both sections of the quiz one day after journal club, but only on basic science questions after three months. Students who participated in basic science review had better knowledge gain and retention. Educational activities building upon foundational knowledge improves learning on clinical rotations. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Student Failures on First-Year Medical Basic Science Courses and the USMLE Step 1: A Retrospective Study over a 20-Year Period

    ERIC Educational Resources Information Center

    Burns, E. Robert; Garrett, Judy

    2015-01-01

    Correlates of achievement in the basic science years in medical school and on the Step 1 of the United States Medical Licensing Examination® (USMLE®), (Step 1) in relation to preadmission variables have been the subject of considerable study. Preadmissions variables such as the undergraduate grade point average (uGPA) and Medical College Admission…

  18. Student Failures on First-Year Medical Basic Science Courses and the USMLE Step 1: A Retrospective Study over a 20-Year Period

    ERIC Educational Resources Information Center

    Burns, E. Robert; Garrett, Judy

    2015-01-01

    Correlates of achievement in the basic science years in medical school and on the Step 1 of the United States Medical Licensing Examination® (USMLE®), (Step 1) in relation to preadmission variables have been the subject of considerable study. Preadmissions variables such as the undergraduate grade point average (uGPA) and Medical College Admission…

  19. Impact of Modernising Medical Careers on basic surgical training and experience of oral and maxillofacial higher surgical trainees.

    PubMed

    Dhanda, Jagtar; Opie, Niel; Webster, Keith; Tanday, Ajit; Mumtaz, Shadaab; Visram, Semina

    2011-01-01

    Modernising Medical Careers (MMC) is a programme for change that aims to improve the quality of patients' care through improvement in postgraduate medical education and training. Its introduction had far reaching affects and many shortcoming due to its failure to take into account the craft specialties. The aim of this paper is to illustrate the impact of MMC on oral and maxillofacial surgical (OMFS) training. An online questionnaire was distributed to OMFS trainees, and data were gathered about current position, year of training, duration and specialties worked during basic surgical training, stage of completion of examinations and courses, and overall satisfaction with training. Comparisons were made between those who had been trained before and after MMC was introduced. Ninety-five trainees (68%) responded. Of these 66 (69%) had basic surgical training before the introduction of MMC and 29 (31%) afterwards. MMC shortened overall time spent on basic surgical training of OMFS trainees by half, to only 1 year. There were similarities between the two groups in terms of the range of specialties experienced. MMC also resulted in more trainees starting higher surgical training without their Membership of the Royal College of Surgeons. There was greater satisfaction with BST for the pre-MMC group than the post-MMC group. It is hoped that the recent changes to training that were implemented after this study will address some of the shortcomings that we have identified. Copyright © 2010. Published by Elsevier Ltd.

  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. Teaching first-year medical students in basic clinical and procedural skills − A novel course concept at a medical school in Austria

    PubMed Central

    Mileder, Lukas; Wegscheider, Thomas; Dimai, Hans Peter

    2014-01-01

    Introduction: Clerkships are still the main source for undergraduate medical students to acquire necessary skills. However, these educational experiences may not be sufficient, as there are significant deficiencies in the clinical experience and practical expertise of medical students. Project description: An innovative course teaching basic clinical and procedural skills to first-year medical students has been implemented at the Medical University of Graz, aiming at preparing students for clerkships and clinical electives. The course is based on several didactic elements: standardized and clinically relevant contents, dual (theoretical and virtual) pre-course preparation, student peer-teaching, small teaching groups, hands-on training, and the use of medical simulation. This is the first course of its kind at a medical school in Austria, and its conceptual design as well as the implementation process into the curriculum shall be described. Evaluation: Between November 2011 and January 2013, 418 students have successfully completed the course. Four online surveys among participating students have been performed, with 132 returned questionnaires. Students’ satisfaction with all four practical course parts was high, as well as the assessment of clinical relevance of contents. Most students (88.6%) strongly agreed/agreed that they had learned a lot throughout the course. Two thirds of the students were motivated by the course to train the acquired skills regularly at our skills laboratory. Narrative feedbacks revealed elements contributing most to course success. Conclusions: First-year medical students highly appreciate practical skills training. Hands-on practice, peer-teaching, clinically relevant contents, and the use of medical simulation are valued most. PMID:24575157

  3. [Study on correction of data bias caused by different missing mechanisms in survey of medical expenditure among students enrolling in Urban Resident Basic Medical Insurance].

    PubMed

    Zhang, Haixia; Zhao, Junkang; Gu, Caijiao; Cui, Yan; Rong, Huiying; Meng, Fanlong; Wang, Tong

    2015-05-01

    The study of the medical expenditure and its influencing factors among the students enrolling in Urban Resident Basic Medical Insurance (URBMI) in Taiyuan indicated that non response bias and selection bias coexist in dependent variable of the survey data. Unlike previous studies only focused on one missing mechanism, a two-stage method to deal with two missing mechanisms simultaneously was suggested in this study, combining multiple imputation with sample selection model. A total of 1 190 questionnaires were returned by the students (or their parents) selected in child care settings, schools and universities in Taiyuan by stratified cluster random sampling in 2012. In the returned questionnaires, 2.52% existed not missing at random (NMAR) of dependent variable and 7.14% existed missing at random (MAR) of dependent variable. First, multiple imputation was conducted for MAR by using completed data, then sample selection model was used to correct NMAR in multiple imputation, and a multi influencing factor analysis model was established. Based on 1 000 times resampling, the best scheme of filling the random missing values is the predictive mean matching (PMM) method under the missing proportion. With this optimal scheme, a two stage survey was conducted. Finally, it was found that the influencing factors on annual medical expenditure among the students enrolling in URBMI in Taiyuan included population group, annual household gross income, affordability of medical insurance expenditure, chronic disease, seeking medical care in hospital, seeking medical care in community health center or private clinic, hospitalization, hospitalization canceled due to certain reason, self medication and acceptable proportion of self-paid medical expenditure. The two-stage method combining multiple imputation with sample selection model can deal with non response bias and selection bias effectively in dependent variable of the survey data.

  4. [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.

  5. Providing context for a medical school basic science curriculum: The importance of the humanities.

    PubMed

    Thompson, Britta M; Vannatta, Jerry B; Scobey, Laura E; Fergeson, Mark; Humanities Research Group; Crow, Sheila M

    2016-01-01

    To increase students' understanding of what it means to be a physician and engage in the everyday practice of medicine, a humanities program was implemented into the preclinical curriculum of the medical school curriculum. The purpose of our study was to determine how medical students' views of being a doctor evolved after participating in a required humanities course. Medical students completing a 16-clock hour humanities course from 10 courses were asked to respond to an open-ended reflection question regarding changes, if any, of their views of being a doctor. The constant comparative method was used for coding; triangulation and a variety of techniques were used to provide evidence of validity of the analysis. A majority of first- and second-year medical students (rr = 70%) replied, resulting in 100 pages of text. A meta-theme of Contextualizing the Purpose of Medicine and three subthemes: the importance of Treating Patients Rather than a Disease, Understanding Observation Skills are Important, and Recognizing that Doctors are Fallible emerged from the data. Results suggest that requiring humanities as part of the required preclinical curriculum can have a positive influence on medical students and act as a bridge to contextualize the purpose of medicine.

  6. Basic list of veterinary medical serials, third edition: using a decision matrix to update the core list of veterinary journals

    PubMed Central

    Ugaz, Ana G; Boyd, C. Trenton; Croft, Vicki F; Carrigan, Esther E; Anderson, Katherine M

    2010-01-01

    Objective: This paper presents the methods and results of a study designed to produce the third edition of the “Basic List of Veterinary Medical Serials,” which was established by the Veterinary Medical Libraries Section in 1976 and last updated in 1986. Methods: A set of 238 titles were evaluated using a decision matrix in order to systematically assign points for both objective and subjective criteria and determine an overall score for each journal. Criteria included: coverage in four major indexes, scholarly impact rank as tracked in two sources, identification as a recommended journal in preparing for specialty board examinations, and a veterinary librarian survey rating. Results: Of the 238 titles considered, a minimum scoring threshold determined the 123 (52%) journals that constituted the final list. The 36 subject categories represented on the list include general and specialty disciplines in veterinary medicine. A ranked list of journals and a list by subject category were produced. Conclusion: Serials appearing on the third edition of the “Basic List of Veterinary Medical Serials” met expanded objective measures of quality and impact as well as subjective perceptions of value by both librarians and veterinary practitioners. PMID:20936066

  7. Basic list of veterinary medical serials, third edition: using a decision matrix to update the core list of veterinary journals.

    PubMed

    Ugaz, Ana G; Boyd, C Trenton; Croft, Vicki F; Carrigan, Esther E; Anderson, Katherine M

    2010-10-01

    This paper presents the methods and results of a study designed to produce the third edition of the "Basic List of Veterinary Medical Serials," which was established by the Veterinary Medical Libraries Section in 1976 and last updated in 1986. A set of 238 titles were evaluated using a decision matrix in order to systematically assign points for both objective and subjective criteria and determine an overall score for each journal. Criteria included: coverage in four major indexes, scholarly impact rank as tracked in two sources, identification as a recommended journal in preparing for specialty board examinations, and a veterinary librarian survey rating. Of the 238 titles considered, a minimum scoring threshold determined the 123 (52%) journals that constituted the final list. The 36 subject categories represented on the list include general and specialty disciplines in veterinary medicine. A ranked list of journals and a list by subject category were produced. Serials appearing on the third edition of the "Basic List of Veterinary Medical Serials" met expanded objective measures of quality and impact as well as subjective perceptions of value by both librarians and veterinary practitioners.

  8. Key steps for integrating a basic science throughout a medical school curriculum using an e-learning approach.

    PubMed

    Dubois, Eline Agnès; Franson, Kari Lanette

    2009-09-01

    Basic sciences can be integrated into the medical school curriculum via e-learning. The process of integrating a basic science in this manner resembles a curricular change. The change usually begins with an idea for using e-learning to teach a basic science and establishing the need for the innovation. In the planning phase, learning outcomes are formulated and a prototype of the program is developed based on the desired requirements. A realistic concept is formed after considering the limitations of the current institute. Next, a project team is assembled to develop the program and plan its integration. Incorporation of the e-learning program is facilitated by a well-developed and communicated integration plan. Various course coordinators are contacted to determine content of the e-learning program as well as establish assessment. Linking the e-learning program to existing course activities and thereby applying the basic science into the clinical context enhances the degree of integration. The success of the integration is demonstrated by a positive assessment of the program including favourable cost-benefit analysis and improved student performance. Lastly, when the program becomes institutionalised, continuously updating content and technology (when appropriate), and evaluating the integration contribute to the prolonged survival of the e-learning program.

  9. [Extended medical services to the inpatient sector--"medical services on individual demand" in the hospital. General legal conditions, 10 basic rules, and practical examples].

    PubMed

    Kersting, Thomas; Pillokat, Alexander

    2006-01-01

    Today, extended medical services--previously known in the context of ambulant healthcare provision or plastic surgery only--are increasingly being offered by hospitals. Hospitals have started to offer these services with good reason: in times of budgetary restraints they want to exploit this emerging new market due to economic necessities and they try to meet rising demands from patients. It is not easy to draw the line between special (extended) medical services and general hospital services. These different categories need to be kept apart, though. Special contracts for these specific extended medical services have to be entered into by hospital and patient in any case where the hospital wants to charge him later on. Different preconditions are to be considered with patients insured by statutory health insurance companies and privately insured patients. The price of extended medical services must be carefully calculated and, in particular, has to be related to the price charged from patients insured via statutory health insurance. Attention should also be paid to other aspects such as taxes, liability law, and hospital subsidisation. The present article presents some basic rules for offering extra medical services in a hospital.

  10. Survey of medical student preference for simulation models for basic dermatologic surgery skills: simulation platforms in medical education.

    PubMed

    Adams, Chad C; Marquart, Jason D; Nicholas, Luke L; Sperling, Leonard C; Meyerle, Jon H

    2014-04-01

    The authors investigated the use of simulator platforms in fourth-year medical student education. To evaluate which simulation platform students preferred for learning dermatologic procedures and to assess the effectiveness of the exercise in terms of the change in confidence that the students had performing dermatologic procedures. After medical students were instructed on how to perform a punch biopsy and then assisted in executing the task, they were surveyed to determine their preferred simulation platform and simulator properties. Students were surveyed at the beginning and completion of the teaching block. One hundred fifty-seven students completed the skills laboratory, and 78 completed the preference questionnaire. Of the 11 surveyed categories, students preferred the pig foot in eight categories. Seventy students responded to a surgical skills questionnaire that assessed their overall confidence in planning and executing the procedure before and after the skills laboratory. The students had a statistically significant increase in confidence in dermatologic procedural skills as a result of the activity. Preference data show that the pig foot model is preferred for teaching dermatologic surgical skills. These results re-affirm that the pig foot model is an effective, low-cost solution for training. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  11. Thermal and resonance neutrons generated by various electron and X-ray therapeutic beams from medical linacs installed in polish oncological centers

    PubMed Central

    Konefał, Adam; Orlef, Andrzej; Łaciak, Marcin; Ciba, Aleksander; Szewczuk, Marek

    2012-01-01

    Background High-energy photon and electron therapeutic beams generated in medical linear accelerators can cause the electronuclear and photonuclear reactions in which neutrons with a broad energy spectrum are produced. A low-energy component of this neutron radiation induces simple capture reactions from which various radioisotopes originate and in which the radioactivity of a linac head and various objects in the treatment room appear. Aim The aim of this paper is to present the results of the thermal/resonance neutron fluence measurements during therapeutic beam emission and exemplary spectra of gamma radiation emitted by medical linac components activated in neutron reactions for four X-ray beams and for four electron beams generated by various manufacturers’ accelerators installed in typical concrete bunkers in Polish oncological centers. Materials and methods The measurements of neutron fluence were performed with the use of the induced activity method, whereas the spectra of gamma radiation from decays of the resulting radioisotopes were measured by means of a portable high-purity germanium detector set for field spectroscopy. Results The fluence of thermal neutrons as well as resonance neutrons connected with the emission of a 20 MV X-ray beam is ∼106 neutrons/cm2 per 1 Gy of a dose in water at a reference depth. It is about one order of magnitude greater than that for the 15 MV X-ray beams and about two orders of magnitude greater than for the 18–22 MeV electron beams regardless of the type of an accelerator. Conclusion The thermal as well as resonance neutron fluence depends strongly on the type and the nominal potential of a therapeutic beam. It is greater for X-ray beams than for electrons. The accelerator accessories and other large objects should not be stored in a treatment room during high-energy therapeutic beam emission to avoid their activation caused by thermal and resonance neutrons. Half-lives of the radioisotopes originating from

  12. Comparison between Training Models to Teach Veterinary Medical Students Basic Laparoscopic Surgery Skills.

    PubMed

    Levi, Ohad; Michelotti, Kurt; Schmidt, Peggy; Lagman, Minette; Fahie, Maria; Griffon, Dominique

    2016-01-01

    The objective of this study was to compare the effectiveness of two different laparoscopic training models in preparing veterinary students to perform basic laparoscopic skills. Sixteen first- and second-year veterinary students were randomly assigned to a box trainer (Group B) or tablet trainer (Group T). Training and assessment for both groups included two tasks, "peg transfer" and "pattern cutting," derived from the well-validated McGill University Inanimate System for Training and Evaluation of Laparoscopic Skills. Confidence levels were compared by evaluating pre- and post-training questionnaires. Performance of laparoscopic tasks was scored pre- and post-training using a rubric for precision and speed. Results revealed a significant improvement in student confidence for basic laparoscopic skills (p<.05) and significantly higher scores for both groups in both laparoscopic tasks (p<.05). No significant differences were found between the groups regarding their assessment of the video quality, lighting, and simplicity of setup (p=.34, p=.15, and p=.43, respectively). In conclusion, the low-cost tablet trainer and the more expensive box trainer were similarly effective in preparing pre-clinical veterinary students to perform basic laparoscopic skills on a model.

  13. The use of self-learning modules to facilitate learning of basic science concepts in an integrated medical curriculum.

    PubMed

    Khalil, Mohammed K; Nelson, Loren D; Kibble, Jonathan D

    2010-01-01

    This study used qualitative and quantitative approaches to evaluate the effectiveness of self-learning modules (SLMs) developed to facilitate and individualize students' learning of basic medical sciences. Twenty physiology and nineteen microanatomy SLMs were designed with interactive images, animations, narrations, and self-assessments. Of 41 medical students, 40 students voluntarily completed a questionnaire with open-ended and closed-ended items to evaluate students' attitudes and perspectives on the learning value of SLMs. Closed-ended items were assessed on a five-point Likert scale (5 = high score) and the data were expressed as mean ± standard deviation. Open-ended questions further evaluated students' perspectives on the effectiveness of SLMs; student responses to open-ended questions were analyzed to identify shared patterns or themes in their experience using SLMs. The results of the midterm examination were also analyzed to compare student performance on items related to SLMs and traditional sessions. Students positively evaluated their experience using the SLMs with an overall mean score of 4.25 (SD ± 0.84). Most students (97%) indicated that the SLMs improved understanding and facilitated learning basic science concepts. SLMs were reported to allow learner control, to help in preparation for subsequent in-class discussion, and to improve understanding and retention. A significant difference in students' performance was observed when comparing SLM-related items with non-SLM items in the midterm examination (P < 0.05). In conclusion, the use of SLMs in an integrated basic science curriculum has the potential to individualize the teaching and improve the learning of basic sciences.

  14. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part II, 10-15.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction and lesson plans and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the second…

  15. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part I, 10-14.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction, lesson plans, and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the first of…

  16. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part II, 10-15.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction and lesson plans and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the second…

  17. Military Curricula for Vocational & Technical Education. Medical Laboratory Specialist (Basic) Part I, 10-14.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    These instructor plans of instruction, lesson plans, and student text and review materials for a secondary-postsecondary-level course for medical laboratory specialist are one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. It is the first of…

  18. [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.

  19. Changing educational needs of psychologists: do we need more medical knowledge, basic science and more psychological science?

    PubMed

    Belar, Cynthia D

    2008-03-01

    Psychologists of the 21st century must be highly skilled and versatile to function effectively in academic health centers (AHCs). Thus, the current paper focuses on the training psychologists receive to prepare them for their diverse roles in AHCs. The paper is framed around the question: Do we need more medical knowledge, basic science and more psychological science? posed to the author by the conference organizers of the 3rd National Association of Psychologists in Academic Health Centers (APAHC) Conference and is based on the perspective of the author.

  20. Configuration of the hemoglobin oxygen dissociation curve demystified: a basic mathematical proof for medical and biological sciences undergraduates.

    PubMed

    Leow, Melvin Khee-Shing

    2007-06-01

    The oxygen dissociation curve (ODC) of hemoglobin (Hb) has been widely studied and mathematically described for nearly a century. Numerous mathematical models have been designed to predict with ever-increasing accuracy the behavior of oxygen transport by Hb in differing conditions of pH, carbon dioxide, temperature, Hb levels, and 2,3-diphosphoglycerate concentrations that enable their applications in various clinical situations. The modeling techniques employed in many existing models are notably borrowed from advanced and highly sophisticated mathematics that are likely to surpass the comprehensibility of many medical and bioscience students due to the high level of "mathematical maturity" required. It is, however, a worthy teaching point in physiology lectures to illustrate in simple mathematics the fundamental reason for the crucial sigmoidal configuration of the ODC such that the medical and bioscience undergraduates can readily appreciate it, which is the objective of this basic dissertation.

  1. The Basic Stages in the Development of Scientific Medical Information in the USSR *

    PubMed Central

    Bagdasarian, S. N.; Enari, Helena

    1971-01-01

    The following is a brief historical survey of the origins and development of medical information service during the pre-revolutionary as well as during the Soviet times. Here are elucidated problems which are connected with the founding of a national health system of information service. Also, presented are data on the activity of the Vsesoiuznyĭ nauchno-issledovatel'skiĭ institut meditsinskoĭ i mediko-tekhnicheskoĭ informatsii Ministerstva zdravookhraneniia U.S.S.R.—tr. All-union scientific-research institute of medical and medico-technical information (VNIIMI) of the U.S.S.R. Ministry of Public Health—and about the measures taken to create a highly efficient national (public) health information service. PMID:4932203

  2. 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.

  3. Awareness, Attitude, and Knowledge of Basic Life Support among Medical, Dental, and Nursing Faculties and Students in the University Hospital.

    PubMed

    Sangamesh, N C; Vidya, K C; Pathi, Jugajyoti; Singh, Arpita

    2017-01-01

    To assess the awareness, attitude, and knowledge about basic life support (BLS) among medical, dental, and nursing students and faculties and the proposal of BLS skills in the academic curriculum of undergraduate (UG) course. Recognition, prevention, and effective management of life-threatening emergencies are the responsibility of health-care professionals. These situations can be successfully managed by proper knowledge and training of the BLS skills. These life-saving maneuvers can be given through the structured resuscitation programs, which are lacking in the academic curriculum. A questionnaire study consisting of 20 questions was conducted among 659 participants in the Kalinga Institute of Dental Sciences, Kalinga Institute of Medical Sciences, KIIT University. Medical junior residents, BDS faculties, interns, nursing faculties, and 3(rd)-year and final-year UG students from both medical and dental colleges were chosen. The statistical analysis was carried out using SPSS software version 20.0 (Armonk, NY:IBM Corp). After collecting the data, the values were statistically analyzed and tabulated. Statistical analysis was performed using Mann-Whitney U-test. The results with P < 0.05 were considered statistically significant. Our participants were aware of BLS, showed positive attitude toward it, whereas the knowledge about BLS was lacking, with the statistically significant P value. By introducing BLS regularly in the academic curriculum and by routine hands on workshops, all the health-care providers should be well versed with the BLS skills for effectively managing the life-threatening emergencies.

  4. Interactive videodisc and compact disc-interactive for ophthalmic basic science and continuing medical education.

    PubMed

    Folberg, R; Dickinson, L K; Christiansen, R A; Huntley, J S; Lind, D G

    1993-06-01

    The authors designed and implemented a complete curriculum in ophthalmic pathology using IBM- and Macintosh-based interactive videodisc (IVD) technology. They also redesigned a portion of this curriculum for a new television-based platform, compact disc-interactive (CD-I). The following issues were addressed: curriculum design, instructional design, the assembly of illustrations and the ownership of such materials, the generation of computer-based medical art and animation, and programming. The issue of academic credit for faculty participating in this effort also was considered. The computer-based IVD program provides the following features: (1) rapid access to thousands of high-quality illustrations with the option of superimposing graphic labels and text directly over pictures; (2) the ability to view enlargements of photographs; (3) an online glossary to view definition of terms coupled with high-quality photographs; and (4) a dynamic introduction to pathophysiology using interactive animation sequences. The authors were able to incorporate the same interactive features into the CD-I version. High-quality medical illustrations can be used effectively on the CD-I platform. Computer-based multimedia workstations are relatively expensive for personal use but may be useful if the equipment can be shared in a learning center or library. Compared with interactive computer-based solutions, consumer-oriented television-based technology such as CD-I is a relatively inexpensive vehicle for providing continuing medical education programs intended for use in the individual practitioner's office or home.

  5. Evaluating fitness to drive after cerebral injury: basic issues and recommendations for medical and legal communities.

    PubMed

    Galski, T; Ehle, H T; McDonald, M A; Mackevich, J

    2000-06-01

    Specialists in rehabilitation are typically called upon to evaluate and render an opinion about whether or not a person can be entrusted to resume driving. And, because driving is an individual privilege to be balanced against the public's right to safety and protection from the dangers of a driver whose residual deficits may impede ability to drive safely, these specialists have developed a number of methods to assess fitness to drive. Unfortunately, many evaluators remain unfamiliar with research used as basis for evaluations or lack understanding of the strengths and weaknesses of tests in use. Therefore, there may be unquestioning trust in tests and methods that leads to errors of significant consequence in decisions about fitness to drive as well as unawareness of expanding risks of litigation that can emanate from inappropriate recommendations. This article intends to draw attention to issues, considerations, and problems underlying the conduct of driver evaluations, including focus on ways in which the legal and medical communities approach question of fitness, legal and medical definitions and terminology, responsibility for assessment as well as tests and methods used in evaluations. Conclusions are drawn from discussion of these matters and recommendations are outlined for addressing identified problems at the interface between medical and legal communities.

  6. The influence of regional basic science campuses on medical students' choice of specialty and practice location: a historical cohort study

    PubMed Central

    Brokaw, James J; Mandzuk, Christina A; Wade, Michael E; Deal, Dennis W; Johnson, Mary T; White, Gary W; Wilson, Jeffrey S; Zollinger, Terrell W

    2009-01-01

    Background Indiana University School of Medicine (IUSM) employs eight regional basic science campuses, where half of the students complete their first two years of medical school. The other half complete all four years at the main campus in Indianapolis. The authors tested the hypothesis that training at regional campuses influences IUSM students to pursue primary care careers near the regional campuses they attended. Methods Medical school records for 2,487 graduates (classes of 1988–1997) were matched to the 2003 American Medical Association Physician Masterfile to identify the medical specialty and practice location of each graduate. Multivariate logistic regression was performed to assess the effect of regional campus attendance on students' choice of medical specialty and practice location, while simultaneously adjusting for several covariates thought to affect these career outcomes. Results Compared to Indianapolis students, those who attended a regional campus were somewhat more likely to be white, have parents with middle class occupations, and score slightly lower on the Medical College Admission Test. Any such differences were adjusted for in the regression models, which predicted that four of the regional campuses were significantly more likely than Indianapolis to produce family practitioners, and that five of the regional campuses were significantly more likely than the others to have former students practicing in the region. When analyzed collectively, attendance at any regional campus was a significant predictor of a primary care practice located outside the Indianapolis metropolitan area. Conclusion Attending a regional campus for preclinical training appears to increase the likelihood of practicing primary care medicine in local communities. PMID:19500392

  7. 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.

  8. [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.

  9. Survey of basic medical researchers on the awareness of animal experimental designs and reporting standards in China.

    PubMed

    Ma, Bin; Xu, Jia-Ke; Wu, Wen-Jing; Liu, Hong-Yan; Kou, Cheng-Kun; Liu, Na; Zhao, Lulu

    2017-01-01

    To investigate the awareness and use of the Systematic Review Center for Laboratory Animal Experimentation's (SYRCLE) risk-of-bias tool, the Animal Research: Reporting of In Vivo Experiments (ARRIVE) reporting guidelines, and Gold Standard Publication Checklist (GSPC) in China in basic medical researchers of animal experimental studies. A national questionnaire-based survey targeting basic medical researchers was carried in China to investigate the basic information and awareness of SYRCLE's risk of bias tool, ARRIVE guidelines, GSPC, and animal experimental bias risk control factors. The EpiData3.1 software was used for data entry, and Microsoft Excel 2013 was used for statistical analysis in this study. The number of cases (n) and percentage (%) of classified information were statistically described, and the comparison between groups (i.e., current students vs. research staff) was performed using chi-square test. A total of 298 questionnaires were distributed, and 272 responses were received, which included 266 valid questionnaires (from 118 current students and 148 research staff). Among the 266 survey participants, only 15.8% was aware of the SYRCLE's risk of bias tool, with significant difference between the two groups (P = 0.003), and the awareness rates of ARRIVE guidelines and GSPC were only 9.4% and 9.0%, respectively; 58.6% survey participants believed that the reports of animal experimental studies in Chinese literature were inadequate, with significant difference between the two groups (P = 0.004). In addition, only approximately 1/3 of the survey participants had read systematic reviews and meta-analysis reports of animal experimental studies; only 16/266 (6.0%) had carried out/participated in and 11/266 (4.1%) had published systematic reviews/meta-analysis of animal experimental studies. The awareness and use rates of SYRCLE's risk-of-bias tool, the ARRIVE guidelines, and the GSPC were low among Chinese basic medical researchers. Therefore, specific

  10. Survey of basic medical researchers on the awareness of animal experimental designs and reporting standards in China

    PubMed Central

    Xu, Jia-ke; Wu, Wen-jing; Liu, Hong-yan; Kou, Cheng-kun; Liu, Na; Zhao, Lulu

    2017-01-01

    Objective To investigate the awareness and use of the Systematic Review Center for Laboratory Animal Experimentation’s (SYRCLE) risk-of-bias tool, the Animal Research: Reporting of In Vivo Experiments (ARRIVE) reporting guidelines, and Gold Standard Publication Checklist (GSPC) in China in basic medical researchers of animal experimental studies. Methods A national questionnaire-based survey targeting basic medical researchers was carried in China to investigate the basic information and awareness of SYRCLE’s risk of bias tool, ARRIVE guidelines, GSPC, and animal experimental bias risk control factors. The EpiData3.1 software was used for data entry, and Microsoft Excel 2013 was used for statistical analysis in this study. The number of cases (n) and percentage (%) of classified information were statistically described, and the comparison between groups (i.e., current students vs. research staff) was performed using chi-square test. Results A total of 298 questionnaires were distributed, and 272 responses were received, which included 266 valid questionnaires (from 118 current students and 148 research staff). Among the 266 survey participants, only 15.8% was aware of the SYRCLE’s risk of bias tool, with significant difference between the two groups (P = 0.003), and the awareness rates of ARRIVE guidelines and GSPC were only 9.4% and 9.0%, respectively; 58.6% survey participants believed that the reports of animal experimental studies in Chinese literature were inadequate, with significant difference between the two groups (P = 0.004). In addition, only approximately 1/3 of the survey participants had read systematic reviews and meta-analysis reports of animal experimental studies; only 16/266 (6.0%) had carried out/participated in and 11/266 (4.1%) had published systematic reviews/meta-analysis of animal experimental studies. Conclusions The awareness and use rates of SYRCLE’s risk-of-bias tool, the ARRIVE guidelines, and the GSPC were low among Chinese

  11. Translating birdsong: songbirds as a model for basic and applied medical research.

    PubMed

    Brainard, Michael S; Doupe, Allison J

    2013-07-08

    Songbirds, long of interest to basic neuroscience, have great potential as a model system for translational neuroscience. Songbirds learn their complex vocal behavior in a manner that exemplifies general processes of perceptual and motor skill learning and, more specifically, resembles human speech learning. Song is subserved by circuitry that is specialized for vocal learning and production but that has strong similarities to mammalian brain pathways. The combination of highly quantifiable behavior and discrete neural substrates facilitates understanding links between brain and behavior, both in normal states and in disease. Here we highlight (a) behavioral and mechanistic parallels between birdsong and aspects of speech and social communication, including insights into mirror neurons, the function of auditory feedback, and genes underlying social communication disorders, and (b) contributions of songbirds to understanding cortical-basal ganglia circuit function and dysfunction, including the possibility of harnessing adult neurogenesis for brain repair.

  12. Translating Birdsong: Songbirds as a model for basic and applied medical research

    PubMed Central

    2014-01-01

    Songbirds, long of interest to basic neuroscientists, have great potential as a model system for translational neuroscience. Songbirds learn their complex vocal behavior in a manner that exemplifies general processes of perceptual and motor skill learning, and more specifically resembles human speech learning. Song is subserved by circuitry that is specialized for vocal learning and production, but that has strong similarities to mammalian brain pathways. The combination of a highly quantifiable behavior and discrete neural substrates facilitates understanding links between brain and behavior, both normally and in disease. Here we highlight 1) behavioral and mechanistic parallels between birdsong and aspects of speech and social communication, including insights into mirror neurons, the function of auditory feedback, and genes underlying social communication disorders, and 2) contributions of songbirds to understanding cortical-basal ganglia circuit function and dysfunction, including the possibility of harnessing adult neurogenesis for brain repair. PMID:23750515

  13. [Proper patient counseling, recommended nutrition, specific medication. The basics of irritable bowel syndrome therapy].

    PubMed

    Fliegner-Baia, M; Keller, J; Layer, P

    2002-10-17

    In the treatment of the irritable bowel syndrome, it is important to qualify unrealistic expectations with regard to treatment, at an early stage. The therapeutic spectrum encompasses establishment of good rapport between physician and patient, modification of life style, provision of good patient information, reassurance, coping strategies, and temporal restraints on medication. Depending on the leading symptoms, the latter may range from laxatives to probiotics, anticholinergics or spasmolytics, prokinetic and anti-diarrheal agents, to 5-HT3/HT4 receptor antagonists. In individual patients with frequently recurrent or permanent pain, the use of tricyclic antidepressants may be considered. Painkillers should be reserved for patients in whom other therapeutic strategies have failed.

  14. Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breast Cancer Patients.

    ERIC Educational Resources Information Center

    Beisecker, Analee E.; And Others

    1994-01-01

    Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

  15. Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breast Cancer Patients.

    ERIC Educational Resources Information Center

    Beisecker, Analee E.; And Others

    1994-01-01

    Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

  16. 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

  17. 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.

  18. Teaching the basics of redox biology to medical and graduate students: Oxidants, antioxidants and disease mechanisms☆

    PubMed Central

    Kalyanaraman, Balaraman

    2013-01-01

    This article provides a succinct but limited overview of the protective and deleterious effects of reactive oxygen and nitrogen species in a clinical context. Reactive oxygen species include superoxide, hydrogen peroxide, single oxygen and lipid peroxides. Reactive nitrogen species include species derived from nitric oxide. This review gives a brief overview of the reaction chemistry of these species, the role of various enzymes involved in the generation and detoxification of these species in disease mechanisms and drug toxicity and the protective role of dietary antioxidants. I hope that the graphical review will be helpful for teaching both the first year medical and graduate students in the U.S. and abroad the fundamentals of reactive oxygen and nitrogen species in redox biology and clinical medicine. PMID:24024158

  19. Teaching the basics of redox biology to medical and graduate students: Oxidants, antioxidants and disease mechanisms.

    PubMed

    Kalyanaraman, Balaraman

    2013-02-08

    This article provides a succinct but limited overview of the protective and deleterious effects of reactive oxygen and nitrogen species in a clinical context. Reactive oxygen species include superoxide, hydrogen peroxide, single oxygen and lipid peroxides. Reactive nitrogen species include species derived from nitric oxide. This review gives a brief overview of the reaction chemistry of these species, the role of various enzymes involved in the generation and detoxification of these species in disease mechanisms and drug toxicity and the protective role of dietary antioxidants. I hope that the graphical review will be helpful for teaching both the first year medical and graduate students in the U.S. and abroad the fundamentals of reactive oxygen and nitrogen species in redox biology and clinical medicine.

  20. Imaging facilities for basic medical units: a case in the state of Guerrero, Mexico.

    PubMed

    Azpiroz-Leehan, Joaquín; Licona, Fabiola Martínez; Méndez, Miguel Cadena

    2011-10-01

    This work presents the methodology to design a small imaging unit in a small regional hospital that takes into account the real imaging needs in the region regardless of current administrative guidelines. The situation of the imaging facilities in Mexico's states is studied and compared with other countries, and a project plan is designed for the specific state (Guerrero) where the clinic is to be located. The proposal includes the acquisition of a basic suite of modalities that include an ultrasound system, a mammography unit, and a conventional X-ray system in addition to a CT system that is not available anywhere within the state. The system should be primarily digital and should incorporate a simple picture archiving and communications system that can be the basis of a future telemedicine unit. The conclusion of this study also proposes changes in the segmented and pyramidal structure of the Mexican health system in order to provide higher quality care at the lower level, to reduce bottlenecks, and to provide higher quality health care near the patient's home.

  1. Use of the NBME Comprehensive Basic Science Examination as a Progress Test in the Preclerkship Curriculum of a New Medical School

    ERIC Educational Resources Information Center

    Johnson, Teresa R.; Khalil, Mohammed K.; Peppler, Richard D.; Davey, Diane D.; Kibble, Jonathan D.

    2014-01-01

    In the present study, we describe the innovative use of the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) as a progress test during the preclerkship medical curriculum. The main aim of this study was to provide external validation of internally developed multiple-choice assessments in a new medical…

  2. Use of the NBME Comprehensive Basic Science Examination as a Progress Test in the Preclerkship Curriculum of a New Medical School

    ERIC Educational Resources Information Center

    Johnson, Teresa R.; Khalil, Mohammed K.; Peppler, Richard D.; Davey, Diane D.; Kibble, Jonathan D.

    2014-01-01

    In the present study, we describe the innovative use of the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) as a progress test during the preclerkship medical curriculum. The main aim of this study was to provide external validation of internally developed multiple-choice assessments in a new medical…

  3. 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

  4. Awareness, Attitude, and Knowledge of Basic Life Support among Medical, Dental, and Nursing Faculties and Students in the University Hospital

    PubMed Central

    Sangamesh, N. C.; Vidya, K. C.; Pathi, Jugajyoti; Singh, Arpita

    2017-01-01

    Objective: To assess the awareness, attitude, and knowledge about basic life support (BLS) among medical, dental, and nursing students and faculties and the proposal of BLS skills in the academic curriculum of undergraduate (UG) course. Recognition, prevention, and effective management of life-threatening emergencies are the responsibility of health-care professionals. These situations can be successfully managed by proper knowledge and training of the BLS skills. These life-saving maneuvers can be given through the structured resuscitation programs, which are lacking in the academic curriculum. Materials and Methods: A questionnaire study consisting of 20 questions was conducted among 659 participants in the Kalinga Institute of Dental Sciences, Kalinga Institute of Medical Sciences, KIIT University. Medical junior residents, BDS faculties, interns, nursing faculties, and 3rd-year and final-year UG students from both medical and dental colleges were chosen. The statistical analysis was carried out using SPSS software version 20.0 (Armonk, NY:IBM Corp). Results: After collecting the data, the values were statistically analyzed and tabulated. Statistical analysis was performed using Mann–Whitney U-test. The results with P < 0.05 were considered statistically significant. Our participants were aware of BLS, showed positive attitude toward it, whereas the knowledge about BLS was lacking, with the statistically significant P value. Conclusion: By introducing BLS regularly in the academic curriculum and by routine hands on workshops, all the health-care providers should be well versed with the BLS skills for effectively managing the life-threatening emergencies. PMID:28852630

  5. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum.

    PubMed

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.

  6. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    PubMed Central

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    Aim There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Methods Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. Results The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Conclusion Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized

  7. SU-A-210-01: Why Should We Learn Radiation Oncology Billing?

    SciTech Connect

    Wu, H.

    2015-06-15

    The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the

  8. [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.

  9. 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.

  10. Animal laboratory, interactive and computer based learning, in enhancing basic concepts in physiology: an outlook of 481 undergraduate medical students.

    PubMed

    Shore, Najla; Khawar, Shireen; Qutab, Miraa; Ayub, Muhammad

    2013-01-01

    Laboratory exercises are intended to illustrate concepts and add an active learning component to courses. Since 1980s, there has been a decline in animal laboratories in medical physiology courses. Other cost-effective non-aninmal alternatives are being sought. The present study was designed to find out the students' opinion regarding the animal versus computer lab and whether innovative teaching methodologies helped students achieve their goals. Opinions of 481 female in medical students of 2nd and 3rd year MBBS were included in the study. A questionnaire based on animal/computer based experiments and new teaching methodologies in physiology was voluntarily filled in by the students. Majority of students immensely benefited from both the animal lab and other teaching methodologies. Although computer based learning is considered effective in helping students acquire basic concepts, there is evidence that some students acquire a more thorough understanding of the material through more advanced and challenging experience of an animal laboratory. The fact that such labs as well various teaching methods offer distinct educational advantages should be taken into account when courses are designed.

  11. 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.

  12. 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.

  13. Professional fulfillment and parenting work-life balance in female physicians in Basic Sciences and medical research: a nationwide cross-sectional survey of all 80 medical schools in Japan.

    PubMed

    Yamazaki, Yuka; Uka, Takanori; Marui, Eiji

    2017-09-15

    In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences. This study examines the professional and personal fulfillment expressed by Japanese female medical doctors who hold positions in Basic Sciences. Topics include career advancement, interest in medical research, and greater flexibility for parenting. A cross-sectional questionnaire survey was distributed at all 80 medical schools in Japan, directed to 228 female medical doctors whose academic rank was assistant professor or higher in departments of Basic Sciences in 2012. Chi-square tests and the binary logistic regression model were used to investigate the impact of parenthood on career satisfaction, academic rank, salary, etc. The survey response rate of female physicians in Basic Sciences was 54.0%. Regardless of parental status, one in three respondents cited research interest as their rationale for entering Basic Sciences, well over twice other motivations. A majority had clinical experience, with clinical duties maintained part-time by about half of respondents and particularly parents. Only one third expressed afterthoughts about relinquishing full-time clinical practice, with physicians who were parents expressing stronger regrets. Parental status had little effect on academic rank and income within the Basic Sciences, CONCLUSION

  14. A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status.

    PubMed

    Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

    2015-01-01

    Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students' academic performance in the comprehensive basic sciences examination. According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination.

  15. A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status

    PubMed Central

    Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

    2015-01-01

    Background: Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. Materials and Methods: The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. Results: The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students’ academic performance in the comprehensive basic sciences examination. Conclusion: According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination. PMID:26430693

  16. 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.

  17. CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).

    PubMed

    Schmidt-Hieber, M; Silling, G; Schalk, E; Heinz, W; Panse, J; Penack, O; Christopeit, M; Buchheidt, D; Meyding-Lamadé, U; Hähnel, S; Wolf, H H; Ruhnke, M; Schwartz, S; Maschmeyer, G

    2016-07-01

    Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients. However, identification of CNS infections in immunocompromised patients could represent a major challenge since metabolic disturbances, side-effects of antineoplastic or immunosuppressive drugs and CNS involvement of the underlying hematological disorder may mimic symptoms of a CNS infection. The prognosis of CNS infections is generally poor in these patients, albeit the introduction of novel substances (e.g. voriconazole) has improved the outcome in distinct patient subgroups. This guideline has been developed by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) with the contribution of a panel of 14 experts certified in internal medicine, hematology/oncology, infectious diseases, intensive care, neurology and neuroradiology. Grades of recommendation and levels of evidence were categorized by using novel criteria, as recently published by the European Society of Clinical Microbiology and Infectious Diseases.

  18. CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)—Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

    PubMed Central

    Schmidt-Hieber, M.; Silling, G.; Schalk, E.; Heinz, W.; Panse, J.; Penack, O.; Christopeit, M.; Buchheidt, D.; Meyding-Lamadé, U.; Hähnel, S.; Wolf, H. H.; Ruhnke, M.; Schwartz, S.; Maschmeyer, G.

    2016-01-01

    Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients. However, identification of CNS infections in immunocompromised patients could represent a major challenge since metabolic disturbances, side-effects of antineoplastic or immunosuppressive drugs and CNS involvement of the underlying hematological disorder may mimic symptoms of a CNS infection. The prognosis of CNS infections is generally poor in these patients, albeit the introduction of novel substances (e.g. voriconazole) has improved the outcome in distinct patient subgroups. This guideline has been developed by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) with the contribution of a panel of 14 experts certified in internal medicine, hematology/oncology, infectious diseases, intensive care, neurology and neuroradiology. Grades of recommendation and levels of evidence were categorized by using novel criteria, as recently published by the European Society of Clinical Microbiology and Infectious Diseases. PMID:27052648

  19. Development of the Basic Knowledge Assessment Tool for Medical-Surgical Nursing (MED-SURG BKAT) © and implications for in-service educators and managers.

    PubMed

    Toth, Jean

    2011-01-01

    BACKGROUND OF THE PROBLEM: Medical-surgical nursing is now the largest specialty in acute care, and needs an objective measure of basic knowledge necessary to provide safe care to patients. The Joint Commission on Accreditation of Healthcare Organizations noted that healthcare organizations have in the past relied on education and experience to support competence, but an increasing number are seeking objective measures of a nurse's knowledge that is required for safe practice. The American Nurses Association adds that safe practice is both a professional and a moral responsibility. A review of the literature failed to locate a standardized test of basic knowledge in medical-surgical nursing. In-service educators and managers need such a test to facilitate orientation programs, and as a way to safely decrease the length of orientation for new employees with previous experience in medical-surgical nursing. The purpose of the study was to develop a valid and reliable test to measure basic knowledge in medical-surgical nursing. The Basic Knowledge Assessment Tool for Medical-Surgical nursing was developed with support for its validity and reliability. © 2011 Wiley Periodicals, Inc.

  20. Standardized Patient’s Views About their Role in the Teaching-Learning Process of Undergraduate Basic Science Medical Students

    PubMed Central

    Dwivedi, Neelam Rekha

    2016-01-01

    Introduction Standardized Patients (SPs) are widely used in medical education. SPs have a number of advantages but also have certain limitations. At the institution, SPs have been used since January 2013 for both teaching-learning and assessment during the basic science years of the undergraduate medical program. Aim The present study was conducted to investigate the perception of SPs about various aspects of the program and obtain suggestions for further improvement. Materials and Methods A Focus Group Discussion (FGD) was conducted with a group of five SPs during the second week of November 2015. Respondents were explained the aims and objectives of the study and invited to participate. Written informed consent was obtained. The FGD was conducted using a discussion guide and was audio recorded. Various aspects of the SP program at the institution were discussed. Motivation/s for joining the program and suggestions for further improvement were obtained. Transcripts were created after listening to the recordings and were read through multiple times. Similar responses were coded. Items with similar codes were grouped together into themes. Results Three respondents were female while two were male. The major advantage of SPs was their flexibility and ability to present a standardized response to the student. Students become familiar and comfortable with SPs. However, as a SP is simulating an illness s/he may not always be able to do complete justice to the role. The process used by SPs to prepare themselves to portray various diseases was highlighted. The use of SPs both during teaching-learning and assessment was also discussed. Some SPs are trained to provide feedback to students. Most SPs joined the program based on invitations from their friends who were already SPs. Challenges in recruiting SPs in a small island were discussed. Suggestions for further improvement were obtained. Conclusion The present study obtained the perception of SPs regarding various aspects

  1. Standardized Patient's Views About their Role in the Teaching-Learning Process of Undergraduate Basic Science Medical Students.

    PubMed

    Shankar, Pathiyil Ravi; Dwivedi, Neelam Rekha

    2016-06-01

    Standardized Patients (SPs) are widely used in medical education. SPs have a number of advantages but also have certain limitations. At the institution, SPs have been used since January 2013 for both teaching-learning and assessment during the basic science years of the undergraduate medical program. The present study was conducted to investigate the perception of SPs about various aspects of the program and obtain suggestions for further improvement. A Focus Group Discussion (FGD) was conducted with a group of five SPs during the second week of November 2015. Respondents were explained the aims and objectives of the study and invited to participate. Written informed consent was obtained. The FGD was conducted using a discussion guide and was audio recorded. Various aspects of the SP program at the institution were discussed. Motivation/s for joining the program and suggestions for further improvement were obtained. Transcripts were created after listening to the recordings and were read through multiple times. Similar responses were coded. Items with similar codes were grouped together into themes. Three respondents were female while two were male. The major advantage of SPs was their flexibility and ability to present a standardized response to the student. Students become familiar and comfortable with SPs. However, as a SP is simulating an illness s/he may not always be able to do complete justice to the role. The process used by SPs to prepare themselves to portray various diseases was highlighted. The use of SPs both during teaching-learning and assessment was also discussed. Some SPs are trained to provide feedback to students. Most SPs joined the program based on invitations from their friends who were already SPs. Challenges in recruiting SPs in a small island were discussed. Suggestions for further improvement were obtained. The present study obtained the perception of SPs regarding various aspects of the SP program at the institution. The overall opinion

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

    ERIC Educational Resources Information Center

    Bleyer, W. Archie; And Others

    1990-01-01

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

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

    ERIC Educational Resources Information Center

    Bleyer, W. Archie; And Others

    1990-01-01

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

  4. Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

    PubMed

    De Leng, Bas; Gijlers, Hannie

    2015-05-01

    To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Opinions and perceptions of students (n = 70) and tutors (n = 4) who used collaborative diagramming in tutorial groups were collected with a questionnaire and focus group discussions. A framework derived from the analysis of discourse in computer-supported collaborative leaning was used to construct the questionnaire. Video observations were used during the focus group discussions. Both students and tutors felt that collaborative diagramming positively affected discussion and knowledge construction. Students particularly appreciated that diagrams helped them to structure knowledge, to develop an overview of topics, and stimulated them to find relationships between topics. Tutors emphasized that diagramming increased interaction and enhanced the focus and detail of the discussion. Favourable conditions were the following: working with a shared whiteboard, using a diagram format that facilitated distribution, and applying half filled-in diagrams for non-content expert tutors and\\or for heterogeneous groups with low achieving students. The empirical findings in this study support the findings of earlier more descriptive studies that diagramming in a collaborative setting is valuable for learning complex knowledge in medicine.

  5. Citation Analysis of Iranian Journal of Basic Medical Sciences in ISI Web of Knowledge, Scopus, and Google Scholar

    PubMed Central

    Zarifmahmoudi, Leili; Kianifar, Hamid Reza; Sadeghi, Ramin

    2013-01-01

    Objective(s): Citation tracking is an important method to analyze the scientific impact of journal articles and can be done through Scopus (SC), Google Scholar (GS), or ISI web of knowledge (WOS). In the current study, we analyzed the citations to 2011-2012 articles of Iranian Journal of Basic Medical Sciences (IJBMS) in these three resources. Material and Methods: The relevant data from SC, GS, and WOS official websites. Total number of citations, their overlap and unique citations of these three recourses were evaluated. Results: WOS and SC covered 100% and GS covered 97% of the IJBMS items. Totally, 37 articles were cited at least once in one of the studied resources. Total number of citations were 20, 30, and 59 in WOS, SC, and GS respectively. Forty citations of GS, 6 citation of SC, and 2 citations of WOS were unique. Conclusion: Every scientific resource has its own inaccuracies in providing citation analysis information. Citation analysis studies are better to be done each year to correct any inaccuracy as soon as possible. IJBMS has gained considerable scientific attention from wide range of high impact journals and through citation tracking method; this visibility can be traced more thoroughly. PMID:24379959

  6. Citation Analysis of Iranian Journal of Basic Medical Sciences in ISI Web of Knowledge, Scopus, and Google Scholar.

    PubMed

    Zarifmahmoudi, Leili; Kianifar, Hamid Reza; Sadeghi, Ramin

    2013-10-01

    Citation tracking is an important method to analyze the scientific impact of journal articles and can be done through Scopus (SC), Google Scholar (GS), or ISI web of knowledge (WOS). In the current study, we analyzed the citations to 2011-2012 articles of Iranian Journal of Basic Medical Sciences (IJBMS) in these three resources. The relevant data from SC, GS, and WOS official websites. Total number of citations, their overlap and unique citations of these three recourses were evaluated. WOS and SC covered 100% and GS covered 97% of the IJBMS items. Totally, 37 articles were cited at least once in one of the studied resources. Total number of citations were 20, 30, and 59 in WOS, SC, and GS respectively. Forty citations of GS, 6 citation of SC, and 2 citations of WOS were unique. Every scientific resource has its own inaccuracies in providing citation analysis information. Citation analysis studies are better to be done each year to correct any inaccuracy as soon as possible. IJBMS has gained considerable scientific attention from wide range of high impact journals and through citation tracking method; this visibility can be traced more thoroughly.

  7. 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.

  8. 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