bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creating a radiation oncology oriented safety culture within a large oncology practice: Lessons learned.
Authors: Dubey Ajay , Bernard Jeff , Heintz Bret , Antes Kyle , Hartman Stacy , Taylor Bernard , Cheek Brennan Scott , Limmer Jeffrey , Wilfong Lalan S. , Hoverman John Russell 
Published: April 2017

85 Background: Texas Oncology (TXO) is a dedicated oncology practice consisting of more than 400 physicians and 57 radiation oncologists at 52 sites of service. In order to enhance communications of the rad onc team, establish accountability by using metrics, and engage continuous improvement, we initiated a program to establish regional quality committees in each radiation oncology practice site. Methods: In 2015, the TXO leadership approved the formation of Regional Quality Committees (RQC) at each site. The key members of each RQC include a Physician Chair, a Physicist Co-Chair, Chief Therapist, Radiation Safety Officer, Dosimetrist, and Nurse. Meeting frequency was recommended monthly, but quarterly meetings were required. Meeting documentation reporting was required including a formal agenda, minutes for items discussed, and listing of attendees. Metrics with regard to RQC activities were reported and recorded beginning in 2016. The 2016 Action plan for the RQC at each site included documentation of timeout procedure, regular chart rounds, new patient conference, as well as a mortality and morbidity conference. Results: See table. Conclusions: Within 3 calendar quarters, a functional RQC was established in all 52 radiation oncology practice sites within TXO. Compliance with the action plan was high with regard to action items not requiring multiple physician participants (RQC committee, timeout, chart rounds, CQI projects, performance metrics). Compliance was lower in activities that required multiple physician participation. Verbal feedback was positive regarding the RQC program. Respecting time demands of physicians, education, and communication were identified as key success factors in the RQC program. [Table: see text]
National trends, outcomes, and costs of radiation therapy in the management of low- and high-intermediate risk endometrial carcinoma.
Authors: Suidan Rudy Sam , He Weiguo , Sun Charlotte C. , Zhao Hui , Smith Grace L. , Klopp Ann , Fleming Nicole D. , Lu Karen H. , Giordano Sharon Hermes , Meyer Larissa 
Published: April 2017

9 Background: Our objective was to assess treatment patterns, outcomes, and costs for women with low- (LIR) and high-intermediate risk endometrial cancer (HIR) who are treated with and without adjuvant radiotherapy (RT). Methods: All pts with endometrioid endometrial cancer who underwent surgery from 2000 – 2011 were identified from the SEER – Medicare database. LIR was defined as G1-2 tumors with <50% myometrial invasion or G3 with no invasion. HIR was defined as G1-2 tumors with ≥50% or G3 with <50% invasion. Pts were categorized according to whether they received adjuvant RT (vaginal brachytherapy [VBT], external beam radiotherapy [EBRT], or both) or no RT. All costs incurred up to 6 months postoperatively were analyzed. Outcomes were compared using the χ2test and a Cox PH regression model. Multivariate analyses were performed on both survival and costs. Results: 10,842 pts were included, of which 70% were LIR and 30% were HIR. 9% of pts with LIR had RT, compared to 46% of those with HIR. Among all pts who underwent RT, the use of VBT increased from 25% in 2000 to 71% in 2011, while EBRT use declined from 41% to 18%, and concurrent VBT/EBRT declined from 34% to 11% (p<0.001). In the LIR group, there was no difference in 10-year overall survival (OS) between pts who had RT and those who did not (67% vs. 65%, multivariate HR 0.95, 95% CI 0.81 – 1.11). In the HIR group, pts who underwent RT had a significant increase in 10-year OS (60% vs. 47%, multivariate HR 0.75, 95% CI 0.67 – 0.85). Similar outcomes were noted on subgroup analysis stratifying by RT modality. RT was associated with an increased risk of gastrointestinal (7% vs. 4%, p<0.001), genitourinary (2% vs. 1%, p<0.001), and hematologic (16% vs. 12%, p<0.001) 2-year complications. Compared to pts who only had surgery, RT was associated with increased mean adjusted costs ($22.5k vs. $14.4k, p<0.001). Costs for pts receiving VBT, EBRT, and concurrent VBT/EBRT were $20.6k, $23.3k, and $26.5, respectively (p<0.001). Conclusions: RT was associated with improved OS in women with HIR, but not in the LIR cohort. RT also had significantly increased costs and a higher morbidity risk. In the absence of other risk factors, consideration of observation without RT in LIR may be reasonable.
Palliative care utilization in patients with newly diagnosed, incurable solid tumor malignancies: The experiences of an institution new to palliative care.
Authors: Bersabe Adrian REYES , Romain Joshua , Delacruz Wilfred P. 
Published: April 2017

92 Background: Early palliative care (PC) referral can enhance quality of life (QOL) in patients with metastatic cancer and even improve overall survival in non-small cell lung cancer. Despite compelling data showing benefits of early integration of PC, barriers to care exist. Our institution recently established an outpatient PC service. To improve utilization of this new service we identified clinicians’ attitudes and barriers to PC, and provided education on the PC referral process. The effects of this intervention on PC utilization were assessed. Methods: We conducted a retrospective chart review of outpatient Hematology/Oncology (HO) referrals to identify patients referred for newly diagnosed, solid tumor malignancies with no curative options. Hospice referrals were excluded. We then formally surveyed clinicians participating in multi-disciplinary tumor boards to identify PC referral practices and attitudes/barriers to PC referrals. Education on PC and instruction on PC referral process were provided during this period. Post-intervention review of PC referrals over 4 months was conducted. Results: Prior to our intervention, of the 53 new consultations reviewed meeting study criteria only three (5.7%) patients were referred to PC. Our survey revealed that 66% (31/47) of oncology providers did not know the institution had onsite PC available and only eight (17%) knew how to place a referral. After education was provided, a second cohort revealed 24.1% (7/29) of patients were appropriately referred for early outpatient PC representing an 18.4% absolute increase. Conclusions: We significantly increased early PC referrals for HO patients with advanced or metastatic disease. However, other efforts to improve institutional awareness and change the culture of care to ensure that majority of these patients are appropriately referred. Longitudinal evaluation will further ensure that timely adjustments are made and that effects are permanent.
Outpatient hematologist and oncologist perceptions of inpatient continuity visits at an urban academic medical center.
Authors: Chen Christopher , DeGregorio Sara , Soriano Margaret , Lennes Inga Tolin , Thompson Ryan , Ferris Timothy 
Published: April 2017

99 Background: In 2012, in an effort to improve continuity between inpatient and outpatient care, Massachusetts General Hospital (MGH) began sending automated email notifications to outpatient physicians when patients with whom they have an established relationship are admitted to MGH. Physicians are allowed to bill internally for a “continuity visit” if they visit their patient during an inpatient stay. We sought to study MGH hematologist and oncologist perceptions of care continuity and the efficacy of this continuity visit program. Methods: In the summer of 2015, all MGH hematology and oncology attending physicians, regardless of whether they had previously billed for a continuity visit, were provided a small financial incentive to participate in an online survey. Ninety-one of 116 physicians responded to the survey (78%). Results: Of the respondents, 74% had previously billed for a continuity visit, although others may have performed continuity visits without formally billing for them. Ninety-six percent of respondents felt that continuity visits are either highly useful or moderately useful to their patients, namely because patients view continuity visits as an expression of interest in their well-being (90%) and/or as a welcome surprise (58%). Ninety-one percent of respondents felt that continuity visits are highly or moderately useful to the inpatient team, because they are able to informally share clinical insights that improve clinical care (71%) and/or answer questions or confirm the inpatient attending’s plan of care (79%). Furthermore, 72% of respondents felt that continuity visits improve their longitudinal relationship with their patients. Lastly, 84% of respondents expressed high or moderate satisfaction with making continuity visits. Conclusions: MGH hematologists and oncologists reported that visiting their hospitalized patients is useful to inpatient care teams and their patients. A small incentive payment may encourage such continuity visits. The next step is to evaluate whether continuity visits make a difference in clinical outcomes, such as patient experience, readmissions, and inpatient length-of-stay.
Clinical Pathways: Management of Quality and Cost in Oncology Networks in the Metastatic Colorectal Cancer Setting
Authors: Ellis Peter G. , O’Neil Bert H. , Earle Martin F. , McCutcheon Stephanie , Benson Hans , Krebs Melinda , Lokay Kathy , Barry Amanda 
Published: April 2017

Purpose: Via Pathways (clinical pathways for cancer) provide evidence-based guidance for specific patient presentations based on the merit of efficacy, then toxicity, and finally cost (if efficacy and toxicity are comparable). We evaluated the impact of a change to the guidance in the metastatic colorectal cancer (mCRC) setting across two large, integrated health networks. Methods: Cetuximab and panitumumab were determined to have equal efficacy in the treatment of mCRC with no significant difference in toxicity based on recent data from key clinical studies. A cost analysis using Centers for Medicare and Medicaid Services average sales data determined a cost advantage for panitumumab. A substitution of panitumumab for cetuximab in the clinical pathway for all mCRC lines of therapy was initiated as of August 2014. Results: In the preimplementation period, 86 (93.5%) and six (6.5%) treatment selections were for cetuximab and panitumumab, respectively. After the pathway change was implemented, 13 (18.1%) and 59 (81.9%) treatment selections were for cetuximab and panitumumab, respectively. The change in prescribing habits was rapidly altered by the pathway change. The estimated annualized cost savings for the two health networks resulting from the response to the pathway change was $711,021. Conclusion: This study demonstrates that clinical pathways can act as a tool to assist oncology practices in decreasing costs and quickly responding to changing treatment paradigms by providing clinicians with consensus-driven treatment recommendations that incorporate the most up-to-date clinical trial results, toxicity considerations, and regimen cost information.
Common Entrapment Neuropathies
Authors: Hobson-Webb Lisa D. , Juel Vern C. 
Published: April 2017

ABSTRACT

Purpose of Review: This article addresses relevant peripheral neuroanatomy, clinical presentations, and diagnostic findings in common entrapment neuropathies involving the median, ulnar, radial, and fibular (peroneal) nerves.

Recent Findings: Entrapment neuropathies are a common issue in general neurology practice. Early diagnosis and effective management of entrapment mononeuropathies are essential in preserving limb function and maintaining patient quality of life. Median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, radial neuropathy at the spiral groove, and fibular neuropathy at the fibular head are among the most frequently encountered entrapment mononeuropathies. Electrodiagnostic studies and peripheral nerve ultrasound are employed to help confirm the clinical diagnosis of nerve compression or entrapment and to provide precise localization for nerve injury. Peripheral nerve ultrasound demonstrates nerve enlargement at or near sites of compression.

Summary: Entrapment neuropathies are commonly encountered in clinical practice. Accurate diagnosis and effective management require knowledge of peripheral neuroanatomy and recognition of key clinical symptoms and findings. Clinical diagnoses may be confirmed by diagnostic testing with electrodiagnostic studies and peripheral nerve ultrasound.
Examining the accuracy of visual diagnosis of tinea pedis and tinea unguium in aged care facilities
Authors: Goto T. , Nakagami G. , Takehara K. , Nakamura T. , Kawashima M. , Tsunemi Y. , Sanada H. 
Published: April 2017

Objective: The aim of this study was to examine the accuracy of visual diagnosis of tinea pedis (Athlete's foot) and tinea unguium (fungal nail infection), as well as to provide information on skin abnormalities that could help identify these diseases in aged care facilities (long-term care facilities (LTCFs) and nursing homes). Method: A multicentre, cross-sectional observational study was conducted in a LTCF and two nursing homes. A dermatologist observed the skin abnormalities in the participants' interdigital and plantar areas, to screen for tinea pedis, and in the participants' toenails, to screen for tinea unguium. If abnormalities were noted, samples such as scales or toenails were collected and examined using direct microscopy. The accuracy of the macroscopic observation for each skin abnormality was examined. Results: A total of 173 residents were recruited. The accuracy of clinical diagnosis using macroscopic observation was relatively low. The sensitivities and specificities for clinical diagnosis were 0.37 and 0.95 for tinea pedis in the interdigital areas, 0.47 and 0.94 for tinea pedis in the plantar areas, and 0.80 and 0.61 for tinea unguium in toenails, respectively. Scales in the plantar areas and discoloration of the toenails were more frequently observed in residents with tinea pedis and tinea unguium than in those without them. Conclusion: Several skin abnormalities were observed in the residents recruited in this study, but there was insufficient correlation with tinea pedis and tinea unguium to be used for screening.
The ability of a colloidal silver gel wound dressing to kill bacteria in vitro and in vivo
Authors: Tran P.L. , Huynh E. , Hamood A.N. , de Souza A. , Mehta D. , Moeller K.W. , Moeller C.D. , Morgan M. , Reid T. W. 
Published: April 2017

Objective: Inhibiting bacterial biofilms is of major significance for proper wound healing. The choice of the dressing material plays a key role, as bacteria can live in dressings and keep reinfecting the wound. This study examines the effectiveness of a colloidal silver gel (Ag-gel) wound dressing in inhibiting the growth of bacteria in a mouse wound model. Method: Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii and two different meticillin-resistant Staphylococcus aureus (MRSA) strains were examined. Bacteria were measured in vitro on the dressing, and in vivo studies were carried out to analyses both the dressing and the infected tissue. Results: Using colony-forming unit (CFU) assays, over 7 logs of inhibition (100%) were found for Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii for the Ag-gel dressing when compared with the control dressing. In vivo, complete inhibition was observered for the three most common bacteria on the Ag-gel dressing and the tissue under that dressing. These results were confirmed by an in vivo live imaging system. However, with MRSA strains, only 2–3 logs of inhibition were recorded. Conclusion: The Ag-gel was effective in preventing biofilm infections caused by both Gram-negative and Gram-positive bacteria.
The Do-it-Yourself (DiY) craft aesthetic of The Trons − Robot garage band
Authors: Snake-Beings Emit 
Published: April 2017

Abstract
The Trons are a Lo-Fi robot-garage-band constructed from discarded and redundant materials, including Meccano, aluminium foil salvaged from food wrappings and automotive solenoids. The central hub of their operation comes from a computer, made obsolete in the mid-1990s, which feeds signals to flimsy materials whose inefficiencies and ‘errors’ add another layer of processing to the sound. This articles discusses the use of discarded materials as processing agents as a Do-it-Yourself (DiY) craft aesthetic that embraces inefficiency and error as active agents in the production of sound. The indeterminate performance of sound, enacted by the Lo-Fi robotics used in The Trons, is viewed in this paper as an example of a strategy that emerges from a deep engagement by the practitioner with the materials of construction. Through an observation of studio practices and interviews with the maker, material engagement is revealed as a way of generating embodied knowledge, a form of craft practice that situates the DiY practitioner as being entangled within the material environment, and with the work evolving as a shared, reciprocal, exchange between human and material. In this article, function and dysfunctional ‘error’ are part of a spectrum of acceptable outcomes of the DiY craft aesthetic, a process in which practitioners and technological materials form an extended network of agency, displacing the human as the exclusive centre of process.
Reviews
Authors: Chua Shuyi , Peterson Andrew 
Published: April 2017

Abstract
THE ETHICS OF PATRIOTISM: A DEBATE, JOHN KLEINIG, SIMON KELLER AND IGOR PRIMORATZ (2015) West Sussex: Wiley-Blackwell, 189 pp., ISBN: 9780470658857, p/bk, £23.50
GLOBAL CITIZENSHIP EDUCATION AND THE CRISES OF MULTICULTURALISM: COMPARATIVE PERSPECTIVES, MASSIMILIANO TAROZZI AND CARLOS ALBERTO TORRES (2016) London: Bloomsbury, 240 pp. ISBN: 9781474235976, h/bk £94.99
The model of teachers’ perceptions of ‘Good Citizens’: Aligning with the changing conceptions of ‘Good Citizens’
Authors: Wong Koon Lin , Lee Chi Kin John , Chan Kin Sang Jacqueline , Kennedy Kerry John 
Published: April 2017

Abstract
The purpose of this study was to investigate teachers’ perceptions of ‘good citizens’ using the Model of Teachers’ Perceptions of ‘Good Citizens’. Teachers play essential roles in the nurturing of students’ civic values because they are key figures in implementing education and curriculum policies in schools. A mixed methods approach was employed to address Hong Kong primary teachers’ perceptions of good citizens. A total of 1089 teachers from 131 Hong Kong primary schools participated in the quantitative study. Subsequently, 29 teachers from twelve schools were chosen for interview. According to the Model of Teachers’ Perceptions of Good Citizens, the findings revealed that teachers perceived good citizens to be those who not only possessed civic knowledge, conservative values, and concern for others in society but were also critical and active citizens. The Model of Teachers’ Perceptions of Good Citizens provided an explanation for the gap between good citizens as advocated by the Hong Kong Special Administrative Region (HKSAR) government and good citizens as embraced by groups within Hong Kong society. This study contributes to the body of literature on teachers’ perceptions of civic education by offering a new lens for thinking about teachers’ perceptions of good citizens.
Far from apathetic: Canadian youth identify the supports they need to speak about and act on issues
Authors: McLean Lorna R. , Bergen Jennifer K. , Truong-White Hoa , Rottmann Jenn , Glithero Lisa 
Published: April 2017

Abstract
According to the government agency responsible for tabulating trends in voting patterns, electoral participation in Canada plunged steadily from the 1990s to early twenty-first century; most of the decline is attributed to a dwindling of interest among youth voters, specifically those between 18 and 24 years of age. Recent national and international research links experiential learning with increased civic engagement. By framing our community student-learning project around student engagement and issues that the students raised, our study evolved as a joint collaboration among a government agency (Elections Canada), a national youth leadership programme (Encounters With Canada) and a Canadian university’s Faculty of Education at the University of Ottawa. This study gives particular voice to students to help educators better understand how teenagers see themselves as citizens, what issues they identify as significant, and what resources and materials they claim they need to engage with in the democratic process.
Artistic scarcity in an age of material abundance: President Lyndon Johnson, the National Endowment for the Arts, and Great Society liberalism
Authors: Heath Karen Patricia 
Published: April 2017

Abstract
1965 saw President Lyndon Johnson push an incredible number of reform bills through Congress as part of his quest for a Great Society – including legislation to create a National Endowment for the Arts (the federal agency that provides grants to artists and arts organizations in the United States). Public confidence was riding high, the economy was good, and Americans demonstrated a remarkable faith in the capacity of the federal government to solve domestic problems. And yet in this age of abundance, Johnson drew on the rhetoric of scarcity to promulgate his domestic policy. When the President spoke of the cultural aspects of the Great Society he typically emphasized qualitative and quantitative goals, i.e. the power of the arts to improve the quality of life of ordinary Americans and to reduce a perceived imbalance between the haves and the have-nots. Whereas other studies have relegated the cultural aspects of the Great Society to the side-lines, this study places such matters centre stage through an analysis of the rationales behind the creation and early programming of the Endowment. In so doing, it illuminates the inherent contradictions of, and tensions within, American liberalism in the mid-1960s.
Resolving the social-democratic dilemma? Andalusia under pressure (2011–15)
Authors: Harguindéguy Jean-Baptiste , Cole Alistair 
Published: April 2017

Abstract
This article focuses on the concept of the ‘social-democratic’ dliemma through the study of the Spanish region of Andalusia. Led by social democrats since the democratic Transition, the Andalusian government has developed a specific territorial model that has been challenged by the austerity measures adopted by the conservative cabinet ruling the central state (2011–15). Through a grass-roots interview-based analysis of Andalusian politics, this study elucidates the political and discursive strategy followed by the Andalusian government for preserving its power, protecting its regional model and resolving the social-democratic dilemma. From a systemic perspective, the article demonstrates that exogenous constraints, though heightened in a period of economic crisis, are to an extent counteracted by domestic pressures.
Modern Art and German Reconstruction: American Curatorial Interventions in Postwar Berlin
Authors: McComas Jennifer 
Published: April 2017

Abstract
This article offers an analysis of two little-known 1951 exhibitions that marked a new era for American cultural diplomacy with postwar Germany. Contemporary Berlin Artists was circulated across the United States, while Amerikanische Malerei: Werden und Gegenwart (‘American Painting in the Making and Now’) introduced contemporary American art to Berliners. Both exhibitions were organized by the American Federation of Arts (AFA) in collaboration with the United States High Commissioner for Germany. The article examines how the AFA employed contemporary art in its exhibitions to advance American cultural and diplomatic goals for West Germany.