bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding fellow hematology curriculums: Characterizing perspectives and defining opportunities for improvement.
Authors: Godby Richard , Lingamaneni Prasanth , Gangat Naseema , Paludo Jonas 
Published: June 2024

9018 Background: Comprehensive hematology education during fellowship is paramount for providing high-quality care, especially in busy practices. Variability in fellow educational experiences is expected. However, fellowship programs must ensure a well-rounded, equitable educational experience for all fellows to prepare them for practice and board exams in the increasingly dynamic field of hematology. Methods: We administered an e-mail survey to hematology/oncology fellows (n=30) at Mayo (Rochester) to explore inpatient hematology education experiences and the Fellow Hematology Curriculum (FHC) during 2021-2022. Based on results, we designed a fellow-led, consultant-supervised quality improvement (QI) initiative to improve FHC. Responses were in a five-point Likert scale and open-ended format. Results: Twenty fellows completed the survey (66% response rate). Respondents were well distributed (35% PGY4, 25% PGY5, 40% PGY6). Resources most used for self-education were ASH SAP (85%), UpToDate (80%), and NCCN guidelines (50%). 100% of respondents agreed/strongly agreed that the FHC could be improved. 95% agreed/strongly agreed that there is a high degree of variability among consultants regarding engagement in fellows’ education. 45% agreed that education is adequately paired with relevant clinical duties to reinforce key concepts. 25% agreed that FHC had well-defined structure and objectives. In the open-ended responses, a structured curriculum covering a set list of topics paired with the relevant rotation was the most common recommendation by the fellows for improving the FHC and the inpatient hematology educational experience. This prompted a QI initiative to implement a structured, evidence-based curriculum covering essential topics required for hematology practice. Each week of a four-week rotation has a relevant theme (eg, “Marrow Failure week” during the inpatient leukemia service). Fellows selected a topic of interest and created a lecture to be used by all faculty and learners during the relevant rotation (eg, “Aplastic Anemia” during the Marrow Failure). Consultants and pharmacists in respective disease groups reviewed the topics and presentations. These lectures are now provided to fellows and faculty via e-mail prior to relevant rotations. Conclusions: Our survey demonstrated that trainees’ individual educational experiences on inpatient hematology services are widely variable and largely unsatisfying without some form of structured, relevant learning. We identified the need for deliberate, coordinated education as a gap to bridge toward achieving the goal of equitable, comprehensive learning. We intend to perform a post-implementation survey after one year of practicing a structured, relevantly paired FHC. This assessment will be used to make improvements in subsequent iterations of the FHC using the Plan-Do-Study-Act methodology.
Global interest in podcasts designed for medical oncology trainees.
Authors: Holstead Ryan , Quinn Ryann 
Published: June 2024

9019 Background: Audio podcasts allow for medical education to be disseminated in an on-demand format and are globally accessible. There are currently a limited number of trainee-directed medical oncology podcasts and their global impact has not been shown. “Talking about Tumors with Ryann and Ryan” is an English language, evidence-based, free-to-use podcast that was initiated in April 2022 with a focus on education of trainees new to the field. Methods: Geographic statistics were collected for podcast episodes with greater than 30 days of availability. The proportion of listeners from different regions was compared between episodes. Trends in listeners from North America and global audiences were descriptively analyzed. Results: 34 episodes were included in this analysis, with content in gastrointestinal, breast, thoracic and cutaneous malignancies. Episodes had a median of 115 downloads, with consistently >30% from outside of Canada and the United States (median 37.3 +/- 6.4%). Twenty-four countries had greater than 10 downloads. The largest audience beyond North America was Australia (13%), Israel (4%), United Kingdom (3%), Pakistan (3%), Sweden (2%), India (1%), and Hong Kong (1%). A review of individual cities within countries was relatively constant, suggestive of persistent listenership. Conclusions: There is a global interest for introductory medical oncology education. Presentation in an evidence-based format and awareness of variation in regional approaches to systemic therapy can increase the impact of podcasts, which by their design can reach a global audience. The development of an index for early education oncology podcasts may improve visibility and access to those interested in this medium.
Educational intervention to facilitate clinician-patient discussions of lung cancer biomarker testing at safety net and non-safety net centers.
Authors: Trosman Julia R. , Martin Nikki A. , Pasquinelli Mary , Weinberg Frank , Lycan Thomas William , Sacks Ruth Lauren , Woodyard Jennifer , Prescott Kevin , Khosla Paramjeet Grewal , Lile Ashley , Shivakumar Latha , Fish-Steagall Ann Ann , Sorgi Marin , Ravelo Arliene , Weldon Christine B. 
Published: June 2024

9023 Background: Biomarker testing is critical for optimal therapy selection in non small cell lung cancer, but it takes time and may delay treatment, causing patient anxiety and dissatisfaction. Patients want to understand the necessity and timing of biomarker testing and therapy decisions, but clinicians find these discussions challenging, especially with lower health literacy patients. As a solution, we deployed 4R Oncology model (4R = Right Info/Care/Patient/Time) at 10 centers (4 safety net, 6 non safety net). Under 4R, clinicians discuss with patients a Care Sequence, a predeveloped care checklist with visual timing of care, emphasizing biomarker testing within the overall care plan. It includes social and supportive care to address Social Determinants of Health (SDOH). Methods: Interviews with clinicians to examine whether / how Care Sequence helped discuss the need and timing for biomarker testing with patients, including lower health literacy patients. The cohort of clinicians (N=18) included oncologists, fellows and nurses; 10 worked at safety net centers. Results: All clinicians reported that Care Sequence helped explain timing of biomarker testing and the need to wait for results (Table). The majority reported that it helped discussions with lower literacy patients and to train fellows how to discuss these issues and place related referrals. These benefits and most of the rationale were reported at a similar rate by safety net and non safety net clinicians. Conclusions: The 4R Care Sequence is a promising educational tool that helps clinicians, including fellows, manage patients’ awareness and expectations for timing of biomarker testing and therapy decisions in lung cancer. The benefits in discussions with lower health literacy patients at both safety net and non safety net centers suggest that 4R can address disparities in patients’ understanding of these complex issues and may reduce anxiety while awaiting treatment. [Table: see text]
Alignment of patient-clinician perspectives in triple-negative breast cancer (TNBC).
Authors: Ackbarali Tariqa , Goins Chelsey , Walker Stephanie , Donahue Sara , Witt Jennifer , Vidal Gregory A. , Traina Tiffany A. 
Published: June 2024

9032 Background: Despite recent advances in therapeutic strategies, TNBC remains difficult to treat due to a poor prognosis and a reduced number of effective treatments. Among racial and ethnic groups, Black and Hispanic women have a disproportionately higher risk of TNBC. To address this, a tethered educational initiative was designed to empower patients through navigation and treatment decision-making, and facilitate patient-clinician partnerships through education and the sharing of real-world outcomes. Methods: Two, one-hour online, interactive, video-based programs were designed for patients/caregivers, and clinicians in collaboration with TOUCH, the Black Breast Cancer Alliance and the National Breast Cancer Foundation. The patient/caregiver program was hosted on CancerCoachLive and MedLive and the provider program hosted on OMedLive; both launching in June 2023. Patient stories were embedded within the program. We report on an analysis of patient outcomes and the intersection of patient and clinician perspectives, including behavioral impact, and qualitative insights. Results: To date, more than 2,000 participants have engaged across both educational programs. Of participating patients/caregivers, 42% were non-White (non-Hispanic) and 76% were people diagnosed with breast cancer. Following the program, 82% felt confident discussing treatment and outcomes with their healthcare team, and 56% reported intent-to-change related to treatment, communication, and engagement with support resources. Patient/caregiver participants (56%) defined ‘providing resources and information about diagnosis and treatment options’as the most helpful role in working with a patient navigator. Qualitative data elucidating specific intended changes and patient experiences will be shared. Of the participants in the clinician program, 89% were physicians, 91% of whom noted their specialty as oncology. In assessing patient openness to discussions with their team; 42% of clinicians believed their patients would approach them, and 71% of patients were very likely to approach their team. Only 60% of clinicians believed their patients would participate in a clinical trial while 85% of patients reported they would be likely to participate. Clinicians reported challenges enrolling patients in clinical trials as: lack of access (33%), low awareness of available trials (17%), and patient lack of interest (15%). Conclusions: Discordances in patient and clinician perspectives were revealed by the outcomes related to willingness of patients to engage in clinical trials and openness in communication between patients and their healthcare teams. These educational programs positively impacted patient and clinician motivation to address areas of care within their control. Real-world accounts of patient experiences provided context and perspectives that can help improve shared decision-making approaches.
A national survey of obstetrics and gynecology resident perspectives on their preparedness to provide care for racially and socioeconomically diverse gynecologic oncology populations.
Authors: Ben Haj Frej Khaoula , Hardy Nicole Janell , Whitcomb Bradford 
Published: June 2024

9037 Background: Despite 83% female representation, Obstetrics and Gynecology (Ob/Gyn) lags behind other residencies in racial diversity, with 35.2% of trainees classified as Underrepresented in Medicine (URM). Fellowships are markedly less diverse, with Gynecologic Oncology representing 26.1% URM. While studies have examined Ob/Gyn residents’ self-perceived preparedness for surgical skills, little is known about their confidence in treating vulnerable patients with gynecologic malignancies. This survey assessed resident confidence in providing Gynecologic Oncology care to patient populations diverse in racial/ethnic background and insurance status, while accounting for residents’ own racial/ethnic backgrounds. Methods: An anonymous, novel Qualtrics survey was disseminated to current US Ob/Gyn residents, to elicit their self-reported preparedness to provide NCCN guideline-based care to diverse Gynecologic Oncology patient populations. Subjects were asked multiple-choice questions to record their own demographics followed by Likert scale questions which ranged from strongly disagree (1) to strongly agree (5) regarding their perceived readiness to care for patients diverse in insurance and racial background. Differences in responses between racial groups were analyzed using the Kruskal-Wallis Rank Sum test while differences in responses between ethnic groups were evaluated using the Wilcoxon Rank Sum test. Results: 207 residents complete the survey, mirroring sample sizes of national surveys of Ob/Gyn residents. There was no statistical difference in self-perceived preparedness between Hispanic and non-Hispanic Ob/Gyn residents regarding providing care for diverse racial minorities (mean Likert Non-Hispanic = 4.1 vs. Hispanic = 4.2; p = 0.222) or insurance types (mean Likert Non-Hispanic= 4.0 vs. Hispanic = 4.0; p=0.563). There was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance experienced more difficulty obtaining non-operative gynecologic care compared to those with other insurance types (Hispanic = 3.7 vs. non-Hispanic = 3.2; p = 0.044). Further, there was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance had to wait longer for outpatient appointments with a gynecologic oncologist (Hispanic = 3.6 vs. non-Hispanic = 3.0; p=0.016). Conclusions: All Ob/Gyn residents will encounter, screen for, and diagnose gynecologic malignancies, regardless of pursuit of Gynecologic Oncology fellowship. This study evaluated Ob/Gyn resident perceptions, finding that they feel overall prepared to provide Gynecologic Oncology care to socioeconomically diverse patient populations, though differences exist when residents are compared based on their backgrounds.
Precision medicine preceptorship in breast and lung cancer for Latin American oncologists.
Authors: Gogineni Keerthi , Leal Ticiana , Dixon Margie D. , Rana Shaheen A. , Pentz Rebecca D. 
Published: June 2024

9040 Background: Cancer is the second leading cause of death in Latin America. Integrating genomic discoveries into patient care could improve morbidity and mortality; however economic barriers to capacity development and access to therapeutics remain. In response to an RFP for a preceptorship for oncologists from Latin America, Emory’s Winship Cancer Institute (WCI) developed a 2-week immersion involving didactics, clinical exposures, and research meetings to increase knowledge and competence of breast and lung cancer genomics. Methods: Interviews with Latin American medical oncologists, Latin America Lung Cancer Association (LALCA) leadership, and literature review were conducted to understand areas of unmet need in oncology training. A gap in knowledge and practice of genomic management of breast and lung cancer was identified and informed development of didactic and clinical exposures. The WCI website, International Association for the Study of Lung Cancer (IASLC) and LALCA publicized the program. Medical oncologists within 6 years of final oncology training applied. Participants completed a baseline needs assessment, pre-program survey to assess goals and confidence in skills, and post-program interview to evaluate the program and reassess confidence in skills. Instruments were developed with WCI’s Intervention, Development, Dissemination and Implementation Shared Resource. WCI faculty were interviewed for feedback. Results: WCI hosted 12 Latin American oncologists over 3 two-week preceptorships between 2020-23, coinciding with local scientific meetings. All participants reported the program was a valuable use of time, valuable for career development and rated the program as excellent/very good. 92% reported the program met their goals and felt engaged all/most of the time. 75% rated attendance at breast and lung cancer clinics, didactics, research meetings, tumor boards as very/extremely valuable. Two-thirds intended to make changes (apply knowledge, improve communication, work with other providers like nurses, aid students in research, improve flow of activity when seeing patients, incorporate clinical research into daily practice, and add immunotherapy) in their practice at home institutions. Phase 1 and surgical oncology clinics were deemed least helpful. Themes emerged from faculty interviews: be strategic about the number of learners in clinic, characterize learner preferences and prior training/experience, articulate the preceptorship’s long-term goals, and include time to team-build. Conclusions: Participants gained exposure to the latest molecular diagnostics and systemic treatments, appreciation for optimal team-based cancer care, and how clinical research drives development of novel biomarkers and therapeutics. Future goals include expanding program access to oncologists from other low- and middle-income countries and promoting post-program collaborations.
O PRIMEIRO PRINCÍPIO DA RAZÃO PRÁTICA EM TOMÁS DE AQUINO
Authors: Santos Lucas Fonseca dos , Ribeiro Mário da Silva , Pinheiro Victor Sales 
Published: June 2024

Objetivo: Investiga-se neste artigo a teoria da lei natural de Tomás de Aquino. Especificamente, visa-se a: (1) expor como Aquino aborda o primeiro princípio da razão prática; (2) expor a interpretação que os filósofos e jusfilósofos constitutivos da Nova Escola da Lei Natural oferecem a respeito do mencionado princípio; (3) expor as principais discordâncias quanto à interpretação da Nova Escola da Lei Natural; (4) argumentar por que a interpretação da Nova Escola da Lei Natural se adequa à abordagem de Aquino; e (5) expor as dificuldades nas interpretações alternativas.
Método: Abordagem teórica e reflexiva segundo bibliografia autorizada e atualizada. Utiliza-se das lições de Tomás de Aquino e de seus intérpretes contemporâneos, com destaque para aqueles que constituem a Nova Escola da Lei Natural.
Resultado: As posições tradicionais derivacionistas não são capazes de explicar adequadamente os atos humanos. Isso se dá porque não explicam a diretividade prática fornecida pelo primeiro princípio prático em um ato considerado imoral. Além disso, apresenta‑se um argumento hermenêutico adicional em favor da interpretação da Nova Escola da Lei Natural a respeito do primeiro princípio prático em Aquino: considerando-se a influência inegável de Aristóteles na obra do aquinate e uma continuidade relativa entre ambos, percebe‑se que há uma tese muito semelhante defendida por ambos – formulada de maneiras diferentes – e que tornam mais consistente a interpretação da teoria neoclássica da lei natural. Assim, compreende-se o papel do primeiro princípio da razão prática como um princípio estruturante e diretivo do ato humano em geral, seja para atos considerados moralmente adequados, seja para atos considerados moralmente inadequados.
Contribuições: As linhas a seguir reúnem anotações preliminares, inobstante técnicas. Sua contribuição remonta ao necessário avanço de estudos atentos à estrutura da razão humana, a qual possui um aspecto teórico, que busca conhecer a verdade das coisas e das proposições filosóficas, e um aspecto prático, que busca orientar os atos humanos para certos fins. Ademais, este artigo contribui também devido às lacunas da literatura nacional a nível filosófico-jurídico e ético, fazendo-se indispensável a uma visão holística das lições do principal expoente da tradição da lei natural – Tomás de Aquino.
Associação entre prática de atividade física e aptidão cardiorrespiratória em adolescentes
Authors: Peixoto Márcio Botelho , Borges Thiago Terra , Reichert Felipe Fossati 
Published: June 2024

O objetivo do estudo foi verificar a associação entre diferentes volumes de atividade física moderada e/ou vigorosa durante o lazer e aptidão cardiorrespiratória (ACR) adequada em adolescentes de ambos os sexos. A atividade física moderada (AFM), vigorosa (AFV) ou moderada-vigorosa (AFMV) de lazer foi avaliada por meio de questionário e a ACR foi medida com o teste de vai-e-vem de 20m. Foram utilizados modelos de Regressão Poisson para análises. As AFM, AFV ou AFMV no lazer foram categorizadas de acordo com três limiares de atividade física no lazer (150, 300 e 420 min/sem). Foram consideras para as análises de associação as AFM, AFV e AFMV, de acordo com o compêndio de atividade físicas para adolescentes. A prática de AFMV no lazer por pelo menos 420 min/sem obteve a maior probabilidade de ACR adequada (RP = 2,03; IC 95%: 1,18 – 3,51). Na mesma direção, a prática de AFV por pelo menos 150 min/sem também foi estatisticamente significativa (RP = 1,72; IC95%: 1,07 – 2,80). Os resultados indicaram uma associação positiva entre prática de atividade física no lazer e ACR, independentemente da intensidade e limiar de tempo, enfatizando que a participação em ambas as intensidades de atividade física no lazer estão associadas aos níveis adequados de aptidão cardiorrespiratória.
Client perspectives on the support provided for the management of diabetes mellitus in dogs and cats
Authors: Reid Emily , Sikora Rachael 
Published: June 2024

Background: Literature suggests that owners of pets with diabetes mellitus are not adequately supported by veterinary professionals to manage their pet's condition. Quality of life assessments for diabetic pets in practice often focus on the animal's clinical signs and overlook owner feedback. Aims: To investigate client perspectives on how having a dog or cat with diabetes mellitus affects pet and owner quality of life, the challenges faced and management options available, and how support could be improved. Methods: A questionnaire was designed using the online tool ‘NoviSurvey’ and completed by UK-based owners. Results: Out of the 99 valid responses, 26% of participants disagreed that their veterinary practice supported them with their pet's diabetes mellitus. Results showed that diabetes mellitus is perceived to have a significant effect on quality of life of not only the pet with the disease but also the owner who is managing it. Conclusions: The effects of having a pet with diabetes mellitus on quality of life are being overlooked by the veterinary profession. Online support groups are an important platform for these owners to connect but should not be their primary source of advice because of a lack of veterinary support. Registered veterinary nurses are well placed to carry out regular quality of life assessments and provide evidence-based advice during clinics.
Reducing Depressive Symptoms Among Latina Mothers of Autistic Children: A Randomized Controlled Trial
Authors: Yu Amy Pei-Lung , Zeng Weiwen , Lopez Kristina , Magaña Sandy 
Published: June 2024

Abstract
This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children. In this two-site randomized waitlist-control study (n = 109 mother-child dyads), a peer-to-peer mentoring (promotora) model was used to deliver an intervention that was designed to increase mothers’ self-efficacy and use of evidence-based strategies. We assessed mothers’ depressive symptom (CES-D) scores at three time points and used linear mixed models to determine whether their scores significantly changed from baseline to postintervention (Time 2) and at 4 months postintervention (Time 3). Results show that mothers in the intervention group reported a significant decrease in mean depressive symptom scores at Time 2 and that the effect was maintained at Time 3 with intermediate to medium effect sizes. There were no differences in results across sites. Findings suggest that Parents Taking Action, a culturally tailored intervention led by peer mentors, showed a significant effect both immediately after the intervention and 4 months postintervention in reducing depressive symptoms among Latina mothers of autistic children.