bluuebunny/crossref_metadata_2025_split huggingface dataset:
P72 Leaving home - managing change
Authors: Clarke Karen 
Published: October 2013

BackgroundAutumn 2013 the hospice will relocate to its new 20-bedded facility. To have a successful move staff/volunteers need to feel supported and engaged.AimChange Management Strategy was implemented to:generate interest, energy and enthusiasmempower managers to take ownership and problem solveengage employees, patients and their familiesimplement the practical steps to ensure safe working practicesattract and retain new employees and volunteers whilst ensuring low turnover.ApproachStaff Engagement questionnaire (September 2011) assessed staffs’ preparedness for change.Change management programme developed based upon Kotter, Lewin and Kübler-Ross.Communication - briefings; hospice newsletter; team meetings; 1:1’s; Away Days.Patients Forum worked with the Deputy CEO on all aspects of the new hospice since June 2011.September 2012 - Day Therapy patient group focused on the new Wellbeing Centre.Staff/volunteers involvement:site visitsFarewell Projectfurniture and equipment consultationpiloting proposed changesplanning decant strategycharting hospice’s historydeveloping operational plansdeveloping orientation/induction programme.Outcomes77 volunteers have confirmed they will relocate<10 staff indicated they will not be relocatingSite visit feedback:“gives a feeling of being involved in the change process literally from ‘the ground up’”“incredibly inspiring …really helped to bring the vision to life….will help immensely when having discussions with staff, patients and relatives about the new hospice.”Further outcomes available post move.ApplicationAt a time of unprecedented change in the hospice movement it is important not to lose sight of the impact on staff and volunteers:“One of the greatest costs of change is that impact on the ability of staff to respect and care for others while they feel under threat themselves.” (Iles 2005).
P73 Does the attachment style of hospice workers predict their emotional response to a move into a bespoke new build unit?
Authors: Meystre Chantal , Murray Jane , Armour Kathy 
Published: October 2013

AimTo investigate the relationship between psychological attachment style and emotional responses to moving into a purpose built hospice.BackgroundMental representations of self and other are formed by our primary relationship. Internal working models inform subsequent relationships, world view and responses to life events. Attachment style research demonstrates predictive value for staff responses in clinical environments. In 2013 our hospice service relocated to a bespoke new build. Practical issues were addressed by project management, but psychological and emotional aspects were unexplored.MethodologyAfter favourable University ethics review the study took place in an English, 17 bedded consultant-led hospice with daycare, and community services. All staff and visiting volunteers were eligible for the study. A modified adult attachment questionnaire with added elements was circulated prior to moving. Gender was not collected to ensure confidentiality.Results42 questionnaires (31%) were returned: 34 staff, 8 volunteers. Statistical analysis revealed no difference between staff and volunteers so they are reported together. The median length of service at the old Hospice was 6.2 years; range <1 to 23 years service. Older staff had worked for the hospice for longer (p < 0.05).Anxious and avoidant attachment styles were not related to length of service in the hospice. Staff with anxious attachment styles grieved more (p < 0.003) and felt it was wrong to sell the old hospice (p < 0.05). Both anxious and avoidant staff with higher scores were less likely to want to move (p < 0.05).Conclusions and Applications to Hospice practiceOur data suggest that attachment style is stable despite the stress of working in a hospice environment. As in other workplaces anxiously attached personnel have predictably more negative emotional responses to life events. This is useful information for staff care and suggests some groups of staff may benefit from targeted clinical supervision during periods of great change.
P74 Tears at the wedding
Authors: Sadler Clair , Nolan Steve , Sansom Gill , Warren Linda , Cox Linda , Cullen Anne 
Published: October 2013

BackgroundA diagnosis of cancer can mean that the ‘taken for granted’ future is disrupted which impacts on self-image and social roles. People may strive to contribute to a meaningful life (Armstrong-Coster, 2004) and develop contingencies to preserve their sense of self-identity so remain within their social worlds (Becker, 1997). In their everyday work, hospice staff face tensions and conflicts within families as well as the loss of anticipated social roles for their patients. In the case presented, the anticipated social role of wife in a young dying women brought into focus personal and professional unity and conflict for hospice staff.AimsTo explore the challenges of a hospice responding to a families wishes by organising a wedding for a dying woman: whose needs are we meeting?MethodsThrough the medium of a Schwartz Centre Round 4 members of hospice staff presented their contrasting experiences and feelings evoked by hospice weddings. In keeping with the SCR, a multidisciplinary discussion was then opened up to staff.ResultsThe juxtaposition of different professional and personal beliefs and values was explored and the challenge of how to manage complex social dynamics of meeting the patient’s and family’s needs when death is a spectre at the wedding celebration. The discussion focused on opposing views of whose needs are the most pressing: the dying woman or the needs of a caring family anticipating bereavement.ConclusionResolution is not the aim of the SCR but open, honest conflict and discussion in a confidential environment allowed the ‘unspeakable’ to be spoken. In dealing with such complex issues in a hospice setting, the SCR allows an effective means of exploration not necessarily resolution.Application to hospice practiceSchwartz Centre Rounds are protected time to allow hospice staff the space to explore socially and emotionally difficult situations.
P75 “You’re a little part of a jigsaw. Going to schwartz centre rounds, you see the other bits of the jigsaw”
Authors: Knight Andrew , Cullen Anne , Todd Jennifer , Reed Liz , Sadler Clair , Gannon Craig 
Published: October 2013

BackgroundSchwartz Centre Rounds (SCR) offer healthcare providers a protected time to talk openly and honestly about situations in their work that challenge them on a human level. Evidence suggests that SCR’s strengthen team working and are valuable to the healthcare providers which translates to the care they offer their patients1.In 2012, Princess Alice Hospice was one of the first hospices in the UK to adopt SCR’s and opened the rounds to both clinical and non-clinical staff and volunteers. Presenters have included nurses, doctors, housekeeping staff, healthcare assistants, trustees and volunteers.AimTo explore in detail the experience of multidisciplinary staff and volunteers of SCR’s in a UK hospice after one year.MethodsA mixed method approach triangulating quantitative evaluation data from the first year and qualitative data from 3 focus groups (presenters, attendees and non-attendees). Categorical indexing was generated from the topic guide themes and sub-categories generated within the identified key themes2.ResultsOver the year SCR’s have had a mean attendance of 46 people (range 37-57). They are consistently well evaluated with 90.5% gaining knowledge helpful in their work, 98.2% gaining insight into how others think/feel in caring for patients and 85.1% feeling the SCR will help them work better with colleagues. Twenty six people attended three focus groups. Each group was representative of clinical and non-clinical staff as well as volunteers. General themes: values and challenges of an inclusive multidisciplinary SCR; appreciating the roles and experience of others; time and commitments; dissonance between the personal and professional self; safety versus exposure; and communicating about Schwartz in a UK Hospice.ConclusionOverall,SCR’s are well valued at Princess Alice Hospice influencing individuals in their everyday work and working relationships. Issues around communication, format and representation have been taken forward to further develop SCR’s at the Hospice.
P76 Rags to revenue
Authors: Midgley Rowena 
Published: October 2013

A pilot scheme was set up in September 2012 to re-evaluate our current textile recycling process, which was selling all the Rags* from our retail shops onto textile recyclers. This scheme examined the possibilities of increasing revenue by re-sorting our discarded Rags, focusing initially in four specific areas; Vintage/Retro, clearance items (to support a new shop), saleable items returned to standard shops and true Rag items. These results showed the potential of 16% of total rags being recovered, giving a large extra revenue opportunity.The next challenge was to find a dual purpose site, large enough to support the resorting project and allowing expansion into other areas, with a shop attached to sell the clearance items thus avoiding further transport costs. In March 2013 the Resorting Centre was opened with a full time manager and two part time deputies, the Clearance shop opened at the start of April 2013. In order to monitor the outputs of the project, all items that are returned back to shops are tagged with a pre printed bar code for our Epos system to track. To fully understand this concept, all Shop Managers were invited to see the process first hand.Additional revenue benefits to this project involve the team expanding into an upcycling section encompassing areas such as, bunting, felting, and removing unusual buttons, to sell in the shops. This will generate new volunteer opportunities in order to support this initiative.We intend to further develop this initial project to resorting books in Sept 2013. This journey will continue to grow and adapt and creates a clear strong platform for further revenue developments, working on the concept of generating more income from our existing donations whilst reducing waste.*Rags = donated clothes considered unsaleable
P77 Willen Hospice Winter Campaign - ‘A Wonderful Gift’
Authors: Green Helen 
Published: October 2013

BackgroundRequirement identified to raise our profile in the local community, with new and existing supporter’s over the Winter (Christmas) period.Holistic campaign designed to drive community responsibility, ownership and involvement.Aims and objectivesProvide opportunity for supporters to engage– giving evidence of the value the Hospice provides to local community.Re-engage with target audiences, driving them to take action.Supporters feel that ‘care’ applies to supporters as well as patients.Volunteers to feel integral and inspired.Employees unite.Generate income through retail streams, event attendance and donations.Approach usedEngaging with Trustees, team members and creative resource a Campaign Brief was created, capturing key stakeholders, aims, and objectives. Communication vehicles and tactical elements were designed, timelines agreed and learning’s taken from our sector peers and retail competitors.The ‘A Wonderful Gift’ proposition helps to demonstrate:The specialist care provided by the Hospice is a gift to patients and families.The cost of giving care is full of surprising facts, just like Christmas is full of surprises.The gift (of support) makes wonderful things happen, gifts that mean something beyond the wrapping paper.From here, tactical elements were designed:An iconic branded blue gift boxCreative designs for Retail outletsCable Display PostersLeafletsWinter Draw TicketsTwelve weeks of Christmas e-shots focusing on selected activity, i.e. e-shop gifts, Christmas cards, Memorial event, Lottery tickets, donating unwanted gifts, purchasing retail gifts, hosting fundraising eventsOutcomesIncreased sales on Christmas Cards, e-shop giftsPositive feedback on visual brandingDrove footfall into Shops/high street interestSocial Media posts - significant increase in ‘chatter’Successful e-shots for Cards and Gifts - 31% unique opens and 5.17% click thru rate
ALDH1-Positive Cancer Stem Cells Predict Engraftment of Primary Breast Tumors and Are Governed by a Common Stem Cell Program
Authors: Charafe-Jauffret Emmanuelle , Ginestier Christophe , Bertucci François , Cabaud Olivier , Wicinski Julien , Finetti Pascal , Josselin Emmanuelle , Adelaide José , Nguyen Tien-Tuan , Monville Florence , Jacquemier Jocelyne , Thomassin-Piana Jeanne , Pinna Guillaume , Jalaguier Aurélie , Lambaudie Eric , Houvenaeghel Gilles , Xerri Luc , Harel-Bellan Annick , Chaffanet Max , Viens Patrice , Birnbaum Daniel 
Published: October 2013

Abstract
Cancer stem-like cells (CSC) have been widely studied, but their clinical relevance has yet to be established in breast cancer. Here, we report the establishment of primary breast tumor–derived xenografts (PDX) that encompass the main diversity of human breast cancer and retain the major clinicopathologic features of primary tumors. Successful engraftment was correlated with the presence of ALDH1-positive CSCs, which predicted prognosis in patients. The xenografts we developed showed a hierarchical cell organization of breast cancer with the ALDH1-positive CSCs constituting the tumorigenic cell population. Analysis of gene expression from functionally validated CSCs yielded a breast CSC signature and identified a core transcriptional program of 19 genes shared with murine embryonic, hematopoietic, and neural stem cells. This generalized stem cell program allowed the identification of potential CSC regulators, which were related mainly to metabolic processes. Using an siRNA genetic screen designed to target the 19 genes, we validated the functional role of this stem cell program in the regulation of breast CSC biology. Our work offers a proof of the functional importance of CSCs in breast cancer, and it establishes the reliability of PDXs for use in developing personalized CSC therapies for patients with breast cancer. Cancer Res; 73(24); 7290–300. ©2013 AACR.
Use of the Proton Pump Inhibitor Pantoprazole to Modify the Distribution and Activity of Doxorubicin: A Potential Strategy to Improve the Therapy of Solid Tumors
Authors: Patel Krupa J. , Lee Carol , Tan Qian , Tannock Ian F. 
Published: October 2013

Abstract
Purpose: Limited drug distribution within solid tumors is an important cause of drug resistance. Basic drugs (e.g., doxorubicin) may be sequestered in acidic organelles, thereby limiting drug distribution to distal cells and diverting drugs from their target DNA. Here we investigate the effects of pantoprazole, a proton pump inhibitor, on doxorubicin uptake, and doxorubicin distribution and activity using in vitro and murine models.
Experimental Design: Murine EMT-6 and human MCF-7 cells were treated with pantoprazole to evaluate changes in endosomal pH using fluorescence spectroscopy, and uptake of doxorubicin using flow cytometry. Effects of pantoprazole on tissue penetration of doxorubicin were evaluated in multilayered cell cultures (MCC), and in solid tumors using immunohistochemistry. Effects of pantoprazole to influence tumor growth delay and toxicity because of doxorubicin were evaluated in mice.
Results: Pantoprazole (&gt;200 μmol/L) increased endosomal pH in cells, and also increased nuclear uptake of doxorubicin. Pretreatment with pantoprazole increased tissue penetration of doxorubicin in MCCs. Pantoprazole improved doxorubicin distribution from blood vessels in solid tumors. Pantoprazole given before doxorubicin led to increased growth delay when given as single or multiple doses to mice bearing MCF7 xenografts.
Conclusions: Use of pantoprazole to enhance the distribution and cytotoxicity of anticancer drugs in solid tumors might be a novel treatment strategy to improve their therapeutic index. Clin Cancer Res; 19(24); 6766–76. ©2013 AACR.
Evaluation and Clinical Analyses of Downstream Targets of the Akt Inhibitor GDC-0068
Authors: Yan Yibing , Serra Violeta , Prudkin Ludmila , Scaltriti Maurizio , Murli Sumati , Rodríguez Olga , Guzman Marta , Sampath Deepak , Nannini Michelle , Xiao Yuanyuan , Wagle Marie-Claire , Wu Jenny Q. , Wongchenko Matthew , Hampton Garret , Ramakrishnan Vanitha , Lackner Mark R. , Saura Cristina , Roda Desamparados , Cervantes Andrés , Tabernero Josep , Patel Premal , Baselga José 
Published: October 2013

Abstract
Purpose: The oncogenic PI3K/Akt/mTOR pathway is an attractive therapeutic target in cancer. However, it is unknown whether the pathway blockade required for tumor growth inhibition is clinically achievable. Therefore, we conducted pharmacodynamic studies with GDC-0068, an ATP competitive, selective Akt1/2/3 inhibitor, in preclinical models and in patients treated with this compound.
Experimental Design: We used a reverse phase protein array (RPPA) platform to identify a biomarker set indicative of Akt inhibition in cell lines and human-tumor xenografts, and correlated the degree of pathway inhibition with antitumor activity. Akt pathway activity was measured using this biomarker set in pre- and post-dose tumor biopsies from patients treated with GDC-0068 in the dose escalation clinical trial.
Results: The set of biomarkers of Akt inhibition is composed of 10 phosphoproteins, including Akt and PRAS40, and is modulated in a dose-dependent fashion, both in vitro and in vivo. In human-tumor xenografts, this dose dependency significantly correlated with tumor growth inhibition. Tumor biopsies from patients treated with GDC-0068 at clinically achievable doses attained a degree of biomarker inhibition that correlated with tumor growth inhibition in preclinical models. In these clinical samples, compensatory feedback activation of ERK and HER3 was observed, consistent with preclinical observations.
Conclusion: This study identified a set of biomarkers of Akt inhibition that can be used in the clinical setting to assess target engagement. Here, it was used to show that robust Akt inhibition in tumors from patients treated with GDC-0068 is achievable, supporting the clinical development of this compound in defined patient populations. Clin Cancer Res; 19(24); 6976–86. ©2013 AACR.
Enzalutamide for Treatment of Patients with Metastatic Castration-Resistant Prostate Cancer Who Have Previously Received Docetaxel: U.S. Food and Drug Administration Drug Approval Summary
Authors: Ning Yangmin M. , Pierce William , Maher V. Ellen , Karuri Stella , Tang Sheng-Hui , Chiu Haw-Jyh , Palmby Todd , Zirkelbach Jeanne Fourie , Marathe Dhananjay , Mehrotra Nitin , Liu Qi , Ghosh Debasis , Cottrell Christy L. , Leighton John , Sridhara Rajeshwari , Ibrahim Amna , Justice Robert , Pazdur Richard 
Published: October 2013

Abstract
This article summarizes the regulatory evaluation that led to the full approval of enzalutamide (XTANDI, Medivation Inc.) by the U.S. Food and Drug Administration (FDA) on August 31, 2012, for the treatment of patients with metastatic castration-resistant prostate cancer who have previously received docetaxel. This approval was based on the results of a randomized, placebo-controlled trial which randomly allocated 1,199 patients with mCRPC who had received prior docetaxel to receive either enzalutamide, 160 mg orally once daily (n = 800), or placebo (n = 399). All patients were required to continue androgen deprivation therapy. The primary endpoint was overall survival. At the prespecified interim analysis, a statistically significant improvement in overall survival was demonstrated for the enzalutamide arm compared with the placebo arm [HR = 0.63; 95% confidence interval: 0.53–0.75; P &lt; 0.0001]. The median overall survival durations were 18.4 months and 13.6 months in the enzalutamide and placebo arms, respectively. The most common adverse reactions (≥10%) included asthenia or fatigue, back pain, diarrhea, arthralgia, hot flush, peripheral edema, musculoskeletal pain, headache, and upper respiratory infection. Seizures occurred in 0.9% of patients on enzalutamide compared with no patients on the placebo arm. Overall, the FDA's review and analyses of the submitted data confirmed that enzalutamide had a favorable benefit–risk profile in the study patient population, thus supporting its use for the approved indication. The recommended dose is 160 mg of enzalutamide administered orally once daily. Enzalutamide represents the third product that the FDA has approved in the same disease setting within a period of 2 years. Clin Cancer Res; 19(22); 6067–73. ©2013 AACR.
Reprogramming Metabolism with Metformin Improves Tumor Oxygenation and Radiotherapy Response
Authors: Zannella Vanessa E. , Dal Pra Alan , Muaddi Hala , McKee Trevor D. , Stapleton Shawn , Sykes Jenna , Glicksman Rachel , Chaib Selim , Zamiara Paul , Milosevic Michael , Wouters Bradly G. , Bristow Robert G. , Koritzinsky Marianne 
Published: October 2013

Abstract
Purpose: Tumor hypoxia is a negative prognostic factor in multiple cancers, due in part to its role in causing resistance to radiotherapy. Hypoxia arises in tumor regions distal to blood vessels as oxygen is consumed by more proximal tumor cells. Reducing the rate of oxygen consumption is therefore a potential strategy to reduce tumor hypoxia. We hypothesized that the anti-diabetic drug metformin, which reduces oxygen consumption through inhibition of mitochondrial complex I, would improve radiation response by increasing tumor oxygenation.
Experimental Design: Tumor hypoxia was measured in xenografts before and after metformin treatment using 2-nitroimidazole hypoxia markers quantified by immunohistochemistry (IHC), flow cytometry, and positron emission tomography (PET) imaging. Radiation response was determined by tumor growth delay and clonogenic survival in xenografts with and without administration of metformin. The impact of metformin use on outcome was assessed in 504 patients with localized prostate cancer treated with curative-intent, image-guided radiotherapy (IGRT) from 1996 to 2012. Three-year biochemical relapse-free rates were assessed using the Kaplan–Meier method.
Results: Metformin treatment significantly improved tumor oxygenation in two xenograft models as measured by IHC, flow cytometry, and PET imaging. Metformin also led to improved radiotherapy responses when mice were administered metformin immediately before irradiation. Clinically, metformin use was associated with an independent and significant decrease in early biochemical relapse rates (P = 0.0106).
Conclusion: Our data demonstrate that metformin can improve tumor oxygenation and response to radiotherapy. Our study suggests that metformin may represent an effective and inexpensive means to improve radiotherapy outcome with an optimal therapeutic ratio. Clin Cancer Res; 19(24); 6741–50. ©2013 AACR.