bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing and testing a measure to describe the quality of cancer MDT meetings
Authors: Taylor C , Atkins L , Richardson A , Ramirez A-J 
Published: May 2011

AbstractIntroduction and aimsCancer multidisciplinary teams (MDTs) aim to improve clinical outcomes, co-ordination of care and patient experience by including all relevant health professionals in discussions about individual patients. A central activity is thereby the MDT meeting (MDM) where cases are discussed and recommendations agreed. MDTs vary in performance according to national peer review data but no standardised measures of MDT effectiveness exist. We have developed an observational measure of MDM quality and conducted preliminary tests of its application.Methods13 key characteristics of MDM effectiveness within 4 domains were included: The Team; Infrastructure for meetings; Meeting organisation and logistics; and Clinical decision-making. Quality criteria were derived from literature review, observing MDMs and expert input. Inter-rater reliability and expert validity were tested and confirmed. A manual was developed describing each characteristic and the quality criteria (from ‘insufficient’ to ‘fully comprehensive’), and the measure was applied to 10 bowel MDTs.ResultsObservation was acceptable to teams and feasible to do within the restraints of a busy MDT meeting. Preliminary application demonstrated wide diversity in quality between teams across all four domains. A degree of internal consistency in quality within teams was evident. Teams were most likely to meet ‘fully comprehensive’ criteria in relation to administrative preparation and attendance at meetings; and least likely for patient-centredness of decision-making, presentation of minimum dataset and prioritisation of the agenda.ConclusionsPreliminary application suggests the measure may contribute to the assessment of MDT performance. Further testing to confirm the validity and reliability is required.
Defining the characteristics of effective MDT working in cancer care
Authors: Taylor C , Ramirez A-J 
Published: May 2011

AbstractIntroduction and aimsCancer multidisciplinary teams (MDTs) aim to improve clinical outcomes, co-ordination of care and patient experience by including all relevant health professionals in discussions about individual patients. MDTs vary in performance according to national peer review data. Defining the characteristics of effective MDT working is a necessary first step to address this. Due to the dearth of relevant evidence and to gain clinical engagement, we sought views from MDT members' regarding the characteristics of MDT effectiveness.MethodsAn on-line survey was conducted between January and March 2009. Invitations to participate were filtered to MDT members through cancer networks and by a link on the NCIN website. Subsequently a series of workshops with stakeholders developed findings into working definitions of the characteristics of an effective MDT.Results2054 MDT members responded to the survey, including representatives from all core professional groups, and most tumour types. Domains of MDT-working (including the team, infrastructure for meetings, organisation and logistics, patient-centred clinical decision-making and team governance) was agreed to be important for effective teamworking by most (78–99%) MDT members. At least 80% of members agreed with most (62/87) statements relating to these domains. Few differences in views by professional group or tumour type were evident. Findings were translated to ‘The characteristics of an effective MDT’ (NCAT, 2010).Conclusion‘The characteristics of an effective MDT’ provides a framework from which to facilitate teams to work optimally. A mechanism to self-assess against characteristics combined with the necessary support to facilitate change is now required.
COMPASS collaborative research Strand 3: Research into practice: implementing a complex psychoeducational intervention to promote early presentation in older women with breast cancer
Authors: Forbes L J L , Ramirez A J 
Published: May 2011

AbstractWomen over 70 have poorer breast cancer survival than younger women, largely due to later stage at diagnosis. Promoting early presentation (PEP) in women attending for final round of breast screening may reduce stage cost-effectively, and is unlikely to lead to overdiagnosis. We tested the radiographer-delivered PEP Intervention to promote early presentation by increasing breast cancer awareness in a randomised controlled trial. Delivered in a positive, motivational way, the intervention aims to equip older women with the knowledge, motivation and skills to present promptly to primary care with breast symptoms.In the trial, research radiographers delivered the intervention in a separate room after the mammogram, requiring considerable service reconfiguration. Training was intensive, and ongoing quality assurance involved performance feedback on videorecordings of interventions.At 2 years, the PEP Intervention increased the proportion of women breast cancer aware compared with usual care four-fold. The NHS Breast Screening Programme has now commissioned its implementation in three breast screening services. Early piloting showed that reconfiguring the service as extensively as in the trial was not sustainable. The training deterred some radiographers, and storing videorecordings for ongoing quality assurance was not feasible.We have, therefore, developed a shorter version of the PEP Intervention, delivered in the mammography room. Training is less intensive, and ongoing quality assurance will consist of direct observations and coaching as necessary. We will now measure feasibility of implementation and the effect on breast cancer awareness in routine practice. If implemented across the whole programme, the PEP Intervention has the potential to reduce avoidable deaths from delayed presentation in older women.
The UK breakthrough cancer pain registry: origin, methods and preliminary data
Authors: Ward J , Laird B , Fallon M 
Published: May 2011

AbstractIntroduction and aimsBreakthrough cancer pain (BTcP) is a debilitating element of cancer pain. Rapidly absorbed formulations of fentanyl, such as fentanyl sublingual tablets (FST, Abstral, proStrakan, Galashiels, UK), are well matched to the rapid onset and short duration of BTcP episodes. Only limited data are available on the use of such agents outside clinical trials. The UK BTcP Registry was initiated to record patients' and clinicians' experiences of titration and treatment with FST.MethodsThe UK BTcP Registry is an ongoing prospective, multi-centre programme. Any patient prescribed FST at a participating centre is eligible for inclusion. Patients and clinicians complete BTcP questionnaires at baseline and after successful titration or cessation of FST therapy; questions include disease history, analgesic use, pain response and medication preference. Questionnaire results are uploaded via a secure online system. The questionnaires and online system also provide clinicians with a method for ongoing monitoring of patients' experiences and outcomes.ResultsTo date, 33 patients have been recruited from 12 centres. In a preliminary analysis (n=31), patients experienced a mean of 4.9 BTcP episodes/day. 23/33 patients (70%) successfully titrated, and did so in a mean of 5.1 days; for 19/23 patients (83%), titration was easy/acceptable. Median pain relief was 70% with titrated FST, compared to 50% at baseline. 12/14 patients (86%) preferred FST to their previous medication.ConclusionThe UK BTcP Registry is a valuable developing resource, providing data on the effectiveness of FST (Abstral) outside of a clinical trial setting. It also provides a monitoring tool for front-line clinicians.
Evaluation of expressive writing as an intervention for patients following a mastectomy for breast cancer – a feasibility study
Authors: Pini S , Harley C , O'Connor D , Velikova G 
Published: May 2011

AbstractBackgroundBreast cancer and treatment can significantly affect bodily appearance. Older women are as likely as younger women to experience body dissatisfaction that is significantly related to poorer mental health. Despite this, the needs of older women for psychological support during cancer treatment remain under-studied.AimThis feasibility study investigated the efficacy and limitations of expressive writing as an intervention for body dissatisfaction following mastectomy for breast cancer.Methods32 women who had mastectomy for breast cancer in the last 5 years were randomised to intervention (expressive writing) or control (factual writing) arms. Both arms completed 3×20-min writing sessions. The intervention arm wrote about their deepest feelings regarding surgery and the impact this had on how they feel about their body. The control arm wrote about their daily activities. Patients completed quality of life assessments 2 weeks and 3 months post intervention and attended an exit interview at 3 months.ResultsAnalysis of the exit interviews showed that patients in the expressive writing group experienced a variety of benefits including; catharsis, reflection, expressing themselves anonymously and the facilitation of future discussions with friends, family and professionals. Negative experiences of the writing included; difficulties expressing emotions, ‘dredging up’ negative experiences and resistance to reflection.ConclusionsExpressive writing is low-cost intervention that may benefit patients experiencing body dissatisfaction following mastectomy. Patients felt the intervention would be well received at the end of treatment and would be suitable to a broad range of patients who may not typically use support or therapeutic services.
A tool to assess lay cancer carers' changing needs in general practice
Authors: Mitchell G K , Girgis A , Jiwa M , Sibbritt D , Burridge L H 
Published: May 2011

AbstractIntroduction/aimsNo General Practitioner (GP)-based tools exist for managing the multidimensional needs of lay carers of people with advanced cancer. This project aims to test a tool for carers to self-identify their needs, and manage them routinely with their GP.MethodsA Needs Assessment Tool for Carers (NAT:C) was tested in a randomised controlled trial. Intervention carers assessed their level of concern for 33 items spanning several domains of need, and identified a maximum of three to discuss at the consultation. Carers completed then discussed the NAT:C with their GP at baseline and 3 months, and their needs on both occasions were compared.ResultsAt November 2010, 54 carers had completed the NAT:C at baseline and 30 at 3 months. A mean of 14.1 (SD 6.4) concerns were identified at baseline, and 10.8 (SD 5.8) at 3 months. At the baseline consultation, a mean of three (median one) required immediate attention and 3.5 (SD 6.3) at a later time. At the 3 month consultation these decreased to 2.1 (median 0) immediate concerns and 1.1 (SD 2.7) for later attention. Caregiver fatigue, and anxiety about unexpected patient problems were the most common immediate concerns at baseline. Caregiver fatigue, planning for the unexpected and carers' own health needs were the most common at 3 months. Carers started to express a need to plan for the future.ConclusionCarers' focus of concern shifts from thinking about the patient's needs and onto their own needs and the future as the patient approaches death.
Description of fossil muskoxen and relative abundance of Pleistocene megafauna in central Alberta
Authors: Jass Christopher N. , Burns James A. , Milot Peter J. 
Published: May 2011

Significant work has gone into describing Ice Age faunas from Alberta, but relatively little work has been dedicated to understanding the actual structure of Quaternary faunal assemblages in the province. Development of such a data set is necessary to fully understand differences in faunal assemblages that existed before and after the last glacial maximum, and may eventually provide an important historical perspective for understanding the impact of large-scale ecosystem disturbance. Muskoxen fossils from central Alberta were examined to differentiate specimens of Bootherium and Ovibos . Those remains, along with other fossils of Pleistocene megafauna collected from gravel deposits near Edmonton, were used to examine patterns of relative abundance from both pre- and postglacial maximum time periods. Relative abundance for genera of Pleistocene megafauna was calculated using the number of individual specimens (NISP) from 11 individual localities (i.e., gravel pits) in central Alberta. Preglacial localities with statistically significant numbers of specimens (n ≥ 30) are dominated by horse ( Equus ). Mammoth ( Mammuthus ) and bison ( Bison ) are common, but other megafauna, such as Jefferson’s Ground Sloth ( Megalonyx jeffersoni ) and Yesterday’s Camel ( Camelops hesternus ), are comparatively rare. Current data for the postglacial fauna indicate a shift in which Bison becomes the most abundant large herbivore on the landscape, a pattern observed in other parts of North America.
Laterally extensive modified placer gold deposits in the Paleoproterozoic Mississagi Formation, Clement and Pardo Townships, Ontario
Authors: Long D.G.F. , Ulrich T. , Kamber B.S. 
Published: May 2011

Local gold concentrations are found in laterally extensive pyrite-bearing, framework-supported, cobble and boulder conglomerates in the basal 30 m of the Mississagi Formation in the south eastern part of the Huronian outcrop belt. These were deposited as part of a valley-fill succession, in shallow gravel-bed braided rivers with local hyperconcentrated flows. The basal contact with underlying Archean psammites is typically highly irregular and shows no obvious sign of weathering suggesting that deposition took place soon after retreat of the glaciers responsible for deposition of the Ramsey Lake Formation. Highest gold concentrations are associated with moderately well-sorted medium to large pebble conglomerate that show some signs of reworking during low flow events. Depositional elements are typically lenticular and of limited lateral extent. Unlike the older pyritic quartz-pebble conglomerates at the base of the Matinenda Formation in the Elliot Lake and Blind River areas, these conglomerates contain no uraninite and are polymict with material derived from a highly restricted catchment area with marked local and regional topographic relief. Porous detrital allogenic pyrite and euhedral post-depositional pyrite have overlapping, generally positive δ34S values, indicating a closed system during diagenesis and metamorphism. The presence of biotite-enriched rims on many of the metavolcanic and metasedimentary clasts in the conglomerates suggests that gold was partly leached from the allogenic pyrite grains at the peak of the Penokean Orogeny at 1.85–1.5 Ga. The potential source of the Au-bearing detrital allogenic pyrite appears to be an as yet undiscovered Archean volcanic-hosted massive sulfide (VHMS) deposit located 1 to 8 km north of the deposit.
A fission track transect across Nares Strait (Canada–Greenland): further evidence that the Wegener Fault is a myth
Authors: Hansen Kirsten , Dawes Peter R. , Frisch Thomas , Jensen Peter Klint 
Published: May 2011

Many workers continue to model Nares Strait between Greenland and Ellesmere Island, Canada, as a plate boundary and locus of major Cenozoic compression and strike-slip, marked by the postulated Wegener (transform) Fault. This, despite continuity of Precambrian–Paleozoic provinces across the seaway including an undeformed Neoproterozoic mafic dyke swarm that crosses at a high angle. As a test of the speculative plate kinematic modelling, apatite fission track (AFT) dating was undertaken along a transect across the Paleoproterozoic shield of Smith Sound, at the south end of Nares Strait, running from sea level to ca. 600 m elevation and as much as 70 km inland on both sides. The shield is overlain by three sedimentary basins separated by major hiatuses. The AFT ages fall into two groups: 282 ± 34 and 650 ± 51 Ma. They indicate maximum depth was >4 km in the lower Paleozoic from both coasts to 50 km inland, and at >50 km inland temperatures were below the annealing interval throughout Phanerozoic time. During the past ca. 280 million years, the rocks of both age groups suffered only minor displacements. The ages form an unbroken, harmonious pattern along the transect with no evidence of thermotectonism since the Permo-Carboniferous. These quantitative data support the field mapping that demonstrates Smith Sound and environs constitute an intact crustal block unaffected by lithospheric fracturing. Nares Strait is not the site of a plate boundary. The Wegener Fault does not exist.
Buried bedrock valleys and glacial and subglacial meltwater erosion in southern Ontario, Canada
Authors: Gao Cunhai 
Published: May 2011

Morphometric features from a recently compiled bedrock topography map by the Ontario Geological Survey suggest a glacial erosion origin for the buried large bedrock valleys and troughs in southern Ontario. The bedrock valleys at Milverton, Wingham and Mount Forest are tunnel valleys, resulting from subglacial meltwater erosion beneath the Huron ice lobe, probably during or shortly after the Late-Wisconsinan glacial maximum. Diagnostic features for this interpretation include abrupt valley beginning and termination, uneven longitudinal valley profiles and up-slope gradients. The Dundas bedrock valley is the western extension of the Lake Ontario Basin. No comparable bedrock valleys were found to connect it to the Milverton valley for a joint drainage system as previously suggested. The Laurentian bedrock trough is the southeastward extension of the Georgian Bay Basin, both developed along shale bedrock between the Precambrian shield highlands and the Niagara Escarpment, resulting from long-term mechanical weathering associated with Pleistocene glacial erosion. This bedrock low has a floor that exceeds 50 km in width and is 26 m and more below the current water level of Georgian Bay. It could drain Georgian Bay should the drift cover be removed. There is no evidence to suggest that a preglacial river channel, if it existed, is still preserved in the floor of the Laurentian trough as previously suggested. The framework for an intensely glacially sculpted bedrock surface differs from the previous view for simple modification of a preglacial landscape and is, therefore, important in regional subsurface geological mapping and groundwater studies.
STRATEGIC INNOVATION IN ESTABLISHED COMPANIES: AN EMPIRICAL STUDY OF APPROPRIATE AMBIDEXTERITY STRATEGIES
Authors: BERGHMAN LISELORE ANN 
Published: May 2011

As strategic innovation may lead to high revenue and profit growth a deeper understanding of any enabling organizational capabilities is highly relevant to both researchers and managers. Therefore, in this paper we focus on the concept of "ambidexterity". More specifically, we use a qualitative research in five Dutch industrial sectors to study the ambidexterity strategies that established firms use for their systematic creation of strategic innovations. We find that established companies have to cope with different ambidexterity frictions in the initiation and commercialization phases of strategic innovation projects. These results add to the emerging academic discussion on ambidexterity by showing that the appropriate ambidexterity approach may not only differ by innovation type but also by the specific phase of the innovation project. Our findings are also relevant to managerial practice as they suggest a limited value of isolated business development units for strategic innovation initiation.
ΔNp63 Versatilely Regulates a BroadNF-κBGene Program and Promotes Squamous Epithelial Proliferation, Migration, and Inflammation
Authors: Yang Xinping , Lu Hai , Yan Bin , Romano Rose-Anne , Bian Yansong , Friedman Jay , Duggal Praveen , Allen Clint , Chuang Ryan , Ehsanian Reza , Si Han , Sinha Satrajit , Van Waes Carter , Chen Zhong 
Published: May 2011

AbstractHead and neck squamous cell carcinoma (HNSCC) and many other epithelial malignancies exhibit increased proliferation, invasion, and inflammation, concomitant with aberrant nuclear activation of TP53 and NF-κB family members ΔNp63, cRel, and RelA. However, the mechanisms of cross-talk by which these transcription factors coordinate gene expression and the malignant phenotype remain elusive. In this study, we showed that ΔNp63 regulates a cohort of genes involved in cell growth, survival, adhesion, and inflammation, which substantially overlaps with the NF-κB transcriptome. ΔNp63 with cRel and/or RelA are recruited to form novel binding complexes on p63 or NF-κB/Rel sites of multitarget gene promoters. Overexpressed ΔNp63- or TNF-α–induced NF-κB and inflammatory cytokine interleukin-8 (IL-8) reporter activation depended on RelA/cRel regulatory binding sites. Depletion of RelA or ΔNp63 by small interfering RNA (siRNA) significantly inhibited NF-κB–specific, or TNF-α–induced IL-8 reporter activation. ΔNp63 siRNA significantly inhibited proliferation, survival, and migration by HNSCC cells in vitro. Consistent with these data, an increase in nuclear ΔNp63, accompanied by increased proliferation (Ki-67) and adhesion (β4 integrin) markers, and induced inflammatory cell infiltration was observed throughout HNSCC specimens, when compared with the basilar pattern of protein expression and minimal inflammation seen in nonmalignant mucosa. Furthermore, overexpression of ΔNp63α in squamous epithelial cells in transgenic mice leads to increased suprabasilar cRel, Ki-67, and cytokine expression, together with epidermal hyperplasia and diffuse inflammation, similar to HNSCC. Our study reveals ΔNp63 as a master transcription factor that, in coordination with NF-κB/Rels, orchestrates a broad gene program promoting epidermal hyperplasia, inflammation, and the malignant phenotype of HNSCC. Cancer Res; 71(10); 3688–700. ©2011 AACR.
Negotiation Process and Negotiation Context
Authors: Crump Larry 
Published: May 2011

AbstractThis article examines how external events grounded in a negotiation’s relevant environment (i.e., negotiation context) influence negotiation process and outcome. Multilateral, regional and bilateral environments are examined through linkage theory to gain understanding about the impact of external events or context on negotiation process and outcome. Linkages between a negotiation and its context are examined through five trade negotiations: the WTO Doha round (multilateral-global); the Free Trade Area of the Americas (multilateral-regional); EU‐Mercosur (bilateral-regional); EU‐Chile (bilateral); and US‐Chile (bilateral). In addition to developing greater understanding about the strategic relationship between a negotiation and its context this article establishes a theoretic framework that defines the known universe of linkage dynamics. The impact of multilateral environments on the regional negotiation process and outcome is of particular interest, as is the strategic use of bilateral environments in seeking to achieve multilateral geopolitical ends.
Conflict of Interest and Value: An Analysis of Negotiations between Taiwan and China, 1992‐1998
Authors: Li Chien-pin 
Published: May 2011

AbstractIn the 1990s, Taiwan and China conducted over twenty rounds of negotiations through the semi-official Strait Exchange Foundation (SEF) and the Association for Relations across the Taiwan Strait (ARATS) concerning the following issues: notarized papers, registered mail, illegal immigration, fishing disputes, airplane hijacking, and post-1997 shipping links between Taiwan and Hong Kong. Regrouping these issues into rights, law-and-order, and shipping, this study analyzes the differences in the negotiation processes and outcomes through variations of value-interest alignments and their perceived impact on future policy objectives.