tbuckley/cabot-search huggingface dataset:
Quality of Life and Burnout Rates Across Surgical Specialties
Authors: Marisa Pulcrano, Stephen R. T. Evans, Michael Sosin
Journal: JAMA Surgery (2016)

Establishing strategies to minimize the burden of burnout and poor quality of life (QOL) on surgeons relies on a thorough understanding of QOL and burnout among the various surgical specialties.To systematically review the literature across multiple surgical specialties and provide a comprehensive understanding of QOL and burnout among all surgeons, to delineate variation in rates of burnout and poor QOL, and to elucidate factors that are commonly implicated in these outcomes.An OVID electronic search encompassing MEDLINE, PsycInfo, and EMBASE was completed using the following MeSH search terms: quality of life, burnout, surgeon, surgical specialty, and United States. Full articles published in English from January 1, 1980, to June 10, 2015, that evaluated US surgical specialists and included more than 1 question related to QOL were included. Review articles and evaluations that included medical students or nonsurgical health care professionals were excluded. Of 1420 titles, 41 articles met these criteria. The standardized methodologic principles of PRISMA for reporting systematic reviews guided analysis. Primary end points were QOL scores and burnout rates that compared sex, age, level of training (resident vs attending), surgical specialty, and the type of assessment tool. Secondary outcomes included proposed work hours and income as factors contributing to burnout. Owing to the heterogeneity of data reporting among articles, qualitative analysis was also reported.Of the 16 specialties included, pediatric (86% to 96%) and endocrine (96%) surgeons demonstrated the highest career satisfaction, whereas a portion of plastic surgeons (33%) and vascular surgeons (64%) were least satisfied. The effect of sex was variable. Residents demonstrated a significantly higher risk for burnout than attending surgeons across multiple specialties, including obstetrics and gynecology, otolaryngology, and orthopedic surgery. One-third of the studies found hours worked per week to be a statistically significant predictor of burnout, decreased career satisfaction, and poorer QOL.Burnout and QOL vary across all surgical specialties. Whether sex affects burnout rates remains unclear. Residents are at an increased risk for burnout and more likely to report a poor QOL than attending surgeons.
The cancer imaging program quality framework at Cancer Care Ontario: The first five years.
Authors: Julian Dobranowski, Saul Melamed, Deanna Langer, Colleen Bedford
Journal: Journal of Clinical Oncology (2014)

244 Background: The Cancer Imaging Program (CIP) at Cancer Care Ontario was established in 2009 to improve the quality of cancer imaging in Ontario. Methods: After initial selection of a Provincial clinical lead in 2009, fourteen regional clinical leads were selected to represent all geographical regions of the province. Through a stakeholder survey and a priority setting process the following four high-level areas of priority emerged to support quality improvement of cancer imaging: (1) Developing and Fostering an Imaging Community of Practice, (2) Imaging Appropriateness, (3) Timely Access to Imaging, and (4) Standardized/Synoptic Reporting. Results: (1) An Imaging Community of Practice was established with the regional clinical leads, who participate in monthly meetings to build and strengthen inter-regional relationships and share information on regional activities and priorities; (2) Best practice standards for imaging in lung and colorectal cancer have been developed by consolidating and endorsing national and international guidelines. New imaging guidelines are being developed by the Program in Evidence-Based Care. Evidence-based recommendations being developed for focal tumour ablation procedures; (3) Three Interventional Radiology procedures (CT-guided lung biopsies, peripherally inserted central catheters and portacaths) have been selected for an ongoing wait time collection that captures monthly point-in-time data. The data has initiated discussions on appropriate benchmarks and identification of factors that may contribute wait times; and (4) Synoptic Radiology Reporting enables the collection of uniform and complete data to improve the information available to referring clinicians for diagnosis and treatment planning. Work is underway in the development of: implementation roadmap, evidence-based clinical checklists, infrastructure to store and share synoptic reports, and international standards for synoptic radiology reporting. Conclusions: The establishment of the CIP as a clinical program under a provincial cancer agency has enabled the development of an Imaging Community of Practice and allowed for work on provincial-wide initiatives that enable quality improvement of cancer imaging.
Variations in use and timing of hospice and palliative care: Differences across health care payers and cancer type.
Authors: Risha Gidwani, Nina Joyce, Bruce Kinosian, Cari Levy, Katherine E. Faricy-Anderson, Mary Ersek, Susan Miller, Vincent Mor
Journal: Journal of Clinical Oncology (2015)

132 Background: Cancer societies recommend cancer patients receive palliative care soon after diagnosis of illness and hospice for at least 3 days before death. While studies suggest receipt of hospice in the last 3 days of life is increasing for patients, the timing of first hospice and first palliative care is currently unknown. It is also not known whether fee-for-service versus capitated healthcare systems differ in their provision of supportive care. We evaluated the timing and frequency of palliative care and hospice use across the Department of Veterans Affairs (VA) and Medicare for dually-eligible Veterans, to understand variations in the use and timing of these services across healthcare systems for the same patient population. Methods: A retrospective evaluation of all VA and Medicare administrative data for the population of Veterans aged 65 or older who died with advanced cancer in 2012. Results: The majority of Veterans received supportive care before death: 67% received hospice and 69% received palliative care. On average, patients had 2 encounters with palliative care before death. Patients with melanoma were most likely to receive palliative care (82%); patients with hematologic malignancies were least likely to receive palliative care (58%). Veterans received VA-based hospice on average 35 days before death (SD = 42), while Veterans receiving Medicare-based hospice did so an average of 25 days before death (SD = 24). However, across both systems, 50% of Veterans were receiving hospice 16 days before death. There were substantial variations in timing of hospice enrollment by cancer type. Of Veterans receiving VA- or Medicare-based hospice, 22% cycled in and out of hospice, meaning they dis-enrolled and re-enrolled in such care. 16% of patients were discharged from hospice before death, with VA more likely to discharge Veterans before death compared with Medicare. Conclusions: There are large variations in healthcare system approaches to timing and use of hospice and palliative care, as well variations by cancer type. VA provides hospice to patients earlier in the disease trajectory, while Medicare is more likely to have patients die while enrolled in hospice.
Hsp90 Inhibitor Ganetespib Sensitizes Non–Small Cell Lung Cancer to Radiation but Has Variable Effects with Chemoradiation
Authors: Yifan Wang, Hui Liu, Lixia Diao, Adam Potter, Jianhu Zhang, Yawei Qiao, Jing Wang, David A. Proia, Ramesh Tailor, Ritsuko Komaki, Steven H. Lin
Journal: Clinical Cancer Research (2016)

HSP90 inhibition is well known to sensitize cancer cells to radiation. However, it is currently unknown whether additional radiosensitization could occur in the more clinically relevant setting of chemoradiation (CRT). We used the potent HSP90 inhibitor ganetespib to determine whether it can enhance CRT effects in NSCLC.We first performed in vitro experiments in various NSCLC cell lines combining radiation with or without ganetespib. Some of these experiments included clonogenic survival assay, DNA damage repair, and cell-cycle analysis, and reverse-phase protein array. We then determined whether chemotherapy affected ganetespib radiosensitization by adding carboplatin-paclitaxel to some of the in vitro and in vivo xenograft experiments.Ganetespib significantly reduced radiation clonogenic survival in a number of lung cancer cell lines, and attenuated DNA damage repair with irradiation. Radiation caused G2-M arrest that was greatly accentuated by ganetespib. Ganetespib with radiation also dose-dependently upregulated p21 and downregulated pRb levels that were not apparent with either drug or radiation alone. However, when carboplatin-paclitaxel was added, ganetespib was only able to radiosensitize some cell lines but not others. This variable in vitro CRT effect was confirmed in vivo using xenograft models.Ganetespib was able to potently sensitize a number of NSCLC cell lines to radiation but has variable effects when added to platinum-based doublet CRT. For optimal clinical translation, our data emphasize the importance of preclinical testing of drugs in the context of clinically relevant therapy combinations. Clin Cancer Res; 22(23); 5876-86. ©2016 AACR.
Treatment of the Immune-Related Adverse Effects of Immune Checkpoint Inhibitors
Authors: Claire F. Friedman, Tracy A. Proverbs-Singh, Michael A. Postow
Journal: JAMA Oncology (2016)

The development of immune checkpoint inhibitors targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1) has significantly improved the treatment of a variety of cancers and led to US Food and Drug Administration approvals for patients with a variety of malignant neoplasms. Immune checkpoint inhibitors enhance antitumor immunity by blocking negative regulators of T-cell function that exist both on immune cells and on tumor cells. Although these agents can lead to remarkable responses, their use can also be associated with unique immune-related adverse effects (irAEs).In general, use of PD-1 inhibitors such as nivolumab and pembrolizumab has a lower incidence of irAEs compared with those that block CTLA-4 such as ipilimumab. The combination of nivolumab and ipilimumab has a higher rate of irAEs than either approach as monotherapy. Consensus guidelines regarding the treatment of the most common irAEs including rash, colitis, hepatitis, endocrinopathies, and pneumonitis have been established. The mainstay of irAE treatment consists of immunosuppression with corticosteroids or other immunosuppressant agents such as infliximab; most irAEs will resolve with appropriate management.The clinical use of immune checkpoint inhibitors is expanding rapidly. Oncology practitioners will therefore be required to recognize and manage irAEs in a growing patient population. Early recognition and treatment are essential to prevent patient morbidity and mortality, and adherence to established algorithms is recommended.
Health Benefits of Smoking Cessation
Authors: R Mulcahy
Journal: JAMA (1990)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 19244: Correlation Between Epicardial Fat and Coronary Calcium Score in Patients With Type 1 Diabetes Mellitus
Authors: Angela G Bertaso, Ticiana C Rodrigues, Jorge L Gross, Juliano E Rolim, Paulo R Schvartzman, Murilo Foppa
Journal: Circulation (2010)

Background: Epicardial adipose tissue (EAT) is a visceral fat depot located under the visceral layer of the pericardium. Previous studies showed a role of EAT and development of coronary atheroscle...
p53 induces formation of NEAT1 lncRNA-containing paraspeckles that modulate replication stress response and chemosensitivity
Authors: Carmen Adriaens, Laura Standaert, Jasmine Barra, Mathilde Latil, Annelien Verfaillie, Peter Kalev, Bram Boeckx, Paul W G Wijnhoven, Enrico Radaelli, William Vermi, Eleonora Leucci, Gaëlle Lapouge, Benjamin Beck, Joost van den Oord, Shinichi Nakagawa, Tetsuro Hirose, Anna A Sablina, Diether Lambrechts, Stein Aerts, Cédric Blanpain, Jean-Christophe Marine
Journal: Nature Medicine (2016)
Returning research results to clinical trial participants: A survey of patients with cancer.
Authors: K. Elzinga, C. V. Fernandez, D. Y. C. Heng, P. A. Tang
Journal: Journal of Clinical Oncology (2011)

2611 Background: The disclosure of trial results (TR) in early stage breast cancer patients (pts) is not well characterized and there is a paucity of information regarding the attitudes of adult cancer pts with tumors in other sites. The purpose of this study was to determine the preferred method of sharing TR with clinical trial participants. Methods: A survey was given to cancer pts who participated in clinical trials at the Tom Baker Cancer Centre via mail (250) or during a clinic visit. Clinical trial participants provided demographic information and indicated their preferred mode of communication of TR, timing and attitudes regarding return of TR, and whether there is a difference of opinion if the clinical trial findings were positive or negative. Results: 146 clinical trial participants completed the survey (median age 59; 68% female; 94% Caucasian; 70% postsecondary education; type of cancer: breast n=84, prostate n=26, other n=36). The majority of patients were treated with adjuvant intent (82%) and had home internet access (92%). Most pts (92%) felt they had a right to receive results of the research they took part in. The preferred method of notification of positive TR was a letter (53%); internet website/email was acceptable in 22%. For negative TR, internet website/email and letter were acceptable in 10% and 31% respectively. Significantly more pts preferred a personal visit for negative TR (43%) compared to positive TR (18.4%) (p<0.0001). 43% of patients preferred a personal visit to a clinic or research lab to get negative results compared to only 18% of patients that receive positive results (p<0.0001). 86% of clinical trial participants would like to receive TR as soon as the study is accepted to be published or sooner. 66% of pts wanted their next of kin to be notified of TR in the event of the pt’s death. 51% of pts would be more likely to participate in a clinical trial if investigators provided TR. Conclusions: The vast majority of clinical trial participants felt that they had a right to receive TR and many viewed receipt of TR as an incentive to participate in clinical trials. Although most pts had internet access, the preferred notification mode was letter for positive TR and in person for negative TR.
Abstract 17211: Titin Mutations Cause Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Matthew Taylor, Sharon Graw, Carl Barnes, Dobromir Slavov, Francesca Brun, Bruno Pinamonti, Ernesto Salcedo, William Sauer, Stelios Pyxaras, Gianfranco Sinagra, Henk Granzier, Luisa Mestroni
Journal: Circulation (2010)

Purpose: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited myocardial disease characterized by fibrofatty replacement of the myocardium and a predisposition to cardiac arrh...
Oncologists' attitudes towards patient and family-centered care.
Authors: Timothy K. Nguyen, Glenn Bauman, Christoper J Watling, Karin Hahn
Journal: Journal of Clinical Oncology (2015)

111 Background: Patient and family-centered care (PFCC) represents an evolution from traditional models of provider-focused and patient-focused care that places a strong emphasis on optimal patient communication, patient autonomy, and shared decision-making within care teams. A shift towards PFCC requires participation across all provider groups. Despite the importance of physician buy-in, research examining physicians’ perspectives on PFCC is lacking. We sought to explore oncologists’ familiarity with the principles of PFCC and perceived barriers to implementing principles of PFCC. Methods: In this qualitative exploratory study, we conducted semi-structured interviews with 18 oncologists (8 radiation, 4 medical, 4 surgical, 2 hematologist-oncologists) at a single Canadian academic cancer institution. Interview data were analyzed using coding principles drawn from grounded theory. Constant comparisons were used to identify recurring themes. Results: We identified 3 dominant themes related to physicians’ interpretations of PFCC: 1) Physicians expressed a limited understanding of the formal principles of PFCC, 2) Physicians identified patient autonomy as essential to PFCC and 3) Disparities between patient and physician objectives exist and result in compromises that may affect the quality of PFCC delivered. Oncologists perceived that spending more time with patients improved PFCC, but also recognized that it would leave less time for other necessary activities. Participants also identified a number of ‘system’ barriers to PFCC, including limited staff and clinical space, excessive case load, a lack of physician support and input into operational decisions, and funding constraints. Many felt that PFCC was challenged by inefficiencies in the system of care delivery, and that progress might lie in reorganization to more clearly match health care staff’s roles and responsibilities to their credentials and skills. Conclusions: Advancing PFCC in our institution will require continued education of physicians regarding the principles of PFCC, acknowledgement and preservation of the PFCC behaviors already in practice and creative solutions to address the system issues that may hamper their abilities to enact PFCC.
Dihydropyrimidine Dehydrogenase Is a Prognostic Marker for Mesenchymal Stem Cell-Mediated Cytosine Deaminase Gene and 5-Fluorocytosine Prodrug Therapy for the Treatment of Recurrent Gliomas
Authors: Taemoon Chung, Juri Na, Young-il Kim, Da-Young Chang, Young Il Kim, Hyeonjin Kim, Ho Eun Moon, Keon Wook Kang, Dong Soo Lee, June-Key Chung, Sung-Soo Kim, Haeyoung Suh-Kim, Sun Ha Paek, Hyewon Youn
Journal: Theranostics (2016)

We investigated a therapeutic strategy for recurrent malignant gliomas using mesenchymal stem cells (MSC), expressing cytosine deaminase (CD), and prodrug 5-Fluorocytosine (5-FC) as a more specific and less toxic option. MSCs are emerging as a novel cell therapeutic agent with a cancer-targeting property, and CD is considered a promising enzyme in cancer gene therapy which can convert non-toxic 5-FC to toxic 5-Fluorouracil (5-FU). Therefore, use of prodrug 5-FC can minimize normal cell toxicity. Analyses of microarrays revealed that targeting DNA damage and its repair is a selectable option for gliomas after the standard chemo/radio-therapy. 5-FU is the most frequently used anti-cancer drug, which induces DNA breaks. Because dihydropyrimidine dehydrogenase (DPD) was reported to be involved in 5-FU metabolism to block DNA damage, we compared the survival rate with 5-FU treatment and the level of DPD expression in 15 different glioma cell lines. DPD-deficient cells showed higher sensitivity to 5-FU, and the regulation of DPD level by either siRNA or overexpression was directly related to the 5-FU sensitivity. For MSC/CD with 5-FC therapy, DPD-deficient cells such as U87MG, GBM28, and GBM37 showed higher sensitivity compared to DPD-high U373 cells. Effective inhibition of tumor growth was also observed in an orthotopic mouse model using DPD- deficient U87MG, indicating that DPD gene expression is indeed closely related to the efficacy of MSC/CD-mediated 5-FC therapy. Our results suggested that DPD can be used as a biomarker for selecting glioma patients who may possibly benefit from this therapy.
P-218 Survival in incidental gallbladder cancer treated with short-course radiotherapy after simple cholecystectomy without re-exploration, and evaluation of tumor biomarkers: The experience at The National Cancer Institute (México)
Authors: J. Zamora Moreno, E. Ruiz-Garcia, E. Mitsoura, G. Estrada, V. Aiello Crocifoglio
Journal: Annals of Oncology (2016)
Human Granulocytic Anaplasmosis and Lyme Disease—Reply
Authors: Yan Liu, Xue-jie Yu
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal