BETHESDA, MD, United States
BETHESDA, MD, United States
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Yox S.,Medscape | Eckstein D.S.,Nova Research Company | Ousley A.,U.S. National Cancer Institute
Journal of Cancer Education | Year: 2010

Deficiencies in palliative and end-of-life care have been well documented by the Institute of Medicine. The National Cancer Institute (NCI), in partnership with Northwestern University, developed an educational curriculum for clinicians who deal with end-of-life issues, the Education in Palliative and End-of-Life Care for Oncology. A live meeting was held to distribute the curriculum to institutional leaders who could take it back to their organizations for broader distribution. To further distribute the materials and ensure they were available whenever a clinician wanted to view them, NCI collaborated with a leading online medical education provider whose websites are visited by over 1,500,000 physicians per month ( http://cme.medscape.com ) to post one module of the curriculum as an online activity certified for physician and nurse continuing education credit. The module is entitled "Last Hours of Living: Practical Advice for Clinicians." A descriptive analysis of the first 7 months of publication was performed. Twenty thousand sixty-one health professionals completed the activity during this time period and earned continuing education credit. Eighty-four percent completed the post-activity evaluation survey. Satisfaction was very high among participants, and many indicated their intention to incorporate new knowledge into practice. Collaboration with a commonly used online medical education provider such as Medscape is effective at broadly disseminating palliative care education to health professionals. © 2010 US Government.


Shavers V.L.,U.S. National Cancer Institute | Fagan P.,University of Hawaii Cancer Center | Jones D.,U.S. National Institute on Drug Abuse | Klein W.M.P.,U.S. National Cancer Institute | And 3 more authors.
American Journal of Public Health | Year: 2012

Objectives. We conducted a review to examine current literature on the effects of interpersonal and institutional racism and discrimination occurring within health care settings on the health care received by racial/ethnic minority patients. Methods. We searched the PsychNet, PubMed, and Scopus databases for articles on US populations published between January 1, 2008 and November 1, 2011. We used various combinations of the following search terms: discrimination, perceived discrimination, race, ethnicity, racism, institutional racism, stereotype, prejudice or bias, and health or health care. Fifty-eight articles were reviewed. Results. Patient perception of discriminatory treatment and implicit provider biases were the most frequently examined topics in health care settings. Few studies examined the overall prevalence of racial/ethnic discrimination and none examined temporal trends. In general, measures used were insufficient for examining the impact of interpersonal discrimination or institutional racism within health care settings on racial/ethnic disparities in health care. Conclusions. Better instrumentation, innovative methodology, and strategies are needed for identifying and tracking racial/ethnic discrimination in health care settings.


Freund K.M.,Boston University | Battaglia T.A.,University of Illinois at Chicago | Calhoun E.,University of Texas Health Science Center at San Antonio | Darnell J.S.,University of Texas Health Science Center at San Antonio | And 22 more authors.
Journal of the National Cancer Institute | Year: 2014

Background Patient navigation is a promising intervention to address cancer disparities but requires a multisite controlled trial to assess its effectiveness. Methods The Patient Navigation Research Program compared patient navigation with usual care on time to diagnosis or treatment for participants with breast, cervical, colorectal, or prostate screening abnormalities and/or cancers between 2007 and 2010. Patient navigators developed individualized strategies to address barriers to care, with the focus on preventing delays in care. To assess timeliness of diagnostic resolution, we conducted a meta-analysis of center-and cancer-specific adjusted hazard ratios (aHRs) comparing patient navigation vs usual care. To assess initiation of cancer therapy, we calculated a single aHR, pooling data across all centers and cancer types. We conducted a metaregression to evaluate variability across centers. All statistical tests were two-sided. Results The 10521 participants with abnormal screening tests and 2105 with a cancer or precancer diagnosis were predominantly from racial/ethnic minority groups (73%) and publically insured (40%) or uninsured (31%). There was no benefit during the first 90 days of care, but a benefit of navigation was seen from 91 to 365 days for both diagnostic resolution (aHR = 1.51; 95% confidence interval [CI] = 1.23 to 1.84; P <. 001)) and treatment initiation (aHR = 1.43; 95% CI = 1.10 to 1.86; P <. 007). Metaregression revealed that navigation had its greatest benefits within centers with the greatest delays in follow-up under usual care. Conclusions Patient navigation demonstrated a moderate benefit in improving timely cancer care. These results support adoption of patient navigation in settings that serve populations at risk of being lost to follow-up. © 2014 The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.


Ousley A.L.,U.S. National Cancer Institute | Swarz J.A.,U.S. National Cancer Institute | Milliken E.L.,Nova Research Company | Ellis S.,University of Massachusetts Donahue Institute
Journal of Cancer Education | Year: 2010

Education is the main avenue for disseminating new research findings into clinical practice. Understanding factors that affect translation of research into practice may help cancer educators design programs that facilitate the time it takes for research-indicated practices to become standard care. To understand various factors, the National Cancer Institute (NCI) Office of Education and Special Initiatives (OESI)1 with individual cooperation from Oncology Nursing Society (ONS), American Society of Clinical Oncology (ASCO), and Association of Oncology Social Work (AOSW) administered a Practitioner Information Needs survey to five different types of practitioners involved in cancer care. While most of the 2,864 practitioners (83%) agreed they had access to current practice information, practitioners in large practice settings were more likely to report having access to research than those small practice settings. However, only 33% indicated that they had adequate time to access the information. Colleagues or experts within the organization were cited as the most frequently relied on information resource (60%), and peerreviewed journals were cited as second (57%). Overall, 66% strongly or somewhat agreed that their organizations exhibit effective change management practices. A majority (69%) agreed that implementation of new practices is hindered by the lack of available staff time. Financial factors and the characteristics of the information presented were also believed to be factors contributing to research implementation. Group differences were observed among practitioner groups and practice settings for some factors. © US Government 2010.


Klabunde C.N.,U.S. National Cancer Institute | Willis G.B.,U.S. National Cancer Institute | McLeod C.C.,Nova Research Company | Dillman D.A.,Washington State University | And 3 more authors.
Evaluation and the Health Professions | Year: 2012

Because health care providers have a central role in implementing guidelines, health care reform, and new standards of care and technologies, surveying them about their practices and perspectives is vital for health services and policy research. In November 2010, the National Cancer Institute convened a workshop to review and discuss current methodologies in designing and fielding large-scale surveys of physicians and medical groups. This report summarizes key issues and future directions for four topic areas addressed in the workshop: sample frames for surveying physicians and medical groups; points of contact and response modes; response incentives; and questionnaire design and burden. Recommendations were made for improving sample frame databases, optimizing mixed-mode surveys, and studying use of incentives with gatekeepers and in medical group settings. There is particular need for empirical assessment of factors that motivate or impede participation of physicians, other types of clinicians, and medical groups in survey research. © The Author(s) 2012.


Franekova M.,University of Zilina | Vyrostko M.,University of Zilina | Luley P.,Nova Research Company
Advances in Electrical and Electronic Engineering | Year: 2013

The paper deals with the problem of determination of error probability of cryptography and safety codes used within the safety-related railway applications with increasing safety integrity level (SIL). In the paper are also described requirements for cryptographic block code and safety linear block code in safetyrelated communications for railway application. The main part is oriented to the description of mathematical apparatus for the error probability of the cryptography and safety block codes for communication between two safety-related devices across GSM-R communication channel. The practical results are related to the quantitative evaluation of an average error probability of the cryptography and safety codes for several lengths of safety-related messages which are expanded about determination of the cryptography degradation with using GMSK modulation scheme. © 2013 ADVANCES IN ELECTRICAL AND ELECTRONIC ENGINEERING.


Andrasik M.P.,Fred Hutchinson Cancer Research Center | Chandler C.,University of South Florida | Powell B.,HVTN Legacy Project | Humes D.,HVTN Legacy Project | And 3 more authors.
American Journal of Public Health | Year: 2014

Objectives. We obtained contextual information regarding documented barriers to HIV clinical trial participation among Black men who have sex with men (MSM), and explored current preventive HIV clinical trial attitudes, beliefs, and perceptions among Black MSM leaders in the United States. Methods. We conducted 2 focus groups with Black MSM leaders attending an annual African American MSM Leadership Conference on HIV/AIDS. Focus group questions explored biomedical research perceptions and attitudes, barriers to participation in biomedical prevention research, and steps that need to be taken to address these barriers. A feedback and member checking (participants presented with final themes to provide feedback and guidance) session was also held at the 2012 conference. Results. Three distinct themes emerged regarding Black MSM engagement and participation in HIV vaccine research: (1) community-based organizations as true partners, (2) investment in the Black gay community, and (3) true efforts to inform and educate the community. Conclusions. A key focus for improving efforts to engage the Black MSM community in preventive HIV clinical trials is building and maintaining equitable and reciprocal partnerships among research institutions, Black-led AIDS service organizations and community-based organizations, and community members.


McLeod C.C.,Nova Research Company | Klabunde C.N.,National Cancer Institute | Willis G.B.,National Cancer Institute | Stark D.,Nova Research Company
Evaluation and the Health Professions | Year: 2013

Surveys of health care providers (e.g., physicians and other health care professionals) are an important tool for assessing health care practices and the settings in which care is delivered. Although multiple methods are used to increase survey data quality, little is known about which methods are most commonly implemented. We reviewed 117 large surveys described in literature published between 2000 and 2010, examining descriptions of survey design features, survey implementation, and response rates. Despite wide variation, the typical provider survey selected practicing physicians as respondents, used the American Medical Association Masterfile as sample frame, included mail as both mode of initial contact and questionnaire administration mode, and offered monetary incentives to respondents. Our review revealed inconsistency of documentation concerning procedures used, and a variety of response rate calculation methods, such that it was difficult to determine practices that maximize response rate. We recommend that reports provide more comprehensive documentation concerning key methodological features to improve assessment of survey data quality. © The Author(s) 2012.


Franko M.,Nova Research Company | Kuchta J.,Nova Research Company | Buday J.,Nova Research Company
SPEEDAM 2012 - 21st International Symposium on Power Electronics, Electrical Drives, Automation and Motion | Year: 2012

The paper deals with the design of permanent magnet synchronous traction motor (PMSM) that was based on volume and stator windings of asynchronous traction motor with an output power 210 kW. The proposed PMSM was built with permanent magnets (PM) placed on the surface of the rotor. There will be described the basic parameters as well as analytical analysis of losses in the machine, with emphasis on losses in PM, that depend on the size of PM and they may form a significant component of loss in the paper. In the paper will be also described the results of measurements realized on PMSM with rotor made in the initial versions of the rotor and three other modifications realized on the built rotor and their experimental verification and valuation in comparison with the theoretical knowledge. Finally they will be compared to the parameters of asynchronous traction motor (ATM) and PMSM with recommendations for mass production of the PMSM for applications in the traction vehicle. © 2012 IEEE.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 150.00K | Year: 2014

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