Medicine and Health Sciences Commons^™

Factors Influencing Family Burden In Pediatric Hematology/Oncology Encounters, Hannah R. Abrams, Hayden S. Leeds, Heidi V. Russell, Melody B. Hellsten

Journal of Patient-Centered Research and Reviews

Purpose: Caring for a child with cancer or hematologic disease places unique stress on a family unit. Families’ subjective experience of this care-related burden mediates the relationship between cost and health-related outcomes. While financial costs are well described for families of pediatric hematology/oncology patients, it is unclear how cost and other factors each contribute to families’ overall experience of care-related burden. This study identifies and groups the challenges that families report and describes their association with overall reported burden.

Methods: This mixed-methods analysis of a cross-sectional single-center study was conducted via structured, self-administered questionnaire provided to inpatient and outpatient caregivers …

Expanded Access (Compassionate Use) For Investigational Drugs Or Biologics, Lukas Gilmore

Parkview Pharmacy Department

A presentation given at the Parkview Cancer Institute (PCI) Oncology Research Committee meeting in October 22, 2019.

Investigational Drug Service Department of Parkview Health

Pharmacologic And Nonpharmacologic Approaches To Palliative Care In Oncology, Daniel Powell, Sunitha Johns, Samia Alam, Isabel E. Cwikla, Brendan Rasor, David W. Koh

Pharmacy and Wellness Review

In recent decades, few fields have changed as drastically as oncology. A wide variety of approaches must be taken in order to best care for cancer patients. With the globalization of health care and modern society, nontraditional management of cancer symptoms is once again increasing in popularity. The National Comprehensive Cancer Network (NCCN) has also recently updated their palliative care guidelines. These guidelines provide a detailed approach for the care of a wide range of cancer patients but largely focus on traditional pharmacotherapy. An increasing number of studies are being conducted on nonpharmacologic approaches to care for patients with cancer. …

Occupational Therapy’S Role In Oncology: Returning To Work During And After Treatment, Annamarie Scheidell, Otas, Stephanie Sloane, Bs, Ms, Otas, Sara Loesche, Ms, Otr/L, Cht

School of Continuing and Professional Studies Posters

Medical advances have improved the five-year survival rate for patients diagnosed with cancer and some late-stage cancers that once were terminal have now become manageable, chronic conditions. Because of this, more individuals with cancer as well as survivors of cancer are re-entering the workforce. Resuming the role of worker is considered an important step in recovery for many. Occupational therapy (OT) can play an important role in facilitating a successful transition back to work for both cancer patients and survivors.

Resilience And Quality Of Life (Qol) Of Head And Neck Cancer And Brain Tumour Survivors In Pakistan: An Analytical Cross-Sectional Study Protocol, Nida Zahid, Wardah Khalid, Khabir Ahmad, Shireen Shehzad, Iqbal Azam Syed, Nargis Asad, Adnan Jabbar, Mumtaz J Khan, Ather Enam

Department of Surgery

Background: Cancer is a devastating disease and has detrimental effects on the quality of life (QoL) of cancer survivors and interferes with their treatment compliance. The aim of the study is to assess resilience and QoL among cancer survivors and to evaluate the important factors affecting their resilience and QoL, with respect to the Pakistani cultural context.
Method and Analysis: A cross-sectional study will be conducted at a tertiary care hospital in Karachi, Pakistan. A minimum sample size of 250 head and neck cancers and 250 brain tumour survivors with 10% inflation for non-response rate will be required. The SD …

Slc36a1-Mtorc1 Signaling Drives Acquired Resistance To Cdk4/6 Inhibitors., Akihiro Yoshida, Yiwen Bu, Shuo Qie, John Wrangle, E. Ramsay Camp, E. Starr Hazard, Gary Hardiman, Renée De Leeuw, Karen E. Knudsen, J. Alan Diehl

Department of Cancer Biology Faculty Papers

The cyclin-dependent kinase 4/6 (CDK4/6) kinase is dysregulated in melanoma, highlighting it as a potential therapeutic target. CDK4/6 inhibitors are being evaluated in trials for melanoma and additional cancers. While beneficial, resistance to therapy is a concern, and the molecular mechanisms of such resistance remain undefined. We demonstrate that reactivation of mammalian target of rapamycin 1 (mTORC1) signaling through increased expression of the amino acid transporter, solute carrier family 36 member 1 (SLC36A1), drives resistance to CDK4/6 inhibitors. Increased expression of SLC36A1 reflects two distinct mechanisms: (i) Rb loss, which drives SLC36A1 via reduced suppression of E2f; (ii) fragile X …

Impact Of Palliative Care Consultation On End Of Life Care Measures: A Retrospective Analysis Of Patients In The Oncology Care Model, Alison Greidinger, Md, Maria Vershvovsky, Md, Evan Lapinsky, Md, Alison Rhoades, Md, Amy Leader, Drph, Vittorio Maio, Pharmd, Jared Minetola, Karen Walsh, Ms, Mba, Valerie Csik, Mph, Cpps, Ruben Rhoades, Md

Department of Medical Oncology Posters

Introduction

• In 2016 ASCO recommended that patients with advanced cancer receive dedicated palliative care (PC) services1. Early PC involvement is associated with lower spending, fewer 30-day readmission rates, decreased chemotherapy administration at the end of life (EOL) and increased hospice referrals2.
• Many patients are not referred and continue to receive chemotherapy and utilize high-acuity services near the EOL.
• The Oncology Care Model (OCM) is a CMS episode-based alternative payment model promoting high-value care.
• We evaluated the effect of PC visits on EOL outcomes including code status (CS) and spending in the last 30 days of life.

Prospectus For Creating A Nurse Suggestive Acuity-Based Staffing Model In Ambulatory Infusion Settings To Improve Patient Safety And Quality Of Care, Yongli Qiu

Master's Projects and Capstones

Due to the lack of reliable and valid infusion nurse suggestive acuity-based staffing model, ambulatory infusion settings are burden with potentially compromised patient safety, poor quality of patient care with over-scheduling of unexpected complex patients, limited resources related to nurses and infusion chairs, the dissatisfaction of patients and family members, and infusion nurses’ burn out. This project seeks to determine the appropriate nurse to patient acuity-based point ratio in staffing and scheduling factors that influence nurse staffing model, and established nurse staffing strategies. This three-month project was conducted with the infusion nurses, a nurse manager, a nurse supervisor, an assistant …

Retrospective Evaluation Of Weight Loss In Maine Medical Center Cancer Institute (Mmcci) Patients Receiving Radiation Treatment For Head And Neck Cancer, Julian Johnson, David Debartolo-Stone, Jessica Moore, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operations Transformation

Treatment for head and neck cancer often results in weight loss as a side effect. One option to mitigate this weight loss is placement of a percutaneous endoscopic gastrostomy (PEG) tube placement. Radiation oncologists at a academic tertiary medical center discuss the option of PEG placement during patient consultation.

A retrospective evaluation of weight loss in patients receiving radiation was conducted over a two-year period. The goal of this data collection was to create a standard for oncology consultations regarding PEG tube placement.

Baseline metrics and a root cause analysis drove subsequent data collection steps. After analyzing the raw data, …

Peer Support For The Maintenance Of Physical Activity And Health In Cancer Survivors: The Peer Trial - A Study Protocol Of A Randomised Controlled Trial, Kirsten N. Adlard, David G. Jenkins, Chloe E. Salisbury, Kate A. Bolam, Sjaan R. Gomersall, Joanne F. Aitken, Suzanne K. Chambers, Jeff C. Dunn, Kerry S. Courneya, Tina L. Skinner

Research outputs 2014 to 2021

BACKGROUND: Despite an overwhelming body of evidence showing the benefits of physical activity (PA) and exercise for cancer survivors, few survivors meet the exercise oncology guidelines. Moreover, initiating, let alone maintaining exercise programs with cancer survivors continues to have limited success. The aim of this trial is to evaluate the influence of peer support on moderate-to-vigorous PA (MVPA) and various markers of health 12 months following a brief supervised exercise intervention in cancer survivors.

METHODS: Men and women previously diagnosed with histologically-confirmed breast, colorectal or prostate cancer (n = 226), who are >1-month post-treatment, will be invited to participate in …

A New Era For Real-World Evidence, Neal J. Meropol, Md

College of Population Health Forum

This presentation will use cancer therapeutic development as a use case for exploring the emerging role of real-world evidence. The current availability of electronic health records with rich information about patients gathered during their routine care is rapidly changing the landscape of evidence generation in medicine. Recent advances have accelerated the introduction of new diagnostics and treatments into clinical practice.

Learning Objectives:

1. Understand potential sources of real-world data for use in evidence generation to guide drug development and patient care.
2. Describe the opportunities and limitations of observational research using real-world data derived from electronic health records.
3. Review examples of real-world …

Trauma-Injury Severity Score Versus Acute Physiology And Chronic Health Evaluation Iv Score In Predicting Mortality, Ayman A. Albatanony, Mohammed N. Nassar, Moharam A. Abd Elshaheed, Mona Km Mesrega

Menoufia Medical Journal

Objective The objective of this study was to compare the performances of Trauma-Injury Severity Score (TRISS) and Acute Physiology and Chronic Health Evaluation (APACHE) IV in predicting mortality of seriously injured patients with polytrauma. Background Several scoring systems have been developed to evaluate trauma outcomes. The TRISS and APACHE IV are commonly used to predict injury severity and the risk of mortality. Patients and methods The study was conducted on 100 of seriously injured patients with polytrauma attending the Emergency Department of the Menoufia University Hospital from 2016 to 2017. The required variables for calculating the two scores were recorded. …

Pilot Implementation Of A Comprehensive Pain Assessment In An Oncology Clinic, Lauren Botta

Doctor of Nursing Practice Final Manuscripts

Purpose/Aims: This project implemented an algorithmic approach to assess pain, functionality, and psychosocial states in newly diagnosed cancer patients. This was accomplished through utilization of a validated pain assessment tool. The tool’s purpose was to identify high-risk patients for Emergency Department (ED) visits or unanticipated hospital admissions (UHA), within a second-year fellow Hematology/Oncology clinic.

Primary aims included: (a) aggregating demographic data to determine the profile of a high-risk patient seen within this clinic, (b) determining those referred to and who followed up with symptom specialists or the ED, and (c) identifying barriers for the next iteration of the project. …

Considering Art Therapy For Adults With Fear Of Cancer Recurrence (Fcr): A Literature Review, Max Roberts

Expressive Therapies Capstone Theses

Fear of cancer recurrence (FCR) is a major problem for many cancer survivors. As cancer treatments improve and more people are surviving cancer, FCR will likely become a larger problem in general for the healthcare system. Art therapists working with cancer survivors need to be prepared for addressing FCR as they are likely to encounter this clinical issue. A literature search was conducted and no research investigating art therapy specifically for FCR was found, indicating there is currently no empirically supported approach to art therapy for FCR. Mindfulness and acceptance-based therapies appear to be efficacious for reducing effects of FCR. …

Understanding The Skills Necessary For Advanced Practice Nurses In Oncology To Deliver Bad News To Patients With Cancer: The Results Of A Delphi Analysis, Matthew Michael Burke

Doctoral Projects

Overcoming the dichotomy of providing bad news in a compassionate, empathetic manner that strengthens dialogue and enhances a caring environment is the ultimate challenge advanced practice nurses (APN) face in oncology. This study aims to understand the skills necessary for APNs in oncology to deliver bad news to patients with cancer.

Using a Delphi analysis, an established method of developing a consensus, a novel, patient-centered survey tool has been developed designed to extract as much information as possible about the present issue from an expert panel. Oncology APNs were recruited via Facebook. The survey tool was administered using a web-based …

The Relationship Between Uncertainty Tolerance And Oncologists’ Perceptions Of Large-Panel Genomic Tumor Testing, Eric Anderson, Alexandra Hinton, Christine Lary, Kimberly Murray, Leo Waterson, Paul Han, Maine Cancer Genomics Initiative

MaineHealth Maine Medical Center

Introduction:

Large-panel genomic tumor testing (GTT) is a new technology that promises to make cancer treatment more precise, but that currently poses many uncertainties regarding its clinical value and appropriate use. Uncertainty Tolerance (UT), a psychological construct that describes trait-level differences in individuals’ responses to uncertainty, may influence oncologists’ perceptions and attitudes regarding GTT.

Effects Of Vitamin D3 And Its Chemical Analogs On The Growth Of Hodgkin’S Lymphoma, In Vitro, Rajendra Ghardbaran, Bo Zhang, Luis Valerio, Onyekwere Onwumere, Madeline Wong, Jason Mighty, Stephen Redenti

Publications and Research

Objective: Vitamin D receptor (VDR) activities have been noted for a number of B cell malignancies which showed varying sensitivities to vitamin D3 (1,25-dihydroxyvitamin D3, VD3, calcitriol) and its synthetic analogs. The objective of this study was to address the potential effects of VD3 and vitamin D3 analogs (VDAs) on the growth of Hodgkin’s lymphoma (HL), a malignant pathology of B cell origin, in vitro.

Results: Immunofluorescence staining showed the expression of VDR by primary Hodgkin’s (H) and Reed–Sternberg (RS)—HRS-tumor cells in HL histological sections. Western blot analyses revealed expression of VDR in the HL cell lines Hs445, HDLM2, KMH2, …

Evidence-Based Toolkit To Evaluate Telemedicine Delivery Of Palliative Care, Aubrey E. Dwyer

Doctoral Projects

Advances in healthcare have led to many individuals with cancer to live longer, however the quality of life of these individuals has decreased. Palliative care is a medical sub-specialty that can assist to care for individuals with a life-limiting illness such as cancer. However, the access to palliative care services in rural communities is limited. According to the Institute of Medicine (IOM) report Dying in America, increasing access to palliative care will not only enhance the quality of life for patients with a life-limiting illness, but also contribute to a more sustainable healthcare system. The key stakeholders within a Midwest …

Management Of Distress In Adult Oncology Patients, Lauren Jongsma

Doctoral Projects

Cancer related distress has the potential to negatively impact the health of the patient and their treatment outcome (Grassi, Spiegel, & Riba, 2017). As identification and treatment of distress has a positive impact on patient outcomes; the Commission on Cancer (2016) required distress screening for accreditation. Key stakeholders within a Midwest hospital system expressed a desire for the improvement in the current state of the distress screening. Thus, the scholarly paper describes the key attributes of the organizational assessment, a literature review on evidence-based distress screening tool and a quality improvement project. The Promoting Action on Research Implementation in Health …

Health Effects Of A Vegan Diet And Pediatric Cancer Prevention, Lindsay Wisehart

Senior Honors Theses

Veganism is a diet which excludes consumption of all animal products. With proper planning and vitamin supplementation to ensure adequate intake of protein, fat, calcium, zinc, iron, and vitamins D and B12, a vegan diet is widely accepted as suitable for growing and developing children. The decreased levels of dairy, red and processed meats, fat, and protein, and increased levels of fruits and vegetables characteristic of a vegan diet have been shown to reduce risk of mortality and a number of diseases including adult and childhood cancer. Childhood cancer is the second leading cause of childhood death in Western society. …

Quality Of Life And Psychological Distress In Cancer Survivors: The Role Of Psycho-Social Resources For Resilience, Craig A. Harms, Lynne Cohen, Julie Ann Pooley, Suzanne K. Chambers, Daniel A. Galvao, Robert U. Newton

Research outputs 2014 to 2021

OBJECTIVE: To examine the association between scores on the Protective Factors for Resilience Scale (PFRS) (as a measure of a person's psycho-social resources for resilience) and quality of life as well as symptoms of psychological distress for adult cancer survivors.

METHODS: In this cross-sectional study, 295 cancer survivors (59% female) provided background demographic information and completed the PFRS as well as measures of quality of life and psychological distress previously validated with cancer survivors. Most of the survivors were diagnosed with breast or prostate cancer.

RESULTS: Analysis of the data confirmed the factor structure for the PFRS …

Coordinating An Oncology Precision Medicine Clinic Within An Integrated Health System: Lessons Learned In Year One, Michael A. Thompson, Jennifer J. Godden, Deborah Wham, Antony Ruggeri, Michael P. Mullane, Amanda Wilson, Shamsuddin Virani, Scott M. Weissman, Brenda Ramczyk, Pamela Vanderwall, James L. Weese

Journal of Patient-Centered Research and Reviews

Precision medicine is a term describing strategies to promote health and prevent and treat disease based on an individual’s genetic, molecular, and lifestyle characteristics. Oncology precision medicine (OPM) is a cancer treatment approach targeting cancer-specific genetic and molecular alterations. Implementation of an OPM clinical program optimally involves the support and collaboration of multiple departments, including administration, medical oncology, pathology, interventional radiology, genetics, research, and informatics. In this review, we briefly introduce the published evidence regarding OPM’s potential effect on patient outcomes and discuss what we have learned over the first year of operating an OPM program within an integrated health …

The Oncology Care Model: Oncology's First Foray Away From Volume And Toward Value-Based Care., Andrew Song, Valerie P. Csik, Amy Leader, Vittorio Maio

Department of Radiation Oncology Faculty Papers

No abstract provided.

The Potential Therapeutic Effects Of Creatine Supplementation On Body Composition And Muscle Function In Cancer, C M. Fairman, K L. Kendall, Nicolas H. Hart, D R. Taaffe, D A. Galvao, R U. Newton

Health Sciences Papers and Journal Articles

Low muscle mass in individuals with cancer has a profound impact on quality of life and independence and is associated with greater treatment toxicity and poorer prognosis. Exercise interventions are regularly being investigated as a means to ameliorate treatment-related adverse effects, and nutritional/supplementation strategies to augment adaptations to exercise are highly valuable. Creatine (Cr) is a naturally-occurring substance in the human body that plays a critical role in energy provision during muscle contraction. Given the beneficial effects of Cr supplementation on lean body mass, strength, and physical function in a variety of clinical populations, there is therapeutic potential in individuals …

Patient-Centered Medical Homes In Community Oncology Practices: Changes In Spending And Care Quality Associated With The Come Home Experience, Teresa M. Waters, Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, Barbara L. Mcaneny

Health Management and Policy Faculty Publications

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for …

Overall Survival And Histology-Specific Subgroup Analyses From A Phase 3, Randomized Controlled Study Of Trabectedin Or Dacarbazine In Patients With Advanced Liposarcoma Or Leiomyosarcoma, S. Patel, M. Von Mehren, D. R. Reed, P. Kaiser, J. Charlson, C. W. Ryan, D. Rushing, M. Livingston, R. G. Maki, G. D. Demetri, +10 Additional Authors

Journal Articles

No abstract provided.

Probabilistic Modeling Of Personalized Drug Combinations From Integrated Chemical Screen And Molecular Data In Sarcoma, N. E. Berlow, R. Rikhi, M. Geltzeiler, J. Abraham, M. N. Svalina, L. E. Davis, E. Wise, M. Mancini, R. G. Maki, C. Keller, +19 Additional Authors

Journal Articles

No abstract provided.

A Phase 1 And Randomized Controlled Phase 2 Trial Of The Safety And Efficacy Of The Combination Of Gemcitabine And Docetaxel With Ontuxizumab (Morab-004) In Metastatic Soft-Tissue Sarcomas, R. L. Jones, S. P. Chawla, S. Attia, P. Schoffski, H. Gelderblom, B. Chmielowski, A. Le Cesne, B. A. Van Tine, J. C. Trent, R. G. Maki, +7 Additional Authors

Journal Articles

No abstract provided.

Eribulin Versus Dacarbazine In Patients With Leiomyosarcoma: Subgroup Analysis From A Phase 3, Open-Label, Randomised Study, J. Blay, P. Schoffski, S. Bauer, A. Krarup-Hansen, C. Benson, D. R. D'Adamo, Y. Jia, R. G. Maki

Journal Articles

No abstract provided.

Challenges And Inconsistencies In Using Lysophosphatidic Acid As A Biomarker For Ovarian Cancer, T. Yagi, M. Shoaib, C. E. Kuschner, M. Nishikimi, B. Becker, Z. T. Lee, J. Kim

Journal Articles

No abstract provided.