3103 research outputs found
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Children\u27s Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy With Chemotherapy for Newly Diagnosed Average-Risk Medulloblastoma
No full textPURPOSE: Children with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume. METHODS: ACNS0331 (ClinicalTrials.gov identifier: NCT00085735) randomly assigned patients age 3-21 years with average-risk MB to receive posterior fossa radiation therapy (PFRT) or involved field radiation therapy (IFRT) following CSI. Young children (3-7 years) were also randomly assigned to receive standard-dose CSI (SDCSI; 23.4 Gy) or low-dose CSI (LDCSI; 18 Gy). Post hoc molecular classification and mutational analysis contextualized outcomes according to known biologic subgroups (Wingless, Sonic Hedgehog, group 3, and group 4) and genetic biomarkers. Neurocognitive changes and ototoxicity were monitored over time. RESULTS: Five hundred forty-nine patients were enrolled on study, of which 464 were eligible and evaluable to compare PFRT versus IFRT and 226 for SDCSI versus LDCSI. The five-year event-free survival (EFS) was 82.5% (95% CI, 77.2 to 87.8) and 80.5% (95% CI, 75.2 to 85.8) for the IFRT and PFRT regimens, respectively, and 71.4% (95% CI, 62.8 to 80) and 82.9% (95% CI, 75.6 to 90.2) for the LDCSI and SDCSI regimens, respectively. IFRT was not inferior to PFRT (hazard ratio, 0.97; 94% upper CI, 1.32). LDCSI was inferior to SDCSI (hazard ratio, 1.67%; 80% upper CI, 2.10). Improved EFS was observed in patients with Sonic Hedgehog MB who were randomly assigned to the IFRT arm (P = .018). Patients with group 4 MB receiving LDCSI exhibited inferior EFS (P = .047). Children receiving SDCSI exhibited greater late declines in IQ (estimate = 5.87; P = .021). CONCLUSION: Reducing the radiation boost volume in average-risk MB is safe and does not compromise survival. Reducing CSI dose in young children with average-risk MB results in inferior outcomes, possibly in a subgroup-dependent manner, but is associated with better neurocognitive outcome. Molecularly informed patient selection warrants further exploration for children with MB to be considered for late-effect sparing approaches
Euphemistic processes on the MDA Show of Strength Telethon, 2012-2014: The post-Jerry Lewis years
No full textDifferent microfluidic environments for in vitro testing of lipid nanoparticles against osteosarcoma
No full textThe use of lipid nanoparticles as biodegradable shells for controlled drug delivery shows promise as a more effective and targeted tumor treatment than traditional treatment methods. Although the combination of target therapy with nanotechnology created new hope for cancer treatment, methodological issues during in vitro validation of nanovehicles slowed their application. In the current work, the effect of methotrexate (MTX) encapsulated in different matrices was evaluated in a dynamic microfluidic platform. Effects on the viability of osteosarcoma cells in the presence of recirculation of cell media, free MTX and two types of blank and drug-containing nanoparticles were successfully assessed in different tumor-mimicking microenvironments. Encapsulated MTX was more effective than the equal dose free drug treatment, as cell death significantly increased under the recirculation of both types of drug-loaded nanoparticles in all concentrations. In fact, MTX-nanoparticles reduced cell population 50 times more than the free drug when 150-µM drug dose was recirculated. Moreover, when compared to the equivalent free drug dose recirculation, cell number was reduced 60 and 100 points more under recirculation of each nanoparticle with a 15-µM drug concentration. Thus, the results obtained with the microfluidic model present MTX-lipid nanoparticles as a promising and more effective therapy for pediatric osteosarcoma treatment than current treatment options
Infographic. Does foot mobility affect the outcome in the management of patellofemoral pain with foot orthoses versus hip exercises? A randomised clinical trial
No full textEducation on the use of Code Lavender for ICU Nurses to Decrease Turnover and Increase Engagement
Get PDFEducation of Code Lavender for Nurses working in the Intensive Care Unit at Parker Adventist Hospital, Parker Colorado
Purpose:
Now more than ever healthcare leaders need to lead with a healing touch and help provide support for development of culture of caring. Nurses provide invaluable emotional support, as they understand the complexities and implications of an illness and its impact on not only a diagnosis or treatment plan, but on the whole person.
Nurses’ knowledge of illness combined with exceptional people skills provide comfort and stability during times often filled with pain and uncertainty for patients and their families.
In the most recent months with the global pandemic of COVID-19 nursing has been tested beyond comprehension. The purpose of this quality improvement initiative is to educate nurses working in the ICU at Parker Adventist Hospital on use of Code Lavender.
Description/Objectives:
The goal is to provide education on Code Lavender as a coordinated, immediate response from a multi-disciplinary team to provide administrative, emotional, and spiritual support to ICU nurses in need of additional support in order to increase engagement and decrease nursing turnover. By addressing the real-time needs of nurses, the desired outcome is that nurses are more satisfied, engage, and likely to remain in their position.
Objectives: Increase nurse satisfaction Decrease RN Turnover in ICU Decrease time to fill for open ICU, RN position
The Impact of Religious Ritual Initiation on Males
Get PDFThe following paper is focused on revealing the influence that religious ritual initiations/rites of passages have on males from the religions of Islam, Christianity, and Judaism. In the first section of the paper, I explain why it is important that the influence that religious ritual initiations have on males be studied. The second section covers the literature that was used to obtain my research results. The third section explains how the methodologies of content analysis and semiotics were incorporated into my research. In the fourth section, I reveal that practices such as self-control and discipline are common traits in how certain Muslims, Jews, and Christians construct manhood while also showing that religious pilgrimages have a high chance of influencing a person’s identity. Lastly, in the fifth section I discuss the limitations of my research while mentioning potential opportunities for further research to be done on the impacts ritual initiations have on people from other religions and non-religious groups
THE HAPPINESS WORKSHOP FOR MIDDLE SCHOOL STUDENTS: THE EXPERIENCE OF LEARNING FLOW THROUGH PHOTOGRAPHIC STORYTELLING
Get PDFAbstract
The Happiness Workshop for Middle School Students:
The Experience of Learning Flow through Photographic Storytelling
The aim of this research project is to fill a gap in understanding regarding the benefits of learning flow experiences for adolescents, and in particular, middle school students in educational settings. The workshop model contained in this document uses photographic storytelling as a creative activity for middle school students to experience flow. What has not been covered is an application for learning flow experiences in a content specific subject such as math which has been identified as a topic for future research. The research contained in this study provides evidence to support the need for incorporating flow experiences for students in classroom settings, to achieve academic learning and success
Oncology Discharge Phone Calls for Active Treatment Patients
Get PDFOncology patients are at an increased risk for complications after hospital discharge, which can lead to poor outcomes. To proactively manage oncology patient needs, a team of specialized oncology nurses implemented post-discharge phone calls. Using a descriptive design, with a convenience sample of 30 active treatment oncology patients, patients were called after hospital discharge using a semi-structured questionnaire tool focused on identification of patient needs and measurement of nursing care required to close gaps in care. The study found 73.3% of patients had a problem with symptom management, 56.7% with medication management, 33.3% with equipment or services, 70% with plan of care, and 23.3% with psychosocial needs. Nursing intervention was measured on a zero-to-four scale. Further use of Friedman’s rank test showed that plan of care related issues required more complex nursing intervention. The scale formulated by this pilot study demonstrates an effective way to measure nursing quality, which could be applied to a range of other nursing issues. The major limitation of the study was the sample size. However, findings from the study indicate specialized nursing care is essential to oncology patients after hospital discharge
Deepening the Universal Apostolic Preferences through Discernment at Xavier University
No full textFollowing Fr. Arturo Sosa, S.J.’s promulgation of the Universal Apostolic Preferences (UAPs) and as part of Xavier University’s strategic planning, the Center for Mission and Identity invited faculty and staff to participate in a semester-long Discernment Group to learn about each of the UAPs and to brainstorm ways to deepen Xavier’s expression of each, resulting in a strategic proposal (one of the President\u27s Annual Goals). Based on the principles of Ignatian Communal Discernment, the Discernment Group met throughout the Fall 2019 semester in prayerful discussion and reflection and produced documents for each of the UAPs, which were then shared and vetted by the university community. The Discernment Group concluded with the creation of a document outline Xavier’s current best practices, next steps, and aspirational goals. The work of integrating the UAPs into the life of the Xavier University is an on-going effort, which is now guided by the document – a strategic plan for the decade. This discernment process may be effective for other Jesuit Catholic institutions seeking methods to advance the UAPs