scholarly journals Attitudes of radiation oncologists toward palliative and supportive care in the United States: Report on national membership survey by the American Society for Radiation Oncology (ASTRO)

2017 ◽  
Vol 7 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Randy L. Wei ◽  
Malcolm D. Mattes ◽  
James Yu ◽  
Adrienne Thrasher ◽  
Hui-Kuo Shu ◽  
...  
2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 105-105 ◽  
Author(s):  
Randy Wei ◽  
James B. Yu ◽  
Malcolm Mattes ◽  
Adrienne Thrasher ◽  
Hui-Kuo George Shu ◽  
...  

105 Background: Radiation oncologists are frequently involved in providing palliative and supportive care (PSC) for patients with advanced cancers through delivery of palliative radiation. Whether they are confident in their ability to assess and initiate treatments for pain, non-pain, and psychosocial distress is unknown. The American Society for Radiation Oncology (ASTRO) surveyed its practicing members in the United States on self-assessment of their primary PSC skills, and access to continuing medical education on PSC. Methods: We electronically surveyed 4,093 practicing radiation oncologists in the United States. The survey consisted of 17-questions in five sections: demographics, PSC training, domains of PSC, perceived barriers as a radiation oncologist to initiate advanced care planning, and discussion on prognosis. Results: The majority (91%) of radiation oncologists surveyed believe PSC is an important competency for radiation oncologists. Most radiation oncologists reported that they are moderately confident in their ability to assess and manage pain and GI symptoms but less confident in their ability to manage anorexia, anxiety, and depression. Despite areas of decreased confidence, a large number (42%) of radiation oncologists do not receive any additional PSC education beyond their residency training. Lastly, a perceived fear of upsetting referring medical oncologists and lack of clinic time are concerns for radiation oncologists who may want to initiate goals of care/advance care planning discussions with patients and their families. Conclusions: Radiation oncologists are more confident in their ability to assess and manage pain than in their ability to manage depression, anxiety, anorexia, and fatigue. There is a need for increasing continuing medical educational efforts in PSC for practicing radiation oncologists, and strengthening PSC training in residency programs.


2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 287-287
Author(s):  
Patricia H. Hardenbergh

287 Background: The goal of this project is to improve quality of cancer care across the United States by connecting community cancer center radiation oncologists with highly specialized, disease site-specific radiation oncologists through the use of online technology. Methods: We have developed a website named chartrounds.com which allows community radiation oncologists to interact online with disease specialists and their peers on a scheduled basis in order to present and review radiation oncology treatment plans and cases in real time. Disease sites currently include breast, head and neck, gastrointestinal, gynecologic, prostate, central nervous systems, pediatric, lymphoma and lung cancers. At the conclusion of each session, participants are asked to complete a feedback questionnaire requesting feedback on quality and relevance of the session and the manner in which it might result in practice changes. Results: 650 community radiation oncology physician members from 49 states and 19 countries have enrolled online. In the initial 18-month period (12/2010-6/2012), 23 disease specialists have lead 188 chart rounds sessions with an average attendance ratio of 10 community physician members to 1 disease specialist. On a 5 point Likert scale with 5 representing the greatest impact possible, the mean response to feedback questions is as follows: session quality: 4.7, time used effectively: 4.6, discussions relevant to daily practice: 4.7, session is likely to result in a change in practice: 4.0.More specifically, members reported that they would make the following changes in their practice: change in clinical management of the radiation patient: 35%, change in the selection of patients for radiation: 17%, change in radiation fields: 15%, change in radiation prescription dose: 9%. Conclusions: Chartrounds.com appears to be impacting radiation oncology practice resulting in changes in management and treatment of patients in community cancer centers. Future directions of this project are aimed at demonstrating how these changes could result in significant improvements in cancer care across the United States. This work is funded by the Improving Cancer Care Grant of the ASCO Conquer Cancer Foundation.


Author(s):  
Andrew Valls

The persistence of racial inequality in the United States raises deep and complex questions of racial justice. Some observers argue that public policy must be “color-blind,” while others argue that policies that take race into account should be defended on grounds of diversity or integration. This chapter begins to sketch an alternative to both of these, one that supports strong efforts to address racial inequality but that focuses on the conditions necessary for the liberty and equality of all. It argues that while race is a social construction, it remains deeply embedded in American society. A conception of racial justice is needed, one that is grounded on the premises provided by liberal political theory.


2021 ◽  
Vol 109 (2) ◽  
pp. 344-351
Author(s):  
Joshua N. Herb ◽  
Rachael T. Wolff ◽  
Philip M. McDaniel ◽  
G. Mark Holmes ◽  
Trevor J. Royce ◽  
...  

2012 ◽  
Vol 83 (2) ◽  
pp. 333-349 ◽  
Author(s):  
Yujin Yaguchi

This article investigates the relationship between Asian American and modern Japanese history by analyzing the image of Japanese Americans in postwar Japan. Based on a book of photographs featuring Japanese immigrants in Hawai‘i published in 1956, it analyzes how their image was appropriated and redefined in Japan to promote as well as reinforce the nation’s political and cultural alliance with the United States. The photographs showed the successful acculturation of Japanese in Hawai‘i to the larger American society and urged the Japanese audience to see that their nation’s postwar reconstruction would come through the power and protection of the United States. Japanese Americans in Hawai‘i served as a lens through which the Japanese in Japan could imagine their position under American hegemony in the age of Cold War.


2016 ◽  
Vol 96 (2) ◽  
pp. E394-E395
Author(s):  
H.Y. Pan ◽  
B.G. Haffty ◽  
B. Falit ◽  
T.A. Buchholz ◽  
L.D. Wilson ◽  
...  

Author(s):  
Marina Moskalenko ◽  
Jennifer Zaccone ◽  
Cheryl A. Fiscelli ◽  
Jennifer Wieworka ◽  
Roberta Anderson ◽  
...  

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