scholarly journals Treatment Sequencing in Advanced BRAF-Mutant Melanoma Patients: Current Practice in the United States

2017 ◽  
Vol 34 (1) ◽  
pp. 17-23
Author(s):  
Céline Audibert ◽  
Mark Stuntz ◽  
Daniel Glass
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Targeted Therapy ◽  
Online Survey ◽  
The United States ◽  
Community Based ◽  
Academic Center ◽  
Melanoma Patients ◽  
To Receive ◽  
Braf Mutant

Background: Treatment of advanced BRAF-mutant melanoma has changed dramatically in the past 3 years thanks to the approval of new immunotherapy and targeted therapy agents. Objectives: The goal of our survey was to investigate when immunotherapy and targeted therapy are used in the management of advanced melanoma patients and whether differences exist between the types of setting. Methods: Oncologists from academic centers, community-based centers, and private clinics were invited to participate in an online survey. Survey questions addressed the proportion of BRAF-mutant patients per treatment line, proportion of patients on targeted therapy and immunotherapy available in the United States, and reasons for prescribing each drug class. Results: A total of 101 physicians completed the survey, of which 47 worked in a private clinic, 33 in an academic center, and 21 in a community-based center. Academic center participants tended to see more severe patients ( P < .001) and had more patients in second-line treatment than participants from other setting types. In addition, academic center physicians had more patients in clinical trials ( P < .001), and they prescribed the ipilimumab and nivolumab combination more frequently. In terms of sequencing, all participants used targeted therapy for severe or rapidly progressing patients and immunotherapy for those who were less severe or slowly progressing. Conclusions: The findings illustrate the differences in treatment approach per type of setting, with patients in academic centers more likely to receive recently approved products or to be enrolled in clinical trials than those in community-based settings.

scholarly journals COVID-19 Vaccine Acceptability and Inequity in the United States: Results from a nationally representative survey

2021 ◽  
Author(s):  
Dustin Gibson ◽  
Smisha Agarwal ◽  
Ankita Meghani ◽  
Rupali J. Limaye ◽  
Alain Labrique
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Online Survey ◽  
The United States ◽  
Demographic Characteristics ◽  
Third Party ◽  
Sample Population ◽  
Nationally Representative ◽  
To Receive ◽  
Racial Ethnic

AbstractBackgroundAt the time of this survey, September 1st, there were roughly 6 million COVID-19 cases and 176,771 deaths in the United States and no federally approved vaccine. The objective of this study was to explore the willingness to accept a COVID-19 vaccine in the United States and describe variability in this acceptability by key racial, ethnic and socio-demographic characteristics.MethodsThis was a cross-sectional digital survey that sampled participants from a nationally-representative panel maintained by a third party, Dynata. Dynata randomly sampled their database and emailed web-based surveys to United States residents ensuring the sample was matched to US Census estimates for age, race, gender, income, and Census region. Participants were asked how willing or unwilling they would be to: 1) receive a COVID-19 vaccine as soon as it was made publicly available, and 2) receive the influenza vaccine for the upcoming influenza season. Participants could respond with extremely willing, willing, unwilling, or extremely unwilling. For those who reported being unwilling to receive a COVID-19 vaccine, reasons for this hesitancy were captured. All participants were asked about where they obtain vaccine-related information, and which sources they trust most. Univariable and multivariable logistic regressions were conducted to examine the association of all demographic characteristics with willingness to receive COVID-19 vaccine.FindingsFrom September 1st to September 7, 2020, 1592 respondents completed the online survey. Overall, weighted analyses found that only 58.9% of the sample population were either willing or extremely willing to receive a COVID-19 vaccine as soon as it was made publicly available. In comparison, 67.7% of the respondents were willing or extremely willing to take the influenza vaccine. By gender, 66.1% of males and 51.5% of females were willing to receive a COVID-19 vaccine. Males were significantly more willing to receive a COVID-19 vaccine (adjusted odds ratio (OR)=1.98, 95% CI: 1.56, 2.53; p<0.001) than females. Blacks were the least willing racial/ethnic group (48.8%) Blacks, (aOR=0.59, 95%CI: 0.43, 0.80; p<0.001) were significantly less willing, than whites, to receive a COVID-19 vaccine. There were numerous reasons provided for being unwilling to receive a COVID-19 vaccine. The most common reason was concern about the vaccine’s safety (36.9%), followed by concerns over its efficacy (19.1%).InterpretationIn conclusion, we found that a substantial proportion (41%) of United States residents are unwilling to receive a COVID-19 vaccine as soon as one is made publicly available. We found that vaccine acceptance differs by sub-populations. In addition to sub-group differences in willingness to receive the vaccine, respondents provided a variety of reasons for being unwilling to receive the vaccine, driven by various sources of vaccine information (and misinformation). This compounds the challenge of delivering a safe and efficacious COVID-19 vaccine at a population level to achieve herd immunity. A multi-pronged and targeted communications and outreach effort is likely needed to achieve a high level of immunization coverage.

scholarly journals Caught in the Crossfire: How Contradictory Information and Norms on Social Media Influence Young Women’s Intentions to Receive HPV Vaccination in the United States and China

2020 ◽  
Vol 11 ◽  
Author(s):  
Shuya Pan ◽  
Di Zhang ◽  
Jingwen Zhang
Keyword(s):  
United States ◽  
Social Media ◽  
Social Norms ◽  
Online Survey ◽  
Hpv Vaccination ◽  
Positive Association ◽  
The United States ◽  
Hpv Vaccines ◽  
Contradictory Information ◽  
To Receive

This study uses online survey data from the United States and China to examine how contradictory information and social norms regarding HPV vaccines obtained through social media are related to young women’s attitudes and intentions surrounding HPV vaccination. The results show that exposure to contradictory information on social media had a greater negative association with intentions to receive HPV vaccination among the United States participants than among the Chinese participants, while social norms supporting HPV vaccines had a stronger positive association with intentions to receive HPV vaccination among the Chinese participants than among the United States participants. These findings extend the literature on social media communication regarding HPV vaccination and contribute to our knowledge of cultural contexts that influence intentions to receive HPV vaccination.

scholarly journals Selective exposure and the authoritarian dynamic: Evidence from Canada and the United States

2020 ◽  
Vol 8 (1) ◽  
pp. 151-172
Author(s):  
Robert A. Hinckley ◽  
Allison Harell
Keyword(s):  
United States ◽  
Free Speech ◽  
Attitude Change ◽  
Online Survey ◽  
Civil Liberties ◽  
The United States ◽  
Selective Exposure ◽  
Political Messages ◽  
Exposure Experiment ◽  
To Receive

This study explores to what extent selective exposure to political messages can produce political (in)tolerance among authoritarians and non-authoritarians. Drawing on a selection-exposure experiment embedded within an online survey conducted in the United States (N = 1978) and Canada (N = 1673), we explore how authoritarians and non-authoritarians react to framing around civil liberties controversies. Participants were randomly assigned to receive a message about a controversial group. In the forced-choice condition, participants were randomly assigned a political or non-political message. In a second condition, participants were given a choice of which message to read more about. The results show that authoritarians who are politically knowledgeable generally avoid messages that promote free speech by consuming non-political information. While messages about the dangers of free speech have the potential to produce more intolerance among authoritarians, we found that this effect was limited to those who are the least likely to consume them when given a choice. By contrast, we found that messages about the risk posed by free speech produced intolerance among non-authoritarians for whom threat-related cognitions were already chronically accessible. The effects of pro-civil liberties messages were limited to unthreatened non-authoritarians. Hence, we conclude that in the contemporary information environment selective exposure can increase polarization around a civil liberties controversy by producing attitude change but this occurs mainly among non-authoritarians.

Developing a Clinical Trials Infrastructure in the United States

2012 ◽  
Vol 2 (5) ◽  
Author(s):  
Paul Eisenberg ◽  
◽  
Petra Kaufmann ◽  
Ellen Sigal ◽  
Janet Woodcock ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trials ◽  
The United States

An Assessment of the Cues College Students Interpret From a Sexual Partner to Determine They Are Refusing

2021 ◽  
pp. 088626052199793
Author(s):  
Tiffany L. Marcantonio ◽  
Danny Valdez ◽  
Kristen N. Jozkowski
Keyword(s):  
United States ◽  
College Students ◽  
Sexual Partner ◽  
Online Survey ◽  
The United States ◽  
Sexual Partners ◽  
Sexual Scripts ◽  
Nonverbal Cues ◽  
Sexual Experiences ◽  
Verbal Cues

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording ( not willing/non-consent vs refusal) on college students’ self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions ( not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students’ sexual experiences more accurately.

scholarly journals 690 Are participants in obstetrical randomized clinical trials representative of the United States pregnant population?

2021 ◽  
Vol 224 (2) ◽  
pp. S433
Author(s):  
Cynthia Coots ◽  
Stephen Wagner ◽  
Matthew J. Bicocca ◽  
Megha Gupta ◽  
Hector Mendez Figueroa ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
The United States

scholarly journals EPID-07. ACCESS TO GLIOBLASTOMA CLINICAL TRIALS FOR RURAL PATIENTS IN THE UNITED STATES FROM 2010–2020

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii79-ii79
Author(s):  
Kathryn Nevel ◽  
Samuel Capouch ◽  
Lisa Arnold ◽  
Katherine Peters ◽  
Nimish Mohile ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Rural Communities ◽  
The United States ◽  
Interventional Treatment ◽  
Phase Ii Trials ◽  
Treatment Trials ◽  
Rural Sites ◽  
Rural Patients ◽  
Urban Sites

Abstract BACKGROUND Patients in rural communities have less access to optimal cancer care and clinical trials. For GBM, access to experimental therapies, and consideration of a clinical trial is embedded in national guidelines. Still, the availability of clinical trials to rural communities, representing 20% of the US population, has not been described. METHODS We queried ClinicalTrials.gov for glioblastoma interventional treatment trials opened between 1/2010 and 1/2020 in the United States. We created a Structured Query Language database and leveraged Google application programming interfaces (API) Places to find name and street addresses for the sites, and Google’s Geocode API to determine the county location. Counties were classified by US Department of Agriculture Rural-Urban Continuum Codes (RUCC 1–3 = urban and RUCC 4–9 = rural). We used z-ratios for rural-urban statistical comparisons. RESULTS We identified 406 interventional treatment trials for GBM at 1491 unique sites. 8.7% of unique sites were in rural settings. Rural sites opened an average of 1.7 trials/site and urban sites 2.8 trials/site from 1/2010–1/2020. Rural sites offered more phase II trials (63% vs 57%, p= 0.03) and fewer phase I trials (22% vs 28%, p= 0.01) than urban sites. Rural locations were more likely to offer federally-sponsored trials (p&lt; 0.002). There were no investigator-initiated or single-institution trials offered at rural locations, and only 1% of industry trials were offered rurally. DISCUSSION Clinical trials for GBM were rarely open in rural areas, and were more dependent on federal funding. Clinical trials are likely difficult to access for rural patients, and this has important implications for the generalizability of research as well as how we engage the field of neuro-oncology and patient advocacy groups in improving patient access to trials. Increasing the number of clinical trials in rural locations may enable more rural patients to access and enroll in GBM studies.

Industry Payments to Plastic Surgeons: What Has Changed Over the Last Six-Years Following Implementation of the Physician Payment Sunshine Act?

2021 ◽  
Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  
Keyword(s):  
United States ◽  
User Interface ◽  
Stock Options ◽  
Data Interpretation ◽  
The United States ◽  
Inclusion Criteria ◽  
Physician Payment ◽  
The Past ◽  
To Receive ◽  
Open Payments

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.

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