Challenges in lung cancer multidisciplinary collaboration experienced by specialists in four countries.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23002-e23002
Author(s):  
Suzanne Murray ◽  
Vivek Subbiah ◽  
Christian Grohé ◽  
Kazuhiko Nakagawa ◽  
Sacha Zahabi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Qualitative Interviews ◽  
The United States ◽  
Team Approach ◽  
Thyroid Cancer Patient ◽  
Fully Integrated ◽  
Therapeutic Environment ◽  
The Us ◽  
The Uk

e23002 Background: The importance and challenges of Multidisciplinary Team (MDT) collaboration in managing lung cancer have been increasingly recognized in an ever more complex therapeutic environment. Data on physicians’ viewpoints regarding MDT collaboration in lung cancer care, collected in a broader study assessing challenges related to lung/thyroid cancer patient management, are presented. Methods: A mixed-methods approach was used to analyze this data, combining qualitative interviews and a quantitative survey. Pulmonologists (PLM), oncologists (ONC) and pathologists (PTH) from Germany (GE), Japan (JP), the United Kingdom (UK) and the United States (US) were recruited. Results: A total of 44 specialists participated in interviews and 377 in a survey. Quantitative data reveal that 53% of pulmonologists in JP and 39% in GE have suboptimal knowledge of the timing of patient referral to an oncologist. Fewer PLM/PTH from JP (43%/47%) report a fully integrated MDT team approach in their clinical setting, compared to those from GE (80%/95%), the UK (96%/82%) and the US (82%/97%). Qualitative data indicate that current MDT team practices are perceived as delaying patient care due to significant inefficiencies (sometimes due to lack of knowledge/skills) and unclear responsibilities within the team. Around half of ONC in each country and 78% of PLM from the UK report a gap in knowledge and relevance of each genetic biomarker test according to clinical presentation. PTH in the UK (70%), the US (50%), and JP (72%) report sub-optimal skills identifying biomarker tests to inform the progression of lung cancer (also a challenge for PLM/ONC). Conclusions: This study indicates a need for multi-level interventions addressing systemic and attitudinal barriers as well as knowledge gaps which affect physicians’ ability to collaborate in lung cancer care.

scholarly journals Delivering More Effective Lung Cancer Support Groups: Applying Best Practices From the United States, United Kingdom, and Australia to Strengthen Skills and Inspire Facilitators

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 177s-177s
Author(s):  
M. Rigney
Keyword(s):  
Lung Cancer ◽  
Support Groups ◽  
Support Group ◽  
The United States ◽  
Lung Cancer Patients ◽  
Cancer Support ◽  
Cancer Support Groups ◽  
The Us ◽  
Cancer Support Group ◽  
The Uk

Background and context: Globally, 1.8 million people are diagnosed with lung cancer annually. Compared with other cancers, lung cancer patients experience higher levels of distress and greater unmet physical and emotional needs. A significant unmet need is social support. Face-to-face support groups can meet this need and may also may increase feelings of control and decrease distress. While lung cancer patients tend to prefer lung cancer-specific over general cancer groups, for many reasons these groups can be challenging to start and maintain. As a result, there are not enough groups available to meet the need. Aim: To provide guidance to those with struggling lung cancer groups, facilitators on three continents were surveyed to better understand their challenges and elicit creative ideas, collect practical tips and gather best practices for starting and maintaining successful lung cancer support groups. Strategy/Tactics: To understand the experiences of lung cancer facilitators, direct feedback was needed. To identify facilitators, member organizations of the Global Lung Cancer Coalition (GLCC) were tapped. Comprised of 37 charity organizations, GLCC is the international “voice” of the lung cancer community. Three GLCC organizations (one each from the United States-US, United Kingdom-UK and Australia-AUS) that either directly offer lung cancer support groups or manage networks of groups, agreed to participate. Program/Policy process: A 21 question online survey was sent to 131 support group facilitators, 7 in AUS, 42 in the UK and 82 in the US. Questions included length of time the group had been running, how often it met, average number of participants and other group/facilitator characteristics. Respondents were asked to identify their greatest challenges in group maintenance and solutions used to overcome those challenges. Knowledge gained from the survey and an extensive literature review were incorporated into the Lung Cancer Support Group Troubleshooting Guide. Outcomes: With a 56% completion rate, specific results varied by demographic area. Groups in AUS and the UK tended to have more participants, were more likely to be cofacilitated by nurses and held in public places. More groups in the US were based in hospitals and run by social workers. 75% of facilitators in the UK and AUS and 71% of those in the US said their groups were successful. What was learned: Creative solutions to lung cancer support group challenges were shared and keys to successful groups identified. Suitable for facilitators at all skills levels, the resulting Guide includes creative solutions for overcoming specific barriers and resource constraints. Widely distributed in the US, a small survey found that 91% of Guide users found it somewhat or very helpful. While written for lung cancer groups, any kind of support group, anywhere in the world that is struggling can benefit from the suggestions and ideas offered by the Guide.

‘To see oursels as ithers see us’: Reflections on Scottish Independence from the United States

2014 ◽  
Vol 23 (3) ◽  
pp. 381-388 ◽  
Author(s):  
Euan Hague ◽  
Alan Mackie
Keyword(s):  
United States ◽  
The United States ◽  
The Us ◽  
Scottish Independence ◽  
The Uk ◽  
Scottish Diaspora

The United States media have given rather little attention to the question of the Scottish referendum despite important economic, political and military links between the US and the UK/Scotland. For some in the US a ‘no’ vote would be greeted with relief given these ties: for others, a ‘yes’ vote would be acclaimed as an underdog escaping England's imperium, a narrative clearly echoing America's own founding story. This article explores commentary in the US press and media as well as reporting evidence from on-going interviews with the Scottish diaspora in the US. It concludes that there is as complex a picture of the 2014 referendum in the United States as there is in Scotland.

scholarly journals Trends in educational mobility: How does China compare to Europe and the United States?

2019 ◽  
Vol 5 (2) ◽  
pp. 214-240
Author(s):  
Rob J Gruijters ◽  
Tak Wing Chan ◽  
John Ermisch
Keyword(s):  
Educational Opportunity ◽  
The United States ◽  
International Standards ◽  
Educational Mobility ◽  
The Us ◽  
The Usa ◽  
Economic Boom ◽  
The Uk ◽  
Large Decline ◽  
Inequality Of Educational Opportunity

Despite an impressive rise in school enrolment rates over the past few decades, there are concerns about growing inequality of educational opportunity in China. In this article, we examine the level and trend of educational mobility in China, and compare them to the situation in Germany, the Netherlands, the UK and the USA. Educational mobility is defined as the association between parents’ and children’s educational attainment. We show that China’s economic boom has been accompanied by a large decline in relative educational mobility chances, as measured by odds ratios. To elaborate, relative rates of educational mobility in China were, by international standards, quite high for those who grew up under state socialism. For the most recent cohorts, however, educational mobility rates have dropped to levels that are comparable to those of European countries, although they are still higher than the US level.

scholarly journals Typical Time to Treatment of Patients With Lung Cancer in a Multisite, US-Based Study

2016 ◽  
Vol 12 (6) ◽  
pp. e643-e653 ◽  
Author(s):  
Regina M. Vidaver ◽  
Marianna B. Shershneva ◽  
Scott J. Hetzel ◽  
Timothy R. Holden ◽  
Toby C. Campbell
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Disease Incidence ◽  
The United States ◽  
Small Cell ◽  
Time Intervals ◽  
Time To Treatment ◽  
Specialist Referral ◽  
Patient Reported ◽  
Typical Time

Introduction: The importance of high-quality, timely lung cancer care and the need to have indicators to measure timeliness are increasingly discussed in the United States. This study explored when and why delays occur in lung cancer care and compared timeliness between two states with divergent disease incidence. Methods: Patients with small-cell or non–small-cell lung cancer were recruited through cancer centers, outpatient clinics, and community approaches, and interviewed over the phone. Statistical analysis of patient-reported dates included descriptive statistics and comparing time intervals between states and across the sites with Mann-Whitney U tests. Additionally, data from patients with longer timelines were qualitatively analyzed to identify possible reasons for delays. Results: On the basis of the dates reported by 275 patients, the median time from first presentation to a clinician to treatment was 52 days; 29% of patients experienced a wait of 90 days or more. Median times for key intervals were 36.5 days from abnormal radiograph to treatment, 9.5 days from initial presentation to specialist referral, 15 days from patient informed of diagnosis to first therapy, and 16 days from referral to treatment to first therapy. More than one quarter of patients perceived delays in care. No significant differences in length of time intervals were identified between states. Monitoring of small nodules, missed diagnosis, and other reasons for longer timelines were documented. Conclusion: Results defined typical time to treatment of patients with lung cancer across a variety of health systems and should facilitate establishing metrics for determining timeliness of lung cancer care.

Antitrust Regulation of IT Giants` Activities: Main Trends of Foreign and Russian Legislation

2021 ◽  
Author(s):  
D.V. Shram ◽  
Keyword(s):  
House Of Representatives ◽  
Network Effects ◽  
The United States ◽  
The European Union ◽  
The United Kingdom ◽  
The Us ◽  
The Usa ◽  
Economic Concentration ◽  
The Uk ◽  
Antitrust Regulation

The article is devoted to the antimonopoly regulation of IT giants` activities. The author presents an overview of the main trends in foreign and Russian legislation in this area. The problems the antimonopoly regulation of digital markets faces are the following: the complexity of determining the criteria for the dominant position of economic entities in the digital economy and the criteria for assessing the economic concentration in the commodity digital markets; the identification and suppression of cartels; the relationship between competition law and intellectual property rights in the digital age. Some aspects of these problems are considered through the prism of the main trends in the antimonopoly policy in the United States, the European Union, the United Kingdom and Russia. The investigation findings of the USA House of Representatives Antitrust Subcommittee against Apple, Google, Amazon and Facebook are presented. The author justifies the need to separate them, which requires the adoption of appropriate amendments to the antimonopoly legislation. The article analyzes the draft law of the European Commission on the regulation of digital markets – Digital Markets Act, reveals the criteria for classifying IT companies as «gatekeepers», and notes the specific approaches to antimonopoly regulation in the UK and the US. The article describes the concepts «digital platform» and «network effects», presented in the «fifth antimonopoly package of amendments», developed in 2018 by the Federal Antimonopoly Service of the Russian Federation, and gives an overview of the comments of the Ministry of Economic Development regarding these concepts wording in the text of the draft law, which formed the basis for the negative conclusion of the regulator. It is concluded that in the context of the digital markets’ globalization, there is a need for the international legal nature antitrust norms formation, since regional legislation obviously cannot cope with the monopolistic activities of IT giants.

The Origins of Neoliberalism and the Role of the German State

2021 ◽  
pp. 16-33
Author(s):  
Julian Germann
Keyword(s):  
International Political Economy ◽  
The United States ◽  
German State ◽  
The Us ◽  
Global Movement ◽  
Anglo American ◽  
The Uk ◽  
Corporate Profits ◽  
German Contribution

This chapter reviews the most prominent explanations of the global rise of neoliberalism provided within critical International Political Economy: (1) a state-centered argument, which holds that neoliberalism was imposed by the United States in a bid to reassert its global dominance; (2) a class-based argument, which sees neoliberalism as the project of globalizing elites who sought to restore their corporate profits and power; and (3) an ideational argument, which describes the rise of neoliberalism as a paradigmatic shift in economic ideas. The chapter argues that these accounts share a common bias: they pivot unduly on the Anglo-American world and are unable to capture the peculiar German contribution to the origins of neoliberalism. As a result, they misread the rise of Germany to the apex of a neoliberal Europe as a belated repetition of the same global movement spearheaded by the US and the UK.

scholarly journals MA18.06 Patterns of Lung Cancer Care in the United States: Developments and Disparities

2018 ◽  
Vol 13 (10) ◽  
pp. S420 ◽  
Author(s):  
E. Blom ◽  
K. Ten Haaf ◽  
D. Arenberg ◽  
H. De Koning
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cancer Care ◽  
The United States

The intelligence of six-year-olds in Hong Kong

1989 ◽  
Vol 21 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Jimmy Chan ◽  
Richard Lynn
Keyword(s):  
United States ◽  
Hong Kong ◽  
Ethnic Minorities ◽  
The United States ◽  
Chinese Children ◽  
Pacific Basin ◽  
The Pacific ◽  
The Us ◽  
The Mean ◽  
The Uk

SummaryEvidence has accumulated to suggest that the mean IQs of Orientals in the United States and in the countries of the Pacific Basin are higher than those of Whites (Caucasoids) in the United States and Britain. This paper presents evidence from IQ tests on 4858 6-year-old Chinese children in Hong Kong. On the Coloured Progressive Matrices these children obtained a mean IQ of 116. Samples from Australia, Czechoslovakia, Germany, Romania, the UK and the US obtain IQs in the range 95–102. It is suggested that these results pose difficulties for the environmentalist explanations commonly advanced to explain the low mean IQs obtained by some ethnic minorities in the United States.

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