scholarly journals Palliation or Prolongation? The Impact of a Peer-Review Intervention on Shortening Radiotherapy Schedules for Bone Metastases

2018 ◽  
Vol 14 (8) ◽  
pp. e513-e516 ◽  
Author(s):  
Gary V. Walker ◽  
Shervin M. Shirvani ◽  
Yerko Borghero ◽  
Matthew D. Callister ◽  
Daniel D. Chamberlain ◽  
...  

Purpose: Shorter fractionation radiation regimens for palliation of bone metastases result in lower financial and social costs for patients and their caregivers and have similar efficacy as longer fractionation schedules, although practice patterns in the United States show poor adoption. We investigated whether prospective peer review can increase use of shorter fractionation schedules. Methods: In June 2016, our practice mandated peer review of total dose and fractionation for all patients receiving palliative treatment during our weekly chart rounds. We used descriptive statistics and Fisher’s exact test to compare lengths of treatment of uncomplicated bone metastases before and after implementation of the peer review process. Results: Between July 2015 and December 2016, a total of 242 palliative treatment courses were delivered, including 105 courses before the peer review intervention and 137 after the intervention. We observed greater adoption of shorter fractionation regimens after the intervention. The use of 8 Gy in one fraction increased from 2.8% to 13.9% of cases postadoption. Likewise, the use of 20 Gy in five fractions increased from 25.7% to 32.8%. The use of 30 Gy in 10 fractions decreased from 55.2% to 47.4% ( P = .002), and the use of ≥ 11 fractions decreased from 16.2% before the intervention to 5.8% after ( P = .006). Conclusion: Prospective peer review of palliative regimens for bone metastases can lead to greater adoption of shorter palliative fractionation schedules in daily practice, in accordance with national guidelines. This simple intervention may therefore benefit patients and their caregivers as well as provide value to the health care system.

2017 ◽  
Vol 12 (3) ◽  
pp. 159
Author(s):  
Melissa Goertzen

A Review of: Riehle, C. F., & Hensley, M. K. (2017). What do undergraduate students know about scholarly communication?: A mixed methods study. Portal: Libraries and the Academy, 17(1), 145–178. http://dx.doi.org/10.1353/pla.2017.0009 Abstract Objective – To examine undergraduate student researchers’ perception and understanding of scholarly communication practices and issues. Design – Mixed method study involving a survey and semi-structured interviews. Setting – Two major undergraduate universities in the Midwest region of the United States. Subjects – Undergraduate students who participated in or had completed undergraduate research experiences with faculty mentors. Method – The method was first approved by Institutional Review Board offices at both campuses involved in the study. Then, students received invitations to participate in a survey via email (Campus 1 = 221 students; Campus 2 = 345 students). Identical online surveys ran separately on each campus; both remained open for a period of three weeks. All respondents received a reminder email one week before the survey closed. Participants answered twelve questions related to demographics and scholarly communication practices. The survey examined knowledge and experience across five areas: the peer review process, author and publisher rights, publication and access models, impact of research, and data management. All students who completed the survey were entered in a drawing for a $50 Amazon card. The response rates were 34.8% (Campus 1) and 18.6% (Campus 2). Surveys on both campuses were administered using different software: campus 1 utilized Qualtrics survey software while campus 2 used an institution-specific survey software. Data sets were normed and merged later in the study to enable comparison and identify broad themes. Survey respondents were also invited to participate in a 15 to 20 minute follow-up interview and were compensated with a $20 Amazon gift card. The interviews consisted of four open-ended questions that further examined students’ knowledge of scholarly communication practices. The researchers coded interview transcripts and identified themes. Qualitative software was used to analyze the surveys and assess coder agreement. Finally, connections and anomalies between survey and interview results were explored. Main Results – Quantitative and qualitative data collected during the study indicate that students were most confident in their understanding of the peer-review process and data management but felt less confident in their knowledge of author and publisher rights, publication and access models, and determining the impact of scholarly research publication. In addition, they value instruction related to scholarly communication topics like the peer-review process, publication models, and data management. However, few students feel confident in their current level of knowledge or ability surrounding the previously mentioned topics. Study findings suggest that this knowledge gap is based on a lack of training or discussion of scholarly communication topics in relation to students’ research activities. Results also suggest that undergraduate students have difficulty articulating their rights as authors and their scholarly communication practices. In many cases, skill sets like data management are learned through trial and error while students progress through the research process. In some cases, faculty mentors have misperceptions and assumptions about undergraduate students’ knowledge and abilities regarding scholarly communication practices. This can create challenges for undergraduate students as they attempt to make informed decisions about research activities based on a limited foundation of experience or information. Finally, results indicate that undergraduate student researchers do not currently view the library as a place to learn about scholarly communication practices. The authors suggest that by forming strategic relationships with undergraduate research program directors, faculty, and graduate student mentors, librarians are in a prime position to incorporate scholarly communication practices into information literacy sessions or provide point-of-need coaching. Conclusion – The researchers conclude that academic libraries are in a unique position to support overarching research, teaching, and learning goals within the academic community. By developing programs that support information literacy and scholarly communication, libraries demonstrate value and align goals with teaching and learning priorities within the higher education community as a whole. Through this work, librarians support students as knowledge creators and advocate for training that emphasizes data literacy, copyright and authors’ rights, and the impact of research within specific disciplines.


CNS Spectrums ◽  
2006 ◽  
Vol 11 (S7) ◽  
pp. 25-31 ◽  
Author(s):  
Daniel E. Casey

AbstractDevelopment of extrapyramidal symptoms (EPS), particularly tardive dyskinesia (TD), has long been a troubling side effect for patients taking antipsychotics. Atypical antipsychotics have been hailed as an improvement over conventional antipsychotics, offering similar efficacy with more favorable EPS profiles. In the recent Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, which compared the conventional antipsychotic perphenazine with atypical antipsychotics olanzapine, quetiapine, risperidone, and ziprasidone in patients with schizophrenia, no significant differences in time to treatment discontinuation due to intolerability were observed between treatment groups. However, perphenazine was associated with a higher rate of patients experiencing EPS as well as a significantly higher rate of discontinuation due to EPS, despite the fact that patients with TD at baseline were excluded from the perphenazine group. Unfortunately, due to short treatment duration, the CATIE study did not have the assay sensitivity to detect differences in TD risk among any of the drugs. Thus, the atypical antipsychotics remain the first line of treatment for most patients, with specific drug selection based on benefit-risk profiles that best fit the individual patient's needs. Frequent monitoring, while noting a patient's subjective experience, remains the best strategy for choosing therapy to maximize symptom relief and minimize the impact of EPS and other side effects over the long-term. This article explores the reported results of the CATIE trial regarding EPS and emphasizes the differentiation of the atypicals from perphenazine on EPS and how these results should be incorporated into daily practice for the clinician.


2015 ◽  
Vol 25 ◽  
pp. 5-9 ◽  
Author(s):  
Robert Neimeyer ◽  
Julie Cerel

Mounting scientific evidence documents that bereavement by suicide can have a powerful and sometimes devastating impact on survivors. Accordingly, the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention in the United States has recently worked to formulate national guidelines to mitigate the harmful after-effects of suicide in social and family systems. The present article addresses one of four strategic directions addressed by the Task Force, namely the development of goals and objectives for surveillance, research and evaluation of the impact of suicide loss. Recommendations range from methodological guidelines for the conduct of future studies to specific content areas of research relevant to the design and implementation of public health, peer support and professional psychotherapeutic attention for communities, families and individuals affected by suicide loss.


2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 282-282
Author(s):  
Rupesh Kotecha ◽  
Tugce Kutuk ◽  
Maria A. Valladares ◽  
Lorrie A. LeGrand ◽  
Muni Rubens ◽  
...  

282 Background: The COVID-19 pandemic resulted in the use of telemedicine for evaluation and management visits in radiation oncology departments to decrease in-person interactions. The primary objective of this study is to evaluate the utility of telemedicine for patient consultation and its effect on radiotherapy simulation and treatment processes. Methods: A standardized simulation requisition directive was used for all consults (telemedicine and in-person) undergoing simulation for external beam radiation therapy at a single tertiary care institution from January to December 2020. These directives were reviewed at daily multi-disciplinary peer review meetings; modifications occurring as a result of this review were prospectively recorded in a departmental quality database. Descriptive statistics were used to identify characteristics associated with consultation type. Mann Whitney and Chi-square tests were used to compare continuous and categorical variables. Results: 1500 consecutive patients were reviewed in this prospective peer review process; 444 (29.6%) had telemedicine visits preceding simulation and 1056 (70.4%) had in-person consults. The median time between physician simulation order and date of simulation was 5 days (IQR: 2-11 days) for telemedicine visits and 4 days (IQR: 1-8 days) for in-person consults ( p<0.05). Significant differences were observed in telemedicine usage across months ( p<0.05) with the highest percentage in July, September, and August (50%, 45.9% and 45%, respectively). As a result of prospective multidisciplinary peer review, 397 modifications in 290 simulations were recorded in total; 101/444 (22.7%) telemedicine simulations had modifications compared to 189/1056 (17.9%) following in-person consultation ( p<0.05). The most common modifications for telemedicine visits resulted from immobilization device changes (n=32, 23.5%), arm positioning (n=19, 14.0%), and changes in the radiotherapy care path (n=17, 12.5%). For telemedicine consults, the median radiotherapy fraction dose was 2.66 Gy (2-4 Gy) and median fraction number was 16 (5-28). There was no difference for fractionation preference between telemedicine and in person consults ( p=0.084). Seven (1.6%) telemedicine visits and 7 (0.7%) in-person consults needed re-simulation during the entire study period ( p=0.136). Conclusions: Telemedicine is a powerful tool with the potential to revolutionize the radiation oncology daily practice. In the initial learning phase, it appears that there is a higher frequency of simulation modifications for patients evaluated by telemedicine. Therefore, as departmental processes incorporate telemedicine in the future, thorough attention is needed to encourage review of common modifications as well as identify patients at high risk of error at time of simulation who may also benefit from in-person evaluation prior to simulation.


2010 ◽  
Vol 39 (3) ◽  
pp. 26-36
Author(s):  
Robert Cargill

Blogging (or “web logging”) has evolved from online journaling to a multi-million dollar enterprise involving over 100 million blogs worldwide. And while journalists and news organizations have been quick to adopt blogging as a publishing tool, the academy has been slow to adopt the technology as a legitimate scholarly enterprise. This article argues that blogging is the next logical step for independent scholars and researchers who seek to publish their original work, and that universities should begin accepting blogging as a legitimate scholarly endeavor. Specifically, archaeologists should embrace blogging because of its ease of use, decreased time to publication, affordability, ability to publish multiple forms of media, and for the increased exposure publishing online brings to a scholar’s work. The article details the impact of blogging on existing publishing models, the peer-review process, and discusses the numerous benefits of blogging for archaeology.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S210-S210
Author(s):  
Elia Femia ◽  
Dana Plude ◽  
George W Rebok

Abstract The National Institutes of Health is the largest public funder of biomedical and bio-behavioral research in the United States. The mission is to enhance health, lengthen life, and reduce illness and disability. To achieve this mission, the NIH provides support for cutting-edge research and technology development in a variety of fields, ranging from translation of innovative ideas in technology to basic science on major health challenges and disease. There are many types of research and training opportunities and technology development programs that are supported by the NIH across the 24 institutes and centers that provide funding. The majority of grant applications are reviewed by the NIH Center for Scientific Review (CSR). In this symposium, attendees will get 1) an overview of the types of applications submitted to the NIH for support; 2) the basics of the NIH peer review process and criteria and scoring system for evaluating applications, and 3) tips for writing a more successful grant application. Peer review is the cornerstone of the NIH grants process, and an insider’s view can lead to a better understanding of how the most meritorious projects are identified that lead to innovative re-search in the biomedical and bio-behavioral sciences.


2018 ◽  
Vol 33 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Marc T. Edwards

In pursuit of high reliability, numerous organizations have promoted Just Culture, but its impact has never been assessed. This report combines data from a longitudinal survey–based study of clinical peer review practices in a cohort of 457 acute care hospitals with 43 measures from the Hospital Compare database and interprets them in relation to the long-term trends of Agency for Healthcare Research and Quality (AHRQ) data on the Hospital Survey of Patient Safety Culture. In all, 211 of 270 respondents (79%) indicated that their hospital has adopted Just Culture. More than half believe that it has had a positive impact. Just Culture implementation and its degree of impact are associated with somewhat better peer review process, but not with objective measures of hospital performance. Non-Punitive Response to Error has consistently been the lowest scoring category (45% positive) in the AHRQ database. Widespread adoption of Just Culture has not reduced reluctance to report or the culture of blame it targets.


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