Factors influencing cancer genetic somatic mutation test ordering by cancer physician

Background Clinical whole exome sequencing was introduced in an Australian centre in 2017, as an alternative to Sanger sequencing. We aimed to identify predictors of cancer physicians’ somatic mutation test ordering behaviour. Methods A validated instrument assessed somatic mutation test ordering, genomic confidence, perceived utility of tumour molecular profiling, and percent of patients eligible for targeted therapy. A cash incentive was included in 189/244 questionnaires which were mailed to all Queensland cancer specialists in November 2018. Results 110 participated (response rate 45%); 54.7% oncologists, and the remainder were surgeons, haematologists and pulmonologists. Oncologists were more likely to respond (p = 0.008), and cash incentive improved the response rate (p < 0.001). 67/102 (65.7%) of physicians ordered ≥ 5 somatic mutation tests annually. Oncologists saw 86.75 unique patients monthly and ordered 2.33 somatic mutation tests (2.2%). An average of 51/110 (46.1%) reported having little/no genomic confidence. Logistic regression identified two significant predictors of somatic mutation test ordering: being an oncologist (OR 3.557, CI 1.338–9.456; p = 0.011) and having greater confidence in interpreting somatic results (OR 5.926, CI 2.230–15.74; p < 0.0001). Conclusions Consistent with previous studies, the majority of cancer physicians ordered somatic mutation tests. However, the percentage of patients on whom tests were ordered was low. Almost half respondents reported low genomic confidence. Somatic mutation test ordering was higher amongst oncologists and those with increased confidence in interpreting somatic variants. It is unclear whether genomically confident individuals ordered more tests or whether ordering more tests increased genomic confidence. Educational interventions could improve confidence and enhance test ordering behaviour.

Factors Influencing Cancer Genetic Somatic Mutation Test Ordering By Cancer Physicians

Background: Clinical whole exome sequencing was introduced in an Australian centre in 2017, as an alternative to Sanger sequencing. We aimed to identify predictors of cancer physicians’ somatic mutation test ordering behaviour. Methods: A validated instrument assessed somatic mutation test ordering, genomic confidence, perceived utility of tumour molecular profiling, and percent of patients eligible for targeted therapy. A cash incentive was included in 189/244 questionnaires which were mailed to all Queensland cancer specialists in November 2018. Results: 110 participated (response rate 45%); 54.7% oncologists, and the remainder were surgeons, haematologists and pulmonologists. Oncologists were more likely to respond (p=0.008), and cash incentive improved the response rate (p<0.001). 67/102 (65.7%) of physicians ordered ≥5 somatic mutation tests annually. Oncologists saw 86.75 unique patients monthly and ordered 2.33 somatic mutation tests (2.2%). An average of 51/110 (46.1%) reported having little/no genomic confidence. Logistic regression identified two significant predictors of somatic mutation test ordering: being an oncologist (OR 3.557, CI 1.338-9.456; p=0.011) and having greater confidence in interpreting somatic results (OR 5.926, CI 2.230-15.74; p<0.0001). Conclusions: Consistent with previous studies, the majority of cancer physicians ordered somatic mutation tests. However, the percentage of patients on whom tests were ordered was low. Almost half respondents reported low genomic confidence. Somatic mutation test ordering was higher amongst oncologists and those with increased confidence in interpreting somatic variants. It is unclear whether genomically confident individuals ordered more tests or whether ordering more tests increased genomic confidence. Educational interventions could improve confidence and enhance test ordering behaviour.

Evaluating the effectiveness of incentives to improve HIV prevention outcomes for young females in Eswatini: Sitakhela Likusasa impact evaluation protocol and baseline results

Background Eswatini continues to have the highest prevalence of HIV in the world, and one of the highest HIV incidences among adult populations (aged 15–49). This analysis reports on both key elements of study design/protocol and baseline results from an impact evaluation of an intervention incentivizing (i) initiation, enrolment, attendance or completion of some form of education, and (ii) lower risk sexual behaviour. Methods The impact evaluation employs a two by two factorial design in which participants are enrolled in either the incentive for education arm (‘education treatment arm’ providing a conditional cash incentive) or the control arm (‘education control arm’). In each of these arms, 50% of participants were randomized to also be eligible for selection – three times a year – to participate in a conditional raffle conditional on testing negative for curable STIs (syphilis and Trichomonas vaginalis). Results Baseline recruitment and screening occurred in 2016 when a total of 6055 individuals were screened of which 4863 participated in the baseline survey, and 4819 individuals were randomized into one of the study arms. The baseline prevalence of HIV, Trichomonas vaginalis, and syphilis among adolescent girls and young women 8.20% (397/4840), 3.31% (150/4533) and 0.17% (8/4830) respectively. Conclusions An educational cash incentive and raffle incentive impact evaluation that addresses adolescent girls and young women who are in-education and out-of-education has the potential to reduce HIV risk in adolescent girls and young women in Eswatini. Trial registration Name of the registry: Pan African Clinical Trials Registry. Trial registration number: PACTR201811609257043. Date of registration: May 11, 2018 ‘Retrospectively registered’. URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4685

Evaluating the Effectiveness of Incentives to Improve HIV Prevention Outcomes for Young Females in Eswatini: Sitakhela Likusasa Impact Evaluation Protocol and Baseline Results

Background: Eswatini continues to have the highest prevalence of HIV in the world, and one of the highest HIV incidences among adult populations (aged 15-49). This analysis reports on both key elements of study design/protocol and baseline results from an impact evaluation of an intervention incentivizing (i) initiation, enrolment, attendance or completion of some form of education, and (ii) lower risk sexual behaviour. Methods: The impact evaluation employs a two by two factorial design in which participants are enrolled in either the incentive for education arm (‘education treatment arm’ providing a conditional cash incentive) or the control arm (‘education control arm’). In each of these arms, 50% of participants were randomized to also be eligible for selection – three times a year – to participate in a conditional raffle conditional on testing negative for curable STIs (syphilis and Trichomonas vaginalis). Results: Baseline recruitment and screening occurred in 2016 when a total of 6,055 individuals were screened of which 4,863 participated in the baseline survey, and 4,819 individuals were randomized into one of the study arms. The baseline prevalence of HIV, Trichomonas vaginalis, and syphilis among adolescent girls and young women 8.20% (397/4,840), 3.31% (150/4,533) and 0.17% (8/4,830) respectively. Conclusions: An educational cash incentive and raffle incentive impact evaluation that addresses adolescent girls and young women who are in-education and out-of-education has the potential to reduce HIV risk in adolescent girls and young women in Eswatini.Name of the registry: Pan African Clinical Trials RegistryTrial registration number: PACTR201811609257043Date of registration: May 11, 2018 ‘Retrospectively registered’URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4685

Factors Influencing Cancer Genetic Somatic Mutation Test Ordering By Cancer Physicians

Background: Clinical whole exome sequencing was introduced in an Australian centre in 2017, as an alternative to Sanger sequencing. We aimed to identify predictors of cancer physicians’ somatic mutation test ordering behaviour. Methods: A validated instrument assessed somatic mutation test ordering, genomic confidence, perceived utility of tumour molecular profiling, and percent of patients eligible for targeted therapy. A cash incentive was included in 189/244 questionnaires which were mailed to all Queensland cancer specialists in November 2018. Results: 110 participated (response rate 45%); 54.7% oncologists, and the remainder were surgeons, haematologists and pulmonologists. Oncologists were more likely to respond (p=0.008), and cash incentive improved the response rate (p<0.001). 67/102 (65.7%) of physicians ordered ≥5 somatic mutation tests annually. Oncologists saw 86.75 unique patients monthly and ordered 2.33 somatic mutation tests (2.2%). An average of 51/110 (46.1%) reported having little/no genomic confidence. Logistic regression identified two significant predictors of somatic mutation test ordering: being an oncologist (OR 3.557, CI 1.338-9.456; p=0.011) and having greater confidence in interpreting somatic results (OR 5.926, CI 2.230-15.74; p<0.0001). Conclusions: Consistent with previous studies, the majority of cancer physicians ordered somatic mutation tests. However, the percentage of patients on whom tests were ordered was low. Almost half respondents reported low genomic confidence. Somatic mutation test ordering was higher amongst oncologists and those with increased confidence in interpreting somatic variants. It is unclear whether genomically confident individuals ordered more tests or whether ordering more tests increased genomic confidence. Educational interventions could improve confidence and enhance test ordering behaviour.

Evaluating the Effectiveness of Incentives to Improve HIV Prevention Outcomes for Young Females in Eswatini: Sitakhela Likusasa Impact Evaluation Protocol and Baseline Results

Background: Eswatini continues to have the highest prevalence of HIV in the world, and one of the highest HIV incidences among adult populations (aged 15-49). This analysis reports on both key elements of study design/protocol and baseline results from an impact evaluation of an intervention incentivizing (i) initiation, enrolment, attendance or completion of some form of education, and (ii) lower risk sexual behaviour. Methods: The impact evaluation employs a two by two factorial design in which participants are enrolled in either the incentive for education arm (‘education treatment arm’ providing a conditional cash incentive) or the control arm (‘education control arm’). In each of these arms, 50% of participants were randomized to also be eligible for selection – three times a year – to participate in a conditional raffle conditional on testing negative for curable STIs (syphilis and Trichomonas vaginalis). Results: Baseline recruitment and screening occurred in 2016 when a total of 6,055 individuals were screened of which 4,863 participated in the baseline survey, and 4,819 individuals were randomized into one of the study arms. The baseline prevalence of HIV, Trichomonas vaginalis, and syphilis among adolescent girls and young women 8.20% (397/4,840), 3.31% (150/4,533) and 0.17% (8/4,830) respectively. Conclusions: An educational cash incentive and raffle incentive impact evaluation that addresses adolescent girls and young women who are in-education and out-of-education has the potential to reduce HIV risk in adolescent girls and young women in Eswatini.Name of the registry: Pan African Clinical Trials RegistryTrial registration number: PACTR201811609257043Date of registration: May 11, 2018 ‘Retrospectively registered’URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4685

Effects of Sequential Prepaid Incentives on Response Rates, Data Quality, Sample Representativeness, and Costs in a Mail Survey of Physicians

While collecting high quality data from physicians is critical, response rates for physician surveys are frequently low. A proven method for increasing response in mail surveys is to provide a small, prepaid monetary incentive in the initial mailing. More recently, researchers have begun experimenting with adding a second cash incentive in a follow-up contact in order to increase participation among more reluctant respondents. To assess the effects of sequential incentives on response rates, data quality, sample representativeness, and costs, physicians (N = 1,500) were randomly assigned to treatments that crossed the amount of a first ($5 or $10) and second ($0, $5, or $10) incentive to form the following groups: Group $5/$5; Group $5/$10; Group $10/$0; Group $10/$5; and Group $10/$10. Overall, second incentives were associated with higher response rates and lower costs per completed survey, and while they had no effect on item nonresponse, they increased sample representativeness.

Evaluating the Effectiveness of Incentives to Improve HIV Prevention Outcomes for Young Females in Eswatini: Sitakhela Likusasa Impact Evaluation Protocol and Baseline Results

Background: Eswatini continues to have the highest prevalence of HIV in the world, and one of the highest HIV incidences among adult populations (aged 15-49). This analysis reports on both key elements of study design/protocol and baseline results from an impact evaluation of an intervention incentivizing (i) initiation, enrolment, attendance or completion of some form of education, and (ii) lower risk sexual behaviour.Methods: The impact evaluation employs a two by two factorial design in which participants are enrolled in either the incentive for education arm (‘education treatment arm’ providing a conditional cash incentive) or the control arm (‘education control arm’). In each of these arms, 50% of participants were randomized to also be eligible for selection – three times a year – to participate in a conditional raffle conditional on testing negative for curable STIs (syphilis and Trichomonas vaginalis ).Results: Baseline recruitment and screening occurred in 2016 when a total of 6,055 individuals were screened of which 4,863 participated in the baseline survey, and 4,819 individuals were randomized into one of the study arms. The baseline prevalence of HIV, Trichomonas vaginalis , and syphilis among adolescent girls and young women 8.20% (397/4,840), 3.31% (150/4,533) and 0.17% (8/4,830) respectively.Conclusions: An educational cash incentive and raffle incentive impact evaluation that addresses adolescent girls and young women who are in-education and out-of-education has the potential to reduce HIV risk in adolescent girls and young women in Eswatini.Name of the registry: Pan African Clinical Trials RegistryTrial registration number: PACTR201811609257043Date of registration: May 11, 2018 ‘Retrospectively registered’URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4685

LEGAL PROTECTION OF LABOR RIGHTS DURING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC

Since the Coronavirus Disease 2019 (Covid-19) pandemic in Indonesia, which continues to grow and has an impact, not a few companies have gone bankrupt. Whether it's a small company, a medium-sized company or even a large corporation are affected by the Coronavirus Disease 2019 (Covid-19). This paper aims to find legal issues on labor right during Covid-19 pandemic in Indonesia. Using the normative legal research, this paper analyzess some of regulation and legal government act to protect labor right who terminated (Pemutusan Hubungan Kerja/PHK) during Covid-19 pandemic. In the end, this paper finds that the government issued two program to solve PHK and protect labor rights, namely Pre-Works Card and Cash Incentive Program (Bantuan Langsung Tunai/BLT). It actively helps employee to create a new job and continue their daily life.