Factors predictive of failure to complete planned intraoperative breast radiation using the intrabeam® system

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135241/1/jso24473_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135241/2/jso24473.pd

Surveillance of Sentinel Node-Positive Melanoma Patients with Reasons for Exclusion from MSLT-II:Multi-Institutional Propensity Score Matched Analysis

BACKGROUND: In sentinel lymph node (SLN)-positive melanoma, two randomized trials demonstrated equivalent melanoma-specific survival with nodal surveillance vs completion lymph node dissection (CLND). Patients with microsatellites, extranodal extension (ENE) in the SLN, or >3 positive SLNs constitute a high-risk group largely excluded from the randomized trials, for whom appropriate management remains unknown. STUDY DESIGN: SLN-positive patients with any of the three high-risk features were identified from an international cohort. CLND patients were matched 1:1 with surveillance patients using propensity scores. Risk of any-site recurrence, SLN-basin-only recurrence, and melanoma-specific mortality were compared. RESULTS: Among 1,154 SLN-positive patients, 166 had ENE, microsatellites, and/or >3 positive SLN. At 18.5 months median follow-up, 49% had recurrence (vs 26% in patients without high-risk features, p 3 positive SLN constitute a high-risk group with a 2-fold greater recurrence risk. For those managed with nodal surveillance, SLN-basin recurrences were more frequent, but all-site recurrence and melanoma-specific mortality were comparable to patients treated with CLND. Most recurrences were outside the SLN-basin, supporting use of nodal surveillance for SLN-positive patients with microsatellites, ENE, and/ or >3 positive SLN

Active surveillance of patients who have sentinel node positive melanoma:An international, multi-institution evaluation of adoption and early outcomes after the Multicenter Selective Lymphadenectomy trial II (MSLT-2)

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/168248/1/cncr33483.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/168248/2/cncr33483_am.pd

Obesity and Pulmonary Complications in Critically Injured Adults

Naglasak ovog istraživanja stavljen je na učeničku percepciju suvremene vizualne umjetnosti i postizanje kvalitete osobe u nastavi Likovne kulture. Korelacija između te dvije odrednice jasna je ako uzmemo u obzir da se većina djela suvremene vizualne umjetnosti bavi pitanjem pojedinca i društva, a samim su time primjena i poučavanje suvremenih umjetničkih praksi u osnovnim školama poželjne kao metode za samoostvarenje učenika. No, prema postojećem Nastavnom planu i programu za likovnu kulturu u osnovnim školama, učenici se u nastavi Likovne kulture minimalno susreću sa suvremenim tendencijama u umjetnosti. Naglaska na refleksiju likovnog djela gotovo da nema, kao niti praktične izvedbe likovnih radova u suvremenim medijima. Ovim radom istražuje se što je kvaliteta osobe, kako su je definirali pojedini psiholozi i filozofi te koja je veza razvoja kvalitete osobe i umjetnosti, tj. kreativnosti i vizualne kulture. Istraživanjem se nastojalo ustanoviti koji čimbenici utječu na razvoj intrapersonalne inteligencije kod učenika, čiji je razvoj neophodan za samoaktualizaciju osobe i kako bi nastava Likovne kulture mogla doprinijeti njenom razvoju. Analizirajući odnos umjetnosti i života, zapanjujući je nesrazmjer poučavanja suvremene umjetnosti i umjetnosti prethodnih razdoblja. Primjenjujući prakse suvremene umjetnosti učenici doista neposredno uče o sebi i svijetu i na taj način ih se priprema za konkretne probleme s kojima bi se mogli susresti u budućnosti te bi se nesrazmjer trebao smanjiti. Prilikom istraživanja pokušalo se odgovoriti na sljedeća pitanja: Kako se intrapersonalna inteligencija učenika može poticati u nastavi Likovne kulture? Kako nastava Likovne kulture može doprinijeti samoostvarenju učenika? Kako suvremena vizualna umjetnost utječe na postizanje kvalitete osobe? Kako učenici promišljaju odnos vizualne umjetnosti i života? Dobivenim rezultatima istraživanja odgovorilo se na istraživačka pitanja. Uključivanjem suvremene vizualne umjetnosti u nastavu, učenici se upoznaju s aktualnim zbivanjima u umjetnosti, a drugačijim pristupima i poticanjima konceptualnog mišljenja omogućuje se kvalitetniji razvoj osobnosti na putu prema samoaktualizaciji.The focus of this research is students' perceptions of contemporary art and the achievement of a person's quality through the process of teaching fine arts. Considering that most contemporary artworks deal with the issue of the individual and society teaching, practicing contemporary art in primary schools is desirable as a method for self-realization. However, according to the existing curriculum for elementary schools, in the fine arts classes, students are minimally confronted with contemporary art. There is almost no encouragement of reflection about fine art, as neither practical implementation through contemporary media. This treatise explores what is the quality of the person, as defined by psychologists and philosophers, and correlation between the development of a person's quality and fine art, creativity, and visual culture. The research is trying to define factors of achieving intrapersonal intelligence, which development is necessary for the self-actualization of person, and how to process teaching of fine arts can contribute to that development. Analyzing the relationship between art and life, the astonishing disparity between teaching contemporary art and art of previous periods is staggering, Through contemporary art practices, students can learn directly about themselves and the world, thus preparing them for the specific problems they might confront in the future. This research appoint the following questions: Which is the way to encourage intrapersonal intelligence in the process of teaching fine arts? How the teaching of fine arts can contribute to self-realization? How contemporary visual art can affect on person's quality of life? Which is students opinion of the relationship between visual art and life? Incorporating contemporary art into the process of teaching, students become familiarized with current developments in the arts. Also, different approaches and encouraging conceptual thinking can support the development of personality in the process of self-actualization

The primary care provider (PCP)‐cancer specialist relationship: A systematic review and mixed‐methods meta‐synthesis

Although they are critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum are poorly understood. By using predefined search terms, the authors conducted a systematic review of the literature in 3 databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in‐depth. Findings from qualitative, quantitative, and disaggregated mixed‐methods studies were integrated using meta‐synthesis. Six themes were identified and incorporated into a preliminary conceptual model of the PCP‐cancer specialist relationship: 1) poor and delayed communication between PCPs and cancer specialists, 2) cancer specialists’ endorsement of a specialist‐based model of care, 3) PCPs’ belief that they play an important role in the cancer continuum, 4) PCPs’ willingness to participate in the cancer continuum, 5) cancer specialists’ and PCPs’ uncertainty regarding the PCP’s oncology knowledge/experience, and 6) discrepancies between PCPs and cancer specialists regarding roles. These data indicate a pervasive need for improved communication, delineation, and coordination of responsibilities between PCPs and cancer specialists. Future interventions aimed at these deficiencies may improve patient and physician satisfaction and cancer care coordination. CA Cancer J Clin 2017;67:156–169. © 2016 American Cancer Society.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136438/1/caac21385_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136438/2/caac21385.pd