Alien Registration- Laliberte, Sarah (Waterville, Kennebec County)

https://digitalmaine.com/alien_docs/15099/thumbnail.jp

Definitive-intent radiotherapy for sinonasal carcinoma in cats: a multicenter retrospective assessment

Treatment of epithelial sinonasal tumors in cats is not commonly reported. Palliative radiation protocols have been described more often than definitive-intent protocols. In this multi-institutional retrospective study, we included 27 cats treated with single-modality radiotherapy. Cats were irradiated using 10 daily fractions of 4.2Gy. Three cats (11.1%) experienced a complete clinical response and 17 (63%) had a partial clinical response. Stable clinical disease was noted in three cats (11.1%). Four cats (14.8%) showed progression within 3 months following treatment. The median time to progression for all cases was 269 days (95% CI: 225;314). The proportion of cats free of progression at 1 and 2 years was 24% (95%CI: 22%;26%) and 5% (95%CI: 5%;6%), respectively. None of the prognostic factors evaluated were predictive of outcome (anemia, tumor volume at the time of staging, modified Adams stage, intracranial involvement, facial deformity, epistaxis, inappetence or weight loss). Median overall survival (OS) for all deaths was 452 days (95%CI: 334;571). The proportion of cats alive at 1 and 2 years was 57% (95%CI: 37%;77%) and 27% (95%CI: 25%;29%), respectively. Surprisingly, cats with epistaxis had a longer median OS of 828 days (95%CI: 356;1301) compared to 296 days (95%CI: 85;508) in cats without epistaxis, (p=0.04, Breslow). Radiation therapy used as a single modality for the treatment of feline sinonasal carcinoma improved clinical signs and was well tolerated

Case studies for Social Transformation through Occupation

Sarah Kantartzis - ORCID 0000-0001-5191-015X https://orcid.org/0000-0001-5191-015XWith the financial support of the European Network of Occupational Therapy in Higher Education (ENOTHE) as part of the work of the project group Social Transformation through Occupation

Alien Registration- Laliberte, Sarah (Waterville, Kennebec County)

https://digitalmaine.com/alien_docs/15099/thumbnail.jp

Intraoperative diagnosis and treatment of thyroid storm in a 15-year-old male.

Thyroid storm, a severe complication of hyperthyroidism, can be a devastating medical emergency requiring rapid management. Intraoperative thyrotoxicosis, a hypermetabolic syndrome with increased thyroid hormone levels, also presents a challenging scenario. Clinical suspicion is key along with eliminating other potentially catastrophic emergencies such as malignant hyperthermia or pheochromocytoma. In this case report, we describe a 15-year-old male undergoing halo traction placement for displaced dens and C1 fractures. Preoperative tachycardia and a history suggestive of hyperthyroidism raised our clinical suspicion for thyrotoxicosis when hypertension and tachycardia developed after induction of anesthesia

Channel culture and economic performance in a competitive environment : Toyota and Nissan

From Crossref via Jisc Publications Router

Definitive‐intent intensity‐modulated radiation therapy provides similar outcomes to those previously published for definitive‐intent three‐dimensional conformal radiation therapy in dogs with primary brain tumors: A multi‐institutional retrospective study

Radiotherapy with or without surgery is a common choice for brain tumors in dogs. Although numerous studies have evaluated use of three-dimensional conformal radiotherapy, reports of definitive-intent, intensity modulated radiation therapy (IMRT) for canine intracranial tumors are lacking. IMRT has the benefit of decreasing dose to nearby organs at risk and may aid in reducing toxicity. However, increasing dose conformity with IMRT calls for accurate target delineation and daily patient positioning, in order to decrease the risk of a geographic miss. To determine survival outcome and toxicity, we performed a multi-institutional retrospective evaluation of dogs with brain tumors treated with IMRT. Fifty-two dogs treated with fractionated, definitive-intent IMRT at four academic radiotherapy facilities were included. All dogs presented with neurologic signs and were diagnosed via magnetic resonance imaging. Presumed radiological diagnoses included 37 meningiomas, 12 gliomas, and 1 peripheral nerve sheath tumor. One dog had two presumed meningiomas and one dog had either a glioma or meningioma. All dogs were treated in the macroscopic disease setting and were prescribed a total dose of 45-50 Gy (2.25-2.5 Gy per fraction in 18-20 daily fractions). Median survival time for all patients, including seven cases treated with a second course of therapy was 18.1 months (95% CI 12.3-26.6 months). As previously described for brain tumors, increasing severity of neurologic signs at diagnosis was associated with a worse outcome. IMRT was well tolerated with few reported acute, acute delayed or late side effects

“Eyes in the Home”: Addressing Social Complexity in Veterans Affairs Home-Based Primary Care

BACKGROUND: Home-Based Primary Care (HBPC) has demonstrated success in decreasing risk of hospitalization and improving patient satisfaction through patient targeting and integrating long-term services and supports. Less is known about how HBPC teams approach social factors. OBJECTIVE: Describe HBPC providers’ knowledge of social complexity among HBPC patients and how this knowledge impacts care delivery. DESIGN, SETTING, AND PARTICIPANTS: Between 2018 and 2019, we conducted in-person semi-structured interviews with 14HBPCproviders representing nursing,medicine, physical therapy, pharmacy, and psychology, at an urban Veterans Affairs (VA) medical center. We also conducted field observations of 6 HBPC team meetings and 2 home visits. APPROACH: We employed an exploratory, content-driven approach to qualitative data analysis. RESULTS: Four thematic categories were identified: (1) HBPC patients are socially isolated and have multiple layers of medical and social complexity that compromise their ability to use clinic-based care; (2) providers having “eyes in the home” yields essential information not accessible in outpatient clinics; (3) HBPC fills gaps in instrumental support, many of which are not medical; and (4) addressing social complexity requires a flexible care design that HBPC provides. CONCLUSION AND RELEVANCE: HBPC providers emphasized the importance of having “eyes in the home” to observe and address the care needs of homebound Veterans who are older, socially isolated, and have functional limitations. Patient selection criteria and discharge recommendations for a resource-intensive program like VA HBPC should include considerations for the compounding effects of medical and social complexity. Additionally, staffing that provides resources for these effects should be integrated into HBPC programming

“Making change by shared doing”: An examination of occupation in processes of social transformation in five case studies

From Crossref journal articles via Jisc Publications RouterSarah Kantartzis - ORCID: 0000-0001-5191-015X https://orcid.org/0000-0001-5191-015XBackground: As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes. Objective: To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice. Material and Methods: A generic descriptive qualitative case study design was utilized in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom. Results: Focusing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation. Conclusions and Significance: Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions.The authors would like to thank the European Network of Occupational Therapy in Higher Education (ENOTHE) for financial support of this research.aheadofprintaheadofprin

“They’re not doing enough.”: women’s experiences with opioids and naloxone in Toronto

Background: Amid increasing opioid overdose deaths in Canada since 2010 and a changing naloxone access landscape, there is a need for up-to-date research on Canadian women’s experiences with opioids. Studies on Canadian take-home naloxone programs are promising, but research beyond these programs is limited. Our study is the first to focus on women’s experiences and perspectives on the opioid crisis in Ontario, Canada’s most populous province, since the opioid crisis began in 2010. Objective: Our objective was to address research knowledge gaps involving Canadian women with criminal justice involvement who use opioids, and identify flaws in current policies, responses, and practices. While the opioid overdose crisis persists, this lack of research inhibits our ability to determine whether overdose prevention efforts, especially involving naloxone, are meeting their needs. Methods: We conducted semi-structured, qualitative interviews from January to April 2018 with 10 women with experience of opioid use. They were recruited through the study’s community partner in Toronto. Participants provided demographic information, experiences with opioids and naloxone, and their perceptions of the Canadian government’s responses to the opioid crisis. Interviews were transcribed verbatim and inductive thematic analysis was conducted to determine major themes within the data. Results: Thematic analysis identified seven major concerns despite significant differences in participant life and opioid use experiences. Participants who had used illicit opioids since naloxone became available over-the-counter in 2016 were much more knowledgeable about naloxone than participants who had only used opioids prior to 2016. The portability, dosage form, and effects of naloxone are important considerations for women who use opioids. Social alienation, violence, and isolation affect the wellbeing of women who use opioids. The Canadian government’s response to the opioid crisis was perceived as inadequate. Participants demonstrated differing needs and views on ideal harm reduction approaches, despite facing similar structural issues surrounding stigma, addiction management, and housing. Conclusions: Participants experienced with naloxone use found it to be useful in preventing fatal overdose, however many of their needs with regards to physical, mental, and social health, housing, harm reduction, and access to opioid treatment remained unmet.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacult