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1.
Trends Cancer. 2018 Aug;4(8):523-536. doi: 10.1016/j.trecan.2018.06.007. Epub 2018 Jul 21.

The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities.

Author information

1
Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: srivasts@mail.nih.gov.
2
Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.

Abstract

Many cancers evolve from benign precancerous lesions and have a natural history of progression that provides a window of opportunity for intervention. The biological mechanisms underlying this evolutionary trajectory can only be truly understood through an extensive characterization of the molecular, cellular, and non-cellular properties of premalignant and malignant tumors, and must also recognize how the microenvironment (stromal cells, immune cells, and other types of cells) contributes to this evolution. We describe here the need to develop comprehensive molecular and cellular atlases for organ-specific premalignant lesions while capturing the spatial, structural, and functional changes over time that will provide a greater understanding of how premalignancy transitions to malignancy. The PreCancer Atlas (PCA) initiative, described in this Opinion, will address this need and aims to overcome the many challenges that currently plague the field. The hope is that PCAs will lead to the development of effective and timely interventions to prevent the development of invasive cancers.

KEYWORDS:

atlas; cellular; microenvironment; molecular; precancer; spatial; temporal; visualization

Publication type

Publication type

2.
AJR Am J Roentgenol. 2018 Mar;210(3):W133-W134. doi: 10.2214/AJR.17.19078.

MRI in De Quervain Tenosynovitis: Is Making the Diagnosis Sufficient?

Author information

1
1 All India Institute of Medical Sciences, New Delhi, India ankurgoyalaiims@gmail.com.

Comment on

PMID:
29469625
DOI:
10.2214/AJR.17.19078
[Indexed for MEDLINE]
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3.
Nurs Leadersh (Tor Ont). 2017;30(3):8-22. doi: 10.12927/cjnl.2018.25388.

Nursing Leadership: Making a Difference in Mental Health and Addictions.

Author information

1
VP and Chief Nursing Executive, Ontario Shores Centre for Mental Health Sciences, Whitby, ON.
2
CAMH Chair in Mental Health Nursing Research; Assistant Professor, Lawrence S. Bloomberg Faculty of Nursing; Faculty of Medicine, Department of Psychiatry, University of Toronto; Clinician-Scientist, Centre for Addiction and Mental Health, Toronto, ON.
3
Project Scientist, Centre for Addiction and Mental Health, Toronto, ON.
4
Chief of Nursing and Professional Practice, Centre for Mental Health and Addiction, Toronto, ON.
5
Vice President Clinical Services, Ontario Shores Centre for Mental Health Sciences, Whitby, ON.

Abstract

Five nurse leaders in mental health offer their perspectives on key issues facing the sector and reflect on how nurses can make a difference in the following critical areas: nursing practice, transitions of care, innovative technologies, challenging stigma and creating patient partnerships.

PMID:
29457765
DOI:
10.12927/cjnl.2018.25388
[Indexed for MEDLINE]
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4.
Health Policy Plan. 2016 Sep;31 Suppl 2:ii35-ii46. doi: 10.1093/heapol/czv117.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

Author information

1
IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK, meenakshi.gautham@lshtm.ac.uk.
2
IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK.
3
Impact Partners in Social Development, Malviya Nagar, New Delhi, India.
4
Public Health Foundation of India, Vasant Kunj Institutional Area, New Delhi, India.

Abstract

Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private registered facilities by developing a standardized and simple system with consistent communication and follow up.

KEYWORDS:

Data sharing; MNCH data; health management information system; private health sector; public health sector; public–private engagement

PMID:
27591205
PMCID:
PMC5009220
DOI:
10.1093/heapol/czv117
[Indexed for MEDLINE]
Free PMC Article
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5.
Health Policy Plan. 2016 Sep;31 Suppl 2:ii25-ii34. doi: 10.1093/heapol/czw017.

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

Author information

1
Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, 122002, India.
2
IDEAS Project, London School of Hygiene and Tropical Medicine, UK and.
3
JaRco Consulting PLC, Addis Ababa, Ethiopia, PO Box 43107.
4
IDEAS Project, London School of Hygiene and Tropical Medicine, UK and bilal.avan@lshtm.ac.uk.

Abstract

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making.

KEYWORDS:

Ethiopia; HMIS; Health system blocks; India; private sector; public sector

PMID:
27591203
PMCID:
PMC5009222
DOI:
10.1093/heapol/czw017
[Indexed for MEDLINE]
Free PMC Article
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6.
Cytotherapy. 2016 Jan;18(1):120-3. doi: 10.1016/j.jcyt.2015.11.005.

Part 2: Making the "unproven" "proven".

Author information

1
Department of Medicine, University of Vermont, Burlington, Vermont, USA. ISCT Chief Scientific Officer 2014-2016. Chair, ISCT Pulmonary Committee 2013-2015. Electronic address: dweiss@uvm.edu.
2
Department of Cell & Molecular Therapies, Royal Prince Alfred Hospital, Centenary Institute, Sydney Medical School, University of Sydney, Sydney, Australia. ISCT Australia & New Zealand, Past Regional Vice President 2008-2012.
3
Andalusian Initiative for Advanced Therapies, Junta de Andalucía, Sevilla, Spain. Chair, ISCT EU LRA Committee, 2014-2016.
4
Bone Marrow Transplantation and Cell Therapy Unit, Associação Portuguesa de Beneficencia, SJ Rio Preto, Sao Paulo, Brazil. ISCT South & Central America, Past Regional Vice President 2013-2015.
5
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan. ISCT Asia, Past Regional Vice President 2013-2015.
6
Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia. ISCT Australia & New Zealand, Regional Vice-President 2014-2016.
7
Western Australian Neuroscience Research Institute, Centre for Comparative Genomics, Murdoch University, Perth, Australia. Member at large of the ISCT Presidential Task Force on the Use of Unproven Cellular Therapies.
8
Division of Oncology, Laboratory of Cellular Therapy, University of Modena & Reggio Emilia, Modena, Italy. ISCT President 2014-2016. Chair of the ISCT Presidential Task Force on the Use of Unproven Cellular Therapies.
9
Center for Stem Cell Research (a unit of inStem, Bengaluru), Department of Hematology, Christian Medical College, Vellore, India. Member at large of the ISCT Presidential Task Force on the Use of Unproven Cellular Therapies.
7.
J Ind Microbiol Biotechnol. 2013 Feb;40(2):245-55. doi: 10.1007/s10295-012-1220-z. Epub 2012 Dec 18.

A simple Pichia pastoris fermentation and downstream processing strategy for making recombinant pandemic Swine Origin Influenza a virus Hemagglutinin protein.

Author information

1
Bioprocess and Scale Up Facility, Defence Research and Development Establishment, Ministry of Defence, Govt. of India, Gwalior 474 002, MP, India. athmabiotech@gmail.com

Abstract

The present Influenza vaccine manufacturing process has posed a clear impediment to initiation of rapid mass vaccination against spreading pandemic influenza. New vaccine strategies are therefore needed that can accelerate the vaccine production. Pichia offers several advantages for rapid and economical bulk production of recombinant proteins and, hence, can be attractive alternative for producing an effective influenza HA based subunit vaccine. The recombinant Pichia harboring the transgene was subjected to fed-batch fermentation at 10 L scale. A simple fermentation and downstream processing strategy is developed for high-yield secretory expression of the recombinant Hemagglutinin protein of pandemic Swine Origin Influenza A virus using Pichia pastoris via fed-batch fermentation. Expression and purification were optimized and the expressed recombinant Hemagglutinin protein was verified by sodium dodecyl sulfate polyacrylamide gel electrophoresis, Western blot and MALDI-TOF analysis. In this paper, we describe a fed-batch fermentation protocol for the secreted production of Swine Influenza A Hemagglutinin protein in the P. pastoris GS115 strain. We have shown that there is a clear relationship between product yield and specific growth rate. The fed-batch fermentation and downstream processing methods optimized in the present study have immense practical application for high-level production of the recombinant H1N1 HA protein in a cost effective way using P. pastoris.

PMID:
23247902
DOI:
10.1007/s10295-012-1220-z
[Indexed for MEDLINE]
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8.
J Palliat Med. 2012 Aug;15(8):916-22. doi: 10.1089/jpm.2012.0006. Epub 2012 Jun 26.

Parent-clinician communication intervention during end-of-life decision making for children with incurable cancer.

Author information

1
Children's National Medical Center, 111 Michigan Avenue N.W., Washington, DC 20010, USA. pshinds@childrensnational.org

Abstract

BACKGROUND:

In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clinicians in time to be of use in the family's care.

METHODS:

Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life communication with their child's clinicians. They completed the questionnaire again two to three weeks later and responded to three open-ended questions to assess the benefit:risk ratio of their study participation three months after the intervention. Clinicians received the interview data within hours of the parent interview and evaluated the usefulness of the information three weeks later.

RESULTS:

All preestablished intervention feasibility criteria were met; 77.3% of families consented; and in 100% of interventions, information was successfully provided individually to 3 to 11 clinicians per child before the child died. No harm was reported by parents as a result of participating; satisfaction and other benefits were reported. Clinicians reported moderate to strong satisfaction with the intervention.

CONCLUSION:

The communication intervention was feasible within hours of decision making, was acceptable and beneficial without harm to participating parents, and was acceptable and useful to clinicians in their care of families.

PMID:
22734685
PMCID:
PMC3396144
DOI:
10.1089/jpm.2012.0006
[Indexed for MEDLINE]
Free PMC Article
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9.
Disasters. 2009 Mar;33(1):58-81. doi: 10.1111/j.1467-7717.2008.01062.x. Epub 2008 May 21.

Making a technological choice for disaster management and poverty alleviation in India.

Author information

1
Scientist, Disaster Management Support Programme, Indian Space Research Organisation, Government of India, India. sanjay@isro.gov.in

Abstract

The right mix of policy, institutional arrangements and use of technology provides the framework for a country's approach to disaster mitigation. Worldwide, there has been a shift away from a strictly 'top-down' approach relying on government alone, to a combination of 'top-down' and 'bottom-up' approaches. The aim is to enhance the indigenous coping mechanisms of vulnerable communities; draw on their cooperative spirit and energy; and empower them through appropriate information and contextual knowledge to mitigate natural disasters. In light of this, the paper examines India's use of space technology in its disaster management efforts. Poverty alleviation and disaster management are almost inseparable in many parts of the country, as vulnerability to natural disasters is closely aligned with poverty. Addressing these issues together requires integrated knowledge systems. The paper examines how knowledge inputs from space technology have strengthened the national resolve to combat natural disasters in conjunction with alleviating rural poverty.

[Indexed for MEDLINE]
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10.
Cell. 2006 Sep 22;126(6):1037-48.

Making or breaking the heart: from lineage determination to morphogenesis.

Author information

1
Gladstone Institute of Cardiovascular Disease and Department of Pediatrics and Biochemistry, University of California, San Francisco, CA 94158, USA. dsrivastava@gladstone.ucsf.edu

Abstract

The cues governing cardiac cell-fate decisions, cardiac differentiation, and three-dimensional morphogenesis are rapidly being elucidated. Several themes are emerging that are relevant for childhood and adult heart disease and the growing field of stem cell biology. This review will consider our current understanding of cardiac cell-fate determination and cardiogenesis--largely derived from developmental studies in model organisms and human genetic approaches--and examine future implications for diagnosis, prevention, and treatment of heart disease in the young and old.

PMID:
16990131
DOI:
10.1016/j.cell.2006.09.003
[Indexed for MEDLINE]
Free full text
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11.
12.
Cancer Nurs. 2001 Apr;24(2):122-34; quiz 135-6.

End-of-life decision making by adolescents, parents, and healthcare providers in pediatric oncology: research to evidence-based practice guidelines.

Author information

1
St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.

Abstract

Participating in end-of-life decisions is life altering for adolescents with incurable cancer, their families, and their healthcare providers. However, no empirically developed and validated guidelines to assist patients, parents, and healthcare providers in making these decisions exist. The purpose of the work reported here was to use three sources (the findings of three studies on decision making in pediatric oncology, published literature, and recommendations from professional associations) to develop guidelines for end-of-life decision making in pediatric oncology. The study designs include a retrospective, descriptive design (Study 1); a prospective, descriptive design (Study 2); and a cross-sectional, descriptive design (Study 3). Settings for the pediatric oncology studies included a pediatric catastrophic illness research hospital located in the Midsouth (Studies 1 and 2); and that setting plus a children's hospital in Australia and one in Hong Kong (Study 3). Study samples included 39 guardians and 21 healthcare providers (Study 1); 52 parents, 10 adolescents, and 22 physicians (Study 2); and 43 parents (Study 3). All participants in the studies responded to six open-ended questions. A semantic content analysis technique was used to analyze all interview data. Four nurses independently coded each interview; interrater reliability per code ranged from 68% to 100% across studies. The most frequently reported influencing factors were "information on the health and disease status of the patient," "all curative options having been attempted," "trusting the healthcare team," and "feeling support from the healthcare provider." The agreement across studies regarding influencing factors provides the basis for the research-based guidelines for end-of-life decision making in pediatric oncology. The guidelines offer assistance with end-of-life decision making in a structured manner that can be formally evaluated and individualized to meet patient and family needs.

PMID:
11318260
[Indexed for MEDLINE]
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13.
Oncol Nurs Forum. 1997 Oct;24(9):1523-8.

Decision making by parents and healthcare professionals when considering continued care for pediatric patients with cancer.

Author information

1
Department of Nursing, St. Jude Children's Research Hospital, Memphis, TN, USA.

Abstract

PURPOSE/OBJECTIVES:

To better define the treatment-related decisions considered most difficult by parents of pediatric patients with cancer and the factors that influenced their final decisions.

DESIGN:

Retrospective-descriptive design.

SETTING:

Pediatric oncology institution in the mid-southern region on the United States.

SAMPLE:

39 parents representing 37 of 83 eligible families, 16 attending physicians, three nurses, and two chaplains.

METHODS:

Parent participants responded by telephone to six open-ended interview questions and a 15-item questionnaire about factors that were important when making the decision to continue care. Healthcare professionals were interviewed face-to-face.

MAIN RESEARCH VARIABLES:

Most difficult treatment-related decisions; factors influencing decision making.

FINDINGS:

Parents reported 15 types of difficult decisions, the majority of which were made late in the course of treatment. Deciding between a phase I drug study or no further treatment (n = 14), maintaining or withdrawing life support (n = 11), and giving more chemotherapy or giving no further treatment (n = 8) were the most frequently reported difficult decisions. Parents rated "recommendations received from healthcare professionals" as the questionnaire factor most important in their decision making, and healthcare professionals rated "discussion with the family of the patient" as the most important factor.

CONCLUSION:

Parents of children or adolescents with cancer and their healthcare providers face difficult treatment-related decisions, many of which occur late in the course of treatment. Parents and healthcare professionals cite similar factors in their decision making but differ in their ratings of the factors' importance. For parents, the information and recommendations they receive from healthcare professionals figure most frequently and most importantly in their decision making. For healthcare professionals, the certainty that the patient will not get better and discussions with the patient's family figure most importantly in their decision making. Once parents conclude that their child can not get better, they are more likely to choose noncurative options such as choosing no further treatment or withdrawing life support.

IMPLICATIONS FOR NURSING PRACTICE:

Nurses can help determine what information parents need in their decision making. Particular attention must be given to ways to communicate the likelihood of the their child's survival.

PMID:
9348593
[Indexed for MEDLINE]

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