Adjunctive Statistical Standardization of Adjuvant Estrogen Receptor and Progesterone Receptor in Canadian Cancer Trials Group MA.27 Postmenopausal Breast Cancer Trial of Exemestane Versus Anastrozole.

Purpose: ASCO/College of American Pathologists guidelines recommend reporting estrogen receptor (ER) and progesterone receptor (PgR) as positive with (1%-100%) staining. Statistically standardized quantitated positivity could indicate differential associations of positivity with breast cancer outcomes.

Methods: MA.

Neurocognitive outcomes following fetal exposure to chemotherapy for gestational breast cancer: A Canadian multi-center cohort study.

Background: Limited knowledge exists on outcomes of children exposed prenatally to chemotherapy for breast cancer (BC). The purpose of this study was to compare long-term neurocognitive, behavioral, developmental, growth, and health outcomes of children exposed in-utero to chemotherapy for BC.

Methods: This is a multi-center matched cross-sectional cohort study involving seven cancer centers across the region of Southern Ontario (Canada), and the Hospital for Sick Children (Toronto, Ontario).

The Role of Denosumab for Surgical Outcomes in Patients with Giant Cell Tumour of Bone: A Systematic Review.

The role of denosumab in patients with resectable giant cell tumour of bone remains unclear. We asked the following research question: for patients (aged ≥ 12 years) with resectable giant cell tumour of bone, what are the benefits and harms of denosumab compared with no denosumab in terms of (1) facilitation of surgery (operative time, blood loss), (2) disease recurrence, (3) pain control, (4) disease stability, and (5) adverse effects (e.g.

Feasibility and Effectiveness of Implementing a Novel Exercise and Self-Management Programme during Chemotherapy for Women with Breast Cancer: A Pilot Randomized Controlled Trial.

The aim of this study was to determine the feasibility and effectiveness of implementing a novel exercise and self-management programme for women with breast cancer during chemotherapy. The study used a pilot implementation design with a randomized controlled trial methodology. The 26 participants were adult breast cancer survivors (Stages 1-3) undergoing chemotherapy treatment.

Bridging the gap: incorporating exercise evidence into clinical practice in breast cancer care.

Purpose: To determine the feasibility (recruitment, retention, and adherence rates) of implementing a multi-dimensional knowledge translation (KT) intervention designed for women with breast cancer, and to explore preliminary estimates of effects of the implementation strategy on exercise level, exercise knowledge and behavior, health-related quality of life, and overall health status among breast cancer survivors.

Methods: Design: Implementation Trial.

Participants: Community-dwelling women, over 18 years of age, currently undergoing chemotherapy for stage 1-3 BRCA.

Interventions for reducing unplanned paediatric admissions: an observational study in one hospital.

Objective: Evidence on how best to intervene to improve paediatric acute care and therefore reduce unplanned hospital admissions is weak. We describe service evaluation work at one hospital to assess interventions at critical clinical and service decision points.

Design: We conducted an observational study using routine daily-collected data (April 2009-December 2015) from a medium-sized district general hospital in south-west UK, using before-and-after comparisons of admissions-related data to evaluate two interventions implemented in April and November 2014, respectively: (1) an advice and guidance (A&G) phone line, where a senior paediatrician is available for general practitioners (GPs) and emergency department (ED) and (2) a Short Stay Paediatric Assessment Unit (SSPAU).

Physical Activity and Breast Cancer: A Qualitative Study on the Barriers to and Facilitators of Exercise Promotion from the Perspective of Health Care Professionals.

We determined the barriers to and facilitators of exercise promotion by health care professionals (HCPs) for women with breast cancer (BC). The study was a qualitative descriptive study. Semi-structured interviews were conducted with HCPs who treat individuals with BC in Ontario.

'Recognized, Valued and Supported'? The Experiences of Adult Siblings of People with Autism Plus Learning Disability.

Background: The potential of adult siblings to offer long-term support to a brother or sister with autism is rarely realized. To understand this, our study explores the expectations of social care among adult siblings.

Method: Using qualitative interviews, we spoke to 21 adult siblings about their family relationships and engagement with service delivery, met with 12 of their siblings with autism and talked to 12 social care staff.

Safe handling of cytotoxics: guideline recommendations.

Background: This evidence-based practice guideline was developed to update and address new issues in the handling of cytotoxics, including the use of oral cytotoxics; the selection and use of personal protective equipment; and treatment in diverse settings, including the home setting.

Methods: The guideline was developed primarily from an adaptation and endorsement of an existing guideline and from three systematic reviews. Before publication, the guideline underwent a series of peer and external reviews to gather feedback.

A phase II study of SB939, a novel pan-histone deacetylase inhibitor, in patients with translocation-associated recurrent/metastatic sarcomas-NCIC-CTG IND 200†.

Background: A subgroup of sarcomas is characterized by defining chromosomal translocations, creating fusion transcription factor oncogenes. Resultant fusion oncoproteins associate with chromatin-modifying complexes containing histone deacetylases (HDAC), and lead to epigenetic transcriptional dysregulation. HDAC inhibitors were shown to be effective in vitro, reversing gene repression by these complexes, restoring PTEN expression and apoptosis via the PI3K/Akt/mTOR pathway.

A Translational Study of the Neoplastic Cells of Giant Cell Tumor of Bone Following Neoadjuvant Denosumab.

Background: Giant cell tumor of bone is a primary bone tumor that is treated surgically and is associated with high morbidity in many cases. This tumor consists of giant cells expressing RANK (receptor activator of nuclear factor-κB) and mesenchymal spindle-like stromal cells expressing RANKL (RANK ligand); the interaction of these cells leads to bone resorption. Denosumab is a monoclonal antibody that binds RANKL and directly inhibits osteoclastogenesis.

Oncologists' protocol and coping strategies in dealing with patient loss.

To identify what protocol and coping strategies oncologists turn to cope with patient loss, the authors interviewed 20 oncologists at 3 hospitals. Using the grounded theory method, findings revealed that their protocol may include meeting with families, participating in bereavement rituals, making a phone call, or sending a condolence card. Coping strategies included social support, activity-oriented coping, turning to faith, compartmentalization, and withdrawing from patients and families.

Cattle herd inspections and fly trapping for the detection of the Old World screw-worm fly (Chrysomya bezziana).

Objectives: To compare the sensitivity of inspections of cattle herds and adult fly trapping for detection of the Old World screw-worm fly (OWS).

Procedures: The incidence of myiases on animals and the number of OWS trapped with LuciTrap®/Bezzilure were measured concurrently on cattle farms on Sumba Island (Indonesia) and in peninsular Malaysia (two separate periods for the latter). The numbers of animal inspections and traps required to achieve OWS detection at the prevalent fly densities were calculated.

Oncologists' strategies and barriers to effective communication about the end of life.

Purpose: Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients.

Continuity, commitment and context: adult siblings of people with autism plus learning disability.

Sibling relationships are usually lifelong and reciprocal. They can assume particular significance when a brother or sister has a learning disability. Until recently, adult siblings of people with disabilities such as severe autism have been ignored by policy, practice and research.

Exemestane versus anastrozole in postmenopausal women with early breast cancer: NCIC CTG MA.27--a randomized controlled phase III trial.

Purpose: In patients with hormone-dependent postmenopausal breast cancer, standard adjuvant therapy involves 5 years of the nonsteroidal aromatase inhibitors anastrozole and letrozole. The steroidal inhibitor exemestane is partially non-cross-resistant with nonsteroidal aromatase inhibitors and is a mild androgen and could prove superior to anastrozole regarding efficacy and toxicity, specifically with less bone loss.

Patients And Methods: We designed an open-label, randomized, phase III trial of 5 years of exemestane versus anastrozole with a two-sided test of superiority to detect a 2.

Difficult patient loss and physician culture for oncologists grieving patient loss.

Background: While caring for critically ill and terminal patients can elicit grief symptoms in health care professionals, few studies have examined oncologists' grief over patient loss using a qualitative approach to inquiry.

Objectives: To explore what makes patient loss difficult for oncologists and to explore the context in which these losses were occurring.

Method: Twenty oncologists were interviewed at three oncology centers in Canada about their experiences of grief over patient loss.

Interleukin-21 has activity in patients with metastatic melanoma: a phase II study.

Purpose: We report a multicenter phase II study of patients with metastatic melanoma (MM), evaluating the efficacy, toxicity, progression-free survival (PFS), immunogenicity, and biomarker profile of interleukin-21 (IL-21).

Patients And Methods: Patients with no prior systemic therapy and with limited-disease MM were treated with IL-21 by using three different dosing regimens. Cohort 1 received 50 μg/kg per day by outpatient intravenous bolus injection for 5 days of each week during weeks 1, 3, and 5 of an 8-week cycle.

What do oncologists want? Suggestions from oncologists on how their institutions can support them in dealing with patient loss.

Purpose: The purpose of the study was to explore what institutional support(s) oncologists want to help them cope with patient loss.

Methods: The grounded theory method was used. Twenty oncologists were recruited and interviewed between November 2010 and July 2011 from three adult oncology centers in Ontario.

Field assessment of synthetic attractants and traps for the Old World screw-worm fly, Chrysomya bezziana.

The performance of newly developed trapping systems for the Old World screw-worm fly, Chrysomya bezziana has been determined in field trials on cattle farms in Malaysia. The efficacy of non-sticky traps and new attractants to trap C. bezziana and non-target flies was compared with the standard sticky trap and Swormlure.

Phase II study of ganitumab, a fully human anti-type-1 insulin-like growth factor receptor antibody, in patients with metastatic Ewing family tumors or desmoplastic small round cell tumors.

Purpose: Ganitumab is a fully human monoclonal antibody against type-1 insulin-like growth factor receptor (IGF1R). An open-label phase II study was conducted to evaluate the efficacy and safety of ganitumab monotherapy in patients with metastatic Ewing family tumors (EFT) or desmoplastic small round cell tumors (DSRCT).

Patients And Methods: Patients ≥16 years of age with relapsed or refractory EFT or DSRCT received 12 mg/kg of ganitumab every 2 weeks.

Primary tumor and patient characteristics in breast cancer as predictors of adjuvant therapy regimen: a regression model.

Purpose: Adjuvant therapy reduces the risk of recurrence of breast cancer. This study was undertaken to determine characteristics guiding choice of adjuvant therapy.

Methods: A retrospective review was completed of characteristics of patients with breast cancer (stages I-III) at a regional center from 2004 to 2007.

Cortical and trabecular bone at the radius and tibia in postmenopausal breast cancer patients: a Peripheral Quantitative Computed Tomography (pQCT) study.

Bone morbidity associated with antineoplastic treatment is a significant health concern for postmenopausal breast cancer patients. Trials have demonstrated that adjuvant therapy with an Aromatase Inhibitor is associated with an increase in musculoskeletal disorders and bone fractures. The objective of this study was to utilize Peripheral Quantitative Computed Tomography (pQCT) to assess in vivo trabecular and cortical volumetric bone at peripheral skeletal sites in healthy postmenopausal women and breast cancer patients prescribed Anastrozole.

An exploratory study of the development of early syllable structure in reading-impaired children.

Babbling between the ages of 8 and 19 months was examined in 19 children, 13 of whom were at high risk for reading disorder (RD) and 6 normally reading children at low familial risk for RD. Development of syllable complexity was examined at five periods across this 11-month window. Results indicated that children who later evidenced RD produced a lower proportion of canonical utterances and less complex syllable structures than children without RD.