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Search Results: 1 - 10 of 2784 matches for " Geoffrey Porter "
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Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care
Robin Urquhart, Geoffrey A Porter, Eva Grunfeld, Joan Sargeant
Implementation Science , 2012, DOI: 10.1186/1748-5908-7-12
Abstract: This study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study.This study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.Cancer treatment and management have become increasingly complex over the past two decades, with therapeutic decisions often based on input from a multidisciplinary team that consists of radiologists, surgeons, pathologists, and oncologists [1]. For patients with suspected or confirmed cancer, clear and thorough recording of diagnostic and surgical procedures and
The impact of audit and feedback on nodal harvest in colorectal cancer
Geoffrey A Porter, Robin Urquhart, Jingyu Bu, Paul Johnson, Eva Grunfeld
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-2
Abstract: This population-based study included all patients undergoing resection for primary colorectal cancer in Nova Scotia, Canada, from 01 January 2001 to 31 December 2005. Linkage of the provincial cancer registry with other databases (hospital discharge, physician claims data, and national census data) provided clinicodemographic, diagnostic, and treatment-event data. Factors associated with adequate nodal harvest were examined using multivariate logistic regression. The specific interaction between year and health district was examined to identify any potential effect of dissemination of the previously-performed audit.Among the 2,322 patients, the median nodal harvest was 8; overall, 719 (31%) had an adequate nodal harvest. On multivariate analysis, audited health district (p < 0.0001), year (p < 0.0001), younger age (p < 0.0001), non-emergent surgery (p < 0.0001), more advanced stage (p = 0.008), and previous cancer history (p = 0.03) were associated with an increased likelihood of an adequate nodal harvest. Interaction between year and audited health district was identified (p = 0.006) such that the increase in adequate nodal harvest over time was significantly greater in the audited health district.Improvements in colorectal cancer nodal harvest did occur over time. A published audit demonstrating suboptimal nodal harvest appeared to be an effective knowledge translation tool, though more so for the audited health district, suggesting a potentially beneficial effect of audit and feedback strategies.In Canada, it is estimated there will be 22,500 new cases of colorectal cancer in 2010. More than 9,100 will die of the disease, making it the second most common cancer-causing death [1]. Survival is clearly related to stage of disease at diagnosis; the status of lymph nodes is a critical discriminator of stage, particularly in discriminating patients with stage II and stage III disease [2]. The use of adjuvant therapies has been clearly shown to improve survival for stag
A team approach to improving colorectal cancer services using administrative health data
Geoffrey Porter, Robin Urquhart, Jingyu Bu, Cynthia Kendell, Maureen MacIntyre, Ron Dewar, George Kephart, Yukiko Asada, Eva Grunfeld
Health Research Policy and Systems , 2012, DOI: 10.1186/1478-4505-10-4
Abstract: The objectives of this paper are to: 1) provide a detailed description of the methodologies employed across the various studies being conducted by Team ACCESS; 2) demonstrate how administrative health data can be used to evaluate access and quality in CRC services; and 3) provide an example of an interdisciplinary team approach to addressing health service delivery issues.All patients diagnosed with CRC in NS between 2001 and 2005 were identified through the Nova Scotia Cancer Registry (NSCR) and staged using the Collaborative Stage Data Collection System. Using administrative databases that were linked at the patient level, Team ACCESS created a retrospective longitudinal cohort with comprehensive demographic, clinical, and healthcare utilization data. These data were used to examine access to and quality of CRC services in NS, as well as factors affecting access to and quality of care, at various transition points along the continuum of care. Team ACCESS has also implemented integrated knowledge translation strategies targeting policy- and decision- makers.The development of Team ACCESS represents a unique approach to CRC research. We anticipate that the skills, tools, and knowledge generated from our work will also advance the study of other cancer disease sites in NS. Given the increasing prevalence of cancer, and with national and provincial funding agencies promoting collaborative research through increased funding for research team development, the work carried out by Team ACCESS is important in the Canadian context and exemplifies how a team approach is essential to comprehensively addressing issues surrounding not only cancer, but other chronic diseases in Canada.In Canada, an estimated 22,200 new cases of colorectal cancer (CRC) were diagnosed in 2011, making it the third most commonly diagnosed cancer in both men and women in Canada [1]. Despite a modest decrease in national mortality rates over the last 20 years, CRC mortality still accounts for approxim
Matrices That Commute with Their Conjugate and Transpose  [PDF]
Geoffrey Goodson
Advances in Linear Algebra & Matrix Theory (ALAMT) , 2013, DOI: 10.4236/alamt.2013.33005
Abstract:

It is known that if A∈Mn is normal (AA*=A*A) , then AA ̄=A ̄A if and only if AAT=ATA. This leads to the question: do both AA ̄=A ̄A and AAT=ATA imply that A is normal? We give an example to show that this is false when n=4, but we show that it is true when n=2 and n=3.


Crystallization Kinetics of Poly(3-hydroxybutyrate) Granules in Different Environmental Conditions  [PDF]
Michael Porter, Jian Yu
Journal of Biomaterials and Nanobiotechnology (JBNB) , 2011, DOI: 10.4236/jbnb.2011.23037
Abstract: Poly(3-hydroxybutyrate) (PHB) is a natural biopolyester accumulated in microbial cells as tiny amorphous granules. The nano- micro-particles have a variety of potential applications and behave differently in different environments. In this work, the in situ crystallization of native PHB granules was investigated under different environmental conditions. The isothermal crystallization kinetics of the granules was shown to follow Avrami’s equation. The model parameter describing crystal growth is a function of temperature or pH and estimated from in situ crystallization measurements with attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy. Empirical equations describing crystal growth are derived for the parameter values. PHB granules heated at 80-140°C in acidic solution (pH 2) up to 4 hr showed an increase in crystallinity from about 5% to 35% and moderate particle aggregation. PHB granules suspended in alkaline solutions (pH 9-12) at room temperature up to 4 hr showed an increase in crystallinity up to 45% and very little particle aggregation. It was found that the amorphousness of PHB granules in vivo is stabilized by water, lipids and proteins. Upon removal of these impurities, partial crystallization is induced which may inhibit extensive particle aggregation.
A phase II experience with neoadjuvant irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) for colorectal liver metastases
Oliver F Bathe, Scott Ernst, Francis R Sutherland, Elijah Dixon, Charles Butts, David Bigam, David Holland, Geoffrey A Porter, Jennifer Koppel, Scot Dowden
BMC Cancer , 2009, DOI: 10.1186/1471-2407-9-156
Abstract: A phase II trial was initiated in which patients with resectable CLM received CPT-11, 5-FU and LV for 12 weeks. Metastasectomy was performed unless extrahepatic disease appeared. Postoperatively, patients with stable or responsive disease received the same regimen for 12 weeks. Patients with progressive disease received either second-line chemotherapy or best supportive care. The primary endpoint was disease-free survival (DFS); secondary endpoints included overall survival (OS) and safety.35 patients were accrued. During preoperative chemotherapy, 16 patients (46%) had grade 3/4 toxicities. Resection was not possible in 5 patients. One patient died of arrhythmia following surgery, and 1 patient had transient liver failure. During the postoperative treatment phase, 12 patients (55%) had grade 3/4 toxicities. Deep venous thrombosis (DVT) occurred in 11 patients (34%) at various times during treatment. Of those who underwent resection, median DFS was 23.0 mo. and median OS has not been reached. The overall survival from time of diagnosis of liver metastases was 51.6 mo for the entire cohort.A short course of chemotherapy prior to hepatic metastasectomy may serve to select candidates best suited for resection and it may also direct postoperative systemic treatment. Given the significant incidence of DVT, alternative systemic neoadjuvant regimens should be investigated, particularly those that avoid the use of a central venous line.ClinicalTrials.gov NCT00168155.The liver is the most common site of metastasis for colorectal cancer. Resection is the only hope for long-term survival for CLM. The median survival in such patients prior to recent advances in chemotherapy ranged from 19 – 30 mo, with five year survivals of 30–39% [1-3]. Recent studies have reported even better survivals [1,2,4,5]. This may be due to improved chemotherapy, administered during various times of the patient's illness. Typically, response rates for first line chemotherapy are 39–60% [6-9]. While i
How Did Social Medicine Evolve, and Where Is It Heading?
Dorothy Porter
PLOS Medicine , 2006, DOI: 10.1371/journal.pmed.0030399
Abstract:
La palabra corporizada
Porter, Luis;
Pro-Posi??es , 2010, DOI: 10.1590/S0103-73072010000200003
Abstract: creative capacity is intimately related to the ways in which the brain processes and stores language. metaphors and their etymologies are footprints of the past, the dna of our thoughts. recent findings in neuroscience concerning the way in which the brain works linguistically have shown that people make use of a particular register determined by the supply of metaphors that they have accumulated throughout their lives to guide their imaginative pathways. the idea that concepts are physically rooted contrasts with the idea of rationalism, which holds the statement that concepts are bodiless abstractions, completely separate from the sensory motor system. this new way of regarding language, therefore, gives rise to a new conceptualization of the human body. by putting the findings of science and the artistic dimensions of metaphors together, we take a step toward encouraging poetic seeing and thinking in education.
Specifics of Course Management System Benefits for New University Faculty
Gavin Porter
Higher Education Studies , 2011, DOI: 10.5539/hes.v1n2p2
Abstract: A comparison of courses that do or do not utilize a Course Management System (CMS) was undertaken from the standpoint of a new faculty member. Seven distinct advantages were found with CMS implementation including initial tutorial group set-ups, email communication, sharing of student generated products, sharing of instructor-generated products, collection of assignments, delivery of graded assignments, and plagiarism checks. CMS training that precedes the start of a course is recommended for new teaching staff, particularly for large courses of greater than 100 students, where CMS implementation has substantial benefits.
Changing Definitions of the History of Public Health
Porter, Dorothy
Hygiea Internationalis : an Interdisciplinary Journal for the History of Public Health , 2000,
Abstract: This article examines the transformation from earlier to contemporary historiographical interpretations of the development of public health systems in relation to the construction of political states. It reviews the changing foci of histories of epidemic and chronic diseases and argues that this work has been central to expanding the conceptual basis for public health history as the ‘history of collective actions in relation to the health of populations’. The article subsequently argues that, therefore, public health history is inherently bound to the history of political collectivism as a form of knowledge constructed through systems of ideological belief.
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