Saturday, August 30, 2014

Effect of Direct Neuroradiologist Participation in Physician Marketing on Imaging Volumes in Outpatient Radiology

Effect of Direct Neuroradiologist Participation in Physician Marketing on Imaging Volumes in Outpatient Radiology
AJNR Blog

Editor's Choice

August 2014

(2 of 3)

This study assessed the benefits of using a sales representative and a neuroradiologistas a marketing and sales team for referrals in outpatient imaging. When referring practices were visited by the 2-person team, referral volumes were 2.5 times greater than when they were visited by the sales representative alone. This impact on imaging referral volumes with the use of the neuroradiologist for direct physician-to-physician marketing supports the concept that neuroradiologist visits are important in establishing and maintaining a relationship with the referring clinician's office and maximizing imaging referrals.

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Abstract

BACKGROUND AND PURPOSE
Over the past several years, decreased demand for and increased supply of imaging services has increased competition among outpatient imaging centers in the United States. This study hypothesizes that using a radiology sales representative and neuroradiologist as a team in marketing and sales will increase imaging referrals in outpatient imaging.

MATERIALS AND METHODS
From January to December 2009, baseline monthly physician referral data of CT and MR scans of 19 referring clinicians (neurologists, neurosurgeons, and anesthesiologists) to an outpatient radiology group were collected. During that time, a nonphysician radiology sales representative visited the referring clinicians' offices every 2 weeks. From January to June 2010, the same radiology sales representative visited the referring clinicians' offices every 2 weeks but was accompanied by a neuroradiologist once a month. From July 2010 to June 2011, the same radiology sales representative visited the referring clinicians' offices twice a month without a neuroradiologist.

RESULTS
Cross-sectional imaging referral volumes were approximately 2.5 times greater during the 6-month period using the neuroradiologist for direct physician-to-physician marketing when compared with the volumes achieved with the sales representative alone, and continued neuroradiologist involvement in marketing and sales is required to maintain referral volumes over time.

CONCLUSIONS
The impact on imaging referral volumes during the 6-month use of the neuroradiologist for direct physician-to-physician marketing in this study supports the assertion that neuroradiologist visits are an important element in establishing and maintaining a relationship with the referring clinician's office and thereby maximizing imaging referrals.

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The post Effect of Direct Neuroradiologist Participation in Physician Marketing on Imaging Volumes in Outpatient Radiology appeared first on AJNR Blog.



Original Article: http://www.ajnrblog.org/2014/08/30/effect-direct-neuroradiologist-participation-physician-marketing-imaging-volumes-outpatient-radiology/

Friday, August 29, 2014

Após um tumor cerebral - iBook e Android

APÓS UM TUMOR CEREBRAL

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APÓS UM TUMOR CEREBRAL

Júlio Pereira

Category: Medical

5 Ratings



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Cancer survivors' uptake and adherence in diet and exercise intervention trials: An integrative data analysis

Cancer survivors' uptake and adherence in diet and exercise intervention trials: An integrative data analysis
Cancer

BACKGROUND

The health benefits of diet and exercise interventions for cancer survivors are well documented. However, little is known regarding demographic and medical predictors of survivors' willingness to participate in diet and exercise intervention trials, study enrollment, intervention adherence, and study completion. To assist in interpreting the generalizability of trial findings and to improve the design of future trials, this study examined predictors of these process measures.

METHODS

An integrative data analysis was performed on data from 3 of the largest home-based diet and exercise intervention trials for cancer survivors (n = 23,841). Demographic and medical factors (ie, sex, race, age, time since diagnosis, and cancer type) were examined as predictors of willingness to participate, study enrollment, intervention adherence, and study completion in the pooled sample. A 99% confidence interval was used to determine statistical significance.

RESULTS

Across trials, 11.1% of contacted survivors were willing to participate, and 5.7% were eligible and enrolled. Among enrollees, 53.4% demonstrated ≥75% adherence to the intervention, and 91.1% completed the study. Race (Caucasian vs others), age, time since diagnosis, and cancer type predicted survivors' willingness to participate (P < .01). All examined predictors were associated with the likelihood of study enrollment (P < .01). No significant predictors of intervention adherence or study completion were found among study enrollees (P ≥ .01).

CONCLUSIONS

Cancer survivors' demographic and medical characteristics predicted their interest and participation in diet and exercise intervention trials. These findings have implications for the generalizability of results and can help to guide procedures used in future trials to enhance patient representation. Cancer 2014. © 2014 American Cancer Society.



Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.28978

Evaluation of high-fidelity simulation training in radiation oncology using an outcomes logic model

Evaluation of high-fidelity simulation training in radiation oncology using an outcomes logic model
Radiation Oncology - Latest Articles

Purpose: To evaluate the feasibility and educational value of high-fidelity, interprofessional team-based simulation in radiation oncology. Methods: The simulation event was conducted in a radiation oncology department during a non-clinical day. It involved 5 simulation scenarios that were run over three 105 minute timeslots in a single day. High-acuity, low-frequency clinical situations were selected and included HDR brachytherapy emergency, 4D CT artifact management, pediatric emergency clinical mark-up, electron scalp trial set-up and a cone beam CT misregistration incident. A purposive sample of a minimum of 20 trainees was required to assess recruitment feasibility. A faculty radiation oncologist (RO), medical physicist (MP) or radiation therapist (RTT), facilitated each case. Participants completed a pre event survey of demographic data and motivation for participation. A post event survey collected perceptions of familiarity with the clinical content, comfort with interprofessional practice, and event satisfaction, scored on a 1-10 scale in terms of clinical knowledge, clinical decision making, clinical skills, exposure to other trainees and interprofessional communication. Means and standard deviations were calculated. Results: Twenty-one trainees participated including 6 ROs (29%), 6 MPs (29%), and 9 RTTs (43%). All 12 cases (100%) were completed within the allocated 105 minutes. Nine faculty facilitators, (3MP, 2 RO, 4 RTTs) were required for 405 minutes each. Additional costs associated with this event were 154 hours to build the high fidelity scenarios, 2 standardized patients (SPs) for a total of 15.5 hours, and consumables.The mean (+/-SD) educational value score reported by participants with respect to clinical knowledge was 8.9 (1.1), clinical decision making 8.9 (1.3), clinical skills 8.9 (1.1), exposure to other trainees 9.1 (2.3) and interprofessional communication 9.1 (1.0). Fifteen (71%) participants reported the cases were of an appropriate complexity. The importance of further simulation events was rated highly at 9.1/10. Conclusions: High-fidelity simulation training is feasible and effective in a radiation oncology context. However, such educational activities require significant resources, including personnel and equipment.

Original Article: http://www.ro-journal.com/content/9/1/189

Friday, August 22, 2014

Tweet of the Week: Illicit Psychoactive Web

Tweet of the Week: Illicit Psychoactive Web
MedPage Today Neurology

(MedPage Today) -- Welcome to another edition of the MedPage Today Tweet of the Week! Every Friday, the editorial team highlights its favorite 140-character contribution from the healthcare twittersphere.

Original Article: http://www.medpagetoday.com/Psychiatry/Addictions/47339

Thursday, August 21, 2014

Whole-Sellar Stereotactic Radiosurgery for Functioning Pituitary Adenomas

Whole-Sellar Stereotactic Radiosurgery for Functioning Pituitary Adenomas
Neurosurgery - Current Issue

imageBACKGROUND: Functioning pituitary adenomas (FPAs) can be difficult to delineate on postoperative magnetic resonance imaging, making them difficult targets for stereotactic radiosurgery (SRS). In such cases, radiation delivery to the entire sella has been utilized as a radiosurgical equivalent of a total hypophysectomy. OBJECTIVE: To evaluate the outcomes of a cohort of patients with FPA who underwent SRS to the whole-sellar region. METHODS: This is a retrospective review of patients who underwent whole-sellar SRS for FPA between 1989 and 2012. Sixty-four patients met the inclusion criteria: they were treated with whole-sellar SRS following surgical resection for persistently elevated hormone levels, and (1) no visible lesions on imaging studies and/or (2) tumor infiltration of dura or adjacent venous sinuses observed at the time of a prior resection. The median radiosurgical volume covering sellar structures was 3.2 mL, with a median margin dose of 25 Gy. RESULTS: The median endocrine follow-up was 41 months; 22 (68.8%) patients with acromegaly, 20 (71.4%) patients with Cushing disease, and 2 (50.0%) patients with prolactinoma achieved endocrine remission. The 2-, 4-, and 6-year actuarial remission rates were 54%, 78%, and 87%, respectively. New-onset neurological deficit was found in 4 (6.3%) patients following treatment. New-onset hypopituitarism was observed in 27 (43.5%) patients, with panhypopituitarism in 2 (3.2%). Higher margin/maximum dose were significantly associated with a higher remission rate and development of post-SRS hypopituitarism. CONCLUSION: Whole-sellar SRS for invasive or imaging-negative FPA following failed resection can offer reasonable rates of endocrine remission. Hypopituitarism following whole-sellar SRS is the most common complication. ABBREVIATIONS: ACTH, adrenocorticotropic hormone FPA, functioning pituitary adenoma CD, Cushing disease FSR, fractionated stereotactic radiotherapy GH, growth hormone GKS, Gamma-knife radiosurgery Gy, gray IGF-1, insulin-like growth factor-1 SRS, stereotactic radiosurgery TSH, thyroid-stimulating hormone UFC, urine free cortisol

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/09000/Whole_Sellar_Stereotactic_Radiosurgery_for.4.aspx

Calendar of Events

Calendar of Events
Neurosurgery - Current Issue

imageNo abstract available

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/09000/Calendar_of_Events.21.aspx

Relationship Between ICU Bed Availability, ICU Readmission, and Cardiac Arrest in the General Wards

Relationship Between ICU Bed Availability, ICU Readmission, and Cardiac Arrest in the General Wards
Critical Care Medicine - Most Popular Articles

imageObjective: The decision to admit a patient to the ICU is complex, reflecting patient factors and available resources. Previous work has shown that ICU census does not impact mortality of patients admitted to the ICU. However, the effect of ICU bed availability on patients outside the ICU is unknown. We sought to determine the association between ICU bed availability, ICU readmissions, and ward cardiac arrests. Design: In this observational study using data collected between 2009 and 2011, rates of ICU readmission and ward cardiac arrest were determined per 12-hour shift. The relationship between these rates and the number of available ICU beds at the start of each shift (accounting for census and nursing capacity) was investigated. Grouped logistic regression was used to adjust for potential confounders. Setting: Five specialized adult ICUs comprising 63 adult ICU beds in an academic medical center. Patients: Any patient admitted to a non-ICU inpatient unit was counted in the ward census and considered at risk for ward cardiac arrest. Patients discharged from an ICU were considered at risk for ICU readmission. Interventions: None. Measurements and Main Results: Data were available for 2,086 of 2,190 shifts. The odds of ICU readmission increased with each decrease in the overall number of available ICU beds (odds ratio = 1.06; 95% CI, 1.00–1.12; p = 0.03), with a similar but not statistically significant association demonstrated in ward cardiac arrest rate (odds ratio = 1.06; 95% CI, 0.98–1.14; p = 0.16). In subgroup analysis, the odds of ward cardiac arrest increased with each decrease in the number of medical ICU beds available (odds ratio = 1.26; 95% CI, 1.06–1.49; p = 0.01). Conclusions: Reduced ICU bed availability is associated with increased rates of ICU readmission and ward cardiac arrest. This suggests that systemic factors are associated with patient outcomes, and flexible critical care resources may be needed when demand is high.

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/09000/Relationship_Between_ICU_Bed_Availability,_ICU.9.aspx

Saturday, August 16, 2014

Thoughts from the Hospital

Thoughts from the Hospital
Neurosurgery Blog

Thoughts from the Hospital

em breve
Description
I remember several times when coming home tired after being on call , but I was always wanting to write something. Sometimes I had had an unusual scene, listened an interesting phrase or experienced a sad case. We are not able to express ourselves in a hospital, even when seriously ill, we don't have time. But that's how the book "Thoughts from the hospital" emerged. My book contains texts that I wrote during college, medical school and during my residency of neurosurgery. I could set the book "Thoughts from the hospital" as clippings thoughts

iBook – AppleStore – http://goo.gl/v4cZb8
Amazon – kindle: http://goo.gl/asLdXw
Google Play: http://goo.gl/yZ3iPw
Cultura: http://goo.gl/eFgq5s
IBA – http://goo.gl/q9U6S7

The post Thoughts from the Hospital appeared first on NEUROSURGERY BLOG.



Original Article: http://neurocirurgiabr.com/thoughts-from-the-hospital/?utm_source=rss&utm_medium=rss&utm_campaign=thoughts-from-the-hospital

No Link Between Sleep Apnea, Cancer, Study Finds

No Link Between Sleep Apnea, Cancer, Study Finds
Cancer: MedlinePlus

Risk factors for the two are similar, an expert says

HealthDay news image

Source: HealthDay

Original Article: http://www.nlm.nih.gov/medlineplus/news/fullstory_147689.html