No abstract

PURPOSE: Cancer clinical trials offices (CTOs) support the investigation of cancer prevention, early detection, and treatment at cancer centers across North America. CTOs are a centralized resource for clinical trial conduct and typically use research staff with expertise in four functional areas of clinical research: finance, regulatory, clinical, and data operations. To our knowledge, there are no publicly available benchmark data sets that characterize the size, cost, volume, and efficiency of these offices, nor whether the metrics differ by National Cancer Institute (NCI) designation. The Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) steering committee developed a survey to address this knowledge gap. METHODS: An 11-question survey that addressed CTO budget, accrual and trial volume, full-time equivalents (FTEs), staff turnover, and activation timelines was developed by the AACI CRI steering committee and sent to 92 academic cancer research centers in North America (n = 90 in the United States; n = 2 in Canada), with 79 respondents completing the survey (86% completion rate). RESULTS: The number of FTE employees working in the CTOs ranged from 4.5 to 811 (median, 104). The median number of analytic cases (ie, newly diagnosed or received first course of treatment) reported by the main center was 3,856. Annual CTO budgets ranged from $250,000 to $23,900,000 (median, $8.2 million). The median trial activation time, based on 61 centers, was 167 days. The median number of accruals per center was 480 (range, 5-6,271) and median number of trials per center was 282 (range, 31-1,833). Budget and FTE ranges varied by NCI designation. CONCLUSION: The response rate to the survey was high. These data will allow cancer centers to evaluate their CTO infrastructure, funding, portfolio, and/or accrual goals as compared with peers. A wide range in each of the outcomes was noted, in keeping with the wide variation in size and scope of cancer center CTOs across the United States and Canada. These variations may warrant additional investigation.

<p><strong>Objective</strong>. The aim of this study was to evaluate the pattern of controls and sanctions by the Health Insurance Institute (HIIS) over primary healthcare practitioners (PHCPs) in Slovenia, the reasons for sanctions and the violence against PHCPs if they followed the HIIS rules.</p><p><strong>Materials and Methods</strong>. We performed analyses using survey data from a cross-sectional study, across public health centres and individual contractors in which 1,458 PHCPs were invited to answer a questionnaire anonymously via an online system used to collect data for the Slovenian Medical Chamber and the Association of General Practice/Family Medicine of South-East Europe. Quantitative data were presented by descriptive statistics and analysed using Pearson’s chisquared test. Results. Responses were obtained from 462 female and 138 male PHCPs. Of the total number of 600 participants, 430 were family medicine specialists. 263 (43.8%) responded that they have been sanctioned for various reasons. PHCPs that are more likely to be sanctioned include family medicine specialists and individual contractors. PHCPs working in areas smaller than 20 000 inhabitants were sanctioned in a bigger proportion than their counterparts. Monetary penalties levied against those working at health centres were usually covered by the health centre. Family medicine specialists, more often than other PHCPs experienced violence from patients or patients’ relatives if they followed HIIS rules. Conclusion. Family medicine specialists are sanctioned more frequently than other PHCPs, individual contractors are sanctioned more frequently than public healthcare PHCPs and PHCPs in working area with a population less than 20.000 are more frequently sanctioned than those working in an area with a bigger population count.</p>

Intestinal failure-associated liver disease (IFALD) is a spectrum of liver disease including cholestasis, biliary cirrhosis, steatohepatitis, and gallbladder disease in patients with intestinal failure (IF). The prevalence of IFALD varies considerably, with ranges of 40–60% in the pediatric population, up to 85% in neonates, and between 15–40% in the adult population. IFALD has a complex and multifactorial etiology; the risk factors can be parenteral nutrition-related or patient-related. Because of this, the approach to managing IFALD is multidisciplinary and tailored to each patient based on the etiology. This review summarizes the current knowledge on the etiology and pathophysiology of IFALD and examines the latest evidence regarding preventative measures, diagnostic approaches, and treatment strategies for IFALD and its associated complications.