Background Hodgkin lymphoma (HL) survivors face substantially elevated risks of breast cancer and cardiovascular disease. They and their physicians are often unaware of these risks and surveillance recommendations. Procedure A prospective one-arm study was conducted among a random sample of 72 HL survivors, ages 27 to 55, participating in the Childhood Cancer Survivor Study (CCSS) who were at increased risk for breast cancer and/or cardiomyopathy and had not had a screening mammogram or echocardiogram, respectively, within the prior two years. A one-page survivorship care plan with recommendations for surveillance was mailed to participants. In addition, survivors’ primary physicians were contacted and provided patient-specific information and a web-based Virtual Information Center was made available for both survivors and physicians. Outcomes were assessed by telephone six months after the intervention. Results The survivor participation (62/72; 86%) and six-month retention (56/61; 92%) rates were high. Tension and anxiety, measured by the Profile of Mood States, did not increase following risk notification; 91% of survivors described their reactions to receiving the information in positive terms. At six months, 41% of survivors reported having completed the recommended mammogram; 20% reported having an echocardiogram (females 30%, males 10%). Only 29% of survivors visited the website. Nine physicians enrolled, and none used the study resources. Conclusion A mailed, personalized survivorship care plan was effective in communicating risk and increasing compliance with recommended medical surveillance. Internet- and telephone-based strategies to communicate risk were not utilized by survivors or physicians.

Background Cancer is the number one disease killer of children and adolescents in North America. For adolescents, this diagnosis comes at a particularly vulnerable stage. Educating adolescents with cancer from diagnosis through treatment teaches and empowers them. Increasing evidence shows that these adolescents want more information. Few educational tools exist for young cancer patients; none are interactive; therefore, a CD‐ROM was developed to meet this need. Procedure Animation, voiceover, music, videos, and games were combined to develop a comprehensive multimedia CD‐ROM to teach 12‐ to 18‐year‐olds with solid tumors about their disease, treatment, coping skills, and late effects in an interactive and non‐threatening way. The CD‐ROM was evaluated in a pre–post design with 65 subjects recruited from four pediatric oncology centers randomized to the CD‐ROM or a “Handbook” containing analogous information. Pre–post questionnaires measured coping strategies, health locus of control, quality of life, cancer knowledge, and self‐efficacy; post‐test variables also included acceptability and use by teens, their families, and healthcare professionals. Results Teens receiving the CD‐ROM were significantly more likely to increase their internal locus of control scores; however, no significant differences were observed on other measures, attributable in part to the study sample size. Among teens, acceptability was higher in the CD‐ROM versus the Handbook group, but not different between the two parent groups. Pediatric oncology healthcare providers gave positive feedback on the CD‐ROM. Conclusions This CD‐ROM is an innovative and engaging educational tool—the first portable interactive product with access on demand for adolescents with solid tumors. Pediatr Blood Cancer. 2010;55:512–519. © 2010 Wiley‐Liss, Inc.

To meet the need for an interactive software product to educate children with leukemia, ages 4-11 years, and their families about the disease and its treatment, we developed and evaluated an interactive, comprehensive, multimedia CD-ROM product, Kidz with Leukemia: A Space Adventure. The prototype was tested using a randomized controlled experimental design. Children with leukemia and their parents were randomized to receive either the newly developed CD-ROM or the book You and Leukemia by Lynn Baker. Health care providers (HCPs) and other content/ technical experts evaluated only the CD-ROM. Data were collected on children's health locus of control, their understanding of leukemia, and the satisfaction of participants with their assigned intervention. Children in the CD-ROM group, compared with those in the book group, showed increased feelings of control over their health. Although there was a high level of satisfaction with the CD-ROM among all users, younger children and their parents were most satisfied. In conclusion, the CD-ROM, Kidz with Leukemia: A Space Adventure, was found to be a useful, engaging, and empowering tool for children with leukemia and can serve as a model for developing future health-related educational materials.

OBJECTIVES:To examine the unit cost of inpatient service department of special ward at Banphaeo Hospital that reformed to be Public Organization( the new model) in Thailand. METHODS: Cost analysis from provider's perspective. Cost center was divided by function and the support units in hospitals into three categories: (1)Patient service PS (2) Revenue producing cost center RPCC ; and (3) non revenue producing cost center NRPCC. Total direct costs were composed of labour costs, material costs and capital costs. Indirect costs were allocated by using direct distribution method. RESULTS: The total cost of private ward 4/2 was ␤17,278,303.45 . The total cost in private ward 4/2 consisted of labour cost was ␤3,739,743.60 , material cost was ␤1,242,991.36 Capital cost was ␤2,733,735.87 . The ratio of lobour cost: material cost: capital cost was 48.46: 16.11: 35.43 and ratio of indirect cost was 55.34. The unit cost of inpatient department private ward 4/2 was ␤16,239 per case ; routine service cost was ␤9,226 . 10 and medical care cost was ␤7,012.90 CONCLUSIONS: The results were useful in decision making for resource allocation. It can be used to facilitate comparison of different studies in various type of organization of hospital administration.

Objectives: Maternal and infant studies can be daunting for new mothers especially if blood or specimen samples are required within a few days of birth and throughout the neonatal period. To facilitate enrollment and retention in these studies, the use of home health nurses have been employed to collect samples in the home rather than requiring mothers and newborns to make site visits. Our objective is to examine the impact of engaging home health nurses on study enrollment, retention, and protocol compliance. MethOds: We evaluated data from three types of maternal and infant studies including neonatal platelet, placental transfer, and lactation studies. Global home health agencies were contracted to collect samples from mothers and neonates in the home. In one of the studies, site visits were required initially and the home health approach was implemented later. We examined enrollment metrics before and after home health services were employed. In the other studies, the home health model was implemented initially, and we descriptively examined retention and protocol compliance. Results: In the study that initially required site visits, a third of the way into the study, no patients had enrolled. After the home health model was implemented, 82 patients enrolled which exceeded enrollment targets 4-fold. In the studies where the home health model was implemented initially, enrollment targets were met or are nearing completion. 100% of enrolled subjects have completed study requirements. Additionally, 100% of home visits were completed successfully with 99.5% completed "in window" without issues. Completed CRFs and lab reports were submitted to PIs "in window" per protocol. Throughout the studies there was no home nurse turn-over. cOnclusiOns: In this simple descriptive review of three types of maternal and infant studies, the use of home health nurses was successful in facilitating enrollment, retention and specimen/data collection.Objectives: To develop economic evaluation using a regional approach with the purpose both to transfer and apply the results in three latin American countries through a consensus methodology. MethOds: Through panel of experts constituted by health technology assessment developers of three Latin American countries it was performed a consensus regarding the criteria to include in the develop of high cost medicines economic evaluations in order to transfer the results in the region. Results: The Transferability and generalizability of economic evaluations between different contexts depends on the variability with each other. In the study was possible to perform three economic evaluations according to the consensus in the next criteria: population, intervention, comparators drugs, perspective, study horizon, discount rate of outcomes and costs, model and resource utilization. Related to the last criteria, even though the practice variation between countries, it was posible to identify similar patterns in resources consumption for the attention in healthcare regional systems. In the same way,...