CLINICAL TRIAL ENROLLMENT IN A MULTIDISCIPLINARY PROSTATE CANCER

Purpose: Clinical oncology trials are hampered by low accrual rates. Less than 5% of adult cancer patients are treated on a clinical trial. We aimed to evaluate clinical trial enrollment in our Multidisciplinary Prostate Cancer Clinic and to assess if a clinical trial initiative, introduced in 2006, increased our trial enrollment.Methods: Prostate cancer patients with non-metastatic disease who were seen in the clinic from 2004 to 2008 were included in the analysis. Men were categorized by whether they were seen before or after the clinical trial enrollment initiative started in 2006. The initiative included posting trial details in the clinic, educating patients about appropriate clinical trial options during the treatment recommendation discussion, and providing patients with documentation of trials offered to them. Univariate and multivariate (MVA) logistic regression analysis evaluated the impact of patient characteristics and the clinical trial initiative on clinical trial enrollment.Results: The majority of the 1,370 men were white (83%), and lived within the surrounding counties or state (69.4%). Median age was 64.2 years. Seventy-three point five percent enrolled in at least one trial and 28.5% enrolled in more than one trial. Sixty-seven percent enrolled in laboratory studies, 18% quality of life studies, 13% novel studies, and 3.7% procedural studies. On MVA, men seen in later years (p < 0.0001) were more likely to enroll in trials. The proportion of men enrolling increased from 38.9% to 84.3% (p<0.0001) after the clinical trial initiative. On MVA, older men (p < 0.0001) were less likely to enroll in clinical trials. There was a trend toward men in the high-risk group being more likely to participate in clinical trials (p = 0.056). There was a second trend for men of Hispanic, Asian, Native American and Indian decent being less likely to participate in clinical trials (p = 0.054).Conclusion: Clinical trial enrollment in the multidisciplinary clinic increased after introduction of a clinical trial initiative. Older men were less likely to enroll in trials. We speculate we achieved high enrollment rates because 1) specific trials are discussed at time of treatment recommendations, 2) we provide a letter documenting offered trials and 3) we introduce patients to the research team at the same clinic visit if they are interested in trial participation.

The prevalence of bulimia nervosa and bulimic behaviors among university students in Texas

This cross-sectional study examined by questionnaire the prevalence of bulimia nervosa and bulimic behaviors in a sample of 1175 undergraduate students enrolled in two state-supported universities in Texas. In one university, the student population was predominantly white; in the other, it was predominantly black. Fifty-nine percent of the respondents were female and 41% were male. Information regarding age, sex, ethnicity, college major, college year, marital status, housing arrangements, religion, socioeconomic status, height, weight, dieting behaviors, and family history of alcoholism, drug abuse, and depression was collected. Bulimia status was assessed using the Revised Bulimia Test (BULIT-R), which is based on the DSM-III-R criteria for bulimia nervosa. Only 1.3% of the females and 0.4% of the males were classified as having bulimia nervosa. The prevalence of bulimic behaviors was considerably higher; 6.4% of the females and 3.6% of the males were classified as having bulimic behaviors. Univariate analysis showed the following factors to be significantly associated with bulimic behaviors: female gender, single marital status, high BMI, a family history of alcoholism, drug abuse, or depression, and certain dieting behaviors. In the present study, ethnicity did not prove to be a significant factor associated with bulimia nervosa or bulimic behaviors. Multivariate analysis showed that, in comparison to normal/underweight individuals, the odds of having bulimic behaviors for severely overweight subjects were 2.23 (95% CI: 1.43, 3.50). Students who were dieting at the time of the study were 3.22 times (95% CI: 2.05, 5.06) as likely to have bulimic behaviors as were students who had never dieted. This study concludes there is a need to distinguish between bulimia nervosa and bulimic behaviors when estimating prevalence of a population. ^

A simulation study of the effects of small center enrollment in multi -center clinical trials

Multi-center clinical trials are very common in the development of new drugs and devices. One concern in such trials, is the effect of individual investigational sites enrolling small numbers of patients on the overall result. Can the presence of small centers cause an ineffective treatment to appear effective when treatment-by-center interaction is not statistically significant?^ In this research, simulations are used to study the effect that centers enrolling few patients may have on the analysis of clinical trial data. A multi-center clinical trial with 20 sites is simulated to investigate the effect of a new treatment in comparison to a placebo treatment. Twelve of these 20 investigational sites are considered small, each enrolling less than four patients per treatment group. Three clinical trials are simulated with sample sizes of 100, 170 and 300. The simulated data is generated with various characteristics, one in which treatment should be considered effective and another where treatment is not effective. Qualitative interactions are also produced within the small sites to further investigate the effect of small centers under various conditions.^ Standard analysis of variance methods and the "sometimes-pool" testing procedure are applied to the simulated data. One model investigates treatment and center effect and treatment-by-center interaction. Another model investigates treatment effect alone. These analyses are used to determine the power to detect treatment-by-center interactions, and the probability of type I error.^ We find it is difficult to detect treatment-by-center interactions when only a few investigational sites enrolling a limited number of patients participate in the interaction. However, we find no increased risk of type I error in these situations. In a pooled analysis, when the treatment is not effective, the probability of finding a significant treatment effect in the absence of significant treatment-by-center interaction is well within standard limits of type I error. ^

A summary of remarks made by William C. Lane, Librarian of Harvard University, published in the Proceedings of the Massachusetts Historical Society, December 1909

Lane addressed the Massachusetts Historical Society about the recent discovery of foundations walls, likely from Goffe College, made during the Boston Elevated Railway's excavations in Harvard Square for the subway on Massachusetts Avenue.

University Hall in 1877

Jenison, Edward S., architect. Typed and attached to verso: North Wing or Mason Hall, part of which is visible at the left, wasthe first university building, erected in 1841. South Wing or South College, at the right, was built in 1849. The central section was completed in 1873. University Hall contained offices of administration, a large auditorium, and classrooms. It was razed in 1951.

Index to subject bibliographies in library bulletins to December 31, 1897.

Mode of access: Internet.

Library science,

Mode of access: Internet.

A course in general science for the intermediate school,

Thesis for degree of Graduate in Education--Univ. of California. May, 1918.

The graduate program in computer science.

Bibliography: p. 7-9.

Syllabus for low level performance for the qualifying examination in computer science /

"April, 1970"

Constitution and by-laws Librarians' Association of the University of Illinois Library constitution.

Mode of access: Internet.

ROBOCAR : educating the layman in computer science /

Originally presented as the author's thesis (M.A.), University of Illinois at Urbana-Champaign.

Government-university relationships in federally sponsored scientific research and development.

Mode of access: Internet.