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Purpose. Few population studies have examined patterns of systemic therapy administration inmetastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices. Patients and Methods. We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and communitybased oncology practices subscribing to a U.S.-wide chemotherapy order entry systemcapturing disease, patient, provider, and treatment data. Multivariate analyses of these prospectively recorded characteristics identified significant predictors of specific therapeutic choices. Results. Overall, 100 different regimens were used in first-line treatment ofMPC. First-line gemcitabine monotherapy usage fell steadily from 72% in 2006 to 16% in 2015. This steep decline mirrored increases in first-line usage of both 5 fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) and gemcitabine1nab-paclitaxel. Younger male patients were more likely to receive FOLFIRINOX as first-line treatment, whereas patients treated at community practices and by oncologists with lower MPC patient volume were more likely to receive gemcitabine plus nab-paclitaxel (all ≤ .05). Among all patients receiving first-line chemotherapy for MPC, 49% went on to receive second-line therapy and 19% received third-line therapy; administration of second- and third-line therapies increased steadily over the time course of follow-up. Younger patients and those treated by oncologists with higher MPC patient volume were more likely to receive second- and third-line therapies. Conclusion. This population-based study provides insight into treatment patterns of MPC in the U.S. Usage patterns varied greatly according to patient and provider characteristics. [ABSTRACT FROM AUTHOR]

Background Since the introduction of biologic therapies for the treatment of metastatic colorectal cancer (mCRC), few studies have examined patterns of care or predictors of specific treatment approaches. Methods We assessed 4877 mCRC patients who received chemotherapy between January 2004 and March 2011 at academic, private, and community-based oncology practices subscribing to a US-wide chemotherapy order entry (system capturing disease, patient, provider, and treatment data. Multivariable analyses of these prospectively recorded characteristics were used to identify independent predictors of specific therapeutic choices. All statistical tests were two-sided. Results Throughout the study period, fluoropyrimidine/oxaliplatin combination was the most commonly used first-line chemotherapy regimen, representing 71% of first-line therapy by 2007. First-line bevacizumab use averaged 51%, peaking at 55% in 2006. Of those who received first-line bevacizumab, 34% continued to receive bevacizumab in the second-line. Only 26% of patients in our cohort ever received an anti-EGFR monoclonal antibody (cetuximab = 22%; panitumumab = 6%) at some point in their treatment course. Patients treated at academic centers, with longer duration of first-line therapy, and at sites in the western United States were statistically more likely to receive an anti-EGFR antibody. Anti-EGFR antibody use fell by 18% after the US Food and Drug Administration limited its use to patients with KRAS wild-type tumors in June 2009. Conclusions Analysis of this US-wide mCRC cohort demonstrates that bevacizumab has been more consistently integrated into treatment regimens than anti-EGFR antibody therapies, particularly in first-line therapy. However, treatment choices vary substantially according to specific patient, practice, and provider characteristics. [ABSTRACT FROM AUTHOR]

Presents a study which assessed violence prevention and intervention programs in Michigan. Respondents and procedures; Program focus; Barriers identified to program success.

Three radio public service announcements (PSA) were created to increase knowledge of 10 gun-safety practices in a mid-Michigan county. Concurrently, a direct-mail coupon highlighting the same gun-safety practices was disseminated to over 70,000 households in the same county. Results of a telephone survey indicate that, compared to unexposed individuals, those who were exposed to the PSA were able to name significantly more gun-safety practices. Specifically, significant differences between those exposed to the PSA versus those not exposed were found for 5 gun-safety practices, as well as for a 4-item index measuring gun locking and storage behaviors, and a 9-item index that included all gun-safety practices. [ABSTRACT FROM AUTHOR]

Examines the effectiveness of a radio public service announcement on the danger to children from an unlocked and loaded gun in Michigan. Increase of uncued knowledge on the locking related gun-safety practices; Implications of the findings; Effective way of preventing gun injuries.

Examines how United States academics communicate their research to external constituents. Focus on nine university researchers investigating hazardous waste remediation, and their dealings with sets of environmental consulting engineers, state government regulators, and industrial scientists; Examination of the researchers' conversations with these groups, as well as the researchers' perceptions of these groups; Implications.

We conducted a 2-year investigation of the extent to which strategies based on social marketing and diffusion of innovations concepts are used in preventive health communication with unique (highly ostracized) populations. Of the 49 organizations in San Francisco that operate HIV prevention programs (N=100),programs that most highly targeted unique populations were surveyed. Personal interviews were then conducted with 38 staff leaders who operated the most and least effective programs. Audiotapes and transcripts were content analyzed to identify the strategies used by program staff. Strategies based on social marketing concepts were more prevalent than strategies based on the diffusion of innovations. More effective programs were characterized by emphasis on homophily, audience segmentation, compatibility-based strategies, and interorganizational collaboration. [ABSTRACT FROM AUTHOR]