Factors associated with clinical trial screening failures in gynecologic oncology.

OBJECTIVE: Low enrollment of adult cancer patients in clinical trials is an ongoing challenge in cancer research. We sought to determine factors associated with clinical trial screening failures in women with gynecologic malignancies at a large urban university health system. METHODS: A retrospective review was conducted of women with gynecologic malignancies who presented to an urban university system between 12/2009 and 12/2012. Data collected included demographic, clinico-pathologic and trial-related factors, as well as reasons for non-participation. RESULTS: Two hundred twenty-one patients were eligible for a clinical trial. Of these, 44% participated while 56% did not. There were more screening failures when trials were offered at the time of primary treatment than at recurrence (62% vs. 38%, p=0.001). There was no significant difference in participation based on age, ethnicity, hospital setting, payor status, family history, comorbidities, prior treatment, substance abuse, recent surgery or trial type. Of the non-participants, 62% declined the study due to perceived harm and 10% due to socio-economic barriers while 20% were excluded due to co-morbidities and 8% due to noncompliance. CONCLUSIONS: Significantly more screening failures for clinical trials occurred when trials were offered at the time of primary treatment. The majority of patients declined based on perceived harm from enrolling in a clinical trial, although 20% of eligible patients were not offered enrollment despite not meeting any exclusion criteria. Our findings underscore the importance of appropriate counseling when offering clinical trials, as well as overcoming physician biases in deciding who is an appropriate candidate.

["The body-consciousness in school"--a back pain-school]. / "Kroppen med i skolen"--et skole-ryg-projekt.

INTRODUCTION: The aim of the present study was to demonstrate the extent of back pain in a school population and to evaluate if it was possible to minimize the number of complaints by increasing the body-consciousness in school children and education of pupils, teachers, and parents. MATERIAL AND METHODS: A prospective, controlled interventional study in two comparable schools with pupils from pre-school up to and including ninth level. All pupils and their parents completed a questionnaire before and after the intervention. RESULTS: The share of pupils with back pain increased in the older age groups, whereas the frequency of physical activity decreased. Pupils who disliked going to school had more frequently back pain than pupils who liked going to school, and pupils who liked going to school were more physically active. There was a correlation between the back pain of the pupils and that of their parents. The intervention did not have any effect on the back pain of the pupils or their parents. DISCUSSION: There was no significant effect of the intervention, which might be explained by the relatively short time of implementation and unexpected practical problems at the school. The base-line values showed a correlation between age and back pain and between back pain and "do not like going to school". The frequency of physical activity decreased in the older age groups. Physically active pupils liked best going to school. There is a uniformity in the complaints of the parents and children and their reaction to the symptoms.

A comparative study of three different kinds of school furniture.

Several studies indicate that the ISO standards for school furniture seem to be inappropriate, and there is increasing evidence that the inclination of the seat should be forward and that it should be possible to adjust the table-top to a certain non-horizontal angle. However, these studies have predominantly used objective measurement methods on adult subjects for short-term experiments in rather artificial surroundings. By means of structured interviews registering the school children's perception of ergonomic comfort, the present study has compared three types of school furniture-the original ISO-standard type, and two different new types characterized by forward slanting seats and tiltable desk-tops, the main difference between the two being approximately 15 cm in the height of the chair as well as the table. The study showed that the highest of the two tilting types was perceived to be significantly better than the two others in terms of table height, chair height, reading position, back-rest, and global assessment. Likewise, the feature of a tiltable table-top was considered overwhelmingly positive independently of the height of the furniture. It is recommended that school authorities, producers of school furniture, and relevant medical personnel consider these results for alternative designs of school furniture. It should be kept in mind, however, that school furniture is only one among many factors in the multifactorial field of the back health of school children.