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Pesquisa : M01.526.485.810.699 [Categoria DeCS]
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[PMID]:28449049
[Au] Autor:Banerjee S; Califano R; Corral J; de Azambuja E; De Mattos-Arruda L; Guarneri V; Hutka M; Jordan K; Martinelli E; Mountzios G; Ozturk MA; Petrova M; Postel-Vinay S; Preusser M; Qvortrup C; Volkov MNM; Tabernero J; Olmos D; Strijbos MH
[Ad] Endereço:Gynaecology Unit Royal Marsden Hospital NHS Foundation Trust, Institute of Cancer Research, London.
[Ti] Título:Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey.
[So] Source:Ann Oncol;28(7):1590-1596, 2017 Jul 01.
[Is] ISSN:1569-8041
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). Methods: A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Results: Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). Conclusions: This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
[Mh] Termos MeSH primário: Esgotamento Profissional/epidemiologia
Saúde do Trabalhador
Oncologistas
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Atitude do Pessoal de Saúde
Esgotamento Profissional/diagnóstico
Esgotamento Profissional/psicologia
Esgotamento Profissional/terapia
Distribuição de Qui-Quadrado
Despersonalização
Emoções
Europa (Continente)/epidemiologia
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Inquéritos Epidemiológicos
Seres Humanos
Satisfação no Emprego
Modelos Lineares
Modelos Logísticos
Masculino
Análise Multivariada
Oncologistas/psicologia
Aceitação pelo Paciente de Cuidados de Saúde
Qualidade de Vida
Fatores de Risco
Fatores Sexuais
Equilíbrio Trabalho-Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1093/annonc/mdx196


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[PMID]:29285944
[Au] Autor:Horváth B
[Ti] Título:[Sándor Miksa Kocsis MD who established the first Oncology Department out of Budapest (Hungary), was born one hundred years ago].
[Ti] Título:Száz éve született dr. Kocsis Sándor Miksa, az elso "vidéki" onkológiai osztály alapító foorvosa..
[So] Source:Orv Hetil;158(52):2087-2088, 2017 Dec.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Mh] Termos MeSH primário: Hospitais Universitários/história
Oncologia/história
Oncologistas/história
[Mh] Termos MeSH secundário: História do Século XIX
História do Século XX
Seres Humanos
Hungria
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Kocsis SM
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.HO2585


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[PMID]:28992853
[Au] Autor:Choi Y
[Ad] Endereço:Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ychoi47@jhmi.edu.
[Ti] Título:Care Coordination and Transitions of Care.
[So] Source:Med Clin North Am;101(6):1041-1051, 2017 Nov.
[Is] ISSN:1557-9859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Care coordination and effective transitions of care are essential for high-quality care in cancer survivors. Aspects of care that require coordination include cancer surveillance, managing the effects of cancer and its treatment, and preventive care, including screening for new cancers, with the clinician responsible for each aspect of care clearly defined. There are many barriers to transitioning and coordinating care across cancer specialists and primary care physicians; possible solutions include survivorship care plans and certain care models. Improving these areas, along with survivorship care training and education, may lead to more effective care coordination and transitions in the future.
[Mh] Termos MeSH primário: Neoplasias/terapia
Oncologistas/psicologia
Pacientes/psicologia
Médicos de Atenção Primária/psicologia
Cuidado Transicional/organização & administração
[Mh] Termos MeSH secundário: Competência Clínica
Seres Humanos
Relações Interprofissionais
Planejamento de Assistência ao Paciente/organização & administração
Percepção
Qualidade da Assistência à Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE


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[PMID]:28982876
[Au] Autor:Haque W; Verma V; Butler EB; Teh BS
[Ad] Endereço:Department of Radiation Oncology, CHI St Luke's Health, The Woodlands, TX, U.S.A.
[Ti] Título:Radical Cystectomy Chemoradiation for Muscle-invasive Bladder Cancer: Impact of Treatment Facility and Sociodemographics.
[So] Source:Anticancer Res;37(10):5603-5608, 2017 10.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The present study sought to compare the differences in practice patterns, as well as clinical outcomes for patients with muscle-invasive bladder cancer undergoing treatment with either radical cystectomy (RC) or concurrent chemoradiaiton (CRT). PATIENTS AND METHODS: The National Cancer Data Base (NCDB) was queried for patients diagnosed with T2/T3/T4aN0M0 bladder cancer, between 2004-2013, that received definitive treatment with either RC or CRT. RESULTS: 16,960 patients met the inclusion criteria; 1,450 (8.5%) underwent CRT, while 15,510 (91.5%) were treated with RC. Patients undergoing CRT were older, more likely to be female, African American, received treatment at an academic facility, and lived <20 miles of the treatment facility. CRT was associated with worse median OS (32.8 months vs. 36.1 months; p=0.0004). CONCLUSION: Older patients are more likely to undergo bladder preservation therapy, while those living farther away from treatment facilities are less likely to under CRT.
[Mh] Termos MeSH primário: Quimiorradioterapia/tendências
Cistectomia/tendências
Acesso aos Serviços de Saúde/tendências
Disparidades em Assistência à Saúde/tendências
Oncologistas/tendências
Padrões de Prática Médica/tendências
Fatores Socioeconômicos
Neoplasias da Bexiga Urinária/terapia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Área Programática (Saúde)
Quimiorradioterapia/efeitos adversos
Quimiorradioterapia/mortalidade
Cistectomia/efeitos adversos
Cistectomia/mortalidade
Bases de Dados Factuais
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Invasividade Neoplásica
Estadiamento de Neoplasias
Modelos de Riscos Proporcionais
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
Estados Unidos
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/patologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE


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[PMID]:28902376
[Au] Autor:Krause SW; Oldenburg M; Hallek M; Neubauer A
[Ad] Endereço:Medizinische Klinik 5, Hämatologie und Internistische Onkologie, Universitätsklinikum Erlangen.
[Ti] Título:[Priorities of German Oncologists. Results of the "choosing wisely" survey of the German Society of Hematology and Medical Oncology (DGHO)].
[Ti] Título:Prioritäten deutscher Onkologen. Auswertung der "Klug entscheiden"-Umfrage der Deutschen Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)..
[So] Source:Dtsch Med Wochenschr;142(18):e124-e130, 2017 Sep.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:During the preparation of "choosing wisely" recommendations, the German Society of Hematology and Medical Oncology (DGHO) had performed a member survey. The large body of replies was systematically and quantitatively analyzed for this report. Replies to the draft recommendations are quantified. Free text replies were iteratively categorized in three levels according to medical categories and additionally, according to their general target of necessary action. 492 members completed the survey within the given limit of 2 weeks. Draft recommendations against oversupply were widely supported (77 %-88 %). 1598 free text replies were analyzed. Unnecessary use of resources was requested in several fields in accordance with our recommendations. Strong demand was put forward regarding soft factors: "talking medicine", individually tailored therapy, supportive medicine and palliative care (51 % together) and social resources (11 %). Possible under-supply was less frequently described in fields of expensive measures (17 % of replies). In the replies to our survey, we found a strong statement for a plus in talking medicine in oncology. Every physician caring for these patients can contribute to this demand. Structural improvements in continuing education and reimbursement in this field are desirable.
[Mh] Termos MeSH primário: Prioridades em Saúde/organização & administração
Prioridades em Saúde/estatística & dados numéricos
Oncologistas/organização & administração
Oncologistas/estatística & dados numéricos
[Mh] Termos MeSH secundário: Alemanha
Hematologia
Seres Humanos
Oncologia
Cuidados Paliativos
Medicina de Precisão
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-109525


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[PMID]:28871988
[Au] Autor:Solanki AA; Martin B; Korpics M; Small C; Harkenrider MM; Mitin T
[Ad] Endereço:Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois. Electronic address: abhishek.solanki@lumc.edu.
[Ti] Título:Bladder-Preserving Therapy Patterns of Care: A Survey of US Radiation Oncologists.
[So] Source:Int J Radiat Oncol Biol Phys;99(2):383-387, 2017 Oct 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Clinical trials have demonstrated the efficacy of bladder-preserving chemoradiation therapy (BPT) in muscle-invasive bladder cancer but have differed in the radiation therapy dose/fractionations, radiation therapy targets, and concurrent chemotherapy regimens used. No data exist on the technical and practical approaches actually used in clinical practice throughout the United States when delivering BPT. We performed a survey to explore radiation oncologists' practice patterns. METHODS AND MATERIALS: We conducted an electronic survey of US radiation oncologists regarding the management of patients with cT2-3N0M0 transitional cell muscle-invasive bladder cancer. The instrument included questions regarding the types of patients treated with BPT, as well as several aspects of treatment delivery. Descriptive statistics were reported for all responses. Pearson χ tests were used for univariate analysis. RESULTS: In total, 277 physicians completed our survey. Most respondents (58%) stated that they only treated 1 to 3 patients in the prior year. Seventy-four percent of respondents primarily treated patients deemed unfit for cystectomy, while only 28% saw patients prior to cystectomy for consultation to discuss BPT. The majority of radiation oncologists used conventional fractionation (91%) instead of hypofractionation (7.6%), but more variability existed for radiation therapy targets. Sixty percent used a small pelvis field, 29% used a whole-pelvis field, and 12% treated the bladder only. There was increased use of hypofractionation (29%) and bladder-only radiation therapy (34%) in patients who were not candidates for cystectomy or chemotherapy (P<.001). Cisplatin-based concurrent chemotherapy was most commonly preferred (89%). In non-cisplatin candidates, most respondents preferred 5-fluorouracil plus mitomycin C (32%) or carboplatin (32%). Intensity modulated radiation therapy use and midtreatment cystoscopic re-evaluation were variable, while hyperfractionation use was low. CONCLUSIONS: Our study describes radiation oncologists' practice patterns for patients undergoing BPT. Although there are areas of consistency, variability exists in many technical and practical aspects of treatment delivery. Further research and education are needed to determine the optimal radiation therapy target, dose/fractionation, and concurrent chemotherapy regimen.
[Mh] Termos MeSH primário: Carcinoma de Células de Transição/radioterapia
Oncologistas/estatística & dados numéricos
Tratamentos com Preservação do Órgão/métodos
Padrões de Prática Médica
Radioterapia (Especialidade)/estatística & dados numéricos
Neoplasias da Bexiga Urinária/radioterapia
Bexiga Urinária
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma de Células de Transição/patologia
Distribuição de Qui-Quadrado
Cistectomia/estatística & dados numéricos
Fracionamento de Dose
Seres Humanos
Radioterapia de Intensidade Modulada/estatística & dados numéricos
Inquéritos e Questionários
Estados Unidos
Neoplasias da Bexiga Urinária/patologia
Neoplasias da Bexiga Urinária/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE


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[PMID]:28871967
[Au] Autor:Koyfman SA; Yom SS
[Ad] Endereço:Departments of Radiation Oncology and Bioethics, Cleveland Clinic, Cleveland, Ohio. Electronic address: koyfmas@ccf.org.
[Ti] Título:Clinical Research Ethics: Considerations for the Radiation Oncologist.
[So] Source:Int J Radiat Oncol Biol Phys;99(2):259-264, 2017 Oct 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Consideration of clinical research ethics in radiation oncology is underexplored relative to other areas of oncology. A number of ethical challenges related to informed consent, randomization, conflicts of interest, and scientific validity and social value are shared with other areas of medicine, although their exact inflections are specific to radiation oncology. In addition, there are unique concerns in radiation oncology arising from the rapid evolution and uneven distribution of radiation technologies; the greater unfamiliarity of the general public and research oversight committees in regard to radiation oncology clinical practice; and the high complexity of managing most radiation oncology research, much of which is carried out in high-acuity multidisciplinary oncologic settings. To produce the best research, adherence to the highest ethical standards should be pursued as an integral component of all radiation oncology research.
[Mh] Termos MeSH primário: Ética em Pesquisa
Oncologistas/ética
Radioterapia (Especialidade)/ética
[Mh] Termos MeSH secundário: Conflito de Interesses
Seres Humanos
Consentimento Livre e Esclarecido
Reprodutibilidade dos Testes
Valores Sociais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE


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[PMID]:28737972
[Au] Autor:Hughes KS; Ambinder EP; Hess GP; Yu PP; Bernstam EV; Routbort MJ; Clemenceau JR; Hamm JT; Febbo PG; Domchek SM; Chen JL; Warner JL; OPO Workshop Members
[Ad] Endereço:Kevin S. Hughes, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Edward P. Ambinder, Icahn School of Medicine at Mount Sinai; Peter Paul Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Gregory P. Hess, Symphony Health, Conshohocken; Gregory P. Hess and Susan M. Domchek,
[Ti] Título:Identifying Health Information Technology Needs of Oncologists to Facilitate the Adoption of Genomic Medicine: Recommendations From the 2016 American Society of Clinical Oncology Omics and Precision Oncology Workshop.
[So] Source:J Clin Oncol;35(27):3153-3159, 2017 Sep 20.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:At the ASCO Data Standards and Interoperability Summit held in May 2016, it was unanimously decided that four areas of current oncology clinical practice have serious, unmet health information technology needs. The following areas of need were identified: 1) omics and precision oncology, 2) advancing interoperability, 3) patient engagement, and 4) value-based oncology. To begin to address these issues, ASCO convened two complementary workshops: the Omics and Precision Oncology Workshop in October 2016 and the Advancing Interoperability Workshop in December 2016. A common goal was to address the complexity, enormity, and rapidly changing nature of genomic information, which existing electronic health records are ill equipped to manage. The subject matter experts invited to the Omics and Precision Oncology Workgroup were tasked with the responsibility of determining a specific, limited need that could be addressed by a software application (app) in the short-term future, using currently available genomic knowledge bases. Hence, the scope of this workshop was to determine the basic functionality of one app that could serve as a test case for app development. The goal of the second workshop, described separately, was to identify the specifications for such an app. This approach was chosen both to facilitate the development of a useful app and to help ASCO and oncologists better understand the mechanics, difficulties, and gaps in genomic clinical decision support tool development. In this article, we discuss the key challenges and recommendations identified by the workshop participants. Our hope is to narrow the gap between the practicing oncologist and ongoing national efforts to provide precision oncology and value-based care to cancer patients.
[Mh] Termos MeSH primário: Genômica
Informática Médica
Oncologia
Oncologistas
[Mh] Termos MeSH secundário: Congressos como Assunto
Seres Humanos
Aplicativos Móveis
Determinação de Necessidades de Cuidados de Saúde
Sociedades Médicas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2017.74.1744


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[PMID]:28655413
[Au] Autor:Turner TB; Dilley SE; Smith HJ; Huh WK; Modesitt SC; Rose SL; Rice LW; Fowler JM; Straughn JM
[Ad] Endereço:Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address: taylorturner@uabmc.edu.
[Ti] Título:The impact of physician burnout on clinical and academic productivity of gynecologic oncologists: A decision analysis.
[So] Source:Gynecol Oncol;146(3):642-646, 2017 Sep.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Physician burnout is associated with mental illness, alcohol abuse, and job dissatisfaction. Our objective was to estimate the impact of burnout on productivity of gynecologic oncologists during the first half of their career. METHODS: A decision model evaluated the impact of burnout on total relative value (RVU) production during the first 15years of practice for gynecologic oncologists entering the workforce from 2011 to 2015. The SGO practice survey provided physician demographics and mean annual RVUs. Published data were used to estimate probability of burnout for male and female gynecologic oncologists, and the impact of depression, alcohol abuse, and early retirement. Academic productivity was defined as annual PubMed publications since finishing fellowship. RESULTS: Without burnout, RVU production for the cohort of 250 gynecologic oncologists was 26.2 million (M) RVUs over 15years. With burnout, RVU production decreased by 1.6 M (5.9% decrease). Disproportionate rates of burnout among females resulted in 1.1 M lost RVUs for females vs. 488 K for males. Academic production without burnout was estimated at 9277 publications for the cohort. Burnout resulted in 1383 estimated fewer publications over 15years (14.9%). CONCLUSIONS: The impact of burnout on clinical and academic productivity is substantial across all specialties. As health care systems struggle with human resource shortages, this study highlights the need for effective burnout prevention and wellness programs for gynecologic oncologists. Unless significant resources are designated to wellness programs, burnout will increasingly affect the care of our patients and the advancement of our field.
[Mh] Termos MeSH primário: Esgotamento Profissional/psicologia
Eficiência
Ginecologia
Modelos Estatísticos
Oncologistas/estatística & dados numéricos
Publicações Seriadas/estatística & dados numéricos
[Mh] Termos MeSH secundário: Alcoolismo/psicologia
Técnicas de Apoio para a Decisão
Depressão/psicologia
Feminino
Seres Humanos
Masculino
Oncologistas/psicologia
Probabilidade
Escalas de Valor Relativo
Aposentadoria
Fatores Sexuais
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE


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[PMID]:28655020
[Au] Autor:Caruso Brown AE
[Ad] Endereço:Department of Pediatrics, and Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, New York.
[Ti] Título:Porous Boundaries.
[So] Source:JAMA;317(24):2487-2488, 2017 Jun 27.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Oncologistas
Relações Profissional-Família
Mídias Sociais
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Comunicação
Seres Humanos
Leucemia/terapia
Pais
Recidiva
Mídias Sociais/tendências
Revelação da Verdade
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.1589



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