Does genetic counseling for women at high risk of harboring a deleterious BRCA mutation alter risk-reduction strategies and cancer surveillance behaviors?

This continuing feature highlights the experiences of various health care organizations in implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards and National Patient Safety Goals. Practical information on what worked and how organizations have been surveyed regarding the standards and goals will be provided along with updates on revisions and recommendations being established by JCAHO. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards are guidelines for health care organizations to improve patient medication safety and quality of care. Medication Management Standard 7.10 states, “The hospital develops processes for managing high-risk or high-alert medications.” An institution's list of high-risk medications can be derived from published lists, retrospective review of hospital-specific incidents, and/or prospective evaluation as new drugs are added to the formulary. The hospital's policy will include the list of high-risk medications and the risk-reduction strategies that it is undertaking to reduce medication errors associated with them. One method of identifying risk-reduction strategies is to conduct a failure mode and effects analysis (FMEA). The process of conducting an FMEA is described and a list of risk-reduction strategies from two hospitals are provided.

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Polysubstance use and associated effects at raves parties / Efectos asociados al policonsumo de drogas en fiestas rave

Health and Addictions/Salud y Drogas ◽

10.21134/haaj.v12i1.9 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Fermín Fernández-Calderón ◽

Óscar M. Lozano Rojas ◽

Izaskun Bilbao Acedos ◽

Antonio J. Rojas Tejada ◽

Claudio Vidal Giné ◽

...

Keyword(s):

High Risk ◽

Risk Reduction ◽

Well Being ◽

Negative Effects ◽

Positive Effects ◽

Polysubstance Use ◽

Reduction Strategies ◽

Logistic Regressions ◽

The One ◽

Risk Reduction Strategies

Objetivos: El presente estudio tiene como objetivo describir los efectos positivos y negativos percibidos por asistentes a fiestas rave underground, y analizar las relaciones existentes entre las drogas consumidas y los efectos percibidos.Método: estudio realizado entre 252 asistentes a 22 fiestas raves underground celebradas en Andalucía, entre los meses de mayo y octubre de 2008. Se han aplicado contrastes de proporciones y regresiones logísticas.Resultados: Los resultados muestran que las drogas más consumidas por los asistentes fueron: alcohol (94.4%), cannabis (76.6%), speed (74.7%), éxtasis (64.1%), cocaína (28.2%), ketamina (23.8%) y LSD (22.9%). AbstractObjetives: The purpose of this study is to describe positive and negative effects perceived by underground rave attenders, and to analyze the relations between drugs consume and perceived risks.Method: The research was developed with a sample of 252 assistant at 22 underground raves in Andalucía (Spain), from May to October 2008. It has been applied contrast proportions and logistic regressions analysis.Results: Results show that the most consumed drugs were: alcohol (94.4%), cannabis (76.6%), speed (74.7%), ecstasy (64.1%), cocaine (28.2%), ketamine (23.8%) and LSD (22.9%). The most positive effects perceived were: euphoria, well-being, happiness (90.3%) and connection with music (75.4%). The most negative effects perceived were: tiredness (78.2%), jaw clenching (55.2%) and concentration decreased (54.4%). Ecstasy is the substance which more increases probability to perceive positive effects, while speed is the one that more increases probability to perceive negative effects.Conclusions: Negative effects experimented for participants show the high risk for rave attendees´ health. These, together with positive effects, must be considered in order to design preventive and risk reduction strategies.

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ATL

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000403 ◽

2015 ◽

Vol 25 (4) ◽

pp. 584-592 ◽

Cited By ~ 1

Author(s):

Meera Joseph ◽

Faiza Rab ◽

Karen Panabaker ◽

Jeff Nisker

Keyword(s):

Ovarian Cancer ◽

Genetic Counseling ◽

Cancer Surveillance ◽

Physician Education ◽

Hereditary Risk ◽

Family Histories ◽

Counseling And Testing ◽

Reduction Strategies ◽

Narrative Response ◽

Risk Reduction Strategies

ObjectiveFamily physicians in Canada as reported in several studies do not recognize the importance of family history in relation to breast/ovarian cancer and thus Canadian women with strong family histories continue to develop early-onset breast cancer without the knowledge of or ability to make choices regarding increased surveillance or preventative strategies. This study explored the feelings of women who learned about their hereditary risk only after their diagnosis younger than 52 years and who eventually tested positive for a BRCA gene mutation.MethodsThirty-four such women were mailed an invitation to participate in this research including a letter of information, consent form, and discussion prompts for their written narrative response. Rigorous mixed method analyses were performed using Charmaz-based qualitative analyses as well as quantitative analyses.ResultsThirteen women (38.2%) responded with narratives for qualitative analysis from which 4 themes were coconstructed as follows: I, types of emotions; II, emotional response; III, coping with emotions; and IV, advice to women at similar risk. Women felt they should have learned about their hereditary risk from their family physician and through public education before their diagnosis. Although not experienced at the time of diagnosis, anger, frustration, and regret were experienced after receiving their BRCA results. These emotions arose from our research participants’ lack of opportunity for prior genetic counseling and testing opportunity for genetic counseling and testing.ConclusionsWith increased public and physician education, it is hoped that women with significant family histories of breast/ovarian cancer will be identified before diagnosis and given options regarding cancer surveillance and risk reduction strategies.

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