scholarly journals Evaluation of Clinical Practices Related to Variants of Uncertain Significance Results in Inherited Cardiac Arrhythmia and Inherited Cardiomyopathy Genes

2020 ◽  
Vol 13 (4) ◽  
Author(s):  
Reka D. Muller ◽  
Thomas McDonald ◽  
Kathleen Pope ◽  
Deborah Cragun
Keyword(s):  
Medical Management ◽  
Online Survey ◽  
Clinical Practices ◽  
Provider Type ◽  
Variants Of Uncertain Significance ◽  
Hypothetical Scenario ◽  
Before And After ◽  
Uncertain Significance ◽  
Management Recommendations ◽  
Inherited Arrhythmias

Background: Increasing use of genetic tests have identified many variants of uncertain significance (VUS) in genes associated with inherited arrhythmias and cardiomyopathies. Evaluation of clinical practices, including medical management recommendations for VUS patients and their families, is important to prevent over- or under-treatment that may result in morbidity or mortality. The purpose of this study is to describe practices related to VUS results including information and medical management recommendations providers give patients and their families. Methods: An anonymous online survey was distributed to genetic counselors (GCs) and cardiologists who have seen at least one patient for inherited arrhythmias or cardiomyopathies. The survey explored providers’ confidence in counseling, explanation of VUSs, topics covered before and after genetic testing, and clinical recommendations using a hypothetical scenario maximizing uncertainty with an unclear clinical and molecular diagnosis. Descriptive statistics were calculated, and median confidence and likelihood of making various medical recommendations were compared across provider type. Results: Providers (N=102) who completed the survey included 29 cardiovascular GCs, 50 GCs from other specialties, and 23 cardiologists. GCs feel more confident than cardiologists counseling about VUS results ( P <0.001); while both cardiovascular GCs and cardiologists feel more confident than other GCs in providing input regarding medical management recommendations ( P =0.001 and P =0.01, respectively). Cardiologists were more likely than cardiac GCs to recommend clinical testing for family members even though testing in the scenario is expected to be uninformative. Conclusions: These findings illustrate how the expertise of different providers may impact decision processes, suggesting the need for interdisciplinary clinics to optimize care for challenging cases.

scholarly journals BRCA1/2 Sequence Variants of Uncertain Significance: A Primer for Providers to Assist in Discussions and in Medical Management

2013 ◽  
Vol 18 (5) ◽  
pp. 518-524 ◽  
Author(s):  
Noralane M. Lindor ◽  
David E. Goldgar ◽  
Sean V. Tavtigian ◽  
Sharon E. Plon ◽  
Fergus J. Couch
Keyword(s):  
Medical Management ◽  
Sequence Variants ◽  
Variants Of Uncertain Significance ◽  
Uncertain Significance

BRCA1 and BRCA2 Variants of Uncertain Significance. Part Two: Medical Management

2011 ◽  
Vol 38 (5) ◽  
pp. 605-611
Author(s):  
Susan Miller-Samuel ◽  
Anne Rosenberg ◽  
Adam Berger ◽  
Leonard Gomella ◽  
David Loren ◽  
...  
Keyword(s):  
Medical Management ◽  
Brca1 And Brca2 ◽  
Variants Of Uncertain Significance ◽  
Uncertain Significance

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

scholarly journals Actions and Uncertainty: How Prenatally Diagnosed Variants of Uncertain Significance Become Actionable

2019 ◽  
Vol 49 ◽  
pp. S61-S71 ◽  
Author(s):  
Allison Werner-Lin ◽  
Judith L. M. Mccoyd ◽  
Barbara A. Bernhardt
Keyword(s):  
Variants Of Uncertain Significance ◽  
Uncertain Significance

Health-Care Workers’ Perception of Reimbursement for Complex Surgical Oncology Procedures

2020 ◽  
Vol 86 (2) ◽  
pp. 140-145
Author(s):  
Shoshana Levi ◽  
Emily Alberto ◽  
Dakota Urban ◽  
Nicholas Petrelli ◽  
Gregory Tiesi
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Online Survey ◽  
Surgical Oncology ◽  
Patient Perceptions ◽  
Cancer Center ◽  
Physician Reimbursement ◽  
Care Workers ◽  
Before And After ◽  
Fee Schedule

Perception of physician reimbursement for surgical procedures is not well studied. The few existing studies illustrate that patients believe compensation to be higher than in reality. These studies focus on patient perceptions and have not assessed health-care workers’ views. Our study examined health-care workers’ perception of reimbursement for complex surgical oncology procedures. An anonymous online survey was distributed to employees at our cancer center with descriptions and illustrations of three oncology procedures—hepatectomy, gastrectomy, and pancreaticoduodenectomy. Participants estimated the Medicare fee and gave their perceived value of each procedure. Participants recorded their perception of surgeon compensation overall, both before and after revealing the Medicare fee schedule. Most of the 113 participants were physicians (33.6%) and nurses (28.3%). When blinded to the Medicare fee schedules, most felt that reimbursements were too low for all procedures (60–64%) and that surgeons were overall undercompensated (57%). Value predictions for each procedure were discordant from actual Medicare fee schedules, with overestimates up to 374 per cent. After revealing the Medicare fee schedules, 55 per cent of respondents felt that surgeons were undercompensated. Even among health-care workers, a large discrepancy exists between perceived and actual reimbursement. Revealing actual reimbursements did not alter perception on overall surgeon compensation.

Antecedents of the attitude toward the athlete celebrities' human brand extensions

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jakeun Koo
Keyword(s):  
Structural Equation ◽  
Online Survey ◽  
Brand Extensions ◽  
Equation Modeling ◽  
Image Transfer ◽  
Content Type ◽  
Before And After ◽  
Research Findings ◽  
Survey Results ◽  
Human Brands

PurposeThe present study aims to examine how consumers evaluate the extended human brands of athlete celebrities beyond their unique brand personality associated with sports. Athlete celebrities' unique image in sports is used as a human brand, and attitude toward the athlete brand extensions is investigated when the athlete's name is included in a new non-sport brand. The concepts of brand extensions were employed to develop the ideas of human brand extensions.Design/methodology/approachIn total, 198 participants answered online survey questions before and after being informed of athlete brand extensions. Partial least squares structural equation modeling is utilized to test the hypotheses.FindingsThe survey results indicated that athlete–product fit and image transfer positively influenced attitude toward the extension. In addition, attitude toward the athlete brand extensions was significantly influenced by consumers' pre-existing attitude toward the celebrity; however, not by celebrity's expertise.Originality/valueThe research findings imply that some brand extension concepts are applicable to human brands to understand the effectiveness of athlete brand extensions for non-sport products.

scholarly journals Return to Learn After Sport-Related Concussion: A Survey of Secondary School and Collegiate Athletic Trainers

2018 ◽  
Vol 53 (10) ◽  
pp. 990-1003 ◽  
Author(s):  
Chelsea L. Williamson ◽  
Grant E. Norte ◽  
Donna K. Broshek ◽  
Joseph M. Hart ◽  
Jacob E. Resch
Keyword(s):  
Secondary School ◽  
Online Survey ◽  
Current Knowledge ◽  
Athletic Trainers ◽  
Management Policy ◽  
Annual Number ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Return To Learn ◽  
National Athletic Trainers Association

Context Recent recommendations have emphasized return-to-learn (RTL) protocols to aid athletes in recovery from sport-related concussion (SRC) but have been based primarily on anecdotal evidence. Objective To investigate the RTL practices of certified athletic trainers (ATs) after an SRC. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A total of 1083 individuals (27%) from a random sample of 4000 ATs in the National Athletic Trainers' Association membership database completed an electronic survey. Participants consisted of 729 self-identified secondary school ATs (SSATs; 67.3%; experience = 14.0 ± 9.7 years) and 354 self-identified collegiate ATs (CATs; 32.7%; experience = 13.4 ± 9.7 years). Main Outcome Measure(s) We used χ2 analyses to assess respondent differences related to current knowledge, current practices, and available resources. Independent t tests were used to compare SSATs and CATs on years of certification and annual number of SRCs evaluated. Results Of our total respondents, 41.2% (n = 446) correctly indicated the absence of evidence-based RTL guidelines. Whereas most (73.9%, n = 800) respondents had an established RTL policy, only 38.1% (n = 413) used such guidelines in their clinical practice. Most (97.1%, n = 708) SSATs and 82.2% (n = 291) of CATs had access to (a) mental health professional(s); however, minorities of SSATs (21.4%, n = 156) and CATs (37.0%, n = 131) never accessed these resources to care for concussed student-athletes. Conclusions Our results suggested that, despite the absence of empirical evidence, most surveyed ATs incorporated some form of RTL protocol in their SRC management policy. The varying AT knowledge, clinical practices, and resources highlighted by our results should be considered when creating or refining an RTL protocol.

scholarly journals Lynch Syndrome Limbo: Patient Understanding of Variants of Uncertain Significance

2017 ◽  
Vol 26 (4) ◽  
pp. 866-877 ◽  
Author(s):  
Ilana Solomon ◽  
Elizabeth Harrington ◽  
Gillian Hooker ◽  
Lori Erby ◽  
Jennifer Axilbund ◽  
...  
Keyword(s):  
Lynch Syndrome ◽  
Patient Understanding ◽  
Variants Of Uncertain Significance ◽  
Uncertain Significance
Sign in / Sign up

Export Citation Format

Share Document