A randomized trial of telephone versus in-person disclosure of BRCA 1/2 results.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1538-1538
Author(s):  
Angela R. Bradbury ◽  
Linda J. Patrick-Miller ◽  
Brian Egleston ◽  
Kyle Smith ◽  
Dominique Fetzer ◽  
...  
Keyword(s):  
State Anxiety ◽  
Psychological Factors ◽  
Patient Characteristics ◽  
Limited Data ◽  
General Anxiety ◽  
Genetic Test Results ◽  
The Family ◽  
Brca 1 ◽  
History Of ◽  
The Impact

1538 Background: While some providers use telephone to share genetic test results, there is limited data on the efficacy and impact on patient cognitive and emotional responses. Methods: Patients who completed in-person genetic counseling for BRCA 1/2 testing were randomized to telephone (TD) or in-person (IPD) disclosure. Baseline (BL) and post-disclosure (PD) surveys assessed knowledge, satisfaction and psychological factors. We used T-tests and multiple linear regressions. Results: 179 patients (68% of approached),126 (72%) agreed to be randomized; 36 (28%) declined randomization (Self-select IPD). Patient characteristics did not differ between arms. Change in knowledge, satisfaction and psychological factors did not differ between TD and IPD (Table). Self-select IPD participants had greater declines in depression and state anxiety (Table). In multivariable models, history of cancer was associated with greater declines in general anxiety (coef -1.4, p=0.01). BRCA+ results were associated with greater increases in knowledge (coef 3.2, p 0.02) and state anxiety (coef 12.0, p<0.01), and declines in satisfaction (coef -6.6, p<0.01). Having a mutation in the family was associated with greater declines in intrusive thoughts (coef -4.8, p<0.01). Conclusions: In general,telephone disclosure of BRCA1/2 results does not appear to negativelyimpact psychological outcomes but outcomes among carriers (BRCA+) differ. Larger studies are needed to understand the impact among subgroups and more diverse populations. Some patients preferred in-person communication and had different outcomes, suggesting more data is needed before telephone disclose is universally adopted. [Table: see text]

scholarly journals P1.11-23 The Impact of the Family History of Different Cancers on Lung Cancer

2019 ◽  
Vol 14 (10) ◽  
pp. S524-S525
Author(s):  
J. Li ◽  
C. Li ◽  
B. Cheng ◽  
J. He ◽  
W. Liang
Keyword(s):  
Lung Cancer ◽  
Family History ◽  
The Family ◽  
History Of ◽  
The Impact

scholarly journals How Do Family Historians Work with Memory?

2020 ◽  
Vol 46 (1) ◽  
pp. 92-106
Author(s):  
Tanya Evans
Keyword(s):  
Material Culture ◽  
Oral History ◽  
First Century ◽  
Family Stories ◽  
The Family ◽  
Archival Documents ◽  
History Of ◽  
Oral History Interviews ◽  
The Impact ◽  
Everyday Knowledge

Drawing on survey data and oral history interviews undertaken with family historians in Australia,England, and Canada this article will explore how family historians construct memories using diverse sources in their research. It will show how they utilize oral history, archival documents, material culture, and explorations of space to construct and reconstruct family stories and to make meaning of the past, inserting their familial microhistories into global macrohistories. It will ask whether they undertake critical readings of these sources when piecing together their families’ stories and reveal the impact of that work on individual subjectivities, the construction of historical consciousness, and the broader social value of family history scholarship. How might family historians join with social historians of the family to reshape our scholarly and “everyday” knowledge of the history of the family in the twenty-first century?

SOCIO-PSYCHOLOGICAL FACTORS OF FORMATION THE READINESS FOR CHARITY AMONG ADOLESCENTS

2019 ◽  
pp. 29-32
Author(s):  
I. Klymenko
Keyword(s):  
High School Students ◽  
Young People ◽  
Extracurricular Activities ◽  
Psychological Factors ◽  
Educational Process ◽  
Personal Factors ◽  
School Students ◽  
Level Of Involvement ◽  
The Family ◽  
The Impact

The article is devoted to the study of psychological factors that can influence upon personal motivation and readiness for charity of adolescent. The findings can help to increase the effectiveness of programs that involve young people in charity and identify the most effective methods to form prosocial behavior of young people aimed at helping and supporting others in the long run. The purpose of the article is to investigate the influence of personal, pedagogical and socio-psychological factors on the formation of young people's readiness for charitable activity. The author analyzed the potential positive consequences of prosocial activity for adolescents, identified the main motives of charity and the specific motivation of high school students, summarized information about the factors and mechanisms of involvement and formation of charitable readiness. Analysis of the data obtained in the empirical study of adolescents from two schools with different pedagogical environment and different levels of organization of school prosocial activity, allowed to identify a number of patterns that indicate the dominant factors in the formation of adolescents readiness for charity. We have found that altruism, empathy and the dominance of values of universalism, goodness and conformity are significant personal characteristics that determine the readiness for charitable activity. Significant personal factors are polymotivation (the combination of personal and social motives for charitable activities), a high level of involvement in such activities and the availability of certain experiences. We have found that the most important environments for development of charity readiness are the family and the school. The immediate environment (project team) and the authority of the mentor, the possibility of self-realization, the reach of the result, the opportunity to receive positive emotions, the level of responsibility play a significant role in increasing the level of involvement in school projects and programs. In a school where teachers attach great importance to the prosocial activity of students in the educational process, the impact of the school environment becomes major. It determines the readiness for further charity both with the family and as a part of extracurricular activities.

scholarly journals 62. Secondary Prophylaxis in Clostridioides difficile Infections: a Closer Look at Outcomes

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S149-S150
Author(s):  
Rubi Rodriguez ◽  
Surafel Mulugeta ◽  
Darius Faison ◽  
Rachel Kenney ◽  
Susan L Davis ◽  
...  
Keyword(s):  
Best Practice ◽  
Patient Characteristics ◽  
Secondary Prophylaxis ◽  
Convincing Evidence ◽  
Bivariate Analysis ◽  
Clostridioides Difficile ◽  
Clinical Culture ◽  
Dosing Regimens ◽  
History Of ◽  
The Impact

Abstract Background Clostridioides difficile infection (CDI) is an urgent public threat and carries a 25% chance of recurrence (rCDI). Data on safety and efficacy of oral vancomycin prophylaxis (OVP) in reducing rCDI is limited. We implemented a best practice advisory (BPA) to alert the prescriber and antibiotic stewardship (ASP) team for patients with CDI in the previous 60 days being initiated on systemic antimicrobials. The alert states “Don’t use antibiotics in patients with recent CDI without convincing evidence of need. Antibiotics pose a high risk of recurrence”. ASP team would recommended OVP if antibiotics are continued. This study evaluated the impact of the BPA alert on OVP prescribing and patient outcomes. Methods IRB approved, retrospective, observational cohort study comparing patients who received OVP to no OVP. Inclusion: adults with history of laboratory confirmed CDI, ≥ 14 days post-CDI treatment completion, BPA from 3/7/19 – 3/31/20, receiving non-CDI systemic antimicrobials, and without history of bezlotoxumab infusion. Data were reported using descriptive statistics and bivariate analysis. Primary endpoint: rCDI within 2-8 weeks post-OVP completion. Secondary endpoints: vancomycin-resistant Enterococcus spp (VRE) in clinical culture post-OVP and 1-year mortality. Results 70 patients included: 32 (46%) no-OVP and 38 (54%) OVP. Baseline characteristics, previous CDI treatment, and outcomes were similar (Table 1). Index CDI was severe in the OVP group (18, 47% vs. 9, 28%). Median Charlson comorbidity index: 7 (3 – 9) no-OVP and 7 (5 – 9) OVP. OVP regimens, 125 mg by mouth: once daily 4 (10%), twice daily 22 (58%), and every 6 hours 12 (32%). Median prophylaxis duration: 10 days (6 – 13). rCDI occurred in 3 (9%) no-OVP and 2 (5%) OVP (P = 0.654). Mortality: 10 (31%) no-OVP and 16 (42%) OVP (P = 0.458). Table 1. Patient Characteristics and Endpoints Conclusion OVP was utilized in approximately half of patients who required non-CDI antibiotics. Efficacy interpretation is limited by inconsistent dosing regimens and significant comorbid illness in the cohort. Future work will focus on further optimizing the BPA and standardizing the OVP regimen. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder) Susan L. Davis, PharmD, Nothing to disclose

scholarly journals An Examination of the Pre-competition and Post-competition State Anxiety Levels of Russian Women’s National Volleyball Team Athletes

2019 ◽  
Vol 7 (5) ◽  
pp. 19
Author(s):  
Mustafa Önder Şekeroğlu
Keyword(s):  
State Anxiety ◽  
Psychological Factors ◽  
Descriptive Study ◽  
Somatic Anxiety ◽  
Self Confidence ◽  
Competition State ◽  
Cognitive Anxiety ◽  
Tactical Training ◽  
Anxiety Levels ◽  
The Impact

This study of 14 Russian women’s national volleyball team athletes aimed to determine their pre-competition and post-competition state anxiety levels according to some variables. This descriptive study used the Competition State Anxiety Inventory-2 (CSAI-2) developed by Martens, Burton, Vealey, Bump and Smith (1990). This inventory has 9 items in 3 sub-factors: cognitive anxiety, somatic anxiety and self-confidence.A comparison of the pre-competition and post-competition anxiety levels found no statistically significant differences in cognitive anxiety (p>0.05), somatic anxiety (p>0.05) and self-confidence (p>0.05). The highest pre-competition somatic anxiety score fell after the competition, while cognitive anxiety and self-confidence increased after the competition when it was low. There were no statistically significant differences in the athletes’ pre-competition and post-competition anxiety levels by age or income. Considering that success does not occur without a certain level of anxiety, coaches should consider the impact of psychological factors in technical and tactical training.

scholarly journals Venous thromboembolism and bleeding in a community setting

2009 ◽  
Vol 101 (05) ◽  
pp. 878-885 ◽  
Author(s):  
Joel Gore ◽  
George Reed ◽  
Darleen Lessard ◽  
Luigi Pacifico ◽  
Cathy Emery ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Total Mortality ◽  
Community Setting ◽  
Patient Characteristics ◽  
Recurrence Rates ◽  
Increased Risk ◽  
History Of ◽  
Recurrent Vte ◽  
The Impact

SummaryBleeding is the most frequent complication of antithrombotic therapy for venous thromboembolism (VTE). However, little attention has been paid to the impact of bleeding after VTE in the community setting. The purpose of this investigation was to describe the incidence rate of bleeding after VTE, to characterize patients most at risk for bleeding, and to assess the impact of bleeding on rates of recurrent VTE and all-cause mortality. The medical records of residents of the Worcester (MA, USA) metropolitan area diagnosed with ICD-9 codes consistent with potential VTE during 1999, 2001, and 2003 were individually validated and reviewed by trained data abstracters. Clinical characteristics, acute treatment, and outcomes (including VTE recurrence rates, bleeding rates, and mortality) over follow-up (up to 3 years maximum) were evaluated. Bleeding occurred in 228 (12%) of 1,897 patients with VTE during our follow-up. Of these, 115 (58.8%) had evidence of early bleeding occurring within 30 days of VTE diagnosis. Patient characteristics associated with bleeding included impaired renal function and recent trauma. Other than a history of prior VTE, the occurrence of bleeding was the strongest predictor of recurrent VTE (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.54–3.09) and was also a predictor of total mortality (HR 1.97; 95%CI 1.57–2.47). The occur-rence of bleeding following VTE is associated with an increased risk of recurrent VTE and mortality. Future study of antithrombotic strategies for VTE should be informed by this finding. Advances that result in decreased bleeding rates may paradoxically decrease the risk of VTE recurrence.

Abstract P232: Influence of Individualized Risk Prediction and Patient Preferences on Selection of Prasugrel Versus Clopidogrel at the Time of Percutaneous Coronary Intervention for an Acute Coronary Syndrome

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Adam C Salisbury ◽  
Kaijun Wang ◽  
David J Cohen ◽  
Yan Li ◽  
John A Spertus
Keyword(s):  
Decision Making ◽  
Acute Coronary Syndrome ◽  
Bleeding Risk ◽  
Patient Characteristics ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
Coronary Syndrome ◽  
Alternative Outcome ◽  
History Of ◽  
The Impact

Introduction: Given the need to weigh prevention of ischemia against bleeding risk with prasugrel vs. clopidogrel at the time of PCI for an acute coronary syndrome (ACS), we developed risk models for both outcomes from TRITON-TIMI 38. We then applied these models to each TRITON patient and examined how preferences for outcomes could influence thienopyridine selection. Methods: We built separate multivariable regression models for ischemia (cardiac death, MI, stroke) and bleeding (TIMI major/minor) from 12,579 patients in TRITON-TIMI 38 with no history of stroke or TIA. For each patient, we calculated the probability of ischemic and bleeding events with prasugrel vs. clopidogrel and the associated benefit:risk ratio (predicted difference in ischemic events/predicted difference in bleeding). We then examined the impact of alternative outcome weights - benefit:risk preference thresholds - on individualized decision making. Results: Based on individualized risk predictions, the majority of ACS patients treated with PCI (66%) may choose prasugrel when preventing ischemia is considered equally important as avoiding bleeding (Figure), but this proportion varied from 32% to 80% when the benefit:risk preference threshold was varied from 3 (reflecting a 3-times greater preference for avoiding bleeding) to 0.25 (reflecting a 4-times greater preference for avoiding ischemia). Conclusions: Based on empirical analyses, the expected absolute benefits and risks of prasugrel vs. clopidogrel depend highly on patient characteristics and preferences. Presenting individualized predictions of benefits and risks with competing treatments may improve shared decision making.

Play and social behavior in maltreated preschoolers

1991 ◽  
Vol 3 (2) ◽  
pp. 191-206 ◽  
Author(s):  
Steven M. Alessandri
Keyword(s):  
Standardized Tests ◽  
Emotionally Disturbed ◽  
Classroom Behavior ◽  
Control Group ◽  
Standardized Measures ◽  
Play Interactions ◽  
The Family ◽  
History Of ◽  
The Impact ◽  
Cognitive Play

AbstractThis study investigates play and nonplay behavior in maltreated and nonmaltreated preschool children. In addition, standardized tests of cognitive and language ability were administered, and teachers rated the children's classroom behavior. Thirty 4–5-year-old children participated in the study: 15 had a history of child abuse, and 15 nonabused children served as a matched control group. Across a 6-week period, children's social and play interactions were videotaped in the classroom. Videotape recordings were analyzed for the level of social participation and cognitive play. No differences were found between the two groups on the standardized measures. However, maltreated, relative to nonmaltreated, children engaged in less overall play and greater functional or sensorimotor play. Maltreated children also engaged in more transitional behavior and aggression, were less competent with peers, and were perceived by teachers as more emotionally disturbed. Results of this study suggest that the impact of maltreatment extends beyond the family into play and social relationships in preschool.

scholarly journals Knowledge, Health Beliefs, and Self-Efficacy regarding Osteoporosis in Perimenopausal Women

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Renée D. Endicott
Keyword(s):  
Pilot Study ◽  
Family History ◽  
Health Beliefs ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Educational Program ◽  
The Family ◽  
Perimenopausal Women ◽  
History Of ◽  
The Impact

The aims of this pilot study were to (1) determine if having a family history of osteoporosis impacts knowledge, health beliefs, and self-efficacy regarding osteoporosis among perimenopausal women aged 42–52 and to (2) describe the impact of an osteoporosis-specific educational intervention had on the knowledge, health beliefs, and self-efficacy of this population. Participants completed three surveys measuring knowledge, health beliefs, and self-efficacy related to osteoporosis before and two months after the educational program. At baseline, no differences were noted in knowledge of osteoporosis among women with and without a family history of osteoporosis, although women with a family history perceived a greater susceptibility for developing osteoporosis than women without the family history. Findings indicate that both groups increased in knowledge of osteoporosis (P<.001). Benefits of calcium increased in the women without a family history of osteoporosis (P<.001) and benefits of exercise increase in women with a family history of osteoporosis (P=.007). There were no significant statistical findings regarding self-efficacy between the two groups of women. Findings indicate that an osteoporosis-specific educational program improves perimenopausal women’s knowledge and some health beliefs.

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