scholarly journals Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer

2018 ◽  
Vol 36 (13) ◽  
pp. 1300-1307 ◽  
Author(s):  
Nicoletta Colombo ◽  
Gloria Huang ◽  
Giovanni Scambia ◽  
Eva Chalas ◽  
Sandro Pignata ◽  
...  
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Brca Mutation ◽  
The United States ◽  
Turnaround Time ◽  
Genetic Counselors ◽  
Stakeholder Satisfaction ◽  
Use Of Resources ◽  
Counseling Model ◽  
Testing And Counseling

Purpose There is a growing demand for BRCA1/ 2 mutation ( BRCAm) testing in patients with ovarian cancer; however, the limited number of genetic counselors presents a potential barrier. To facilitate more widespread BRCAm testing in ovarian cancer, pretest counseling by the oncology team could shorten testing turnaround times and ease the pressure on genetic counselors. Patients and Methods The prospective, observational Evaluating a Streamlined Onco-genetic BRCA Testing and Counseling Model Among Patients With Ovarian Cancer (ENGAGE) study evaluated a streamlined, oncologist-led BRCAm testing pathway. The analysis population comprised 700 patients with ovarian cancer at 26 sites in the United States, Italy, and Spain. The primary objectives were to assess turnaround time and, using questionnaires, to evaluate stakeholder satisfaction (patients, oncologists, and geneticists or genetic counselors) with the oncologist-led BRCAm testing pathway. Results The median overall turnaround time was 9.1 weeks (range, 0.9 to 37.1 weeks), with median turnaround times in the United States, Italy, and Spain of 4.1 weeks (range, 0.9 to 37.1 weeks), 20.4 weeks (range, 2.9 to 35.4 weeks), and 12.0 weeks (range, 2.0 to 36.7 weeks), respectively. Patient satisfaction with the oncologist-led BRCAm testing pathway was high, with > 99% of patients expressing satisfaction with pre- and post- BRCAm test counseling. Oncologist satisfaction with the BRCAm testing pathway was also high, with > 80% agreeing that the process for performing BRCAm testing worked well and that counseling patients on BRCAm testing was an efficient use of their time. Oncologists expressed higher levels of satisfaction with the BRCAm testing pathway than did geneticists or genetic counselors. Conclusion The results of the ENGAGE study demonstrate that an oncologist-led BRCAm testing process is feasible in ovarian cancer. Development of local BRCAm testing guidelines similar to the one used in this study could allow faster treatment decisions and better use of resources in the management of patients with ovarian cancer.

scholarly journals Core Elements Affecting Sharing: Evidence from the United States

2021 ◽  
Vol 13 (7) ◽  
pp. 3943
Author(s):  
Aurelija Burinskienė ◽  
Edita Leonavičienė ◽  
Virginija Grybaitė ◽  
Olga Lingaitienė ◽  
Juozas Merkevičius
Keyword(s):  
United States ◽  
The United States ◽  
Collaborative Consumption ◽  
Factors Affecting ◽  
Use Of Resources ◽  
Personal Consumption ◽  
Depth Analysis ◽  
Core Elements ◽  
Long Time ◽  
Number Of Visits

The new phenomenon called sharing or collaborative consumption emerged a decade ago and is continuously growing. It creates new possibilities for society, and especially for business, is beneficial for the environment, makes more efficient use of resources, and presents a new competitive business model. The scientific literature lacks a more in-depth analysis of the factors influencing sharing activity growth; therefore, the paper’s authors attempt to fill this gap. The authors aim to identify the factors affecting the use of sharing platforms. To reach the goal, the authors developed a regression model and constructed a list of 71 variables. The study used monthly United States data from January 2017 to June 2020 from the publicly available Federal Reserve Economic Data (FRED)and Google trends databases. The comparison to other indexes proves that the proposed index, representing the number of visits to sharing platforms (SEP), is a unique one. The first index allowed us to revise the sharing activity monthly. The authors identified that variables such as wage level, social network users, import level, and personal consumption are critical in affecting the number of visits to sharing platforms. The presented framework could be helpful for practitioners and policymakers analysing the stimulation of sharing or collaborative consumption. It includes indicators representing different areas, such as society, technology, and country, and allows for monthly investigations. Such activity was evident for a long time when online platforms contributed to its wider accessibility. The results help to forecast the number of visits monthly. Sharing is still an emerging area for research; thus, the authors tried to explore the phenomenon of sharing to expand the conceptual level of knowledge.

scholarly journals Contributors to and consequences of burnout among clinical genetic counselors in the United States

2021 ◽  
Author(s):  
Colleen Caleshu ◽  
Helen Kim ◽  
Julia Silver ◽  
Jehannine Austin ◽  
Aad Tibben ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Genetic Counselors ◽  
Clinical Genetic

BRCA1/2 Genetic Testing in the Community Setting

2002 ◽  
Vol 20 (22) ◽  
pp. 4485-4492 ◽  
Author(s):  
Wendy Y. Chen ◽  
Judy E. Garber ◽  
Suzanne Higham ◽  
Katherine A. Schneider ◽  
Katie B. Davis ◽  
...  
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Genetic Testing ◽  
Cancer Prevention ◽  
Community Setting ◽  
The United States ◽  
Care Providers ◽  
Prevention Strategies ◽  
History Of ◽  
Genetic Results

PURPOSE: BRCA1/2 genetic testing has been commercially available in the United States since 1996. Most published reports described BRCA1/2 testing as research studies at large academic centers, but less is known about testing in the community. This study evaluates the process and early outcomes of BRCA1/2 genetic testing as a clinical service in the community setting. METHODS: Surveys were mailed to women in the United States whose health care providers ordered BRCA1/2 genetic testing from Myriad Genetic Laboratories from August 1998 through July 2000. Women tested at 149 large academic centers were excluded. Main outcome measures were demographic characteristics, recall of and satisfaction with the genetic testing process, and likelihood of pursuing cancer prevention strategies. RESULTS: Among the 646 respondents, 414 (64%) had a personal history of cancer and 505 (78%) had at least one first-degree relative with breast and/or ovarian cancer. Most subjects (82%) recalled discussions of informed consent before testing (median time, 30 minutes). Genetic results were conveyed during an office visit (57%), by telephone (39%), or by mail (3%). More than 75% of respondents were “very satisfied with the counseling received.” Cancer-free subjects with a germline mutation were more likely to consider prevention strategies after receiving the genetic results. CONCLUSION: Virtually all respondents had a personal and/or family history of breast/ovarian cancer. Although pretest and posttest communications were not standardized, overall satisfaction with clinical breast cancer genetic testing was high. Additional follow-up will provide data on future cancer prevention practices and cancer incidence.

scholarly journals Perceived Risk of Mosquito-Borne Arboviruses in the Continental United States

Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1562
Author(s):  
Saul Lozano ◽  
Jonathan Day ◽  
Lilyana Ortega ◽  
Maggie Silver ◽  
Roxanne Connelly
Keyword(s):  
United States ◽  
Risk Perception ◽  
Vector Control ◽  
News Media ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
The United States ◽  
Transmission Risk ◽  
Accurate Information ◽  
Use Of Resources

The United States experienced local transmission of West Nile Virus (WNV) for the first time in 1999, and Zika Virus (ZIKV) in 2016. These introductions captured the public’s attention in varying degrees. The research presented here analyzes the disproportional perception of ZIKV risk compared to WNV transmission risk, by the public and vector control personnel. The risk perception of vector control was measured through purposive sampled interviews (24 interviews in 13 states; May 2020–June 2021), while the public’s perception was estimated from news publications (January 2000–December 2020), and Google searches (January 2004–December 2020). Over time, we observed a decrease in the frequency of press reporting and Google searches of both viruses with decreasing annual peaks in the summer. The highest peak of ZIKV news, and searches, surpassed that of WNV. We observed clear differences in the contents of the headlines for both viruses. We propose that the main reason in risk perception differences between the viruses were psychological. Zika infections (mosquito-borne and sexually transmitted) can result in devastating symptoms in fetuses and newborns, observations that frequently appeared in ZIKV-related headlines. Our results highlight the likely influence the news media has on risk perception and the need for public health agencies to play active roles in the conversation, helping disseminate timely and accurate information. Understanding the factors that shape risk perceptions of vector-borne diseases will hopefully lead to better use of resources by providing better guidance.

Multicenter study to evaluate the benefits of technology-assisted workflow on i.v. room efficiency, costs, and safety in small community hospitals

2019 ◽  
Vol 76 (13) ◽  
pp. 964-969 ◽  
Author(s):  
Jordyn P Higgins ◽  
Sarah Hardt ◽  
Debby Cowan ◽  
Eula Beasley ◽  
Stephen F Eckel
Keyword(s):  
United States ◽  
Multicenter Study ◽  
The United States ◽  
Turnaround Time ◽  
Error Reporting ◽  
Small Community ◽  
Community Hospitals ◽  
Error Type ◽  
Average Turnaround Time ◽  
Sterile Product

Abstract Purpose To evaluate the benefits of technology-assisted workflow (TAWF) compared to manual workflow (non-TAWF) on i.v. room efficiency, costs, and safety at community hospitals with less than 200 beds. Methods Four hospitals in the United States (2 with and 2 without TAWF) were evaluated, and characteristics of medication errors and frequency of each error type were measured across the institutions. The average turnaround time per workflow step and cost to prepare each compounded sterile product (CSP) were also calculated. The results were evaluated using descriptive and inferential statistics. Results The TAWF hospital sites detected errors at a significantly higher rate (3.78%) compared to the non-TAWF hospital sites (0.13%) (p < 0.05). The top error-reporting category for the TAWF sites was incorrect medication (71.66%), whereas the top error-reporting category for the non-TAWF sites could not be determined because of the small number of errors detected. Use of TAWF may be associated with a decrease in turnaround time and a decrease in overall cost to prepare a CSP. Conclusion Significantly more errors were detected in small community hospitals that use TAWF in the i.v. room compared to those not using it. There were differences in error types observed between technology and nontechnology groups. The use of TAWF was associated with faster preparation times and lower costs of preparation per CSP.

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