Hispanic Infants with Cystic Fibrosis Show Low CFTR Mutation Detection Rates in the Illinois Newborn Screening Program

States develop specific protocols for cystic fibrosis (CF) newborn screening to reflect the population served. We hypothesized that mutation distribution and detection rates would differ between Hispanic and non-Hispanic CF patients diagnosed by IL newborn screen with more Hispanic infants carrying mutations not detected by the state panel. Data from CF cases diagnosed via newborn screen in IL between 3/1/2008 and 10/31/2010 were reviewed. More Hispanic infants with CF had one or more undefined mutations after screening, in comparison to non-Hispanic Caucasian patients (40% vs. 9.5%; p?相似文献   

工作-家庭中心性与延迟退休态度的关系研究

延迟退休态度是影响新退休政策推行的重要社会心理因素。本研究采用《延迟退休态度问卷》等工具,抽取450名临近退休员工,考察工作-家庭中心性与延迟退休态度的关系以及工作投入、组织支持感在其二者关系上的作用机制。研究发现：（1）临近退休员工对延迟退休的态度较为消极。（2）低组织支持感条件下,工作投入在工作-家庭中心性与延迟退休态度之间起到完全中介作用。低组织支持感不利于缓解家庭中心性员工对延迟退休的消极态度。（3）高价值认同条件下,家庭中心性与工作投入、延迟退休态度的正向关系弱化。给予员工高价值认同可以提升对延迟退休的积极态度。高关心利益也可缓解家庭中心性员工对延迟退休的消极态度。     

The public's perception of psychotherapy and counseling: Differential views on the effectiveness of psychologists,psychiatrists, and other providers

This study examined the public's perceptions relative to the effectiveness of psychotherapy and counseling, expectations of treatment efficacy for different psychotherapy and counseling providers (i.e., clinical psychologists, counseling psychologists, counselors, general medical practitioners, marital and family therapists, psychiatrists, self-help groups, and social workers), professional characteristics, and factors that may influence treatment utilization in an adult population. The sample viewed psychotherapy or counseling as moderately effective and perceived psychotherapy/counseling to be effective for 26 to 50 percent of all cases. The perceived amount of time necessary for noticeable improvement in psychotherapy or counseling was approximately four months, and the expected necessary length of treatment was approximately eight months. Participants stated they were moderately willing to seek psychotherapy or counseling if they were to experience a mental problem, and reported discernible differences among the eight psychotherapy/counseling providers in terms of treatment efficacy. Differences were also found in the relative perception of providers' personal/professional qualities and characteristics.     

学生感知的教师欺凌态度与学生欺凌行为的关系——学生欺凌态度的中介作用及其性别的调节作用

校园欺凌严重影响青少年身心的健康发展,教师是预防和干预校园欺凌的重要力量。本研究拟在考察学生感知的教师欺凌态度与学生欺凌行为关系的基础上,探究学生欺凌态度的中介效应以及性别的调节作用。本研究采用《校园欺凌量表》、《学生欺凌态度量表》以及《学生感知的教师欺凌态度量表》对来自北京市两所初中的698名初一和初二学生进行测查。结果显示:(1)初中男生总体及不同类型的欺凌行为及其欺凌态度均显著高于女生,而女生所感知的教师欺凌严重性态度则显著高于男生;(2)学生感知的教师欺凌严重性态度显著负向预测学生欺凌行为;(3)学生欺凌态度在学生感知的教师欺凌态度和学生欺凌行为之间起部分中介作用;(4)学生欺凌态度的中介效应存在显著性别差异,男生欺凌态度为部分中介作用,而女生欺凌态度为完全中介作用。     

Attitudes Toward Cystic Fibrosis Carrier and Prenatal Testing and Utilization of Carrier Testing Among Relatives of Individuals with Cystic Fibrosis

A questionnaire and an offer of free carrier testing was mailed to 173 relatives of individuals with CF. The questionnaire addressed their knowledge of clinical and genetic aspects of CF, as well as their attitudes toward carrier testing, prenatal diagnosis, and pregnancy termination for CF. Eighty-one individuals returned the questionnaire (47%) and 50 elected carrier testing (29%). Most respondents underestimated their carrier risk (60%), but overestimated their risk to have a child with CF (63%). Most (93%) indicated they would utilize carrier testing, and 70% would use prenatal testing; however, only 7% would consider terminating a pregnancy for CF. The intention to use prenatal testing was correlated with the perceived health of the proband and whether the respondent was planning to have (more) children. The acceptability of abortion was correlated with the respondent's perceived impact or burden of CF.     

Pregnant Women’s Perspectives on Expanded Carrier Screening

Expanded carrier screening (ECS) is a relatively new carrier screening option that assesses many conditions simultaneously, as opposed to traditional ethnicity-based carrier screening for a limited number of conditions. This study aimed to explore pregnant women’s perspectives on ECS, including reasons for electing or declining and anxiety associated with this decision-making. A total of 80 pregnant women were surveyed from Northwestern Medicine’s Clinical Genetics Division after presenting for aneuploidy screening. Of the 80 participants, 40 elected and 40 declined ECS. Trends regarding reasons for electing or declining ECS include ethnicity, desire for genetic risk information, lack of family history, perceived likelihood of being a carrier, and perceived impact on reproductive decisions. Individuals who declined ECS seemed to prefer ethnicity-based carrier screening and believed that ECS would increase their anxiety, whereas individuals who elected ECS seemed to prefer more screening and tended to believe that ECS would reduce their anxiety. These findings provide insight on decision-making with regard to ECS and can help guide interactions that genetic counselors and other healthcare providers have with patients, including assisting patients in the decision-making process.     

Understanding pregnant women's decision making concerning prenatal screening

OBJECTIVE: This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory. DESIGN: We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation. MAIN OUTCOME MEASURES: These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening. RESULTS: Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done. CONCLUSION: These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process.     

What are the factors determining user intentions to use AV while impaired?

In this study, we employ the Integrated Choice Latent Variable (ICLV) framework to model the public’s intention of using Autonomous Vehicles (AVs) while impaired under the influence of alcohol, medicine, or fatigue. We identify five latent constructs from psychometric indicators that define respondent’s perception and attitudes towards AVs which are i) perceived benefits, ii) perceived risks, iii) enjoy driving, iv) wheels public transport attitude, and v) rails public transport attitude. We use these latent variables along with explanatory variables to study user intentions regarding delegation of vehicle control from human driving to autonomous driving. The study uses survey data collected from 1,065 Czech residents between 2017 and 2018. Our findings indicate that user intentions are primarily defined by attitudes rather than socio-demographic attributes. However, the inclusion of both types of variables is crucial in evaluating user intentions. Despite a positive outlook towards AVs, people were found to be reluctant in using AVs while impaired which can be attributed to distrust towards the technology. Our analysis shows that with appropriate efforts from policymakers, the public’s attitude can be changed to promote adoption. The efforts will have to be emphasized towards building positive attitudes (such as perceived benefits) and diminishing existing negative attitudes (such as perceived risks).     

大学生网络成瘾：背景性渴求与同伴网络过度使用行为及态度的交互作用

基于整体-交互作用模型,选取北京市某高校所有大一学生2511名为被试开展问卷调查,考察了大学生网络使用背景性渴求的特点及其与网络成瘾之间的关系,并就网络使用背景性渴求与同伴网络过度使用行为与态度对网络成瘾的交互作用进行了检验。结果发现:(1)与非网络成瘾大学生相比,网络成瘾大学生的网络使用背景性渴求更高,所感知到的同伴网络过度使用行为更多,同伴对网络过度使用的态度更积极;(2)网络使用背景性渴求各维度、感知到的同伴网络过度使用行为可正向预测大学生的网络成瘾;(3)背景性渴求中的积极结果预期与同伴对网络过度使用的态度对网络成瘾存在显著的交互效应:在低积极结果预期条件下,同伴对网络过度使用的态度可以负向预测网络成瘾程度,而在高积极结果预期条件下,同伴态度对网络成瘾的预测作用不显著。结论:外因在内因比较微弱的条件下发挥更为明显的作用。     

Cystic Fibrosis Prenatal Screening in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

For over a decade, prenatal screening for cystic fibrosis (CF) has been considered a model for the integration of genetic testing into routine medical practice. Data from pilot studies and public policy discourse have led to recommendations by some professional organizations that CF screening should be offered or made available to pregnant women and their partners, and to couples planning a pregnancy. It is crucial that genetic counselors gain thorough understanding of the complexities of CF and the implications of positive test results, so that they may serve as a reliable, educated referral base and resource for health care providers and their patients. While not all pregnant women will be referred for genetic counseling prior to CF carrier testing, genetic counselors often will be asked to counsel clients after they have a positive test result, or who are found to be at increased risk. Genetic counselors can play an important role in providing accurate and current information as well as support for patients informed decisions. These recommendations were created by a multicenter working group of genetic counselors with expertise in CF and are based on personal clinical experience, review of pertinent English language medical articles, and reports of expert committees. The recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care providers professional judgment based on the clinical circumstances of a particular client.     

Spiritual care in psychiatry: Professionals’ views

In this study we explored the views of Mental Health professionals and general practitioners (GPs) regarding spiritual care and the effect of personal and cultural background on their views. Data were collected through anonymous questionnaires posted to hospital nursing and medical staff at Hollins Park Hospital, Warrington, UK, and to all GPs within the hospital catchments area. Forty-five percent of GPs, 33% of psychiatrists, and 76% of nursing staff (p < 0.05) felt strongly that human beings are made up of spirit as well as body. More nurses felt that spiritual care is equally as important as other forms of care (52%) compared with psychiatrists (33%) and GPs (29%). A higher percentage of nursing than medical staff had previous training in this area and were more likely than medical staff to consider themselves appropriate to give spiritual advice. A total of 20% of GPs and 33% of psychiatric staff stated the need for training in this area and GPs especially felt they lacked time. Professionals’ views are influenced by cultural and religious backgrounds, with significantly more non-UK born respondents feeling strongly that human beings all have a spiritual component. Many doctors do not consider spiritual care has a role for them to be involved in and many feel too pressured in daily life to take this on. Nurses are more inclined to take a holistic approach to care in this respect. Some people with mental health problems have spiritual care needs and we should be aware of this as an important facet to therapy.     

The relationship between perceived organizational support and proactive behaviour directed towards the organization

Numerous studies have shown that perceived organizational support has positive consequences on both employees and organizations. However, no study has examined the causal relationship between perceived organizational support and proactive behaviour directed towards the organization and few studies have identified potential mechanisms underlying this relationship. We first investigated the direction of causality between perceived organizational support and proactive behaviour, and hypothesized that perceived organizational support leads to proactive behaviour directed towards the organization. Second, based on social exchange and motivational perspectives, we examined two potential mechanisms underlying this relationship, i.e., felt obligation and work engagement. Employees from a Belgian Federal Public Service were invited to take part in a three-wave longitudinal survey. Using a cross-lagged panel design, our results (N = 1963) revealed that Time 2 perceived organizational support was positively related to Time 3 proactive behaviour towards the organization, whereas the reverse was not true. Additionally, our results (N = 1293) showed that Time 2 felt obligation and Time 2 work engagement mediated the positive relationship between Time 1 perceived organizational support and Time 3 proactive behaviour directed towards the organization.     

Does the campaign against tobacco use necessarily reduce the attractions of smoking for young people? Identity issues surrounding initiation into tobacco consumption

The present study examines the attitude of Swiss adolescents towards tobacco consumption as a function of its implications for identity and their perception of the antismoking social norm. A total of 228 girls and 213 boys, aged 11–15 years, answered a questionnaire assessing personal attitude towards tobacco consumption (the main dependent variable), the salience of the antismoking norm (perceived attitudes of family, teachers, politicians and society in general), and their identification with smokers, as well as their self-image and their perception of the image (positive and negative) of smokers. The results show that a prosmoking attitude is associated with a stronger identification with smokers, a more positive (and less negative) image of smokers, a more negative self-image, and weaker salience of the antismoking norm. A pro-smoking attitude is also associated with a self-image that is closer to the image of the smoker, independently of the latter's valence. Finally, a prosmoking attitude is associated with a negative self-image specifically among those who identify more strongly with smokers but who also perceived a strong antismoking norm. This last result suggests that a strong antismoking norm can help to make smoking an attractive behaviour for young people, in particular those with a negative self-image.     

The impact of banners on digital television: the role of program interactivity and product involvement

In a sample of 281 respondents, the effect of a noninteractive and a medium-interactive television program on recall and brand attitudes for low- and high-involvement products advertised in banners during these programs was investigated. Medium-interactive programs resulted in less product and brand recall and recognition of brands in embedded banner advertisements, but generated more positive brand attitudes than noninteractive programs. These effects were more outspoken for a high-involvement product than for a low-involvement product. The impact of perceived program interactivity on brand attitude is fully mediated program valence and involvement for low-involvement products, but not for high-involvement products, for which perceived program interactivity had a direct impact on brand attitude.     

Update and Review: Cystic Fibrosis

Cystic fibrosis (CF) is one of the most commonly inherited recessive disorders in U.S. Caucasians, with a carrier frequency of approximately 1 in 29. Genetic counseling and CF mutation analysis has traditionally been offered to the affected patient and his/her extended family, in keeping with policy statements from professional organizations (ASHG, NSGC, ACOG). The target population for CF testing and counseling may be evolving after the release of the 1997 National Institutes of Health Consensus Statement, Genetic Testing for Cystic Fibrosis, which recommends that CF screening be offered to all preconceptional and pregnant couples. Genetic counseling for CF is complicated by reports of polymorphisms in the CF gene that are associated with symptoms that do not meet the diagnostic criteria for CF, such as bilateral congenital absence of the vas deferens, bronchiectasis, and idiopathic pancreatitis. To aid genetic counselors with these issues, this review explores the symptoms of CF, patient management, gene function, genetics, genotype/phenotype correlation, and genetic counseling issues.     

社区卫生服务中医发展战略

在社区卫生服务中发挥中医药优势,不仅能够提高人民健康水平,而且能够促进机构自身发展,用管理学的SWOT（斯沃特）战略分析法分析了当前中医药在社区卫生服务发展中的优势与劣势、外部机会与威胁,对其发展面临的问题作了综合性的剖析,并提出相应的发展策略。     

Between Hippocrates and God: Ugandan mental health professional's views on suicide

A negative attitude towards suicide is generally assumed to be predominant in low-income countries. In order to understand the negative attitude in general it is necessary to look at how religion and morality influence the attitudes. Our aim in this qualitative interview study was to investigate what attitudes professional mental health workers in Uganda bear towards suicide and suicidal persons. The professionals argue for their attitude by employing religious, communal and medical ethics arguments, which draw both in a negative and positive direction. The professionals are in general unambiguously negative towards suicide and positive towards suicidal people who are mentally ill. In cases other than mental illness non-accepting attitudes surface. This is discussed against previous research showing that effective treatment of suicidal people is to be based on a trusting and accepting relationship.     

Physically active students' intentions and self-efficacy towards healthy eating

This study investigated intentions and self-efficacy of physically active university students towards healthy eating. The application of Planned Behavior theory has shown that attitudes, intention, perceived behavioral control, and subjective norms play an important role in shaping people's behavior. 96 students, who participated in physical activities, voluntarily completed the Questionnaire for the Planned Behavior Model and the Health Behavior Questionnaire. The former examines attitudes, intentions, perceived behavioral control, and the lately added attitude strength, and role identity towards the behavior factors. The latter assesses one's efficacy expectations towards healthy eating. The regression showed strong associations between the examined variables, signifying that attitudes, perceived behavioral control, and role identity could account for one's intention towards healthy eating behaviors. On the other hand, one's self-efficacy for healthy eating could be explained from the attitudes, intention, perceived behavioral control, and attitude strength held. Overall, systematic participation in physical activities appeared to be accompanied with a relatively healthier diet, while self-efficacy had a significant association with maintaining the healthy eating behaviors. Possible interpretations, limitations, and implications for health professionals are discussed.     

Knowledge and Attitudes Toward a Free Education and Ashkenazi Jewish Carrier Testing Program

Carrier testing is offered on the basis of Ashkenazi Jewish background in both the prenatal and preconception settings, with the goal of decreasing the prevalence of affected individuals and allowing informed decision-making during childbearing. The purpose of this study was to (1) document the demographic characteristics of individuals who attended a free education and screening program, (2) learn how the education program changed attendees' knowledge and attitudes by learning more about these disorders, and (3) determine how participants perceived their carrier status risk. One hundred seventy-four individuals completed questionnaires at the beginning and end of an educational program about the Ashkenazi Jewish genetic disorders. There was a statistically significant difference in the participant's level of knowledge from the pre- to post education (p < .001). Females reported a significantly higher level of concern about the disorders (p = .004) and their carrier status (p = .006) before the education, as well as about their carrier status post education (p = .05). Finally, having one or more parent affiliated with Orthodox Judaism was related to higher knowledge before the education program (p = .05). In conclusion, this study demonstrated that an educational carrier screening program increased knowledge about the disorders and also produced mild anxiety regarding personal and reproductive risks.