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61.
Erica M. Bednar Michael T. WalshJr. Ellen Baker Kimberly I. Muse Holly D. Oakley Rebekah C. Krukenberg Cara S. Dresbold Sandra B. Jenkinson Amanda L. Eppolito Kelly B. Teed Molly H. Klein Nichole A. Morman Elizabeth C. Bowdish Pauline Russ Emaline E. Wise Julia N. Cooper Michael W. Method John W. Henson Andrew V. Grainger Banu K. Arun Karen H. Lu 《Journal of genetic counseling》2018,27(6):1482-1496
An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project’s success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings. 相似文献
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Using participant observation, in-depth interviews, and legislative histories, we examine Westboro Baptist Church, a religious group infamous for homophobic rhetoric and funeral protests. Employing cultural and interactionist perspectives that focus on the semiotics of death, the sacred, and desecration, we outline how Westboro’s activities purposively violate deeply held signifiers of moral order through language, while simultaneously respecting extant laws of behavior. This strategy, in conjunction with the political profitability of opposing the group, explains why the group’s activism triggered extensive legal disputes and modifications at multiple levels of governance. Westboro’s actions and use of symbols—and those of others against the group—lay bare multiple threads in the sacred cultural fabric of American society. 相似文献
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Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study 下载免费PDF全文
Kornanong Yuenyongchaiwat David Sheffield Ian Baker Frances Maratos 《The Japanese psychological research》2015,57(4):288-299
Cardiovascular responses to mental stress tests have been related to future blood pressure (BP) levels. However, most studies have been completed in North America and Europe; only one study has been conducted in Asia. Therefore, the study explored whether cardiovascular responses to mental stress predict future resting BP in Thailand. Hemodynamic measures were obtained from 101 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. A follow‐up assessment of resting BP was undertaken 1 year later. Results showed that Thais responded to standardized mental stress tasks with large and significant cardiovascular reactivity. Regression analyses indicated that, after adjustment for baseline BP and traditional risk factors, heightened systolic blood pressure (SBP) responses to mental arithmetic were associated with increased future SBP (ΔR2 = .045). These findings suggest that BP reactivity predicts future BP and may play a role in the development of hypertension. In addition, Thais displayed large cardiovascular responses to standardized mental stress tasks, of a similar magnitude to previous studies of North Americans and Europeans. 相似文献
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