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Alyssa Kne Heather Zierhut Shari Baldinger Karen K. Swenson Pamela Mink Patricia McCarthy Veach Michaela L. Tsai 《Journal of genetic counseling》2017,26(4):697-715
Family history information comprises an important tool in identifying and referring patients at risk for hereditary breast and ovarian cancer (HBOC) to cancer genetic counseling. Despite recommendations and support provided by numerous professional organizations, cancer genetic counseling services are underutilized by atrisk patients. This study aimed to: (1) determine the rate of genetic counseling utilization following a referral letter, (2) characterize factors (barriers and supports) which influenced uptake of services, and (3) identify potential strategies for increasing utilization. This study evaluated the uptake of cancer genetic counseling among 603 screening mammography patients identified as having an increased risk for HBOC based on National Comprehensive Cancer Network (NCCN) guidelines. At risk individuals and their primary care providers were mailed a referral letter recommending genetic counseling. Three focus groups (N = 24) were conducted to identify responses to receiving a letter recommending genetic counseling, barriers to seeking genetic counseling, and facilitating factors to utilizing these services. Participant responses were qualitatively analyzed using thematic and cross case analysis. Within one year, 50/603 (8 %) of the identified at-risk women completed a genetic counseling appointment. Participant-perceived barriers which influenced their decision not to seek genetic counseling included lack of relevance and utility, limited knowledge about genetic counseling, concerns about the genetic counseling process, and concerns about cost and insurance coverage. Participant-perceived facilitating factors which would support a decision to seek genetic counseling included greater awareness and education about genetic counseling services when receiving a referral, and improved follow up and guidance from their provider. Findings from this study support the need for patient and primary care provider education, and improved provider-patient communication to increase uptake of genetic counseling services. 相似文献
853.
B. Blair Braden Kara B. Dassel Heather A. Bimonte-Nelson Holly P. O’Rourke Donald J. Connor Sallie Moorhous 《Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition》2017,24(3):227-246
Many studies suggest sex differences in memory and hippocampal size, and that hormone therapy (HT) may positively affect these measures in women; however, the parameters of HT use that most likely confer benefits are debated. We evaluated the impact of sex and postmenopausal HT use on verbal learning and memory and hippocampal size in 94 cognitively intact women and 49 men. Using analysis of covariance that controlled for age and education, women had better total word learning and delayed verbal memory performance than men. HT analyses showed that non-HT users performed similarly to men, while HT users performed better than men in Delayed Memory regardless of whether use was current or in the past. Women had larger hippocampal volumes than men regardless of whether they were HT users. Using univariate linear models, we assessed group differences in the predictive value of hippocampal volumes for verbal learning and memory. Hippocampal size significantly predicted memory performance for men and non-HT users, but not for HT users. This lack of relationship between hippocampal size and verbal learning and memory performance in HT users suggests HT use may impact memory through extra-hippocampal neural systems. 相似文献
854.
Sarah K. Tauber John Dunlosky Heather L. Urry Philipp C. Opitz 《Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition》2017,24(5):555-574
Age-related differences in memory monitoring appear when people learn emotional words. Namely, younger adults’ judgments of learning (JOLs) are higher for positive than neutral words, whereas older adults’ JOLs do not discriminate between positive versus neutral words. In two experiments, we evaluated whether this age-related difference extends to learning positive versus neutral pictures. We also evaluated the contribution of two dimensions of emotion that may impact younger and older adults’ JOLs: valence and arousal. Younger and older adults studied pictures that were positive or neutral and either high or low in arousal. Participants made immediate JOLs and completed memory tests. In both experiments, the magnitude of older adults’ JOLs was influenced by emotion, and both younger and older adults demonstrated an emotional salience effect on JOLs. As important, the magnitude of participants’ JOLs was influenced by valence, and not arousal. Emotional salience effects were also evident on participants’ free recall, and older adults recalled as many pictures as did younger adults. Taken together, these data suggest that older adults do not have a monitoring deficit when learning positive (vs. neutral) pictures and that emotional salience effects on younger and older adults’ JOLs are produced more by valence than by arousal. 相似文献
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Heather Greenhalgh-Spencer 《Studies in Philosophy and Education》2017,36(1):33-48
Within the digital workforce, women are disappearing. While there are many factors that could be ‘blamed’ for this phenomenon, this article takes issue with the sexist and patriarchal discourses that are deployed within the digital workforce. In many ways, sexist discourses are taken for granted within the digital workplace; and in that way, the discourses themselves are rendered invisible through a lack of concerted uncovering of the ways that these sexist discourses produce—and reproduce—women as sexual objects and outsiders in this field of work. The sexist and patriarchal discourses I address in this article validate the gender binary even as there is gendered play. It is this ‘play’ that also makes counter-hegemonic discourse and discursive acts productive (and reproductive), as I argue toward the end of the paper. Schools are a place where counter-hegemonic discourses and acts can be nurtured and, hopefully, affect and counteract the disappearance of women in digital fields. 相似文献
858.
Recent research on community involvement points to the importance of both agentic (advancing the self) and communal motives (serving others) as key predictors, though few studies have examined both simultaneously. At the same time, research has identified generativity, defined as concern for future generations as a legacy of the self, as particularly relevant for community involvement. Moreover, generativity involves both agentic and communal motives, meaning that advancing personal goals and caring for others are integrated in this construct. Therefore, the purpose of this study was to examine how individual differences in attributes pertaining to self and to others—specifically, self‐esteem, initiative, and empathy—related to both generativity and community involvement. A sample of adolescents (N = 160; 64% female, Mage = 17) and a sample of young adults (N = 237; 84% female, Mage = 20) completed a survey including measures of community involvement and generativity. Generative concern fully mediated the associations between individual differences (self‐esteem, initiative, and empathy) and community involvement, suggesting that the early generativity has a role in fostering capacities and contribution in youth. These developmental indicators pertaining to self and others link to actions that benefit the community through a desire to benefit future generations. 相似文献
859.
Heather Tolle 《Deviant behavior》2017,38(8):870-878
The current study seeks to evaluate the use of gang membership as a measure of social structure in social structure social learning theory. The Evaluation of Gang Resistance Education and Training Program in the United States, 1995–1999 dataset was used with structural equation modeling to test if inclusion of gang membership as a social structure variable was a better predictor of deviance than social learning elements alone. The analysis suggests that gang membership will have an impact on the mechanisms of social learning, supporting the use of gang membership as a measure of social structure. 相似文献
860.
Jessika H. Bottiani Sarah Lindstrom Johnson Heather L. McDaniel Catherine P. Bradshaw 《American journal of community psychology》2020,65(3-4):423-436
Students often have differing perceptions of their school's climate. Although these subjective perceptions can be meaningful outcome predictors, discrepancies create challenges for those seeking to globally characterize or intervene to improve the climate of a school. Trained, independent observers can provide insights on perceptible and ostensibly malleable aspects of the school; however, the extent to which these observations help us to understand differences in students’ report of school climate has not been examined. To study this, we assessed convergence and divergence between independent observers’ assessments and students’ perceptions of school climate at the classroom and school levels. Data come from the Maryland Safe and Supportive Schools Initiative (MDS3), which included 20,647 students and observations of 303 teachers in 50 high schools. Students responded to survey items regarding safety, engagement, and environment; independent observers assessed teachers’ classroom practices and the school physical environment. A three-level model partitioned variance to the individual, classroom, and school levels. The variance in students’ climate perceptions was primarily between students, with most classroom and school intraclass correlation coefficients (ICCs) ranging from 0.01 to 0.08, though one was as high as 0.20; however, observations explained large percentages of between-school variation in climate (58%–91%). Findings suggest the potential utility of outside observations for explaining school-level variation in school climate to inform decision-making and future research. 相似文献