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We examined healthcare providers’ perceptions of genetic counseling and testing in African American women at moderate to high-risk of carrying a BRCA1/2 mutation. We conducted 20 in-depth interviews with genetic counselors (n = 5), medical oncologists (n = 8), obstetrician/gynecologists (n = 2) and surgeons (n = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers’ perceptions of African American women’s use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient-provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual- and system-level barriers to African American women’s use of genetic services, including lack of follow-up after referrals to genetic specialists and challenges to obtaining financial coverage for under- and uninsured high-risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at-risk African American women.  相似文献   
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Recently Hupé and Rubin (2003, Vision Research 43 531- 548) re-introduced the plaid as a form of perceptual rivalry by using two sets of drifting gratings behind a circular aperture to produce quasi-regular perceptual alternations between a coherent moving plaid of diamond-shaped intersections and the two sets of component 'sliding' gratings. We call this phenomenon plaid motion rivalry (PMR), and have compared its temporal dynamics with those of binocular rivalry in a sample of subjects covering a wide range of perceptual alternation rates. In support of the proposal that all rivalries may be mediated by a common switching mechanism, we found a high correlation between alternation rates induced by PMR and binocular rivalry. In keeping with a link discovered between the phase of rivalry and mood, we also found a link between PMR and an individual's mood state that is consistent with suggestions that each opposing phase of rivalry is associated with one or the other hemisphere, with the 'diamonds' phase of PMR linked with the 'positive' left hemisphere.  相似文献   
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The present study used general growth mixture modeling to identify pathways of antisocial behavior development within an epidemiological sample of urban, primarily African American boys. Teacher-rated aggression, measured longitudinally from 1st to 7th grade, was used to define growth trajectories. Three high-risk trajectories (chronic high, moderate, and increasing aggression) and one low-risk trajectory (stable low aggression) were found. Boys with chronic high and increasing trajectories were at increased risk for conduct disorder, juvenile and adult arrest, and antisocial personality disorder. Concentration problems were highest among boys with a chronic high trajectory and also differentiated boys with increasing aggression from boys with stable low aggression. Peer rejection was highest among boys with chronic high aggression. Interventions with boys with distinct patterns of aggression are discussed.  相似文献   
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This study investigated age and responding-hand (left, right, and bimanual) related changes in visuospatial attention. Two tasks were completed by 107 neurologically normal right-handed subjects ranging in age from 5 to 70 years and distributed across four age groups. Task-specific differences between groups were apparent. In the line-bisection task, the younger and older groups displayed symmetrical neglect while the young and middle groups displayed pseudoneglect. In the chimeric-faces task the leftward bias was less pronounced in the older group and more susceptible to responding-hand effects in the middle and older groups. Whilst results, especially those of the bimanual method, provided strong support for an activation model, they imposed an age limitation on its appropriateness as an explanation for performance on the chimeric-faces task. Results are discussed as reflecting changes in the corpus callosum and right hemisphere.  相似文献   
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Investigates the effect of the first-grade classroom environment on the shy behavior, aggressive behavior, and concentration problems of 609 children in 19 East Baltimore public schools. First-grade classroom environment was assessed in terms of dominant pattern of classroom achievement and behavior. Structured teacher ratings assessed child shy behavior, aggressive behavior, and concentration problems at the end of first grade. Children in low-achieving classroom environments had significantly higher teacher ratings of shy behavior and aggressive behavior than children in mixed-achieving or high-achieving environments, even after controlling for potentially confounding child characteristics and classroom behavior environment effects. Analyses controlling for child characteristics and classroom achievement environment effects indicated that children in poor-behaving classroom environments also had significantly higher teacher ratings of shy behavior than children who were not in poor-behaving environments. Subgroup analyses indicated that repeaters in mixed-achieving environments had significantly higher levels of shy behavior compared with nonrepeaters, and repeaters in poor-behaving environments had significantly higher levels of aggressive behavior compared with nonrepeaters. Implications for prevention research are discussed.  相似文献   
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Differential reinforcement of other behavior (DRO) is commonly used to reduce behavioral excesses. Momentary DRO schedules involve delivery of reinforcement contingent upon the absence of the target behavior at a given moment. Two variations of momentary DRO exist: fixed-momentary (FM) DRO and variable-momentary (VM) DRO. In the current study, we directly compared FM-DRO and VM-DRO schedules to reduce challenging behavior maintained by automatic reinforcement exhibited by four children with autism spectrum disorder. The results suggest that both the DRO schedules were equally effective to reduce challenging behavior. A social validity measure showed that most caregivers rated the VM-DRO as a preferred schedule and noted the potential for FM-DRO schedule to become more discriminable over time, which could reduce its effectiveness. However, most caregivers also commented that the FM-DRO schedule was easier to implement.  相似文献   
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Adults with developmental disabilities are less likely to meet physical activity guidelines than typically developing counterparts. Contingency management (CM) interventions increase physical activity in sedentary adults. The current study systematically replicated previous research among sedentary adults diagnosed with developmental disabilities living in a residential group home, using a token economy in the context of a CM intervention. Using a changing criterion design, participants (N = 4) were given tokens contingent on meeting increasing step goals over 8 weeks, tracked via a Fitbit Flex?. CM increased the number of steps substantially for three of four participants. These findings extend previous research supporting the use of token‐based CM interventions for increasing daily steps among individuals with developmental disabilities. Because the current study was conducted in a residential group home setting, it may offer a long‐term sustainable approach to improving the health of some individuals living with developmental disabilities.  相似文献   
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