In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included. 相似文献
Participating in after-school programs (ASPs) has become a common experience for children. This special issue provides a perspective on the current status of research on ASPs. This introductory article overviews the historical and current context of ASPs and then describes a developmental ecological model to guide research in this area. The model offers a framework from which to organize and synthesize the research presented in this issue. Key principles include a holistic view of development that recognizes interrelations between multiple domains of youth adjustment, attention to multiple, relevant factors within and outside of youth that affect development, examining the dynamic interplay between persons, program features, and other contexts over time, and understanding the active role of youth in affecting their own development. These principles are examined in relation to five main areas: youth characteristics, social ecologies, program features, participation, and short- and long-term outcomes. Recommendations for future research are discussed. 相似文献
ABSTRACTAn analysis of the transition from railways to highways as the dominant British transport system during the twentieth century shows that public storylines about competing niche and regime technologies can have a powerful influence on socio-technical transitions. These storylines are developed by supporters and opponents of the competing technologies, with each group attempting to frame their favoured technology positively. The public salience of these storylines can be evaluated by assessing how highly they score on four elements of frame resonance: empirical fit, experiential commensurability, actor credibility, and macro-cultural resonance. These storylines can be seen at play across the entirety of the transition to a road-based transport system, from the very early history of the automobile through to the turn of the millennium, when public opposition to road transport was becoming increasingly pronounced. This case study uniquely traces discursive conflict over the entire course of a multi-decade transition. While existing literature in the multi-level perspective typically emphasises the disadvantages faced by niche-innovations, this case study shows that powerful storylines, enabled by the right cultural repertoires and possibly negative storylines about existing socio-technical systems, can create powerful political support for a new technology, giving it an advantage against more established incumbents. 相似文献