Factors Influencing Breast Cancer Genetic Testing Among High Risk African American Women: A Systematic Review

African American women are disproportionately impacted by breast cancer and its associated effects. They have the highest breast cancer mortality rate of all racial and ethnic groups in the U.S., yet, many high risk African American women do not follow-up with genetic testing despite, having a shorter survival rate and more likely to develop malignancies or aggressive forms of breast cancer than white women. Purpose: This review explored breast cancer genetic follow up and barriers among African American women and made recommendations for designing tailored high risk breast cancer programs. Method: The Integrative Model of Behavioral Prediction framework provided the framework for the review. PubMed, PSYINFO, CINAHL and Cochrane Collection Plus databases were searched for articles published from 2007 to 2017 that focused on attitude and beliefs that influenced genetic testing follow up among African American women. Three reviewers independently reviewed and appraised articles. The quality of the articles was assessed to determine the evidence level and overall recommendations using the Joanna Bridge Institute grading criteria. Results: Sixteen of the 2275 articles reviewed met the inclusion criteria of which, seven showed statistically significance changes related to family concerns, medical mistrust and cost barriers; decreases in breast cancer worry and perceived risk after genetic counseling; and higher education level and diagnosed early increased genetic testing. Conclusions: This systematic review provides greater understanding of how the social determinants of health influence decisions about genetic testing and treatment to determine why African American women who are at risk for breast cancer, do not progress to genetic testing. It provided recommendations for designing sensitive curriculum content for African American women and providers to increase genetic follow-up and reduce breast cancer disparity. The results of this review could be used to design comprehensive, tailored interventions to address the identified barriers, increase breast cancer awareness and early detection, and help minority women make informed, value decisions about genetic testing and treatment options. Recommendations: Future research is required to examine the role communities, agencies and policy makers play in improving clinical outcomes for minorities

Reductionism as a Tool for Creative Exploration

This paper reports on research that investigates how qualitative reduction of elements of an object might stimulate creativity amongst design practitioners. As humans, we have the ability to generate a complete image of an object as a representation even when parts of the three-dimensional object are missing, as long as appropriate visual clues are given. If reduced elements of an object describe the complete state of the object, element reduction might be utilised as a trigger for further creative imagination. In other words, designing the way to reduce elements of an object might be an opportunity to stimulate a design practitioner’s imagination. In order to explore the possibilities of reductionism in design, the authors conducted an experiment wherein design students were given varying levels of reduced information in a design representation and asked to complete the design using simple 3D materials. We observed the ways in which the design students approached the original image of an object using images whose quality were reduced in a variety of ways. The results indicate that even if the design students saw a visually-reduced image of an object, they develop their imagination relying on three factors: materiality, composition and prior-knowledge. The authors suggest that reducing these informative elements could possibly be the key to stimulating their imagination

Számítógépek és rendszerek – Gondolatok a teleszféráról

A cikket olvasó gyakorta meglepődik?: hol egy szokatlan terminuson, hol egy sajátos közelítésmódon. A legnagyobb meglepetés azonban akkor éri, amikor megtudja, hogy a szöveg 1971-ból való. Az írás nem csupán kuriózum: Rodgers azon túl, hogy megjósolja – egyebek mellett – a web-et és a multimédiát, találó szempontokból vizsgálja az információs és kommunikációs technika változásának társadalmi következményeit is

QUALITY CONTROL FROM A SUBSET OF HUMAN SURGICAL TISSUE SPECIMENS FROM THE IU SIMON CANCER CENTER TISSUE PROCUREMENT AND DISTRIBUTION CORE COLLECTED IN 2009-2010: AN H&E AND RIN VALUE ASSESSMENT

poster abstractQuality control (QC) of human tissue specimens for research is critical for the development of new bio-markers and their ability to determine clinical trial outcomes. In this study, we evaluated sixty-nine samples for both RNA and histology quality control measures from the IU Simon Cancer Center Tissue Bank. The IU Simon Cancer Center Tissue Bank is a centralized tissue procurement resource established to collect high quality tissue for basic clinical and translational research, collecting approximately 550 clinical cases per year using an informed consent and HIPAA signed document. All tissues are collected and processed in liquid nitrogen within 30 minutes of removal. The tissue samples are sliced and diced into 100 to 150 mg sample size. Each sample is placed into individual 2ml cryovials. Two representative samples are placed in 10% neutral buffered formalin. Two investigators QC the slides by microscopy to evaluate the following: percent of tumor, percent of necrosis, percent of fibrosis/inflammation, and percent of normal adjacent tissue. RNA was extracted using the Purescript RNA isolation kit (Gentra). Fifty-four of sixty-nine cases passed both histology and RNA (RIN value) QC. Of the fifteen cases that did not pass our QC criteria, thirteen cases did not pass the histology QC due to lack of tumor content (below 50%) in the sample, while the remaining two cases failed the RNA QC. Seventy-eight percent of samples passed our QC measures. The results were consistent with the existing literature on tissue quality control in human surgical tissue specimens

Investigación educativa en torno a la diversidad y la mejora de la calidad de la Educación

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Processing of discharge summaries in general practice: a retrospective record review

Background: There is a need for greater understanding of the epidemiology of primary care patient safety in order to generate solutions to prevent future harm. Aim: To estimate the rate of failures in processing actions requested in hospital discharge summaries and to determine factors associated with these failures.Design and setting: We undertook a retrospective records review. Our study population was emergency admissions for patients aged ?75 years, drawn from ten practices in three areas of England.Method: One GP researcher reviewed the records for 300 patients after hospital discharge to determine the rate of compliance with actions requested in the discharge summary and to estimate the rate of associated harm from non-compliance. Where GPs documented decision making contrary to what was requested, these instances did not constitute failures. Data were also collected on time taken to process discharge communications.Results: There were failures in processing actions requested in 46% (112/246) of discharge summaries (CI 39-52%). Medications changes were not made in 17% (124/750) of requests (CI 14-19%). Tests were not completed for 25% of requests (CI 16-34%) and 27% of requested follow-ups were not arranged (CI 20-33%). The harm rate associated with these failures was 8%. Increased risk of failure to process test requests was significantly associated with the type of clinical IT system and male patients.Conclusion: Failures occurred in the processing of requested actions in almost half of all discharge summaries, and with all types of action requested. Associated harms were uncommon and most were of moderate severity

Building a patient safety toolkit for use in general practice

Despite 340 000 000 primary care consultations annually in the UK, most of the literature on patient safety has focused on hospital-based services. To improve safety in primary care settings, we must know what methods, tools and indicators are available to measure and monitor patient safety. In collaboration with patient safety experts at the University of Dundee, we were able to identify a number of existing tools, and many of these were adopted for use in the Patient Safety Toolkit

Variability of eta Carinae III

Spectra (1951-78) of the central object in eta Car, taken by A.D. Thackeray, reveal three previously unrecorded epochs of low excitation. Since 1948, at least, these states have occurred regularly in the 2020 day cycle proposed by Damineli et al. They last about 10 percent of each cycle. Early slit spectra (1899-1919) suggest that at that time the object was always in a low state. JHKL photometry is reported for the period 1994-2000. This shows that the secular increase in brightness found in 1972-94 has continued and its rate has increased at the shorter wavelengths. Modulation of the infrared brightness in a period near 2020 days continues. There is a dip in the JHKL light curves near 1998.0, coincident with a dip in the X-ray light curve. Evidence is given that this dip in the infrared repeats in the 2020 day cycle. As suggested by Whitelock & Laney, the dip is best interpreted as an eclipse phenomenon in an interacting binary system; the object eclipsed being a bright region (`hot spot'), possibly on a circumstellar disc or produced by interacting stellar winds. The eclipse coincides in phase and duration with the state of low excitation. It is presumably caused by a plasma column and/or by one of the stars in the system.Comment: 10 pages, 7 postscript figures, accepted for MNRA

Exploring cancer health disparities among formerly incarcerated African Americans

Incarcerated populations have a higher burden of chronic disease and elevated risk factors for cancer (BJS, 2012). In 2013, cancer (31%) and heart disease (26%) accounted for over half of all prisoner deaths. The Genomics Research Program of the National Cancer Institute’s Division of Cancer Control and Population Sciences (2016) identified incarcerated persons as an understudied population about which there is limited data regarding cancer risks and outcomes. A majority of studies on corrections populations focus on health issues associated with reduction of infectious diseases such as HIV, Tuberculosis, and Hepatitis. Scant research has been conducted on issues associated with cancer prevention and control among African Americans with a history of incarceration. This qualitative, participatory, pilot research study explores the domains of cancer health disparities among African American men and women who were formerly incarcerated in Illinois prisons. Four qualitative focus groups will be conducted. The primary purpose of the focus groups is to collect and qualitatively analyze preliminary data on the barriers to access, utilization and treatment of cancer. This presentation seeks to: (1) describe the need for enhanced access to cancer care and treatment, (2) advocate for the inclusion of best practices in cancer care in corrections systems and, (3) identify policy recommendations and initiatives aimed at reducing cancer disparities among incarcerated and formerly incarcerated persons