Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12279
A qualitative study to understand guideline-discordant use of imaging to stage incident prostate cancer
BACKGROUND: Approximately half of veterans with low-risk prostate cancer receive guideline-discordant imaging. Our objective was to identify and describe (1) physician knowledge, attitudes, and practices related to the use of imaging to stage prostate cancer, (2) patient attitudes and behaviors related to use of imaging, and (3) to compare responses across three VA medical centers (VAMCs). METHODS: A qualitative approach was used to explore patient and provider knowledge and behaviors relating to the use of imaging. We conducted 39 semi-structured interviews total-including 22 interviews with patients with newly diagnosed with prostate cancer and 17 interviews with physicians caring for them-between September 2014 and July 2015 at three VAMCs representing a spectrum of inappropriate imaging rates. After core theoretical concepts were identified, the Theoretical Domains Framework (TDF) was selected to explore linkages between themes within the dataset and existing domains within the framework. Interviews were audio-recorded, transcribed verbatim, and then coded and analyzed using Nvivo software. RESULTS: Themes from patient interviews were categorized within four TDF domains. Patients reported little interest in staging as compared to disease treatment (goals), and many could not remember if they had imaging at all (knowledge). Patients tended to trust their doctor to make decisions about appropriate tests (beliefs about capabilities). Some patients expressed a minor concern for radiation exposure, but anxiety about cancer outcomes outweighed these fears (emotion). Themes from physician interviews were categorized within five TDF domains. Most physicians self-reported that they know and trust imaging guidelines (knowledge) yet some were still likely to follow their own intuition, whether due to clinical suspicion or years of experience (beliefs about capabilities). Additionally, physicians reported that medico-legal concerns, fear of missing associated diagnoses (beliefs about consequences), influence from colleagues who image frequently (social influences), and the facility where they practice influences rates of imaging (environmental context). CONCLUSIONS: Interviews with patients and physicians suggest that physicians are the primary (and in some cases only) decision-makers regarding staging imaging for prostate cancer. This finding suggests a physician-targeted intervention may be the most effective strategy to improve guideline-concordant prostate cancer imaging.
PMCID:5010696
PMID: 27590603
ISSN: 1748-5908
CID: 2232672
Erratum: Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: The Global Burden of Disease Study 2015 (The Lancet HIV (2016) 3 (e361-e387) PII: S235230181630087X DOI: 10.1016/S2352-3018(16)30087-X)
GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980"“2015: the Global Burden of Disease Study 2015. Lancet HIV 2016; 3: e361"“87"”In this Article, Kerrie E Doyle and David M Pereira have been added to the list of collaborators and Claudia C Pereira has been removed. These corrections have been made as of Aug 22, 2016.
SCOPUS:84991574497
ISSN: 2352-3018
CID: 4184042
Perceptions About Parental Engagement Among Hispanic Immigrant Mothers of First Graders from Low-Income Backgrounds
Parental engagement is critical to children's educational achievement. Before and during elementary school, it is crucial for parents to be involved in their children's education in order to foster development and achievement. Hispanic parents' immigrant status, coupled with a lack of English proficiency, means that they often find themselves of low socioeconomic status (SES). Being low SES also means that parents possess fewer resources for engaging with their children. The current study seeks to understand low-income, primarily Hispanic mothers' perceptions of their roles in their first grade children's education. Mothers were interviewed regarding parenting confidence related to teaching their children, and responses were analyzed using qualitative research methods. Mothers in this study associated their roles in their children's education with two primary areas: helping their children to learn, and raising their children to be well-behaved and respectful. The main barrier to parental confidence in these roles appeared to be mothers' lack of English proficiency. This is consistent with previous research demonstrating that Hispanic parents maintain the perception of a lack of proficiency in English as a significant barrier to parental involvement in their children's education in the United States. Future interventions with teachers and parents may benefit from these findings in consideration of the optimal ways to involve parent related to their perceived personal strengths regarding parental engagement.
ISI:000390943600005
ISSN: 1573-1707
CID: 2504182
Role for Myopia in Determining Measurements of Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Layer (GCL) Thinning in Multiple Sclerosis (MS) [Meeting Abstract]
ISI:000394210600003
ISSN: 0146-0404
CID: 2492232
Optical coherence tomography detects significant retinal atrophy in progressive MS which is modulated by disease modifying therapies [Meeting Abstract]
ISI:000383267201479
ISSN: 1477-0970
CID: 2492052
Retinal thickness and visual disability in patients with multiple sclerosis and disease-free controls with myopia [Meeting Abstract]
ISI:000383267202122
ISSN: 1477-0970
CID: 2492082
Attenuation of the melanopsin-mediated sustained pupillary constriction response in MS: A putative pathophysiologic signature for interrogating the integrity of the retinohypothalamic tract in MS [Meeting Abstract]
ISI:000383267202303
ISSN: 1477-0970
CID: 2492122
Neuroscientific Insights: Attention, Working Memory, and Inhibitory Control
In this article, Cybele Raver and Clancy Blair explore a group of cognitive processes called executive function (EF)-including the flexible control of attention, the ability to hold information through working memory, and the ability to maintain inhibitory control. EF processes are crucial for young children's learning. On the one hand, they can help students control their anxiety when they face challenging academic tasks. On the other, these same processes can be undermined when children experience chronically stressful situations-for example, poverty, homelessness, and neighborhood crime. Such adverse early experiences interfere with children's development of EF, hampering their ability to manage challenging situations. Through both behavioral examples and empirical evidence, Raver and Blair illustrate how children's cognitive development is intertwined with EF. They show how children's regulation of higher-order thinking is related to the regulation of emotion in both top down and bottom-up fashion-and they review research on early brain development, EF and emotion regulation, and children's academic performance. They also examine the efficacy of educational interventions that target EF and of integrated interventions that target both emotional and cognitive regulation. What does our understanding of EF imply for policy in pre-K-3 education? First, write Raver and Blair, to help young children learn, school districts need data not only on their academic readiness but also on key dimensions of EF. Second, we already have interventions that can at least partially close the gap in neurocognitive function and academic achievement between children who face multiple types of adversity and those who don't. In the long run, though, they argue, the best way to help these children is to invest in programs that reduce their exposure to chronic severe stress.
ISI:000386422000006
ISSN: 1550-1558
CID: 2700792
Dressed and groomed for success in elementary school: Student appearance and academic adjustment
Teacher judgments of student competence can influence student achievement. Clothes, behavior, and physical appearance may all be used to infer student competence. We examined how fourth-grade teacher ratings of student physical appearance (e.g., appropriateness of clothing) relate to concurrent academic adjustment in terms of achievement, classroom engagement, teacher-child relations, parent-teacher partnership, and student academic self-concept and motivation, controlling for academic competence, ethnicity, and family characteristics. We followed 1,311 children from birth to grade 4. Children described by teachers more negatively in terms of their appearance had worse academic adjustment. Student physical appearance was also related to self-reported intrinsic motivation and academic self-concept, as well as to directly assessed math scores. Our results are consistent with social psychological and cognitive theories of stereotyping and classroom expectations, and suggest that school disengagement experienced by disadvantaged students may be partially rooted in elementary classroom dynamics.
SCOPUS:84984889459
ISSN: 0013-5984
CID: 2806542
Trends in Chronic Kidney Disease in China [Letter]
PMID: 27579659
ISSN: 1533-4406
CID: 5584282
