K Armstrong

..Factors contributing to racial differences in health care system distrust (HCSD) are currently unknown. Proposed potential contributing factors are prior experiences of racial discrimination and racial residential segregation...

..Controversy continues about screening mammography, in part because of the risk of false-negative and false-positive mammograms. Pre-test breast cancer risk factors may improve the positive and negative predictive value of screening...

..Value of information methods can identify priority areas for investigation and inform research methods...

..Characteristics of how genetic tests are delivered may influence willingness to undergo testing and, if they affect population subgroups differently, alter disparities in testing...

..Although fear of insurance discrimination is associated with the decision not to undergo BRCA1/2 testing, there was no evidence of actual insurance discrimination from BRCA1/2 testing...

..The decision about prophylactic oophorectomy is difficult for many premenopausal women with BRCA1/2 mutations because of concerns and controversy about the use of hormone replacement therapy (HRT) after oophorectomy...

....

..Although tamoxifen citrate has been approved for primary reduction of breast cancer risk since 1998, little is known about the prescription of tamoxifen by primary care physicians...

..However, to our knowledge there are no published studies examining the magnitude and determinants of racial differences in the use of genetic susceptibility testing...

..This study was conducted to determine the effect of a tailored decision support system (DSS) that provides individualized survival and cancer incidence curves specific to expected outcomes of alternative management strategies...

..We examined the racial/ethnic and geographic variation in distrust of physicians in the United States...

..Uncovering the hidden constraints that we impose on health care choice may help us reduce unwanted disparities in health care...

....

....

....

..However, the effect of framing as survival versus mortality on understanding and treatment choice is not known...

..These results support the use of models of genetic counseling that allow for sharing the health care providers' opinions when desired by the patient...

..To examine the life expectancy and cost-effectiveness of hormone replacement therapy (HRT) and raloxifene therapy in healthy 50-year-old postmenopausal women...

..These findings suggest that ensuring equal access to testing for high-risk individuals irrespective of race may be as important for the future of predictive genetic testing as restricting the use of testing among low-risk individuals...

..Although only 20-30% of postmenopausal women in the United States take HRT, the relationship between breast cancer risk perception and use of HRT is not known...

..Women who undergo testing are also more interested in ovarian cancer risk information and less concerned about job and insurance discrimination...

..Preliminary interviews suggested that fear of undisclosed ingredients in the influenza vaccine may impede vaccine acceptance in this vulnerable population...

..These data suggest that surveillance and prevention strategies may have different outcomes in BRCA1 and BRCA2 mutation carriers...

..Adjusting for treatment had little impact on these results, despite variation in the racial difference in receipt of prostatectomy with differing comorbidity levels...

..Prior measures of health care system distrust have not reflected this multidimensional structure and may be limiting research into the role of health care system distrust in health and health care in the US...

....

..These differences may result in disparities in the uptake of predictive genetic testing in the future...

..However, previous studies of survival curves did not measure comprehension, used face-to-face explanations, and focused on a VA population...

..Our objective was to determine the prevalence and determinants of the adoption of breast cancer risk assessment by primary care physicians...

..The risks and benefits of mammography screening among women 40 to 49 years of age remain an important issue for clinical practice...

..66.5% vs 57.1%, p =.05). CONCLUSIONS: A mailed educational brochure is more effective than a simple reminder in increasing influenza vaccination rates among inner-city, elderly patients...

..Ross syndrome is an uncommon disorder characterized by the triad of segmental anhidrosis, hyporeflexia, and tonic pupils...

..Patients cite physician recommendation as the most important motivator of screening. This study explored the barriers of and facilitators to physician recommendation of CRCS...

..The aim of this study was to describe Chinese acupuncture patients' perceived sensations of, and beliefs about, acupuncture needling...

..However, participation rates have been low in studies that involve fecal sampling. Attitudes toward such studies among potential study participants have not been assessed...

....

....

..Volunteerism has also received increasing attention in the national agenda for social change. Yet little is known about physicians' community volunteer activities...

..To develop a model to predict risk of postoperative death, we sought to identify factors associated with postoperative mortality for Medicare patients undergoing esophagectomy for cancer...

..Knowledge of SSB patterns among linguistically isolated communities is essential for efficient dissemination of cancer information to these at-risk communities...

..We examined whether racial disparities in stage-specific colorectal cancer survival changed between 1960 and 2005...

....

..No other measure of social capital was associated with HbA1c. In this study of black veterans with diabetes we observed that living in neighborhoods where people work together is associated with better glucose control...

....

..Out-of-hospital (OOH) care for chest pain is protocol-driven and may be less likely to demonstrate differences between men and women...

..The extent to which retail clinics provide access to care for underserved populations remains largely unknown. The purpose of this study was to determine whether retail clinics tend to be located in census tracts with higher medical need...

..This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care...

..Esophagectomy is underused as treatment for resectable stage I, II, and III esophageal cancers...

..The objective of this study was to determine the association between physicians' perceived effect of guidelines on clinical practice and self-reported prostate-specific antigen (PSA) screening patterns...

..We report disclosure and uptake patterns by BRCA1/2-positive individuals to at-risk relatives, in the setting of no-cost genetic counseling and testing...

..The result is that health care disparities can be challenging to interpret unless the analytic and policy perspective is clear...

..As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants...

..Thus, we evaluated whether the breast cancer risk reduction conferred by BPO in BRCA1/2 mutation carriers is altered by use of post-BPO HRT...

..This study evaluated the association between trust in health care providers and prior health care experiences, structural characteristics of health care, and sociodemographic factors among African Americans and whites...

..Research should focus on interventions to reduce advanced presentation of the disease and disease-related mortality among black men...

..To examine potential disparities in willingness to be vaccinated against smallpox among different U.S. racial/ethnic groups...

..Organizational leaders and scholars have issued calls for the medical profession to refocus its efforts on fulfilling the core tenets of professionalism. A key element of professionalism is participation in community affairs...

..Prostate-specific antigen screening has led to an increase in the diagnosis and treatment of localized prostate cancer. However, the role of active treatment of low- and intermediate-risk disease in elderly men is controversial...

..The association between use of surgery and survival is weaker among African-American than white women, raising questions about potential racial differences in the effectiveness of surgery...

..Extensive use of complementary and alternative medicine (CAM) among cancer survivors has been described in literature, but the rate has not previously been compared to other groups in a true population sample...

..Over the next decade, BRCA1/2 testing is likely to become substantially less expensive and to move into primary care practice where pretest counseling may be limited...

..The need to interpret psychological distress and the stressfulness of genetic testing among high-risk women with respect to relevant comparison data is discussed...

....

..This instrument can facilitate the investigation of the prevalence, causes, and effects of health care system distrust in the United States...

..Further education regarding these specific points may enhance the use of genetic testing...

..In many cases, misconceptions may be barriers to uptake of genetic testing. Dispelling these misconceptions is an important step in the translation of advances in human genomics into improvements in health...

....

..Although National Cancer Institute (NCI) designation as a cancer center is based almost solely on research activities, it is often viewed, by patients and referring providers, as an indication of clinical excellence...

..Breast cancer screening in community practices may be different from that in randomized controlled trials. New screening modalities are becoming available...

..To determine the impact of adjuvant androgen deprivation therapy (ADT) for patients who have node-positive prostate cancer in the prostate-specific antigen (PSA) era...

..This study examined whether people residing in states with statutes requiring written informed consent prior to HIV testing were less likely to report a recent HIV test...

..Primary androgen deprivation therapy (PADT) is frequently used as a sole modality of treatment in men with localized prostate cancer, despite a lack of clinical trial data supporting its use...

....

....

..These results indicate a clear need to improve quality of care provided to pregnant women who use tobacco...

..The authors tested whether the magnifier scale lowers risk perceptions for low-probability (in 0%-1% magnifying glass section of scale) but not high-probability (>1%) events compared to a standard rating scale (SRS)...

..Accurate measurement of people's risk perceptions is important for numerous bodies of research and in clinical practice, but there is no consensus about the best measure...

..However, the lack of oversight of these sites raises concerns about low quality and inconsistent information. These concerns led us to evaluate internet cancer risk calculators...

..To contribute to the debate about whether numeric statements of risk ought to be included in risk communications...

..These results demonstrate significant gaps between the intended message and the message received in physician risk communications. Implications for medical decisions, patient distress, and future research are discussed...

..This study examines patients' risk perceptions following communication with health care providers during genetic counseling about the risks of breast cancer and BRCA1/2 mutations...

..Eight hundred women who saw a primary care physician in the University of Pennsylvania Health System in the 3 years before the study, of whom 234 had undergone BRCA1/2 counseling (cases) and of whom 566 had not (controls)...

..To evaluate whether the proportion of the local population without health insurance coverage is related to whether women undergo mammography screening...

..This study was undertaken to assess perceptions of smoking-related health risks among women smokers...

..To conduct a meta-analysis of the diagnostic performance of the percent free prostate-specific antigen (%fPSA) test in determining prostate cancer status and to assess its value in helping to decide whether to biopsy the prostate...

..This understanding may lay the groundwork for improved understanding and trust between biomedical practitioners and African American patients. ..

....

..In addition, within each category, we will investigate differences related to primary surgery and adjuvant radiation therapy. ..

..This project will increase our understanding of the use of testing among Black and White women with early onset breast cancer and the patient and provider determinants of disparities in that use. ..