During a disaster, home-based care is intended to continue to function using existing care delive... more During a disaster, home-based care is intended to continue to function using existing care delivery models. Home-based care providers (HBCP) are often the closest contact with their clients—even during a disaster, seeing them in non-traditional care settings including shelters and hotels. This closeness and commitment to clients, gives HBCP unique insights into strategies to promote aging in place. The purpose of this study was to identify the individual and community-level support needs of older adults after a disaster through the lens of home-based care. Five focus groups were conducted with HBCP (n=27) in two disaster-affected settings: 2017’s Hurricane Irma in Florida and Hurricane Harvey in Texas. Participants were identified by contacting home health agencies listed in an open-source database of agencies receiving Centers for Medicare and Medicaid Services funding. Data was manually coded using an inductive approach and themes were iteratively identified. Forty-nine codes were...
As the use and scope of direct-to-consumer genetic testing (DTC GT), also becoming known as consu... more As the use and scope of direct-to-consumer genetic testing (DTC GT), also becoming known as consumer-driven genetic testing, increases, consumers may seek genetic counseling to understand their results and determine healthcare implications. In this study, we interviewed individuals who sought genetic counseling after receiving DTC GT results to explore their motivations, expectations, and experiences. Participants How to cite this article: Marzulla T, Roberts JS, DeVries R, Koeller DR, Green RC, Uhlmann WR. Genetic counseling following direct-to consumer genetic testing: Consumer perspectives.
A rcvim of this brevity can only suggest the richness of this book. Beginning with the sdi tors&#... more A rcvim of this brevity can only suggest the richness of this book. Beginning with the sdi tors' introduction about health and morality in American society and continuing throughout each essay, the question looms: Where is the locus of responsibility in a just society? So exodlent is this book, that the next report emerging from the John D. and Cathetine T. MacArthur Network on the Determinants and Consequences of Health Promoting and Health Damaging Behavior is eagerly awaited.
We conducted an empirical study to explore clinician and lay opinions on the acceptability of phy... more We conducted an empirical study to explore clinician and lay opinions on the acceptability of physician paternalism. Respondents read a vignette describing a patient with brain hemorrhage facing urgent surgery that would be lifesaving but would result in long-term severe disability. Cases were randomized to show either low or high surrogate distress and certain or uncertain prognosis, with respondents rating the acceptability of not offering brain surgery. Clinicians (N = 169) were more likely than nonclinicians (N = 649) to find the doctor withholding surgery acceptable (30.2% vs. 11.4%, p ≤ 0.001). Among clinicians, the doctor withholding surgery was more acceptable when prognosis was certain to be poor (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.04, 4.01). There was no effect of surrogate distress on clinician ratings. Responses among lay public were more variable. Given the differences in attitudes across clinicians and lay public, there is an ongoing need to engage st...
Birth and death' are distinguished frad other points of status' aasage because they 4onnect human... more Birth and death' are distinguished frad other points of status' aasage because they 4onnect humanity with the unknown. By /comparing the soc4al structuring of birth and death, thio paper \)roposis ga mare generic area of study:. cosmic status passage. After a diseussion of the changes in the experience of birth °. and death fostered by'modernization, the similaritles of these (;xperiences are explored in siigeneraa categories: the role
It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from... more It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparat...
Journal of applied gerontology : the official journal of the Southern Gerontological Society, Jan 21, 2015
Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenc... more Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenced by oncologists' attitudes and beliefs about older patients. Nevertheless, few studies have explored oncologists' perspectives on how patient age affects their treatment decisions. In-depth interviews were conducted with 17 oncologists to examine factors that influence their chemotherapy decisions for adults with incurable cancer near death. Transcripts of recorded interviews were coded and content analyzed. Oncologists identified patient age as a key factor in their chemotherapy decisions. They believed older adults were less likely to want or tolerate treatment, and felt highly motivated to treat younger patients. Qualitative analysis of in-depth interviews resulted in a nuanced understanding of how patient age influences oncologists' chemotherapy decisions. Such understanding may inform practice efforts aimed at enhancing cancer care at the end of life for older patients.
It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from... more It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparat...
Responding to consumer demands, many hospitals are setting up ABCs for couples who desire a more ... more Responding to consumer demands, many hospitals are setting up ABCs for couples who desire a more self-directed, family-centered experience. Such programs require that administrators and staff anticipate potential problems for personnel and clients.
During a disaster, home-based care is intended to continue to function using existing care delive... more During a disaster, home-based care is intended to continue to function using existing care delivery models. Home-based care providers (HBCP) are often the closest contact with their clients—even during a disaster, seeing them in non-traditional care settings including shelters and hotels. This closeness and commitment to clients, gives HBCP unique insights into strategies to promote aging in place. The purpose of this study was to identify the individual and community-level support needs of older adults after a disaster through the lens of home-based care. Five focus groups were conducted with HBCP (n=27) in two disaster-affected settings: 2017’s Hurricane Irma in Florida and Hurricane Harvey in Texas. Participants were identified by contacting home health agencies listed in an open-source database of agencies receiving Centers for Medicare and Medicaid Services funding. Data was manually coded using an inductive approach and themes were iteratively identified. Forty-nine codes were...
As the use and scope of direct-to-consumer genetic testing (DTC GT), also becoming known as consu... more As the use and scope of direct-to-consumer genetic testing (DTC GT), also becoming known as consumer-driven genetic testing, increases, consumers may seek genetic counseling to understand their results and determine healthcare implications. In this study, we interviewed individuals who sought genetic counseling after receiving DTC GT results to explore their motivations, expectations, and experiences. Participants How to cite this article: Marzulla T, Roberts JS, DeVries R, Koeller DR, Green RC, Uhlmann WR. Genetic counseling following direct-to consumer genetic testing: Consumer perspectives.
A rcvim of this brevity can only suggest the richness of this book. Beginning with the sdi tors&#... more A rcvim of this brevity can only suggest the richness of this book. Beginning with the sdi tors' introduction about health and morality in American society and continuing throughout each essay, the question looms: Where is the locus of responsibility in a just society? So exodlent is this book, that the next report emerging from the John D. and Cathetine T. MacArthur Network on the Determinants and Consequences of Health Promoting and Health Damaging Behavior is eagerly awaited.
We conducted an empirical study to explore clinician and lay opinions on the acceptability of phy... more We conducted an empirical study to explore clinician and lay opinions on the acceptability of physician paternalism. Respondents read a vignette describing a patient with brain hemorrhage facing urgent surgery that would be lifesaving but would result in long-term severe disability. Cases were randomized to show either low or high surrogate distress and certain or uncertain prognosis, with respondents rating the acceptability of not offering brain surgery. Clinicians (N = 169) were more likely than nonclinicians (N = 649) to find the doctor withholding surgery acceptable (30.2% vs. 11.4%, p ≤ 0.001). Among clinicians, the doctor withholding surgery was more acceptable when prognosis was certain to be poor (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.04, 4.01). There was no effect of surrogate distress on clinician ratings. Responses among lay public were more variable. Given the differences in attitudes across clinicians and lay public, there is an ongoing need to engage st...
Birth and death' are distinguished frad other points of status' aasage because they 4onnect human... more Birth and death' are distinguished frad other points of status' aasage because they 4onnect humanity with the unknown. By /comparing the soc4al structuring of birth and death, thio paper \)roposis ga mare generic area of study:. cosmic status passage. After a diseussion of the changes in the experience of birth °. and death fostered by'modernization, the similaritles of these (;xperiences are explored in siigeneraa categories: the role
It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from... more It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparat...
Journal of applied gerontology : the official journal of the Southern Gerontological Society, Jan 21, 2015
Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenc... more Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenced by oncologists' attitudes and beliefs about older patients. Nevertheless, few studies have explored oncologists' perspectives on how patient age affects their treatment decisions. In-depth interviews were conducted with 17 oncologists to examine factors that influence their chemotherapy decisions for adults with incurable cancer near death. Transcripts of recorded interviews were coded and content analyzed. Oncologists identified patient age as a key factor in their chemotherapy decisions. They believed older adults were less likely to want or tolerate treatment, and felt highly motivated to treat younger patients. Qualitative analysis of in-depth interviews resulted in a nuanced understanding of how patient age influences oncologists' chemotherapy decisions. Such understanding may inform practice efforts aimed at enhancing cancer care at the end of life for older patients.
It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from... more It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparat...
Responding to consumer demands, many hospitals are setting up ABCs for couples who desire a more ... more Responding to consumer demands, many hospitals are setting up ABCs for couples who desire a more self-directed, family-centered experience. Such programs require that administrators and staff anticipate potential problems for personnel and clients.
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Papers by R. Vries