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Qualitative cancer genetic counseling research, part II: Findings from a exploratory ethnographic study in a cancer clinic

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Journal of Genetic Counseling 2001年第2期10卷 151-168页

作者： Peters, June A. McAllister, Carol L. Rubinstein, Wendy S. Department of Human Genetics Graduate School of Public Health University of Pittsburgh Cancer Genetics Program Clinical Genetics Branch Division of Cancer Epidemiology and Genetics National Cancer Institute (NCI) Rockville MD United States Department of Human Services Administration Graduate School of Public Health and Anthropology Department University of Pittsburgh Pittsburgh PA United States Departments of Medicine and Obstetrics-Gynecology and Reproductive Sciences School of Medicine University of Pittsburgh Pittsburgh PA United States Department of Human Genetics Graduate School of Public Health University of Pittsburgh Pittsburgh PA United States Cancer Genetics Program Pittsburgh PA United States Clinical Genetics Branch (CGB) Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD 20852 6120 Executive Blvd. United States

This is a report of the preliminary findings of a brief exploratory ethnographic study in a cancer diagnosis and treatment clinic. The main research purpose was to explore the meaning of cancer and cancer treatment to patients themselves and to their relatives and close friends. The methods are described in detail in a paper focusing on the experiences of being a novice ethnographer (Peters et al. (2001) J Genet Counsel 10(2):133-150.). The preliminary results of this exploratory fieldwork indicate that the experience of attending a cancer treatment clinic for evaluation and/or treatment is a complex social, emotional as well as medical process for patients and families. Themes with relevance to genetic counselors that emerged from this early observation period included ideas about causes of cancer, the complex nature of families and kinship, coping and support, use of food, and healing. These initial findings have implications for genetic counseling practice and hopefully will stimulate more qualitative social and behavioral research in cancer genetic counseling. © 2001 National Society of Genetic Counselors, Inc.

关键词： Anthropology Behavioral Ethnography Family Genetic counseling Hereditary cancer Participant-observation Psychosocial Qualitative Research

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Qualitative cancer genetic counseling research, part I: Ethnography in a cancer clinic

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Journal of Genetic Counseling 2001年第2期10.0卷 133-150页

作者： Peters, June A. McAllister, Carol L. Rubinstein, Wendy S. Department of Human Genetics Graduate School of Public Health University of Pittsburgh Cancer Genetics Program Clinical Genetics Branch Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD United States Department of Human Services Administration Graduate School of Public Health (GSPH) University of Pittsburgh Pittsburgh PA United States Departments of Medicine and Obstetrics-Gynecology and Reproductive Sciences School of Medicine University of Pittsburgh Pittsburgh PA United States Department of Human Genetics Graduate School of Public Health University of Pittsburgh Pittsburgh PA United States Cancer Genetics Program Pittsburgh PA United States Clinical Genetics Branch (CGB) Division of Cancer Epidemiology and Genetics (DCEG) National Cancer Institute (NCI) Rockville MD 20852 6120 Executive Blvd. United States

This is a report of the experience of several months' ethnographic research by a genetic counselor researcher in a cancer treatment clinic. One goal of the exercise was to directly experience a method of qualitative research known as ethnography, which relies heavily on participant-observation, in an applied clinical setting. Another goal was to explore a previously undescribed research area in the genetic counseling literature, namely, the meaning of cancer and cancer treatment for affected individuals and their support companions. Here we report on a personal account of the experiences of conducting and publishing the research. The preliminary analysis and results of this field experience are published elsewhere (Peters et al. (2007) J Genet Counsel 10(2):151-168.). These initial findings support the feasibility of genetic counselors, who are trained in specific social science methodologies, to conduct qualitative research pertinent to genetic counseling practice. © 2001 National Society of Genetic Counselors, Inc.

关键词： Anthropology Behavioral Ethnography Family Genetic counseling Hereditary cancer Participant-observation Psychosocial Qualitative Research

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Consumer expectations regarding emerging technologies

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Bulletin of Science, Technology and Society 2001年第2期21卷 99-107页

作者： Gleason, J.M. Ault, III, J.T. Creighton University United States Department of Decision Sciences College of Business Administration Creighton University Omaha NE United States University of Missouri Kansas City MO United States Indiana University United States Texas Tech University United States University of Nebraska Omaha NE United States The Citadel United States Boston University Overseas Graduate Program United States Department of Industrial Engineering American University of Armenia Armenia University of California Berkeley CA United States Dept. of Sociology and Anthropology College of Arts and Sciences Creighton University Omaha NE United States University of Tulsa United States University of Nebraska Lincoln NE United States Creighton University Acad. Comp. and Institutional Res. United States Information Services Social Sciences Data Lab.

This article reports the results of marketing research that was undertaken as part of an information technology prototype development project. The project was devoted to the creation of a multimedia-based prototype system to provide timely and accurate information from government geographic information databases to government decision makers and the general public in an easy-to-use interactive visual format. The general public (i.e., private citizens, schools, and businesses - society in general) had to be able to access the product via broadband-to-the-home (-business/school) technology. Because of significant time and budget constraints, a satisficing approach to the marketing research was adopted. This approach led to the definition of several social categories of the general public whose opinions were thought to be critical to the commercial development of the prototype: (a) elementary and secondary education leaders (both technophiles and technophobes), (b) adults with a record as early adopters of information technologies, (c) adults with no previous interest in (or limited experience with) information technologies, and (d) high school students. Six focus groups were defined based on these social categories. The results of the marketing research devoted to information needs of the focus group participants are reported, and implications related to their expectations regarding emerging technologies are discussed. The research suggests that expectations in the portion of the market on which the success of the technologies depend are often inconsistent with the types of technologies that are being developed for that market.

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The theory and methodology of provider profiling

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International Journal of Health Care Quality Assurance 2000年第7期13卷 316-321页

作者： Tucker III, Jessie L. Department of Health Care Administration US Army-Baylor University Graduate Program in Health Care Administration San Antonio TX United States Accrediting Commission on Education for Health Services Administration San Antonio TX United States

Physician profiling is the comparison of physician practice patterns to determine the existence and effects of significant differences in outcomes. To optimize care quality, these comparisons can be used to influence provider behavior through awareness when outcomes are poor or do not warrant provider expenditures. To maximize the value of such a technique, the underlying bases for comparison and the uses of derived data must be understood. Several factors must be considered or controlled for when determining comparable providers. Additionally, the worth or significance of findings must also be understood. This paper seeks to provide information in these two areas for the benefit of those responsible for managing care at all levels. © MCB University Press.

关键词： Customer satisfaction Evidence Health care Outcomes Quality

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Homeopathy: Attitudes and opinions of members of the American Pharmaceutical Association

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Journal of the American Pharmaceutical Association (Washington, D.C. : 1996) 2000年第2期40卷 259-261页

作者： Sayner-Flusche, Amy Gupchup, Gireesh V. Dole, Ernest J. St. Louis College of Pharmacy St. Louis MO United States Pharmacy Administration Graduate Program United States College of Pharmacy University of New Mexico Albuquerque United States

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Advances in aircraft carrier life cycle cost analysis for acquisition and ownership decision-making

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NAVAL ENGINEERS JOURNAL 2000年第3期112卷 97-110页

作者： Chewning, IM Moretto, SJ Irvin M. Chewning:is currently the Director of the Aircraft Carrier Cost Estimating and Industrial Analysis Group of the Naval Sea Systems Command. Over the past four years Mr. Chewning has guided the cost analysis effort for the new CVNX class aircraft carrier through a three-part analysis of alternatives and is currently steering it towards Milestone I in June of 2000. In 1999 the CVNX cost analysis team was presented the NAVSEA Association of Scientists and Engineers “outstanding team achievement” award for its work on the CVNX analysis of alternatives. Mr. Chewning's professional career includes over 16 years as an employee of Newport News Shipbuilding as a Pipe Fitter Piping Systems Designer Piping Systems Engineer and Cost Engineer. He has worked at the Naval Sea Systems Command since 1980 as a Senior Cost Analyst Branch Head and Deputy Division Director of the Cost Estimating and Analysis Division. He has preformed cost analysis work for virtually all USN combatant programs including submarines cruisers destroyers frigates and aircraft carriers. He also performed the cost analysis work for the OSD evaluation of the Israeli Naval Modernization Program in the 1980's. Mr. Chewning is also Chairman of the NATO Specialist Team on Ship Costing a subgroup of the NATO Naval Group Six on Ship Design. Under his leadership two Allied Naval Engineering Publications have been completed in the 1990's: ANEP-41 on Ship Costing and ANEP-49 on Ways to Reduce Costs of Ships. In 1999 the NATO Specialist Team on Ship Costing completed a paper titled “Manpower Reduction and the Use of Commercial Standards and Practices to Reduce Costs of Ships.” The result of this work will be incorporated in a future revision of the aforementioned ANEFs. Mr. Chewning is a graduate of North Carolina State University with a Bachelor of Science in Mechanical Engineering. Mr. Chewning has also completed courses at the University of Virginia and Christopher Newport University Mr. Chewning is a graduate of the Program Management College

The U.S. Navy recently conducted an analysis of alternatives (AOA) to set the stage for determining the characteristics and acquisition strategy for its next generation aircraft carrier. The platform design selected is expected to be in service throughout the 21st century. The parameters under consideration for change in the new carrier design lie in the areas of propulsion and electric power generation, aviation, survivability, service life, and total ownership cost (TOC) reduction. The issue of affordability is paramount This paper focuses on the need for the program management office and its supporting cost analysis staff to understand the life cycle cost (LCC) of the existing and proposed future aircraft carriers and to then translate these LCC's into meaningful information for cost-conscious decision making. The challenge is to relate the LCC in terms the key decision-makers and the engineering team can use to satisfy their respective roles. Thus, it is necessary to translate the results of the given ship design alternative LCC's into the paradigms of the respective stakeholders: Fleet User (operators of aircraft carriers) Ship Designers (translators of the fleet operator requirements) program Sponsors (providers of the funding resources) program Management Office, Ship builder and Supporting Industry (executors of the acquisition and construction of the ship) Navy and OSD decision-makers (overseers of program execution) The paper describes the aircraft carrier LCC breakdown structure that has resulted, in part, from a recent navy/shipbuilder integrated product team effort to capture total ownership costs. The structure has been used in the AOA as a tool to identify cost drivers and to add the time element to the cast equation in order to perform return on investment and program affordability analysis. The expanded ship work breakdown structure (ESWBS) has emerged as the central backbone of the cost work breakdown for AOA work. The ESWBS structure is a natural

关键词： Aircraft carriers

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Social Constructs and Human Service: Managerial Sensemaking of Volunteer Motivation

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Voluntas 1999年第4期10卷 345-361页

作者： Liao-Troth, Matthew A. Dunn, Craig P. Public Services Graduate Program DePaul University Chicago IL United States Public Services Graduate Program DePaul University Chicago IL 60604 243 South Wabash Avenue United States College of Business Administration San Diego State University San Diego CA United States

Managers of volunteers in human service interpret their job and experiences through a cognitive construct grounded in past interactions and experiences. This construct - sensemaking - then guides the managers' perceptions of subsequent interactions with peers, volunteers, and supervisors. Volunteers similarly make sense of their surroundings through cognitive constructions grounded in their own experiences. Unfortunately, managers and volunteers do not always make sense of their surroundings in the same way. Research has demonstrated that supervisors and paid employees may not necessarily agree in their perceptions of such issues as, for example, employee motivation. Such differences can lead to disagreements about the meaning of behaviors and the design of reward systems, eventually compromising organizational performance. In this study, sensemaking of volunteer motivation was assessed from the manager's perspective and compared with a previous study of volunteers themselves. Differences in understanding such a primary question as why volunteers are present can reasonably be expected to have an impact on organizational effectiveness. Interestingly, the predicted outcome of a different sensemaking schema was not supported in either the understanding of motivation or in the relative importance assigned to altruism. Additional attributes of volunteer managers were also considered to determine if sensemaking is driven by environmental factors such as exposure to volunteers, tenure as a volunteer manager, or social roles associated with gender constructs. These additional attributes were not found to significantly affect the process of attribution of altruistic motives.

关键词： Sensemaking Volunteer management Volunteer motivation

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Contemporary organizational strategies for enhancing value in health care

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International Journal of Health Care Quality Assurance 1999年第5期12.0卷 183-189页

作者： Richardson, Mary L. Gurtner, William H. Graduate Program in Health Services Administration School of Public Health and Community Medicine University of Washington Seattle United States Clinical Services Development University of California Oakland United States

To a rapidly changing environment, health-care organizations are adopting a variety of value enhancement strategies. Typically characterized as quality improvement activities, these strategies generally include efforts to improve: clinical effectiveness;financial performance;consumer satisfaction;employee satisfaction;and risk management/quality assurance activities. Early efforts involved the use of continuous quality improvement (CQI) or total quality management (TQM) strategies with a focus on improving financial performance, while clinical effectiveness has been a greater emphasis more recently. This study examines the manner in which 14 US health-care systems, noted for innovation in quality improvement and value enhancement, are utilizing these activities to promote productive organizational change. An interview format, for use with key informants in each organization, was developed using a model with four dimensions - strategic, cultural, technical, and structural. © MCB University Press.

关键词： Kaizen Management Organizational change Value

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Crowd Management Practices

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Journal of Convention & Event Tourism 1999年第2-3期1卷 119-150页

作者： Rob Ammon Jr. EdD[a][b] & Gil Fried JD[c][d] [a] Department of Physical Education USA [b] Graduate Program in Sport Management at Slippery Rock University of Pennsylvania USA [c] Health and Human Performance Department USA [d] Sport Administration Curriculum at the University of Houston USA

Imagine thousands of people pushing you down onto steel tubing with such force that your body helps bend and ultimately collapse the tubing-throwing scores of people to the hard turf. No imagination would be necessary if you were one of the fans in the student section at Camp Randall Stadium witnessing the Michigan versus Wisconsin football game in 1993. Seventy-seven fans were injured in the attempted “rush” onto the field. These injuries produced 11 lawsuits and reigniting the debate concerning crowd management techniques which had been dormant since shortly after the stampede at a Who concert that killed 11 people in the *** following study was undertaken to determine what crowd management techniques are currently being utilized at stadiums throughout North America. The lessons learned from dealing with potentially rowdy crowds can be applied to numerous public assembly facilities which might host a variety of events that can draw diverse crowds. The stadiums were analyzed according to their size, year built and related variables. Next, the survey analyzed what crowd management techniques and training were utilized and who was responsible for crowd management activities. The survey also analyzed whether or not the facilities had ever faced crowd surges and techniques utilized to prevent potential catastrophes. In addition, the study examined what stadiums were doing to control alcohol related activities such as violence and sneaking alcohol into a facility. Lastly, the survey analyzed the liability threat facing facilities and examined their past liability track record.

关键词： Security safety crowd control

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The road to Impeccable -: An uncommon approach to ship acquisition

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NAVAL ENGINEERS JOURNAL 1999年第3期111卷 245-255页

作者： Shen, TWT Proctor, BL Saha, D Mr. Terry Shen:is the Assistant Project Manager for the Ocean Surveillance Ship (T-AGOS 23) Acquisition Project at Naval Sea Systems Command (NAVSEA). He is responsible for the program management of the large SWATH (Small Waterplane Area Twin Hull) ship construction in the Gulf region. Mr. Shen has over 14 years of experience in ship acquisitions and has co-authored several technical papers published by the Association of Scientists & Engineers the Society of Naval Architects & Marine Engineers and the American Society of Naval Engineers. He is a graduate of the University of Maryland with a BS in aerospace engineering and a BA in speech communication a 1986 graduate of the DSMC Program Management Course and a 1991 graduate of the Virginia Polytechnic Institute with an MBA in business administration. Mr. Barry Proctor:is NAVSEA's Ship Design Manager for the T-AGOS 23 program. He has held this position since March 1997. Prior to that time he was NAVSEA's Ship Design Manager for the T -AKR 300 class vessels. He has over 18 years of experience as a Naval Architect for NAVSEA (O3D). He has a BS in civil engineering from the University of Maryland and an MS in naval architecture and marine engineering from the University of Michigan. Mr. Deepak Saha:provides design support to NAVSEA's Program Office and Ship Design Manager on the T -AGOS 23 ship acquisition. His involvement with the program started at the time the first shipbuilder declared bankruptcy. He is Manager of the Commercial Ship Design Group at M. Rosenblatt & Son Inc. (MR&S) Arlington Branch. He has over 26 years of experience as a marine engineer and naval architect. He obtained a BS in marine engineering from Calcutta India in 1972 and a BSE in naval architecture from the University of Michigan in 1983. He also holds a Chief Engineer's License (Unlimited Horsepower Diesels).

The road to the acquisition of the USNS Impeccable (T-AGOS 23) has seen a few uncommon and challenging twists and turns, resulting in delays and disruption to the program. The saga began in 1993, when the original shipbuilder, facing financial difficulties, filed for Chapter XI bankruptcy protection. For two more years the program was stalled before the Navy was able to warrant the work that had been done up to that point. In 1995 the contract was reassigned to another shipbuilder to complete the vessel and obtain the necessary certificates to comply with all the applicable requirements of the American Bureau of Shipping (ABS). This unprecedented approach put the Navy in the unique situation of being responsible for two of the most controversial issues in a ship construction process, i.e., detail design and equipment warranties. This paper gives the status of the program, discusses how various technical issues and production demands are being addressed, and describes the future hurdles that need to be overcome before delivery of the vessel.

关键词： Ships SPT/ADA/Gcn5 Acetyltransferase Road Navy Shipyards

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