10 results on '"Shah, Payal"'
Search Results
2. International Education in Secondary Schools Explored: A Mixed-Method Examination of One Midwestern State in the USA
- Author
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Ortloff, Debora Hinderliter, Shah, Payal P., Lou, Jingjing, and Hamilton, Evelyn
- Abstract
In recent years, more and more attention has been paid to international education in schools in the USA. Education professionals, business leaders, and politicians realize that schools and school leaders must identify multiple opportunities for students to interact with and experience a global society. Nationally, there has been a considerable investment of funds by several key foundations and much political talk about the need to push American education towards a model of schooling that expressly responds to the need for internationally competent citizens. Using mixed methodology design, this study is fueled by a desire to better understand several overarching elements in international education. In short, the authors of this paper posit that no further research, policy formation, or program development within the realm of international education for public schools can be undertaken until an understanding of the current state of international education and the capacity for internationalization is empirically explored. (Contains 1 table and 2 notes.)
- Published
- 2012
- Full Text
- View/download PDF
3. Pediatric Medical Device Development and Regulation: Current State, Barriers, and Opportunities.
- Author
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Espinoza, Juan, Shah, Payal, Nagendra, Gautam, Bar-Cohen, Yaniv, and Richmond, Frances
- Subjects
- *
GOVERNMENT regulation , *PEDIATRICS , *PRODUCT design , *MEDICAL equipment laws , *MEDICAL equipment safety measures , *NEW product development laws , *MEDICAL equipment , *DIFFUSION of innovations - Abstract
Few medical devices are designed and marketed specifically for children. Instead, adult devices are often repurposed and used off-label in pediatrics. The innovation gap between pediatric and adult devices is complex and multifactorial. This review aims to summarize the medical device landscape, describe barriers to pediatric device development, and provide an update on current strategies to help overcome these limitations. Medical devices are regulated by the Food and Drug Administration. They are registered, cleared, or approved on the basis of a 3-tier risk classification system and a differentiated set of regulatory pathways. This includes some for products that receive special designations on the basis of specific aspects that warrant more rapid review and approval. Pediatric devices number only one-quarter of those developed for adults for multiple reasons. Clinically, innovators must adjust their products to address the smaller sizes, growth, and longer duration of use in children. Smaller sample sizes and population heterogeneity also challenge the ability to obtain sufficient safety data for regulatory submissions. Financial concerns stem from lower pediatric reimbursement rates coupled with a lack of nationally standardized coverage. There are a number of promising initiatives, including the Pediatric Device Consortia Program, Early Feasibility Studies, and the new System of Hospitals for Innovation in Pediatrics -- Medical Devices. However, the gap will likely not be narrowed without broad cooperation across stakeholders from industry, academia, patient advocacy groups, health care providers, investors, payors, regulators, and Congress. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
4. The contemporary landscape of genetic testing and breast cancer: Emerging issues.
- Author
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Shah, Payal D. and Domchek, Susan M.
- Subjects
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GENETIC testing laws , *BREAST tumors , *DISEASE susceptibility , *HEALTH services accessibility , *INFORMED consent (Medical law) , *RISK assessment , *GENETIC testing , *PATIENT selection , *GENETIC privacy - Abstract
The landscape of genetic testing for breast cancer susceptibility has transformed dramatically over the last decade and a half. Traditionally, the process of genetic testing resided fully within a medical infrastructure, from identification of appropriate testing candidates to gene selection to risk mitigation recommendations. More recently, decreasing costs, advancing technology, and a growing understanding of therapeutic implications of certain genetic test results have led to more widespread uptake of testing that increasingly involves broad multigene panels. Germline genetic testing for breast cancer susceptibility can now be obtained through one of three approaches: through clinical care; a direct‐to‐consumer (DTC) approach that is entirely consumer‐driven; or a hybrid, patient‐initiated, provider‐mediated model. Increased access to testing has led to extensive dialogue about the best way to conduct testing and act on results. Points of discussion include: selection of appropriate candidates for genetic testing; optimal composition of genes on panels; informed consent; safe return of results; privacy; and legal protections for those found to have relevant pathogenic or likely pathogenic variants. As more individuals undergo genetic testing, a growing population of individuals with inherited breast cancer predisposition informs optimal management of cancer risk and also highlights unanswered questions. This article aims to review the current state of genetic testing for inherited breast cancer susceptibility including testing approaches, the legal, ethical and social landscape, and selected contemporary management issues. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
5. Twenty-one-gene recurrence score assay in BRCA-associated versus sporadic breast cancers: Differences based on germline mutation status.
- Author
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Shah, Payal D., Patil, Sujata, Dickler, Maura N., Offit, Kenneth, Hudis, Clifford A., and Robson, Mark E.
- Subjects
- *
BRCA genes , *TUMOR suppressor genes , *BRCA proteins , *BREAST cancer , *CANCER , *BREAST tumor treatment , *BREAST tumors , *CANCER relapse , *COMPARATIVE studies , *DATABASES , *DISEASE susceptibility , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *MULTIVARIATE analysis , *GENETIC mutation , *PROGNOSIS , *RESEARCH , *RESEARCH funding , *RISK assessment , *SURVIVAL , *LOGISTIC regression analysis , *EVALUATION research , *RETROSPECTIVE studies , *GENE expression profiling - Abstract
Background: Biological differences between BRCA-associated breast cancer and sporadic breast cancer may warrant different adjuvant chemotherapy (ACRx) recommendations despite similar phenotypic features. A 21-gene expression profile (Oncotype DX) generates a prognostic recurrence score (RS) that predicts the ACRx benefit in patients with hormone receptor-positive breast cancer. No reports describe assay results for BRCA-associated breast cancer.Methods: A review of Memorial Sloan Kettering Cancer Center databases identified 4908 patients with hormone receptor-positive, node-negative breast cancer who underwent Oncotype DX testing between July 2006 and March 2014. BRCA1/BRCA2 carriers (cases) were identified and matched (1:2) by age at diagnosis and tumor size to noncarrier controls. Two-sample nonparametric tests were used to compare the baseline characteristics, RSs, and risk stratification between BRCA1 and BRCA2 patients. Conditional logistic regression was used to assess these differences by mutational status.Results: Fifty mutation-associated cases (19 BRCA1 cases and 31 BRCA2 cases) and 100 controls who were well matched for age (P = .9) and tumor size (P = .6) were included. BRCA1 and BRCA2 carriers had similar median RSs (P = .6) and risk category stratification (P = .3). The median RS was higher for cases versus controls (24 vs 16; P < .0001). Risk stratification also differed by mutational status (P = .0002). Cases had more high-risk disease (28% vs 7%) and intermediate-risk disease (56% vs 36%) and less low-risk disease (16% vs 57%). Cases were more likely than controls to receive ACRx (74% vs 46%; P = .002).Conclusions: Germline BRCA-associated hormone receptor-positive breast cancer may be associated with intrinsically less favorable biology. Few affected carriers have RS indicating a clear absence of benefit from ACRx. The increased use of ACRx and benefit from ACRx in BRCA carriers may mitigate otherwise inferior outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
6. International education in secondary schools explored: a mixed-method examination of one Midwestern state in the USA.
- Author
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Ortloff, Debora Hinderliter, Shah, Payal P., Lou, Jingjing, and Hamilton, Evelyn
- Subjects
- *
GLOBAL studies , *SECONDARY education , *PUBLIC schools , *GLOBALIZATION , *EDUCATIONAL change - Abstract
In recent years, more and more attention has been paid to international education in schools in the USA. Education professionals, business leaders, and politicians realize that schools and school leaders must identify multiple opportunities for students to interact with and experience a global society. Nationally, there has been a considerable investment of funds by several key foundations and much political talk about the need to push American education towards a model of schooling that expressly responds to the need for internationally competent citizens. Using mixed methodology design, this study is fueled by a desire to better understand several overarching elements in international education. In short, the authors of this paper posit that no further research, policy formation, or program development within the realm of international education for public schools can be undertaken until an understanding of the current state of international education and the capacity for internationalization is empirically explored. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
7. A qualitative exploration of men's perceptions of the terms "male sterilization" versus "vasectomy" in the southern United States.
- Author
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White, Ashley L., Mann, Emily S., Billings, Deborah L., and Shah, Payal
- Subjects
- *
VASECTOMY , *CONTRACEPTION , *HISTORICAL literacy , *HETEROSEXUAL men , *THEMATIC analysis - Abstract
Objectives: Clinical literature and contraception information guides use the terms "male sterilization" and "vasectomy" interchangeably. We investigate the meanings men attach to "sterilization" and how those meanings compare to perceptions of "vasectomy."Study Design: Cisgender, heterosexual men, ages 25 to 67, living across seven U.S. southern states participated in individual telephone interviews from May to December 2019. Interviews explored men's experiences with contraception, including their perception of the term "sterilization." We audio-recorded and transcribed the interviews and conducted thematic analyses using an inductive approach.Results: While most participants described "vasectomy" as a relatively benign procedure, they described "sterilization" as "sinister," "bleak," and "barbaric." Participants' discussions of sterilization invoked associations with eugenicist practices and specific historical examples of forced sterilization. While some participants recognized that vasectomy is a means of achieving sterilization, most viewed the term "sterilization" as incongruous with the modern medical procedure of "vasectomy," precisely because sterilization has been used as a form of reproductive oppression.Conclusion: Our findings suggest that men have strong affective responses to the term "sterilization." Participants' knowledge of historical eugenicist practices has implications for the acceptability of vasectomy as a permanent contraceptive option in our contemporary context.Implications: The phrase "male sterilization" can be associated with eugenics and coercive reproductive practices. Using the term for reproductive counselling, education, or research purposes may have implications for the acceptability of vasectomy as a permanent contraceptive option. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
8. Dermatologists' Perceptions and Confidence in Cosmetic Care for Male Patients.
- Author
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Shah P, Cartron AM, Roman J, and Zampella J
- Subjects
- Clinical Competence statistics & numerical data, Cosmetic Techniques psychology, Dermatologists education, Education, Continuing, Female, Health Services Accessibility, Humans, Male, Patient Acceptance of Health Care statistics & numerical data, Sex Factors, Skin Care psychology, Surveys and Questionnaires statistics & numerical data, United States, Attitude of Health Personnel, Cosmetic Techniques statistics & numerical data, Dermatologists statistics & numerical data, Skin Care statistics & numerical data
- Abstract
Background: Despite a growing interest in nonsurgical cosmetic procedures in men, the utilization of aesthetic treatments remains comparatively low, suggesting the presence of barriers to care., Objective: To describe barriers to cosmetic intervention for male patients from the perspective of dermatologists., Materials and Methods: An anonymous, online survey was distributed through a listserv made available by the American Academy of Dermatology., Results: Dermatologist respondents perceived a low utilization of cosmetic services in male patients (5%) and a lack of opportunity (72.3%) to provide such services. Respondents also perceived a lack of sufficient education/training (40.9%), experience (20.5%), and a lack of evidence in the field (20.5%) for dermatologists as potential barriers to cosmetic care for male patients. Presence of targeted messaging and in-office educational materials for male patients was found to be associated with increased utilization of cosmetic treatments by male patients (p = .012, p = .012, respectively). Dermatologists reported strong confidence in delivering various noninvasive cosmetic treatments to male patients., Conclusion: Despite dermatologists' reported confidence in performing cosmetic procedures in men, many perceive insufficient education/training and experience with this population which may create barriers to cosmetic care for male patients. Increasing educational materials and targeted messaging to male patients may decrease barriers for patients to receive desired cosmetic care., (Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
9. How common are cognitive errors in cases presented at emergency medicine resident morbidity and mortality conferences?
- Author
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Chu D, Xiao J, Shah P, and Todd B
- Subjects
- Congresses as Topic, Electronic Health Records standards, Emergency Medicine statistics & numerical data, Health Knowledge, Attitudes, Practice, Humans, Medical Errors mortality, Morbidity, Mortality, Retrospective Studies, United States epidemiology, Cognition physiology, Emergency Medicine education, Internship and Residency statistics & numerical data, Medical Errors statistics & numerical data
- Published
- 2018
- Full Text
- View/download PDF
10. Pay for performance.
- Author
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Hemani A, Jaffe C, Morgenstern M, Salatich A, Satjapot S, Shah P, and VonDielingen R
- Subjects
- United States, Quality Assurance, Health Care economics, Reimbursement, Incentive
- Published
- 2008
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