Risk Reduction Behaviors and Provider Communication Following Genetic Counseling and BRCA1 Mutation Testing in an African American Kindred

Little is known about the impact of cancer genetic counseling and testing on health behaviors in racial and ethnic subgroups. This prospective observational study examined use of risk reduction strategies following BRCA1 counseling and testing. Participants were female members of an African American kindred who received genetic education, counseling and testing (n = 40) and completed a 1-year follow-up interview. Mutation carriers were more likely to opt for breast (100%, 7/7) and ovarian (25%; 1 of 4) cancer surveillance than prophylactic surgery. Following genetic counseling, 71% (5/7) of the BRCA1 carriers who opted for surveillance reported having a mammogram within the year following receipt of their genetic test results. Ovarian cancer screening among mutation carriers increased from 0% at baseline to 25% (one of four) at 1 year. Compared to noncarriers (23%, 7/30), carriers (70%, 7/10) were more likely to discuss their BRCA1 test results with their primary health care providers. Surveillance for breast cancer was preferred to prophylactic surgery and chemoprevention as a way to reduce risk for these cancers. Our data indicate that patient-provider communication about BRCA1 test results is suboptimal.     

Effect of personality dimensions on the diurnal pattern of motor activity

The effects of personality dimensions, age, and gender on 24-hour motor activity patterns were studied in 101 healthy subjects between 20-70 years. We measured motor activity by wrist-actigraphy and personality dimensions by the Tridimensional Personality Questionnaire (TPQ) of Cloninger. Random Regression Models were used to estimate the effects of personality dimensions, age, and gender on the diurnal pattern of motor activity. Harm Avoidance as well as Reward Dependence influenced the overall level of motor activity, independent of age and gender. Subjects high on Harm Avoidance showed lower activity levels than subjects low on Harm Avoidance, whereas subjects high on Reward Dependence had higher overall levels of motor activity than subjects low on Reward Dependence. Older subjects were found to be less active than younger subjects, but the activity level did not differ between males and females.     

Longitudinal direct and indirect pathways linking older sibling competence to the development of younger sibling competence

A 4-wave longitudinal model tested direct and indirect links between older sibling (OS; M = 11.7 years) and younger sibling (YS; M = 9.2 years) competence in 152 rural African American families. Data were collected at 1-year intervals. At each wave, different teachers assessed OS competence, YS competence, and YS self-regulation. Mothers reported their own psychological functioning; mothers and YSs reported parenting practices toward the YS. OS competence was stable across time and was linked with positive changes in mothers' psychological functioning from Wave 1 to Wave 2. Mothers' Wave 2 psychological functioning was associated with involved-supportive parenting of the YS at Wave 3. OS Wave 2 competence and Wave 3 parenting were indirectly linked with Wave 4 YS competence, through Wave 3 YS self-regulation. Structural equation modeling controlled for Wave 1 YS competence; thus, the model accounted for change in YS competence across 3 years.     

Investigating biases in trainee counsellors' attitudes to clients from different cultures

Two studies were conducted to explore the assumption that trainee counsellors who are members of the indigenous population will exhibit biased attitudes when they are confronted with the case-history of clients from other ethnic groups. Dependent measures included a structured methodology and free-response methods. This evidence indicates that respondents showed more favourable patterns of attribution for White clients than for clients from three other ethnic groups (Asian, Jewish and West Indian). There appeared to be discrimination in the biased attributions for particular out-group clients.     

Is personality disorder inherited? An overview of the evidence

Genetic factors appear to be of considerable importance in determining normal variation in personality. This is suggested by family, twin, and adoption studies as well as by indirect findings based on animal and psychophysiological studies. In contrast, there is consistent evidence that the contribution of shared family environment is minimal. Despite difficulties in defining personality disorder, it appears that many types of personality disorder, in particular schizotypal personality disorder and antisocial personality disorder/criminality, are also influenced genetically. The genetic transmission of normal personality traits and disorder is most easily explained by the contribution of multiple genes of small effect rather than by single-gene inheritance. Recent advances in molecular genetics have led to the localization of genes of minor effect for some traits. This raises the possibility of detecting a molecular basis of traits and disorders such as personality and personality disorder.Anita Thapar is supported by a Research Training Fellowship from the Medical Research Council.     

Herzl,Ahad Ha-'Am,and Berdichevsky: Comments on their nationalist concepts

This paper was conceived and written when I was a fellow at the Annenberg Research Institute, Philadelphia, Pennsylvania.     

A conceptual overview of selected consultation models

Because of their current popularity and utility 4 consultation models have been selected for analysis: consultee centered, group process, social action, and ecological (exemplified by Gerald Caplan, Ronald Lippitt, Saul Alinsky, and James Kelly, respectively). The process of consultation as outlined by these models is described along the following dimensions: definitions of consultation, self-perceptions of the consultant, target populations, motivation of the client system, entry, goals, diagnosis, techniques, termination, and evaluation. The discussion focuses on criteria for selecting an appropriate consultation model.     

DFC-algorithms for Suszko logic and one-to-one Gentzen type formalizations

We use here the notions and results from algebraic theory of programs in order to give a new proof of the decidability theorem for Suszko logic SCI (Theorem 3).We generalize the method used in the proof of that theorem in order to prove a more general fact that any prepositional logic which admits a cut-free Gentzen type formalization is decidable (Theorem 6).We establish also the relationship between the Suszko Logic SCI, one-to-one Gentzen type formalizations and deterministic and algorithmic regular languages (Remark 2 and Theorem 7, respectively).