Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Contributions of striatal subregions to place and response learning

The involvement of different subregions of the striatum in place and response learning was examined using a T-maze. Rats were given NMDA lesions of the dorsolateral striatum (DLS), anterior dorsomedial striatum (ADMS), posterior dorsomedial striatum (PDMS), or sham surgery. They were then trained to retrieve food from the west arm of the maze, starting from the south arm, by turning left at the choice point. After 7 d of training, with four trials a day, a probe test was given in which the starting arm is inserted as the north arm, at the opposite side of the maze. A left turn would indicate a "response" strategy; a right turn, a "place" strategy. The rats were then trained for 7 more days, followed by a second probe test. Unlike rats in the other groups, most of the rats in the PDMS group turned left, using the response strategy on both probe tests. These results suggest that the PDMS plays a role in spatially guided behavior.     

Infants' comprehension of toy replicas as symbols for real objects

Infants' understanding of toy model-real exemplar relations was assessed through preferential looking and habituation tasks. Results from the preferential looking task suggest that 18-month toddlers are just beginning to demonstrate comprehension of symbolic relations between iconic models and their real object counterparts. Performance of 10- and 14-month-old infants in the preferential looking task did not improve when across-domain pairs of videos were used in place of within-domain pairs. Habituation task results indicated that 10-month-olds do not comprehend symbolic relations between miniature toy replicas and their "real" counterparts, but that such understanding begins to emerge by age 14 months. Interactions between symbolic processing and early lexical development are considered, as are methodological implications for the study of infant categorization.     

Normative data for the selective reminding test: a random digit dialing sample

Healthy control participants (46 women, M age=44.3 yr., SD=7.6; 29 men) were recruited to undergo a comprehensive neuropsychological battery and serve as a comparison group in a study of cognitive functioning in patients with Lyme isease. Participants were selected using Mitofsky-Waksberg random digit dialing. The Buschke 12-word, six-trial Selective Reminding Test was administered as part of the neuropsychological battery and normative data are presented stratified by age and sex. Performance on alternate forms of this measure were examined. Mean education, intelligence quotient, and Wide Range Achievement Test-3 Reading scores are reported.     

Relational integration, inhibition, and analogical reasoning in older adults

The difficulty of reasoning tasks depends on their relational complexity, which increases with the number of relations that must be considered simultaneously to make an inference, and on the number of irrelevant items that must be inhibited. The authors examined the ability of younger and older adults to integrate multiple relations and inhibit irrelevant stimuli. Young adults performed well at all but the highest level of relational complexity, whereas older adults performed poorly even at a medium level of relational complexity, especially when irrelevant information was presented. Simulations based on a neurocomputational model of analogical reasoning, Learning and Inference with Schemas and Analogies (LISA), suggest that the observed decline in reasoning performance may be explained by a decline in attention and inhibitory functions in older adults.     

How learning one category influences the learning of another: intercategory generalization based on analogy and specific stimulus information

We investigated the effect of learning one category structure on the learning of a related category structure. Photograph-name combinations, called identifiers, were associated with values of four demographic attributes. Two problems were related by analogous demographic attributes, common identifiers, or both to examine the impact of common identifier, related general characteristics, and the interaction of the two variables in mediating learning transfer from one category structure to another. Problems sharing the same identifier information prompted greater positive transfer than those not sharing the same identifier information. In contrast, analogous defining characteristics in the two problems did not facilitate transfer. We computed correlations between responses to first-problem stimuli and responses to analogous second-problem stimuli for each participant. The analogous characteristics produced a tendency to respond in the same way to corresponding stimuli in the two problems. The results support an alignment between category structures related by analogous defining characteristics, which is facilitated by specific identifier information shared by two category structures.     

The costs and benefits of tonal centers for chord processing

Harmonic priming studies have shown that a musical context, with its established tonal center, influences target chord processing. This study investigated costs and benefits of priming tonal centers for target processing by adding a baseline condition (sequences without a specific tonal center). Results confirmed harmonic priming, with faster processing for related than for unrelated and less related targets (tonic chord, out-of-key chord, subdominant chord). Comparing targets in baseline contexts with targets in sequences with well-established tonal centers revealed a benefit of processing for related targets but a cost of processing for unrelated and less related targets. Findings are discussed in terns of tonal knowledge activation and suggest that an activated tonal center gives rise to strong expectations for the tonic.     

Selective deficit of motor imagery as tapped by a left-right decision of visually presented hands

This paper presents the case of MT, a patient suffering from apraxia with left-hemisphere damage who showed a selective deficit in mentally rotating images of hands whereas he was still able to mentally rotate other visual stimuli. The deficit was particularly evident when MT was asked to decide which hand (left or right) was represented in a picture. suggested that in order to carry out this task, participants would mentally rotate a representation of their own body part until it aligns with the stimulus and it does appear that MT's ability to mentally simulate movements is impaired. In contrast, he was able to mentally rotate other forms of bi- and three-dimensional stimuli. Our findings are also consistent with proposal that there are at least two ways in which objects can be mentally rotated, one that recruits processes devoted to motor preparation (e.g., hands), and another that does not.     

Effects of experience on fetal voice recognition

Abstract - The ability of human fetuses to recognize their own mother's voice was examined. Sixty term fetuses were assigned to one of two conditions during which they were exposed to a tape recording of their mother or a female stranger reading a passage. Voice stimuli were delivered through a loudspeaker held approximately 10 cm above the maternal abdomen and played at an average of 95 dB SPL. Each condition consisted of three 2-min periods: no stimulus, voice (mother or stranger), and no stimulus. Fetal heart rate increased in response to the mother's voice and decreased in response to the stranger's; both responses were sustained for 4 min. The finding of differential behavior in response to a familiar versus a novel voice provides evidence that experience influences fetal voice processing. It supports an epigenetic model of speech perception, presuming an interaction between genetic expression of neural development and species-specific experience.     

The experience of spirituality in the psycho-social adaptation of cancer survivors

This article presents the results of a retrospective, phenomenological study of the experience of spirituality in the psychosocial adaptation of cancer survivors. The experience of illness for the participants in the study is one which promotes greater personal and spiritual growth. The study demonstrates that illness provokes personal growth and transformation in the individual. While making use of pre-existing coping resources, the person with cancer reevaluates and restructures her or his life, integrating new values, priorities, and perspectives which lead the patient to invest her or his life in something meaningful and beneficial to others.