A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

"Shhh! We're tryin' to concentrate": attention and environmental distracters in novel word learning

The authors' purpose in this study was to evaluate the role of attention, as a central dimension of temperament, in children's real-time acquisition of novel vocabulary. Environmental distractions were administered to 47 22-month-old children as they acquired novel vocabulary in a fast-mapping task. Two distraction conditions impeded novel word acquisition, but only 1 impeded attention allocation. Attention allocation was correlated with novel word acquisition under conditions of distraction, but not in their absence. Results suggest that attention allocation is especially important for word learning under conditions of distraction. Given that in their day-to-day lives children often encounter new words amid a host of environmental distractions, children with constitutionally fewer attentional resources, such as temperamentally difficult children, may be at a vocabulary-learning disadvantage.     

Tenderness and Steadiness: Relating Job and Interpersonal Demands and Resources With Burnout and Physical Symptoms of Stress in Canadian Physicians

This study examined the extent to which job and interpersonal demands and resources are associated with burnout and physical symptoms of stress among Canadian physicians. Using the job demands‐resources (JD‐R) model, we predicted that demands would be more strongly related to emotional exhaustion and physical symptoms, whereas resources would be more strongly related to personal accomplishment and decreased depersonalization. The findings reveal that communication skills and emotional labor contributed to the explained variances beyond workload and work–life conflict (as job demands), as well as autonomy, predictability, and understanding (as job resources). The predictors were differentially associated with the outcome variables in a manner that is consistent with the JD‐R model. Implications for physician well‐being and improved patient outcomes are discussed.     

The exponential learning equation as a function of successful trials results in sigmoid performance

While the exponential learning equation, indicating a gradually diminishing improvement, is one of the standard equations to describe learning, a sigmoid behavior with initially increasing then decreasing improvement has also been suggested. Here we show that the sigmoid behavior is mathematically derived from the standard exponential equation when the independent variable of the equation is restricted to the successful trials alone. It is suggested that for tasks promoting success-based learning, performance is better described by the derived sigmoid curve.     

Prospective memory: The relative effects of encoding,retrieval, and the match between encoding and retrieval

Previous prospective memory studies have revealed some important features of encoding, retrieval, and the match between the encoding and the retrieval that contribute to prospective memory performance. However, these studies have not provided evidence concerning the relative importance of these three factors because no study has investigated all three in a single design. We developed a laboratory-based paradigm that allowed us to manipulate different characteristics of encoding, retrieval, and the match between encoding and retrieval simultaneously in a single experiment. The results of eight experiments showed that all three factors have an influence on prospective memory performance, but that the match between encoding and retrieval has a significantly larger influence than either encoding or retrieval factors.     

More than One Way to be Happy: A Typology of Marital Happiness

This study utilized observational and self‐report data from 57 happily married couples to explore assumptions regarding marital happiness. Suggesting that happily married couples are not a homogeneous group, cluster analyses revealed the existence of three types of couples based on their observed behaviors in a problem‐solving task: (1) mutually engaged couples (characterized by both spouses' higher negative and positive problem‐solving); (2) mutually supportive couples (characterized by both spouses' higher positivity and support); and (3) wife compensation couples (characterized by high wife positivity). Although couples in all three clusters were equally happy with and committed to their marriages, these clusters were differentially associated with spouses' evaluations of their marriage. Spouses in the mutually supportive cluster reported greater intimacy and maintenance and less conflict and ambivalence, although this was more consistently the case in comparison to the wife compensation cluster, as opposed to the mutually engaged cluster. The implications of these typologies are discussed as they pertain to efforts on the part of both practitioners to promote marital happiness and repair marital relations when couples are faced with difficulties.     

The Effect of Perceived Locomotor Constraints on Distance Estimation

Two experiments were conducted to examine the ways in which the visual estimation of distance to a target is affected by constraints perceived to be placed on the subsequent locomotion to the target without vision. We hypothesized that an appraisal of impending effort would play a role in ascertaining the distance to be walked. In Experiment 1, the amount of resistance to walking was variable and unpredictable. One group of subjects performed against relatively low resistance, whereas another group performed against substantially greater resistance. In the low-resistance condition, no significant differences in CE, VE, time to target, or number of steps to target were found between any of the eight combinations of predictable or unpredictable resistances during walking. In the high-resistance condition, however, significant differences were found for CE and number of strides to target when resistance varied unpredictably during walking. Experiment 2 was similar in design but required subjects to walk with combinations of normal or short steps after they had viewed the target knowing only the gait type that would be used to begin locomotion. No differences in CE, VE, or time to target were found between four different combinations of gait type and predictability, under subjectively controlled conditions. When the step constraints were externally imposed, however, differences were found for CE. None of the results from either experiment, in which the number of strides needed to reach the target or the predictability of gait did not change from normal, supported the hypothesis that motor output requirements are necessary in forming a mental representation of the target position that can be used to walk to the target with eyes closed. Whichever locomotor technique was used to walk the estimated distance in these cases, the representation was able to be used independently. When walking mechanics were altered by externally imposed constraints, however, the success at reaching the estimated target position was reduced. These latter results are consistent with those obtained using up, down, and level walking and support the premise that mental representations used in blind walking are linked to the locomotor mechanics afforded by environmental conditions.