Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Classification of Antisocial Behaviors Along Severity and Frequency Parameters

Antisocial behaviors were systematically classified along a hierarchy of seriousness or severity that also accounted for frequency of occurrence and heterogeneity of behaviors. Items from the CD and ODD schedules of the NIMH DISC-IV and from the Elliot Delinquency Scales were listed at specified frequencies. Nine mental health clinicians rated the level of seriousness of each alternative on a scale from 0 (trivial) to 5 (very serious). Reliability of the ratings was assessed. Over two thirds of the items showed excellent agreement among the raters, 8% showed poor agreement and 21% showed fair to moderate agreement. The overall reliability of a single rater’s score was 0.56 and the reliability of the average was 0.84. The classification meets high psychometric standards for reliability and has face validity. The final output provides a classification along a spectrum that takes into account severity, frequency of occurrence during the previous year, and presence of multiple behaviors. It is useful for classification purposes and for longitudinal tracking of antisocial behavior.     

Fos protein expression in olfactory-related brain areas after learning and after reactivation of a slowly acquired olfactory discrimination task in the rat

Fos protein immunodetection was used to investigate the neuronal activation elicited in some olfactory-related areas after either learning of an olfactory discrimination task or its reactivation 10 d later. Trained rats (T) progressively acquired the association between one odor of a pair and water-reward in a four-arm maze. Two groups of pseudotrained rats were used: PO rats were not water restricted and were submitted to the olfactory stimuli in the maze without any reinforcement, whereas PW rats were water-deprived and systematically received water in the maze without any odorous stimulation. When the discrimination task was well mastered, a significantly lower Fos immunoreactivity was observed in T rats compared to PW and PO rats in most of the analyzed brain areas, which could reflect the post-acquisition consolidation process. Following memory reactivation, differences in Fos immunoreactivity between trained and some pseudotrained rats were found in the anterior part of piriform cortex, CA3, and orbitofrontal cortex. We also observed that Fos labeling was significantly higher in trained rats after memory reactivation than after acquisition of the olfactory task in most of the brain areas examined. Our results support the assumption of a differential involvement of neuronal networks after either learning or reactivation of an olfactory discrimination task.     

Retrieval improvement is induced by water shortage through angiotensin II

Angiotensin II (ANGII) has an evolutionary preserved role in determining adaptative responses to water-shortages. In addition, it has been shown to modulate diverse phases of memory. Still, it is not clear whether ANGII improves or spoils memory. We demonstrated that endogenous angiotensins enhance consolidation of a long-term associative memory in the crab Chasmagnathus and that water shortage improves memory consolidation through brain ANGII actions. Here, we show that weakly trained crabs, when water-deprived, exhibit enhanced retrieval. Subsequently, memory retention is indistinguishable from that of strongly trained crabs. ANGII, but not angiotensin IV, is a necessary and sufficient condition for such enhancing effect. We conclude that ANGII released due to water shortage leads to enhanced memory retrieval. Thus, it seems that ANGII has an evolutionary preserved role as a multifunction coordinator that enables an adaptative response to water-shortage. The facilitation of memory consolidation and retrieval would be among those coordinated functions.     

Epidemiological Measurement of Children's and Adolescents' Exposure to Community Violence: Working with the Current State of the Science

A number of measures have been used in epidemiological studies of children's exposure to community violence, yet the quality of these instruments is not uniformly good. This paper undertakes a systematic review of the most commonly used (or most promising) self-report or interview-administered instruments, with regard to their conceptual bases and psychometric properties. Based on the review, recommendations are made for working with the current state of the science in order to move the field forward. A key recommendation is for sounder conceptualization of work in the field and greater transparency in the reporting of research, in order to facilitate the comparability of studies.     

Psychosocial adaptation in relatives of critically injured patients admitted to an intensive care unit

The aim of this study is to analyze how the length of time a patient spends in an Intensive Care Unit (ICU) affects close relatives, with regard to specific clinical variables of personality, family relationships and fear of death. The study group consisted of 57 relatives of seriously ill patients admitted to the ICU of "Virgen del Rocío" Rehabilitation and Trauma Hospital (Seville, Spain). The instruments applied were: a psychosocial questionnaire, clinical analysis questionnaire, family environment scale and fear of death scale. The relatives of patients admitted to ICU obtained higher scores in hypochondria, suicidal depression, agitation, anxious depression, guilt-resentment, paranoia, psychasthenia, psychological maladjustment and self-expression, and less in fear of their own death, as when compared to interviews with the same relatives 4 years later. The length of time a patient spent in the ICU influenced relatives in some clinical variables of personality, family relationships and fear of death     

AIDS and social exclusion: personality features or adaptive behaviors?

The purpose of this survey is to detect common personality features in people infected with AIDS who have a case history of drug addiction and who live in a situation of social exclusion. The sample comprised 105 male participants from the Autonomous Community of Andalusia, divided into 4 groups: (a) 30 men with AIDS, having an intravenous drug addiction case history and who live in a condition of social exclusion; (b) 30 men with IVDA case history, also living in a situation of social exclusion; (c) 15 men in a social exclusion condition; and (d) 30 men in a condition of social adaptation. The evaluation instruments were an author-designed semi-structured interview and the Multiaxial Clinical Inventory (MCMI-II; Millon, 1987). Although some differences were found, the results indicate that there is no specific personality profile in the "social exclusion" population. People in a condition of social exclusion (AIDS, drug addicts, and poor people) may obtain similar scores in the variables studied, but there is no clear specific personality profile in the excluded population, although there may be certain situations in which the segregated groups present similar behaviors. Furthermore, these behaviors do not always correspond to personality features but are adaptive responses to a harsh and complex reality.     

Simulation of the filtering role of habituation to stimuli

In the context of a medium-term study designed to integrate the simulation of different types and processes of learning-such as classical, operant, and some cognitive types--one must start with other more elementary ones that are facilitators of the more complex types and processes. Of special interest is habituation, owing to the filtering out of irrelevant stimuli, which means that the simulated agent does not have to respond to them. This paper presents two difference functions constructed to computationally simulate the characteristics that define habituation. The behavior of these functions is described, as are differences arising from stimulus intensity and interstimulus intervals. Results are compared with existing empirical data.     

The immoral gene: Does it really exist?

Over the last years several European patents were opposed for protecting technology violating the morality requirement under Article 53(a) EPC. Attempts have been made by the Appeal Boards of the European Patent Office (EPO), as well as by amendments introduced into the Implementing Regulations of the European Patent Convention (EPC), to address this sensitive patentability requirement more precisely. The most recent hot topic coming up in this context is the patentability of stem cells. It is to be expected that this discussion will still go on in the field of biotechnological inventions for the next several years. An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

An on-line task for contrasting auditory processing in the verbal and nonverbal domains and norms for younger and older adults

Contrasting linguistic and nonlinguistic processing has been of interest to many researchers with different scientific, theoretical, or clinical questions. However, previous work on this type of comparative analysis and experimentation has been limited. In particular, little is known about the differences and similarities between the perceptual, cognitive, and neural processing of nonverbal environmental sounds and that of speech sounds. With the aim of contrasting verbal and nonverbal processing in the auditory modality, we developed a new on-line measure that can be administered to subjects from different clinical, neurological, or sociocultural groups. This is an on-line task of sound to picture matching, in which the sounds are either environmental sounds or their linguistic equivalents and which is controlled for potential task and item confounds across the two sound types. Here, we describe the design and development of our measure and report norming data for healthy subjects from two different adult age groups: younger adults (18–24 years of age) and older adults (54–78 years of age). We also outline other populations to which the test has been or is being administered. In addition to the results reported here, the test can be useful to other researchers who are interested in systematically contrasting verbal and nonverbal auditory processing in other populations.