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.     

Possible knowledge of unknown truth

Fitch’s argument purports to show that for any unknown truth, p, there is an unknowable truth, namely, that p is true and unknown; for a contradiction follows from the assumption that it is possible to know that p is true and unknown. In earlier work I argued that there is a sense in which it is possible to know that p is true and unknown, from a counterfactual perspective; that is, there can be possible, non-actual knowledge, of the actual situation, that in that situation, p is true and unknown. Here I further elaborate that claim and respond to objections by Williamson, who argued that there cannot be non-trivial knowledge of this kind. I give conditions which suffice for such non-trivial counterfactual knowledge.     

The Relation between Individual and Group Conflicts in Psychotherapy

Abstract

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference–countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconsciousaswellasconscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.     

The Development of Children's Concepts of Hardness

This study was conducted for three purposes. First, we assessed the development of children's concepts of hardness as an intensive physical quantity. We hypothesized a U-shaped behavioral growth curve for children's judgments on tasks measuring intensive physical quantity, but the hypothesis was not confirmed. The justifications accompanying correct and incorrect judgments for hardness were similar to those where U-shaped behavioral growth was found for other intensive physical quantities (temperature and sweetness). The second purpose was to determine how children solve seriation and transitivity tasks where hardness was the content. More older than younger children solved these tasks, and the transitivity task was correctly solved after the seriation task was correctly solved. One pattern of solutions for transitivity and intensive physical quantity allowed for differentiation between younger and older children who solved the intensivity tasks correctly. The third purpose was to determine whether children think that objects' hardnesses are labile (i.e., hard objects can become soft and vice versa) by simply adding more of that substance. More younger than older children thought that this was true     

The Baby Boomers Meet Menopause: Fertility, Attractiveness, and Affective Response to the Menopausal Transition

The purpose of this study was to identify social factors that affect women’s concerns about menopause. Data from a sample of 1,037 baby-boomer women who took part in two waves of the Midlife in the United States survey (MIDUS) were utilized. Two waves of survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women’s concerns about the effects of menopause on attractiveness, fertility, and the cessation of menstruation were examined. Analyses were replicated in Wave I and II of the study. Women who occupied multiple roles had fewer concerns about the loss of fertility. Women who had more symptoms were significantly more concerned about the effects of menopause on attractiveness. Concerns about the effects of menopause were also related significantly to women’s age, education, and financial security.