Genetic Risk Assessment for Women with Epithelial Ovarian Cancer: Referral Patterns and Outcomes in a University Gynecologic Oncology Clinic

Little is known about genetic service utilization and ovarian cancer. We identified the frequency and outcome of genetic counseling referral, predictors of referral, and referral uptake for ovarian cancer patients. Using pathology reports, we identified all epithelial ovarian cancer patients seen in a university gynecologic oncology clinic (1/04–8/06). Electronic medical records (EMR) were used to document genetic service referral, time from diagnosis-to-referral, point-in-treatment at referral, personal/family cancer history, demographics, and genetic test results. Groups were compared using chi-squared and Fisher’s exact test for categorical variables and t-tests for continuous variables. The study population consisted of 376 women with ovarian cancer, 72 (19 %) of who were referred for genetic counseling/testing, primarily during surveillance. Of those referred, 42 (58 %) had personal or family genetic counseling and 34 (47 %) were ultimately tested or identified due to known family mutation. Family history and prior cancer were associated with referral. Family history, living in a larger community, higher-stage disease, and serous histology were associated with undergoing genetic counseling. Risk assessment identified 20 BRCA1/2 (5.3 %) and 1 HNPCC (0.3 %) mutation carriers. Based on recent estimates that 11.7–16.6 % of women with ovarian cancer are BRCA carriers and 2 % are HNPCC carriers, results suggest under-identification of carriers and under-utilization of genetic services by providers and patients. Interventions to increase medical providers’ referrals, even in a specialized oncology clinic, are necessary and may include innovations in educating these providers using web-based methods. Ease of referral by the introduction of an electronic cancer genetic referral form represents another new direction that may increase genetic risk assessment for high-risk women with ovarian cancer.     

Study strategies and beliefs about learning as a function of academic achievement and achievement goals

Prior research by Hartwig and Dunlosky [(2012). Study strategies of college students: Are self-testing and scheduling related to achievement? Psychonomic Bulletin &; Review, 19(1), 126–134] has demonstrated that beliefs about learning and study strategies endorsed by students are related to academic achievement: higher performing students tend to choose more effective study strategies and are more aware of the benefits of self-testing. We examined whether students’ achievement goals, independent of academic achievement, predicted beliefs about learning and endorsement of study strategies. We administered Hartwig and Dunlosky’s survey, along with the Achievement Goals Questionnaire [Elliot, A. J., &; McGregor, H. A. (2001). A 2 × 2 achievement goal framework. Journal of Personality &; Social Psychology, 80, 501–519] to a large undergraduate biology course. Similar to results by Hartwig and Dunlosky, we found that high-performing students (relative to low-performing students) were more likely to endorse self-testing, less likely to cram, and more likely to plan a study schedule ahead of time. Independent of achievement, however, achievement goals were stronger predictors of certain study behaviours. In particular, avoidance goals (e.g., fear of failure) coincided with increased use of cramming and the tendency to be driven by impending deadlines. Results suggest that individual differences in student achievement, as well as the underlying reasons for achievement, are important predictors of students’ approaches to studying.     

Body-image,quality of life and psychological distress: a comparison between kidney transplant patients and a matching healthy sample

The purpose of the current study was to assess the uniqueness of the condition of kidney transplant recipients in comparison to a sample of matching healthy peers in relation to body-image dissatisfaction and identification, quality of life and psychological distress. Participants were 45 kidney transplant recipients who were under follow-up care at a Transplant Unit of a major Medical Center, and a sample of 45 matching healthy peers. Measures were taken using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Body Identification Questionnaire (BIQ), Brief Symptoms Inventory (BSI), and the SF-12]. The major findings were the following: (i) kidney transplant recipients reported lower levels of quality of life and higher levels of PsD when compared to their healthy peers; (ii) no difference in body-image dissatisfaction was found between the two studied groups; (iii) significant correlations between body-image dissatisfaction quality of life and PsD were found only in the kidney transplant recipients. The kidney transplantation condition has a moderating effect in the association between body-image dissatisfaction PsD but not in the association between body-image dissatisfaction and quality of life; (iv) kidney transplant recipients experienced higher levels of body identification than did their healthy peers. Taken together, these findings highlight the unique condition of kidney transplant recipients, as well as the function that body-image plays within the self.     

Generalization of relative competence mediating conformity across differing tasks

Subject correctness and group agreement were initially varied for college subjects performing a multiple-choice informational task (Canadian Knowledge Inventory). On a subsequent perceptual task (Raven's Standard Progressive Matrices), the dependent variable of conformity was assessed to examine generalization of relative competence formed on the informational task. It was seen that: (1) Those who perceived themselves to be less competent than the group on the first task exhibited the greatest level of conformity on the second task, thus replicating previous research on perceived relative competence as a determinant of conformity; (2) suspicion reduced conformity.     

Prompting a consumer behavior for pollution control

A field application of behavior modification studied the relative effectiveness of different prompting procedures for increasing the probability that customers entering a grocery store would select their soft drinks in returnable rather than nonreturnable containers. Six different 2-hr experimental conditions during which bottle purchases were recorded were (1) No Prompt (i.e., control), (2) one student gave incoming customers a handbill urging the purchase of soft drinks in returnable bottles, (3) distribution of the handbill by one student and public charting of each customer's bottle purchases by another student, (4) handbill distribution and charting by a five-member group, (5) handbills distributed and purchases charted by three females. The variant prompting techniques were equally effective, and in general increased the percentage of returnable-bottle customers by an average of 25%.     

Conformity as a function of task generalization and relative competence

Subject correctness and group agreement were varied for college subjects engaged in a light discrimination task. On another task, employing multiple-choice questions about Canada, the dependent variable of conformity was assessed to examine generalization of relative competence formed on the light discrimination task. It was seen that (1) relative competence was seen to mediate conformity for a specific task (Canadian Knowledge Inventory), but did not generalize across tasks (i.e. from the light discrimination task to the Canadian Knowledge Inventory); (2) with respect to the Canadian Knowledge Inventory, subjects who perceived themselves as more competent than the group did not conform as much as those who either perceived themselves as less competent than or as competent as the group; (3) the experimental manipulations did not affect conformity, further supporting the findings that perceived competence does not generalize across classes of tasks; (4) females conformed more than males: and (5) nonsuspicious subjects conformed more than suspicious subjects.