Providers’ Perceptions and Practices Regarding <Emphasis Type="BoldItalic">BRCA1/2</Emphasis> Genetic Counseling and Testing in African American Women

We examined healthcare providers’ perceptions of genetic counseling and testing in African American women at moderate to high-risk of carrying a BRCA1/2 mutation. We conducted 20 in-depth interviews with genetic counselors (n = 5), medical oncologists (n = 8), obstetrician/gynecologists (n = 2) and surgeons (n = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers’ perceptions of African American women’s use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient-provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual- and system-level barriers to African American women’s use of genetic services, including lack of follow-up after referrals to genetic specialists and challenges to obtaining financial coverage for under- and uninsured high-risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at-risk African American women.     

Caudate nucleus-dependent response strategies in a virtual navigation task are associated with lower basal cortisol and impaired episodic memory

The present research examined the relationship between endogenous glucocorticoids, navigational strategies in a virtual navigation task, and performance on standard neuropsychological assessments of memory. Healthy young adult participants (N = 66, mean age: 21.7) were tested on the 4 on 8 virtual maze (4/8 VM) and standard neuropsychological tests such as the Rey-Osterrieth Complex Figure (RO) and the Rey Auditory Verbal Learning Task (RAVLT), which measure episodic memory. The 4/8 VM differentiates between navigational strategies, where participants either use a hippocampal-dependent spatial strategy by building relationships between landmarks, or a caudate nucleus-dependent stimulus–response strategy by automatizing a pattern of open and closed arms to learn the location of objects within the maze. Degree of stress was assessed by administering the Perceived Stress Scale (PSS) questionnaire. Cortisol samples were taken on two consecutive days upon waking, 30 min after waking, at 11 am, 4 pm, and 9 pm. There was a significant difference in basal levels of cortisol between spatial and response learners. Interestingly, response learners had significantly lower cortisol levels throughout the day. The two groups did not differ in terms of perceived stress as measured with the PSS questionnaire. Moreover, there was no significant correlation between PSS scores and salivary cortisol levels, indicating that the higher cortisol levels in the spatial group were not associated with greater perceived stress. In addition, participants who spontaneously used a spatial strategy performed significantly better on the RAVLT and RO. These data indicate that the cortisol levels in the spatial group may be optimal in terms of episodic memory performance whereas the cortisol levels in the response group may be associated with poorer memory. These results are suggestive of an inverted U-shaped curve describing the effects of basal levels of circulating cortisol on memory in young adults.     

Effects of action planning and coping planning within the theory of planned behaviour: A physical activity study of patients undergoing haemodialysis

Objective

Patients on dialysis have low physical activity levels. The aim of the study was to examine the validity of action planning and coping planning within the theory of planned behaviour framework, for predicting physical activity behaviour of patients on haemodialysis.

Design

This is a prospective study design.

Methods

One hundred and forty-four patients who were undergoing haemodialysis were selected from dialysis centres. The mean age of the patients was 56.61 (SD = 11.38) years. The patients completed a questionnaire including variables from the theory of planned behaviour, action planning and coping planning. Physical activity was prospectively assessed at 4-weeks with the validated International Physical Activity Questionnaire self-report measure. A hierarchical regression analysis was performed to examine the effects of action planning and coping planning on physical activity behaviour.

Results

There was a main effect for coping planning but not for action planning. Moreover, the analyses resulted in a significant amount of incremental variance accounted for by the interaction of coping planning and intention.

Conclusion

Results suggest the combination of high levels of coping planning and intention is associated with increases in physical activity.     

Virtual muscularity: a content analysis of male video game characters

The 150 top-selling video games were content analyzed to study representations of male bodies. Human males in the games were captured via screenshot and body parts measured. These measurements were then compared to anthropometric data drawn from a representative sample of 1120 North American men. Characters at high levels of photorealism were larger than the average American male, but these characters did not mirror the V-shaped ideal found in mainstream media. Characters at low levels of photorealism were also larger than the average American male, but these characters were so much larger that they appeared cartoonish. Idealized male characters were more likely to be found in games for children than in games for adults. Implications for cultivation theory are discussed.     

Book reviews

Abstract

Boff, K. R., Kaufmann, L., &; Thomas, J. P. (Eds) (1986). Handbook of perception and human performance, Vols 1 and 2. Chichester: John Wiley. ISBN 0-471-88544-4 and 0-471-82957-9. £85.00 and £77.50.

Garnham, A. (1988). Artificial intelligence: An introduction. London: Routledge and Kegan Paul. Pp. 277. ISBN 0-7102-1416-2. £8.95.     

Comparison of DSM-III-R chronic major depression and major depression superimposed on dysthymia (double depression): validity of the distinction

The nosology of chronic depression has become increasingly complex since the publication of the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987), but there are few data available to evaluate the validity of the distinctions between the subtypes of chronic depression. The validity of the distinction between DSM-III-R chronic major depression (CMD) and major depression superimposed on dysthymia (double depression, DD) was examined. Participants were 635 patients with chronic depression in a 12-week trial of antidepressant medications. Patients with CMD, DD, and a 3rd group with a chronic major depressive episode superimposed on dysthymia (DD/CMD) were compared on demographic and clinical characteristics, family history, and response to treatment. Few differences were evident, although the depression of patients with DD/CMD tended to be more severe.     

Secular declines in Spearman's g: some evidence from the United States

The Flynn Effect (J. Flynn, 1987) refers to the apparent increases in intelligence quotient (IQ) observed over the past few decades. A related phenomenon is that the variance in test scores accounted for by Spearman's g (C. Spearman, 1904) varies according to IQ level. That is, g accounts for less variance in high IQ groups than in low IQ groups. Spearman termed this variant aspect of g the "law of diminishing returns." This study extends prior research on the Flynn Effect and the law of diminishing returns by examining changes in the statistical importance of Spearman's g that may accompany secular increases in IQ. Based on the standardization data from the United States versions of the Wechsler scales (i.e., Wechsler Preschool and Primary Scales of Intelligence, D. Wechsler, 1967; Wechsler Intelligence Scale for Children, D. Wechsler, 1949; Wechsler Adult Intelligence Scale, D. Wechsler, 1955), this study indicated that, in most cases, the statistical significance of Spearman's g has indeed declined over the past several years. A. R. Jensen (1998) suggested that the components of the Flynn Effect warrant special investigation. The present study addresses this issue, in part by analyzing the Verbal and Performance subscales of the Wechsler scales. Additionally, this study further confirms the law of diminishing returns as applicable to different ages and time periods.     

The impact of sleep deprivation on decision making: a review

Few sleep deprivation (SD) studies involve realism or high-level decision making, factors relevant to managers, military commanders, and so forth, who are undergoing prolonged work during crises. Instead, research has favored simple tasks sensitive to SD mostly because of their dull monotony. In contrast, complex rule-based, convergent, and logical tasks are unaffected by short-term SD, seemingly because of heightened participant interest and compensatory effort. However, recent findings show that despite this effort, SD still impairs decision making involving the unexpected, innovation, revising plans, competing distraction, and effective communication. Decision-making models developed outside SD provide useful perspectives on these latter effects, as does a neuropsychological explanation of sleep function. SD presents particular difficulties for sleep-deprived decision makers who require these latter skills during emergency situations.     

Do you remember proposing marriage to the Pepsi machine? False recollections from a campus walk

During a campus walk, participants were given familiar or bizarre action statements (e.g., “Check the Pepsi machine for change” vs. “Propose marriage to the Pepsi machine”) with instructions either to perform the actions or imagine performing the actions (Group 1) or to watch the experimenter perform the actions or imagine the experimenter performing the actions (Group 2). One day later, some actions were repeated, along with new actions, on a second walk. Two weeks later, the participants took a recognition test for actions presented during the first walk, and they specified whether a recognized action was imagined or performed. Imagining themselves or the experimenter performing familiar or bizarre actions just once led to false recollections of performance for both types of actions. This study extends previous research on imagination inflation by demonstrating that these false performance recollections can occur in a natural, real-life setting following just one imagining.     

Working memory capacity and fluid intelligence are strongly related constructs: comment on Ackerman, Beier, and Boyle (2005)

The authors agree with P. L. Ackerman, M. E. Beier, and M. O. Boyle (2005; see record 2004-22408-002) that working memory capacity (WMC) is not isomorphic with general fluid intelligence (Gf) or reasoning ability. However, the WMC and Gf/reasoning constructs are more strongly associated than Ackerman et al. (2005) indicate, particularly when considering the outcomes of latent-variable studies. The authors' reanalysis of 14 such data sets from 10 published studies, representing more than 3,100 young-adult subjects, suggests a strong correlation between WMC and Gf/reasoning factors (median r=.72), indicating that the WMC and Gf constructs share approximately 50% of their variance. This comment also clarifies the authors' "executive attention" view of WMC, it demonstrates that WMC has greater discriminant validity than Ackerman et al. (2005) implied, and it suggests some future directions and challenges for the scientific study of the convergence of WMC, attention control, and intelligence.