Development and Evaluation of a Decision Aid for BRCA Carriers with Breast Cancer

BRCA+ breast cancer patients face high risk for a second breast cancer and ovarian cancer. Helping these women decide among risk-reducing options requires effectively conveying complex, emotionally-laden, information. To support their decision-making needs, we developed a web-based decision aid (DA) as an adjunct to genetic counseling. Phase 1 used focus groups to determine decision-making needs. These findings and the Ottawa Decision Support Framework guided the DA development. Phase 2 involved nine focus groups of four stakeholder types (BRCA+ breast cancer patients, breast cancer advocates, and genetics and oncology professionals) to evaluate the DA's decision-making utility, information content, visual display, and implementation. Overall, feedback was very favorable about the DA, especially a values and preferences ranking-exercise and an output page displaying personalized responses. Stakeholders were divided as to whether the DA should be offered at-home versus only in a clinical setting. This well-received DA will be further tested to determine accessibility and effectiveness.     

Alternative Measures of American National Identity: Implications for the Civic‐Ethnic Distinction

Studies of national identity distinguish between ethnic and civic nations and have sought to identify these alternative conceptions of national identity in public opinion. The standard measurement technique is to assess the normative content of American national identity by asking survey respondents to rate the importance of particular traits for making someone a “true” American. We argue that such measures are problematic, chiefly because of the impact of nonrandom measurement error. We explore the influence of using ranking measures instead of ratings, using a survey experiment conducted on a nationally representative sample of Americans in 2008. The ranking method is superior for distinguishing between ethnic and civic conceptions of nationhood and, therefore, for predicting preferences on issues such as immigration policy. We develop a new statistical method that effectively “converts” ratings into scores that approximate rankings, resulting in the creation of more valid measures of both ethnic and civic national identities.     

Are imaging and lesioning convergent methods for assessing functional specialisation?: investigations using an artificial neural network

This article presents an investigation of the relationship between lesioning and neuroimaging methods of assessing functional specialisation, using synthetic brain imaging (SBI) and lesioning of a connectionist network of past-tense formation. The model comprised two processing ‘routes’: one was a direct route between layers of input and output units, while the other, indirect, route featured an intermediate layer of processing units. Emergent specialisation within the network was assessed (1) by lesioning either the direct or indirect route and measuring past-tense performance for regular and irregular verbs, and (2) by measuring functional activation in each route when processing each verb type (SBI). SBI and lesioning approaches failed to converge when network activation was summed over each route in our SBI approach. Examination of individual network solutions suggested that the verb types might be using the indirect route differently in terms of the pattern of activation across the route, rather than in terms of gross activation. A subsequent SBI analysis compared patterns of activation in the indirect route and confirmed that these patterns were more similar between regular-type verbs than between regular and irregular verbs. As the spatial and temporal resolution of neuroimaging techniques improves, the results of this investigation suggest that the key to finding functional specialisation will be to distinguish local coding differences across behaviours that are the results of developmental processes. Other analyses suggest that lesioning data may be limited because, with increasing damage, they reveal the resting activations of a computational system rather than a computational specialisation per se.     

Examining predictors of physical activity among inactive middle-aged women: an application of the health action process approach

This study tested several relationships predicted by the Health Action Process Approach (HAPA) in a sample of 175 generally healthy, inactive, middle-aged women (40-65 yrs old) over a 12 week period. Participants' physical activity, risk perceptions, outcome expectancies, action self-efficacy and intention were measured at baseline. Planning and maintenance self-efficacy were measured 4 weeks later. Physical activity behaviour was measured 12 weeks after baseline. The HAPA relationships were examined using a structural equation model. The data fit the model well and revealed several significant relationships. Action self-efficacy was the best predictor of intention. Maintenance self-efficacy was the best predictor of planning and behaviour. Contrary to the tenets of HAPA and to past research, planning did not predict behaviour. Overall, HAPA provides a useful framework for identifying determinants of physical activity intentions and behaviour within a group of inactive, middle-aged women.     

Memory Conformity for New and Old Items with Immediate and Delayed Testing

Memory conformity for images was examined using a mixed factorial design. Participants were presented with 50 images then later completed an old/new recognition test on these plus 50 fillers. Some received post‐event information (PEI) attributed to a co‐witness that was introduced either soon after the original 50 images were presented or 2 days later. The memory test was either soon after the co‐witness PEI was shown or 2 days later. When the memory test was 2 days after receiving PEI, the PEI had no effect. PEI had a large effect when presented just before testing. The memory conformity effect was largest when PEI was presented, and the when memory test was completed 2 days after the initial presentation. Memory conformity effects were larger for new items than for old when PEI immediately preceded the test. Thus, the PEI affected the false alarm rate more than the hit rate. Copyright © 2012 John Wiley & Sons, Ltd.     

Subliminal access to abstract face representations does not rely on attention

The present study used masked repetition priming to examine whether face representations can be accessed without attention. Two experiments using a face recognition task (fame judgement) presented masked repetition and control primes in spatially unattended locations prior to target onset. Experiment 1 (n=20) used the same images as primes and as targets and Experiment 2 (n=17) used different images of the same individual as primes and targets. Repetition priming was observed across both experiments regardless of whether spatial attention was cued to the location of the prime. Priming occurred for both famous and non-famous targets in Experiment 1 but was only reliable for famous targets in Experiment 2, suggesting that priming in Experiment 1 indexed access to view-specific representations whereas priming in Experiment 2 indexed access to view-invariant, abstract representations. Overall, the results indicate that subliminal access to abstract face representations does not rely on attention.     

Phosphodiesterase type 5 (PDE5) inhibition improves object recognition memory: indications for central and peripheral mechanisms

A promising target for memory improvement is phosphodiesterase type 5 (PDE5), which selectively hydrolyzes cyclic guanosine monophosphate (cGMP). In rodents, PDE5 inhibitors (PDE5-Is) have been shown to improve memory performance in many behavioral paradigms. However, it is questioned whether the positive effects in animal studies result from PDE5 inhibition in the central nervous system or the periphery. Therefore, we studied the effects of PDE5 inhibition on memory and determined whether compound penetration of the blood-brain barrier (BBB) is required for this activity. Two selective PDE5-Is, vardenafil and UK-343,664, were tested in the object recognition task (ORT) in both a MK-801- and scopolamine-induced memory deficit model, and a time-delay model without pharmacological intervention. Compounds were dosed 30 min before the learning trial of the task. To determine if the PDE5-Is crossed the BBB, their concentrations were determined in plasma and brain tissue collected 30 min after oral administration. Vardenafil improved object recognition memory in all three variants of the ORT. UK-343,664 was ineffective at either preventing MK-801-induced memory disruption or time-dependent memory decay. However, UK-343,664 attenuated the memory impairment of scopolamine. Vardenafil crossed the BBB whereas UK-343,664 did not. Further, co-administration of UK-343,664 and scopolamine did not alter the brain partitioning of either molecule. This suggests that the positive effect of UK-343,664 on scopolamine-induced memory decay might arise from peripheral PDE5 inhibition. The results herein suggest that there may be multiple mechanisms that mediate the efficacy of PDE5 inhibition to improve memory performance in tasks such as the ORT and that these involve PDE5 located both within and outside of the brain. To further elucidate the underlying mechanisms, the cellular and subcellular localization of PDE5 needs to be determined.     

Extended practice of reciprocal wrist and arm movements of varying difficulties

An experiment was designed to determine the degree to which reciprocal aiming movements of the wrist and arm with various accuracy requirements (Fitts' tasks) are enhanced by extended practice. The vast majority of research on motor learning shows performance improvement over practice. However, literature examining the effect of practice on Fitts' task performance is limited and inconclusive. Participants were asked to flex/extend their limb/lever in the horizontal plane at the wrist (arm stabilized) or elbow joint (wrist stabilized) in an attempt to move back and forth between two targets as quickly and accurately as possible. The targets and current position of the limb were projected on the screen in front of the participant. Target width was manipulated with amplitude constant (16°) in order to create indexes of difficulty (ID) of 1.5, 3, 4.5, and 6. Contrary to the earlier reports, after 20 days of practice, we found minimal changes in movement time or the movement time-ID relationships for the arm and wrist over practice. However, the variability in the movement endpoints decreased over practice and wrist movements at ID=6 were characterized by shorter movement times and longer dwell times relative to arm movements with dwell time for the wrist increasing over practice. These data are consistent with the notion that Fitts' tasks provide a stable measure of perceptual-motor capabilities.