Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Does handedness influence the strength of phantom limb illusions in the virtual reality box?

Subjects had to judge the size of a tactile stimulus held in the unseen hand, while a visible phantom hand representing that unseen hand held a tactile stimulus of same or different size. No asymmetries in interference effects were found that could be related to hand or handedness. The method lends itself to quantification of virtual reality box illusions and can be used to evaluate the role of experience and sources of variability in the strength of the illusion across subjects.     

Houses built on sand: effects of exemplar stability on susceptibility to attitude change

Attitude representation theory (C. G. Lord & M. R. Lepper, 1999) explains both attitude-behavior consistency and attitude change with the same principles. When individuals respond evaluatively to an attitude object, they activate and combine assumptions about the attitude object with perceptions of the immediate situation. The assumptions activated can vary across time, even without additional information. Previous research has shown that individuals activate exemplars when answering attitude questions, attitude reports vary with the valence of the assumptions activated, and activating differently liked exemplars reduces attitude-behavior consistency. The present research completed study of the theoretical implications of exemplar stability by showing that individuals with temporally unstable exemplars, whether spontaneous (Experiment 1) or manipulated (Experiments 2 and 3), are more susceptible to subsequent attitude change than are individuals with stable exemplars.     

The Hours: Between Safety and Servitude

This paper explores the issue of how character is created and re-created in the context of relationships. This theme, salient in the recent film The Hours, has been particularly problematic for creative women, who are often caught in tensions between self-development and relationship. Two case examples are given, in counterpoint to the film and to illustrations from Woolf's life and work. Through these various lenses, we can consider the complex interplays between our conjectures as to the expected price of relationship, and the actual price exacted as our various dramas unfold.     

Part-whole practice of movement sequences

A 16-element movement sequence was taught under part-whole and whole-practice conditions. Participants (N = 18) produced a right-arm lever movement to sequentially presented target locations. The authors constructed part-whole practice by providing practice on only the 1st 8 elements on the 1st day of practice (100 repetitions of the 8-element sequence) and on all 16 elements on the 2nd day of practice (100 repetitions of the 16-element sequence). The whole-practice group practiced all 16 elements on both days (100 repetitions of the 16-element sequence per day). No differences in sequence structure or in movement duration of the 16-element sequence were noted on the retention test (Day 3). On transfer tests in which the 1st and last 8 elements were tested separately, however, the participants in the part-whole practice group performed more quickly than the participants in the whole-practice group, especially on the last 8 elements. Participants in the whole-practice group appeared to code the sequence so that it was relatively difficult to fully partition it into separate movements. Thus, on the transfer tests, there continued to be residual effects of the 8 elements that did not have to be produced but slowed down the rate of responding for the whole-practice group. That finding was not observed for the part-whole practice group.     

Visual identification and spatial location in Alzheimer's disease

Twelve patients with Alzheimer's disease (AD) and 15 healthy elderly control subjects were shown sets of luminance-defined letters, texture-defined letters, luminance-defined squares, and texture-defined squares. They were asked to name the letters or point to the target square on each page. The stimuli were graded into four levels of difficulty based on the amount of contrast between the figure and the background. Performance was measured in terms of the maximum level of difficulty at which the participant correctly identified or located the three figures. Contrary to expectations, no significant difference was found between the performance of AD patients and control subjects on texture discrimination tasks vs. luminance discrimination tasks. However, results indicate that AD patients are impaired in performing a task requiring them to locate a texture-defined target of known shape in a noisy background field. By contrast, AD patients show no significant deficit in a task requiring them to locate a texture-defined shape in a known location. This argues that the observed deficit in the location task is not due to a failure in the system that discriminates target texture from background texture (since both location and identification tasks require the same textural discriminations), but rather to an impairment of the system responsible for "finding things" (i.e., locating known targets at unknown locations). This observation suggests that AD patients may suffer selective damage to the dorsal "Where" pathway, which is responsible for localizing objects in space.     

ERP evidence for the time course of graphic, phonological, and semantic information in Chinese meaning and pronunciation decisions

Two words that varied in their relationship were presented sequentially to Chinese readers who made meaning and pronunciation decisions. In the meaning task, they decided whether the words had the same meaning. In the pronunciation task, they decided whether the words had the same pronunciation. In both tasks, the word pairs represented 1 of 4 relationships: graphically similar, homophonic, semantically related, or unrelated. Event related potentials (ERP) recordings made from the onset of the 2nd word suggested a temporal unfolding of graphic, phonological, and semantic effects. Specifically, graphically-related pairs produced a smaller P200 in the pronunciation task and a smaller N400 in the meaning task. Homophones produced reduced N400 component with bilateral sources in the meaning task.     

Modeling memory decline in older adults: the importance of preclinical dementia, attrition, and chronological age

This longitudinal study examined memory loss in a sample of 391 initially nondemented older adults. Analyses decomposed observed memory loss into decline associated with preclinical dementia, study attrition, terminal decline, and chronological age. Measuring memory as a function of only chronological age failed to provide an adequate representation of cognitive change. Disease progression accounted for virtually all of the memory loss in the 25% of the sample that developed diagnosable dementia. In the remainder of the sample, both chronological age and study attrition contributed to observed memory loss. These results suggest that much of memory loss in aging adults may be attributable to the progression of preclinical dementia and other nonnormative aging processes that are not captured by chronological age.     

Developments in long-term explicit memory late in the first year of life: behavioral and electrophysiological indices

Coincident with developments in the temporal-cortical explicit memory network, long-term recall abilities are newly emergent late in the first year of human life. We recorded event-related potentials (ERPs) in 9-month-olds as an index of the integrity of the neural substrate underlying a task thought to reflect explicit memory, namely, deferred imitation. ERP measures of recognition memory 1 week after unique laboratory experiences predicted whether and how much infants recalled of the experiences 1 month later. The findings further imply that memory storage and consolidation processes are a major source of variability in long-term recall memory late in the first year of life.