Focusing on Patient Needs and Preferences May Improve Genetic Counseling for Colorectal Cancer

During cancer genetic counseling, different items which counselors consider important are discussed. However, relatively little empirical evidence exists regarding the needs and preferences of counselees. In this study needs and preferences were assessed from counselees with a personal and/or family history of colorectal cancer (CRC), who were referred for genetic counseling regarding CRC. They received a slightly modified version of the QUOTE-GENE^ca questionnaire prior to their first visit to the Hereditary Cancer Clinic. Response rate was 60 % (48/80 participants). Counselees rated the importance of 45 items assessing their needs and preferences regarding the content and process of genetic counseling. Participants rated the items regarding discussion of information about their familial CRC risk (100 %) and preventive options (98 %) as important or very important. Fewer participants rated items concerning general information on genetics as important. Sensitive communication during counseling was considered very important by a large percentage of counselees. Generally, no major differences were seen between participants in relation to individual characteristics. Our data suggest that focusing on familial CRC risk and surveillance options, in combination with sensitive communication may lead to better satisfaction with genetic counseling.     

Acceptance of Genetic Counseling and Testing in a Hospital-Based Series of Patients with Gynecological Cancer

Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseling and testing to unselected EC and OC patients. Therefore, in 2007, EC and OC patients were invited for genetic counseling and testing. Patients were asked for their reasons to accept or decline. Nineteen out of fifty-two EC patients (36 %) and twenty-two out of thirty-five OC patients (63 %) accepted genetic counseling, mainly to receive risk assessment for themselves and relatives. Counseling was declined mainly because patients did not want more tests or had no relatives for whom it was relevant. Eighteen out of nineteen EC patients (95 %) and twenty out of twenty-two OC patients (91 %) underwent genetic testing. One EC patient carried an MSH6 mutation (mutation detection rate: 6 %). BRCA1/2 mutations were found in two out of twenty OC patients (10 %). Eleven patients (29 %) received surveillance recommendations for themselves and their relatives. Finally, family history recorded by the gynecologist was compared to that taken by the clinical geneticist. Gynecologists reported family history in ten out of forty-one participants (24 %). In conclusion, genetic counseling and testing are acceptable to patients with OC and/or EC. The 10 % BRCA1/2 mutation detection rate and underreporting of family history by gynecologists warrant referral for genetic counseling for all OC patients, followed by BRCA1/2 testing if indicated. We recommend that microsatellite instability and immunohistochemical analysis be performed in all EC patients, followed by genetic counseling if appropriate. These strategies will lead to better cancer prevention in gynecological cancer patients and their relatives.     

Omimigrid-Pc: A new development in computerized repertory grids

A new approach to computer programs used to administer and/or analyze repertory grids is described. The system outlined here, OMNIGRID-PC, is a variation of OMNIGRID, which was designed to have broad practical and theoretical applications. The general features of OMNIGRID are discussed; then the unique features of the OMNIGRID-PC system, Versions 1.0 and 1.5, are explained in detail along with their underlying theoretical rationale. The Appendix more fully explicates the interpretive significance of the most substantive new feature of Version 3.5–Cromwell Format data collection.     

Collective Intentionality,Evolutionary Biology and Social Reality1

Abstract

The paper aims to clarify and scrutinize Searle”s somewhat puzzling statement that collective intentionality is a biologically primitive phenomenon. It is argued that the statement is not only meant to bring out that “collective intentionality” is not further analyzable in terms of individual intentionality. It also is meant to convey that we have a biologically evolved innate capacity for collective intentionality.The paper points out that Searle”s dedication to a strong notion of collective intentionality considerably delimits the scope of his endeavor. Furthermore, evolutionary theory does not vindicate that an innate capacity for collective intentionality is a necessary precondition for cooperative behavior. ^{1 1}Useful comments made by the participants of the Amsterdam seminar in Philosophy and History of Economics (11 November 2002), by the participants of the Third Workshop in Collective Intentionality (Rotterdam, 12-14 December 2002), and by the editors of this special issue are gratefully acknowledged. I also want to thank an anonymous referee for making helpful suggestions.      

Temperament Styles of Nigerian and U.S. Children

Abstract

Temperament styles of 400 Nigerian children are described in reference to possible gender and age differences and compared with those of 3200 U.S. children in light of Jung's theory of temperament as modified by Myers and Briggs, one that highlights four bipolar qualities: extroversion-introversion, practical-imaginative, thinking-feeling, and organized-flexible styles. Nigerian children generally prefer introverted to extroverted styles, practical to imaginative styles, feeling to thinking styles, and organized to flexible styles. In contrast to males, females are more likely to prefer feeling and organized styles. Age differences are seen only on organized-flexible styles, with a preference for flexible styles increasing with age. In contrast to U.S. children, Nigerian children tend to express higher preferences for introversion, practical, feeling, and organized styles.     

Context and Prior Impression Effects on Attention, Judgment Standards, and Ratings: Contrast Effects Revisited

The present study extended research on contrast effects by (a) examining the effect of context performances on ratings of a target performance when a prior impression of the target performer already exists, and (b) clarifying the issue of whether contrast is caused by attention to context-discrepant behavior or shifts in judgment standards. The results demonstrated that the existence of a prior impression mitigates the influence of context performances on ratings. Judgment standards were found to be unstable and dependent on information provided to raters by the experimental manipulations. Regression analyses showed that both attention and standards of judgment mediate the relationship between context and ratings. Implications of these findings for contrast effects, performance ratings, and the importance of reliable judgment standards for real-world performance appraisals are discussed.     

Emergent persons

Recent psychological theorizing about the emergence of persons makes a number of ontological claims that are not always explicit. A critical consideration of such claims reveals both considerable convergence and some points of disagreement across different psychological theories of emergent personhood. What is clear is that all such theories resist the reduction of persons to biophysical or sociocultural properties, conditions, and processes. In various ways, they each call for a nonreductionistic recognition of the sociocultural constitution of important aspects of personhood, without denying the necessity of biophysical requirements of personhood. Because standard emergentist positions in physical science and the philosophy of physical science mostly ignore the sociocultural level of reality, psychological theorizing about the emergence of persons requires an alternative ontological framework. It is proposed that an ontology of levels of reality that includes the physical, chemical, biological, sociocultural, and personal/psychological is appropriate for understanding how persons are both substantively and relationally emergent within the biophysical, sociocultural world. With such an ontological framework in place, it is possible to understand human activity in the world as the primary vehicle for both the phylogenetic evolution and ontogenetic development of persons.