Risk Reduction Behaviors and Provider Communication Following Genetic Counseling and BRCA1 Mutation Testing in an African American Kindred

Little is known about the impact of cancer genetic counseling and testing on health behaviors in racial and ethnic subgroups. This prospective observational study examined use of risk reduction strategies following BRCA1 counseling and testing. Participants were female members of an African American kindred who received genetic education, counseling and testing (n = 40) and completed a 1-year follow-up interview. Mutation carriers were more likely to opt for breast (100%, 7/7) and ovarian (25%; 1 of 4) cancer surveillance than prophylactic surgery. Following genetic counseling, 71% (5/7) of the BRCA1 carriers who opted for surveillance reported having a mammogram within the year following receipt of their genetic test results. Ovarian cancer screening among mutation carriers increased from 0% at baseline to 25% (one of four) at 1 year. Compared to noncarriers (23%, 7/30), carriers (70%, 7/10) were more likely to discuss their BRCA1 test results with their primary health care providers. Surveillance for breast cancer was preferred to prophylactic surgery and chemoprevention as a way to reduce risk for these cancers. Our data indicate that patient-provider communication about BRCA1 test results is suboptimal.     

Research misconduct among clinical trial staff

Between 1993 and 2002, 39 clinical trial staff were investigated for scientific misconduct by the Office of Research Integrity (ORI). Analysis of ORI case records reveals practices regarding workload, training and supervision that enable misconduct. Considering the potential effects on human subjects protection, quality and reliability of data, and the trustworthiness of the clinical research enterprise, regulations or guidance on use of clinical trial staff ought to be available. Current ORI regulations do not hold investigators or institutions responsible for supervision and training of clinical trial staff. Given the important issues at stake, the definition of research misconduct should encompass the intentional or negligent mismanagement of scientific projects. Individual institutions and professional associations not only can but should adopt stricter standards of conduct than those reflected in federal regulations.     

Drawing Memories: Edouard Manet's Remembrances of the Past

The author examines Edouard Manet's quotations of traditional masters in his work. Instead of debating whether Manet simply imitated, competed with, or paid tribute to the great painters of the past, the author suggests that Manet used the depictions of his painterly past not as a remedial but as a deliberate device. By relying primarily on Freud's Interpretation of Dreams and Jokes and Their Relation to the Unconscious, the author interprets the traditional works embedded in Manet's paintings as dream thoughts lying behind a façade. The author examines these depictions as if they were associations and memories of Manet's painterly past and in so doing uncovers Manet's subtle use of the past as a means of articulating social commentaries and of creating dialogues with both his contemporaries as well as his predecessors. Drawing on Freud's idea of deferred action (Nachtraegklichkeit), the author illustrates how Manet reflects upon the present through images of the past while at the same time rearticulating the scenes of the past through the lens of the present.     

The role of self-to-object updating in orientation-free performance on spatial-memory tasks

A single view of a room-sized path produces an orientation-specific memory representation, yet when memory is tested at a location on the path, orientation-free performance is observed. Either a virtual-views or an updating hypothesis can account for orientation-free performance by attributing it, respectively, to an orientation-free long-term-memory representation or to a working-memory representation of the body's updated location relative to the path. Experiments 1 and 2 test these hypotheses by manipulating the test-site location and the complexity of the trajectory from the study site to the test site. Experiment 3 tests orientation to the test space as a function of trajectory complexity. Results support a virtual-views explanation for the orientation-free performance of males and an updating explanation for females.     

Allocentric coding of object-to-object relations in overlearned and novel environments

R. F. Wang and E. S. Spelke's (2000) finding that disorientation disrupts knowledge is consistent with egocentric but not allocentric coding of object location. The present experiments tested the hypothesis that egocentric coding may dominate early on but that once an allocentric representation is established, then target location is retrieved from it. This hypothesis predicts that disorientation will disrupt configuration knowledge in a novel environment, such as that used by Wang and Spelke, but not in an overlearned environment. Experiments 1 and 2 tested whether disorientation disrupted configuration knowledge of an overlearned environment, and Experiments 3-7 tested whether disorientation disrupted configuration knowledge of a novel, room-sized environment. In none of the experiments did disorientation disrupt configuration knowledge. Hence, in addition to showing allocentric coding of overlearned interlandmark relations, the present findings are consistent with the immediate availability of allocentric location codes in a novel, room-sized environment.     

Working 61 plus hours a week: why do managers do it?

The authors investigated why some managers work extreme hours, defined as 61 or more hours per week. The authors tested explanations drawn from theories including the work-leisure tradeoff, work as an emotional respite, social contagion, and work as its own reward. In a demographically homogeneous sample of male managers, the best explanations for why some worked 61 or more hours per week were the financial and psychological rewards they received from doing so. The hypothesis derived from A. Hochschild's (1997) research that managers who work long hours seek relief at work from pressures at home was not supported. Findings in a small sample of managerial women were consistent with the work-leisure trade-off hypothesis, the social contagion hypothesis, and the work as its own reward hypothesis.     

Nature of marital relations among chronic pain patients

Fifty-two chronic pain patients and their spouses were evaluated for their marital relations utilizing the FACES III. In most areas of family functioning the couples provided evidence of difficulties and demonstrated a significant level of agreement about the nature of the problems. On the circumplex model the couples were functioning at the mid-to extreme-range. This study suggests that marital difficulties among chronic pain sufferers may indeed be pervasive.     

Using the Family Paper Sculpture for education,therapy, and research

The Family Paper Sculpture is a semi-projective task useful in family life education, in clinical work with families, and in research involving family system variables. Families or individuals are asked to make a picture of the family using round disks for individuals, red and black strips to show similarities and differences among individuals, and boundary markers to show individuals who are separate, or pairs, or groups of individuals who belong together. Examples are given which demonstrate the value of the technique for educational, therapeutic, and research purposes.She is on leave from the University of Houston-Clear Lake, Houston, Texas, where she is an Associate Professor of Behavioral Sciences.The research reported here was supported in part by grants from the (U.S.) National Institute of Mental Health.