Ethical Issues in Cancer Genetics: 1) Whose Information Is It?

This article presents and discusses four clinical cases that exemplify the complexity of ethical dilemmas concerning the provider's obligation to disclose or withhold genetic information from patients. Case 1: What is the responsibility of the cancer genetics provider to ensure that a positive test results is shared with distant relatives? Case 2: To ensure that results go to at-risk relatives, do we have the right to ignore the wishes of the designated next-of-kin? Case 3: Do we have the right to reveal a familial BRCA1 mutation to a patient's relative, who is at 50% risk? Case 4: Do we have an obligation to reveal that a patient is not a blood relative and therefore, not at risk to have inherited a familial mutation? These cases form the basis for discussing the provider's dual obligations to keeping patient confidentiality and informing patients and families about risk (i.e. duty to warn). We also provide a summary of consensus points and additional discussion questions for each case.     

Motor initiation and execution in patients with conversion paralysis

Motor initiation and motor execution in four patients with conversion paralysis were investigated in a non-affected motor modality (speech). In line with the hypothesis of dissociated control in conversion disorder [Cognit. Neuropsychiatry 8 (1) (2001) 21] motor initiation, but not response duration, was expected to be impaired. The motor initiation times (reaction time: RT) and motor execution times (response duration: RD) were compared on four RT-tasks that required the production of a verbal response: a simple choice RT-task, a mental letter rotation task, and an implicit and an explicit mental hand rotation task. Because conversion disorder is expected to primarily involve an impairment in the initiation of movement, we expected the following task characteristics to uniquely affect RT and not RD: type of instruction (implicit versus explicit instructed imagery), angle of rotation, and target arm (affected versus non-affected arm). The results indeed showed the task characteristics to significantly affect the participants' RT and not their RD. It was concluded that conversion paralysis is associated with a specific impairment in the explicit initiation of processes with a spatial and motor component.     

Social recognition memory requires two stages of protein synthesis in mice

Olfactory recognition memory was tested in adult male mice using a social discrimination task. The testing was conducted to begin to characterize the role of protein synthesis and the specific brain regions associated with activity in this task. Long-term olfactory recognition memory was blocked when the protein synthesis inhibitor anisomycin was injected 20 min before, immediately after, or 6 h after sampling. No effect was observed when anisomycin was administered 3 h or 18 h after sampling. Immunohistochemical analysis of Fos expression revealed that sampling-like exposure to a juvenile increased the activity of a subset of cells in the accessory olfactory bulb and the brain areas that are associated with it. Additionally, increased Fos expression was measured in the main olfactory bulb and the piriform cortex, whereas no signs of activation were seen in the cortical nucleus of the amygdala, all components of the main olfactory system. No increases in Fos immunoreactivity were observed after 4 h. Our data suggest that long-lasting olfactory recognition memory requires two stages of protein synthesis. The first stage takes place within 1-2 h and the second stage between 6-7 h after sampling. The first but not the second stage is paralleled by an increase in the number of Fos-immunoreactive cells in brain areas associated with both the main and accessory olfactory systems. It therefore appears that the role of the second stage of protein synthesis in recognition memory depends on the integrity of the first stage of protein synthesis.     

Emotional conditioning to masked stimuli and modulation of visuospatial attention

Two studies investigated the effects of conditioning to masked stimuli on visuospatial attention. During the conditioning phase, masked snakes and spiders were paired with a burst of white noise, or paired with an innocuous tone, in the conditioned stimulus (CS)+ and CS- conditions, respectively. Attentional allocation to the CSs was then assessed with a visual probe task, in which the CSs were presented unmasked (Experiment 1) or both unmasked and masked (Experiment 2), together with fear-irrelevant control stimuli (flowers and mushrooms). In Experiment 1, participants preferentially allocated attention to CS+ relative to control stimuli. Experiment 2 suggested that this attentional bias depended on the perceived aversiveness of the unconditioned stimulus and did not require conscious recognition of the CSs during both acquisition and expression.     

Examining the validity of numerical ratios in loudness fractionation

Direct psychophysical scaling procedures presuppose that observers are able to directly relate a numerical value to the sensation magnitude experienced. This assumption is based on fundamental conditions (specified by Luce, 2002), which were evaluated experimentally. The participants' task was to adjust the loudness of a 1-kHz tone so that it reached a certain prespecified fraction of the loudness of a reference tone. The results of the first experiment suggest that the listeners were indeed able to make adjustments on a ratio scale level. It was not possible, however, to interpret the nominal fractions used in the task as "true" scientific numbers. Thus, Stevens's (1956, 1975) fundamental assumption that an observer can directly assess the sensation magnitude a stimulus elicits did not hold. In the second experiment, the possibility of establishing a specific, strictly increasing transformation function that related the overt numerals to the latent mathematical numbers was investigated. The results indicate that this was not possible for the majority of the 7 participants.     

Novel figurative phrases and idioms: phrase characteristics over multiple presentations

In a series of three studies, characteristics of novel figurative phrases were compared with those of established idioms. Studies 1 and 2 found that certain correlations were found to be strong and in one direction for familiar idioms and comparably strong but in the opposite direction for novel figurative phrases, with the correlations for less familiar idioms usually falling partway between these extremes. Study 2 also noted that written or auditory presentation had minimal effects on characteristic ratings. In Study 3 the correlations among characteristics stayed relatively constant for familiar idioms after one, three, or six presentations, but for the novel figurative phrases, after multiple presentations the correlations changed in the direction of the established idioms.     

Tell me where you come from and I know what makes you tick: Managing the consumer personality–satisfaction link in diverse cultures

Marketing programs that evoke high satisfaction and marketing success in one culture often fail in others, but the understanding of those cultural differences is insufficient. The question of how culture is linked to consumer satisfaction is still not answered satisfactorily. One promising paradigm for exploring such questions comes from progress in cross-cultural personality psychology. Thus, we examine the influence of individual-level cultural orientations on personality, and the role of personality and affect in satisfaction formation across cultures. Based on experimental data, we show that a high individualism orientation triggers higher levels of extraversion; a high uncertainty-avoidance orientation triggers higher levels of neuroticism. Based on field data from Japan, Spain, and the United States, we identify equivalent relationships amongst personality-related antecedent processes shaping satisfaction indicating universality across these cultures. The findings demonstrate the usefulness of cross-cultural personality psychology theory and methods for understanding and predicting consumer responses to marketing actions across cultures.     

The internal environment of knowledge claims: One aspect of the knowledge-society connection

In the sociology of knowledge, the relationship between society and knowledge —or rather what separates them — remains an unsolved problem. A critical analysis of various solutions that we must look for to this problem suggests the plausibility of a passage between social groups, styles of argumentation and objects of knowledge. An empirical model of decision displacements is proposed on the basis of a corpus of texts and of observations derived from concrete analysis of a laboratory situation.     

Brain stem electrical responses of stutterers and normals by sex,ears, and recovery

Auditory brainstem electrical responses (BSER) of right and left ears of active stutterers, recovered stutterers, and nonstutterers, both male and female adults, were obtained at click rates of 11.1 and 71.1/sec. Latency intervals of waves I, III, and V were measured. The auditory systems of subjects were stressed using a rapid rate of 71.1 clicks/sec. The latency of wave V was used as the measure of the stress condition.Analysis of variance was used to determine statistical significances of main effects and interactions of mean BSER (waves I, III, V, and wave V in stress condition) of left and right ears of male stutterers (active and recovered), female stutterers (active and recovered), and male and female nonstutterers.With one exception, all main effects and all higher order interactions were nonsignificant. The one main effect that was significant was gender. Females have significantly faster rates of neural transmission than do males. The question was raised, does this finding contribute toward an explanation of the sex ratio in stuttering?