Managing Variant Interpretation Discrepancies in Hereditary Cancer: Clinical Practice,Concerns, and Desired Resources

Variant interpretation is a complex process, and classification may vary between sources. This study aimed to determine the practice of cancer genetic counselors regarding discrepancies in variant interpretation and to identify concerns when counseling these discrepancies. An electronic survey was sent to genetic counselors in the NSGC Cancer Special Interest Group. The vast majority of counselors (93%) had seen a variant interpretation discrepancy in practice. A large majority (96%) of respondents indicated that they conducted their own research on reported variants. Most respondents cited variant databases as the most common resource utilized in researching variants. Approximately 33% of counselors spent 45 min or more of extra time researching a discrepancy compared to researching a variant with a single classification. When asked how they approached counseling sessions involving variant interpretation discrepancies, the free responses emphasized that counselors considered family history, clinical information, and psychosocial concerns, showing that genetic counselors tailored the session to each individual. Discrepancies in variant interpretation are an ongoing concern for clinical cancer genetic counselors, as demonstrated by the fact that counselors desired further resources to aid in addressing these discrepancies, including a centralized database (89%), guidelines from a major organization (88%), continuing education about the issue (74%), and functional studies (58%). Additionally, most respondents reported that the ideal database would be owned by a non-profit organization (59%) and obtain information directly from laboratories (91%). This investigation was the first to address these discrepancies from a clinical point of view. The study demonstrates that discrepancies in variant interpretation are a concern for clinical cancer genetic counselors and outlines the need for additional support.     

Nursing Practices in Catholic Healthcare: A Case Study of Nurses in a Catholic Private Hospital

We aimed to investigate Catholic Identity and Mission communication specifically how nurses were expressing the Catholic healthcare values in practice. A mixed-methods, case study design was used and included non-participant observation, a mid-level manager focus group (n = 7) and online surveys (n = 144). Document and observational data analysis revealed the organisation’s commitment to visible indication of Catholic values adherence. Focus group analysis revealed two themes, ‘Catholic values in action’ and ‘taking the extra step’. The impact of Catholic Identity and Mission on nurses and nursing care recipients remains elusive and warrants further understanding.     

A smoke-mixing device for measuring nicotine preference

A smoke-mixing device is described that allows individuals to select their preferred nicotine deliveries from cigarette smoke on a puff-by-puff basis. This methodology offers advantages over previous strategies to investigate the role of nicotine as a reinforcing constituent of tobacco.     

How not to revisit Highway 61: Negative repetition effects in a post-cue naming task

Repetition effects were studied in a post-cue naming task, in which participants were cued to name one of two stimuli following their presentation. When pairs of pictures were repeated in a second block, former distractors (not named in Block 1) were named faster than former targets (named in Block 1). This negative repetition effect was not found when two words rather than two pictures were used or when a semantic categorization task was used with two pictures. From this we conclude that the effect reflects a process of mapping from a semantic representation to a name. Negative repetition was not found with a simultaneous selection cue, suggesting that it arose only when there was competition for name selection. It was also dependent on memory for previous acts of semantic naming. We propose that negative repetition reflects a form of speech monitoring that is applied when there is competition in the process of mapping from semantic to name representations.     

African American Adolescent Mothers' Vocational Aspiration–Expectation Gap: Individual, Social And Environmental Influences

This study investigated the vocational aspirations and expectations of 160 African American adolescent mothers living in urban poverty. Discriminant function analysis was used in an attempt to distinguish between participants with, and those without, a discrepancy between their vocational aspirations and expectations. The two groups were found to be distinct in several ways. Depressive and anxious symptoms along with childcare provided by relatives, were associated with a gap between aspirations and expectations. Higher grade point averages, living with biological parents, and having a career mentor were more often associated with a match between expectations and aspirations. A combination of factors, including psychological functioning, social support, achievement, and contextual factors specific to the tasks of teen parenting, should be considered in future attempts to understand and describe adolescent mothers' vocational development.     

Two Portraits of the Humean Moral Agent

Among contemporary ethicists, Hume is perhaps best known for his views about morality's practical import and his spectator–centered account of moral evaluation. Yet according to the so–called spectator complaint, these two aspects of Hume's moral theory cannot be reconciled with one another. I argue that the answer to the spectator complaint lies in Hume's account of goodness and greatness of mind. Through a discussion of these two virtues, Hume makes clear the connection between his views about moral motivation and his understanding of moral evaluation by providing us with two portraits of the Humean moral agent.     

Reconciling conflicting findings regarding postcessation weight concerns and success in smoking cessation.

Correlates of concern about weight gain following smoking cessation and self-efficacy about controlling weight gain were examined in 940 men and 1,166 women who were surveyed on 2 occasions as part of a randomized trial of work-site interventions for smoking cessation. Weight concerns were positively associated with female sex, body weight, dieting for weight control, nicotine addiction, and social encouragement to quit. Bivariate analyses replicated prior findings that elevated weight concerns are associated with a reduced likelihood of quitting smoking, at least in women. Analyses controlling for demographics, nicotine dependence, and social factors replicated prior findings that weight concerns are not negatively related to smoking cessation and that some measures of concern are positively related to cessation. These analyses suggest that conflicting findings found in this literature are due primarily to how weight concerns are defined and whether covariates like nicotine addiction are used in data analyses.