If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

Why Me? Why Not Me?

The decision to undergo BRCA testing is very complex and emotionally laden. This decision can be further complicated by the loss of a mother at an early age. The following personal account by a genetic counselor discusses the testing process and the struggle to accept the results and reframe one’s self-identity. The sensitive nature of this testing and the implications for other family members is explored.     

Humans’ folk physics is not enough to explain variations in their tool-using behavior

Two experiments examined adult humans’ folk physics (i.e., their naturally occurring and spontaneous understanding of the physical world) using variations of trap-table problems used to study chimpanzees’ folk physics. When presented with these problems, people unnecessarily avoided retrieving a reward by pulling a rake on the side of a table with a trapping hole—even though it was highly unlikely that the hole would trap the reward. However, when the distance between the reward and the trap was sufficiently large and the distance that the reward had to travel to be retrieved was sufficiently short, people preferred to retrieve a reward by pulling the rake on the side of the table with the trap. These results underscore that behavior during tool-use tasks has many possible causes, only one of which might be a subject’s folk physics.     

Effects of exposure to muscular and hypermuscular media images on young men's muscularity dissatisfaction and body dissatisfaction

This study examined the effects of exposure to muscular and hypermuscular media images on young men's body images, and the moderating roles of baseline body dissatisfaction (BD) and muscularity dissatisfaction (MD). Men (M age = 21.9, SD = 2.8) were exposed to pictures of muscular (n = 34) or hypermuscular (n = 29) male physiques throughout a 30-min health seminar. In support of the study hypotheses, higher levels of baseline BD and MD were associated with greater post-seminar BD and MD. In addition, MD moderated the effects of the exposure conditions on BD; greater baseline MD was associated with greater post-seminar BD, but only among men who viewed the muscular images. These results speak to the importance of pre-existing muscularity concerns in determining men's reactions to muscular physique images, and suggest that exposure to the media ideal of muscularity, and not muscularity per se, elicits body dissatisfaction in men with pre-existing muscularity concerns.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.     

Survivors of a kamikaze attack: PTSD and perceived adjustment to civilian life

30 survivors of the U.S.S. Emmons (M age = 81.3 yr., SD = 2.3), which was sunk by kamikaze attacks during World War II, were given an adapted form of the Posttraumatic Stress Disorder Checklist-Civilian and a set of questions regarding the effects of their World War II experiences on seven clusters of 42 interpersonal and personal characteristics (Adjustment Characteristics). Participants were categorized into two groups, those who served on the Emmons at any given time during World War II (Any Service), and those who were serving on the Emmons when it was sunk during the battle for Okinawa (Okinawa). Analyses using Mann-Whitney U tests indicated that the Okinawa group reported higher checklist scores, but the scores were unrelated to 41 of the 42 Adjustment Characteristics. Also, Spearman rank-order correlations were statistically insignificant for all comparisons between checklist scores and Adjustment Characteristic clusters, and the total number of positive responses to the 42 characteristics. In contrast, Mann-Whitney U and chi square analyses comparing the Any Service and Okinawa groups indicated statistically significant differences for 14 Adjustment Characteristics, 4 clusters of those characteristics, and the total number of positive responses: The Okinawa group reported poorer outcomes in each comparison. Many of these differences were among Adjustment Characteristics evocative of the attributes of Lee's Agape love style. The findings suggest that for the survivors of the Emmons, the presence or absence of a traumatic event was a better predictor of adjustment to civilian life than the reported severity of PTSD symptoms.     

Evidence of reliability and validity for the Universal Orientation scale

The relationships of Universal Orientation with Right-Wing Authoritarianism and Social Dominance Orientation were examined in two studies. Undergraduate students from various universities completed three measures. 314 participated in Study 1 and 461 participated in Study 2. Scores on the Universal Orientation scale correlated weakly with those on the Right-Wing Authoritarianism scale (r = -.14 for both samples) and moderately with the Social Dominance Orientation scale (r = -.50 for Sample 1 and r = -.36 for Sample 2). Low Cronbach alphas for the Universal Orientation scale (alpha = .68 for the first sample and alpha = .60 for the second sample) suggest the scale requires revision.     

Retrieval-induced facilitation: initially nontested material can benefit from prior testing of related material

Classroom exams can assess students' knowledge of only a subset of the material taught in a course. What are the implications of this approach for long-term retention? Three experiments (N = 210) examined how taking an initial test affects later memory for prose materials not initially tested. Experiment 1 shows that testing enhanced recall 24 hr later for the initially nontested material. This facilitation was not seen for participants given additional study opportunities without initial testing. Experiment 2 extends this facilitative effect to a within-subjects design. Experiment 3 demonstrates that this facilitation can be modulated by conscious strategies. These results have implications for educational practice and the theoretical developments of the testing effect, associative memory, and retrieval inhibition.