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     

The Relationship of Nondirectiveness to Genetic Counseling: Report of a Workshop at the 2003 NSGC Annual Education Conference

Nondirectiveness has been a guiding principle for genetic counseling since the founding of the profession. However, its efficacy and appropriateness in this role have been frequently questioned. A workshop at the 2003 Annual Education Conference of the National Society of Genetic Counselors provided audience participation in a discussion of these issues. Participants presented arguments for and against nondirectiveness as a central ethos. They described complex personal transitions in adapting what they had learned about nondirectiveness during training to the realities of the workplace. There was support for flexible approaches to genetic counseling, with varying adherence to nondirectiveness, based on client and family needs and values, clinical circumstances, and desired counseling outcomes. The discussion supports the use of clinical experience, outcomes research, and the experience of other professions to move beyond nondirectiveness and more accurately identify the theoretical bases that underlie genetic counseling in the variety of circumstances in which it is currently practiced.     

Septal co-infusions of glucose with a GABAB agonist impair memory

Septal infusions of glucose exacerbate memory deficits produced by co-infusions of drugs that increase gamma-aminobutyric acid (GABA)(A) receptor activity. To further understand the interaction between glucose and GABA, this experiment tested whether glucose would also potentiate spatial working memory deficits produced by septal infusions of the GABA(B) receptor agonist baclofen. Fifteen minutes prior to assessing spontaneous alternation (SA), male Sprague-Dawley derived rats were given septal infusions of vehicle, glucose (33 nmol), baclofen (0.1 nmol), or glucose combined with baclofen in one solution. Septal co-infusions of glucose with baclofen, at doses that individually had no effect, significantly impaired SA. Thus, the memory-impairing effects of glucose are observed with either GABA(A) or GABA(B) receptor ligands. This raises the possibility that glucose may impair memory by increasing synaptic levels of GABA and subsequent activation of these different receptor subtypes. These effects of glucose could contribute to the memory-impairing effects of hyperglycemia.     

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.     

A dual-process account of digit invariance learning

Performance in the McGeorge and Burton (1990) digit invariance task was originally thought to be mediated by unconscious abstraction of a “rule” that identified the invariant feature across all study items. Subsequent explanations have suggested explicit strategy use or similarity-to-exemplar matching rather than abstraction. This paper presents data that suggest that both similarity and abstraction can be used under different task demands. Delay between study and test afforded abstraction of the invariant knowledge whereas reducing the pool of study exemplars enhanced responding based on specific similarity. These results parallel effects found in the categorization literature. Rule abstraction in this sense may be due to statistical learning of feature frequency rather than abstraction of a central tendency or a complex/conceptual rule. Categorizing responses into subjective memory states (remember/know/guess) demonstrates that neither the similarity matching nor the abstraction mechanism uses information from episodic memory. Confidence measures show that participants are more confident of responses when the prototypical representation is used but not specific similarity. Taken together, these data suggest that abstracted knowledge is not held consciously but that participants have meta-awareness of when they are using the abstracted representation.     

Between ignorance and truth: Partition dependence and learning in judgment under uncertainty

In 3 studies, participants viewed sequences of multiattribute objects (e.g., colored shapes) appearing with varying frequencies and judged the likelihood of the attributes of those objects. Judged probabilities reflected a compromise between (a) the frequency with which each attribute appeared and (b) the ignorance prior probability cued by the number of distinct values that the focal attribute could take on. Thus, judged probabilities were partition dependent, varying with the number of events into which the state space was subjectively divided. This bias was diminished among participants more confident in what they learned, was strong and insensitive to level of confidence when ignorance priors were especially salient, and required ignorance priors to be salient only when probabilities were elicited (not during encoding).