A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

An immunochemical approach to model and long-term suppression of depressive and anxiety behavior

The inhibitor of monoaminooxydase isatin and the ligand of B-receptors cholecystokinin-4 play a significant role in the suppression and induction of depressive and anxiety states. We induced the formation of auto-antibodies to these compounds against their conjugates with antigen-carrier by immunization of white rats. The result was long-term (more than 2 months) stimulation of depressive and anxiety behavior after immunization to isatin and, in contrast, the suppression of such behavior after immunization to cholecystokinin. The perspective of immunochemical approach to long-term correction of behavior is discussed.     

Getting hammered? ‥‥ students coping with alcohol

• This research draws on identity and coping theories to develop an understanding of the ways in which students with differing stances towards alcohol (both drinkers and light/non‐drinkers) deal with alcohol‐dominated social situations. We report findings from two studies, the first based on the stories of 160 students and the second based on in‐depth interviews with eight students. Our research found that many undergraduates view alcohol as playing a central role in ‘student life’, with excessive drinking being the norm. However, there is a significant group who are not comfortable with this view, nor do they ascribe to it. Choosing not to engage with the stereotypical student image presents a very real set of problems, stresses and barriers and the students discussed the various coping strategies they had in place to deal with these problems. We discuss the implications of these findings and the challenges for public policy in this area.

Copyright © 2006 John Wiley & Sons, Ltd.     

"In the storminess": multi-disciplinary approaches to scriptural images representing ethical challenges in the pastor-congregant relationship

In this qualitative study the authors examine the Scriptural images that 10 Lutheran pastors employed in describing the ethical challenges in the pastor-congregant relationship. The analysis of Scriptural images is part of a larger study on pastors' experiences of a mandatory workshop, "Crossing the Boundaries (CTB),"which is required of Evangelical Lutheran Church in Canada (ELCIC) seminarians. The pastors' images were analyzed from the four perspectives of depth psychology, theology, social ethics, and sociology. In commenting on tensions in the pastors' Scriptural images the authors note commonalities among the four theoretical perspectives and discuss implications for practice and future research.     

Recurrence plot analyses suggest a novel reference system involved in newborn spontaneous movements

The movements of newborns have been thoroughly studied in terms of reflexes, muscle synergies, leg coordination, and target-directed arm/hand movements. Since these approaches have concentrated mainly on separate accomplishments, there has remained a clear need for more integrated investigations. Here, we report an inquiry in which we explicitly concentrated on taking such a perspective and, additionally, were guided by the methodological concept of home base behavior, which Ilan Golani developed for studies of exploratory behavior in animals. Methods from nonlinear dynamics, such as symbolic dynamics and recurrence plot analyses of kinematic data received from audiovisual newborn recordings, yielded new insights into the spatial and temporal organization of limb movements. In the framework of home base behavior, our approach uncovered a novel reference system of spontaneous newborn movements.     

Eighteen month test-retest stability of the youth self report in a sample of Catalonian adolescents

The aim of this study is to assess the test-retest stability of the Spanish version of Youth Self Report after 18 mo. for a sample of 357 Catalonian high school students (158 boys and 199 girls). At Time 2 the girls' scores increased on Delinquent and Aggressive Behavior scales and, therefore on Externalizing scores. At Time 2 the boys' scores increased on Attention Problems and Delinquent Behavior and decreased on Anxious/Depressed, Social Problems, and Internalizing scales. Significant differences in the remaining scales were not observed. The test-retest intraclass correlations for the broad-band scales ranged between .62 (Internalizing) and .68 (Externalizing) and for the narrow-band scales between .37 and .67. The correlations for girls and boys were similar but slightly higher for girls on Anxious/Depressed and Thought Problems.     

Anterior medial temporal lobe activation during encoding of words: FMRI methods to optimize sensitivity

The existence of a rostrocaudal gradient of medial temporal lobe (MTL) activation during memory encoding has historically received support from positron emission tomography studies, but less so from functional MRI (FMRI) studies. More recently, FMRI studies have demonstrated that characteristics of the stimuli can affect the location of activation seen in the MTL when those stimuli are encoded. The current study tested the hypothesis that MTL activation during memory encoding is related to the modality of stimulus presentation. Subjects encoded auditorily or visually presented words in an FMRI novelty paradigm. Imaging and analysis parameters were optimized to minimize susceptibility artifact in the anterior MTL. Greater activation was observed in the anterior than posterior MTL for both modalities of stimulus presentation. The results indicate that anterior MTL activation occurred during encoding, independent of stimulus modality and provide support for the hypothesis that verbal-semantic memory processing occurs in anterior MTL. The authors suggest that technical factors are critical for observing the rostrocaudal gradient in MTL memory activation.     

Instrumental and vocal music effects on EEG and EKG in neonates of depressed and non-depressed mothers

Neonates (M age = 16 days) born to depressed and non-depressed mothers were randomly assigned to hear an audiotaped lullaby of instrumental music with vocals or without vocals. Neonatal EEG and EKG were recorded for 2 min (baseline) of silence and for 2 min of one or the other music presentation. Neonates of non-depressed mothers showed greater relative right frontal EEG asymmetry to both types of music, suggesting a withdrawal response. Neonates of depressed mothers on the other hand showed greater relative left frontal EEG asymmetry to the instrumental without vocal segment, suggesting an approach response, and greater relative right frontal EEG asymmetry to the instrumental with vocal segment, suggesting a withdrawal response. Heart rate decelerations occurred following the music onset for both groups of infants, however, compared to infants of non-depressed mothers, infants of depressed mothers showed a delayed heart rate deceleration, suggesting slower processing and/or delayed attention. These findings suggest that neonates of depressed and non-depressed mothers show different EKG and EEG responses to instrumental music with versus without vocals.     

Moderate versus light pressure massage therapy leads to greater weight gain in preterm infants

Sixty-eight preterm infants (M GA = 30 weeks) were randomly assigned to a moderate or to a light pressure massage therapy group to receive 15 massages three times per day for 5 days. Behavior state, stress behaviors and heart rate were recorded for 15 min before and during the first 15-min therapy session. Weight gain was recorded over the 5-day therapy period. The moderate versus light pressure massage group gained significantly more weight per day. During the behavior observations the moderate versus light pressure massage group showed significantly lower increases from the pre-session to the session recording on: (1) active sleep; (2) fussing; (3) crying; (4) movement; and (5) stress behavior (hiccupping). They also showed a smaller decrease in deep sleep, a greater decrease in heart rate and a greater increase in vagal tone. Thus, the moderate pressure massage therapy group appeared to be more relaxed and less aroused than the light pressure massage group which may have contributed to the greater weight gain of the moderate pressure massage therapy group.     

Prenatal, perinatal and neonatal stimulation: a survey of neonatal nurseries

A recent survey was conducted on stimulation of mothers and babies during pregnancy and the neonatal period. The survey was responded to by 82 neonatology staff members from Neonatal Intensive Care Units (NICUs) at hospitals in the United States. Some forms of stimulation were extremely common including (1) skin-to-skin following birth in the delivery room (83% of hospitals); (2) containment (swaddling and surrounded by blanket rolls) in the NICU (86%); (3) music in the NICU (72%); (4) rocking in the NICU (85%); (5) kangaroo care (98%); (6) non-nutritive sucking during tubefeedings in the NICU (96%); and (7) breastfeeding in the NICU (100%). Other forms of stimulation occurred less frequently including (1) pregnancy massage (19%); (2) labor massage (30%); (3) the Doula (assistant who comforts during labor and delivery) (30%); (4) waterbeds in the NICU (23%); and (5) preterm infant massage in the NICU (38%).