Uptake of BRCA1 Genetic Testing in Adult Sisters and Daughters of Known Mutation Carriers in Norway

This study was undertaken to examine transmission of information to first-degree relatives of BRCA1 mutation carriers and uptake of genetic testing. The intention was to consider revision of current legislation related to privacy if information on life-saving health care was not disseminated to at-risk family members. The Norwegian Radium Hospital provides clinical genetics services for families at high risk for hereditary breast and ovarian cancer. Together with major hospitals nationwide we provide medical surveillance. Nearly all expenses are covered by the National Health insurance. Because of the high number of families with founder mutations in BRCA1, we are in a unique position to gather information about these groups. Within a consecutive series, we identified 75 BRCA1 mutation carriers and registered information transmission and uptake of genetic testing 6 months or more after the index mutation carriers had been informed about their mutation status. These 75 BRCA1 mutation carriers had 172 living first-degree relatives, aged 18 years or older (84 females, 88 males). Forty-four out of 54 (81.5%) of females over 30 had opted for genetic testing. The testing rate among all relatives was 43%. At any age, 63% of the females underwent genetic testing compared with 24% of the males (p<0.05). The overwhelming majority of adult females at risk opted for genetic testing. Males with daughters more frequently than males without daughters asked for testing. The findings give neither reason to reconsider legislation on privacy, nor for us to consider more aggressive methods of contacting relatives.     

Technological paternalism: On how medicine has reformed ethics and how technology can refine moral theory

The objective of this article is to investigate ethical aspects of technology through the moral term “paternalism”. The field of investigation is medicine. The reason for this is twofold. Firstly, “paternalism” has gained moral relevance through modern medicine, where physicians have been accused of behaving paternalistic and threatening patients’ autonomy. Secondly, medicine is a brilliant area to scrutinise the evaluative aspects of technology. It is argued that paternalism is a morally relevant term for the ethics of technology, but that its traditional conception is not adequate to address the challenges of modern technology. A modification towards a “technological paternalism” is necessary. That is, “technological paternalism” is a fruitful term in the ethics of technology. Moreover, it is suited to point out the deficiencies of the traditional concept of paternalism and to reform and vitalise the conception of paternalism in ethics in order to handle the challenges of technology.     

Validation of health locus of control patterns in Swedish adolescents

The purpose of the present study was to investigate the relationships between Health Locus of Control (HLOC) questionnaire subscales (Internal, Powerful Others, Chance) and self-esteem in Swedish adolescents (N = 506). Results from traditional correlational analyses were compared with findings using an alternative method of clustering individuals according to their pattern of scores on the three HLOC subscales. One-way analysis of variance, with eight possible groupings of high and/or low scores on the three subscales, indicated that those with a combination of strong belief in internal control of health, high degree of belief that health is determined by powerful others, and low degree of belief that health is a function of chance/luck had better self-esteem than those with a quite opposite pattern, involving high belief in chance and low belief in internal control. The potential benefit to researchers and clinicians of using this method of combining the HLOC subscales, instead of the traditional correlational method, is discussed.     

Locus of semantic interference in picture-word interference tasks

Picture#x2014;word interference studies typically show that semantically related distractor words embedded within a picture slow picture-naming responses, relative to unrelated ones. This semantic interference effect is commonly interpreted as arising from the competition of lexical#x2014;semantic (e.g., Schriefers, Meyer, & Levelt, 1990) or lexical#x2014;phonological (e.g., Starreveld & La Heij, 1996) codes. The experiment reported here tests a crucial assumption shared by these accounts#x2014;namely, that the effect reflects a lexical, rather than a nonverbal, conceptual conflict. Pictures were named while participants attempted to ignore embedded distractors that were in either verbal or pictorial format. The presence of both words and pictures substantially interfered with naming responses, but only words, not pictures, were found to induce semantic interference. These findings support the claim that for semantic interference to arise, both target picture and distractor have to be lexicalized. Consequently, a general conceptual locus of the effect can be excluded, and the claim that semantic interference is based on a lexical conflict is confirmed.     

Should we presume moral turpitude in our children? – Small children and consent to medical research

When children are too young to make their ownautonomous decisions, decisions have to be madefor them. In certain contexts we allow parentsand others to make these decisions, and do notinterfere unless the decision clearly violatesthe best interest of the child. In othercontexts we put a priori limits on whatkind of decisions parents can make, and/or whatkinds of considerations they have to take intoaccount. Consent to medical research currentlyfalls into the second group mentioned here. Wewant to consider and ultimately reject one ofthe arguments put forward for putting medicalresearch into the second category. We willargue that some objections to children'sparticipation in research are either based onan implausibly restrictive conception of whatis in fact in the child's best interests orthat there is an implicit and false premisehidden in this argument; i.e., the premise thatour children have so deeply fallen into moralturpitude that we must assume that they wouldnot want to fulfill their moral obligations,or, that they will grow up to be morallydeficient and will then wish not to have actedwell while a child.     

The effect of social network intervention for women with rheumatoid arthritis

A partially-controlled intervention study was performed. Female patients with rheumatoid arthritis (RA) were allocated to three groups: the network intervention group (n = 104), the attention control group (n = 85), and the no-treatment control group (n = 75). The network intervention consisted of an assessment session and a network meeting. Patients were assessed at baseline and approximately 10 and 18 months after the intervention. The network intervention group reported an increase in network size. Daily emotional support increased for the intervention patients compared with patients in the attention control group. The degree of social dysfunction was reduced for patients in the intervention group compared to patients in the no-treatment control group. Furthermore, for single patients, the intervention significantly increased the social network size and improved both social functioning, and perceived overall health, compared to both control groups. The results suggest that the social needs of single patients should be given special attention in clinical settings.     

Don't Tell Me What I Don't Want to Hear! Politicization and Ideological Conflict Explain Why Citizens Have Lower Trust in Climate Scientists and Economists Than in Other Natural Scientists

Studies suggest that citizens have higher trust in some groups of scientists than in others. However, we still know little about the causes of these trust gaps. The current study fills this knowledge gap by examining Norwegian citizens' trust in climate scientists, economists, and so-called “less politicized natural scientists.” I argue that trust in climate scientists and economists is lower than trust in less politicized natural scientists because the former fields are politicized, while the latter are not. Politicization strengthens ideological conflicts between citizens' ideology and research produced by climate scientists and economists, which leads to lower trust in these groups of scientists. I test this argument by running regression analyses on data from a representative survey of the Norwegian population. The results support the argument: Citizens have significantly higher trust in less politicized natural scientists than in both climate scientists and economists, and these differences can be explained by ideological biases in trust. Citizens with a proeconomic growth ideology have significantly lower trust in climate scientists than in less politicized natural scientists, and citizens with a left-wing economic ideology have significantly lower trust in economists than in less politicized natural scientists.     

Visual bridgingof empty gaps in the optic flow

This is a study of perception of bending motion and jointed rigid motions over large invisible segments of a bending line. In this project, we investigated the visual perception of changing form of lines, built up by a series of dots and presented under highly reduced pictorial conditions. The changing form was indicated by one or two moving and continuously changing visible fragments of the line. The most extreme condition studied was the perception of the bending of an initially vertical 24-dot line, visually represented only by the stationary base dot and the two moving dots at its top. In this experiment, nearly all subjects reported experiencing a smooth bending connection over the 21-dot empty gap. Three experiments are described and analyzed. The results suggest that the human visual system is astonishingly well adapted for derivation of relevant figurai information from such severely reduced, continuously changing optical presentation. An explanation in terms of automatic sensory mechanisms related to the physiological receptive field effect is proposed.