Communicating BRCA1/2 genetic test results within the family: A qualitative analysis

Genetic testing for BRCA1/2 mutations associated with hereditary breast and ovarian cancer reveals significant risk information about one's chances of developing cancer. It is important to study communication processes in families where members are undergoing genetic testing because the information received is crucial not just to the individual concerned but also to other members of the biological family. This study investigates family communication of BRCA1/2 test results from both the informants’ and recipients’ perspectives. A total of 10 female patients and 22 of their relatives were interviewed. Patients’ and their relatives described feelings of responsibility for sharing genetic information within the family to enable others to reduce their risks of developing cancer. However, there were limits to an individuals’ responsibility once key family members had been informed, who then had to take responsibility for continuing dissemination of information. Whilst there was an implicit responsibility to inform the family of a mutation, information was edited or withheld in the best interest of relatives, dependent upon their perceived emotional readiness, resilience and current life stage and circumstances. The pre-existing family culture and the impact previous cancer diagnoses had upon the family also influenced the process of communication. Findings are discussed in relation to extant literature and implications for clinical practice are considered.     

The two landscapes of northern Norway

Our concepts of the world come from our common activities in the world. Without coastal fishing, or seafaring, in boats too large for their crews to draw them ashore, there is no place for the concept of a harbour. And without reindeer herding, there will be no concept of JASSA. That is one point. The other is this: without some of the coastal fisherman's skill and local knowledge, you will not be able to recognize a natural harbour when you see one. And without the reindeer herder's skill, you will not be able to recognize a JASSA when you see one. To put it all rather bluntly. Though there is more of both work and experience behind the first part of this article, about the world of coastal fishing, most of my academic friends have found the latter part, about the concept JASSA, the better and more readable. Can it be that the better teacher is the one who has just learnt the lesson himself?     

Studies in Affective Reaction: II. Dependence of Affective Ratings upon the Stimulus-Situation

Meehl, Paul E. Clinical vs. Statistical Prediction: A Theoretical Analysis and Review of the Evidence. Minneapolis: Univ. Minnesota Press, 1954. Pp. 149. Reviewed by Henry Winthrop.     

Visual search,anticipation, and reactive comparisons between highly-skilled and beginning tennis players

Abstract

Simulated tennis playing situations were created for the laboratory testing of visual search patterns, anticipation, reactions, and movements to compare male and female high-level and beginning players. Of particular interest was the degree to which each measure would differentiate the groups. Participants were highly-rated university players (N-30) and students enrolled in a beginning tennis class (N = 30). Under one testing condition, visual search patterns were recorded as they viewed filmed opponents serve (60 trials) and hit ground strokes (60 trials). Also recorded was anticipation accuracy and speed of the intended type and location of serves and the intended placement of ground strokes. In other testing, execution of a split step was followed by moving rapidly to the comet location for a simulated stroke in response to a series of light cues. Reaction and movement times were recorded. Discrimination analysis revealed that experts and beginners were most differentiated due to fixations on certain cues and predicting ball direction. As to visual search analysis of fixation duration for nine possible areas during the serves, only the head area was significant. Beginners directed more time toward the head region than did the highly skilled. Experts and novices had similar visual patterns with respect to ground strokes, and a few differences existed within the two female groups, in the two male groups. as well as between males and females. Anticipation measures for the serve indicated that experts were faster and more accurate than beginners, and males were faster than females. Ground stroke data revealed that the highly-skilled were faster and more accurate than novices. Finally, the simulated split-step data showed that reaction times and movement times were faster for the experts versus the beginners, and males were quicker in movement times than females.     

Effects of Language of Implementation on Functional Analysis Outcomes

This study evaluated the influence of language of implementation on functional analysis outcomes for a child with a severe intellectual disability from a Spanish-speaking home. Challenging behavior was assessed during 5-min sessions under 4 conditions; attention, play-verbal, play-nonverbal, and demand and across 2 phases; implementation in English versus Spanish. The highest levels of challenging behavior occurred during the attention and demand conditions of the English phases. These results suggest that the language of implementation may influence the overall levels of challenging behavior within functional analysis conditions.     

Mother and infant coordinate heart rhythms through episodes of interaction synchrony

Animal studies demonstrated the powerful impact of maternal-infant social contact on the infant's physiological systems, yet the online effects of social interactions on the human infant's physiology remain poorly understood. Mothers and their 3-month old infants were observed during face-to-face interactions while cardiac output was collected from mother and child. Micro-analysis of the partners’ behavior marked episodes of gaze, affect, and vocal synchrony. Time-series analysis showed that mother and infant coordinate heart rhythms within lags of less than 1 s. Bootstrapping analysis indicated that the concordance between maternal and infant biological rhythms increased significantly during episodes of affect and vocal synchrony compared to non-synchronous moments. Humans, like other mammals, can impact the physiological processes of the attachment partner through the coordination of visuo-affective social signals.     

Psychosoziale Versorgung von Krebspatienten

Objectives

The aim of this study was to determine rates of psychooncological care for cancer inpatients and outpatients under routine conditions in a large University hospital. The percentage of patients who received care was analyzed and compared with self-rated and expert rated supportive care needs.

Methods

The percentage of inpatients who received psychooncological care was calculated by comparing the number of cancer patients treated at the hospital as documented by the local tumor registry (n=1,979) with the number of patients treated by a psychooncologist in that hospital as documented by the hospital??s psychooncological consultation liaison service. The percentage of outpatients who received psychooncological care was calculated by comparing the number of incident cancer cases as documented by the local tumor registry (n=5,886) with the number of patients who received at least one consultation at the local tumor counseling centre. Supportive care needs were estimated by analyzing data of a prospective patient survey in the same hospital (n=1,803) using the Hospital Anxiety and Depression Scale and single items to determine social burden and the wish for emotional support.

Results

The results showed that 11% of inpatients and outpatients (n=234 and n=638, respectively) received psychooncological care. Social care needs were prevalent in 37% and psychological care needs in 52% of the patients during the stay in hospital and in 42% (social and psychological) 6 months later. Of the patients 41% expressed the need to see a social worker and 29% to see a psychologist. Large differences were found between patients with different tumor entities.

Conclusion

Psychooncological care delivered to cancer patients under routine conditions was below the actual rate required as estimated by screening instruments and as expressed by the patients.     

Pr?diktoren tumorassoziierter Fatigue

Fatigue is a serious cancer-related syndrome reported by cancer patients during and after treatment. Especially the impact of chronic fatigue on quality of life is substantial. The aim of this study was to identify predictors of fatigue after finishing treatment from an early stage of the cancer treatment. A sample of 551 cancer patients with heterogeneous diagnoses completed questionnaires assessing fatigue, psychological and psychosomatic data plus treatment data. The patients were recruited from an acute care hospital (t1) and the participants completed the questionnaire 2?C2.5 years after treatment (t2). Regression analysis showed that the strongest predictor of later fatigue was fatigue during the therapy. Other impact factors are radiotherapy and pain. The results suggest that the diagnosis and treatment of acute fatigue should be carried out at an early stage of cancer treatment to prevent chronic fatigue. Suitable diagnostic methods and treatment options will be presented.     

Moving Knowledge into Action: Developing the Rapid Synthesis and Translation Process Within the Interactive Systems Framework

The Interactive Systems Framework (ISF) for Dissemination and Implementation presents an overall framework for translating knowledge into action. Each of its three systems requires further clarification and explanation to truly understand how to conduct this work. This article describes the development and initial application of the Rapid Synthesis and Translation Process (RSTP) using the exchange model of knowledge transfer in the context of one of the ISF systems: the Prevention Synthesis and Translation System (see [special issue “introduction” article] for a translation of the Wandersman et al. (Am J Community Psychol 41:3–4, 2008) article using the RSTP). This six‐step process, which was developed by and for the Division of Violence Prevention at the Centers for Disease Control and Prevention in collaboration with partners, serves as an example of how a federal agency can expedite the transfer of research knowledge to practitioners to prevent violence. While the RSTP itself represents one of the possible functions in the Prevention Synthesis and Translation System, the resulting products affect both prevention support and prevention delivery as well. Examples of how practitioner and researcher feedback were incorporated into the Rapid Synthesis and Translation Process are discussed. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith