A biologically plausible model of associative memory which uses disinhibition rather than long-term potentiation

Mammalian memory is commonly "explained" in terms of long-term potentiation (LTP) of excitatory synapses. However, depotentiation of inhibitory pathways (disinhibition) is also a known phenomenon in the brain. Artificial neural networks which are offered as partial models of the cerebrum traditionally encode memory by the potentiation of excitatory "synapses" in a manner which is thought of as analogous to LTP. Analysis shows that such models have seriously limited storage capacities. The models also depend on mechanisms which do not appear to be biologically plausible. This paper demonstrates that these difficulties are avoided by encoding memory by means of disinhibition rather than LTP. The resulting models are simple and plausible, though unconventional.     

Genetic Risk Assessment for Women with Epithelial Ovarian Cancer: Referral Patterns and Outcomes in a University Gynecologic Oncology Clinic

Little is known about genetic service utilization and ovarian cancer. We identified the frequency and outcome of genetic counseling referral, predictors of referral, and referral uptake for ovarian cancer patients. Using pathology reports, we identified all epithelial ovarian cancer patients seen in a university gynecologic oncology clinic (1/04–8/06). Electronic medical records (EMR) were used to document genetic service referral, time from diagnosis-to-referral, point-in-treatment at referral, personal/family cancer history, demographics, and genetic test results. Groups were compared using chi-squared and Fisher’s exact test for categorical variables and t-tests for continuous variables. The study population consisted of 376 women with ovarian cancer, 72 (19 %) of who were referred for genetic counseling/testing, primarily during surveillance. Of those referred, 42 (58 %) had personal or family genetic counseling and 34 (47 %) were ultimately tested or identified due to known family mutation. Family history and prior cancer were associated with referral. Family history, living in a larger community, higher-stage disease, and serous histology were associated with undergoing genetic counseling. Risk assessment identified 20 BRCA1/2 (5.3 %) and 1 HNPCC (0.3 %) mutation carriers. Based on recent estimates that 11.7–16.6 % of women with ovarian cancer are BRCA carriers and 2 % are HNPCC carriers, results suggest under-identification of carriers and under-utilization of genetic services by providers and patients. Interventions to increase medical providers’ referrals, even in a specialized oncology clinic, are necessary and may include innovations in educating these providers using web-based methods. Ease of referral by the introduction of an electronic cancer genetic referral form represents another new direction that may increase genetic risk assessment for high-risk women with ovarian cancer.     

The Experiences in Close Relationship Scale (ECR)-Short Form: Reliability,Validity, and Factor Structure

Convergence between the MMPI–2 Restructured Form (MMPI–2–RF; Ben-Porath &; Tellegen, 2008) interpersonal scales and 2 interpersonal circumplex (IPC) measures was examined. University students (N = 405) completed the MMPI–2 and 2 IPC measures, the Interpersonal Adjectives Scales Revised Big Five Version (IASR–B5; Trapnell &; Wiggins, 1990) and the Inventory of Interpersonal Problems Circumplex (IIP–C; Horowitz, Alden, Wiggins, &; Pincus, 2000). Internal consistency was adequate for 3 of the 6 scales investigated. The majority of scales were located in their hypothesized locations, although magnitude of correlations was somewhat weaker than anticipated, partly owing to restricted range from using a healthy sample. The expected pattern of correlations that defines a circular matrix was demonstrated, lending support for the convergent and discriminant validity of the MMPI–2–RF interpersonal scales with respect to the assessment of interpersonal traits and problems.     

Performances on Symbol Digit Modalities Test,Color Trails Test,and modified Stroop test in a healthy,elderly Danish sample

ABSTRACT

This study presents Danish data for the Symbol Digit Modalities Test (SDMT), Color Trails Test (CTT), and a modified Stroop test from 100 subjects aged 60–87 years. Among the included demographic variables, age had the highest impact on test performances. Thus, the study presents separate data for different age groups. For SDMT and CTT1, Danish Adult Reading Test (DART) score also had a significant impact on test performances. The incongruent version of the modified Stroop test was significantly correlated to education. Moderate and significant correlations were found between the three tests. Even though the three tests are commonly used, few normative data for elderly exists. SDMT and CTT performances from this study were in the same range as previously published international norms, but the validity of the result from the modified Stroop test could not be investigated.     

The Evolution of Cancer Risk Assessment in the Era of Next Generation Sequencing

Cancer genetics professionals face a new opportunity and challenge in adapting to the availability of cancer genetic testing panels, now available as a result of Next Generation Sequencing (NGS) technology. While cancer panels have been available for over a year, we believe that there is not yet enough data to create practice guidelines. Despite this, a year of experience allows us to provide our opinion on points to consider as cancer genetic counselors incorporate this testing technology into genetic counseling practice models. NGS technology offers the ability to potentially diagnose hereditary cancer syndromes more efficiently by testing many genes at once for a fraction of what it would cost to test each gene individually. However, there are limitations and additional risks to consider with these tests. Obtaining informed consent for concurrent testing of multiple genes requires that genetics professionals modify their discussions with patients regarding the potential cancer risks and the associated implications to medical management. We propose dividing the genes on each panel into categories that vary by degree of cancer risk (e.g. penetrance of the syndrome) and availability of management guidelines, with the aim to improve patient understanding of the range of information that can come from this testing. The increased risk for identifying variants of uncertain significance (VUS) when testing many genes at once must be discussed with patients. Pretest genetic counseling must also include the possibility to receive unexpected results as well as the potential to receive a result in the absence of related medical management guidelines. It is also important to consider whether a single gene test remains the best testing option for some patients. As panels expand, it is important that documentation reflects exactly which genes have been analyzed for each patient. While this technology holds the promise of more efficient diagnosis for many of our patients, it also comes with new challenges that we must recognize and address.     

Psychotherapie auf Palliativstationen

Exemplary for psychotherapeutic activity in the ??sphere of death?? the article focuses on the present situation of psychotherapists working on palliative care units in Germany. For that a questionnaire has been developed which includes 17 items dealing with fields of concrete psychotherapeutic work, psychotherapy training, relations with teams and institutions, subjectively felt burden and contentment etc. The questionnaire was sent to most of the German palliative care infirmaries. There is a high presence of psychotherapists in these units who are well trained in different therapeutic methods, numerically led by behavior therapy and non-directive therapy. In addition most colleagues are qualified in psychooncology and specialized pain management. Surprisingly topics, such as death or spirituality are not so often found in therapeutic contacts as would be expected. Furthermore there is a rather negative outlook on the preparation for the palliative working field during psychotherapy training. This requires extensions and supplementary curricula concerning existential themes in psychotherapy. The psychotherapists feel well integrated in their therapeutic teams but many of them have a feeling of at best a mediocre appreciation in their institutions. In spite of the difficult and stressful work the general job satisfaction is stated as high to very high.     

Dissoziation

Dissociation and dissociative disorders represent a heterogenous phenomenology of symptoms which are understood as a result of the disintegration of certain usually integrated functions of the psyche. Despite an ongoing debate among scientists about its causation the assumption of a trauma-related etiology is carried forward both in clinical and scientific contexts. Therapists often believe dissociation to constitute an infirm basis for psychotherapeutic treatments. Contrarily, research suggests several kinds of therapeutic interventions and combinations thereof in particular, to be effective in relieving patients even of complex dissociation if certain requirements are met. This review summarizes the historical and conceptual implications as well as recent developments in the concept, diagnosis and therapy of dissociation.     

A robust classic

In the present research, we argue for the robustness of illusory correlations (ICs, Hamilton & Gifford, 1976) regarding two boundary conditions suggested in previous research. First, we argue that ICs are maintained under extended experience. Using simulations, we derive conflicting predictions. Whereas noise-based accounts predict ICs to be maintained (Fielder, 2000; Smith, 1991), a prominent account based on discrepancy-reducing feedback learning predicts ICs to disappear (Van Rooy et al., 2003). An experiment involving 320 observations with majority and minority members supports the claim that ICs are maintained. Second, we show that actively using the stereotype to make predictions that are met with reward and punishment does not eliminate the bias. In addition, participants' operant reactions afford a novel online measure of ICs. In sum, our findings highlight the robustness of ICs that can be explained as a result of unbiased but noisy learning.     

Family Physicians’ Awareness and Knowledge of the Genetic Information Non-Discrimination Act (GINA)

Historically, physicians have expressed concern about their patients’ risk of genetic discrimination, which has acted as a barrier to uptake of genetic services. The Genetic Information Nondiscrimination Act of 2008 (GINA) is intended to protect patients against employer and health insurance discrimination. Physicians’ awareness and knowledge of GINA has yet to be evaluated. In 2009, we mailed surveys to 1500 randomly selected members of the American Academy of Family Physicians. Questions measured physicians’ current knowledge of GINA and their level of concern for genetic discrimination. In total, 401 physicians completed the survey (response rate 26.9%). Approximately half (54.5%) of physicians had no awareness of GINA. Of physicians who reported basic knowledge of GINA, the majority were aware of the protections offered for group health insurance (92.7%), private health insurance (82.9%), and employment (70.7%). Fewer physicians were aware of GINA’s limitations regarding life insurance (53.7%) and long-term care insurance (58.8%). Physicians demonstrated highest levels of concern for health insurance, life insurance, and long-term care insurance discrimination, with less concern for employer and family/social discrimination. Level of concern for the risk of genetic discrimination did not correlate significantly with awareness of GINA. Approximately 17 months after GINA was signed into federal law, physicians’ knowledge remained limited regarding the existence of this legislation and relevant details. Physicians who are aware of GINA continue to have significant concerns regarding the risk of genetic discrimination. This study reveals the need to further educate physicians about the existence of GINA and the protections offered.     

Self‐Concealment and Willingness to Seek Counseling for Psychological,Academic, and Career Issues

Cramer's (1999) model of self‐concealment and willingness to seek counseling was extended to examine the role of positive and negative social experiences in a sample of 235 college students reporting a psychological, academic, or career issue. Structural equation modeling indicated that self‐concealment predicted willingness through the mediators of negative social experiences and psychological distress. Forty‐eight percent of the variance in psychological distress and 6% of the variance in willingness were accounted for in the model.