Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

The specific action of different personality risk factors on cancer of the breast, cervix, corpus uteri and other types of cancer: A prospective investigation

We report the results of a prospective study of a random sample of 1353 elderly but healthy men and women who were followed up for a period of 10 yr, when mortality and cause of death were ascertained. Overall results have been reported elsewhere for mortality from cancer, coronary heart disease and other causes; here we are concerned with the personality factors predicting breast cancer, cervical cancer, cancer of the corpus uteri specifically, as well as other types of cancer in women. Ten specific hypotheses were tested, using specially constructed questionnaires for the purpose, and for most of these statistically significant support was obtained. The results justify belief that specific types of cancer may be related to specific stress/personality factors.     

Time-series analysis in operant research

A time-series method is presented, nontechnically, for analysis of data generated in individual-subject operant studies, and is recommended as a supplement to visual analysis of behavior change in reversal or multiple-baseline experiments. The method can be used to identify three kinds of statistically significant behavior change: (a) changes in score levels from one experimental phase to another, (b) reliable upward or downward trends in scores, and (c) changes in trends between phases. The detection of, and reliance on, serial dependency (autocorrelation among temporally adjacent scores) in individual-subject behavioral scores is emphasized. Examples of published data from the operant literature are used to illustrate the time-series method.     

肺癌早期综合诊疗思考

通过分析目前肺癌患者5年生存率徘徊在10%,这一现实问题,可以得到一些重要启示和思考。今后肺癌治疗发展方向将是完善个体化、多学科早期综合治疗模式;利用基因芯片技术开展肺癌早期诊断,对肺癌高危人群开展大规模普查;开展靶向性、高效低毒、抗耐药性的肺癌治疗药物研究,进行肺癌逆转的分子干预治疗和分子阻断治疗,要用早期综合地手段诊疗肺癌。     

A Qualitative Study of Health Professionals' Views Regarding Provision of Information About Health-Protective Behaviors During Genetic Consultation for Breast Cancer

This study aimed to explore health professionals' views and practice regarding the provision of information about health-protective behaviors (e.g., exercise, alcohol consumption, diet) during genetic consultation for breast cancer. Ten genetic counselors participated in three focus groups, and seven medical specialists were interviewed in a focus group or individually. Data was analyzed using the constant comparative method. Findings suggested that health professionals held differing, often opposing, views about the value of health-protective behaviors for women at increased risk of breast cancer. The content and extent of information provided about health-protective behaviors varied widely, and participants expressed a need to form consensus regarding information provision both within and across clinics. The main barriers to providing information regarding health-protective behaviors included the lack of research evidence regarding the impact of these factors and higher priority of other information need to be provided in the limited consultation time. Participants generally did not consider it their role to promote health-protective behaviors, and were concerned about the psychological impact of providing information about behavioral risk factors during genetic consultations.     

Break philosophy through internally

This paper contrasts and illustrates two types of breakthroughs in philosophy; i.e., external and internal ones. Both are made possible through its application to a newfield. In the external breakthrough, a new field is discovered by such factors without philosophy as encounters with different traditions of thought and advance in technology. In the internal one, a new field is brought into attention by critical examination of one or another assumption within philosophy that has once dismissed the field as too trivial or insignificant to be its proper subject. Based on this distinction, a research guideline for philosophy is proposed that one must always seek the possibility of its internal breakthrough. It is also suggested that the philosophy of science and epistemology can be innovated internally when they are applied to a new field, that is, statistics. Finally the distinction between pure and applied philosophy is reinterpreted in the light of the internal breakthrough.     

BENCHMARKS AFFECT PERCEPTIONS OF PRIOR DISABILITY IN A STRUCTURED INTERVIEW

Though covered under the Americans with Disabilities Act of 1990, job candidates with a record of a disability may be adversely evaluated. Two experiments demonstrate that subtle knowledge of a prior disability creates a bias that can be removed by a structured interview. A job candidate was labeled as having once suffered from depression, substance abuse, cancer, or no disability. The candidate who once suffered from depression or substance abuse was judged more negatively than a control candidate, while a cancer survivor was not. Though disabilities are not perceived equally, benchmarked rating scales can enhance attention to relevant behaviors, thus controlling the potential for bias.We thank Steven Gregson, Michael Records and Cynthia Strickland for their help with pilot studies. Shawn Bocketti is now with IBM, Stephen Maser is with Linkage Incorporated, and Craig Wennet is with the United States Coast Guard.     

A unified approach to exploratory factor analysis with missing data,nonnormal data,and in the presence of outliers

Factor analysis is regularly used for analyzing survey data. Missing data, data with outliers and consequently nonnormal data are very common for data obtained through questionnaires. Based on covariance matrix estimates for such nonstandard samples, a unified approach for factor analysis is developed. By generalizing the approach of maximum likelihood under constraints, statistical properties of the estimates for factor loadings and error variances are obtained. A rescaled Bartlett-corrected statistic is proposed for evaluating the number of factors. Equivariance and invariance of parameter estimates and their standard errors for canonical, varimax, and normalized varimax rotations are discussed. Numerical results illustrate the sensitivity of classical methods and advantages of the proposed procedures.This project was supported by a University of North Texas Faculty Research Grant, Grant #R49/CCR610528 for Disease Control and Prevention from the National Center for Injury Prevention and Control, and Grant DA01070 from the National Institute on Drug Abuse. The results do not necessarily represent the official view of the funding agencies. The authors are grateful to three reviewers for suggestions that improved the presentation of this paper.     

Psychological Adjustment to Breast Cancer

Breast cancer remains a highly prevalent and extraordinarily stressful experience for hundreds of thousands of women each year in the United States and around the world. Psychological research has provided a picture of the emotional and social impact of breast cancer on patients' lives, and of factors associated with better versus worse adjustment. Psychosocial interventions have been beneficial in decreasing patients' distress and enhancing their quality of life. Recent research also suggests that psychological factors may be related to potentially important biological disease-related processes. In addition to providing an understanding of the psychological factors in breast cancer, research in this area has provided a framework for research on adaptation to health-related stress in general.     

Training Counsellors to Work with People who Live with Cancer: A Needs-led Approach to Planning

This paper traces the development of a cancer counselling service within a voluntary helping agency. The steps of recognizing the needs of people with cancer, identifying multi-faceted desired outcomes and the implementation of one specific goal, that of provision of a counselling service, are outlined. Significant events, stages and decisions made during this process are described and discussed. The emphasis throughout is on the importance of needs analysis and client group consultation in order that the planned service is best placed to meet such needs.