Quality assurance in the clinical genetics setting—Report of a workshop

Participants in a panel discussion sponsored by thead hoc Quality Assurance Committee of the National Society of Genetic Counselors discuss early efforts to develop and implement quality assurance instruments at institutional, state, and regional levels. Uniform guidelines and self-assessment tools can help genetic counselors and clinical geneticists to provide the best possible care to individuals affected by genetic diseases. Further work will be needed to address aspects not covered here and to assure that guidelines allow for creative variation among professionals and centers. An interdisciplinary approach to such standard-setting is recommended.CGC     

Driving skills after whiplash

Previous studies have shown that some persons with longlasting problems after whiplash have changed eye movements. These changes have been related to disturbance of the posture control system. The question raised in the present study is whether such disturbances can influence daily life functions connected with balance, position and external movements, such as car driving. A group of 23 persons with disturbed eye movements due to whiplash injury, was tested in a driving simulator, together with a closely matched control group. The results revealed significant differences between the two groups with respect to response times to the traffic signs presented, identification of type of sign, as well as steering precision while the subjects’ attention was directed to the process of identifying the signs. Alternative explanations such as driving experience, pain, medication or malingering are at least partly controlled for, but cannot completely be ruled out. A distorted posture control system leading to disturbance of eye movements seems to be the most likely primary causative factor, but these disturbances are most certainly complexly determined. Reduced attention capacity is considered to be a mediating secondary factor. Registration of eye movements may be a useful diagnostic tool to evaluate driving skill after whiplash.     

When women can’t do math: The interplay of self-construal, group identification, and stereotypic performance standards

The present research examined the interplay of self-construal (independent vs. interdependent), gender group identification, and performance standards (positive vs. negative) on women’s math performance. Female participants were given a subtle self-prime prior to completing a math test under conditions where either a positive or negative group-based performance standard was rendered accessible. We report an interactive effect of self-construal, gender identification, and performance standard such that a negative (compared to a positive) standard decreased performance under interdependent self-prime (“we”) conditions, whereas the reverse pattern emerged under independent self-prime (“I”) conditions. Importantly, we observed this interplay of performance standards and self-construal only in individuals who self-identify with their gender group whereas performance outcomes of low identifiers were not affected by the experimental manipulations.     

Cyclic variations in sustained human performance

Biological rhythms play a prominent role in the modulation of human physiology and behavior. [Smith, K., Valentino, D., & Arruda, J. (2003). Rhythmic oscillations in the performance of a sustained attention task. Journal of Clinical and Experimental Neuropsychology, 25, 561-570] suggested that sustained human performance may systematically fluctuate in a cyclic manner with periods of 1.5 min and 5.2 min. The current series of investigations sought to manipulate those periodicities by altering task difficulty, administering caffeine, and testing on a more ecologically valid task. Strong evidence of a 1.5 min periodicity was found across studies. Most participants did not demonstrate the 5.2 min periodicity. Moreover, the 1.5 min periodicity was resistant to task manipulations and appeared in similar levels across conditions in all three experiments. These rhythms may be indicative of an endogenous system that modulates sustained attention in humans. Evidence supporting this idea and implications of the research are discussed.     

Driving anger: correlates and a test of state-trait theory

A survey and field study evaluated predictions from state-trait theory applied to driving anger. Trait driving anger, the propensity to become angry when driving, correlated positively with anger in frequently occurring driving situations and in day-to-day driving and with aggressive and risky behaviors while driving. Although not correlated with crash rates or moving violations, trait driving anger correlated with crash-related conditions such as loss concentration, loss of vehicular control, and close calls. Results generally supported predictions from state-trait theory and the construct validity of the Driving Anger Scale, as well as mapping correlates of the disposition to become angry while driving.     

童年压力及死亡威胁启动对择偶要求的影响

本实验从生命史理论出发, 研究童年期环境压力如何与当前环境中的压力线索相互作用并影响个体对异性的择偶要求。被试为70名大学本科生, 其中一部分被试被分配到死亡威胁启动组, 他们阅读一篇描述近期国内暴力犯罪及死亡率上升的新闻报道, 另一部分被试被分配到控制组, 他们阅读一篇描述一个人花了很长时间寻找遗失钱包的文章。被试自我报告对异性的理想择偶要求及其童年压力。控制了性别及恋爱状态后, 多元回归分析表明：童年压力与启动条件仅在身体吸引力的理想标准上有显著交互作用。其中, 低童年压力组在死亡威胁启动下对异性身体吸引力的理想标准显著高于控制条件, 而高童年压力组在死亡威胁启动下对异性身体吸引力的理想要求则显著低于控制条件。此外, 启动条件在异性做“好父母”的择偶标准上有显著主效应, 死亡威胁启动下的被试对异性做好父母的择偶标准高于控制组被试。而在对资源的择偶标准上既不存在童年压力和死亡威胁启动的主效应, 也不存在交互作用。研究说明童年压力与当前环境压力会影响个体对异性的择偶要求, 但对不同择偶要求的影响作用不同。     

Comparative assessment of the behaviour of drivers with Mild Cognitive Impairment or Alzheimer’s disease in different road and traffic conditions

The objective of this research was the analysis of the driving performance of drivers with Mild Cognitive Impairment (MCI) or Alzheimer’s disease (AD), in different road and traffic conditions, on the basis of a driving simulator experiment. In this experiment, healthy “control” drivers, patients with MCI, and patients with AD, drove at several scenarios at the simulator, after a thorough neurological and neuropsychological assessment. The scenarios include driving in rural and urban areas in low and high traffic volumes. The driving performance of healthy and impaired drivers was analysed and compared by means of Repeated Measures General Linear Modelling techniques. A sample of 75 participants was analysed, out of which 23 were MCI patients and 14 were AD patients. Various driving performance measures were examined, including longitudinal and lateral control measures. The results suggest that the two examined cerebral diseases do affect driving performance, and there were common driving patterns for both cerebral diseases, as well as particular characteristics of specific pathologies. More specifically, cognitively impaired drivers drive at lower speeds and with larger headway compared to healthy drivers. Moreover, they appear to have difficulties in positioning the vehicle on the lane. The group of patients had difficulties in all road and traffic environments, and especially when traffic volume was high. Most importantly, both cerebral diseases appear to significantly impair reaction times at incidents. The results of this research suggest that compensatory behaviours developed by impaired drivers are not adequate to counterbalance the direct effects of these cerebral diseases on driving skills. They also demonstrate that driving impairments increase as cognitive impairments become more severe (from MCI to AD).