Clinical Characterization and Risk Profile of Individuals Seeking Genetic Counseling for Hereditary Breast Cancer in Brazil

Hereditary breast cancer (HBC) accounts for 5–10% of breast cancer cases and it significantly increases the lifetime risk of cancer. Our objective was to evaluate the sociodemographic variables, family history of cancer, breast cancer (BC) screening practices and the risk profile of cancer affected or asymptomatic at-risk women that undergo genetic counseling for hereditary breast cancer in public Brazilian cancer genetics services. Estimated lifetime risk of BC was calculated for asymptomatic women using the Gail and Claus models. The majority of women showed a moderate lifetime risk of developing BC, with an average risk of 19.7% and 19.9% by the Gail and Claus models, respectively. The average prior probability of carrying a BRCA1/2 gene mutation was 16.7% and overall only 32% fulfilled criteria for a hereditary breast cancer syndrome as assessed by family history. We conclude that a significant number of individuals at high-risk for HBC syndromes may not have access to the benefits of cancer genetic counseling in these centers. Contributing factors may include insufficient training of healthcare professionals, disinformation of cancer patients; difficult access to genetic testing and/or resistance in seeking such services. The identification and understanding of these barriers is essential to develop specific strategies to effectively achieve cancer risk reduction in this and other countries were clinical cancer genetics is not yet fully established.     

The Influence of Cancer-related Distress and Sense of Coherence on Anxiety and Depression in Patients with Hereditary Cancer

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.     

Case Demonstration of Environmental Cuing and Brief Supervision Monitoring as Performance Management Interventions with Educational Care Providers

Abstract

The present study evaluated two interventions to improve task completion-data recording by two classroom instructors at a school for children and youth with neurodevelopmental disorders. Compared to a baseline phase, intervention through environmental cuing (strategic task scheduling) was ineffective. The addition of brief supervision monitoring (task preview and review) increased task completion-data recording to high levels and the improved performance of the classroom instructors and was sustained one month following the study in the absence of intervention. Social validity assessment documented high approval of and satisfaction with brief supervision monitoring. We discuss these findings with reference to practical and efficient methods of performance management that can be implemented with care providers in educational services settings.     

Counseling and Mental Health Care in Palestine

The authors provide a brief overview of counseling and mental health care in Palestine, including their history and a summary of their current status. Finally, a discussion is presented of future trends in the development of the profession with regard to recent changes in the region.     

Multi‐Criteria Evaluation for Collaborative Circulating Farming with Collective Operations Between Arable and Cattle Farmers

Tokachi sub‐prefecture in Hokkaido is one of the most famous dairy and crop farming regions in Japan. It is known that Tokachi is faced with various difficult problems such as soil degradation, water contamination and unpleasant odours because of the excessive use of chemical fertilizers and inappropriate treatment of livestock excretion. In this paper, we focus on Shihoro town where agricultural outputs are relatively large in Tokachi, and propose collaborative circulating farming with collective operations between arable and cattle farmers. Under the assumption that the decision‐maker in this problem is a representative of a farming organization who hopes for sustainable agricultural development and values the intentions of local residents including arable and cattle farmers in this region, we employ multi‐attribute utility theory in order to evaluate multiple alternatives of the farming management problem. Copyright © 2012 John Wiley & Sons, Ltd.     

The stability of aspect-based career preferences and of the recommended list of occupations derived from them

Career-related preferences (e.g., team work, independence, length of training, income), which are an elaboration and extension of vocational interests, are one of the cornerstones that guide individuals to promising occupations recommended for further exploration. These preferences are informative and can serve individuals and their career counselors only if they are reliable and stable. Study 1 tested the two-week reliability of 31 career-related preferences of 213 freshman students and the two-year stability of the preferences of 132 of these students. Both the within-aspect preferred levels (e.g., only indoors most preferred, but mostly indoors also acceptable) and the importance of the aspects were elicited. The median within-participant two-week reliability was .85 for preferred levels and .64 for aspect importance; the median two-year stabilities were .75 and .51, respectively. In Study 2, the preferences elicited in Study 1 were used to derive a list of recommended occupations compatible with each participant's preferences at Time 1, Time 2 (2 weeks later), and Time 3 (2 years later), using a compensatory-model-based fit index. The percentage of identical occupations in the lists of the top ten recommended occupations was quite high — 62% for Time 1 and Time 2, and 54% for Time 1 and Time 3. The theoretical and practical implications of the reliability and stability of recommendations based on aspect-based career preferences are discussed.