Acceptance of Genetic Counseling and Testing in a Hospital-Based Series of Patients with Gynecological Cancer

Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseling and testing to unselected EC and OC patients. Therefore, in 2007, EC and OC patients were invited for genetic counseling and testing. Patients were asked for their reasons to accept or decline. Nineteen out of fifty-two EC patients (36 %) and twenty-two out of thirty-five OC patients (63 %) accepted genetic counseling, mainly to receive risk assessment for themselves and relatives. Counseling was declined mainly because patients did not want more tests or had no relatives for whom it was relevant. Eighteen out of nineteen EC patients (95 %) and twenty out of twenty-two OC patients (91 %) underwent genetic testing. One EC patient carried an MSH6 mutation (mutation detection rate: 6 %). BRCA1/2 mutations were found in two out of twenty OC patients (10 %). Eleven patients (29 %) received surveillance recommendations for themselves and their relatives. Finally, family history recorded by the gynecologist was compared to that taken by the clinical geneticist. Gynecologists reported family history in ten out of forty-one participants (24 %). In conclusion, genetic counseling and testing are acceptable to patients with OC and/or EC. The 10 % BRCA1/2 mutation detection rate and underreporting of family history by gynecologists warrant referral for genetic counseling for all OC patients, followed by BRCA1/2 testing if indicated. We recommend that microsatellite instability and immunohistochemical analysis be performed in all EC patients, followed by genetic counseling if appropriate. These strategies will lead to better cancer prevention in gynecological cancer patients and their relatives.     

Memory for Movement Sequences in Gymnastics: Effects of Age and Skill Level

The authors studied the performances of 8- to 13-year-old skilled (n = 30) and less skilled (n = 30) gymnasts on a gymnastics routine recall task by examining the role of memorization strategies and imagery ability. Subjects had to reproduce 3 movement sequences presented on videotape. The number of trials needed to achieve correct recall, the strategies employed, and the subjects' imagery ability were analyzed. Recall performance improved with age and skill level. Movement labeling was the most prevalent strategy used; its frequency increased with age, although it did not lead to better recall performance. Performance was higher, however, among subjects with better imagery skills. The role of strategy development in the age-related improvement in memory performance was not clearly demonstrated. The effect of skill level is interpreted in terms of knowledge bases and kinesthetic movement encoding.     

Neurocognitive performance of 5- and 6-year-old children who met criteria for attention deficit/hyperactivity disorder at 18 months follow-up: results from a prospective population study

The aim of this prospective study was to examine whether neurocognitive performance of children aged 5–6 years distinguished children who were later diagnosed with attention deficit/hyperactivity disorder (ADHD) or borderline ADHD from children without ADHD after adjustment for behavioral measures and to examine the influence of comorbid psychopathology. Out of a general population of 1,317 children, 366 children were selected on the basis of their scores on the Child Behavior Checklist (CBCL). Eighteen months later, the parents were interviewed using a standardized child psychiatric interview: 33 children were classified as ADHD and 75 children as borderline ADHD, and there were 258 children without ADHD. Children with rated ADHD were significantly impaired on measures of visuomotor ability and working memory compared to children without ADHD after adjustment for CBCL results. The performance of borderline ADHD children was in between that of children with and without ADHD. In addition, 4 groups of children were analyzed: 9 ADHD, 24 ADHD with comorbid oppositional defiant disorder/conduct disorder (ODD/CD), 59 ODD/CD, and 274 controls. Children with rated comorbid ADHD and ODD/CD performed significantly worse on these tasks compared to children with rated ODD/CD and control children while they did not differ from ADHD children. Our results imply that neurocognitive measures can contribute to the early identification of ADHD with and without comorbid ODD/CD.     

Activation of multiple phoneme associates of graphemes in visual word recognition

One general issue in the domain of visual word recognition is to delineate the nature of readers' knowledge of the print-sound mapping. A more specific question is to determine whether multiple grapheme-phoneme associations are available and activated during the phonological transcoding of a letter string. Evidence for the activation of irregular associations during print-to-sound transcoding, independently from lexical influences, was assessed in a letter detection task by examining performance on target-absent pseudowords. We contrasted two types of pseudowords that could be considered homophone with a real word by application of either grapheme-phoneme correspondence rules or of multiple phonemic activation. Performance on both types of homophones was compared to nonhomophone control pseudowords, strictly equivalent in terms of orthographic similarity to the base words. The finding of a homophony disadvantage for the homophones by multiple activation was interpreted as evidence for multiple phonemic activation in the print-to-sound conversion system.     

For your Eyes Only: A Q-Methodology on the Ontology of Happiness Among Chronically Ill Filipino Elderly in a Penal Institution

Happiness is a positive phenomenon that is universal in nature and is therefore, pertinent to all human beings. However, the definition of happiness differs from person to person, and varies among cultures, economic status, social connectedness, spiritual upbringing and daily situations. An individual’s contextual perception of happiness can change when subjected to bleak conditions such as incarceration wherein inmates, especially those who are old and are experiencing health impairments are stripped off with their customary source of happiness. Since Filipinos are known to be as “happy people,” this study purports to surface the different facets of what constitute happiness in the context of a penal institution in the Philippine setting. The Q-methodology is the primary design used in the study. It combines the objectivity of quantitative approach with the essence of human experiences as explored in qualitative studies. The participants (P-sample) were twenty elderly inmates suffering from chronic ailments. They were asked to arrange 32 statements (Q-sample), derived from the initial interview, in the Q-sort table based on their degree of agreement, which were then further explicated in the post-sort interviews. The results were then subjected to by-person factor analysis with varimax rotation using the PQ Method version 2.11. Five profiles emerged from the by-person factor analysis, namely: (1) ‘Sense of Affinity’, (2) ‘Sense of Opportunity’, (3) ‘Sense of Indemnity’, (4) ‘Sense of Positivity’ and (5) ‘Sense of Resiliency’. The discussion focused on similarities and differences among profiles regarding the four principal themes (familial, social, internal and spiritual components of happiness) derived from the statements used as the Q-sample. The perception of happiness varies from profile to profile. The differences in views on what constitutes happiness among profiles are more prominent than their said similarities. Most leanings are directed toward the familial and spiritual aspects of happiness however, happiness can also be internally motivated and cognitively construed. While happiness has a direct relationship to an individual’s overall perception of well-being, the nurse, being the primary provider of holistic care, plays a pivotal role in promoting optimum health through awareness, knowledge, and appreciation of vis-a vis an unwavering involvement with the unique and distinct psychological and emotional needs of the elderly inmates characterized by respect, openness, authenticity and inter-subjectivity.     

Memory for Movement Sequences in Gymnastics: Effects of Age and Skill Level

The authors studied the performances of 8- to 13-year-old skilled (n = 30) and less skilled (n = 30) gymnasts on a gymnastics routine recall task by examining the role of memorization strategies and imagery ability. Subjects had to reproduce 3 movement sequences presented on videotape. The number of trials needed to achieve correct recall, the strategies employed, and the subjects' imagery ability were analyzed. Recall performance improved with age and skill level. Movement labeling was the most prevalent strategy used; its frequency increased with age, although it did not lead to better recall performance. Performance was higher, however, among subjects with better imagery skills. The role of strategy development in the age-related improvement in memory performance was not clearly demonstrated. The effect of skill level is interpreted in terms of knowledge bases and kinesthetic movement encoding.     

Is there room for criticism of studies of psychodynamic psychotherapy?

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler (see record 2010-02208-012). Shedler declared unequivocally that "empirical evidence supports the efficacy of psychodynamic therapy" (p. 98). He did not mention any specific criticisms that have been made of evidence on psychodynamic psychotherapies or address possible distinctions between evidence for short-term versus long-term psychodynamic psychotherapies. Instead, he attributed dissenting views to biases in evidence dissemination and review, which he suggested are rooted in a "lingering distaste in the mental health professions professions for past psychoanalytic arrogance and authority" related to a "hierarchical medical establishment that denied training to non-MDs and adopted a dismissive stance toward research" (Shedler, 2010, p. 98). Shedler (2010) justified his blanket dismissal of criticisms of evidence supporting psychodynamic psychotherapy on the basis of several published meta-analyses. The validity of conclusions from metaanalyses depends on the quality of the evidence synthesized, the nature of the studies included, and the rigor of the statistical analyses employed. Many meta-analyses, however, are not performed rigorously, which can result in treatment efficacy estimates that obscure important intertrial differences and that are unlikely to be replicated in clinical practice.