TESTICULAR SELF-EXAMINATION: VALIDATION OF A TRAINING STRATEGY FOR EARLY CANCER DETECTION

Testicular self-examination (TSE) can lead to early diagnosis and treatment of testicular cancer, the third leading cause of death in young men. We evaluated the effectiveness of a brief and specific checklist for teaching TSE skills. Ten men were videotaped while performing testicular self-examinations before and after training. The TSE training resulted in large and significant increases in the number of TSE steps completed and duration of the TSE. Two urological validation measures supported the improvements observed in the mens' self-examinations. Subjects reported continued performance of TSE during a follow-up telephone interview. This pilot study indicates that a brief and specific checklist is an effective strategy for teaching early cancer detection skills.     

Parental alcohol consumption and postneonatal mortality

The purpose of this study was to evaluate the role of maternal and paternal alcohol consumption as independent risk factors in postneonatal mortality. Questions on the frequency and quantity of alcoholic drinks consumed were included in a questionnaire used as part of a case-control study. Over a period of 11 months the families of 157 cases and 468 controls, matched for age and locality, were interviewed. Odds ratios and 95% confidence intervals were obtained by matched univariate analysis and by multiple conditional logistic regression. Maternal consumption during pregnancy, maternal consumption during breastfeeding and maternal consumption in the past year were not risk factors for postneonatal mortality. A multiple matched analysis did not alter these results. Matched univariate analysis of paternal alcohol consumption gave several positive results, including variables pertaining to the father's consumption in a multiple logistic regression model with traditional risk factors, which revealed that the frequency of paternal consumption in the last year, as estimated by the mother, was found to have a significant effect on postneonatal mortality.     

Whose Gene Is It? A Case Discussion About Familial Conflict over Genetic Testing for Breast Cancer

A multidisciplinary group of genetic and other professionals discuss a complex case of familial conflict over access to genetic information. One twin wishes to know the results of her deceased mother's tests for BRCA1 mutations; a second twin objects to researchers making this information available. As the case discussion unfolds, the apparent facts of this case are called into question and the lines of ethical certainty become less clear.     

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.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

An empirical study of the diathesis-stress theory of disease

One thousand, one hundred and twenty-one Jewish concentration camp survivors were compared with 367 Jewish controls who had not been in a concentration camp, and had not lost any family members in such a camp. Of interest was the mortality of camp and comparison groups, on the hypothesis that the stress of being in a camp would adversely affect inmates. It was found that former camp inmates were over twice as likely to die of cancer, coronary heart diesease, or other causes as the comparison subjects of similar age and sex composition, and that severity of stress was correlated with mortality in the expected direction. Diathesis, determined by means of a special interviewer-administrated questionnaire, was found to interact synergistically with stress in producing high mortality.     

Group climate in an open-ended cancer support group

A number of well-described, controlled studies assessing cancer support group intervention support their effectiveness. All of these experimental groups have been close-ended and typically involve six to eight weekly sessions. Because many cancer patients are unable or unwilling to participate in closed, extended-session groups, there is particular need for analysis of the effectiveness of short-term, open-ended groups. Additionally, objective measures are needed to delineate the factors contributing to a successful outcome in cancer support groups. We used the Short Form of the Group Climate Questionnaire (GCQ-S) to characterize 23 sessions in an open-ended, short-term, Veterans Hospital based cancer support group. The cancer group scored significantly lower on the Avoiding and Conflict dimensions (p<.001) compared to a normative psychotherapy group sample. There was no difference on the Engaged dimension. This pilot study suggests that a cancer support group in this setting can create an environment where members are cohesive and take responsibility for their own change process, while keeping interpersonal conflict to a minimum. Based on these preliminary findings, we encourage controlled clinical trials examining the efficacy of open-ended cancer support groups.At the time of this study, Dr. Daroff was a resident in Psychiatry, University of California, San Francisco.     

从个体到集体：心理学视角下的集体记忆

基于拓展思维的社会互动主义视角, 采用流行病学研究思路, 记忆的形成与维护构成了集体记忆心理学研究的核心问题。相关研究一方面以“对话”为研究语境, 系统阐释了集体记忆形成中的社会传染、检索诱发遗忘、共享现实和网络聚合等心理机制; 另一方面, 聚焦于既存的记忆, 阐释了集体记忆有效性的心理原则, 同时, 记忆的身份关联性得到了确证。集体记忆心理学研究仍需拓展视野, 加强对文化记忆的有效性研究, 密切关注媒介技术变革引发的记忆变化, 积极推进本土化研究。