Development and evaluation of a breast cancer prevention decision aid for higher-risk women

Objective To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. Design Pre‐test–post‐test study using decision aid alone and in combination with counselling. Setting Breast Cancer Risk Assessment Clinic. Participants Twenty‐seven women aged 50–69 with 1.66% or higher 5‐year risk of breast cancer. Intervention Self‐administered breast cancer prevention decision aid. Main outcome measures Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life‐style practices; psychological distress; and satisfaction with preparation for consultation. Results The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life‐style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. Conclusion The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.     

FAMILIAL RESTRICTIVE CARDIOMYOPATHY

The cases of a father and daughter with idiopathic restrictive cardiomyopathy are described. In contrast to other forms of cardiomyopathy, this type is rarely familial.     

Deficits in emotional intelligence underlying adolescent sex offending

The present study investigated whether a battery of tests designed to measure different levels of emotional intelligence could differentiate adolescent sex offenders from a non-offender control group. Fifteen male adolescent sex offenders ranging in age from 14 to 17 years were recruited through Health and Community Services (VIC, Australia) and 49 non-offender males, matched for age, completed the battery. The battery comprised the Trait Meta-Mood Scale (TMMS), Davis' Interpersonal Reactivity Index (IRI), the Inventory of Interpersonal Problems (IIP-32), the Revised Toronto Alexithymia Scale (TAS-20) and the Openness to Feelings facet of the NEO PI-R. Discriminant analyses using all five tests showed that 89.9 per cent of the sample were correctly allocated their respective groups. Overall the sex offenders were higher on aggression and attention to feelings, less clear about their feelings and less capable to repair unpleasant moods and prolong positive ones. It was concluded that these findings could be the focus of treatment approaches for adolescent sex offenders.     

Treatment of Aplastic Anemia with Nandrolone Decanoate

Highly satisfactory results obtained with50 mg./week nandrolone decanoate(Deca-Durabolin) for 3-16 months arereported in 10 cases of aplastic anemia.In the series thus treated there were onlytwo deaths, occurring after only a fewmonths of treatment. All other casesbenefited to a large degree: in six, normalization was achieved, and a distinctimprovement was seen in two still undertreatment. Once therapy had been commenced, there was a period of latencywhich fluctuated between 1 and 9months. Except for one patient withFanconi’s anemia, the other normalizedcases have not relapsed after suspensionof the drug.

Submitted on March 13, 1970 Revised on May 4, 1970 Accepted on June 10, 1970     

Reimagining care for adolescent and young adult cancer programs: Moving with the times

Literature regarding the development of adolescent and young adult (AYA) cancer programs has been dominantly informed by pediatric centers and practitioners. However, the majority of young adults are seen and treated at adult cancer centers, in which cancer volumes afford the development of innovative supportive care services. Although the supportive care services in adult cancer centers are helpful to AYAs, some of the most prominent and distinct issues faced by AYAs are not adequately addressed through these services alone. This article describes how the AYA Program at Princess Margaret Cancer Centre has collaborated with existing supportive care services in addition to supplying its own unique services to meet the comprehensive needs of AYAs in the domains of: symptom management (sexuality and fatigue), behavior modification (return to work and exercise), and health services (advanced cancer and survivorship). These collaborations are augmented by patient education interventions and timely referrals. The objective of this article was to assist other centers in expanding existing services to address the needs of AYA patients with cancer. Cancer 2016;122:1038–1046. © 2016 American Cancer Society     

Erythrocytosis Secondary to Increased Oxygen Affinity of a Mutant Hemoglobin, Hemoglobin Kempsey

An abnormal hemoglobin, termed hemoglobin Kempsey, was found in association with erythrocytosis in ten members of an Australian family. Genetictransmission fits an autosomal dominant pattern. Chemical characterization ofhemoglobin Kempsey identified a single amino acid substitution, ^99AspAsn.Properties of hemoglobin Kempsey include a marked increase in oxygen affinity, retention of the Bohr effect, and decreased heme-heme interaction. Possible structure-function relations of this and other abnormal hemoglobinsassociated with erythrocytosis are discussed.

Submitted on August 25, 1967 Accepted on November 6, 1967