Risk-based recommendations for mammographic screening for women in their forties

PURPOSE: To develop risk-based recommendations for mammographic screening for women in their 40s that take into account the woman's age, race, and specific risk factors. METHODS: We assumed that regular mammographic screening is justified for a 50-year-old woman, even one with no risk factors, and that a younger woman with an expected 1-year breast cancer incidence rate as great or greater than that of a 50-year-old woman with no risk factors would benefit sufficiently to justify regular screening. Recommendations under this criterion were based on age- and race-specific breast cancer incidence rates from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) Program; assessments of risk factors from the Breast Cancer Detection and Demonstration Project (BCDDP); and reports in the literature. RESULTS: Two methods, the exact-age procedure (EAP) and the grouped-age procedure (GAP), were developed. The less precise GAP only requires following a flow diagram. The proportion of white women recommended for screening by the EAP ranges from 10% for 40-year-old women to 95% for 49-year-old women, and the corresponding percentages for black women are 16% and 95%. The assumptions that underlie the guidelines are discussed critically. CONCLUSION: For women or physicians who prefer an individualized approach in deciding whether to initiate regular mammographic screening in the age range of 40 to 49 years, the present report offers recommendations based on individualized risk-factor data and clearly stated assumptions that have an empiric basis. These recommendations can be used to facilitate the counseling process.     

Maltreated children's memory: Accuracy, suggestibility, and psychopathology.

Memory, suggestibility, stress arousal, and trauma-related psychopathology were examined in 328 3- to 16-year-olds involved in forensic investigations of abuse and neglect. Children's memory and suggestibility were assessed for a medical examination and venipuncture. Being older and scoring higher in cognitive functioning were related to fewer inaccuracies. In addition, cortisol level and trauma symptoms in children who reported more dissociative tendencies were associated with increased memory error, whereas cortisol level and trauma symptoms were not associated with increased error for children who reported fewer dissociative tendencies. Sexual and/or physical abuse predicted greater accuracy. The study contributes important new information to scientific understanding of maltreatment, psychopathology, and eyewitness memory in children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

THE FEDERAL ROLE IN ENERGY R&D

This paper documents and analyzes recent trends in Federal energy research and development programs. In light of the marketplace philosophy of the present Administration, the possible benefits of a strong Federal research program versus the potential advantages of relying on private sector research programs to develop new technology alternatives are analyzed in some detail. The impacts of the Reagan budget cuts and other initiatives on several major energy programs, including nuclear power, photovoltaics, and conservation, are also analyzed. This analysis reveals some of the difficulties inherent in attempting to project the consequences of particular policy decisions in a complex and changing environment, and identifies some of the problems of trying to evaluate the success of particular programs or actions on a limited time scale.     

Psychogenic-organic symptom overlap: Considerations for nonmedical psychotherapists.

Discusses common presenting complaints and those of emergent significance that have an organic etiology. The following categories are discussed: head, eyes, ears, throat, neck, cardiac, respiratory, gastrointestinal, genito-urinary, musculoskeletal, and neurologic complaints. It is suggested that many therapists lack adequate medical information to suspect the presence of organic problems when symptoms are indistinguishable from psychogenic/psychosomatic problems. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Different types of signal coupling in the visual cortex related to neural mechanisms of associative Processing and perception

The hypothesis of object representation by synchronization in the visual cortex has been supported by our recent experiments in monkeys. They demonstrated local synchrony among /spl gamma/ activities (30-90 Hz) and their perceptual modulation, according to the rules of figure-ground segregation. However, /spl gamma/-synchrony in primary visual cortex is restricted to few mm, challenging the synchronization hypothesis for larger cortical object representations. The restriction is due to randomly changing phase relations among locally synchronized patches which, however, form continuous waves of /spl gamma/-activity, traveling across object representations. The phase continuity of these waves may support coding of object continuity. Interactions across still larger distances, measured among cortical areas in human data, involve amplitude envelopes of /spl gamma/ signals. Based on models with spiking neurons we discuss potentially underlying mechanisms. Most important for /spl gamma/ synchronization are local facilitatory connections with distance-dependent delays. They also explain the occurrence of /spl gamma/ waves and the restriction of /spl gamma/-synchrony. Fast local feedback inhibition generates /spl gamma/ oscillations and supports local synchrony, while slow shunting inhibitory feedback supports figure-ground segregation. Finally, dispersion in inter-areal far projections destroys coherence of /spl gamma/ signals, but preserves their amplitude modulations. In conclusion, we propose that the hypothesis of associative processing by /spl gamma/ synchronization be extended to more general forms of signal coupling.