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McLoone J, Watts K, Menzies S, Meiser B, Butow P, Kasparian N. When the risks are high: psychological adjustment among melanoma survivors at high risk of developing new primary disease. QUALITATIVE HEALTH RESEARCH 2012; 22:1102-1113. [PMID: 22673092 DOI: 10.1177/1049732312448542] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this study we explored the psychosocial experiences of melanoma survivors at high risk of developing new primary disease. A total of 20 survivors (9 men, 11 women, mean age 57.6 years) completed a semistructured telephone interview, exploring melanoma-related beliefs and experiences, psychological adjustment to melanoma risk, and supportive care needs. Participants perceived melanoma as potentially terminal and reported persistent worries about the possibility of developing new or metastatic disease. Fear of developing a new melanoma endured for years after treatment completion and, for some, created a pervasive sense of uncertainty. Still, not a single participant sought formal emotional support to address his or her melanoma-related concerns. Belief in the benefits of early intervention, including self- and clinical skin examination, provided a sense of control and a recommended course of action in an otherwise uncontrollable situation. The expertise of the High Risk Clinic physicians was perceived as instrumental in creating a sense of reassurance.
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Watts KJ, Meiser B, Mitchell G, Kirk J, Saunders C, Peate M, Duffy J, Kelly PJ, Gleeson M, Barlow-Stewart K, Rahman B, Friedlander M, Tucker K. How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer. BMC Cancer 2012; 12:320. [PMID: 22838957 PMCID: PMC3472271 DOI: 10.1186/1471-2407-12-320] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 07/13/2012] [Indexed: 12/20/2022] Open
Abstract
Background Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women’s treatment choices - treatment-focused genetic testing ‘TFGT’ - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service. Design/methods In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50 years) are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of > 10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a) an educational pamphlet about genetic testing (intervention) or (b) a genetic counseling appointment at a family cancer center (standard care). Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12 months and include decisional conflict (primary outcome);uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision making; and decision regret. A process-oriented retrospective online survey will examine health professionals’ attitudes toward TFGT; a health economic analysis will determine the cost effectiveness of the intervention. Discussion This trial will provide crucial information about the impact, efficiency and cost effectiveness of an educational pamphlet designed to inform younger women newly diagnosed with breast cancer about genetic testing. Issues regarding implementation of the trial are discussed. Trial registration The study is registered with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12610000502033)
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Meiser B, Gleeson M, Watts K, Peate M, Zilliacus E, Barlow-Stewart K, Saunders C, Mitchell G, Kirk J. Getting to the point: what women newly diagnosed with breast cancer want to know about treatment-focused genetic testing. Oncol Nurs Forum 2012; 39:E101-11. [PMID: 22374498 DOI: 10.1188/12.onf.e101-e111] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify young women's information preferences regarding treatment-focused genetic testing (TFGT) and to develop and evaluate a novel educational resource. RESEARCH APPROACH Qualitative interview study and pilot testing of a novel resource. SETTING Two familial cancer services and one outpatient oncology clinic in Sydney and Melbourne, Australia. PARTICIPANTS 26 women with breast cancer aged 50 years and younger who either previously had TFGT (n = 14) or had a diagnosis of breast cancer within the previous 6-12 months. METHODOLOGIC APPROACH Participants were asked about their views of TFGT in semistructured interviews. A brief pamphlet on TFGT then was developed and pilot tested with 17 of the 26 women. MAIN RESEARCH VARIABLES Women's attitudes and preferences with regard to timing, mode of delivery, and amount and format of information regarding TFGT were explored. FINDINGS Most women wanted to be informed about TFGT at or around the time of their cancer diagnosis via a face-to-face consultation. No clear preference existed for which type of healthcare professional should provide information on TFGT. Brief written information about TFGT was viewed as important supporting material. The educational resource developed was well received. CONCLUSIONS The potential for more widespread TFGT in the future indicates a need for patient educational materials that enable women to make informed choices about TFGT. This pilot study has provided timely initial evidence on the efficacy of a brief written resource in preparing women for decision making about TFGT. INTERPRETATION The resource developed in this study will assist oncology nurses to make important genetic risk information available to women newly diagnosed with breast cancer at a stressful time.
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Guethoff S, Meiser B, Schramm R, Ueberfuhr P, Hagl C, Reichart B, Kaczmarek I. 204 Long-Term Benefit of Tacrolimus over Cyclosporine Preventing Cardiac Allograft Vasculopathy (CAV) after Heart Transplantation: 10-Year Results of a Prospective Randomized Trial Comparing Tacrolimus Versus Cyclosporine Both in Combination with Mycophenolate Mofetil. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Zilliacus E, Meiser B, Gleeson M, Watts K, Tucker K, Lobb EA, Mitchell G. Are we being overly cautious? A qualitative inquiry into the experiences and perceptions of treatment-focused germline BRCA genetic testing amongst women recently diagnosed with breast cancer. Support Care Cancer 2012; 20:2949-58. [PMID: 22441502 DOI: 10.1007/s00520-012-1427-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 02/27/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE Women with breast cancer, who are found to be BRCA1/2 mutation carriers, have a high risk of ovarian cancer and metachronous breast cancer. Treatment-focused genetic testing (TFGT), offered around the time of diagnosis, allows genetic test results to inform surgical treatment decisions. However, concern has been raised that offering TFGT at this time may overly increase psychological burden. This study aimed to qualitatively explore women's attitudes and experiences of TFGT. METHODS Women who had been diagnosed with breast cancer at age 50 years or less undertook a semi-structured telephone interview (n = 26). The sample included women who had been offered TFGT, based on family history and/or other risk criteria (n = 14), and women who had been diagnosed within the past 6-12 months and had not been offered TFGT (n = 12). Interviews explored women's attitudes towards TFGT, perceived benefits and disadvantages, implications of TFGT and impact on surgical decision making. Interviews were transcribed verbatim and thematically analysed. RESULTS Women expressed positive attitudes towards TFGT and felt it was highly relevant to their surgical decision making. They did not feel that an offer of TFGT shortly after, or at the time of diagnosis, added undue psychological burden. The majority of women interviewed felt that TFGT should be incorporated into standard clinical care. CONCLUSIONS TFGT is viewed favourably by women newly diagnosed with breast cancer. Future randomized controlled trials are needed to examine the long-term impact of TFGT. We conclude that an offer of TFGT is not perceived as 'too much, too soon' by relevant patients.
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Peate M, Meiser B, Cheah BC, Saunders C, Butow P, Thewes B, Hart R, Phillips KA, Hickey M, Friedlander M. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. Br J Cancer 2012; 106:1053-61. [PMID: 22415294 PMCID: PMC3304428 DOI: 10.1038/bjc.2012.61] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/27/2012] [Accepted: 02/06/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA). METHODS A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18-40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models. RESULTS Compared with usual care, women who received the DA had reduced decisional conflict (β=-1.51; 95%CI: -2.54 to 0.48; P=0.004) and improved knowledge (β=0.09; 95%CI: 0.01-0.16; P=0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (β=-3.73; 95%CI: -7.12 to -0.35; P=0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P<0.001), fertility options (P=0.005), and rated it more helpful (P=0.002), than those who received standard care. CONCLUSION These findings support widespread use of this DA shortly after diagnosis (before chemotherapy) among younger breast cancer patients who have not completed their families.
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Watts K, Meiser B, Conlon H, Rovelli S, Tiller K, Zorbas H, Lewis C, Neil G, Friedlander M. A specialist breast care nurse role for women with metastatic breast cancer: enhancing supportive care. Oncol Nurs Forum 2012; 38:627-31. [PMID: 22037326 DOI: 10.1188/11.onf.627-631] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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108
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Kaczmarek I, Zaruba MM, Bigdeli AK, Sadoni S, Schramm R, Überfuhr P, Reichart B, Meiser B. Prospective randomized 3-arm trial comparing tacrolimus with mycophenolate mofetil (MMF) or sirolimus with calcineurininhibitor-free immunosuppression (Sirolimus/MMF) after heart transplantation: 5-year results. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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109
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Güthoff S, Meiser B, Schramm R, Ueberfuhr P, Reichart B, Kaczmarek I. Cardiac allograft vasculopathy (CAV): 10-year results of a randomized trial comparing tacrolimus versus cyclosporine in combination with mycophenolate mofetil after heart transplantation. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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110
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Meiser B, Price MA, Butow PN, Karatas J, Charles M, Phillips KA. Are women at high risk for serous gynaecological cancer (SGC) opting for risk-reducing salphingo-oophorectomy motivated by high levels of anxiety and risk perceptions? Hered Cancer Clin Pract 2012. [PMCID: PMC3395335 DOI: 10.1186/1897-4287-10-s2-a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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111
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White V, Farrelly A, Meiser B, Jefford M, Young M, Winship I, Ieropoli S, Koehler J. What are the unmet support needs of women with a known BRCA1/2 mutation? Hered Cancer Clin Pract 2012. [PMCID: PMC3326865 DOI: 10.1186/1897-4287-10-s2-a54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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112
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Peate M, Saunders C, Gregson J, Thewes B, D'Abrew N, Meiser B, White K, Hickey M. Development and evaluation of an information booklet about breast cancer and early menopause. Breast J 2011; 18:95-6. [PMID: 22098588 DOI: 10.1111/j.1524-4741.2011.01191.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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113
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Wilde A, Meiser B, Mitchell PB, Schofield PR. Community attitudes to genetic susceptibility-based mental health interventions for healthy people in a large national sample. J Affect Disord 2011; 134:280-7. [PMID: 21763000 DOI: 10.1016/j.jad.2011.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 06/20/2011] [Accepted: 06/20/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Despite an apparent high interest in predictive genetic testing for common multifactorial disorders, few data describe anticipated health behaviour as a consequence of such testing. METHODS A large population-based public survey with community dwelling adults (N = 1046) ascertained through random digit dialling. Attitudes were assessed via structured interviews. RESULTS Intention to start therapies or courses to learn to develop better strategies to cope with stress (80%) was significantly and positively associated with self-estimation of risk for major depressive disorder as higher than average (ß = 0.12, p = 0.001); endorsement of family environment as a causal attribution (ß = 0.11, p < 0.001); and endorsement of gene-environment interaction as a causal mechanism of mental illness (ß = 0.12, p = 0.017). Intention to modify potential life stressors (84%) was significantly and positively associated with self-estimation of risk for depression as higher than average (ß = 0.07, p = 0.029); endorsement of 'abuse' as a causal attribution (ß = 0.10, p = 0.003); and endorsement of 'gene-environment interaction' as a causal mechanism (ß = 0.10, p = 0.002). LIMITATIONS The hypothetical nature of the genetic risk scenario may have weakened participants' sensitivity to the potential personal impact of such a genetic test result. CONCLUSIONS Perceptions that modifiable environmental factors strongly contribute to overall risk of major depressive disorder appeared to drive willingness to engage in risk-modifying interventions in the hypothetical scenario of a genetic predisposition. Our results suggest that screening for genetic risk in consort with environmental risk factor assessment has potential community acceptability and clinical value as an early intervention and preventive tool for high risk groups.
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Wilde A, Bonfiglioli C, Meiser B, Mitchell PB, Schofield PR. Portrayal of psychiatric genetics in Australian print news media, 1996-2009. Med J Aust 2011; 195:401-4. [PMID: 21978348 DOI: 10.5694/mja10.10167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate how Australian print news media portray psychiatric genetics. DESIGN AND SETTING Content and framing analysis of a structured sample of print news items about psychiatric genetics published in Australian newspapers between 1996 and 2009. MAIN OUTCOME MEASURES Identify dominant discourses about aetiology of mental illness, and perceived clinical outcomes and implications of psychiatric genetics research. RESULTS We analysed 406 eligible items about the genetics of psychiatric disorders. News coverage of psychiatric genetics has steadily increased since 1996. Items attributing the aetiology of psychiatric disorders to gene-environment interactions (51%) outnumbered items attributing only genetic (30%) or only environmental factors (20%). Of items that referred to heritability of mental illness, frames of genetic determinism (78%) occurred more frequently than probabilistic frames (22%). Of frames related to genetic prophesy, genetic optimism frames (78%) were used more frequently than frames of genetic pessimism (22%). Psychosocial and ethical implications of psychiatric genetics received comparatively relatively little coverage (23%). The analysis identified 22 predictions about psychiatric genetic discoveries and the availability of molecular-based interventions in psychiatry, most of which (20/22, 91%) failed to manifest by the predicted year. CONCLUSIONS Excessive optimism about the power of genetic technology in psychiatric health care, perceived clinical benefits, and largely unfulfilled predictions about availability of these benefits could encourage unrealistic expectations about future molecular-based treatment options for mental health.
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Wilde A, Meiser B, Mitchell PB, Hadzi-Pavlovic D, Schofield PR. Community interest in predictive genetic testing for susceptibility to major depressive disorder in a large national sample. Psychol Med 2011; 41:1605-1613. [PMID: 21159212 DOI: 10.1017/s0033291710002394] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite international concern about unregulated predictive genetic testing, there are surprisingly few data on both the determinants of community interest in such testing and its psychosocial impact. METHOD A large population-based public survey with community-dwelling adults (n=1046) ascertained through random digit dialling. Attitudes were assessed by structured interviews. RESULTS The study found strong interest in predictive genetic testing for a reported susceptibility to depression. Once the benefits and disadvantages of such testing had been considered, there was significantly greater interest in seeking such a test through a doctor (63%) compared to direct-to-consumer (DTC; 40%) (p<0.001). Personal history of mental illness [odds ratio (OR) 2.58, p<0.001], self-estimation of being at higher than average risk for depression (OR 1.92, p<0.001), belief that a genetic component would increase rather than decrease stigma (OR 1.62, p<0.001), and endorsement of benefits of genetic testing (OR 3.47, p<0.001) significantly predicted interest in having such a test. CONCLUSIONS Despite finding attitudes that genetic links to mental illness would increase rather than decrease stigma, we found strong community acceptance of depression risk genotyping, even though a predisposition to depression may only manifest upon exposure to stressful life events. Our results suggest that there will be a strong demand for predictive genetic testing.
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Eissner G, Hartmann I, Kesikli A, Holler E, Haffner S, Sax T, Schray C, Meiser B, Reichart B. CD4+CD25+FoxP3+ regulatory T cells enhance the allogeneic activity of endothelial-specific CD8+/CD28-CTL. Int Immunol 2011; 23:485-92. [DOI: 10.1093/intimm/dxr041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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117
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Ratnayake P, Wakefield CE, Meiser B, Suthers G, Price MA, Duffy J, Tucker K. An exploration of the communication preferences regarding genetic testing in individuals from families with identified breast/ovarian cancer mutations. Fam Cancer 2011; 10:97-105. [PMID: 20878485 DOI: 10.1007/s10689-010-9383-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The responsibility for informing at-risk relatives of the availability of genetic testing for breast/ovarian cancer gene (BRCA1 or BRCA2) mutations currently falls on the probands. This study explored the support needs of individuals from families with identified BRCA1 or BRCA2 mutations when communicating about genetic risk and genetic testing with at-risk family members. Thirty-nine semi-structured telephone interviews were conducted with individuals from families with identified BRCA mutations. Interview responses were cross-tabulated by sample characteristics using the qualitative research analysis software NVivo8. The development of educational materials, which individuals could use when communicating the risks of carrying a BRCA gene mutation with their relatives, was identified as a specific need. Many participants expressed a preference for a staged approach, where relatives are notified of their increased risk and the availability of genetic testing risk either face-to-face or via a letter, with additional educational sources, including brief written information or access to a website, made available for those wishing to access more in-depth information. This research identified a need for the development of educational/informational resources to support individuals with identified breast/ovarian cancer mutations to communicate with their at-risk relatives about genetic risk and genetic testing availability.
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118
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Juraskova I, Jarvis S, Mok K, Peate M, Meiser B, Mireskandari S, Friedlander M. OVERcome: An intervention study to improve sexual function in women with breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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119
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Saleh M, Barlow-Stewart K, Meiser B, Kirk J, Tucker K. An Exploration of the Cultural Context of Kinship and Genetics Amongst Arabic-Australians: Implications for Practice. J Genet Couns 2011; 20:465-75. [DOI: 10.1007/s10897-011-9371-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Accepted: 04/20/2011] [Indexed: 11/29/2022]
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120
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Watts KJ, Sherman KA, Mireskandari S, Meiser B, Taylor A, Tucker K. Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer. Psychol Health 2011; 26 Suppl 1:21-39. [DOI: 10.1080/08870441003592587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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121
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Wakefield CE, Watts KJ, Meiser B, Sansom-Daly U, Barratt A, Mann GJ, Lobb EA, Gaff CL, Howard K, Patel MI. Development and pilot testing of an online screening decision aid for men with a family history of prostate cancer. PATIENT EDUCATION AND COUNSELING 2011; 83:64-72. [PMID: 20580521 DOI: 10.1016/j.pec.2010.05.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 05/14/2010] [Accepted: 05/25/2010] [Indexed: 05/23/2023]
Abstract
OBJECTIVE This study aimed to develop and pilot test an online screening decision aid (DA) for men with a family history of prostate cancer. METHODS Eligible men (with no previous prostate cancer diagnosis) were recruited through relatives attending a urology outpatient clinic. Men evaluated the DA in two stages. First, they appraised a paper-based version using a questionnaire (n=22). Second, the same men were asked to reflect on an interactive web-based version via a semi-structured telephone interview (n=20). RESULTS Men evaluated both forms of the DA positively. Of the paper-based version, the majority of participants found the DA useful (91%), and that it contained enough information to make a screening decision (73%). All participants reported that the online DA was easy to use and navigate. Most participants reported that a website was their preferred mode of receiving prostate cancer screening information (70%). CONCLUSION The developed DA may represent the first online decision-making tool designed specifically for men with a family history prostate cancer that presents age and risk specific information to the user. PRACTICE IMPLICATIONS Comprehensive evaluations of the efficacy and impact of educational interventions such as this are crucial to improve services for individuals making informed screening decisions.
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Kaczmarek I, Ueberfuhr P, Meiser B, Reichart B, Eifert S. 331 Gender Does Matter: Gender-Specific Outcome Analysis of 67.000 Hearts from the ISHLT Registry. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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123
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Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, Sangster J, Hadzi-Pavlovic D, Hickey M. It's now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study. J Clin Oncol 2011; 29:1670-7. [PMID: 21444865 DOI: 10.1200/jco.2010.31.2462] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE For many young women with early breast cancer, fertility is a priority. Interventions to retain fertility options generally need to be accessed before chemotherapy, but many women do not receive information regarding these options in a timely fashion. Knowledge about fertility and decisional conflict has not previously been measured in young patients with breast cancer considering future pregnancies. METHODS One hundred eleven young women with early breast cancer who had not yet completed their families were recruited around the time of diagnosis. Knowledge regarding fertility-related information, decisional conflict, and preferences regarding fertility information and decision making was measured. RESULTS From a potential fertility-related knowledge score of 10, the mean was 5.2 (standard deviation = 2.3; range, 0 to 10). Decreased knowledge was associated with increased decisional conflict about pursuing fertility preserving interventions (odds ratio [OR] = 0.57; 95% CI, 0.44 to 0.73; P < .001). Thirty-one percent of women reported that they would consider undertaking in vitro fertilization (IVF) as a method to conserve their fertility, whereas 38% were uncertain. Consideration of IVF was not related to whether subjects were in a committed relationship (OR = 1.20; P = .716) or a definite desire for more children (OR = 1.54; P = .513). CONCLUSION Around diagnosis, many young patients with breast cancer have low levels of knowledge about fertility issues. Further, low knowledge is associated with increased decisional conflict, which is likely to undermine the quality of decision making. These findings suggest that targeted and timely fertility information may reduce decisional conflict and increase informed choice. Neither relationship status nor firm plans regarding future children reliably predict desire to pursue fertility preservation.
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Wakefield CE, Watts KJ, Homewood J, Meiser B, Siminoff LA. Attitudes toward organ donation and donor behavior: a review of the international literature. Prog Transplant 2011. [PMID: 21265292 DOI: 10.7182/prtr.20.4.p54651601pg80183] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior. DATA SOURCES MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009. STUDY SELECTION Eligible studies included members of the general public (i.e., not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors. Data Extraction-The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis. DATA SYNTHESIS Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs. CONCLUSIONS The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs. (Progress in Transplantation.
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Brenner P, Hinz M, Huber H, Schmoeckel M, Reichenspumer H, Meiser B, Hammer C, Reichart B. Influence of ischemic time on hyperacute xenograft rejection of pig hearts in a working heart perfusion model with human blood. Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02091.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brenner P, Reichenspurner H, Schmoeckel M, Wimmer C, Rucker A, Eder V, Meiser B, Hinz M, Felbinger T, Hammer C, Reichart B. Prevention of hyperacute xenograft rejection in orthotopic xenotransplantation of pig hearts into baboons using immunoadsorption of antibodies and complement factors. Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02093.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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127
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Kaczmarek I, Meiser B, Ziegler FV, Schramm R, Bigdeli A, Beiras-Fernandez A, Überfuhr P, Reichart B. De-novo calcineurininhibitor-free immunosuppression with sirolimus, mycophenolate Mofetil and ATG after heart transplantation: 5-year results. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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128
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Güthoff S, Meiser B, Überfuhr P, Eifert S, Reichart B, Kaczmarek I. Long-term comparison of tacrolimus versus cyclosporine in combination with mycophenolate mofetil after heart transplantation - ten year results of a prospective randomized trial. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1268910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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129
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Wakefield CE, Ratnayake P, Meiser B, Suthers G, Price MA, Duffy J, Tucker K. "For all my family's sake, I should go and find out": an Australian report on genetic counseling and testing uptake in individuals at high risk of breast and/or ovarian cancer. Genet Test Mol Biomarkers 2011; 15:379-85. [PMID: 21254855 DOI: 10.1089/gtmb.2010.0158] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
CONTEXT Despite proven benefits, the uptake of genetic counseling and testing by at-risk family members of BRCA1 and BRCA2 mutation carriers remains low. AIMS This study aimed to examine at-risk individuals' reported reasons for and against familial cancer clinic (FCC) attendance and genetic testing. METHODS Thirty-nine telephone interviews were conducted with relatives of high-risk mutation carriers, 23% (n = 9) of whom had not previously attended an FCC. Interview responses were analyzed using the frameworks of Miles and Huberman. RESULTS The reasons most commonly reported for FCC attendance were for clarification of risk status and to gain access to testing. While disinterest in testing was one reason for FCC nonattendance, several individuals were unaware of their risk (n = 3) or their eligibility to attend an FCC (n = 2), despite being notified of their risk status through their participation in a large-scale research project. Individuals' reasons for undergoing testing were in line with that reported elsewhere; however, concerns about discrimination and insurance were not reported in nontestees. CONCLUSIONS Current guidelines regarding notifying individuals discovered to be at increased risk in a research, rather than clinical setting, take a largely nondirective approach. However, this study demonstrates that individuals who receive a single letter notifying them of their risk may not understand/value the information they receive.
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Mitchell PB, Meiser B, Wilde A, Fullerton J, Donald J, Wilhelm K, Schofield PR. Predictive and diagnostic genetic testing in psychiatry. Clin Lab Med 2011; 30:829-46. [PMID: 20832655 DOI: 10.1016/j.cll.2010.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The recent advent of commercially available genetic tests for the diagnosis of several mental illnesses has led to intense controversy amongst the psychiatric research community. In this article the authors review these developments, and contrast these with the growing evidence from genomewide association studies that highly heritable psychiatric conditions such as schizophrenia are due to the contributions and interaction of multiple allelic variants, each of small effect size. There is also evidence for the contribution of some highly penetrant rare de novo copy number variants, though the lack of disease specificity for these is of concern. This article outlines the prerequisites for predictive and diagnostic genetic tests, such as clinical validity and utility, and reviews the opportunity that genetic tests for mental illnesses present. As the scientific discourse on genetic tests for complex disorders is not limited to psychiatry, the authors outline current thoughts on the significance of genome-wide association studies across health, and the phenomenon of direct-to-consumer tests in medicine. The attitudes and understanding of patients, families, and clinicians about the future (currently hypothetical) scenario of psychiatric genetic tests are discussed, as is the potential for such testing to increase, rather than diminish stigma. Finally, recommendations on the future development and availability of genetic tests in psychiatry are provided.
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Saleh M, Barlow-Stewart K, Meiser B, Tucker K, Eisenbruch M, Kirk J. Knowledge, attitudes and beliefs of Arabic-Australians concerning cancer. Psychooncology 2010; 21:195-202. [PMID: 22271540 DOI: 10.1002/pon.1884] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Revised: 10/10/2010] [Accepted: 10/17/2010] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To explore with Arabic-Australian patients and their communities, the cultural context of cancer, both sporadic and inherited, by examining their beliefs about its causes and the modes of communication about cancer with family, friends and the community. METHOD The design is an ethnographic and qualitative interview study with thematic analysis. Arabic-Australian participants were recruited in two stages. First, patients who had attended a family cancer clinic in Sydney, Australia, were invited to participate. Second, participants from the general community in Sydney were recruited with the aim of either verifying or challenging the reported findings from the clinic sample. RESULTS A total of 38 interviews with 26 females and 12 males provided cultural descriptions of illnesses, including cancer, and its causes. The terminologies around cancer and a cancer diagnosis were believed to have more impact and generate greater fear in people in the Arabic community living in Australia than the terms used to describe a diagnosis of other illnesses. Despite this, those interviewed were aware of screening and community programs and were open to discuss their views about cancer with the research team. CONCLUSION Arabic-Australians are an important group in the community with unique culture-specific attributes that can affect communication about cancer in the clinical setting. Barriers to communication such as the negative feelings associated with the word cancer and the stigma it arouses must be acknowledged. Culturally competent clinical practices with this group include the incorporation of these belief systems into the communication process and avoidance of stereotyping.
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Peate M, Meiser B, Friedlander M, Saunders C, Martinello R, Wakefield CE, Hickey M. Development and pilot testing of a fertility decision aid for young women diagnosed with early breast cancer. Breast J 2010; 17:112-4. [PMID: 21129095 DOI: 10.1111/j.1524-4741.2010.01033.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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133
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Wakefield CE, Watts KJ, Homewood J, Meiser B, Siminoff LA. Attitudes toward Organ Donation and Donor Behavior: A Review of the International Literature. Prog Transplant 2010; 20:380-91. [DOI: 10.1177/152692481002000412] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior. Data Sources MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009. Study Selection Eligible studies included members of the general public (ie, not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors. Data Extraction The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis. Data Synthesis Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs. Conclusions The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs.
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Karatas JC, Barlow-Stewart K, Strong KA, Meiser B, McMahon C, Roberts C. Women's experience of pre-implantation genetic diagnosis: a qualitative study. Prenat Diagn 2010; 30:771-7. [PMID: 20661891 DOI: 10.1002/pd.2542] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide an in-depth account of the experience of pre-implantation genetic diagnosis (PGD). METHOD Exploratory qualitative interview study. Participants were recruited from one major in vitro fertilization (IVF) clinic in Sydney, Australia. Data were collected through 14 in-depth interviews with women at different stages of PGD, utilized a thematic approach and facilitated by NVivo software. RESULTS Women reported using PGD as empowering and led them to feel in control of their reproductive futures. Health professionals who did not tell women about PGD were seen as a barrier to accessing treatment. The ability to select embryos free from the genetic condition (for which it was at risk) alleviated stress. Despite this, stress experienced with PGD was significant for women, and often related to past experiences of reproductive trauma and grief. The outcome of embryos was also the cause of stress for women. CONCLUSION Women undergoing PGD have a diverse range of reproductive and genetic histories, psychosocial circumstances and world views that all interact and impact their experience of PGD. Successful support and care of these women should address all of these factors and tailor the support provided for women using this physically and emotionally complex form of reproductive technology.
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Karatas JC, Barlow-Stewart K, Meiser B, McMahon C, Strong KA, Hill W, Roberts C, Kelly PJ. A prospective study assessing anxiety, depression and maternal-fetal attachment in women using PGD. Hum Reprod 2010; 26:148-56. [PMID: 20959384 DOI: 10.1093/humrep/deq281] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND PGD has been described in previous cross-sectional and retrospective studies as a stressful experience. No prospective studies of the psychological impact of PGD are currently available. METHODS Using a prospective study design, validated measures exploring anxiety and depression were used to assess women using PGD prior to treatment, following embryo transfer, following the pregnancy test result and at 24 weeks of pregnancy. Maternal-fetal attachment was also assessed during pregnancy. RESULTS The prospective design revealed the cyclical pathway through PGD for many women, often comprising repeated cycles of ovarian stimulations and IVF and frozen embryo transfers. As predicted, there were significant fluctuations in women's anxiety scores, with increases observed following embryo transfer and pregnancy testing. Women's anxiety scores returned to baseline levels during pregnancy as assessed at 24 weeks gestation. Depression scores did not significantly fluctuate during PGD. Maternal-fetal attachment scores in this sample did not differ from the normative Australian data. CONCLUSIONS For some women, the PGD pathway is convoluted and requires multiple IVF cycles and embryo transfers to achieve pregnancy. A subset of women experience significant emotional burden during PGD treatment, and it is these women who require closer attention and support. In this sample, emotional adjustment in pregnancy following PGD appears to be sound.
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Wakefield CE, Homewood J, Taylor A, Mahmut M, Meiser B. Time Perspective in Hereditary Cancer: Psychometric Properties of a Short Form of the Zimbardo Time Perspective Inventory in a Community and Clinical Sample. Genet Test Mol Biomarkers 2010; 14:617-27. [DOI: 10.1089/gtmb.2009.0185] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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137
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Karatas JC, Barlow-Stewart K, Strong KA, Meiser B, McMahon C, Roberts C. Women's experience of pre-implantation genetic diagnosis: a qualitative study. Prenat Diagn 2010. [PMID: 20661891 DOI: 10.1002/pd.2542.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To provide an in-depth account of the experience of pre-implantation genetic diagnosis (PGD). METHOD Exploratory qualitative interview study. Participants were recruited from one major in vitro fertilization (IVF) clinic in Sydney, Australia. Data were collected through 14 in-depth interviews with women at different stages of PGD, utilized a thematic approach and facilitated by NVivo software. RESULTS Women reported using PGD as empowering and led them to feel in control of their reproductive futures. Health professionals who did not tell women about PGD were seen as a barrier to accessing treatment. The ability to select embryos free from the genetic condition (for which it was at risk) alleviated stress. Despite this, stress experienced with PGD was significant for women, and often related to past experiences of reproductive trauma and grief. The outcome of embryos was also the cause of stress for women. CONCLUSION Women undergoing PGD have a diverse range of reproductive and genetic histories, psychosocial circumstances and world views that all interact and impact their experience of PGD. Successful support and care of these women should address all of these factors and tailor the support provided for women using this physically and emotionally complex form of reproductive technology.
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Trainer AH, Meiser B, Watts K, Mitchell G, Tucker K, Friedlander M. Moving Toward Personalized Medicine: Treatment-Focused Genetic Testing of Women Newly Diagnosed With Ovarian Cancer. Int J Gynecol Cancer 2010; 20:704-16. [DOI: 10.1111/igc.0b013e3181dbd1a5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives:The presence of a germline BRCA mutation defines a genotype-specific group of women whose invasive ovarian cancer is associated with an increasingly well-defined prognostic and chemosensitivity biological profile. To determine the criteria that may be used to select patients for BRCA treatment-focused genetic testing, we performed a systemic literature search of studies that assessed BRCA1 and BRCA2 mutation frequency in women with ovarian cancer unselected for family history. The results are discussed with regard to the added clinical value gained by identifying a germline BRCA mutation at the time of the ovarian cancer diagnosis.Methods:BRCA-related studies were identified in the CD-ROM databases PubMed (including MEDLINE), PsychINFO, and CINAHL and included in the review if they met the following criteria: they (a) assessed mutation frequency in women with ovarian cancer who were unselected for family history and ethnicity, (b) were published in a peer-review journal, (c) between January 1997 and October 2009, and (d) in the English language.Results:Studies investigating the prevalence of BRCA1 or BRCA2 mutations in ovarian cancer patients unselected for family history or ethnicity have found a pathological BRCA mutation rate of approximately 3% to 17%. Without a significant family history, specific features that may be used to target treatment-focused BRCA testing in the ovarian cancer setting include young age at onset (<50 years), high-grade serous tumor histology, and specific ethnicity associated with known BRCA founder mutations.Conclusions:We believe that given the growing appreciation of the prognostic significance of BRCA mutations and the differential chemosensitivity shown by these tumors, as well as the potential of novel agents such as poly(ADP-ribose) polymerase inhibitors, the identification of a germline BRCA mutation concurrent with a new diagnosis of ovarian cancer will significantly impact on tailoring personalized ovarian management in the future.
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Zilliacus EM, Meiser B, Lobb EA, Kirk J, Warwick L, Tucker K. Women's experience of telehealth cancer genetic counseling. J Genet Couns 2010; 19:463-72. [PMID: 20411313 DOI: 10.1007/s10897-010-9301-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Accepted: 03/25/2010] [Indexed: 12/20/2022]
Abstract
Telegenetics offers an alternative model of delivering genetic counseling to rural and outreach areas; however there is a dearth of qualitative research into the patient's experience. Twelve women who had received telemedicine genetic counseling for hereditary breast and/or ovarian cancer (HBOC) within the previous 12 months participated in a semi-structured telephone interview. The interview explored women's experience with telegenetics, satisfaction, perceived advantages and disadvantages and quality of the interaction with their genetic professionals. Overall women were highly satisfied with telegenetics. Telegenetics offered them convenience and reduced travel and associated costs. The majority of women described feeling a high degree of social presence, or rapport, with the off-site genetic clinician. One woman with a recent cancer diagnosis, reported that telemedicine was unable to meet her needs for psychosocial support. This finding highlights the need to be mindful of the psychosocial support needs of women with a recent diagnosis being seen via telegenetics. Patients attending for HBOC genetic counseling are generally highly satisfied with the technology and the interaction. Care should be taken, however, with patients with more complex psychosocial needs.
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140
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Karatas JC, Barlow-Stewart K, Meiser B, McMahon C, Strong KA, Hill W, Roberts C, Kelly P. Psychological adjustment, knowledge and unmet information needs in women undergoing PGD. Hum Reprod 2010; 25:1481-9. [DOI: 10.1093/humrep/deq086] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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141
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Price MA, Butow PN, Charles M, Bullen T, Meiser B, McKinley JM, McLachlan SA, Phillips KA. Predictors of breast cancer screening behavior in women with a strong family history of the disease. Breast Cancer Res Treat 2010; 124:509-19. [PMID: 20364401 DOI: 10.1007/s10549-010-0868-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 03/20/2010] [Indexed: 01/06/2023]
Abstract
This study applied the self-regulation model to examine cognitive and emotional predictors of screening in unaffected women with a strong family history of breast cancer. 748 unaffected female members of an Australian registry of multiple-case breast cancer families formed the sample. Participants completed a baseline psychosocial questionnaire and a screening questionnaire 3 years later. Multinomial logistic regression was employed to determine predictors of under- and over-screening according to national guidelines. At follow-up 16% of women under-screened and 10% over-screened with mammography; 55% under-screened with clinical breast examination (CBE); and 9% over-screened with breast self-examination (BSE). Of the women found screening according to guidelines for mammography 72% reported ever having received specific recommendations for mammography screening from a health professional. Compared to appropriate screeners, under-screeners on mammography were less likely to have received a screening recommendation (as were under-screeners on CBE), were younger and reported lower perceived breast cancer risk, but were at higher relative risk (RR) of breast cancer and were more likely to report elevated depression. Over-screeners on mammography were more likely to be younger and have a lower RR of breast cancer. Over-screeners on BSE reported elevated cancer-specific anxiety, were less likely to be university educated and more likely to have received a recommendation for BSE. Under- and over-screening is common in women with a strong family history of breast cancer. Evaluation of interventions targeting perceived risk of breast cancer, anxiety and depression are needed to ensure women obtain accurate advice from relevant specialists and enact screening recommendations.
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Zilliacus E, Meiser B, Lobb E, Dudding TE, Barlow-Stewart K, Tucker K. The Virtual Consultation: Practitioners' Experiences of Genetic Counseling by Videoconferencing in Australia. Telemed J E Health 2010; 16:350-7. [DOI: 10.1089/tmj.2009.0108] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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143
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Meiser B, Rahmel A, Kaczmarek I, Smits J, Reichart B. Impact of allocation rules on outcome after heart transplantation in Germany. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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144
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Akra B, Balasso A, Moravec S, Liepsch D, Fano C, Dauner M, Meiser B, Reichart B. Flow map visualization across tissue engineered heart valve prostheses. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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145
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Akra B, Uhlig A, Haas U, Fano C, Dauner M, Schmitz C, Meiser B, Reichart B. Fibroblasts and endothelial cells adhesion to polyurethane aortic valve scaffolds under low- and high-flow conditions. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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146
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Januszewska K, Kellerer D, Malec E, Meiser B, Schmitz C, Reichart B, Überfuhr P. Heart-lung transplantation – single center experience. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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147
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Eißner G, Hartmann I, Haffner S, Meiser B, Reichart B. Regulatory T cells enhance allogeneic lysis of human endothelial cells by T lymphocytes. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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148
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Kaczmarek I, Eifert S, Kofler S, Meiser B, Reichart B. 327: Gender Does Matter – Gender Specific Outcome Analysis of 1000 Heart Transplants at a Single Centre. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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149
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Kaczmarek I, Eifert S, Beiras-Fernandez A, Bigdeli AK, Meiser B, Überfuhr P, Reichart B. Gender does matter – gender specific outcome analysis of 1000 heart transplants at a single centre. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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150
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Smits J, Rahmel A, Laufer G, Meiser B. Considerations for Patients Awaiting Heart Transplantation. Thorac Cardiovasc Surg 2010; 58 Suppl 2:S179-84. [DOI: 10.1055/s-0029-1240655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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