Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations.

OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS: A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION: This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening

A Multifaceted Approach to Modernizing NASA's Advanced Multi-Mission Operations System (AMMOS) System Architecture

The Advanced Multi-Mission Operations Systems (AMMOS) is NASA's premier space mission operations product line offering for use in deep-space robotic and astrophysics missions. The general approach to AMMOS modernization over the course of its 29-year history exemplifies a continual, evolutionary approach with periods of sponsor investment peaks and valleys in between. Today, the Multimission Ground Systems and Services (MGSS) office-the program office that manages the AMMOS for NASA-actively pursues modernization initiatives and continues to evolve the AMMOS by incorporating enhanced capabilities and newer technologies into its end-user tool and service offerings. Despite the myriad of modernization investments that have been made over the evolutionary course of the AMMOS, pain points remain. These pain points, based on interviews with numerous flight project mission operations personnel, can be classified principally into two major categories: 1) information-related issues, and 2) process-related issues. By information-related issues, we mean pain points associated with the management and flow of MOS data across the various system interfaces. By process-related issues, we mean pain points associated with the MOS activities performed by mission operators (i.e., humans) and supporting software infrastructure used in support of those activities. In this paper, three foundational concepts-Timeline, Closed Loop Control, and Separation of Concerns-collectively form the basis for expressing a set of core architectural tenets that provides a multifaceted approach to AMMOS system architecture modernization intended to address the information- and process-related issues. Each of these architectural tenets will be further explored in this paper. Ultimately, we envision the application of these core tenets resulting in a unified vision of a future-state architecture for the AMMOS-one that is intended to result in a highly adaptable, highly efficient, and highly cost-effective set of multimission MOS products and services