The roles of family members, health care workers, and others in decision-making processes about genetic testing among individuals at risk for Huntington disease

Purpose: To understand how individuals at risk for Huntington disease view the roles of others, e.g., family members and health care workers, in decision making about genetic testing. Methods: Twenty-one individuals (eight mutation-positive, four mutation-negative, and nine not tested) were interviewed for approximately 2 hours each. Results: Interviewees illuminated several key aspects of the roles of family members and health care workers (in genetics and other fields) in decision making about testing that have been underexplored. Family members often felt strongly about whether an individual should get tested. Health care workers provided information and assistance with decision making and mental health referrals that were often helpful. Yet health care workers varied in knowledge and sensitivity regarding testing issues, and the quality of counseling and testing experiences can range widely. At times, health care workers without specialized knowledge of Huntington disease offered opinions of whether to test. Input from families and health care workers could also conflict with each other and with an individual's own preferences. Larger institutional and geographic contexts shaped decisions as well. Conclusion: Decision-making theories applied to Huntington disease testing have frequently drawn on psychological models, yet the current data highlight the importance of social contexts and relationships in testing decisions. This report, the first to our knowledge to explore individuals' perceptions of social factors (particularly family and health care worker involvement) in Huntington disease testing decisions, has critical implications for practice, education, research, and policy

Effect of transient pinning on stability of drops sitting on an inclined plane

We report on new instabilities of the quasi-static equilibrium of water drops pinned by a hydrophobic inclined substrate. The contact line of a statically pinned drop exhibits three transitions of partial depinning: depinning of the advancing and receding parts of the contact line and depinning of the entire contact line leading to the drop's translational motion. We find a region of parameters where the classical Macdougall-Ockrent-Frenkel approach fails to estimate the critical volume of the statically pinned inclined drop

Discovery and Description of a Sphagnum Bog in Iowa, With Notes on the Distribution of Bog Plants in the State

This Sphagnum bog is located in Dead Man\u27s Lake, Pilot Knob State Park, Hancock Co., Iowa. The county is in the center of the state east and west and is in the second tier of counties from the north, just south of Winnebago Co., which, in turn, borders Minnesota. Pilot Knob Park is in the northeastern part of the county, half in Section 3 and half in Section 4 of Ellington Township (97-23). It is right at the northern border of the county and three miles west of the eastern border. It can be reached by driving 3.5 miles east from Forest City (Winnebago Co.) on U.S. 9, and going south for a mile on Iowa 332 to the entrance at the northwest corner of the park. The park is an irregular mass of morainic hills, formed of pebbly Mankato (Wisconsin) drift, with marshy and boggy depressions in between, with Pilot Knob (1450\u27), by far the most outstanding of these hills, towering about 300\u27 above the level of Lime Creek, to the southwest, and 100\u27 above Dead Man\u27s Lake. For a description of the forest, mostly oak, which covers the whole upland area, see Macbride (1903) Forestry Notes for Hancock Co. Oak wilt has caused much tree destruction in the last three years. Pilot Knob early attracted considerable attention, and received its name from it use as a landmark, to pilot the traveller. This is not only the finest morainic mound thus far described in Iowa, but is one of the finest in the whole country (Ibid. :90). The amazing height, for Iowa prairie country, excited various writers to a free use of superlatives: From the top of Pilot Knob a larger area of fertile land may be seen than from anywhere else on this earth I believe (Secor, 1919:128)

Decision‐Making About Reproductive Choices Among Individuals At‐Risk for Huntington's Disease

We explored how individuals at‐risk for HD who have or have not been tested make reproductive decisions and what factors are involved. We interviewed 21 individuals (8 with and 4 without the mutation, and 9 un‐tested) in‐depth for 2 hours each. At‐risk individuals faced a difficult series of dilemmas of whether to: get pregnant and deliver, have fetal testing, have pre‐implantation genetic diagnosis, adopt, or have no children. These individuals weighed competing desires and concerns: their own desires vs. those of spouses vs. broader moral concerns (e.g., to end the disease; and/or follow dictates against abortion) vs. perceptions of the interests of current or future offspring. Quandaries arose of how much and to whom to feel responsible. Some changed their perspectives over time (e.g., first “gambling,” then being more cautious). These data have critical implications for genetic counselors and other health care workers and future research, particularly as more genetic tests become available

Disclosures of Huntington disease risk within families: Patterns of decision‐making and implications

Patterns of disclosure of Huntington disease risk and genetic test results among family members are important, but have been underexplored. We interviewed 21 individuals in‐depth—eight mutation‐positive for HD, four mutation‐negative, and nine not tested—for 2 hr each. Within families, critical questions arose of what, when, and to whom to disclose, and what to do post‐disclosure. Interviewees wrestled with dilemmas of what to tell (e.g., suspicions vs. confirmed symptoms; initiation vs. completion of testing; partial vs. indirect information), how to disclose (e.g., planning in advance vs. “blurting out” information in arguments), and whether and how to tell extended family members. Questions arose of when to tell (i.e., to avoid disclosing “too early” or “too late”). Similarities and differences emerged related to types of relationships (e.g., parents telling offspring vs. offspring telling parents vs. siblings telling each other). Individuals often disclosed because of perceived duty to foster the health of their family members, enabling these others to pursue appropriate medical evaluation, if desired. Yet tensions arose because the information could burden these members, who also have rights to remain “in denial” if they wish and not discuss the topic or pursue testing. Post‐disclosure, dilemmas emerged of whether and how much to encourage family members to pursue testing. These data shed important light on critical issues that have received little, if any, attention concerning what, how, and when disclosure occurs, and have key implications for at‐risk individuals, genetic counselors, and other health care workers (HCWs), and for future research. At‐risk individuals would benefit from considering these issues in advance. HCWs need to realize that these decisions are multi‐faceted. Future research can explore whether, when, how, and how often HCWs raise these issues with individuals

Spacetime dynamics of spinning particles - exact electromagnetic analogies

We compare the rigorous equations describing the motion of spinning test particles in gravitational and electromagnetic fields, and show that if the Mathisson-Pirani spin condition holds then exact gravito-electromagnetic analogies emerge. These analogies provide a familiar formalism to treat gravitational problems, as well as a means for comparing the two interactions. Fundamental differences are manifest in the symmetries and time projections of the electromagnetic and gravitational tidal tensors. The physical consequences of the symmetries of the tidal tensors are explored comparing the following analogous setups: magnetic dipoles in the field of non-spinning/spinning charges, and gyroscopes in the Schwarzschild, Kerr, and Kerr-de Sitter spacetimes. The implications of the time projections of the tidal tensors are illustrated by the work done on the particle in various frames; in particular, a reciprocity is found to exist: in a frame comoving with the particle, the electromagnetic (but not the gravitational) field does work on it, causing a variation of its proper mass; conversely, for "static observers," a stationary gravitomagnetic (but not a magnetic) field does work on the particle, and the associated potential energy is seen to embody the Hawking-Wald spin-spin interaction energy. The issue of hidden momentum, and its counterintuitive dynamical implications, is also analyzed. Finally, a number of issues regarding the electromagnetic interaction and the physical meaning of Dixon's equations are clarified.Comment: 32+11 pages, 5 figures. Edited and further improved version, with new Section C.2 unveiling analogies for arbitrary spin conditions, and new Sec. 3.2.3 in the Supplement making connection to the post-Newtonian approximation; former Sec. III.B.4 and Appendix C moved to the (reshuffled) Supplement; references updated. The Supplement is provided in ancillary file. Matches the final published versio

Latent heat must be visible in climate communications

C.R.'s portion of the work was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration (80NM0018D0004). This work used JASMIN, the UK collaborative data analysis facility.Anthropogenic forcing is driving energy accumulation in the Earth system, including increases in the sensible heat content of the atmosphere, as measured by dry-bulb temperature—the metric that is almost universally used for communications about climate change. The atmosphere is also moistening, though, representing an accumulation of latent heat, which is partly concealed by dry-bulb temperature trends. We highlight that, consistent with basic theory, latent heat gains are outpacing sensible heat gains over about half of the Earth's surface. The difference is largest in the tropics, where global “hotspots” of total heat accumulation are located, and where regional disparities in heating rates are very poorly represented by dry-bulb temperatures. Including latent heat in climate-change metrics captures this heat accumulation and therefore improves adaptation-relevant understanding of the extreme humid heat and precipitation hazards that threaten these latitudes so acutely. For example, irrigation can lower peak dry-bulb temperatures, but amplify latent heat content by a larger margin, intensifying dangerous heat stress. Based on a review of the research literature, our Perspective therefore calls for routine use of equivalent temperature, a measure that expresses the combined sensible and latent heat content of the atmosphere in the familiar units of °C or K. We recognize that dry-bulb air temperature must remain a key indicator of the atmospheric state, not least for the many sectors that are sensitive to sensible heat transfer. However, we assert here that more widespread use of equivalent temperature could improve process understanding, public messaging, and adaptation to climate change.Publisher PDFPeer reviewe

Mesoproterozoic surface oxygenation accompanied major sedimentary manganese deposition at 1.4 and 1.1 Ga

This research was funded by the Australian Science and Industry Endowment Fund (SIEF) as part of The Distal Footprints of Giant Ore Systems: UNCOVER Australia Project (RP04-063)—Capricorn Distal Footprints. EAS also thanks the donors of The American Chemical Society Petroleum Research Fund for partial support of this research (61017-ND2).Peer reviewedPublisher PD

NLO BFKL Equation, Running Coupling and Renormalization Scales

I examine the solution of the BFKL equation with NLO corrections relevant for deep inelastic scattering. Particular emphasis is placed on the part played by the running of the coupling. It is shown that the solution factorizes into a part describing the evolution in Q^2, and a constant part describing the input distribution. The latter is infrared dominated, being described by a coupling which grows as x decreases, and thus being contaminated by infrared renormalons. Hence, for this part we agree with previous assertions that predictive power breaks down for small enough x at any Q^2. However, the former is ultraviolet dominated, being described by a coupling which falls like 1/(\ln(Q^2/\Lambda^2) + A(\bar\alpha_s(Q^2)\ln(1/x))^1/2)with decreasing x, and thus is perturbatively calculable at all x. Therefore, although the BFKL equation is unable to predict the input for a structure function for small x, it is able to predict its evolution in Q^2, as we would expect from the factorization theory. The evolution at small x has no true powerlike behaviour due to the fall of the coupling, but does have significant differences from that predicted from a standard NLO in alpha_s treatment. Application of the resummed splitting functions with the appropriate coupling constant to an analysis of data, i.e. a global fit, is very successful.Comment: Tex file, including a modification of Harvmac, 46 pages, 8 figures as .ps files. Correction of typos, updating of references, very minor corrections to text and fig.

Uranium Contamination in the Subsurface Beneath the 300 Area, Hanford Site, Washington

This report provides a description of uranium contamination in the subsurface at the Hanford Site's 300 Area. The principal focus is a persistence plume in groundwater, which has not attenuated as predicted by earlier remedial investigations. Included in the report are chapters on current conditions, hydrogeologic framework, groundwater flow modeling, and geochemical considerations. The report is intended to describe what is known or inferred about the uranium contamination for the purpose of making remedial action decisions