Attitudes toward genetic testing, family planning and preimplantation genetic testing in families with a germline CDKN2A pathogenic variant.

Individuals with a germline CDKN2A pathogenic variant (PV) have a highly increased life time risk of melanoma and pancreatic cancer. This cross-sectional study assessed the attitudes among toward genetic testing, family planning, and preimplantation genetic testing (PGT) in confirmed CDKN2A PV carriers and individuals with a 50% risk of the PV (at-risk carriers) using of a one-time questionnaire.A total of 537 individuals were screened for eligibility, of whom 208 of 366 (57%) confirmed carriers (56% female, median age 54 years [IQR 46-63]) and 39 of 171 (23%) at-risk carriers (59% female, median age of 26 years [IQR 22-32]) participated in the study. Primary motivations for genetic testing were to gain control over their personal and children's cancer risk, as well as increasing cancer surveillance practices. In contrast, concerns about obtaining a mortgage and life insurance were frequently cited as reasons for postponing genetic testing. Family planning decisions remained largely unaffected in both confirmed and at-risk carriers; however, the majority of confirmed carriers were still unaware of their familial or personal cancer risk when starting a family. More than 60% of the participants were unfamiliar with PGT and only a minority (19% of confirmed carriers and 10% of at-risk carriers) would be open to considering PGT as a reproductive option. This study found different attitudes toward genetic testing, family planning, and PGT among individuals affected by the CDKN2A PV. Understanding these different attitudes can help clinicians to address the complexities surrounding these issues, especially for younger individuals facing difficult decisions about the timing of genetic testing, family planning, and the potential use of assisted reproductive options.

Preferential edge habitat colonization by a specialist weevil, Rhinoncomimus latipes (Coleoptera: Curculionidae).

Understanding the behavioral basis of dispersal and colonization is critical in biological control systems, where success of a natural enemy depends in part on its ability to find and move to new host patches. We studied behavior of the specialist weevil Rhinoncomimus latipes Korotyaev, a biological control agent of mile-a-minute weed, Persicaria perfoliata (L.) H. Gross, by releasing weevils at the forest edge and monitoring their colonization of potted host plants arrayed along the edge, out into the open field, and into the forest. Both distance from the release cage and habitat where plants were located affected colonization, with more than twice as many weevils found on plants at 2 m than at 6 or 14 m; at 14 m, 6-8 times as many weevils colonized plants along the forest edge compared with plants in the open field or within the forest. In a second experiment, weevils that were released in an open field 12 m from the forest edge initially flew in all directions, but again ultimately colonized more plants at the edge than out in the open field. This species may be adapted to seek host plants at the forest edge, because P. perfoliata generally is found in riparian corridors in its native range and along forest edges in North America. Results suggest that R. latipes will move successfully to new P. perfoliata patches along wooded edges, but may not readily locate isolated patches in the open or those embedded in forests.

[Consequences of changing from fixed amount payments to percentage payment of drugs]. / Konsekvenser av endring fra fast kronebeløp til prosentvis egenandel for legemidler.

Two pharmacies in Drammen recorded and analyzed 1,155 prescriptions in February 1989. The purpose was to compare the proportion of costs paid by customers and national reimbursement by percentage patient copayment (20%) and fixed amount as copayment (NOK 60). On average the patient's copayment increased by 23.9%. All prescriptions below NOK 300 were cheaper for the patient by percentage copayment, while all above NOK 300 were more expensive. For medical equipment items the copayment increased by 74%. When calculated for Norway the increase in patient copayment amounts to about NOK 50 million. The costs of reimbursement were reduced by 2.4%. About 30% of the total reimbursement refers to cardiovascular diseases.