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 screen magnifier using "high level" implementation techniques.

This paper presents the architecture of, and the techniques used to build, a screen magnifier for visually impaired people that uses the "high-level" features of the Microsoft Windows operating system. The magnifier uses information from the Desktop Window as its source and overlays this with a topmost, transparent, layered window that contains the magnified image. Issues concerning cursor enlargement, tooltip suppression, and focus tracking are discussed. A stable magnifier results that does not need to use the "dirty" low-level techniques that are typically used to build screen magnifiers. The only known problem of the magnifier is that it fails to suppress the original, unmagnified cursor of the few applications that use custom cursors.

A modified Perkins Brailler for text entry into windows applications.

In this paper, we describe how a Perkins Brailler can be adapted so that it can function as a keyboard to a personal computer. The paper describes the earlier work of others and the hardware and software of our system and concludes with indications of how the system may be improved.

Full-screen magnification for windows using DirectX Overlays.

This paper presents the basic features of software-based magnifiers used by some visually impaired people to read information from a computer screen. The paper briefly presents two major approaches to full-screen magnification for modern multiple window systems (the paper focuses on Microsoft Windows). This paper describes in detail the architecture and operation of a full-screen magnifier that uses Microsoft DirectX Overlays. This approach leads to a robust magnifier that has a low computational overhead. The magnifier has problems with video cards that use a YUV color model but these problems may be addressed by RGB to YUV translation software--an issue that is still to be investigated. The magnifier also has problems when the generic device driver, rather than the manufacturer's device driver, is installed on the system. The paper presents two further strategies for full screen magnification, namely, using multimonitor support and true type fonts for text enlargement.