Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings

An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project’s success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.     

Containment lost: the challenge to child psychotherapists posed by modern CAMHS

The paper is an examination of some emotional challenges facing child psychotherapists working in modern CAMHS following the introduction of the NHS internal market for commissioning and providing services. Its introduction has brought the loss of organisational containment for all CAMHS clinicians. The meaninglessness in work reported by clinicians is a clue to this loss. This loss is especially difficult for child psychotherapists because of their particular investment in the apprehension of meaning in symptoms and other presentations by patients. The paper proposes that meaninglessness is itself a clue to the ascendancy of what Freud called the death instinct, and that this is inherent within the internal market model. Because service design and delivery is predicated upon it, the internal market model structurally determines that clinicians are bound to senior management in a way that leaves child psychotherapists open to professional life-threatening dynamics associated with the death instinct. The ?K (Bion) world of CAMHS is thus deathly, leaving child psychotherapists vulnerable to self-destruction. We have lost a workplace in which our approach flourished conferring on us the identity of a discipline structurally favoured, because of the help we provided through this approach to patient and clinic work. This loss of identity brings the dangers of containment lost. This situation leaves child psychotherapists emotionally vulnerable and is akin to Satan’s loss in Milton’s Paradise Lost.     

Testing the role of response repetition in spatial priming in visual search

In common “attention” tasks, which require stimulus-identity processing prior to the formation of a speeded key-press response, spatial priming effects depend on response repetition. Typically, the repetition of a stimulus location is advantageous when the prior response repeats, but disadvantageous or inconsequential when the prior response changes. This link between responding and space makes it difficult to draw inferences about attentional bias from two-choice key-press tasks. Instead, the findings are accounted for by episodic retrieval theories, which argue that the response associated with a prior stimulus location is retrieved when a later stimulus occupies its space. This retrieval operation is advantageous if the prior response is needed but not otherwise, which explains typical patterns. This perspective motivated us to evaluate whether spatial priming effects in the visual-search literature depend critically on response repetition. To assess this, we reevaluated a series of experiments recently published by Tower-Richardi, Leber, and Golomb (Attention, Perception, & Psychophysics, 78(1), 114–132, 2016). Their goal was to determine the reference frame of spatial priming across visual search displays. Reassessment reveals that spatial priming was strongly dependent on response repetition when spatiotopic, retinotopic, and object-centered reference frames were perfectly confounded. However, when eye movements were made to dissociate the spatiotopic and object-centered reference frame from the retinotopic reference frame, spatial priming was positive and unaffected by response repetition. The findings demonstrate that at least two distinct processes factor into spatial priming across visual searches, which occur at different levels of representation.     

Acceptability,Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York

Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.     

The Broadest Necessity

In this paper the logic of broad necessity is explored. Definitions of what it means for one modality to be broader than another are formulated, and it is proven, in the context of higher-order logic, that there is a broadest necessity, settling one of the central questions of this investigation. It is shown, moreover, that it is possible to give a reductive analysis of this necessity in extensional language (using truth functional connectives and quantifiers). This relates more generally to a conjecture that it is not possible to define intensional connectives from extensional notions. This conjecture is formulated precisely in higher-order logic, and concrete cases in which it fails are examined. The paper ends with a discussion of the logic of broad necessity. It is shown that the logic of broad necessity is a normal modal logic between S4 and Triv, and that it is consistent with a natural axiomatic system of higher-order logic that it is exactly S4. Some philosophical reasons to think that the logic of broad necessity does not include the S5 principle are given.     

Cell phone-induced ostracism threatens fundamental needs

Cell phones are useful tools with both practical and social benefits. However, using them in the context of face-to-face conversations may be problematic. We consider this behavior a form of ostracism and test its effects on the satisfaction of basic psychological needs for belonging, self-esteem, control, and meaningful existence. In Study 1 participants who recalled a time in which a friend was checking a cell phone during a serious conversation reported feeling more ostracized (ignored and excluded), greater pain, and threat to basic needs than participants recalling a conversation without a cell phone interruption or a control event. Study 2 replicated and extended this effect: Cell phone-induced ostracism’s effects were partially mediated by decreased feelings of relational evaluation, and threatened basic needs both in serious and casual conversation contexts. Findings from both studies also indicated that cell phone-induced ostracism hurts women more so than men.     

Psychosocial aspects of successful ageing and resilience: critique,integration and implications / Aspectos psicológicos del envejecimiento exitoso y la resiliencia: crítica,integración e implicaciones

Abstract

As the number of older adults increases worldwide, it is becoming increasingly important to find effective ways of fostering better ageing trajectories. The models used to shape this process inform research, policy and practice and impact older adults themselves. Two important ageing models are successful ageing (SA) and resilience (RES). Aligning the conceptual framework in research contexts with those of older adults’ perspectives is an integral component of driving forward the research agenda in a manner that has the greatest potential to benefit older adults. Studies conducted with laypersons indicate that psychosocial components are important components of successful ageing models; therefore, it is imperative that these non-biomedical components are incorporated. There are many similarities between SA and RES models, but an important distinguishing feature is the incorporation of adversity into conceptualizations of resilience. SA models suggest high levels of functioning as a requirement for ageing successfully, regardless of the circumstances the individual experiences; resilience models take into account the level of adversity being experienced by the individual. Individuals can demonstrate RES by having a more positive outcome than would be expected given their level of adversity. The incorporation of psychosocial constructs into SA models and the integration of SA and RES paradigms has important implications for research and for older adults themselves. Through the promotion of models of ageing that include psychosocial components and elements of adversity, greater generalizability to a broader population is possible with enhanced potential for research derived from these efforts to more positively influence individuals’ trajectories of ageing.     

Substance use treatment programs in the active duty US military: A narrative review

Substance use disorders (SUDs) are a growing problem for the U.S. military. Each branch of the military has its own dedicated substance abuse treatment program. However, there has been limited attention to the research conducted on these programs. The purpose of this narrative review is to describe SUD treatment programs in the U.S. military and to review the extant research published between 2001–2015. Fourteen peer-reviewed articles, 2 official reports, 1 book chapter, 1 thesis, and 1 dissertation were identified. Most SUD treatment programs are nonconfidential, although a confidential program is being piloted by the Army. Recently, the programs have increased their focus on assessment and treatment of comorbid psychological disorders. Further research is required to examine the efficacy, effectiveness, and cost-effectiveness of the treatment programs.     

Associative false consumer memory: effects of need for cognition and encoding task

Two experiments investigated the effects of product–attribute associations on false consumer memory. In both experiments, subjects were presented with sets of related product attributes under incidental encoding conditions. Later, recognition memory was tested with studied attributes, non-studied but associated attributes (critical lures) and non-studied unrelated attributes. In Experiment 1, the effect of Need for Cognition (NFC) was assessed. It was found that individuals high in NFC recognised more presented attributes and falsely recognised more associative critical lures. The increase in both true and associative false memory was accompanied by a greater number of responses that index the retrieval of detailed episodic-like information. Experiment 2, replicated the main findings through an experimental manipulation of the encoding task that required subjects to consider purchase likelihood. Explanations for these findings are considered from the perspective of activation processes and knowledge structures in the form of gist-based representations.     

Unsilencing Critical Conversations in Social-Studies Teacher Education using Agent-based Modeling

In this article, we argue that when complex sociopolitical issues such as ethnocentrism and racial segregation are represented as complex, emergent systems using agent-based computational models (in short agent-based models or ABMs), discourse about these representations can disrupt social studies teacher candidates' dispositions of teaching social studies without engaging in critical conversations about race and power. Our study extends the literature on agent-based computing to the domain of social studies education, and demonstrates how preservice teachers' participation in agent-based modeling activities can help them adopt a more critical stance toward designing learning activities for their future classrooms.