Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Enhancing Critical Consciousness Through a Cross‐Cultural Immersion Experience in South Africa

Using phenomenological approaches, the author explored the meanings and essences of a cross‐cultural immersion experience in South Africa among counseling master's‐level students. Five core themes—the meaning of being American, sociopolitical awareness, engagement with South Africans and their communities, appreciation of life, and commitment to change—characterized the development of critical consciousness (Freire, 1973 , 2000 ). Findings support positive influences of cross‐cultural immersion as an experiential pedagogical method for multicultural development. Usando enfoques fenomenológicos, se exploraron los significados y esencias de una experiencia de inmersión transcultural en Sudáfrica entre estudiantes de nivel máster en consejería. Cinco temas centrales (el significado de ser estadounidense, la conciencia sociopolítica, la interacción con individuos sudafricanos y sus comunidades, la valoración de la vida y el compromiso con el cambio) caracterizaron el desarrollo de la conciencia crítica (Freire, 1973 , 2000 ). Los hallazgos confirman influencias positivas de la inmersión transcultural como un método pedagógico basado en la experiencia para el desarrollo multicultural.     

Don't you know that you want to trust me? Subliminal goal priming and persuasion

We investigated the effect of goal priming on the processing of a persuasive message. Before reading a persuasive message about tap water consumption, participants were subliminally primed (or not) with the goal “to trust”. Subsequently, they completed a questionnaire about their perception of the message, the source of the message, and tap water consumption intentions. The results indicated that non-conscious activation of the goal “to trust” leads to a better evaluation of the message, increases behavioral intentions in accordance with the message, and positively influences the assessment of the source.     

Effects of image background on spatial-frequency thresholds for face recognition

A great deal of work has been devoted to the question of which spatial frequencies, if any, are optimal for various visual tasks, such as face and object recognition. However, to date these studies have all been carried out with stimuli set against a uniform background. It is possible that this type of stimulus does not produce ecologically valid results. The natural world in which visual tasks normally take place involves a great deal of luminance variation and distracting visual structure, which may alter the spatial frequencies necessary for a task. We conducted two experiments that examined the effects of image background on the spatial-frequency thresholds (50% maximum of a low-pass or high-pass Butterworth filter) for face recognition by the psychophysical methods of adjustment and constant stimuli. In both experiments we found no significant difference in spatial-frequency thresholds between uniform-grey backgrounds and natural-scene backgrounds, and only minor differences between uniform-grey backgrounds and fractal noise backgrounds. This suggests that results obtained with uniform backgrounds are ecologically valid and that background effects, if they exist, are small.     

Taking a Turn Toward the Masculine: The Impact of Mortality Salience on Implicit Leadership Theories

The present research investigates the influence of subtle death-related thoughts (i.e., mortality salience) on people's images of effective leaders (i.e., their implicit leadership theories [ILTs]). We test the prediction that mortality salience will change the content of these implicit theories to be more gender stereotypical such that individuals will conceive of effective leaders in a significantly more masculine, or agentic, manner. To test this prediction, we assessed the communal and agentic components of participants' ILTs after they were presented with a mortality salience or control manipulation. Results show that priming individuals to think about their mortality with two open-ended questions resulted in a significant shift in their ILTs such that an effective leader is described in significantly more agentic terms compared to the control condition. This masculine shift in people's ILTs was demonstrated in both women and men, and mortality salience did not influence perceptions of effective leaders' communal traits. This work contributes to research on gender bias in leadership, ILTs, and terror management theory and has implications for female leaders.     

Defining ‘Modern’ Malay womanhood and the coexistent messages of the veil

The gender constructions and performances of Malay women are often perceived by outside researchers as ‘shrouded under a veil’ of increasing Islamic conservatism. Urban Malay women, however, argue that women actively engage in the construction and performance of gender identities. Based on research conducted in Kuala Lumpur, Malaysia, during 2001 and 2003, this article argues that women advantageously alter, transform and utilise the constructs placed upon them by Islam, by ethnic identification and by conceptions of ‘modernity’. Often one image of ‘womanhood’ is presented and in public e an image that is socially accepted, honoured and respected e while less publicly alternative forms of ‘womanhood’ articulate individual goals and aims. Using an agent-oriented perspective, this article further includes an analysis of women's individual renegotiations of larger cultural constructs and the ways in which the tudong, or headscarf, has become a symbol by which individual women express their understanding of social position and personal freedoms in an industrialised Islamic context.     

A Psychometric Evaluation of the Approach and Avoidance of Alcohol Questionnaire Among Alcohol-Dependent Patients Attending Residential Treatment

Despite research suggesting that alcohol-dependent individuals have both craving and avoidant tendencies for alcohol, few studies have measured self-report tendencies using the Approach and Avoidance of Alcohol Questionnaire (AAAQ). The goal of this study was to examine the psychometric properties of the AAAQ using a sample of adults receiving 12 step-based residential treatment for alcohol dependence. As part of a larger study, 100 adults receiving residential treatment completed the AAAQ and several other assessments shortly after treatment admission. Analyses of the AAAQ examined its factor structure, internal consistency, and convergent and predictive validity. A maximum likelihood estimation factor analysis using oblique rotation produced 3 factors accounting for 69 % of the variance. A confirmatory factor analysis suggested that the 3-factor model was a moderate fit for data from a second sample of patients. Internal consistency was fairly high and convergent validity was demonstrated by relationships with another scale of alcohol craving, time since last drink, and quantity and frequency of pre-treatment alcohol use. Regarding predictive validity, the level of approach tendencies on the AAAQ was significantly related to abstinence status during the first 6 months following treatment. Avoidance level was not related to abstinence. The results largely replicated past studies utilizing outpatient samples and suggest that the AAAQ shows promise as a psychometrically sound, internally reliable self-report craving measure for individuals with alcohol dependence.     

Juggling roles and expectations: dilemmas faced by women talking to relatives about cancer and genetic testing

Health professionals do not inform their patients’ kin about BRCA1/2 test results or genetic testing without their written consent. Thus, the onus is on women attending genetic counselling to talk to relatives about the family history and their potential increased risk. This communication process within the family is largely unexplored and provides the focus of the present study. Fifteen healthy women attending a genetics clinic for predictive testing were interviewed prior to receiving their test result and again 6 months later. A grounded theory approach was used. Findings illustrate the dilemmas women faced in juggling social roles and expectations, which had an impact on communication within the family in the context of predictive genetic testing. Tensions between responsibilities towards themselves and others and their fulfilment of social roles had an impact on who women informed and on how they did so. These factors should be considered when assigning patients the role of information provider.     

Using MATLAB with the Psychophysics Toolbox to present the heterochromatic fusion nystagmus stimulus

We present a program for MATLAB that generates and presents theheterochromatic fusion nystagmus stimulus. This stimulus allows assessment of isoluminant states through recordings of reflexive eye movements (optokinetic nystagmus). The reflexive nature of the subject’s response makes this stimulus especially useful with nonverbal subjects, such as children and animals. Unfortunately, the stimulus is complex and difficult to program. By presenting the present program, we hope to help those who wish to use this tool in their research. The code of the function can be downloaded at www. dal.ca/~mcmullen/downloads.html.