Genetic Counselors’ Current Use of Personal Health Records-Based Family Histories in Genetic Clinics and Considerations for Their Future Adoption

Given the widespread adoption of electronic medical records and recent emergence of electronic family history tools, we examined genetic counselors’ perspectives on the emerging technology of the personal health record (PHR)-based family history tool that links to an electronic medical record (EMR). Two-hundred thirty-three genetic counselors responded to an on-line survey eliciting current use of electronic family history (EFH) tools and familiarity with PHR-based family history tools. Additionally, after being shown a series of screen shots of a newly developed PHR-based family history tool based on the U.S. Surgeon General’s My Family Health Portrait (United States Department of Health and Human Services 2009), participants were surveyed about the perceived usefulness, ease of use, and impact on current workflow that this kind of tool would have in their practices. Eighty-three percent reported that their institution has an EMR, yet only 35 % have a dedicated space for family history. Eighty-two percent reported that less than 5 % of their patients have a PHR, and only 16 % have worked with patients who have a PHR. Seventy-two percent or more agreed that a PHR-based family history tool would facilitate communication, increase accuracy of information, ensure consistency in recording information, increase focus on actual counseling, reduce repetitive questions, improve efficiency, and increase the legibility and clarity. Our findings suggest that participants were familiar with existing EFH tools, but that the majority did not use them in practice. Genetic counselors’ adoption of such tools is limited due to non-existence of this kind of technology or inability to integrate it into their clinics. They are also strongly in favor of adopting a PHR-based family history tool in genetics clinics, but have practical concerns that must be addressed before the tool can be implemented.     

The effect of anxiety on linguistic parameters of public speech: A verbal impairment model

This study presents a new research paradigm designed to explore the effect of anxiety on semantic information processing. It is based on the premise that the demonstrated effect of anxiety on cognitive performance and apparent inconsistencies reported in the literature might be better understood in terms of linguistic properties of inner speech which underlies analytic (vs. intuitive) thought processes. The study employed several parameters of functional linguistics in order to analyse properties of public speech by high- and low-anxious individuals. Results indicate that anxiety is associated with greater use of associative clauses that take the speaker further away from the original starting point before coming back and concluding (identified as reduced semantic efficiency). This is accompanied by a speech pattern that includes greater amounts of factual information unaccompanied by elaborate argumentation. While these results are considered tentative due to methodological and empirical shortcomings, they suggest the viability of this approach.     

Coaching Approach Behavior and Leading by Modeling: Rationale,Principles, and a Session-by-Session Description of the CALM Program for Early Childhood Anxiety

Whereas the cognitive-behavioral treatment of childhood anxiety has been well-researched and empirically supported over the last 20 years, interventions for anxiety in young children (ages 7 and below) have garnered little attention. Because young children generally lack the required developmental skills to effectively engage in cognitive-behavioral treatment, a simple downward extension of treatments used for older children is inappropriate. The CALM program (Coaching Approach behavior and Leading by Modeling) was developed as a developmentally compatible intervention to treat anxiety disorders in young children ages 3 to 7. The CALM program is an adaptation of Parent-Child Interaction Therapy (PCIT), and an extension of Pincus, Eyberg, and Choate's (2000) adaptation of PCIT for young children with separation anxiety disorder. It is a parent-focused treatment that teaches parents skills to effectively reinforce their children's brave behavior and coaches the use of these skills during in-session parent-child interactions. The treatment emphasizes live, bug-in-the-ear coaching of parents during in vivo exposure sessions. This article describes the CALM program in detail.     

Are you with me? Probing the human capacity to recognize external/internal attention in others’ faces

ABSTRACT

Facial cues provide information about affective states and the direction of attention that is important for human social interaction. The present study examined how this capacity extends to judging whether attention is internally or externally directed. Participants evaluated a set of videos and images showing the face of people focused externally on a task, or internally while they performed a task in imagination. We found that participants could identify the focus of attention above chance in videos, and to a lesser degree in static images, but only when the eye region was visible. Self-reports further indicated that participants relied particularly on the eye region in their judgements. Interestingly, people engaged in demanding cognitive tasks were more likely judged to be externally focused independent of the actual focus of attention. These findings demonstrate that humans use information from the face and especially from the eyes of others not only to infer external goals or actions, but also to detect when others focus internally on their own thoughts and feelings.     

Problem-solving Strategies and Expertise in Engineering Design

A study is reported which focused on the problem-solving strategies employed by expert electronics engineers pursuing a real-world task: integrated-circuit design. Verbal protocol data were analysed so as to reveal aspects of the organisation and sequencing of ongoing design activity. These analyses indicated that the designers were implementing a highly systematic solution-development strategy which deviated only a small degree from a normatively optimal top-down and breadth-first method. Although some of the observed deviation could be described as opportunistic in nature, much of it reflected the rapid depth-first exploration of tentative solution ideas. We argue that switches from a predominantly breadth-first mode of problem solving to depth-first or opportunistic modes may be an important aspect of the expert's strategic knowledge about how to conduct the design process effectively when faced with difficulties, uncertainties, and design impasses.     

Predicting the difficulty of complex logical reasoning problems

The aim of the present research was to develop a difficulty model for logical reasoning problems involving complex ordered arrays used in the Graduate Record Examination. The approach used involved breaking down the problems into their basic cognitive elements such as the complexity of the rules used, the number of mental models required to represent the problem, and question type. Weightings for these different elements were derived from two experimental studies and from the reasoning literature. Based on these weights, difficulty models were developed which were then tested against new data. The models had excellent predictive validity and showed the relative influence of rule based factors and factors relating to the number of underlying models. Different difficulty models were needed for different question types, suggesting that people used a variety of approaches and, at a wider level, that both mental models and mental rules may be used in reasoning.     

Web-based recruitment in the Millennial generation: Work–life balance,website usability,and organizational attraction

In this digital era, traditional recruitment efforts have increasingly been supplemented with or replaced by recruiting applicants on the Web. Concurrently, organizations are increasingly adapting to younger individuals from the Millennial generation as they enter the workforce. We combine these salient issues to examine Web-based recruitment of the Millennial generation by assessing predictors of organizational attraction. Using a sample of Millennials (N = 493), we found that perceptions of both work–life balance and website usability incrementally predicted attraction, when controlling for perceptions of other organization characteristics. In addition, person–organization fit mediated these relationships. These findings speak to the importance of examining how aspects of Web-based recruitment influence Millennial applicants.     

Religiosity and treatment response to antidepressant medication: a prospective multi-site clinical trial

The present study examined the relationship between religiosity/spirituality and treatment response to antidepressant medication (citalopram). One-hundred and forty-eight Caucasian and African-American adults with uncomplicated major depression were treated with citalopram (20–60?mg/day) over an eight-week period in a prospective multi-site clinical trial. Treatment response was assessed weekly with the Hamilton Rating Scale for Depression. Religiosity (i.e., religious behaviours) and spirituality (i.e., spiritual well-being) were assessed at week 3. No significant associations between spirituality and treatment response were found; however, there was a strong curvilinear relationship between religiosity and treatment response. Compared to lower or higher levels of religiosity, a moderate level of religiosity was significantly associated with a higher likelihood of remission and greater reduction in severity of depression. This association was independent of social support, ethnicity, gender, education, and baseline depression severity. A moderate amount of religiosity appears to be independently associated with an enhanced treatment response to citalopram.