Pregnant Women’s Perspectives on Expanded Carrier Screening

Expanded carrier screening (ECS) is a relatively new carrier screening option that assesses many conditions simultaneously, as opposed to traditional ethnicity-based carrier screening for a limited number of conditions. This study aimed to explore pregnant women’s perspectives on ECS, including reasons for electing or declining and anxiety associated with this decision-making. A total of 80 pregnant women were surveyed from Northwestern Medicine’s Clinical Genetics Division after presenting for aneuploidy screening. Of the 80 participants, 40 elected and 40 declined ECS. Trends regarding reasons for electing or declining ECS include ethnicity, desire for genetic risk information, lack of family history, perceived likelihood of being a carrier, and perceived impact on reproductive decisions. Individuals who declined ECS seemed to prefer ethnicity-based carrier screening and believed that ECS would increase their anxiety, whereas individuals who elected ECS seemed to prefer more screening and tended to believe that ECS would reduce their anxiety. These findings provide insight on decision-making with regard to ECS and can help guide interactions that genetic counselors and other healthcare providers have with patients, including assisting patients in the decision-making process.     

Development,Feasibility, and Refinement of a Toxic Stress Prevention Research Program

Innovative interventions accessible to at-risk populations to prevent the intergenerational cycle of toxic stress are needed. This paper describes the iterative development of a community-based intervention, 2Gen Thrive, which was designed to prevent toxic stress and promote resilience by improving caregiver capacity to respond to children’s emotional, behavioral, and developmental needs. 2Gen Thrive leverages the collaboration between a Children’s Hospital and an Early Head Start/Head Start education center to help low-income, minority families thrive in the context of risk factors for toxic stress. In this paper, we focus on the process of developing, piloting, and refining our 2Gen Thrive preventive intervention research program, which has been developed following a community-based participatory research (CBPR) approach. The primary objective was to pilot test two prevention interventions we adapted for use in this target population: Classroom Theraplay, a classroom-wide intervention designed to prevent toxic stress among children exposed to adversity by fostering nurturing relationships with their teachers; and Dialectical Behavior Therapy Skills Training for Parents (DBT4P), a group intervention developed to bolster parental responsiveness by teaching Dialectical Behavioral Therapy (DBT) mindfulness and emotion regulation skills. We evaluated qualitative and process data as well as quantitative data from standardized instruments, including The Classroom Assessment Scoring System (CLASS), Patient Health Questionnaire (PHQ-9), Difficulties in Emotion Regulation Scale (DERS), and Parenting Stress Index (PSI/SF). Results demonstrate the feasibility, acceptability, and appropriateness of these preventive interventions delivered in the early education setting, and of conducting intervention research using a CBPR approach.     

Chimpanzees demonstrate individual differences in social information use

Studies of transmission biases in social learning have greatly informed our understanding of how behaviour patterns may diffuse through animal populations, yet within-species inter-individual variation in social information use has received little attention and remains poorly understood. We have addressed this question by examining individual performances across multiple experiments with the same population of primates. We compiled a dataset spanning 16 social learning studies (26 experimental conditions) carried out at the same study site over a 12-year period, incorporating a total of 167 chimpanzees. We applied a binary scoring system to code each participant’s performance in each study according to whether they demonstrated evidence of using social information from conspecifics to solve the experimental task or not (Social Information Score—‘SIS’). Bayesian binomial mixed effects models were then used to estimate the extent to which individual differences influenced SIS, together with any effects of sex, rearing history, age, prior involvement in research and task type on SIS. An estimate of repeatability found that approximately half of the variance in SIS was accounted for by individual identity, indicating that individual differences play a critical role in the social learning behaviour of chimpanzees. According to the model that best fit the data, females were, depending on their rearing history, 15–24% more likely to use social information to solve experimental tasks than males. However, there was no strong evidence of an effect of age or research experience, and pedigree records indicated that SIS was not a strongly heritable trait. Our study offers a novel, transferable method for the study of individual differences in social learning.     

Layers of engagement: Staff perceptions of spiritual care in residential aged care

ABSTRACT

Addressing the spiritual care needs of residents living in aged-care facilities should be an important dimension of quality care. We conducted semi-structured interviews with residential aged-care staff (including caregivers, nurses, managers, and chaplains) in New Zealand to explore how spiritual care is understood and operationalized. Many participants appeared to equate spiritual care with holistic care that respects the whole person. Participants discussed five types of spiritual care engagement requiring different skills, knowledge, and personal commitment, including information gathering, facilitation, companionship, end-of-life care, and counseling. Our findings suggest that the spiritual care that was offered by our participants, clergy and non-clergy alike, was predominantly informal and unplanned.     

Peer-Based Interventions on Academic Integrity: Assessing Immediate and Long Term Learning

The current study extends previous literature regarding the effectiveness of learning about academic integrity through peer instruction by assessing the impact of a peer instructional approach for actual and perceived learning gains over time. One trained residence don provided one interactive 30-min presentation covering four major aspects of academic integrity and misconduct (i.e., definition, detection, consequences, and importance of academic integrity) to groups of undergraduate students. In total, 192 participants attended the workshop and were surveyed for their knowledge of academic integrity immediately before the presentation, immediately after the presentation, and after a four week delay. Perceptions regarding the presentation also were assessed. Consistent with previous literature, results indicate perceived learning gains and preference for having an interactive presentation delivered by a residence don. In addition, actual gains in knowledge were found immediately after the presentation and gains remained evident over a four-week delay. Outcomes suggest that peer instruction is a viable and effective approach for educating students about academic integrity.     

Normative and Maladaptive Personality Trait Models of Mood,Psychotic, and Substance Use Disorders

The Personality Inventory for DSM-5 (PID-5) is a questionnaire developed to assess the five domains represented in the alternative model for personality disorders proposed in Section III of the DSM-5. This study examined the ability of the PID-5 to distinguish between different mental disorders compared to a questionnaire measure of the five-factor model (FFM) of normative personality. The study included the administration of the PID-5 and Revised NEO Personality Inventory (NEO PI-R), a measure of the FFM, to treatment-seeking individuals with Depressive, Bipolar, Psychotic, and Alcohol Use Disorders (AUD). Diagnostic groups were compared at the domain level of PID-5 and NEO PI-R, with sex and age as covariates. The main findings on the PID-5 included higher Detachment scores for Bipolar and Depressive Disorders than Psychotic and AUDs, lower Psychoticism/higher Disinhibition scores for the AUD group compared to all other groups, and lower Negative Affect for the Psychotic Disorders versus AUD group. On the NEO PI-R, the AUD diagnostic group was associated with lower Conscientiousness and Agreeableness scores compared to all other groups, and lower Neuroticism scores than the Bipolar and Depressive groups. Group pairwise comparisons did not appear to show many differences between the PID-5 and NEO PI-R. The results suggest that the alternative DSM-5 model for personality disorders may have clinical utility in distinguishing personality profiles between diagnostic groups. These findings emphasize the importance of additional research on the capacity of maladaptive personality to contribute to the assessment of differential diagnoses.     

The Effect of Employee Assistance Services on Reductions in Employee Absenteeism

Personal and work-related stressors experienced by employees can result in substantial costs to employers in the form of employee absenteeism. Employee Assistance Programs (EAPs) provide an important vehicle to assist employees with behavioral health issues, personal concerns, and work-related problems that impact employee absenteeism. This study tested the impact of EAPs on reducing employee absenteeism utilizing a well-matched control group and human resource timecard data. The study recruited employees from 20 areas of state government and used a prospective, quasi-experimental design with propensity score matching. EAP (n = 145) users were matched to non-EAP (n = 145) users on baseline demographic, psychosocial, and work-related characteristics that differentiate the groups. Hours of sick time recorded were provided by human resource offices. Differences in sick leave usage were tested using mixed model repeated measures. A steeper decline in sick leave usage for EAP than non-EAP employees was found, with estimates of 4.8 to 6.5% fewer hours lost per month to illness. Further analysis found that EAP services were most effective in helping clients move from moderate to low levels of sick leave rather than in reducing sick leave for those experiencing chronic absenteeism. Research on the effectiveness of EAPs rarely utilizes well-matched control groups and frequently relies on self-reported outcomes. Using an objective measure of work time lost, this study provides empirical evidence that users of EAP services tend to reduce their absenteeism at a faster pace than non-EAP users experiencing similar challenges to maintaining productivity.     

The Influence of Perceived Deservingness on Policy Decisions Regarding Aid to the Poor

In the current climate of welfare reform, it is important to understand how perceptions of the poor affect policy decisions. This paper examines how people distinguish between the undeserving poor and the deserving poor, and how this differentiation affects policy decisions. Survey respondents rated each policy in a set of hypothetical policies on a liberal-conservative continuum. Analyses were then conducted to explore differences in the respondents' likelihood of recommending the most liberal and the most conservative of these policies. Study 1 demonstrated that liberal policies were more likely to be recommended and conservative policies were less likely to be recommended when the target group was perceived to be deserving rather than undeserving. Study 2 replicated this effect of perceived deservingness and demonstrated an effect of attribution of responsibility. That is, liberal policies were more likely to be recommended and conservative policies were less likely to be recommended when the responsibility for the target's poverty was attributed to society rather than to the individual.