Acceptability of Telemedicine and Other Cancer Genetic Counseling Models of Service Delivery in Geographically Remote Settings

This work examined acceptability of cancer genetic counseling models of service delivery among Maine residents at risk for hereditary cancer susceptibility disorders. Pre-counseling, participants ranked characteristics reflecting models of care from most to least important including: mode-of-communication (in-person versus telegenetics), provider level of training (genetic specialty versus some training/experience), delivery format (one-on-one versus group counseling), and location (local versus tertiary service requiring travel). Associations between models of care characteristic rankings and patient characteristics, including rural residence, perceived cancer risk, and perceived risk for a hereditary cancer risk susceptibility disorder were examined. A total of 149/300 (49.7 % response rate) individuals from 11/16 Maine counties responded; 30.8 % were from rural counties; 92.2 % indicated that an important/the most important model of care characteristic is provider professional qualifications. Among other characteristics, 65.1 % ranked one-on-one counseling as important/the most important. In-person and local counseling were ranked the two least important characteristics (51.8 % and 52.1 % important/the most important, respectively). Responses did not vary by patient characteristics with the exception of greater acceptance of group counseling among those at perceived high personal cancer risk. Cancer telegenetic services hold promise for access to expert providers in a one-on-one format for rurally remote clients.     

Learning the form of causal relationships using hierarchical bayesian models

People learn quickly when reasoning about causal relationships, making inferences from limited data and avoiding spurious inferences. Efficient learning depends on abstract knowledge, which is often domain or context specific, and much of it must be learned. While such knowledge effects are well documented, little is known about exactly how we acquire knowledge that constrains learning. This work focuses on knowledge of the functional form of causal relationships; there are many kinds of relationships that can apply between causes and their effects, and knowledge of the form such a relationship takes is important in order to quickly identify the real causes of an observed effect. We developed a hierarchical Bayesian model of the acquisition of knowledge of the functional form of causal relationships and tested it in five experimental studies, considering disjunctive and conjunctive relationships, failure rates, and cross-domain effects. The Bayesian model accurately predicted human judgments and outperformed several alternative models.     

Is personal growth initiative associated with later life satisfaction in Chinese college students? A 15‐week prospective analysis

Personal growth initiative (PGI) is presumed to foster positive change leading to positive psychological adjustment. Accordingly, in this study we examined PGI as a predictor of life satisfaction 15 weeks later in a sample of 152 Chinese college students. Time 1 PGI was found to explain a significant amount of unique variance in Time 2 life satisfaction, even after controlling for Time 1 life satisfaction and Time 2 PGI. Specifically, (lower) intentional behavior and planfulness at baseline emerged as significant predictors of later life satisfaction. No evidence was found indicating that life satisfaction at Time 1 accounted for any significant amount of unique variance in PGI processes at Time 2, after controlling for baseline PGI processes and concurrent life satisfaction. Overall, the present findings are the first to demonstrate the importance of PGI as a prospective predictor of positive psychological adjustment in adults.     

A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

ABSTRACT

Dropout is an important factor that may compromise the validity of findings from randomized controlled trials (RCTs) of dialectical behaviour therapy (DBT). We conducted a targeted meta-analytic review of dropout from RCTs of DBT, with the aims of (1) calculating average rates of dropout from DBT; (2) investigating factors that moderate dropout; (3) examining whether dropout rates from DBT differ to control interventions; (4) synthesising reasons for dropout. Forty RCTs of DBT met full inclusion criteria. The weighted mean dropout rate was 28.0% (95% CI = 23.6, 32.9). Dropout rates were not related to target disorder, dropout definition, delivery format, therapist experience, and therapist adherence. Unexpectedly, dropout rates were significantly higher in trials that offered telephone coaching and utilized a therapist consultation team. DBT dropout rates did not significantly differ to dropout rates from control interventions. Few trials reported reasons for dropout, and there was little consistency in the reported reasons. Findings suggest that over one in four patients drop out from DBT in RCTs. This review highlights the urgency for future trials to explicitly report detail pertaining to patient dropout, as this may assist in the development of strategies designed to prevent future dropouts in RCTs of DBT.