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).     

Deradicalizing Detained Terrorists

Deradicalization of terrorists constitutes a critical component of the global “war on terror.” Unfortunately, little is known about deradicalization programs, and evidence for their effectiveness is derived solely from expert impressions and potentially flawed recidivism rates. We present the first empirical assessment of one such program: the Sri Lankan rehabilitation program for former members of the Liberation Tigers of Tamil Eelam (a terrorist organization that operated in Sri Lanka until their defeat in 2009). We offer evidence that deradicalization efforts that provided beneficiaries with sustained mechanisms for earning personal significance significantly reduced extremism after 1 year (Study 1). We also found that upon release, beneficiaries expressed lower levels of extremism than their counterparts in the community (Study 2). These findings highlight the critical role of personal significance in deradicalization efforts, offer insights into the workings of deradicalization, and suggest practical methods for improving deradicalization programs worldwide.     

Differential Effects of Right‐Wing Authoritarianism and Social Dominance Orientation on Dimensions of Generalized Prejudice in Brazil

Previous research within a dual‐process cognitive‐motivational theory of ideology and prejudice has indicated that dimensions of generalized prejudice are structured around attitudes towards dangerous, derogated and dissident groups, and that these prejudice dimensions are differentially predicted by the ideological attitudes of Right‐Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO). However, to date, these findings have been restricted to New Zealand samples. We describe two studies examining whether the structure of prejudiced attitudes and the differential prediction by RWA and SDO replicate in the Brazilian context, incorporating context‐relevant examples of each group—politicians, those from the northeast region of Brazil, and environmentalists. Results broadly supported the three‐factor structure of dangerous, derogated, and dissident groups. Consistent with previous research, regression and structural equation analyses showed that RWA explained prejudice against dangerous groups, SDO explained prejudice against derogated groups, and both RWA and SDO explained prejudice against dissident groups. This research provides some evidence for the generalizability of the three‐dimensional structure of generalized prejudice and differential prediction by RWA and SDO. Copyright © 2014 European Association of Personality Psychology     

Ethics,Changing Populations,and the Dental Profession

This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.     

The neurobiology of substance and behavioral addictions

Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.     

Specific phonological impairments in dyslexia revealed by eyetracking

Phonological deficits in dyslexia are typically assessed using metalinguistic tasks vulnerable to extraneous factors such as attention and memory. The present work takes the novel approach of measuring phonology using eyetracking. Eye movements of dyslexic children were monitored during an auditory word recognition task in which target items in a display (e.g., candle) were accompanied by distractors sharing a cohort (candy) or rhyme (sandal). Like controls, dyslexics showed slower recognition times when a cohort distractor was present than in a baseline condition with only phonologically unrelated distractors. However, unlike controls, dyslexic children did not show slowed recognition of targets with a rhyme distractor, suggesting they had not encoded rhyme relationships. This was further explored in an overt phonological awareness test of cohort and rhyme. Surprisingly, dyslexics showed normal rhyme performance but poorer judgment of initial sounds on these overt tests. The results implicate impaired knowledge of rhyme information in dyslexia; however they also indicate that testing methodology plays a critical role in how such problems are identified.     

Anterior medial temporal lobe activation during encoding of words: FMRI methods to optimize sensitivity

The existence of a rostrocaudal gradient of medial temporal lobe (MTL) activation during memory encoding has historically received support from positron emission tomography studies, but less so from functional MRI (FMRI) studies. More recently, FMRI studies have demonstrated that characteristics of the stimuli can affect the location of activation seen in the MTL when those stimuli are encoded. The current study tested the hypothesis that MTL activation during memory encoding is related to the modality of stimulus presentation. Subjects encoded auditorily or visually presented words in an FMRI novelty paradigm. Imaging and analysis parameters were optimized to minimize susceptibility artifact in the anterior MTL. Greater activation was observed in the anterior than posterior MTL for both modalities of stimulus presentation. The results indicate that anterior MTL activation occurred during encoding, independent of stimulus modality and provide support for the hypothesis that verbal-semantic memory processing occurs in anterior MTL. The authors suggest that technical factors are critical for observing the rostrocaudal gradient in MTL memory activation.     

Transformations of mathematical and stimulus functions

Following a pretest, 8 participants who were unfamiliar with algebraic and trigonometric functions received a brief presentation on the rectangular coordinate system. Next, they participated in a computer-interactive matching-to-sample procedure that trained formula-to-formula and formula-to-graph relations. Then, they were exposed to 40 novel formula-to-graph tests and 10 novel graph-to-formula tests. Seven of the 8 participants showed substantial improvement in identifying formula-to-graph relations; however, in the test of novel graph-to-formula relations, participants tended to select equations in their factored form. Next, we manipulated contextual cues in the form of rules regarding mathematical preferences. First, we informed participants that standard forms of equations were preferred over factored forms. In a subsequent test of 10 additional novel graph-to-formula relations, participants shifted their selections to favor equations in their standard form. This preference reversed during 10 more tests when financial reward was made contingent on correct identification of formulas in factored form. Formula preferences and transformation of novel mathematical and stimulus functions are discussed.     

Stability of pigeon body weight under free-feeding conditions

Increases in regulatory oversight of animal research require verification of effects of standard practices. There are no formal guidelines for establishing free-feeding weights in adult pigeons. In the present study, pigeons were obtained from a commercial supplier, weighed upon arrival, and then held in quarantine for 7 days with free access to food. Subsequently, still with continuous access to food, they were weighed daily for 30 days. No significant changes in weights occurred over the 30-day period for male pigeons, indicating that seven days is sufficient for establishing a baseline body weight. A secondary finding of higher day-to-day variability in the weights of female pigeons may serve as a method of sexing pigeons.