Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

Investigating the Effectiveness of an Arts-Based and Mindfulness-Based Group Program for the Improvement of Resilience in Children in Need

We discuss preliminary findings from a study that investigated the effectiveness of a Holistic Arts-Based Group Program (HAP) for the development of resilience in children in need. The HAP teaches mindfulness using arts-based methods, and aims to teach children how to understand their feelings and develop their strengths. We assessed the effectiveness of the HAP by using comparison and control groups, and standardized measures. We hypothesized that children who participated in the HAP would have better scores on resilience and self-concept compared with children who took part in an Arts and Crafts group (the comparison group), and children who were waiting to attend the HAP (the control group). A total of 36 children participated in the study; 20 boys aged 8–13?years and 16 girls aged 8–14?years. A mixed-designed MANOVA was conducted using scores from 21 participants. We found evidence that the HAP program was beneficial for the children in that they self-reported lower emotional reactivity (a resilience measure) post-intervention. No changes were noted for perceptions of self-concept. Consideration should be given to how we can attend to young people’s needs in relevant ways as resilience is a condition of a community’s ability to provide resources as much as it is part of an individual’s capacity for growth. Programs such as the HAP can engage children in a creative and meaningful process that is enjoyable and strengths-based.     

An Evaluation of the NAMI Basics Program

This brief report describes results from an evaluation of NAMI Basics, a peer-delivered family education program for family caregivers of children and adolescents with mental illness. Over six classes, family members are given information (e.g. education about mental illness and treatments), skills training (e.g. family communication skills) and advocacy support. We report data from 36 caregivers who completed pre and posttest instruments measuring self-care, empowerment, and family problem-solving and communication skills. Results showed significant improvements in self-care, empowerment, and “incendiary” family communication after participation in the program. Results suggest that NAMI Basics may improve both parental functioning and familial processes. Implications and future directions are discussed.     

An optimal adjustment procedure to minimize experiment time in decisions with multiple alternatives

Decisions between multiple alternatives typically conform to Hick’s Law: Mean response time increases log-linearly with the number of choice alternatives. We recently demonstrated context effects in Hick’s Law, showing that patterns of response latency and choice accuracy were different for easy versus difficult blocks. The context effect explained previously observed discrepancies in error rate data and provided a new challenge for theoretical accounts of multialternative choice. In the present article, we propose a novel approach to modeling context effects that can be applied to any account that models the speed–accuracy trade-off. The core element of the approach is “optimality” in the way an experimental participant might define it: minimizing the total time spent in the experiment, without making too many errors. We show how this approach can be included in an existing Bayesian model of choice and highlight its ability to fit previous data as well as to predict novel empirical context effects. The model is shown to provide better quantitative fits than a more flexible heuristic account.     

Adult mice maintained on a high-fat diet exhibit object location memory deficits and reduced hippocampal SIRT1 gene expression

Mounting evidence has established that diet-induced obesity (DIO) is associated with deficits in hippocampus-dependent memory. The bulk of research studies dealing with this topic have utilized rats fed a high-fat diet as an experimental model. To date, there has been a paucity of research studies that have established whether the memory deficits exhibited in DIO rats can be recapitulated in mice. Moreover, the majority of experiments that have evaluated memory performance in rodent models of DIO have utilized memory tests that are essentially aversive in nature (i.e., Morris water maze). The current study sought to fill an empirical void by determining if mice maintained on a high-fat diet exhibit deficits in two non-aversive memory paradigms: novel object recognition (NOR) and object location memory (OLM). Here we report that mice fed a high-fat diet over 23 weeks exhibit intact NOR, albeit a marked impairment in hippocampus-dependent OLM. We also determined the existence of corresponding aberrations in gene expression within the hippocampus of DIO mice. DIO mice exhibited significant reductions in both SIRT1 and PP1 mRNA within the hippocampus. Our data suggest that mice maintained on a high-fat diet present with impaired hippocampus-dependent spatial memory and a corresponding alteration in the expression of genes that have been implicated in memory consolidation.     

Behavioural state differentially engages septohippocampal cholinergic and GABAergic neurons in R6/1 Huntington's disease mice

Huntington's disease (HD) is a neurodegenerative condition characterised by progressive motor, psychological and cognitive decline. R6/1 HD transgenic mice model the clinical hippocampal-dependent cognitive deficits observed in patients. Cholinergic and GABAergic septohippocampal projections play important roles in hippocampal-dependent cognition. The current study examined neuronal activity of cholinergic and GABAergic septohippocampal projections in response to arousal elicited during differing behavioural states. The different behavioural states examined were; home cage (controls), acute exploration of a novel enriched environment and either spontaneous wakefulness (dark phase) or spontaneous sleep (light phase). We employed triple-label immunohistochemistry using c-Fos as an indirect marker of neuron activation and parvalbumin and choline acetyltransferase (ChAT) to label GABAergic and cholinergic neurons in the basal forebrain, respectively. The Y-maze was used to assess short-term hippocampal-dependent memory independently during either the dark or light phase and revealed a memory deficit in R6/1 HD mice compared to wild types that was particularly prominent during the dark phase. Three-way ANOVA of basal forebrain cholinergic and GABAergic activity through co-expression of c-Fos revealed overt responses to differing behavioural states. Both genotypes increased cholinergic neuron activity in response to exploring a novel enriched environment and also an increase during the dark phase compared to the light phase. Novel enriched environment exploration caused a larger response of GABAergic neuron activity in R6/1 HD mice, which also failed to increase the activity of GABAergic neurons during the dark phase compared to the light phase as observed for wildtype mice. Basal levels of c-Fos-positive cells were greatly increased in the hippocampal granule cell layer of R6/1 HD mice during both circadian phases. The differential activation of septohippocampal cholinergic and GABAergic neurons in R6/1 HD mice in response to differing behavioural states may be associated with impaired hippocampal-dependent short-term memory.     

Discrimination, acculturation, acculturative stress, and Latino psychological distress: a moderated mediational model

Prior research has found that perceived discrimination is associated with adverse mental health outcomes among Latinos. However, the process by which this relationship occurs remains an understudied area. The present study investigated the role of acculturative stress in underlying the relationship between perceived discrimination and Latino psychological distress. Also examined was the ability of acculturation to serve as a moderator between perceived discrimination and acculturative stress. Among a sample of Latino adults (N = 669), moderated mediational analyses revealed that acculturative stress mediated the perceived discrimination-psychological distress relationship, and that the link between perceived discrimination and acculturative stress was moderated by Anglo behavioral orientation but not Latino behavioral orientation. The findings are discussed within a stress and coping perspective that identifies the psychological consequences associated with perceived discrimination and acculturative stress.     

Naturalistic Moral Realism and Moral Disagreement: David Copp’s Account

To enhance the plausibility of naturalistic moral realism, David Copp develops an argument from epistemic defeaters aiming to show that strongly a priori synthetic moral truths do not exist. In making a case for the non-naturalistic position, I locate Copp??s account within the wider literature on peer disagreement; I identify key points of divergence between Copp??s doctrine and conciliatorist doctrines; I introduce the notion of ??minimal moral competence??; I contend that some plausible benchmarks for minimal moral competence are grounded in substantive moral considerations; and I discuss two forms of spinelessness that Copp??s moral naturalism could result in.