Implementing a Virtual Health Telemedicine Program in a Community Setting

Aurora Health Care in eastern Wisconsin has a clinical genetics program driven by genetic counselors in the cancer/adult and prenatal genetics settings. In 2015, the workforce shortage of genetic counselors left us with 4 open positions for genetic counselors that we were unable to fill. We explored many models of alternative service delivery, and determined virtual health (VH) via telemedicine to be the best option for our system. Historically, telemedicine technologies have been used to provide access to healthcare services to patients in remote areas. We, however, were struggling to find genetics counselors to staff both our remote clinics and urban clinics. To solve this problem, we recruited genetic counselors from across the country to work remotely from their current home or home office utilizing VH to staff our clinics. We then created clinical workflows and an implementation process of virtual health for 9 prenatal and cancer clinics across the eastern Wisconsin footprint of our healthcare system over the course of 12 months. Here we provide our experience and process in establishing a VH program in order to help other institutions that have been affected by the workforce shortage of clinical genetics professionals.     

Comparing Live and Video Observation to Assess Early Parent-child Interactions in the Home

Observation is the ‘gold standard’ for assessing parent-child behavior, however few studies have compared coding live, in real time, versus coding from videotapes in terms of their achievable levels of coder reliability within the field of parent programme research. This is important for practitioners and researchers for whom decisions might be influenced by time and financial constraints, but where outcomes may have real practical and clinical implications. Trained coders in the Dyadic Parent-Child Interaction Coding System Revised, coded 40 half-hour videotapes of 33 parent-toddler dyads interacting in the home on 29 items of dyadic behaviour. Four theorised composite variables were constructed. Videotaped data were compared to data drawn from the same interactions previously coded ‘live’ in the home. Correlations indicated significant agreement between the two modes at the item by item level (p?<?.001). Wilcoxon Rank tests revealed significant differences (p?<?.001) between the two modes. Eight items exceeded a ±30% change in median score suggesting clinically relevant differences. Although both methods achieved acceptable levels of inter-rater reliability, video coding achieved higher levels of agreement. Subtle differences exist between the two modes. Whilst neither mode proved superior it is suggested that they should not be used interchangeably.     

Parental Opioid Abuse: A Review of Child Outcomes,Parenting, and Parenting Interventions

Opioid abuse is now considered an epidemic, and many of the adults using this substance are parents. The purpose of the current paper is twofold: (1) to review rigorously conducted studies (e.g., included a comparison group; utilized inferential statistics) examining the association of opioid abuse with parenting and child outcomes, and (2) to review parenting intervention programs with these caregivers. Findings indicate that there are very few rigorously conducted studies examining children and parenting when parents abuse opioids. Furthermore, only four intervention programs have been conducted using randomized control trials and inferential statistics. We conclude that there is limited research that can be labeled as a rigorous science currently addressing this aspect of the opioid epidemic. Recommendations for further research are delineated.     

Military Family Advocacy in the U.S. Army: Program Service Outcomes and Family Participation

Violence in military families remains a vexing problem. Since the advent of the Global War on Terror, there is inconsistent evidence that the prevalence of family violence is increasing, particularly during and after military deployments. However, child neglect appears to increase significantly during military deployments. The military has developed family advocacy programs designed to keep families safe and intervene to reduce the deleterious effects of exposure to family violence. This is one of the first studies to examine the quality with which a family advocacy program is implemented and the degree to which families engage with the program. To conduct this study, the case files of 226 families who came in contact with the Army Family Advocacy Program (FAP) and whose cases were closed in 2013 were reviewed and coded across several implementation and service outcomes. These included involvement of qualified staff, whether or not appropriate victim and offender assessments were completed, degree of inter-agency communication, and appropriateness of referrals, among others. Soldier and family member participation in FAP and other Army-sponsored programs designed to reduce violence was also assessed. Generally speaking, the Army Family Advocacy Program was implemented with high quality, established processes and procedures for handling cases were largely followed, and FAP staff responded rapidly and thoroughly to reported abuse. However, family engagement with Army services and supports was low. Developing robust approaches to engaging families in family programming must be a high priority going forward.     

Do storybooks with anthropomorphized animal characters promote prosocial behaviors in young children?

For millennia, adults have told children stories not only to entertain but also to impart important moral lessons to promote prosocial behaviors. Many such stories contain anthropomorphized animals because it is believed that children learn from anthropomorphic stories as effectively, if not better than, from stories with human characters, and thus are more inclined to act according to the moral lessons of the stories. Here we experimentally tested this belief by reading preschoolers a sharing story with either human characters or anthropomorphized animal characters. Reading the human story significantly increased preschoolers' altruistic giving but reading the anthropomorphic story or a control story decreased it. Thus, contrary to the common belief, realistic stories, not anthropomorphic ones, are better for promoting young children's prosocial behavior.     

The Effect of Message Persistence and Disclosure on Liking in Computer-Mediated Communication

In computer-mediated communication (CMC) systems, the messages that a user types usually persist on the screen for some time, a feature that distinguishes CMC from face-to-face interaction. Persistence may activate psychological self-perception, leading communicators to infer from their persistent messaging how they feel about the subject more so than if messages did not persist. This study applies persistence and self-perception to the relationships between self-disclosure and liking. It identifies which among several disclosure or liking relationships may be most susceptible to self-perception effects. An experiment found that message persistence interacts with a conversational partner’s responses to self-disclosure and intensifies liking toward the partner. Suggestions follow for future research further exploring the mechanisms of persistence, and reconceptualizing self-perception factors in interactive media settings.     

Happiness and International Migration

In this paper, we consider the extent to which the aggregate happiness of a country affects the flow of people across its borders. We merge data from the World Values Survey, which produces happiness indices for 84 countries between 1981 and 2004, with three different migration datasets: emigration rates from the Organization for Economic Cooperation and Development, immigration rates from the U.S. Census, and net migration rates from the United Nations. We find that happiness has a U-shaped relationship with emigration rates: emigration rates fall in happiness for relatively unhappy countries, but rise for relatively happy countries. The U-shaped relationship also holds for migrant flows into the U.S. When analyzing net migration rates, we find that the reverse relationship exists. Net migration is associated with an increase in happiness for relatively unhappy countries, but after a threshold level of happiness, net migration is associated with a decrease in happiness. Our findings are robust to various empirical specifications and datasets.     

Virtual muscularity: a content analysis of male video game characters

The 150 top-selling video games were content analyzed to study representations of male bodies. Human males in the games were captured via screenshot and body parts measured. These measurements were then compared to anthropometric data drawn from a representative sample of 1120 North American men. Characters at high levels of photorealism were larger than the average American male, but these characters did not mirror the V-shaped ideal found in mainstream media. Characters at low levels of photorealism were also larger than the average American male, but these characters were so much larger that they appeared cartoonish. Idealized male characters were more likely to be found in games for children than in games for adults. Implications for cultivation theory are discussed.     

Asymmetry between encoding and retrieval processes: Evidence from divided attention and a calibration analysis

Two experiments provide further information on the effects of divided attention (DA) on encoding and retrieval processes. The first experiment examined the effects of decision and motor difficulty of a concurrent reaction time task. A calibration analysis was used in the second experiment to test the hypothesis that shifting attentional emphasis away from encoding to the secondary task reduces the level of processing the to-be-remembered items receive. Overall, the results confirm and extend the conclusions of Craik, Govoni, Naveh-Benjamin, and Anderson (1996) and Naveh-Benjamin, Craik, Guez, and Dori (1998), by pointing to clear differences between encoding and retrieval processes: Encoding is affected by simultaneous task demands, especially those associated with "central" resources involved in conscious decision making, whereas retrieval is obligatory in that it is largely immune to the effects of simultaneous demands. The results of the calibration analysis suggest that one reason for the poorer memory performance as a result of DA at encoding is a qualitative shift to less deep, elaborative strategies.