Comparison of Telephone and Televideo Modes for Delivery of Genetic Counseling: a Randomized Trial

Telephone and televideo have yielded equivalent patient satisfaction and psychosocial outcomes when compared to in-person genetic counseling, yet little is known about how they compare to one another. In this randomized controlled trial, veterans received genetic counseling via telephone or traveled to a clinic to participate via encrypted televideo. Knowledge and visit satisfaction were assessed 2 weeks later. Travel time, mileage, and out-of-pocket costs were calculated for videoconferencing. Qualitative interviews were conducted with patients and counselors to assess acceptability. Of the 20 male patients randomized to telephone, 90% received counseling and provided outcomes; of the 18 randomized to televideo, 67% received counseling and 50% provided outcomes. Telephone patients answered a mean of 4.4 of eight questions correctly at baseline and 4.7 at follow-up; televideo means were 5.6 and 6.5, respectively. Satisfaction was 25.2 out of 30 for telephone and 26.9 for televideo. Televideo patients incurred a median of 2.8 h of travel time, 40 roundtrip miles, and $67.29 in costs. Patients and counselors found both modes acceptable for providing education and answering questions. Although patients liked the flexibility of telephone, counselors felt patients missed more appointments and were distracted when using telephone. A noted advantage of videoconferencing was reading body language. Further evaluation of alternative delivery modes is needed.     

Beyond Consent: Building Trusting Relationships With Diverse Populations in Precision Medicine Research

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: (1) Address the role of history and experience on trust, (2) engage concerns about potential group harm, (3) address cultural values and communication barriers, and (4) integrate patient values and expectations into oversight and governance structures.     

Shifts of criteria or neural timing? The assumptions underlying timing perception studies

In timing perception studies, the timing of one event is usually manipulated relative to another, and participants are asked to judge if the two events were synchronous, or to judge which of the two events occurred first. Responses are analyzed to determine a measure of central tendency, which is taken as an estimate of the timing at which the two events are perceptually synchronous. When these estimates do not coincide with physical synchrony, it is often assumed that the sensory signals are asynchronous, as though the transfer of information concerning one input has been accelerated or decelerated relative to the other. Here we show that, while this is a viable interpretation, it is equally plausible that such effects are driven by shifts in the criteria used to differentiate simultaneous from asynchronous inputs. Our analyses expose important ambiguities concerning the interpretation of simultaneity judgement data, which have hitherto been underappreciated.     

Pupillary Stroop effects

We recorded the pupil diameters of participants performing the words’ color-naming Stroop task (i.e., naming the color of a word that names a color). Non-color words were used as baseline to firmly establish the effects of semantic relatedness induced by color word distractors. We replicated the classic Stroop effects of color congruency and color incongruency with pupillary diameter recordings: relative to non-color words, pupil diameters increased for color distractors that differed from color responses, while they reduced for color distractors that were identical to color responses. Analyses of the time courses of pupil responses revealed further differences between color-congruent and color-incongruent distractors, with the latter inducing a steep increase of pupil size and the former a relatively lower increase. Consistent with previous findings that have demonstrated that pupil size increases as task demands rise, the present results indicate that pupillometry is a robust measure of Stroop interference, and it represents a valuable addition to the cognitive scientist’s toolbox.     

Decision frame and procedural justice: interactive effects on perceptions of distributive justice

This work examined the effect of procedural justice and item frame on responses to positively and negatively worded survey items. Under conditions of low procedural justice, there is a significant difference in the rating of distributive justice items positively and negatively framed, but not when procedural justice is high. Implications for decision frame theory and biasing of responses to survey items are considered.     

Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services

Comorbidity among the anxiety disorders is common and may negatively impact treatment outcome. Potentially, transdiagnostic cognitive-behavioral treatments (CBT) deal more effectively with comorbidity than standard CBT. The present study tested the effectiveness of The Unified Protocol (UP) applied to Mental Health Services. Pre-post-treatment effects were examined for psychiatric outpatients with anxiety disorders receiving UP treatment in groups. Forty-seven patients (mean-age = 34.1 (SD = 9.92), 77% females) with a principal diagnosis of anxiety were included. We found significant and clinically meaningful changes in the primary outcomes Clinical Global Impression Severity Scale (CGI-S; d = 1.36), Hamilton Anxiety Scale (HARS; d = .71), and WHO-5 Well-being Index (WHO-5; d = .54). Also, comorbid depressive symptoms and levels of positive and negative affect changed significantly after treatment. Patients with high levels of comorbidity profited as much as patients with less comorbidity; however, these patients had higher scores after treatment due to higher symptom burden at onset. Patients with comorbid depression profited more from treatment than patients without comorbid depression. The treatment effects found in the present study correspond to treatment effects of other TCBT studies, other UP group studies, and effectiveness studies on standard CBT for outpatients. The results indicate that the UP can be successfully applied to a MHS group setting, demonstrating positive effects on anxiety and depressive symptoms for even highly comorbid cases.     

Intergenerational Continuity in Qualities of the Parent–Child Relationship: Mediating and Moderating Mechanisms

Intergenerational continuity in parenting quality has been demonstrated but the mechanisms underlying this continuity are less understood. This study investigated whether the offspring personality and years of education mediate the continuity in qualities of the parent–child relationship and whether offspring personality moderates this association. The sample comprised 1308 Finnish offspring (G2; 62% female) and their mothers (G1). G1 (Mean age?=?37.7) reported self-perceived qualities of the parent–child relationship in terms of emotional warmth and acceptance towards G2 aged 3–18 years in 1980. Thirty-two years later, once having become parents themselves, G2 (Mean age?=?42.9) self-rated their own qualities of the parent–child relationship towards their children using the same scales. Between these follow-ups, G2 self-rated their personality (consisting of temperament and character traits) using the Temperament and Character Inventory and reported years of education. Results indicated that G2 character traits—Self-directedness and Cooperativeness—partially mediated the intergenerational continuity in self-perceived emotional warmth and explained 16% of this association. No mediating role of G2 temperament traits was found (all ps?>?.240). Character traits accounted for the indirect association better than education in a multiple mediator model. Moreover, no moderating role of either temperament or character traits was found (all ps?≥?.064). Study findings show that warm and accepting qualities of the parent–child relationship in childhood are related to offspring character traits that reflect personality maturity in adulthood, which in turn would predict their own positive parent–child relationship later in life.