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.     

Salivary Cortisol as a Biomarker in Social Science Research

Cortisol, a neuroendocrine hormone measurable in saliva, responds to internal and external triggers. In providing a peripheral ‘window on the brain’, it has been increasingly incorporated into social psychological studies. Cortisol secretion can be studied in two main ways, examination of acute stress reactivity and examination of the basal circadian patterns. These can inform aspects of acute and chronic stress exposure and relationships with health. Within non‐clinical populations, cortisol effects are largely driven by differences in the perception of threat. For social psychologists, this provides an interesting avenue for the investigation of social factors that mediate perceptions of threat, such as social support, relationship processes, and group dynamics in acute and chronic stress. This paper provides a background to understanding the regulation and function of cortisol, and issues arising in relation to its measurement in saliva. It discusses and makes recommendations on the use of appropriate cortisol measures in the study of both acute and chronic stress. Used and interpreted appropriately, stress reactivity and basal ambulatory measures of salivary cortisol can provide a valuable adjunct to self‐report and observation in social psychological research. © 2013 John Wiley & Sons Ltd     

Improving the 'how' and 'what' decisions of elite table tennis players

Training methods in sport usually focus on improving either technical or tactical aspects of performance, ignoring the fact that successful performance requires the athlete to simultaneously decide what movement to perform and how it should be executed. Young elite table tennis players were trained, in a first phase, to improve their forehand and backhand movements and, in a second phase, to make a tactical switch between forehand and backhand movements. Half of the players took part in behavioral training focusing on how to perform the required movements, whereas half received additional video feedback about their technical and tactical performance (decision training). The results indicate that improvements of how decisions (techniques) and what decisions (tactics) can occur as a consequence of combining technical and tactical training. These results were stable in delayed Post-test analyses of competitive matches. It was concluded that a combination of both technical and tactical training is beneficial to elite table tennis performers, particularly during early seasonal training programs.     

Visual neglect in the first weeks after a stroke in the right hemisphere

The aim of the study was to characterize symptoms of visual neglect among patients who recently survived a stroke in the right hemisphere (RH), and to contribute to the understanding of change in symptoms during the first months after a RH stroke. Thirteen patients with a RH stroke and twenty controls were assessed by using standard neglect tests. Five patients were followed up by repetitive test sessions during the next four months. To assess more subtle symptoms, reaction-time (RT) measures derived from an experimental cue-target paradigm were included in the final test session. A high frequency of neglect symptoms was documented at the first test session. The changes in performance during the first weeks were characterized by a high inter-individual as well as a high intra-individual variability. Although the remission rate on standard tests was high in the follow-up study, the RT measures indicated sustained symptoms of visual extinction in all patients. The long-term implication of the changes of neglect symptoms during the first weeks after a stroke and signs of sustained symptoms of visual extinction calls for further longitudinal studies including a larger group of patients.     

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.