Parent Perspectives of Support Received from Physicians and/or Genetic Counselors Following a Decision to Continue a Pregnancy with a Prenatal Diagnosis of Trisomy 13/18

Families that choose to continue a pregnancy with a prenatal diagnosis of Trisomy 13/18 are a minority that present unique challenges for those in charge of their care. This study investigated the extent to which these patients felt supported by their healthcare providers, and any differences in the perceived level of support experienced by those working with a physician versus those working with a genetic counselor. Two online support groups, SOFT and Hope for Trisomy, distributed an online survey to their members. Means, standard deviations and chi-square analysis were calculated to describe their responses. One-hundred fourteen surveys were included in the final analysis. Respondents were more likely to agree that genetic counselors provided unbiased information in a way that they understood, compared to physicians. Review of qualitative responses found that portrayal of Trisomy 13/18 by healthcare providers used directive language when describing the lethality, morbidity and burden of the condition. Language included terms such as “incompatible with life” and comments on burden to other family members. Healthcare providers can assist families that receive a prenatal diagnosis of Trisomy 13 or 18 by providing up-to-date written resources and connecting them with support groups for parents who have received a similar diagnosis. Our study found that involving genetic counselors in the prenatal care of these patients is likely beneficial.     

Evaluation of Breast Cancer Patients with Genetic Risk in a University Hospital: Before and After the Implementation of a Heredofamilial Cancer Unit

The identification of patients at risk for breast cancer by genetic testing has proven to reduce breast cancer mortality. In 2010, due to a lack of systematization in hereditary cancer assistance in our center, we implemented a multidisciplinary Heredofamilial Cancer Unit (HFCU). We analyze if the HFCU improved the rates of referrals and preventive management of breast cancer patients with genetic risk. We retrospectively compared family history records, referrals of high-risk patients to genetic counseling, and detection and management of patients with BRCA1/2 mutations in two cohorts of breast cancer patients diagnosed before (first period: 2007–2010) and after the creation of the HFCU (second period: 2010–2013). In the first period, 893 patients were included, and 902 were included in the second. Due to the inability to establish their genetic risk, 142 patients (15.9%) vs. 70 (7.8%) were excluded from analysis (p?<?0.001). Among the evaluable patients, 194 (25.8%) vs. 223 (26.8%) fulfilled one or more risk criteria (p?=?0.65). Family history documentation in patient’s medical records (92.4 vs. 97.8%, p?<?0.001) and referral rate (26.3 vs. 52%, p?<?0.0001) significantly increased in the second period. Eight BRCA1/2 mutations were detected among patients referred in the first period and 17 among those referred to the HFCU. The rate of preventive surgeries in patients with BRCA mutations significantly increased in the second period (25 vs. 76.5%, p?=?0.03). In conclusion, there was a clear improvement in family history records, referrals, and preventive surgeries in breast cancer patients with genetic risk after the implementation of the HFCU.     

Factors Influencing Clinical Follow-Up for Individuals with a Personal History of Breast and/or Ovarian Cancer and Previous Uninformative <Emphasis Type="Italic">BRCA1</Emphasis> and <Emphasis Type="Italic">BRCA2</Emphasis> Testing

Genetic testing for inherited cancer risk has recently improved through the advent of multi-gene panels and the addition of deletion and duplication analysis of the BRCA genes. The primary aim of this study was to determine which factors influence the intent of individuals with a personal history of breast and/or ovarian cancer and negative or uncertain BRCA1 and BRCA2 testing to return to a hereditary cancer program for additional genetic risk assessment, counseling, and testing. Surveys were sent to 1197 individuals and 257 were returned. Of those participants who were planning to return to clinic, most cited having family members who could benefit from the test result as the primary motivation to return. Many participants who were not planning to return to clinic cited the cost of testing as a barrier to return. Cost of testing and concerns about insurance coverage were the most commonly cited barriers for the group of participants who were undecided about returning to clinic. Results from this study may be used to guide re-contact efforts by clinicians to increase patient uptake to return to clinic for up-to-date genetic risk assessment, counseling, and testing.     

Gratitude as a Variable of Mediation between Parental Support and Self-Esteem in Adolescence

Despite there has been a growing interest in the study of gratitude, few studies have investigated which factors support and promote it; notably, no study has yet addressed ways in which parents could promote gratitude in their children. The present study aims to investigate the relation between parental emotional support and self-esteem through the mediation of gratitude. The analyses have been conducted considering both the maternal and the paternal roles. To that end, an explorative model has been proposed of these relations. A self-report questionnaire was administered to 279 15–19 year-old adolescents (M?=?16.83, SD?=?.85) living in Northern Italy. Findings show that (a) the mother’s emotional support, but not the father’s, sustains gratitude, and (b) gratitude completely mediates the relation between maternal emotional support and self-esteem. Limitations and research implications are discussed.     

Sociality and intergenerational transfer of older adults’ nostalgia

Interest in nostalgia has blossomed, yet its nature in older adulthood and potential for intergenerational transfer to younger adults has remained neglected. In Experiment 1, we focused on the content of older adults’ nostalgic (vs. ordinary) recollections and asked whether older adults’ nostalgia could be transferred to younger adults. We showed that nostalgia expressed in older adults’ narratives was positively associated with nostalgia reported by young-adult readers. In Experiment 2, undergraduates read a nostalgic or ordinary narrative written by an older adult. Then they rated their own nostalgia as well as their perceived social connectedness, self-continuity, and meaning in life. Exposure to older adults’ nostalgic (vs. ordinary) narratives promoted concurrent nostalgia among young adults, along with associated psychological benefits (social connectedness, self-continuity, meaning). The findings illustrate the potential for intergenerational transfer of nostalgia through written narratives, and attest to the universality of nostalgic themes across younger and older adults.     

Stress in remote work: two studies testing the Demand-Control-Person model

The popularity of remote work continues to rise, but uncertainty remains about how it influences employee well-being. We extend the Demand-Control-Person (DCP) model to test both person and job factors as important considerations in remote work, suggesting that emotional stability influences the utility of autonomy as a job resource in protecting employees from strain. Additionally, we test self-determination theory (SDT), positioning need satisfaction for autonomy, relatedness, and competence as mechanisms explaining the relationship between remote work and strain. In two field studies, high–emotional stability employees reporting high levels of autonomy experienced the lowest levels of strain, with negative relationships between extent of remote work and strain. In contrast, low–emotional stability employees who also have high autonomy appear more susceptible to strain, and this may increase when they work remotely more often. Our multilevel structural equation modelling revealed that high–emotional stability employees with high autonomy appear best positioned to meet their needs for autonomy and relatedness, even when remote work is more frequent; these in turn reduced the likelihood of strain. Thus, our results support the DCP and SDT models, revealing theoretical and practical implications for designing and managing remote work arrangements.     

Bilingualism and age are continuous variables that influence executive function

We analyzed the effects of bilingualism and age on executive function. We examined these variables along a continuum, as opposed to dichotomizing them. We investigated the impact that bilingualism and age have on two measures of executive control (Stroop and Flanker). The mouse-tracking paradigm allowed us to examine the continuous dynamics of the responses as participants completed each trial. First, we found that the Stroop effect was reduced with younger age and higher levels of bilingualism; however, no Bilingualism by Age interaction emerged. Second, after controlling for baseline, the Flanker effect was not influenced by bilingualism or age. These results support the notion that bilingualism is one way of enhancing some aspects of executive function – specifically those related to the Stroop task – across the adult life span. In sum, different levels of bilingualism, and different ages, result in varying degrees of executive function as measured by the Stroop task.     

Meta-analytic techniques reveal that corvid causal reasoning in the Aesop’s Fable paradigm is driven by trial-and-error learning

The classic Aesop’s fable, Crow and the Pitcher, has inspired a major line of research in comparative cognition. Over the past several years, five articles (over 32 experiments) have examined the ability of corvids (e.g., rooks, crows, and jays) to complete lab-based analogs of this fable, by requiring them to drop stones and other objects into tubes of water to retrieve a floating worm (Bird and Emery in Curr Biol 19:1–5, 2009b; Cheke et al. in Anim Cogn 14:441–455, 2011; Jelbert et al. in PLoS One 3:e92895, 2014; Logan et al. in PLoS One 7:e103049, 2014; Taylor et al. in Gray R D 12:e26887, 2011). These researchers have stressed the unique potential of this paradigm for understanding causal reasoning in corvids. Ghirlanda and Lind (Anim Behav 123:239–247, 2017) re-evaluated trial-level data from these studies and concluded that initial preferences for functional objects, combined with trial-and-error learning, may account for subjects’ performance on key variants of the paradigm. In the present paper, we use meta-analytic techniques to provide more precise information about the rate and mode of learning that occurs within and across tasks. Within tasks, subjects learned from successful (but not unsuccessful) actions, indicating that higher-order reasoning about phenomena such as mass, volume, and displacement is unlikely to be involved. Furthermore, subjects did not transfer information learned in one task to subsequent tasks, suggesting that corvids do not engage with these tasks as variants of the same problem (i.e., how to generate water displacement to retrieve a floating worm). Our methodological analysis and empirical findings raise the question: Can Aesop’s fable studies distinguish between trial-and-error learning and/or higher-order causal reasoning? We conclude they cannot.     

The Default Position: Optimizing Pediatric Participation in Medical Decision Making

Inclusion of children in medical decision making, to the extent of their ability and interest in doing so, should be the default position, ensuring that children are routinely given a voice. However, optimizing the involvement of children in their health care decisions remains challenging for clinicians. Missing from the literature is a stepwise approach to assessing when and how a child should be included in medical decision making. We propose a systematic approach for doing so, and we apply this approach in a discussion of two challenging clinical cases. The approach is informed by a literature review, and is anchored by case studies of teenagers' refusal of clinical care, regulatory requirements for research assent, and the accepted approach to involving cognitively impaired adults in medical decisions.     

Configurations of Young Peoples’ Important Life Goals and Their Associations with Thriving

The aims of this study were to determine whether, and how, young people’s beyond-the-self life goals coexisted with other life goals, and whether having at least one beyond-the-self goal was associated with higher thriving (the Five Cs of Positive Youth Development [PYD]) and volunteering, compared to having either no goals, or goals that were only self-focused. The authors conducted latent class analyses among five school cohort groups using data from five studies (combined using integrative data analysis techniques). Across grade groups, the authors identified classes, which can generally be characterized by (1) low endorsement of goals, (2) prominence of helping others and contributing to community goals, (3) prominence of goals related to a good life (e.g., make money, friends, live an adventurous life), and (4) endorsement of most life goals. In the older two grade groups we identified additional classes: a group with a high endorsement of goals oriented at helping others and serving God/higher power in the undergraduate group, and a group with high endorsement of goals to create something new and make the world a better place in the graduate group. There were differences in the Five Cs of PYD and volunteering between the classes. The authors discuss the implications of these results for future research and practice regarding young people’s life goals.