What Patients and Their Relatives Think About Testing for BMPR2

Clinical genetic testing is available for mutations in BMPR2 associated with pulmonary arterial hypertension (PAH). The aim of this study is to assess attitudes of individuals affected by or at risk for PAH regarding genetic testing. Structured telephone interviews were conducted with 119 individuals affected by or at risk for PAH recruited from pulmonary hypertension clinic at Vanderbilt, Vanderbilt familial PAH registry, attendees at 2006 PHA meeting, and a local PAH support group. Sixty-four percent reported knowing little or nothing about BMPR2 testing. Predictors of greater self-assessed knowledge included having an affected family member and learning about BMPR2 testing through the internet. Most respondents reported that while they spent some time thinking about being tested for BMPR2, they had little trouble deciding. The most frequently cited reason for testing was to provide information for their children. About 20% said they had been tested, even though <5% have actually received clinical testing. Although patients with PAH and their at-risk relatives typically feel relatively uninformed about testing for mutations in BMPR2 and at times are confused about their testing status, they nonetheless report that it is easy to decide about testing.     

Sympathy for the Devil? Uncovering Inhibitors and Enablers of Emotional Engagement Between Zoo Visitors and the Tasmanian Devil,Sarcophilus harrisi

This article explores enablers and inhibitors of emotional engagement between visitors and Tasmanian devils at Healesville Sanctuary, Australia. A qualitative research approach was utilized including 44 interviews (ten with staff and 34 with visitors) and eight hours of observations of 622 visitors. Findings are presented in relation to six themes: (a) visitors’ motivations for viewing Tasmanian devils, (b) visitors’ emotional responses to Tasmanian devils, (c) role of previsit expectations, (d) species’ attributes inhibiting emotional engagement, (e) species' attributes enabling emotional engagement, and (f) elements of exhibit design and interpretation influencing emotional engagement. Results show clear views of active animals, first-person interpretation, and an understanding of conservation threats were enablers of forming an emotional connection. Inability to view animals and general misconceptions of devils were inhibitors of forming an emotional connection. Implications for exhibit management, interpretation, and conservation are discussed.     

Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

Mental health systems need scalable solutions that can reduce the efficacy–effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers’ fidelity to evidence-based treatment models and children’s and caregivers’ engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.     

A typology of behavior problems in preschool children

The purpose of this study was to produce a typology of behavior problems in preschool children. Distinct subtypes were identified through the use of cluster analytic techniques on data from the Behavior Assessment System for Children (BASC)-Parent Rating Scales. Analyses were based on archival data collected on a sample of 268 children, aged 2 to 5 years, who were referred to determine their suitability for a day treatment program. Five distinct and reliable subtypes of preschool children's behavior problems emerged. Ratings of adaptive and social skills based on the BASC Adaptive Scales and measures from the Parenting Stress Index served as external variables to assess the distinctiveness of the derived subtypes. The findings provide evidence for the reliability and validity of the subtypes identified in this study that are consistent with the findings of previous subtyping investigations focusing on school-aged children.     

Changes in cochlear microphonic sensitivity after priming C57BL/6j mice at various ages for audiogenic seizures.

Groups of mice were briefly exposed to a one-octave band of noise at 14, 18, 28, 38, or 58 days of age. Five days later the groups were divided, and some mice were behaviorally tested for audiogenic seizures by reexposing them to the same sound. The round window cochlear microphonic potential was measured in the remaining animals and compared with that observed in unprimed control subjects. Seizure behavior occurred in all animals primed on Day 18 but rarely for subjects in the other age groups. Cochlear microphonic threshold curves in mice primed on Day 18 showed a 30-dB loss in sensitivity, while all other primed groups showed little change. These data were discussed in terms of the "disuse-supersensitivity" hypothesis previously proposed to account for the physiological effects of priming in mice.     

The role of graded category structure in imaginative thought

Participants generated lists of exemplars from the categories of animals, tools, and fruit, and their lists were used to determine the relative accessibility of individual exemplars. Measures of accessibility included output dominance (the number of participants who listed an exemplar), rank (how early instances were listed), and two scores that reflect their combination-output precedence and dominance/rank. Other participants drew and described novel exemplars of those categories that might exist on an imaginary planet and reported on the factors that influenced their creations. References to Earth animals, tools, or fruit were used to determine imagination frequency (the number of participants who mentioned relying on particular Earth exemplars). Items high in accessibility were also high in imagination frequency, implying that those items that come to mind most readily are the ones most likely to serve as starting points for the development of novel ideas. This result held even when task constraints weighed against the use of such items (Experiment 2) and when participants were encouraged to be as creative as possible (Experiment 4), suggesting that it is difficult to avoid the influence of highly accessible category exemplars. Other measures of category structure, including the rated typicality, familiarity, and frequency of exemplars, did not predict imagination frequency as well. The results are discussed in terms of expanding concept boundaries and the inadvertent application of knowledge that is readily accessible.     

Influences on the Food Choice Behaviors of Adults With Severe Mental Illness

The objective of this research was to gain a deeper understanding of factors influencing the healthiness of food choice behaviors of community-dwelling adults with severe mental illness. Semi-structured interviews were conducted in an outpatient treatment facility with 20 program participants and 10 staff. Grounded theory analysis methods were used. Five dominant themes emerged: food availability, preference for simple food preparation, perceived cost of food, complexity of choice, and relative importance of healthy food choices. The theme of medication effects only emerged from staff interviews. This research can be useful to inform the design of nutrition interventions for this population.     

Gender differences on the mental rotations test: a factor analysis

The purpose of the present study was to examine possible gender differences in strategy when completing the mental rotations test. Two experiments examined gender differences and the factor structure on outcomes that can be obtained on this test. Experiment 1 involved large groups testing and Experiment 2 used small groups. Factor analytic results in both experiments generally supported the notion that items with one wrong and one blank response or one correct and one blank reflect reluctance to guess, whereas one correct and one wrong or two wrong answers reflect propensity to guess. Even though the factor structure was the same in males and females, the data provided mitigated support for the hypothesis that males have a higher propensity to guess and females show a greater reluctance to guess. Findings are discussed in terms of their implications for the interpretation of gender differences on the MRT.     

Interaction of reinforcement schedules, a behavioral prosthesis, and work-related behavior in adults with mental retardation

The effects of variable-interval (VI) and fixed-ratio (FR) schedules of reinforcement for work-related behavior and an organizer for the work materials (behavioral prosthesis) were evaluated with 3 adults with severe or profound mental retardation. The participants had been recommended for study because of high rates of off-task and aberrant behavior in their daily vocational training programs. For 2 participants, VI and FR schedules resulted in the same outcome: more aberrant behavior than on-task and off-task behavior combined. The FR schedule nearly eliminated emission of aberrant and off-task behavior by the 3rd participant. Combining the behavioral prosthesis with FR reinforcement (FR+O) increased the proportion of time spent in on-task behavior by all participants under certain FR schedule parameters. Second-by-second analyses of the observation records revealed that FR schedules reduced off-task and aberrant behavior during work sequences (i.e., ratio runs), and FR+O led to a further reduction of these behaviors during postreinforcement pauses. Overall, the results show how organizer and schedule parameters can be adjusted to produce an optimized balance between productivity and reinforcement while undesirable behavior is minimized.