“Bridge to the Literature”? Third-Party Genetic Interpretation Tools and the Views of Tool Developers

Patients and health care consumers can obtain access to their “raw,” or uninterpreted, genetic data from direct-to-consumer genetic testing companies, researchers, or providers and pursue self-directed analysis via third-party interpretation tools. Yet relatively little is known about the nature of currently available interpretation tools or the motivations of tool developers. We conducted a structured content analysis of 23 third-party interpretation tool websites and supporting information, tracking features such as types of information returned, modes of generating and presenting that information, and privacy and security measures. We additionally conducted qualitative interviews with a subset of 10 tool developers. A majority of tools (16 of 23, or 70%) offer some type of health or wellness-related information, often extracted from publicly available variant annotation databases. Half of those interviewed characterized their activities as “bridging” users to the scientific literature rather than interpretation, for which they gave a variety of scientific, ethical, and regulatory justifications. The scale, heterogeneity, and complexity of information available from third-party interpretation are unprecedented. While developers aim to enlighten and empower tool users, interpretation-free “bridging” to rapidly evolving databases may instead impose burdens on genetic counselors and other health care providers asked to provide further contextualization and explanation.     

A Two-Phase Approach to Developing SNAP: an iPhone Application to Support Appointment Scheduling and Management for Women with a <Emphasis Type="Italic">BRCA</Emphasis> Mutation

Professional organizations provide surveillance guidelines for BRCA1 and BRCA2 (BRCA) carriers with intact breasts and/or ovaries to facilitate early cancer detection. However, literature indicates adherence to surveillance guidelines is inconsistent at best. Using the Messaging Model for Health Communication Campaigns framework, we undertook a two-phase formative research approach to develop an intervention to promote adherence to surveillance guidelines. Discussion groups identified preferred intervention format and function in phase I. Findings indicated carriers desired a phone application (app) to assist with surveillance management and appointment tracking. Thus, an iPhone app for carriers to track appointments based on published surveillance guidelines was developed. In phase II, we obtained feedback from BRCA carriers via a survey during a prototype demonstration at a regional conference. Participants in phase II wanted reminder capabilities and the ability to add and modify information fields. This feedback informed intervention modifications, resulting in the Scheduling Necessary Advised Procedures (SNAP) iPhone app currently being pilot tested by BRCA carriers throughout the USA.     

In which direction to move? Facilitative and interference effects of gestures on problem solver's thinking

Recent research shows that co-speech gestures can influence gesturers’ thought. This line of research suggests that the influence of gestures is so strong, that it can wash out and reverse an effect of learning. We argue that these findings need a more robust and ecologically valid test, which we provide in this article. Our results support the claim that gestures not only reflect information in our mental representations, but can also influence gesturer's thought by adding action information to one's mental representation during problem solving (Tower of Hanoi). We show, however, that the effect of gestures on subsequent performance is not as strong as previously suggested. As opposed to what previous research indicates, gestures' facilitative effect through learning was not nullified by the potentially interfering effect on subsequent problem-solving performance of incompatible gestures. To conclude, using gestures during problem solving seems to provide more benefits than costs for task performance.     

Emotional processes in risky and multiattribute health decisions

Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.     

Does Rumination Mediate the Association of Private Prayer,Stress, and Their Interaction with Depression among Christians? A Cross-Sectional Study

Mechanisms underlying significant associations between different types of prayer and depression are unknown. Based on the conceptualization of prayer as stress buffering coping style and the Response Style Theory, we proposed that rumination mediates the association of prayer types and stress with depression. This cross-sectional study (N?=?227 Christians, M_age 41.74, SD 14.82, age range 18–82 years, 76% female) used path modeling to test whether rumination mediated the associations between prayer types and prayer types by stress interactions with depression. Rumination fully mediated the associations of the colloquial and ritual prayer by stress interactions with depressive symptoms, while meditative and petitionary prayer was directly associated with depressive symptoms. Further, petitionary prayer and the ritual prayer by stress interaction were associated with more and not with less rumination and depressive symptoms, respectively. Summarized, first empirical evidence supports an integration of prayer, stress, and rumination into one model of depression. However, the exact nature of their interplay depends on the prayer type. If replicated, our findings allow the integration of prayer into cognitive-behavioral treatment of depression in religious and spiritual clients.     

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.     

Impulsive choice and pre‐exposure to delays: iv. effects of delay‐ and immediacy‐exposure training relative to maturational changes in impulsivity

Impulsive choice describes preference for smaller, sooner rewards over larger, later rewards. Excessive delay discounting (i.e., rapid devaluation of delayed rewards) underlies some impulsive choices, and is observed in many maladaptive behaviors (e.g., substance abuse, gambling). Interventions designed to reduce delay discounting may provide therapeutic gains. One such intervention provides rats with extended training with delayed reinforcers. When compared to a group given extended training with immediate reinforcers, delay‐exposed rats make significantly fewer impulsive choices. To what extent is this difference due to delay‐exposure training shifting preference toward self‐control or immediacy‐exposure training (the putative control group) shifting preference toward impulsivity? The current study compared the effects of delay‐ and immediacy‐exposure training to a no‐training control group and evaluated within‐subject changes in impulsive choice across 51 male Wistar rats. Delay‐exposed rats made significantly fewer impulsive choices than immediacy‐exposed and control rats. Between‐group differences in impulsive choice were not observed in the latter two groups. While delay‐exposed rats showed large, significant pre‐ to posttraining reductions in impulsive choice, immediacy‐exposed and control rats showed small reductions in impulsive choice. These results suggest that extended training with delayed reinforcers reduces impulsive choice, and that extended training with immediate reinforcers does not increase impulsive choice.     

Imagine Me and You,I Do: Effects of imagined intergroup contact on anti‐fat bias in the context of job interviews

Imagined intergroup contact (IIC) has been demonstrated to alleviate prejudice toward social groups as a whole, but the extent to which it prevents biases in ratings of individual job candidates has not yet been examined. This study uses a simulated employment interview where a female candidate either higher or lower in body fat is rated by participants who have undergone an IIC or a control manipulation. IIC successfully alleviated discrimination in ratings of interviewee competence but had no significant effect on ratings of warmth. Competence ratings fully mediated the effect of the two‐way interaction of IIC and interviewee body fat on a dichotomous hiring recommendation provided 1 week later. IIC may be an effective and inexpensive intervention for reducing bias in job interview contexts.     

The role of diversity practices and inclusion in promoting trust and employee engagement

This paper investigates the association of diversity practices with an important aspect of workplace well‐being, engagement. It was hypothesized that this association would be mediated by trust climate, and that this mediation relationship would be stronger when employees experienced feelings of inclusion in the workplace. Using a sample of 4,597 health sector employees, results indicated that diversity practices are associated with a trusting climate that, in turn, is positively related to employee engagement. Furthermore, the relationship between diversity practices and trust climate was moderated by inclusion. Theoretical and practical implications of the study are discussed along with recommendations for future research.