Comparison of Informed Consent Preferences for Multiplex Genetic Carrier Screening among a Diverse Population

Multiplex genetic carrier screening is increasingly being integrated into reproductive care. Obtaining informed consent becomes more challenging as the number of screened conditions increases. Implementing a model of generic informed consent may facilitate informed decision-making. Current Wayne State University students and staff were invited to complete a web-based survey by blast email solicitation. Participants were asked to determine which of two generic informed consent scenarios they preferred: a brief versus a detailed consent. They were asked to rank the importance of different informational components in making an informed decision and to provide demographic information. Comparisons between informational preferences, demographic variables and scenario preferences were made. Six hundred ninety three participants completed the survey. When evaluating these generic consents, the majority preferred the more detailed consent (74.5 %), and agreed that it provided enough information to make an informed decision (89.5 %). Those who thought it would be more important to know the severity of the conditions being screened (p?=?.002) and range of symptoms (p?=?.000) were more likely to prefer the more detailed consent. There were no significant associations between scenario preferences and demographic variables. A generic consent was perceived to provide sufficient information for informed decision making regarding multiplex carrier screening with most preferring a more detailed version of the consent. Individual attitudes rather than demographic variables influenced preferences regarding the amount of information that should be included in the generic consent. The findings have implications for how clinicians approach providing tailored informed consent.     

What are the combined effects of negative emotions and illness cognitions on self-care in people with type 2 diabetes? A longitudinal structural equation model

Objective: To explore whether negative emotions mediate the effect of diabetes cognitions on diabetes self-care and conversely whether diabetes cognitions mediate the effect of negative emotions on diabetes self-care.

Design: Longitudinal observational study in adults with type 2 diabetes.

Main outcome measures: Self-reported depression and anxiety (Diabetes Wellbeing Questionnaire), cognitions (Illness Perceptions Questionnaire-Revised; Beliefs about Medicines Questionnaire), and diabetes self-care (Summary of Diabetes Self-Care Activities Scale) were completed at baseline and six months. Analyses used structural equation modelling.

Results: Baseline medication concerns were associated with elevated symptoms of depression and anxiety at follow-up, but emotions did not mediate medication concern’s effect on diabetes self-care. Baseline depression and anxiety symptoms were associated with specific diabetes cognitions over time, but these cognition domains did not mediate emotion’s effect on diabetes self-care. Personal control remained independent of emotions and was associated with diabetes self-care over time.

Conclusions: Negative emotions did not act directly or alongside cognitions to influence diabetes self-care. The reciprocal relationship between diabetes cognitions and emotions suggests cognitive restructuring, in addition to other mood management intervention techniques would likely improve the emotional wellbeing of adults with type 2 diabetes. Likewise, personal control beliefs are likely important intervention targets for improving self-care.     

Inhibition, Contextual Segregation, and Subject Strategies in List Method Directed Forgetting

This experiment tested alternative explanations of list method directed forgetting effects. Two word lists were studied by 135 subjects. Between lists, subjects were instructed to remember both lists (remember group), remember both lists as well as in which list words were studied (segregate group), or to forget the first list and remember the second (forget group). All subjects took both recall and recognition tests with test order varied between subjects. Among subjects who took the recall test first, the forget group showed a directed forgetting effect (poorer performance on List 1 than List 2) with both recall accuracy, recall typing time, and recognition reaction time measures. Contextual segregation of List 1 words by forget subjects was ruled out as a sufficient cause of the effect. Limited support was obtained for a differential rehearsal explanation of the effect. Within-group comparisons and findings of release from directed forgetting support inhibitory processes as the major cause of the directed forgetting effect.     

Scalable choice models

Two representational criteria for probabilistic choice models are studied. These criteria, called scalability and weak scalability, are shown to be characterized by behavioral axioms designated, respectively, as pairwise dependence and weak pairwise dependence. The former is shown to be equivalent to the order independence axiom of Tversky. In addition, structural conditions on the choice alternatives are established under which all axioms are equivalent.     

Visual imagery lowers sensitivity to hue-varying,but not to luminance-varying,visual stimuli

Visual sensitivity (d′) is reduced if a subject is instructed to maintain a visual image while the target is presented (the Perky effect; Segal, 1971). This effect, typically .6 d’ units in magnitude for a colored target presented briefly on a uniform white background, is abolished if both target and background are white. (This was found with simple and complex visual images, and with FC and YN signal-detection methods.) It is concluded that visual imagery may lower the sensitivity of a psychophysical chromatic channel, but not that of an achromatic channel.     

Activities of Suburban and Inner-City Youth

A questionnaire on out-of-classroom activities was adminstered to 238 inner-city ninth grade students and 382 ninth graders from a high socio-economic suburb. Differences in activity patterns between the two groups were slight, and where differences did exist, they may have been due to financial limitations rather than student preferences. Some differences in attitudes toward school and future expectations did exist, but little relationship is apparent between these differences and out-of-classroom activities.     

Physical Attractiveness,Dating Behavior,and Implications for Women

The primary objective of this study was to determine which of two sociological theories of dating preference was more powerful in predicting women's actual dating frequency. The two theories tested were Waller's theory, which emphasizes physical attractiveness, and Blood's theory, which emphasizes personality. The present study supported Waller's theory. Discussion and implications for women and counselors are presented.     

The psychological health of employed and unemployed recent graduates as a function cognitive appraisal and of coping

In the literature on the effects of unemployment on graduates two competing hypothesis have found support. On one hand graduates have higher expectations about status and occupational identity, hence being unemployed should be more distressing. On the other hand graduates have access to more personal and situational resources and should cope better with the stress of unemployment. In a study of 181 recent graduates it was found that those who were employed (n = 88) scored higher on both somatization and interpersonal sensitivity than those who were unemployed (n = 93). A large percentage also reported not being in the job to which they aspired and scored low on job commitment. The unemployed graduates had a more positive approach to problem-solving, higher achievement motivation, more perceived social support, were more assertive, and felt less hopeless than their employed peers. They also engaged in more constructive leisure activities than the employed group. The data provide tentative support for the hypothesis that graduates are better at coping with unemployment. However the indication is that any advantage to be gained is relative to the type of job occupied by the employed group to whom they are compared. The general conclusion is that opting for a job which does not meet expectations or aspirations may be more psychologically damaging in the short term than being unemployed and hopeful. This is a function of the individual's vulnerability or resistance to stress and highlights the need for graduates to be prepared more effectively for the path to a career.     

Are Better Workers Also Better Humans? On Pharmacological Cognitive Enhancement in the Workplace and Conflicting Societal Domains

The article investigates the sociocultural implications of the changing modern workplace and of pharmacological cognitive enhancement (PCE) as a potential adaptive tool from the viewpoint of social niche construction. We will attempt to elucidate some of the sociocultural and technological trends that drive and influence the characteristics of this specific niche, and especially to identify the kind of capabilities and adaptations that are being promoted, and to ascertain the capabilities and potentialities that might become diminished as a result. In this context, we will examine what PCE is, and how and why it might be desirable as a tool for adaptation within the workplace. As human beings are, or at least should be allowed to be, more than merely productive, able-bodied and able-minded workers, we will further examine how adaptation to the workplace niche could result in problems in other domains of modern societal life that require the same or other cognitive capabilities. In this context we will also focus on the concept of responsibility and how it pertains to PCE and the modern workplace niche. This will shed some light on the kind of trends related to workplace niche construction, PCE and capability promotion that we can expect in the future, and on the contexts in which this might be either beneficial or detrimental to the individual as a well-rounded human being, and to other members of society.