Traditional Roles in a Non-Traditional Setting: Genetic Counseling in Precision Oncology

Next generation sequencing technology is increasingly utilized in oncology with the goal of targeting therapeutics to improve response and reduce side effects. Interpretation of tumor mutations requires sequencing of paired germline DNA, raising questions about incidental germline findings. We describe our experiences as part of a research team implementing a protocol for whole genome sequencing (WGS) of tumors and paired germline DNA known as the Michigan Oncology Sequencing project (MI-ONCOSEQ) that includes options for receiving incidental germline findings. Genetic counselors (GCs) discuss options for return of results with patients during the informed consent process and document family histories. GCs also review germline findings and actively participate in the multi-disciplinary Precision Medicine Tumor Board (PMTB), providing clinical context for interpretation of germline results and making recommendations about disclosure of germline findings. GCs have encountered ethical and counseling challenges with participants, described here. Although GCs have not been traditionally involved in molecular testing of tumors, our experiences with MI-ONCOSEQ demonstrate that GCs have important applicable skills to contribute to multi-disciplinary care teams implementing precision oncology. Broader use of WGS in oncology treatment decision making and American College of Medical Genetics and Genomics (ACMG) recommendations for active interrogation of germline tissue in tumor-normal dyads suggests that GCs will have future opportunities in this area outside of research settings.     

The Role of Parental Distress in Moderating the Influence of Child Neglect on Maladjustment

Despite pervasive evidence of the harmful impact of neglect on children’s adjustment, individual differences in adaptation persist. This study examines parental distress as a contextual factor that may moderate the relation between neglect and child adjustment, while considering the specificity of the relation between neglect and internalizing versus externalizing problems. In a sample of 66 children (33 with a documented child protective services history of neglect prior to age six), neglect predicted internalizing, and to a lesser extent externalizing, problems as rated by teachers at age seven. Parental distress moderated the relation between neglect and internalizing, but not externalizing, problems. Specifically, higher levels of neglect predicted more internalizing problems only among children of distressed parents. These findings indicate that parent-level variables are important to consider in evaluating the consequences of neglect, and point to the importance of considering contextual factors when identifying those children most at risk following neglect.     

Relationship of Youth Involvement in Diabetes-Related Decisions to Treatment Adherence

The aim of this study was to examine the relationship of youth’s involvement in diabetes-related decisions to adherence. Children and adolescents (8–19 years) and their parents (N = 89) completed the Decision Making Involvement Scale and the Self Care Inventory, a self-report measure of adherence. After controlling for youth age, the degree to which youth expressed an opinion and information to parents was associated with better parent- and youth-reported adherence. The degree to which parents expressed an opinion and information to youth was associated with worse parent-reported adherence. Joint decision-making behaviors (e.g., negotiation; provision of options) also were associated with better youth-reported adherence. Encouraging youth to express opinions and share illness-related information with parents during illness management discussions may improve adherence. Additional research is needed to identify mechanisms of effect and determine associations between decision making involvement and health behaviors and outcomes over time.     

Responding to the Psychological Needs of Health-Care Workers During the COVID-19 Pandemic: Case Study from the Medical College of Wisconsin

With the advent of the novel coronavirus (COVID-19) pandemic, health-care workers have been faced with an inordinately high level of trauma as frontline providers. The Medical College of Wisconsin (MCW) partnered with affiliate hospitals and community partners to mobilize a matrix of available support and interventions to deliver psychological services to reach all levels of health-care providers in timely, accessible formats. While virtual peer support groups were the most utilized resource among the support group options, other opportunities also provided unique benefits to learners whose education had been disrupted by the pandemic. Mental health must be prioritized for health-care workers in the event of future public health crises. Lessons learned from this pandemic indicate that it is critical to involve learners early on in the process in order to meet their educational needs and to increase access to evidence-based care.

     

Jandu Yani U (for all families): Tailored Triple P Training and Support Promote Empowerment in Remote Aboriginal Communities

Journal of Child and Family Studies - To enhance the accessibility and acceptability of evidence-based parenting programs in Indigenous communities, there is a need to build a confident and skilled...     

Creative Imagination is Stable Across Technological Media: The Spore Creature Creator Versus Pencil and Paper

T. B. Ward (1994) investigated creativity by asking participants to draw alien creatures that they imagined to be from a planet very different from Earth. He found that participant drawings reliably contained features typical of common Earth animals. As a consequence, Ward concluded that creativity is structured. The present investigation predicts that this limitation on creativity is not restricted to drawings: the use of different technology will not change creative output. To investigate this question, participants performed Ward's task twice: once using pencil and paper and once using software made to design creatures (the Spore Creature Creator). Only minor significant differences were found. This preliminarily suggests that changing tools does not affect the overall rigidity of the creative process. This lends further support to Ward's thesis on the structural rigidity of creativity. We conclude by suggesting an elaboration to Ward's thesis that will be explored in future work. We suggest that aesthetics might be one of the factors that contribute to creative constraint, in that creatures that are too unusual would be less interesting.     

Opening Up Openness: A Theoretical Sort Following Critical Incidents Methodology and a Meta-Analytic Investigation of the Trait Family Measures

Existing taxonomies of Openness's facet structure have produced widely divergent results, and there is limited comprehensive empirical evidence about how Openness-related scales on existing personality inventories align within the 5-factor framework. In Study 1, we used a critical incidents sorting methodology to identify 11 categories of Openness measures; in Study 2, we meta-analyzed the relationships of these categories with global markers of the Big Five traits (utilizing data from 106 samples with a total sample size of N = 35,886). Our results identified 4 true facets of Openness: aestheticism, openness to sensations, nontraditionalism, and introspection. Measures of these facets were unadulterated by variance from other Big Five traits. Many traits frequently conceptualized as facets of Openness (e.g., innovation/creativity, variety-seeking, and tolerance) emerged as trait compounds that, although related to Openness, are also dependent on other Big Five traits. We discuss how Openness should be conceptualized, measured, and studied in light of the empirically based, refined taxonomy emerging from this research.     

Babies Born Dying: Just Bad Karma? A Discussion Paper

The paper examines the notion of being born dying and karma. Karma is a belief upheld by Buddhists and non-Buddhists: That is, karma follows people from their previous lives into their current lives. This raises a difficult question: Does karma mean that a baby’s death is its own fault? While great peace can be found from a belief in karma, the notion of a baby’s karma returning in some sort of retributive, universal justice can be de-emphasized and is considered “un-Buddhist.” Having an understanding of karma is intrinsic to the spiritual care for the dying baby, not only from the perspective of parents and families who have these beliefs, but also for reconciling one’s own beliefs as a healthcare practitioner.     

Belief-based action prediction in preverbal infants

Successful mindreading entails both the ability to think about what others know or believe, and to use this knowledge to generate predictions about how mental states will influence behavior. While previous studies have demonstrated that young infants are sensitive to others’ mental states, there continues to be much debate concerning how to characterize early theory of mind abilities. In the current study, we asked whether 6-month-old infants appreciate the causal role that beliefs play in action. Specifically, we tested whether infants generate action predictions that are appropriate given an agent’s current belief. We exploited a novel, neural indication of action prediction: motor cortex activation as measured by sensorimotor alpha suppression, to ask whether infants would generate differential predictions depending on an agent’s belief. After first verifying our paradigm and measure with a group of adult participants, we found that when an agent had a false belief that a ball was in the box, motor activity indicated that infants predicted she would reach for the box, but when the agent had a false belief that a ball was not in the box, infants did not predict that she would act. In both cases, infants based their predictions on what the agent, rather than the infant, believed to be the case, suggesting that by 6 months of age, infants can exploit their sensitivity to other minds for action prediction.