"Evidence-debased medicine" and the integrity of the medical profession

Patients trust physicians to prescribe based on their fiduciary duty to act in the best interests of their patients, and physicians prescribe based on confidence in research data and clinical guidelines. Recent reports erode confidence in evidence-based medicine. Through self-regulation and a willingness to change, the medical profession can assert its status as a profession distinct from outside influence, serving one interest: the healthcare of patients and the public.     

Bilingual recognition memory: Stronger performance but weaker levels-of-processing effects in the less fluent language

The effects of bilingual proficiency on recognition memory were examined in an experiment with Spanish–English bilinguals. Participants learned lists of words in English and Spanish under shallow- and deep-encoding conditions. Overall, hit rates were higher, discrimination greater, and response times shorter in the nondominant language, consistent with effects previously observed for lower frequency words. Levels-of-processing effects in hit rates, discrimination, and response time were stronger in the dominant language. Specifically, with shallow encoding, the advantage for the nondominant language was larger than with deep encoding. The results support the idea that memory performance in the nondominant language is impacted by both the greater demand for cognitive resources and the lower familiarity of the words.     

The use of a mental imagery intervention to enhance integrated regulation for exercise among women commencing an exercise program

The purpose of this study was to examine the effects of a mental imagery intervention designed to enhance integrated regulation for exercise among women commencing an exercise program. Healthy women who previously did not exercise regularly (N?=?102; M _age ?=?29.54, SD?=?8.34) participated in an 8-week cardiovascular exercise program in which they exercised 3 times each week at a moderate intensity. The intervention group (n?=?51) received weekly guided imagery sessions which were administered in person via audio recording. A comparison group (i.e., attention control; n?=?51) received health information delivered in the same manner. Despite substantial dropout of participants from both groups, the analysis revealed that participants in the imagery group experienced greater changes in integration than participants in the comparison group. These findings support the utility of imagery interventions for influencing exercise-related cognitions, and more specifically integrated regulation.     

Illness representations in patients with multimorbid long-term conditions: qualitative study

Most research on illness representations explores how patients view single conditions, but many patients report more than one long-term condition (known as multimorbidity). It is not known how multimorbidity impacts on patient illness representations. This exploratory qualitative study examined patients' representations of multimorbid long-term conditions and sought to assess how models of illness representation might need modification in the presence of multimorbidity. We explored two major issues: (1) the impact of multimorbidity on patient representations of their individual conditions and (2) the representation of multimorbidity itself. Twenty eight adults with at least two long-term conditions (mean of 4) were interviewed. The presence of multimorbidity impacted on patient illness representations in relation to the dimensions of identity, perceived cause, coherence and consequences. Representations of multimorbidity itself concerned representations of the burden of medication and perceived priorities among conditions and synergies and antagonisms between conditions and their management. The results have implications for the measurement of multimorbidity (through scales such as the Illness Perception Questionnaire) and the use of illness representations in the design and delivery of interventions to improve health behaviour and outcomes of patients with multiple long-term conditions.     

Personality traits in old age: measurement and rank-order stability and some mean-level change

Lothian Birth Cohorts, 1936 and 1921 were used to study the longitudinal comparability of Five-Factor Model (McCrae & John, 1992) personality traits from ages 69 to 72 years and from ages 81 to 87 years, and cross-cohort comparability between ages 69 and 81 years. Personality was measured using the 50-item International Personality Item Pool (Goldberg, 1999). Satisfactory measurement invariance was established across time and cohorts. High rank-order stability was observed in both cohorts. Almost no mean-level change was observed in the younger cohort, whereas Extraversion, Agreeableness, Conscientiousness, and Intellect declined significantly in the older cohort. The older cohort scored higher on Agreeableness and Conscientiousness. In these cohorts, individual differences in personality traits continued to be stable even in very old age, mean-level changes accelerated.     

Genetic Testing Integration Panels (GTIPs): A Novel Approach for Considering Integration of Direct-To-Consumer and Other New Genetic Tests into Patient Care

There has been a dramatic increase in the number of genetic tests available but few tests have practice guidelines. In addition, many tests have become available outside of clinical settings through direct-to-consumer (DTC) companies and several offer tests not considered standard of care. To address several practical challenges associated with the rapid introduction of clinical and DTC genetic tests, we propose that genetic counselors and geneticists organize expert panels in their institutions to discuss the integration of new tests into patient care. We propose the establishment of Genetic Testing Integration Panels (GTIPs) to bring together local experts in medical genetics, genetic counseling, bioethics and law, health communication and clinical laboratory genetics. We describe key features of this approach and consider some of the potential advantages and limitations of using a GTIP to address the many clinical challenges raised by rapidly emerging clinical and DTC genetic tests.     

Social Influence on consumer decisions: Motives,modes, and consequences

Research on consumer decision making has long recognized the influence of others. In this comment on Simpson, Griskevicius, and Rothman (this issue), we agree with them that consumer decisions are best understood in the social contexts in which these decisions are made. We explain how research on consumer social influence incorporates social motives, and we trace the effects of these motives on consumers’ information processing and their purchase and consumption decisions.     

Report from the National Society of Genetic Counselors Service Delivery Model Task Force: A Proposal to Define Models, Components, and Modes of Referral

The Service Delivery Model Task Force (SDMTF) was appointed in 2009 by the leadership of the National Society of Genetic Counselors (NSGC) with a charge to research and assess the capacity of all existing service delivery models to improve access to genetic counseling services in the context of increasing demand for genetic testing and counseling. In approaching this charge, the SDMTF found that there were varying interpretations of what was meant by "service delivery models" and the group held extensive discussions about current practices to arrive at consensus of proposed definitions for current genetic service delivery models, modes of referral and components of service delivery. The major goal of these proposed definitions is to allow for conversations to begin to address the charge to the committee. We propose that current models of service delivery can be defined by: 1) the methods in which genetic counseling services are delivered (In-person, Telephone, Group and Telegenetics), 2) the way they are accessed by patients (Traditional referral, Tandem, Triage, Rescue and Self-referral) and 3) the variable components that depend upon multiple factors unique to each service setting. This report by the SDMTF provides a starting point whereby standardized terminology can be used in future studies that assess the effectiveness of these described models to overcome barriers to access to genetic counseling services.     

The role of expectations in children's experience of novel events

The expectations children bring to interactions, as well as the information they receive prior to them, may be important for children's experiences of new adults. In this study, 148 children (8-13years old) reported on their expectations of adults, received one of three types of information about a new adult (positive, realistic, or control), and then "interacted" with a videotaped "controlling" adult. The effect of information type depended on children's age and prior expectations, with expectancy effects emerging in the context of positive information at the younger end of our age range and in the context of realistic information at the older end of our age range. Furthermore, the more expectations exceeded perceptions (i.e., the more disappointment), the lower children's rapport, affect, and prosocial intentions were and the more internal causal attributions they made. Results are discussed in terms of their theoretical and applied contributions.