Clinician-Stakeholders’ Perspectives on Using Patient Portals to Return Lynch Syndrome Screening Results

Test results for genetic conditions, such as Lynch Syndrome (LS), have traditionally been returned by genetic counselors or other providers who can explain results implications and provide psychosocial support. Returning genetic results through an Electronic Health Record’s patient portal may increase the efficiency of returning results and could activate patient follow-up; however, stakeholder input is necessary to determine acceptability and appropriate implementation for LS. Twenty interviews were conducted with clinicians from six specialties involved in LS screening that represent a range of settings. Data were analyzed using directed content analysis and thematic analysis across content categories. Participants felt that patient portals could supplement personal calls, but the potential sensitive nature of LS screening results indicated the need for caution. Others felt that LS results could be returned through portals if there were clear explanations of the result, reputable additional information available within the portal, urging follow up confirmatory testing, and a referral to a genetics specialist. Patient portals were seen as helpful for prompting patient follow-up and providing resources to notify at-risk family members. There is potential for patient portals to return LS screening and other genetic results, however we raise several issues to resolve before implementation is warranted.     

Effects of counseling Ashkenazi Jewish women about breast cancer risk

The goal of this study was to determine whether genetic counseling or psychosocial group counseling provided to Ashkenazi women can reduce breast cancer worry, cancer risk perception, and interest in having genetic testing. Women (N=211) were randomized to receive individual genetic risk counseling, to receive a group psychosocial group counseling, or to serve as a control group. The authors found that both counseling methods reduced cancer worry, lowered perceptions of breast cancer risk, and decreased interest in having genetic testing. Counseling can help women gain a more accurate perception of their risk, expose them to the benefits and limitations of genetic testing, and reduce their worry about cancer.     

Jewish identity and intentions to obtain breast cancer screening

This study explored the associations between 2 dimensions of Jewish identity (cultural identification and religious practice) and intentions to perform breast cancer screening. Ashkenazi Jewish women (N = 220) completed surveys as part of an ongoing study of breast cancer risk counseling. Multiple regressions examined the relationships between the 2 identity measures and intention to follow routine recommendations for mammography, intention to perform monthly breast self-exam, and interest in genetic testing for breast cancer susceptibility. Cultural identity positively predicted interest in testing, whereas religious identity was inversely related. Religious identity was a significant predictor of intention to adhere to mammography recommendations. Findings show that culture and religion, although correlated, may have different associations with health attitudes.     

Perception of coherent motion in random dot displays by pigeons and humans.

Pigeons and humans were required to discriminate coherent from random motion in dynamic random dot displays. Coherence and velocity thresholds were determined for both species, and both thresholds were found to be substantially higher for pigeons than for humans. The results are discussed with reference to differences in motion processing in mammals and birds. It is suggested that the inferior motion sensitivity of pigeons can be attributed to poorer spatiotemporal motion integration.     

Response-specific slowing in older age revealed through differential stimulus and response effects on P300 latency and reaction time

Older age produces numerous changes in cognitive processes, including slowing in the rate of mental processing speed. There has been controversy over the past three decades about whether this slowing is generalized or process-specific. A growing literature indicates that it is process-specific and suggests it is most dramatic at the interface where a stimulus input is translated into a response output. We tested this hypothesis using a task in which young and older adult males made either compatible or incompatible responses to the word LEFT or RIGHT shown briefly and variously located in a 4 row × 6 column matrix surrounded by # signs or by letters chosen randomly from the sets A-G or A-Z. Processing speed was measured using P300 latency and reaction time. Experimental effects on these two measures provided support for the hypothesis in revealing that stimulus identification processes were preserved, whereas processes related to translating a stimulus input into a designated response output and then selecting that response were compromised in the elderly.     

Individual differences in trajectories of arithmetical development in typically achieving 5- to 7-year-olds

The arithmetical performance of typically achieving 5- to 7-year-olds (N = 29) was measured at four 6-month intervals. The same seven tasks were used at each time point: exact calculation, story problems, approximate arithmetic, place value, calculation principles, forced retrieval, and written problems. Although group analysis showed mostly linear growth over the 18-month period, analysis of individual differences revealed a much more complex picture. Some children exhibited marked variation in performance across the seven tasks, including evidence of difficulty in some cases. Individual growth patterns also showed differences in developmental trajectories between children on each task and within children across tasks. The findings support the idea of the componential nature of arithmetical ability and underscore the need for further longitudinal research on typically achieving children and of careful consideration of individual differences.