A randomized controlled trial on the long-term effects of a 1-month behavioral weight control program assisted by computer tailored advice

OBJECTIVES: To examine the long-term effects of a new behavioral weight control program (Kenkou-tatsujin, KT program). The program consisted of twice-interactive letter communications including computer-tailored personal advice on treatment needs and behavioral modification. DESIGN: A randomized controlled trial comparing Group KM: KT program with 6-month weight and targeted behavior's self-monitoring, Group K: KT program only, Group BM: an untailored self-help booklet with 7-month self-monitoring of weight and walking, and Group B: the self-help booklet only. PARTICIPANTS: Two hundreds and five overweight Japanese females were recruited via a local newspaper. MEASUREMENTS: Weight loss (body weight, BMI, reduction quotient, etc.) and behavioral changes (daily eating, exercise and sleeping habits). FINDINGS: A significant weight loss was observed in all groups. At 1 month, Groups KM and K were superior, but at 7 months, the mean weight loss was significantly more in Group KM than the other 3 groups. At 7 months, 8 dietary habits and 4 physical activities were improved in all subjects. Habitual improvement was related to the weight loss in Groups KM and K at 1 month.     

“Editing” Genes: A Case Study About How Language Matters in Bioethics

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.     

Human Germline CRISPR-Cas Modification: Toward a Regulatory Framework

CRISPR germline editing therapies (CGETs) hold unprecedented potential to eradicate hereditary disorders. However, the prospect of altering the human germline has sparked a debate over the safety, efficacy, and morality of CGETs, triggering a funding moratorium by the NIH. There is an urgent need for practical paths for the evaluation of these capabilities. We propose a model regulatory framework for CGET research, clinical development, and distribution. Our model takes advantage of existing legal and regulatory institutions but adds elevated scrutiny at each stage of CGET development to accommodate the unique technical and ethical challenges posed by germline editing.     

Germline Manipulation and Our Future Worlds

Two genetic technologies capable of making heritable changes to the human genome have revived interest in, and in some quarters a very familiar panic concerning, so-called germline interventions. These technologies are: most recently the use of CRISPR/Cas9 to edit genes in non-viable IVF zygotes and Mitochondrial Replacement Therapy (MRT) the use of which was approved in principle in a landmark vote earlier this year by the United Kingdom Parliament. The possibility of using either of these techniques in humans has encountered the most violent hostility and suspicion. However it is important to be aware that much of this hostility dates back to the fears associated with In Vitro Fertilization (IVF) and other reproductive technologies and by cloning; fears which were baseless at the time concerning both IVF and cloning the use of both of which have proved to be highly beneficial to humanity and which have been effectively regulated and controlled. This paper argues that CRISPR should by pursued through researh until it is safe enough for use in humans but there is no reason to suppose at this stage that such use will be unsafe or unethical (Collins 2015).     

青少年抑郁症后父母认知行为改变的质性研究

基于质性研究方法,对青少年患抑郁症后父母认知行为改变、当前家庭面临的困境进行研究。采用半结构式访谈法对18名青少年抑郁症患者的父亲/母亲进行深度访谈,运用Colaizzi七步分析法对访谈数据进行分析。研究结果揭示,青少年被诊断抑郁症后,尽管父母会反思与青少年抑郁症相关的家庭因素并发生相应的认知行为改变,但青少年家庭依然面临内外部困境,应发挥家庭、学校、社区、医院四方疾病管理体系的协同作用,为青少年抑郁症患者及其家庭提供长期支持,促进青少年治疗和社会功能恢复。

     

Developmental neuropsychological assessment of 4- to 5-year-old children born following Preimplantation Genetic Diagnosis (PGD): A pilot study

The purpose of this pilot study was to evaluate developmental neuropsychological profiles of 4- to 5-year-old children born after Preimplantation Genetic Diagnosis (PGD). Twenty-seven participants received a neurological examination and a battery of neuropsychological assessments including Wechsler Preschool & Primary Scale of Intelligence - Third Edition (WPPSI-III; cognitive development), Preschool Language Scale, Fourth Edition (PLS-4; language development), Wide Range Assessment of Visual Motor Abilities (visual motor abilities), Childhood Autism Rating Scales II (a screening test for autistic spectrum disorders), and the Miles ABC Test (ocular dominance). Parental questionnaires included the Behavior Rating Inventory of Executive Function Preschool Version (BRIEF-P; executive function), Child Behavior Checklist (CBCL) and the Carey Temperament Scales Behavioral Style Questionnaire (socioemotional development and temperament), and the Vineland Adaptive Behavior Scales, Interview Edition, Second Edition (general adaptive behavior). Subjects’ tests results were compared to each test’s norms. Children born after PGD demonstrated scores within the normal or above-normal ranges for all developmental outcomes (mean ± SD): WPPSI-III-VIQ 107.4 ± 14.4 (p = .013), PLS-4-Total 113.2 ± 12.4, p < .001), CBCL-Total 41.1 ± 8.6 (p < .001), BRIEF-P-Global Executive Composite 44.8 ± 9.5 (p = .009). Twelve (44%) of the PGD children had a significant difference between their VIQ and PIQ scores (compared to 27% in the general population). One subject was found to show possible signs of autistic spectrum disorder, although a family history of autism was noted. In conclusion, in this pilot study, children assessed at age 4–5 years and conceived after PGD displayed developmental neuropsychological outcomes within normal limits as compared to their chronologic peers. A larger study is needed to evaluate and follow the neuropsychological development of children born after PGD.     

Communication of Information about Genetic Risks: Putting Families at the Center

Genetic information is a family affair. With the expansion of genomic technologies, many new causal genes and variants have been established and the potential for molecular diagnoses increased, with implications not only for patients but also their relatives. The need for genetic counseling and intrafamilial circulation of information on genetic risks grew accordingly. Also, the amount and, particularly, the complexity of the information to convey multiplied. Sharing information about genetic risks with family members, however, has never been an easy matter and often becomes a source of personal and familial conflicts and distress. Ethical requisites generally prevent healthcare professionals from directly contacting their consultands' relatives (affected or still at risk), who often feel unsupported throughout that process. We discuss here the communication of genetic risks to family members. We first consider genomic testing as a basis for family‐centered health care, as opposed to a predominant focus on the individual. We reviewed the literature on sharing genetic risk information with family members, and the associated ethical issues for professionals. Some clinical cases are presented and discussed, and key issues for meeting the needs of individuals and families are addressed. We argue that genetic information is inextricably linked to the family and that communicating about genetic risks is a process grounded within the broader milieu of family relationships and functioning. We conclude for the need for a more family‐centered approach and interventions that can promote sensitive attitudes to the provision of genetic information to and within the family, as well as its inclusion in educational and training programmes for genetic healthcare professionals.     

Modification of Hostile Interpretation Bias in Depression: A Randomized Controlled Trial

Interpretation Bias Modification (IBM) is gaining attention in the literature as an intervention that alters cognitive biases and reduces associated symptoms. Forty, primarily college-aged, non-treatment-seeking adults with major depressive disorder (MDD) were randomly assigned to receive either IBM targeting hostile interpretation bias (IBM-H) or a healthy video control (HVC) condition. Compared to those in HVC, participants in IBM-H reported more benign interpretations and fewer hostile interpretations at posttreatment. No difference in depressive interpretation bias was found between groups at posttreatment. IBM-H led to improved anger control at posttreatment and follow-up compared to HVC, though no effects of condition were found on trait anger or depressive symptoms. The IBM-H group perceived their treatment as less credible than the HVC group. For individuals with high expectancy of treatment success, IBM-H led to lower posttreatment depressive symptoms compared to HVC, while findings trended in the opposite direction for those with low expectancy of success. Overall, these preliminary findings point to boundary conditions for the efficacy of IBM protocols for anger and depression and potential improvements to be made to future IBM protocols.     

Efficacy of Attention Bias Modification Using Threat and Appetitive Stimuli: A Meta-Analytic Review

Attention bias modification (ABM) protocols aim to modify attentional biases underlying many forms of pathology. Our objective was to conduct an effect size analysis of ABM across a wide range of samples and psychological problems. We conducted a literature search using PubMed, PsycInfo, and author searches to identify randomized studies that examined the effects of ABM on attention and subjective experiences. We identified 37 studies (41 experiments) totaling 2,135 participants who were randomized to training toward neutral, positive, threat, or appetitive stimuli or to a control condition. The effect size estimate for changes in attentional bias was large for the neutral versus threat comparisons (g = 1.06), neutral versus appetitive (g = 1.41), and neutral versus control comparisons (g = 0.80), and small for positive versus control (g = 0.24). The effects of ABM on attention bias were moderated by stimulus type (words vs. pictures) and sample characteristics (healthy vs. high symptomatology). Effect sizes of ABM on subjective experiences ranged from 0.03 to 0.60 for postchallenge outcomes, –0.31 to 0.51 for posttreatment, and were moderated by number of training sessions, stimulus type, and stimulus orientation (top/bottom vs. left/right). Fail-safe N calculations suggested that the effect size estimates were robust for the training effects on attentional biases, but not for the effect on subjective experiences. ABM studies using threat stimuli produced significant effects on attention bias across comparison conditions, whereas appetitive stimuli produced changes in attention only when comparing appetitive versus neutral conditions. ABM has a moderate and robust effect on attention bias when using threat stimuli. Further studies are needed to determine whether these effects are also robust when using appetitive stimuli and for affecting subjective experiences.     

Evolution of Research on Interventions for Individuals with Autism Spectrum Disorder: Implications for Behavior Analysts

The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has ended. Many investigators from other disciplines are now carrying out large-scale intervention studies and beginning to report successes of their own. The increasing number and range of studies has the potential to improve services for individuals with ASD, and it challenges behavior analysts to intensify their research efforts.