Using heart rate as a physical activity metric

Physical activity (PA) is critical for a healthy lifestyle. The current study assessed heart rate (HR) as a primary measure of moderate and vigorous PA with four typically developing children. First, individualized HR assessments were conducted to determine moderate and vigorous HR zones. Next, participants engaged in various exercises at a local YMCA facility (i.e., biking, elliptical, basketball, and exergame boxing) to determine how HR during these activities aligned with their individualized HR zones. During exercise bouts, HR was typically above moderate, but below vigorous HR zones for all participants. Additionally, exercises that restricted range of motion (i.e., biking and elliptical) engendered generally lower HR than exercises with greater range of motion. Vocal instructions to exercise at vigorous levels were effective at increasing HR to vigorous levels for one participant. The advantages of using HR as a metric of PA during assessment and intervention are discussed.     

Decision-Making About Reproductive Choices Among Individuals At-Risk for Huntington's Disease

We explored how individuals at-risk for HD who have or have not been tested make reproductive decisions and what factors are involved. We interviewed 21 individuals (8 with and 4 without the mutation, and 9 un-tested) in-depth for 2 hours each. At-risk individuals faced a difficult series of dilemmas of whether to: get pregnant and deliver, have fetal testing, have pre-implantation genetic diagnosis, adopt, or have no children. These individuals weighed competing desires and concerns: their own desires vs. those of spouses vs. broader moral concerns (e.g., to end the disease; and/or follow dictates against abortion) vs. perceptions of the interests of current or future offspring. Quandaries arose of how much and to whom to feel responsible. Some changed their perspectives over time (e.g., first “gambling,” then being more cautious). These data have critical implications for genetic counselors and other health care workers and future research, particularly as more genetic tests become available.     

Students with Disabilities Use of Various Options to Access Alternative Schools and Area Learning Centers

Alternative schools that were developed to encourage students experiencing difficulties in conventional schools to graduate from high school have been in existence since the 1970s. Alternative schools represent a form of school choice available to parents and students. This investigation focused on the extent to which students with disabilities are accessing Alternative Schools and Area Learning Centers (ALC) in Minnesota. More specifically, attention centered on (a) the option used by both students with and without disabilities to enroll in the school, (b) the extent to which students crossed district boundaries to attend the school, and (c) differential participation by category of disability. Results indicate that students with disabilities are accessing Alternative SchooVALC programs in ways similar to non-disabled students. Moreover, students with emotionalhehavioral disorders are heavily represented in these schools. It also was discovered that when students enter these programs, special education labels are often dropped and services discontinued. Implications for students with emotional and behavioral disorders are discussed.     

An assessment of age differences in theory of mind using the virtual assessment of mentalizing ability

ABSTRACT

Prior research has shown that older adults perform more poorly than young on tasks that assess theory of mind (ToM). However, these studies have used tasks that are performed “offline” (i.e., requiring a second-person perspective) as opposed to “online” (i.e., requiring a first-person perspective). Therefore, the present study was designed to establish whether age-related ToM difficulties are also evident when an “online” measure of ToM is used. Forty younger and 40 older adults completed the Virtual Assessment of Mentalizing Ability (VAMA) along with two conventional ToM tasks. No age differences were evident on the conventional measures, but older adults had lower accuracy on the VAMA relative to their younger counterparts. The overall pattern of errors did not differ between the groups. These data provide no evidence that age effects are reduced when stimuli are used that are more likely to engage the mentalizing processes elicited in real life social interactions.     

Experiences of surgery readiness assessments in British Columbia

Abstract

Background: A surgical readiness assessment is a major step in the medical journey of trans people seeking gender-affirming surgery. Much of the peer-reviewed literature surrounding surgical readiness assessments emphasizes the perspectives of academics and clinicians, leaving the voices of trans and gender diverse patients largely unheard.

Aims: This paper foregrounds patient experiences with surgery readiness assessments to discuss the tensions, challenges and opportunities they generate.

Methods: We conducted a thematic analysis of 35 in-depth interviews with trans people who accessed or were seeking to access gender-affirming surgery in British Columbia.

Results: We developed three main themes to capture participants’ narratives of their surgical assessment experiences. The first, assessments as gatekeeping, explores the stories of people who described their assessments as outdated and even discriminatory processes. The second, assessments as a barrier to care, discusses the informational missteps, bureaucratic regulations, economic issues, and geographic concerns that made assessments difficult to access. The third, assessments as useful, includes positive stories about assessments that often involved feeling supported by an assessor and feeling prepared for the next steps.

Discussion: These narratives demonstrate how much variation exists among people’s experiences of readiness assessments for gender-affirming surgery. No matter how their actual assessment turned out, many participants approached their appointments with a great deal of anxiety and trepidation. We attributed this stress was to challenges ranging from lengthy wait times, arbitrary medical gatekeeping, a lack of access to knowledgeable and supportive providers, unclear or changing administrative processes, and insufficient communication. To address these challenges, it is crucial for the medical system to create more accessible pathways with centralized, up-to-date information for people trying to access assessments. Patients are best served by multi-disciplinary gender-affirming teams that provide individualized care.