Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Cancer Genetic Counselees’ Self-Reported Psychological Distress, Changes in Life, and Adherence to Recommended Surveillance Programs 3–7 Years Post Counseling

The aim of the present cross-sectional study was to investigate psychological distress, changes in life, adherence to surveillance programs and satisfaction with cancer genetic counseling based on Swedish participants’ self-reported data. A total of 218 probands (72% response rate) affected by breast, breast/ovarian or colorectal cancer and/or a family history of cancer were surveyed 3–7 years after receiving cancer genetic counseling. Participants reported a relatively high level of anxiety and a low level of depression. Probands affected by colorectal cancer reported a higher level of depression than did non-affected individuals with a family history of colorectal cancer. Overall, the participants reported moderate changes in family relations, priorities and appreciation of daily life activities. The majority of at-risk probands reportedly adhered to recommended surveillance programs. The mean level of satisfaction with cancer genetic counseling was high. About half of the participants would have accepted additional counseling sessions, contact with a psychologist or further help concerning informing family members. The present results indicate no adverse effects of genetic counseling, but they do suggest that typical counseling procedures could be improved by provision of additional psychosocial support.     

A probabilistic computational model of cross-situational word learning

Words are the essence of communication: They are the building blocks of any language. Learning the meaning of words is thus one of the most important aspects of language acquisition: Children must first learn words before they can combine them into complex utterances. Many theories have been developed to explain the impressive efficiency of young children in acquiring the vocabulary of their language, as well as the developmental patterns observed in the course of lexical acquisition. A major source of disagreement among the different theories is whether children are equipped with special mechanisms and biases for word learning, or their general cognitive abilities are adequate for the task. We present a novel computational model of early word learning to shed light on the mechanisms that might be at work in this process. The model learns word meanings as probabilistic associations between words and semantic elements, using an incremental and probabilistic learning mechanism, and drawing only on general cognitive abilities. The results presented here demonstrate that much about word meanings can be learned from naturally occurring child-directed utterances (paired with meaning representations), without using any special biases or constraints, and without any explicit developmental changes in the underlying learning mechanism. Furthermore, our model provides explanations for the occasionally contradictory child experimental data, and offers predictions for the behavior of young word learners in novel situations.     

What Information Do Cancer Genetic Counselees Prioritize?

This study explored the informational needs of individuals attending genetic counseling for hereditary cancer, using a free-choice and a forced choice method. Prior to the consultation the informational needs of 334 counselees from Sweden and Norway were assessed by the QUOTE-gene (ca) questionnaire and by a study specific forced choice method, using Q-methodology. Questionnaire responses indicated that counselees' major concerns pertained to the need to be taken seriously, to be provided with sufficient risk estimation and medical/genetic information and to be involved in the decision making process. Furthermore, prior to counseling, counselees noted that the counselors' consideration and skillfulness were also extremely important. Analysis of the Q-sorting results revealed that counselees' needs could be assigned to one of five groups: the "need for facts; caring communication and medical information; information and support in communicating the genetic information to others; practical care and practical/medical information". Particularly noteworthy, counselees with varying backgrounds characteristics prioritized different needs. Cancer genetic counselees probably have different needs due to their medical and demographic background when attending genetic counseling. Addressing counselees' specific concerns more sufficiently and thereby increasing the overall effectiveness of the counseling session requires increased insight into individual needs, by for instance, utilizing screening methods such as QUOTE-gene (ca) prior to the counseling session.     

Swedish University Students’ Opinion Regarding Information About Soft Markers

The aim of this study was to investigate the opinions of Swedish university students about information regarding soft markers, when observed at second trimester ultrasound screening. A cross-sectional survey, where 85 Swedish university students completed a study specific questionnaire containing eleven hypothetical scenarios, involving various parameters (disease/syndromes/malformations with different characteristics), and location of the markers. Almost all participants indicated that they would wish to be informed, prior to the ultrasound examination, about the assessment and significance of soft markers. However, the number of respondents who requested information about a potential actual finding was considerably less. Several participants wanted to be informed about detected markers associated to serious conditions but not when the marker indicated an increased risk for a treatable disease. Also, the specific location of the marker was of importance to the participants. The majority of respondents wished to be informed about the soft markers if they were observed in the heart or the brain of the foetus, compared to if they were located in the intestine or the skeleton. The students’ opinion, in this study, implicate the importance of pre-examination information to enable expectant parents to make informed choice regarding the second trimester ultrasound screening as well as on reciving information of actual findings.     

EFL Teachers’ Verbal and Nonverbal Immediacy: A Study of its Impact on Students’ Emotional States,Cognitive Learning,and Burnout

Effective teacher–student interaction is an essential element of an ideal classroom which promotes the opportunity for expanded learning and stimulates the connections between students and teacher. The focus of the present study is on an instructional communication element that is teacher immediacy. It is defined as the mutual sensory and psychological stimulation between teacher and students. It can be verbal or nonverbal. Verbal immediacy is characterized as stylistic differences in expression from which like–dislike is inferred and includes using humor or personal examples, getting feedback, or even calling students by name. Nonverbal immediacy encompasses behaviors such as appropriate eye contact, the use of gestures, movement about the classroom, smiling, and vocal variety. In particular, the present study sought to explore the impact of English as a foreign language (EFL) teachers’ perceived verbal/nonverbal immediacy on students’ self-actualization, stress-control, and self-esteem. Moreover, it examined the role of EFL teachers’ immediacy behaviors in students’ cognitive learning and emotional exhaustion, which is a burnout subscale. To this end, 206 EFL students participated from selected universities of Mashhad, a city in northeast of Iran. The respondents were asked to complete five inventories about themselves and the previous EFL teacher they had had classes with. The results of structural equation modeling demonstrated that teacher immediacy behavior had a positive significant impact on all student-related variables: stress tolerance (β?=?.65, t?=?7.59), self-actualization (β?=?.69, t?=?8.02), self-esteem (β?=?.63, t?=?7.71), burnout (β?=?.31, t?=?4.05), and cognitive learning (β?=?.45, t?=?6.08). The highest impact was exerted on self-actualization and self-esteem.