Pilot Trial of Acceptance-Based Behavioral Weight Loss and Neurocognition Among American Indians

Acceptance-based behavioral therapies (ABTs) for obesity may be superior to standard behavioral therapies but have not been adequately tested with American Indians (AIs). Neurocognitive function is also unexamined in relation to behavioral weight loss among AIs despite findings that neurocognition predicts outcomes in general samples, may help explain some of the benefits of ABTs, and may be relevant to marginalized groups. The primary objective of this pilot was to examine the feasibility/acceptability of ABT in an AI sample. Exploratory analyses examined the relationship between neurocognition and weight loss. Forty-eight AI adults with overweight/obesity (ages 43.3 ± 10.3 years, 85% female; baseline body mass index = 36.8 ± 4.4 kg/m²) enrolled in a 6-month open ABT weight loss trial. Feasibility indices, including screening/enrollment, session attendance, retention rates for posttreatment assessments, and program acceptability were examined. Percent weight loss (%WL) was assessed as well as fluid and crystalized neurocognition (National Institutes of Health Toolbox Cognition Battery [NIHTB-CB]). We enrolled 79% of the eligible sample and retained 75% (N = 36) at posttreatment assessments. Program completers lost an average of 5.2 ± 4.9% of initial body weight (d_z = 1.14), whereas intent-to-treat analyses show a mean loss of 4.1 ± 4.7%. Participants reported high satisfaction, effectiveness, and cultural appropriateness. Exploratory analyses of neurocognitive domains suggested that crystalized cognition was higher among completers, and higher baseline cognitive flexibility predicted greater %WL (β = .34, p = .05). ABT resulted in clinically significant weight loss in an AI sample. A controlled trial of ABT in a larger, more diverse sample is warranted to determine whether (a) the findings are robust, generalizable, and/or superior to other treatments and (b) neurocognitive factors moderate outcomes.     

Theory of Mind Deficit in Schizophrenia and Associated Cognitive Functions

This study examined the Theory of Mind (ToM) ability of schizophrenic persons in association with other cognitive functions like memory, executive functioning and attention. Results showed evidence of relationship between ToM and cognitive functions i.e. executive function, working memory and intelligence but no uniform predictive model was found across all the ToM tasks. It was also noted that predicting variables related to different cognitive domains varied markedly for schizophrenia and control groups. It seems that there are multiple cognitive pathways to ToM mechanism, although these different forms may not have an additive effect.     

Relationship of Workplace Factors and Job Involvement of Healthcare Employees with Quality of Patient Care in Teaching and Non-teaching Hospitals

The present study examined the effects of certain hospital workplace factors on job involvement among healthcare employees at the paramedical levels and quality of patient care in public hospitals in North India. The sample consisted of paramedical healthcare employees (N = 200), from a medical college affiliated teaching hospital and public hospitals (non-teaching) run by the railway services. Data were analyzed statistically to examine the hypothesized differences between the two types of hospitals. Results showed that employee perceptions of the workplace factors, namely, participation in decision making, innovative practices, perceived organizational support and role efficacy were significantly different in the teaching and non-teaching hospitals. Stepwise regression analysis of the data revealed that the factor ‘innovative practices’ was a positive predictor of job involvement in the non-teaching hospitals but a negative predictor of in job involvement in the teaching hospital. Job involvement significantly mediated the relationship between the perception of workplace factors and quality of patient care only in the non-teaching hospitals. The present study has important implications for initiating changes in the hospital system, particularly in public hospitals, where no systematic study has yet been conducted to determine the effects of workplace factors on job involvement of healthcare professionals and the quality of patient care in India.     

Patients’ Opinions on Genetic Counseling on the Increased Risk of Parkinson Disease among Gaucher Disease Carriers

Gaucher disease (GD) is an autosomal recessive disease caused by GBA mutations that is especially common in the Ashkenazi Jewish (AJ) population. The link between GBA mutations and Parkinson disease (PD), a later-onset neurodegenerative condition, is well established, and studies have shown that GBA carriers have an increased lifetime risk of developing PD. Carrier screening for GD is frequently offered to couples during or prior to pregnancy, especially to those of AJ descent. However, no studies have been performed to assess if prospective parents would want to learn about their risk of developing PD incidentally through carrier screening. It is also unknown if pre-test counseling on this topic would affect screening uptake. In order to answer these questions, a survey was administered to individuals who screened negative for GBA mutations. Of the 75 participants, 86.7% believed that patients should be informed about the increased risk of PD prior to having GD carrier screening, and 93.3% responded that this information would not have changed their decision to have carrier screening. These results indicate that healthcare providers should take into consideration patient preferences when determining how to counsel about GD carrier screening. Additionally, these results have implications for genetic counseling about other later-onset conditions that may be incidentally ascertained through carrier screening.