Identifying Interest in and Barriers to Psychiatric Genetic Counseling

Mental illness is common in the United States and genetic counseling for psychiatric indications can help individuals understand multifactorial inheritance, recurrence risk estimates, and identify ways to protect their future mental health. Despite interest in and efficacy of the service documented in populations outside of the United States, individuals with personal and/or family histories of psychiatric conditions are very rarely accessing psychiatric genetic counseling services. The purpose of our study was to identify interest in and barriers to psychiatric genetic counseling with the hopes of better characterizing this population and improving access to this beneficial service in the future. An online survey was developed to assess exposure to genetic counseling, perceived causes of psychiatric conditions, and level of interest in, reasons for, and barriers to psychiatric genetic counseling. Individuals with self-reported personal and/or family histories of any mental illness were invited to participate via emails and advertisements to local Houston support groups, psychiatry and maternal fetal medicine clinics, and other platforms. Categorical variables were compared using contingency tests. Overall, 87% of respondents reported being extremely, very, or somewhat interested in psychiatric genetic counseling. There was no significant difference in the level of interest in psychiatric genetic counseling for individuals with a family history of serious mental illness, such as schizophrenia, when compared to those with a family history of any type of mental illness. Similarly, degree of relation and number of affected family members was not associated with significant differences in the level of interest. Any patient with a personal and/or a family history of any type of psychiatric condition(s) may be interested in and benefit from this service. The most common reasons for interest in psychiatric genetic counseling were “to understand more about the condition” and “recurrence risk” (71% and 66% of respondents respectively). The most common perceived barriers to psychiatric genetic counseling were “cost/insurance coverage” and “time” (80% and 38% of respondents respectively). This study provides important insight into this population, confirms interest levels reported by prior studies, and provides information for genetic counselors and other providers interested in increasing access to psychiatric genetic counseling

The Effects of Education and Process Development with Providers on Advance Care Planning in the Rural Primary Care Clinic

Timely advance care planning (ACP) conversations, with a health care provider, can lead to better care and increased satisfaction for patient and family at the end of life. One rural health clinic had no formal plan in place to implement ACP conversations until presentation of a health crisis; limited ACP during the Medicare wellness visit; and no use of the ACP Current Procedural Terminology (CPT) codes. The purpose of this quality improvement project was to implement a process to improve ACP for persons age 65 and older in a rural health clinic. The Iowa Model of Evidence Based Practice to Promote Quality of Care was used to guide this project. All providers and frontline staff were surveyed about ACP to assess process barriers, comfort with initiating ACP, and learning needs. An education session on initiating ACP with patients age 65 and older during the initial or subsequent Medicare wellness exam and the use of new CPT billing codes for ACP occurred. After three months, the providers and frontline staff were surveyed about their comfort level with ACP and frequency of ACP CPT billing codes were determined. Survey results did not show an increased comfort level; however, the clinic implemented the use of the ACP packet and flow chart successfully, with 38% of the ACP packets being utilized. This resulted in two return visits for beginning ACP conversations. The implementation of the ACP packet and flow chart assisted to improve the process of ACP at one rural primary care clinic

Personality and Everyday Social Justice Behavior: "A Broader Set of Acts"

This dissertation contributes to the growing body of literature exploring activist behaviors intended to promote social justice. Across 3 studies, a new measure of social justice behavior was created and validated using the Act Frequency Approach (Buss and Craik, 1980). Although existing measures of social justice behavior tend to narrowly define the construct as engagement in collective action, participants in Study 1 (n = 137) were encouraged to nominate and evaluate a broad set of acts also relevant to their daily lives. The final 22-item Everyday Social Justice Behavior (ESJB) scale reflects a range of global and domain-specific actions that were rated as prototypical by both 53 undergraduate novices and 20 activist experts in Study 2. Participants in study 3 (n = 388) were then asked to self-rate how frequently they perform each of the items in the ESJB scale, along with a series of other measures of proposed correlates. Consistent with Hypothesis 1, both membership in marginalized groups (e.g. women, sexual minorities) and holding a political orientation on the left side of the spectrum were positively related to scores on the ESJB scale. Moreover, confirming Hypothesis 2, ESJB scores were positively related to structural attributions of social change, intersectional awareness, beliefs about the importance and confidence in taking action, openness to experience, extraversion and empathy, and negatively related to social dominance orientation, system justification, and the need for cognitive closure Furthermore, consistent with Hypothesis 3, ESJB was correlated moderately with another established measure of progressive activist engagement, suggesting that they are related, yet distinct measures of social justice behavior. Finally, confirming Hypothesis 4, there were significant group differences between participants who scored high on both ESJB and Collective Action for Social Justice (CASJ) as compared to participants who scored high on only one measure or low on both. Overall, the findings affirm the benefits of the Act Frequency Approach to behavioral measure development and the value of using it to explore the relationships between individual differences and social justice behaviors.PhDPsychology and Women's StudiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/107069/1/smontgo_1.pd

Provenancing antiquarian museum collections using multi-isotope analysis

Many of the most significant archaeological sites in Europe were excavated by antiquarians over one hundred years ago. Modern museum collections therefore frequently contain human remains that were recovered during the nineteenth and early twentieth centuries. Here we apply multi-isotope analysis (87Sr/86Sr, δ18O, δ13C, δ15N) and 14C dating to evaluate the provenance of human remains within a collection that is thought to have been recovered from one of the most important archaeological sites in Britain. Excavated in 1910, the site of Coldrum in Kent is a megalithic burial monument that may be one of the earliest sites associated with the transition to farming in Britain. The interpretation of this site is therefore key to understanding how agriculture began. Using isotope analysis we show that although the human skeletal collections attributed to Coldrum do contain some of the earliest dated Neolithic human remains in Britain, they also contain the remains of individuals of fifth to seventh centuries AD date. We evaluate subsistence and mobility patterns of early Neolithic populations and provide new information about the origins of those individuals in the collection that date to the fifth to seventh centuries AD. We demonstrate the utility of employing isotope analysis to provide direct and independent information about the provenance of human remains in museum collections

Decolonizing Children\u27s Literature: Diversity & Representation in Six Scholarly Journals

Research on children\u27s publishing shows that children\u27s literature remains an overwhelmingly White, cisgender, heterosexual, and abled field. The same can be said about the scholarship of children\u27s literature, but little research has been done to measure representation and diversity within the discipline. Our collaborative research team (five undergraduate research assistants and one faculty member) analyzes data from six children\u27s literature journals over a 10-year period; using criteria from Lee & Low\u27s Diversity Baseline Survey and the Cooperative Children\u27s Book Center at UW-Madison, we measure how much of the published scholarship in recent children\u27s literature journals can be considered diverse. Finally, we tie our findings to a new journal in the field, Research on Diversity in Youth Literature, which was founded in 2016 as a dedicated space for diverse scholars and their work. In sum, this information helps us determine whether children\u27s literature is a field that is progressing in its stated goals of increased diversity and representation

Accelerometry-Based Step Count Validation for Horse Movement Analysis During Stall Confinement

Quantitative tracking of equine movement during stall confinement has the potential to detect subtle changes in mobility due to injury. These changes may warn of potential complications, providing vital information to direct rehabilitation protocols. Inertial measurement units (IMUs) are readily available and easily attached to a limb or surcingle to objectively record step count in horses. The objectives of this study were: (1) to compare IMU-based step counts to a visually-based criterion measure (video) for three different types of movements in a stall environment, and (2) to compare three different sensor positions to determine the ideal location on the horse to assess movement. An IMU was attached at the withers, right forelimb and hindlimb of six horses to assess free-movement, circles, and figure-eights recorded in 5 min intervals and to determine the best location, through analysis of all three axes of the triaxial accelerometer, for step count during stall confinement. Mean step count difference, absolute error (%) and intraclass correlation coefficients (ICCs) were determined to assess the sensor's ability to track steps compared to the criterion measure. When comparing sensor location for all movement conditions, the right-forelimb vertical-axis produced the best results (ICC = 1.0, % error = 6.8, mean step count difference = 1.3) followed closely by the right-hindlimb (ICC = 0.999, % error = 15.2, mean step count difference = 1.8). Limitations included the small number of horse participants and the lack of random selection due to limited availability and accessibility. Overall, the findings demonstrate excellent levels of agreement between the IMU's vertical axis and the video-based criterion at the forelimb and hindlimb locations for all movement conditions

Privilege and Marginality: How Group Identification and Personality Predict Rightâ and Leftâ Wing Political Activism

In two studies, we examine how different processes might underlie the political mobilization of individuals with marginalized versus privileged identities for leftâ wing activism (LWA) versus rightâ wing activism (RWA). In the first study, with a sample of 244 midlife women, we tested the hypotheses that endorsement of system justification beliefs and social identities were direct predictors of political activism, and that system justification beliefs moderated the mobilization of social identities for activism on both the left and the right. We found that system justification predicted RWA only among those who felt close to privileged groups; the parallel reverse effect did not hold for LWA, though rejection of systemâ justifying beliefs was an important direct predictor. In Study 2, we replicated many of these findings with a sample of 113 college students. In addition, we tested and confirmed the hypothesis that LWA is predicted by openness to experience and is unrelated to RWA, but not that openness plays a stronger role among those with marginalized identities. These two studies together support our overall hypothesis that different personality processes are involved with political mobilization of privileged and marginalized individuals on the right and the left.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141967/1/asap12132_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141967/2/asap12132.pd

Optimising recruitment to the HAND-1 RCT feasibility study:integration 1 of the QuinteT Recruitment Intervention (QRI)

© 2020, The Author(s). Background: Recruitment to randomised controlled trials (RCTs) can be challenging, with most trials not reaching recruitment targets. Randomised feasibility studies can be set up prior to a main trial to identify and overcome recruitment obstacles. This paper reports on an intervention—the QuinteT Recruitment Intervention (QRI)—to optimise recruitment within a randomised feasibility study of surgical treatments for patients with Dupuytren’s contracture (the HAND-1 study). Methods: The QRI was introduced in 2-phases: phase 1 sought to understand the recruitment challenges by interviewing trial staff, scrutinising screening logs and analysing audio-recorded patient consultations; in phase 2 a tailored plan of action consisting of recruiter feedback and training was delivered to address the identified challenges. Results: Two key recruitment obstacles emerged: (1) issues with the recruitment pathway, in particular methods to identify potentially eligible patients and (2) equipoise of recruiters and patients. These were addressed by liaising with centres to share good practice and refine their pathway and by providing bespoke feedback and training on consent discussions to individual recruiters and centres whilst recruitment was ongoing. The HAND-1 study subsequently achieved its recruitment target. Conclusions: Transferable lessons learnt from the QRI in the feasibility study will be implemented in the definitive RCT, enabling a “head start” in the tackling of wider issues around screening methods and consent discussions in the set up/early recruitment study phases, with ongoing QRI addressing specific issues with new centres and recruiters. Findings from this study are likely to be relevant to other surgical and similar trials that are anticipated to encounter issues around patient and recruiter equipoise of treatments and variation in recruitment pathways across centres. The study also highlights the value of feasibility studies in fine-tuning design and conduct issues for definitive RCTs. Embedding a QRI in an RCT, at feasibility or main stage, offers an opportunity for a detailed and nuanced understanding of key recruitment challenges and the chance to address them in “real-time” as recruitment proceeds

Weight loss reduces basal-like breast cancer through kinome reprogramming

Additional file 1. Tumor burden and growth were not affected by diet. a. Tumor burden was quantified at sacrifice. b. Tumor volume was measured by calipers at detection and sacrifice. (N = 28 10 %; N = 31 60 %; N = 29, 60–10 %)