Session Outcome Research Articles

Image Polarity Detection on Resource-Constrained Devices

Image polarity detection opens new vistas in the area of pervasive computing. State-of-the-art frameworks for polarity detection often prove computationally demanding, as they rely on deep learning networks. Thus, one faces major issues when targeting their implementation on resource-constrained embedded devices. This article presents a design strategy for convolutional neural networks that can support image-polarity detection on edge devices. The outcomes of experimental sessions, involving standard benchmarks and a pair of commercial edge devices, confirm the approach suitability.

Group acceptance and commitment therapy for patients and caregivers in psychosis services: Feasibility of training and a preliminary randomized controlled evaluation.

Psychological interventions reduce the impact of psychosis, but widescale implementation is problematic. We tested the feasibility of group acceptance and commitment therapy for Psychosis (G-ACTp), delivered by frontline staff, and co-facilitated by service-user experts-by-experience (SU-EbyE), for service-users and informal caregivers (ISRCTN: 68540929). We estimated recruitment/retention rates and outcome variability for future evaluation. Staff and SU-EbyE facilitators completed 1-day workshops, then delivered closely supervised G-ACTp, comprising four sessions (weeks 1-4) and two boosters (10 and 12weeks). Participants recruited from adult community psychosis services were randomized to receive G-ACTp immediately or after 12weeks, completing outcome assessments at 0, 4, and 12weeks. Service-use/month was calculated for 1-year pre-randomization, weeks 0-12, and 5-year uncontrolled follow-up. Of 41 facilitators trained (29 staff, 12 SU-EbyE), 29 (71%; 17 staff, 12 SU-EbyE) delivered 18 G-ACTp courses. Participant refusal rates were low (9% of service-users [10/112]; 5% of caregivers [4/79]); 60% of those invited to participate attended ≥1 G-ACTp session (64% of service-users [39/61]; 56% of caregivers [35/63]). Randomization of facilitators and participants proved problematic and participant follow-up was incomplete (78% [66/85]; 82% of service-users [36/44]; 73% of caregivers [30/41]). Effect sizes ranged from very small to large mostly favouring treatment. Service-use reductions require cautious interpretation, as very few participants incurred costs. Implementation appears feasible for service-users; for caregivers, retention needs improving. Outcome variability indicated n=100-300/arm followed up (α=0.05, 90% power). Methodological limitations' mean replication is needed: identified sources of potential bias may be reduced in a cluster randomized design with sessional outcome completion. Group acceptance and commitment therapy can be successfully adapted for people with psychosis and their caregivers. Implementation (training and delivery) is possible in routine community mental health care settings. Clinical and economic outcomes are promising, but replication is needed. Recommendations are made for future studies.

Accuracy and Bias in Vulnerability Perceptions of Partners Undergoing Emotion-Focused Therapy for Couples.

The primary mechanism of change in emotion-focused couples therapy (EFT-C) is described as one partner accessing and expressing vulnerability, with the other partner responding affiliatively, with compassion, acceptance, validation, and support. These interactions are assumed to restructure the negative, rigid interactional cycle that usually brings couples to therapy and helps build a positive emotional bond. The primary aim of this study was to test whether for this process to occur, partners need to accurately perceive their spouse's experiences of vulnerability during therapy. Specifically, it examined the factors (i.e., tracking accuracy, assumed-similarity bias, and directional bias) shaping partners' perceptions of their spouse's vulnerability and whether accurate perceptions predict positive session outcomes during EFT-C. Data from 36 couples who took part in the York Emotional Injury Project were analyzed. Following each session, clients reported their own experience of vulnerability as well as their perceptions of their partners' vulnerability. Session outcome was defined as the extent to which clients reported resolution. Using a multilevel Truth and Bias model, the results indicated that partners accurately perceived changes in their spouses' expressions of vulnerability (i.e., significant tracking accuracy). Interestingly, partners' perceptions were also tied to their own expressions of vulnerability (i.e., significant assumed-similarity bias) and tended to underestimate the level of their partners' vulnerability expressions (i.e., significant negative mean-level bias). Using a multilevel Response Surface Analysis, we found that accuracy regarding partners' vulnerability was associated with higher levels of resolution.

P1128INTERMITTENT SALINE FLUSH VS CONTINUOUS SALINE INFUSION IN HEPARIN FREE DIALYSIS, A COMPARATIVE ANALYSIS

Abstract Background and Aims Proper anticoagulation during dialysis for the patients with bleeding risk or contraindication for heparin is a challenge. Regional anticoagulation with heparin and protamine or citrate and calcium though accepted has well known complications and has logistic and monitoring problem. Intermittent saline flush is another well accepted techniques. But it is labour intensive and often leads to fiber loss or coagulation of the dialyser. Keeping these in mind we hypothesised continuous prepump saline infusion may be another alternative technique in these situations. In this study We compared the outcome between intermittent saline flush versus continuous saline infusion while dialysing patients without heparine. Method Patients >18 year of age, on mHD @3/wk atleast for 3 months, having mature Avfistula and Hb between 8.5-11.5gm/dl with standard EPO and decided for heparin free dialysis were included for the study. Exclusion criteria were Intradialytic weight gain more than 3kg receiving any blood component transfusion or albumin,parenteral nutritional product infusion, any need for UF /Na/HCO3 profiling. Patients on antiplatelet drug or P-time prolonged > 6sec, APTT > 2 times normal, and platelet count less than 80,000 were also excluded. After inclusion, for each patient 8 session were studied systematically as per the preset protocol. Session 1,3,5,7 was subjected to intermittent saline flush(ISF) where as session 2,4,6,8 were subjected to continuous saline infusion(CSIF). The blood flow during dialysis was kept in the range of 250ml/min to 300ml/min and dialysate flow was kept fixed at 500ml/min. and UF goal was kept between 2.5 to 3.5lit and treatment duration was fixed at 4hrs.In ISF, every 15min 80ml (=priming volume of the dialyser, F6, Polysulphone, Fresenius)0.9%NS was flushed in the dialyser clamping the arterial line where as in CSIF 0.9%NS bottle is connected to the prepump arterial line and saline is infused through saline infusion pump @320ml/hr. The each dialysis session outcome were recorded and analysed. Potential clotting in the bubble trap was visually observed in each hour and graded on a 4 point scale. 1=normal, 2= fibrinous ring,3=clot formation and 4= coagulated system. In either group the total saline infusion volume added in the net UF goal. The dialyser was inspected visually at the end of each session 1= normal,2= a few blood stripes affecting less than 10% of the surface area,3= many blood stripes more than 10% of surface area, 4= coagulated dialyser. URR(as per KDOQI guideline) and kt/v(by diascan software of Gambro AK96 machine) was calculated in each session. Data were analysed with spss v23. Results Total 8 patients(5men 3 women) were included for the study. After exclusion total 54 session of dialysis were finally analysed. The incidence of the of blood clot in the whole dialysis system leading to stopping of dialysis was 3 in ISF and 1 in CSIF (p=0.001).The multiple linear regression analysis with repeated measurememt for the time and UF rate adjusted clot incidence of different grade in bubble trap was significantly low in the CSIF group than the ISF group.(p=0.0001). When adjusted for total body water,net UF,PreHD Urea, blood flow the difference in URR and Kt/v both the group was not significantly different (p=0.8). Among the two group the operational comfort for nurses were significantly better(p=0.3) in the CSIF group than the ISF group. Conclusion While considering heparine free dialysis Continuous saline infusion @320ml/hr is easy less labourintensive method than intermittent saline flush technique with significantly less clotting incidence and without any adverse effect on the dialyser clearance.

The PERSEO Experience: A Water-Filled Garment Prototype for Personal Radiation Protection of Astronauts Successfully Tested on Board the International Space Station

The PERSEO project (PErsonal Radiation Shielding for intErplanetary missiOns), funded by the Italian Space Agency, has led to the development of a first technological demonstrator of a radiation shielding garment, to be used in a pressurized space habitat, that can be filled at need with on-board water and used for personal protection in case of solar particle events. The collaboration, including academic partners and companies active in space research and technology development, designed and manufactured the prototype that has been successfully tested on board the International Space Station by the European Space Agency astronaut Paolo Nespoli in November 2017, during the VITA mission. The effectiveness of the garment in terms of reduction of the radiation dose to sensitive organs (subject to the occurrence of short-term non-cancer effects following acute exposure) has been evaluated with Monte Carlo simulations with an anthropomorphic phantom. The successful outcome of the experimental session on board has demonstrated the practicality of use and wearability of the prototype, and, in perspective, the feasibility of a personal radiation shielding strategy, complementary to habitat shielding and based on the use of available resources, of fundamental importance also in view of future manned interplanetary missions.

Rhinology Future Debates 2018, a EUFOREA Report.

The third Rhinology Future Debates was organized by the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) in 2018 in Brussels. Experts from different specialties and countries, alongside patients, health policy makers and industry representatives discussed relevant topics in Rhinology, in an attempt to improve current clinical practices, through implementation of precision medicine, by empowering patients' participation and the use of eHealth tools. The debates which are available on-line (www.rhinology-future.com) dealt with 5 topics in Rhinology: the adoption of allergen-specific immunotherapy (AIT) by implementing change management strategies, the needs and obstacles in care delivery in respiratory diseases, 3D technology in nose and sinus surgery, ambulatory nasal surgery, and clinical evidence for efficacy of biologicals in CRSwNP and asthma. This report summarizes the outcomes of the brainstorming sessions highlighting novel approaches and unmet needs in the field of respiratory diseases by focusing on integrated care pathways.

Group therapists: combine alliance building with paying specific attention to the patient’s perception

Abstract In slow-open groups as well as therapies of less than ten sessions, each group session holds importance. Patients, therapists and co-therapists have different perspectives and may gain different experiences from a group session. This study investigates the perspectives of patients, therapists and co-therapists on alliance, new insights and therapist techniques in the same group session. Do the three actors perceive these group aspects similarly or differently? Which group aspects are related with the outcome coping? One hundred and forty-nine sessions of a cognitive behaviour therapy group have been investigated. Patients, therapists and co-therapists gave ratings on their perceived alliance, group topics and insights as well as therapists’ technique competency. Concerning new insights, there was concordance between patients and co-therapists (r = .211, p < .05). Concerning alliance, there was a concordance between patients and therapists (r = .327, p < .01). Therapists focusing on alliance building was associated with lower patient outcomes in terms of work coping (β = –.391). The quality of therapeutic techniques was the same in groups with higher and lower outcomes. Patients’ perception of whether they felt good in the group session was explanative for session outcome, while therapists’ perceptions and context conditions (supervision, number of participants) was not. Patients, therapists and co-therapists have different perspectives on the same group therapy session. Patients’ perceptions are associated with session outcomes. A lower session outcome must not be associated with a poor technique performance of the therapist. Therapists should not only be aware of alliance building and correct technical performance, but they must also be aware of patients’ perceptions of the group process and outcome. Key learning aims The present research is the first evaluation of group session aspects and session outcomes in rehabilitation patients with work anxieties in slow-open groups. We will learn: (1) Whether patients’, therapists’ and co-therapists’ perceptions of the same group session are similar or different; (2) Whether group sessions that result in worse outcomes are different from group sessions resulting in a better outcome; (3) Which aspects of the group session are predictive for a better outcome.

Biosafety and Biosecurity Challenges Facing Veterinary Diagnostic Laboratories in Lower-Middle Income Countries in Southeast Asia: A Case Study of Thailand.

Introduction:Global concerns over emerging and transboundary infectious zoonotic diseases have increased disease diagnostic demands, especially in the veterinary sector. In developing or newly developed countries where the sector often works under limited capacity, biosafety and biosecurity are unlikely to be high-priority issues. A recent development program supported by the Biological Threat Reduction Program of the Defense Threat Reduction Agency funded by the US government aimed to increase biosafety and biosecurity measures of government veterinary diagnostic and research laboratories in Thailand.Objective:The purpose of this article is to identify biosafety and biosecurity challenges, opportunities, and recommendations.Methods:Eleven government laboratory centers were assessed against the Biosafety in Microbiological and Biomedical Laboratories (BMBL) biosafety level 2 (BSL-2) requirements checklist. The BMBL assessment outcomes were then combined with the outcomes of discussion sessions, and the results of pre- and post-test questionnaires conducted during biosafety assessment workshops and self-evaluation reports using the Food and Agriculture Organization Biosafety Laboratory Mapping Tool of each laboratory center were reviewed and summarized.Results:Despite established national policies on laboratory biosafety and biosecurity, major challenges included (1) harmonization and enforcement of these policies, especially at the regional level, and (2) engagement of personnel in implementations of biosafety and biosecurity measures.Conclusion:Consistent biosafety policy and allocated resources together with regular training are required to develop sustainable biosafety and biosecurity at the national level. Collaboration between regional countries, international organizations, and donors is essential for improving biosafety and biosecurity on a global scale through setting regional priorities, enacting regulatory standards, and providing technical and financial support.

Feasibility of a Mindfulness-Based Intervention with Sheltered Youth Experiencing Homelessness

ObjectivesEvidence of the acceptability and potential efficacy of mindfulness strategies with at-risk youth is mounting. Yet only a few studies have assessed these strategies among youth experiencing homelessness (YEH).MethodsWe conducted a mixed methods feasibility study of an adapted mindfulness-based intervention (MBI) with sheltered YEH. The MBI consisted of five 1.5-h sessions delivered at a youth homeless shelter over 2.5 weeks. A one-group pre/post-test design was utilized to collect quantitative assessments of real-time cognitions followed by qualitative inquiry to assess participants’ experiences and perceptions of the intervention.ResultsParticipants (N = 39) were between 18–21 years old with the majority identifying as male (56.4%), heterosexual (74.4%), Black (51.3%) and Hispanic (15.4%). Attendance was challenging for participants (2.2 sessions attended on average) who had varying work and school obligations. However, pre–post session survey data completeness was excellent (92% completion rate). Participants completed self-report surveys prior to and after each session that measured affect. Significant improvement in pre–post session outcomes were found for frustration, restlessness, stress, depression, boredom, and mindlessness. Participants reported high levels of acceptability of the curriculum content and delivery format. However, several substantial adaptations that youth identified may improve feasibility and acceptability among YEH. The results are limited by the small sample size and the use of a curriculum not developed with or for YEH.ConclusionsThis study demonstrates the potential feasibility of using MBIs among YEH although adaptations to existing curricula are necessary to increase relevance, acceptability of, and access to MBIs among YEH.

Implementation of speech pathology telepractice services for clinical swallowing assessment: An evaluation of service outcomes, costs and consumer satisfaction

Introduction Timely assessment of swallowing disorders (dysphagia) by speech pathologists helps minimise patient risk, optimise quality of life, and limit healthcare costs. This study involved a multi-site implementation of a validated model for conducting adult clinical swallowing assessments via telepractice and examined its service outcomes, costs and consumer satisfaction. Methods Five hub-spoke telepractice services, encompassing 18 facilities were established across a public health service. Service implementation support, including training of the telepractice speech pathologists (T-SP) and healthcare support workers in each site, was facilitated by an experienced project officer. New referrals from spoke sites were managed by the hub T-SP as per published protocols for dysphagia assessments via telepractice. Data was collected on existing service models prior to implementation, and then patient demographics, referral information, session outcomes, costs and patient and T-SP satisfaction when using telepractice. Results The first 50 sessions were analysed. Referrals were predominantly for inpatients at spoke sites. Telepractice assessments were completed successfully, with only minor technical issues. Changes to patient management (i.e. food/fluid changes post assessment) to optimise safety or progress oral intake, was required for 64% of patients. Service and cost efficiencies were achieved with an average 2-day reduction in waiting time and an average cost benefit of $218 per session when using the telepractice service over standard care. High clinician and patient satisfaction was reported. Conclusion Telepractice services were successfully introduced across multiple sites, and achieved service and cost benefits with high consumer satisfaction.

Designing an Electronic Brainstorming Environment for Engaging East-Asian Teams

ABSTRACTThis study examines the effects of content anonymity on performance and satisfaction in electronic brainstorming (EBS), focusing on the social identity factors among participants and the group interaction environment (the EBS interface). The research model includes participants’ individualism, group cohesion, perceived instrumentality, and the resulting affective responses towards session outcome and process. A custom-designed electronic brainstorming interface was implemented in two conditions, in tightly controlled experimental sessions with 18 four-member student teams. Structural equation modeling and rating of idea quality were conducted. The study confirmed prior findings that anonymous interfaces lead to generally better subjective and objective outcomes. Displaying participant contributions anonymously in one sequential pool contributed to greater satisfaction and better group performance than identifying the four group members and segregating their contributions. Perceived instrumentality was found to mediate enjoyment and satisfaction in different ways depending on subjects’ individualist and group orientations.

RETRACTED ARTICLE: Examining therapy dynamics and session outcome using differential equations model and multilevel data disaggregation

We, the Editors and Publisher of the journal Psychotherapy Research, have retracted the following article: Xu Li & Dennis M. Kivlighan Jr (2020) Examining therapy dynamics and session outcome using differential equations model and multilevel data disaggregation, Psychotherapy Research, 30:5, 604-621, DOI: 10.1080/10503307.2019.1649730 Since publication, concerns had been raised about informed consent. The University of Maryland College Park Institutional Review Board investigated and they found that some data included in the publication were obtained from therapy clients who had either not been asked to provide consent or who had withdrawn consent for their data to be included in the study research. The investigation concluded that this article should be retracted. The authors agree with the retraction of this article. We have been informed in our decision-making by our editorial policies and COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.

Assessing treatment integrity in personalized CBT: the inventory of therapeutic interventions and skills

ABSTRACTThe third wave of cognitive behavioral therapy (CBT) has increased the heterogeneity of today’s CBT practice, while developments in patient-focused research are paving the road to the empirical personalization of CBT. This paper presents the development and psychometric properties of a therapy video rating instrument, which was designed to adequately assess the treatment integrity (adherence and competence) of modern, personalized CBT. The Inventory of Therapeutic Interventions and Skills (ITIS) was developed based on two existing CBT adherence and competence scales and augmented with third wave content and overarching therapeutic strategies. The instrument was then applied by graduate students and post-graduate clinicians to rate N = 185 therapy videos from N = 70 patients treated at a university outpatient clinic. Descriptive results, inter-rater reliability, item structure, and associations with session outcome and alliance were examined. Average inter-rater reliability was excellent for Interventions items and good for Skills items. Intercorrelations were low between Interventions items, but higher and significant between Skills items, which loaded on a single factor. Several ITIS items were shown to be predictive of session outcome and alliance, even after controlling for the nested data structure. Implications of these results for future research and clinical training are discussed.

EcoEd: Cohesive training and skill development for digital ecoscience tools

Digital research infrastructures such as data portals and virtual laboratories enable easier access to data and analytical tools. Such infrastructures are essential to deliver research excellence that drives innovation, but we also need to ensure that we have a skilled workforce that can use these infrastructures. Therefore, training and skill development of students, researchers, government practitioners and industry professionals is key to the long-term success of this investment. In Australia, a suite of digital infrastructures has been developed for environmental sciences to enhance our understanding of the natural world and making forward projections into novel conditions (e.g. Atlas of Living Australia, Biodiversity and Climate Change Virtual Laboratory, ecocloud, Terrestrial Ecosystem Research Network). To provide users with a holistic approach to environmental spatial data discovery and analysis, these infrastructures have joined forces to deliver an exciting and innovative new training program. This program, called ecoEd, provides cohesive training and skill development to university lecturers, researchers and industry professionals enabling them to combine theoretical concepts with real-world applications. In this presentation, I will present how ecoEd was developed and the outcomes of the training sessions in which a group of ecoEd Champions absorbed ready-to-use lecture and workshop modules along with tools and knowledge on how to use the platforms. These resources can immediately be used in undergraduate courses that focus on topics such as ecology, biogeography, conservation biology, environmental management and spatial analysis as well as in stand alone workshops for researchers and practitioners. The training program aims to provide the Champions with the resources and knowledge required so that they can confidently re-deliver the lectures and workshops in their own institutions. As such, ecoEd is increasing the capacity of Australia’s environmental science community to advance science and deliver outcomes that underpin the sustainable use of our ecosystems using the latest advances in digital technologies. Moreover, it is enabling first-rate science education in Australia by supporting and nurturing our future scientists.

Associative learning in people with aphasia: exploring spacing of practice as a potential facilitator

ABSTRACT Background It remains controversial whether the reduction in associative learning ability previously reported among people with aphasia is specific to linguistic learning or whether the difficulty lies in the formation of new associative learning. Furthermore, an effective associative learning approach that benefits people with aphasia with different profiles of language impairment and levels of severity is yet to be identified. Aims This study investigates associative learning within linguistic and non-linguistic domains, contrasting the performance of people with aphasia (n = 11) and two groups of control participants [young (n = 18) and old (n = 18)] to identify if, for people with aphasia, reduced associative learning occurs across domains or is specific to the linguistic domain. In addition, the effect of massed and spaced practice is examined to explore potential facilitative learning approaches for people with aphasia. Methods and procedures Learning of linguistic (word-pairs) and non-linguistic (picture-pairs) material took place separately but follow the same procedures. The study involves pair-association learning, with a study phase (involving massed and spaced practice) followed by an immediate cued recall task to assess learning outcomes. Retention of learning was assessed 2 days post-study, with a delayed recognition task and a delayed cued recall task. Outcomes and results The findings show that, in cued-recall tasks, despite an overall reduced performance among people with aphasia, patterns of learning largely mirrored the control participants. Word-pairs were better retained than picture-pairs with spaced practice producing better results than massed in both learning conditions. Conclusion This study advances our understanding of how people with aphasia learn new associations and, regardless of language impairment, associative learning can be facilitated by spaced practice. The findings of the current study highlight the potential importance of adopting spaced practice in clinical settings to maximise outcomes of therapy sessions.

Physiological synchrony in psychotherapy sessions

Objective: In this proof-of-principle study, a convenience sample of 55 dyadic psychotherapy sessions conducted by one therapist was analyzed. This study aimed at exploring physiological synchrony in naturalistic psychotherapy sessions and the association of such synchrony with self-report ratings. Methods: The electrocardiograms and respiration behavior of both therapist and client were monitored simultaneously. Four clients were included, and session outcome was documented by session reports in two clients. From electrocardiograms, heart rate and heart rate variability were derived in consecutive 15-second intervals throughout sessions. Entire sessions (average duration, 51 min) were assessed for physiological synchrony of therapist’s and client’s respiration, electrocardiogram, heart rate, and heart rate variability. Two methods of synchrony computation were applied to the time series: windowed cross-correlation and correlation of local slopes (concordance). Both methods included surrogate controls using segment-wise shuffling. Results: Significant synchrony of three measures, but not of electrocardiograms, was present in this dataset. In regression models, we found associations between synchronies and alliance ratings, and further self-report variables. Conclusions: Results support the existence of physiological synchrony in this collection of psychotherapy sessions, which speaks for the sympathetic and parasympathetic coupling between this therapist and her clients and its link with ratings of the therapy process. The feasibility of deriving signatures of synchrony of physiological signals with the described methodology was corroborated. The findings now await generalization by further research.

Co-Designing Game Solutions for Hybrid Urban Spaces. How Game Elements Can Improve People Experience with the Mobility Services

Digital technologies integrated in the physical spaces enable new practices that open new possible interactions between people and the urban public spaces. These emerging hybrid spaces might have a crucial role in the processes aiming at having a more satisfying urban life. Mobility is a field strongly impacted by hybrid urban spaces and this should be considered in order to improve the quality of life in cities. In this paper the authors, starting from the concept of Mobility as a Service (MaaS), show as game elements applied in different moments of the travel experience and disseminated in different parts of these hybrid spaces can enhance the interaction between people and mobility services. Finally the outcome of a co-design session about a game solution aiming at improving the people experience with the mobility services is presented as an example of this assumption.

Role‐play: An innovative immune response simulation session enhances understanding of abstract principles of immunology

Undergraduate medical education is moving towards engaging students in active learning as opposed to heavily relying on traditional lecture based pedagogy. Immunology is a complex discipline to comprehend and most entering medical students have little to no prior knowledge of this intricate discipline. We developed a novel hands‐on “immune response simulation” session to engage students in active learning of immunological principles and improve integration with medical microbiology.Students are taught didactic immunology lectures followed by this active learning session where groups of students utilize their immunology knowledge to stimulate an immune response scenario to five major classes of pathogens. Students prepare short enactments playing roles of a host immune cell or a pathogen. Faculty facilitates this learning session and administers the assessment tools. The session outcomes are evaluated by administering pre‐ and post‐immunology tests.Preliminary results indicate that there is a significant increase in immunology knowledge gained and that students were highly engaged in learning immunology through this innovative pedagogy. Our results indicate that Immune response simulation is an effective pedagogical novelty where students are actively engaged in learning complex immunological principles in a fun, hands on experiential learning session. This novel pedagogical intervention might prove valuable in engaging students in learning other physiological principles.Support or Funding InformationNo funding was received for this project.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Genetic counseling for consumer-driven whole exome and whole genome sequencing: A commentary on early experiences.

Counseling after consumer-driven whole exome sequencing (WES) and whole genome sequencing (WGS) presents challenges for genetic counselors as availability of this testing increases. There are no standard practice guidelines and limited resources for genetic counselors in this area, but consumer demand for counseling and data interpretation exists and is likely to grow along with testing opportunities. In this paper, we comment upon our experiences as three independent, private practice genetic counselors who have provided counseling services for clients with WES/WGS reports and data. In our counseling experience, we have encountered three main types of client motivation for seeking testing and counseling: generally healthy individuals who are curious to learn more about their genomic data, individuals with family histories of various conditions, and/or who want to better understand specific disease risks, and individuals who are ill, undiagnosed and searching for an understanding of their ailments. Research is needed to better understand client motivations for undergoing testing and counseling, as well outcomes of counseling sessions. In addition to improvements in variant identification, classification and bioinformatics, there is a need for practice guidelines, counseling resources, service delivery models, and efforts to increase awareness and access to genetic counseling services.

Anniversary Commemoration and Work of the International Law Commission's Seventieth Session

This essay analyzes the outcome of the seventieth session of the U.N. International Law Commission held in the summer of 2018 in New York and Geneva. Notably, the Commission completed on second reading two topics: subsequent agreements and subsequent practice in relation to the interpretation of treaties; and identification of customary international law. The Commission completed on first reading two further topics: protection of the atmosphere; and provisional application of treaties. Progress was also made in developing draft conclusions on peremptory norms of general international law (jus cogens), draft principles on protection of the environment in relation to armed conflict, and draft articles on succession of states in respect of state responsibility. The Commission commenced a debate but otherwise did not make progress with respect to its topic on the immunity of state officials from foreign criminal jurisdiction. The Commission, however, added a new topic to its agenda on general principles of law, and added two new topics to its long-term work program, namely on universal criminal jurisdiction and sea-level rise in relation to international law. The Commission did not work on a topic that completed its first reading in 2017 and that, after receiving reactions from governments and others, will likely undergo its second reading in 2019: crimes against humanity.