A Call to Action for Bioengineers and Dental Professionals: Directives for the Future of TMJ Bioengineering

The world’s first TMJ Bioengineering Conference was held May 25–27, 2006, in Broomfield, Colorado. Presentations were given by 34 invited speakers representing industry, academics, government agencies such as NIH, and private practice, which included surgeons, engineers, biomedical scientists, and patient advocacy leaders. Other attendees included documentary film makers and FDA officials. The impetus for the conference was that the field of TMJ research has been lacking continuity, with no open forum available for surgeons, scientists, and bioengineers to exchange scientific and clinical ideas and identify common goals, strengths, and capabilities. The goal was thus to plant the seeds for establishing a forum for multidisciplinary and interdisciplinary interactions. The collective wisdom and interactions brought about by a melting pot of these diverse individuals has been pooled and is disseminated in this article, which offers specific directives to bioengineers, basic scientists, and medical and dental professionals including oral and maxillofacial surgeons, pain specialists, orthodontists, prosthodontists, endocrinologists, rheumatologists, immunologists, radiologists, neurologists, and orthopaedic surgeons. A primary goal of this article was to attract researchers across a breadth of research areas to lend their expertise to a significant clinical problem with a dire need for new talent. For example, researchers with expertise in finite element modeling will find an extensive list of clinically significant problems. Specific suggestions for TMJ research were presented by the leading organizations for TMJ surgeons and TMJ patients, and further research needs were identified in a series of group discussions. The specific needs identified at the conference and presented here will be essential for those who endeavor to engage in TMJ research, especially in the areas of tissue engineering and biomechanics. Collectively, it is our hope that many of the questions and directives presented here find their way into the proposals of multidisciplinary teams across the world with new and promising approaches to diagnose, prevent and treat TMJ disorders.     

Genetic data partnerships: academic publications with privately owned or generated genetic data

PurposeAccess to large genetic data sets, many of which are privately owned, is essential to precision medicine and other research protocols. Academic researchers are increasingly capitalizing on this privately held data. Our goal is to understand these private–academic “genetic data partnerships.”MethodsWe analyzed publications using human genetic data generated or held by major private genetic testing companies that were indexed in PubMed between 2011 and 2017.ResultsWe found that (1) the number of publications using private genetic data is increasing over time (from 4 in 2011 to 57 in 2017); (2) there are two main models of data-sharing, including researchers using existing private data held by industry (n = 172) or researchers sending in new samples for analysis (n = 6); (3) 45% of the publications were supported at least in part by the National Institutes of Health; and (4) the type of contributor consent is not disclosed/unclear in the publication almost half (43%) the time.ConclusionPrivately held or analyzed genetic databanks offer academic researchers the opportunity to efficiently access large amounts of genetic data. But more transparency should be encouraged, if not required, to ensure the proper notification of contributors and to further understand the use of public research funds for private collaborations.     

Attitudes toward the right to autonomous decision‐making in psychiatric genetic testing: Controversial and context‐dependent

Recent breakthroughs in psychiatric genetics have identified genetic risk factors of yet unknown clinical value. A main ethical principal in the context of psychiatric research as well as future clinical genetic testing is the respect for a person's autonomy to decide whether to undergo genetic testing, and whom to grant access to genetic data. However, experience within the psychiatric genetic research setting has indicated controversies surrounding attitudes toward this ethical principal. This study aimed to explore attitudes concerning the right of individuals to self‐determine testing and disclosure of results, and to determine whether these attitudes are context‐dependent, that is, not directly related to the test result but rather to specific circumstances. N = 160 individuals with major depression or bipolar disorder and n = 29 relatives of individuals with either illness completed an online‐questionnaire assessing attitudes toward genetic testing, genetic research, disclosure of results, incidental findings, and access to psychiatric genetic test results. Generally, the right of the person's autonomy was considered very important, but attitudes varied. For example, half of those who considered that children should have the right to refuse psychiatric genetic testing even against their parents' will, also state that they should be tested upon their parents' wishes. Also, the majority of respondents considered the physician entitled to disregard their stated wishes concerning the disclosure of incidental findings in case of good treatment options. Thus, researchers and clinicians must be aware that attitudes toward psychiatric genetic testing are often mutable and should discuss these prior to testing.     

Do clinical researchers believe they should be clinically active? A survey in the United States and the United Kingdom

Do clinical researchers believe they should be clinically active? In an on‐line survey among 64 senior researchers from the United States (59%) and the United Kingdom (41%), there was a strong consensus that clinical practice is desirable, especially for psychotherapy researchers, but not absolutely necessary. The researchers were uniformly opposed to the idea that researchers should be required by professional organizations to engage in clinical practice. Four advantages of clinical involvement were identified: (1) it experientially grounds researchers in the complexities of clinical reality; (2) it inspires ideas and helps generate hypotheses; (3) it enables researchers to test the practical applicability of research‐based models and interventions and (4) it enhances public credibility and confirms one's identity as a clinical psychologist. However, these benefits were balanced by two salient costs: (1) clinical work is associated with intensive time demands and can therefore potentially interfere with research productivity and (2) exposure to a small number of vivid but unrepresentative clinical cases can cloud one's judgment and interfere with scientific objectivity. The potential of these findings to improve the strained relationship between clinical researchers and practitioners is discussed.     

Commentary on Norcross and Karpiak's “Clinical Psychologists in the 2010s: 50 Years of the APA Division of Clinical Psychology”

This commentary offers a challenge to Norcross and Karpiak's (2012) claim that the psychodynamic orientation is on the decline in clinical psychology, based upon the data that they present. I urge clinical psychologists/scientists to recognize that there are psychodynamic researchers who have embraced evidence‐based philosophy and practices; I advocate a rapprochement between Division 12 (Society of Clinical Psychology) and 39 (Psychoanalysis), and I propose a defense of pluralism in which all clinical psychologists recognize the obligation to engage other orientations and points of view that differ from their own and to do so respectfully.     

From process to progress—2017 International Conference on Neurofibromatosis 1, Neurofibromatosis 2 and Schwannomatosis

The neurofibromatoses are inherited, tumor suppressor disorders that are characterized by multiple, benign peripheral nerve sheath tumors and other nervous system tumors. Each disease is associated with a distinct genetic mutation and with a different pathogenesis and clinical course. Neurofibromatosis 1 (NF1) is common and epitomized by multiple neurofibromas with widespread complications. NF2 and schwannomatosis are rare diseases that are typified by multiple schwannomas that are particularly painful in people with schwannomatosis. Since 1985, the Children's Tumor Foundation (formerly the National Neurofibromatosis Foundation) has hosted an international Neurofibromatosis Conference, bringing together international participants who are focused on NF research and clinical care. The 2017 Conference, held in Washington, DC, was among the largest gatherings of NF researchers to date and included presentations from clinicians and basic scientists, highlighting new data regarding the molecular and cellular mechanisms underlying each of these diseases as well as results from clinical studies and clinical trials. This article summarizes the findings presented at the meeting and represents the current state‐of‐the art for NF research.     

A national collaboration to disseminate skills for outpatient teaching in internal medicine: program description and preliminary evaluation.

The shift of clinical care and teaching to outpatient settings has challenged ambulatory and community-based teachers. To address this challenge, U.S. internal medicine organizations devised "Faculty Development for General Internal Medicine: Generalist Faculty Teaching in Ambulatory Settings," a national program to train leaders to create local faculty development projects. In 1999, teams from all 386 internal medicine training institutions were invited to apply. Participation required an acceptable plan for a local project and inclusion of an institutional leader, residency or clerkship director, and a community-based faculty member on the project team. Team members attended one of three national training conferences held in 1999 and 2000 that included plenary sessions, workshops, and team meetings. Participants were invited to a wrap-up conference to present their accomplishments. One hundred ten teams from 57 university and 53 non-university hospitals attended the training conferences; 412 (93%) participants returned conference evaluations. All sessions were rated highly. Participants preferred workshops and team meetings to plenary sessions. Two hundred thirty-five (57%) would have recommended the training conference to colleagues as an outstanding experience; 148 (36%) as a good experience; and 25 (6%) as a satisfactory experience. Forty-nine teams (122 participants) returned for the wrap up conference where 35 teams presented their local faculty development projects. Cost per team trained was US$11,818. This program demonstrated a national desire for training in teaching skills, reached a broad audience of ambulatory-based clinical teachers, provided highly rated faculty development conferences in teaching skills, and facilitated development of a variety of local projects at modest expense. Partnerships were forged between academic leaders and community-based teachers.     

‘Information is information’: a public perspective on incidental findings in clinical and research genome‐based testing

The potential for genomic incidental findings is increasing with the use of genome‐based testing. At the same time approaches to clinical decision making are shifting to shared decision‐making models involving both the healthcare community and the public. The public's voice has been nearly absent in discussions on managing incidental findings. We conducted nine focus groups and nine interviews (n = 63) with a broad cross‐section of lay public groups to elucidate public viewpoints on incidental findings that could occur as a result of genome‐based testing in clinical and research situations. Data were analyzed using qualitative content analysis. Participants wanted incidental findings disclosed to them whether or not these were clinical or research findings. Participants used different terms to define and describe incidental findings; they wanted to know that incidental findings are possible and be given a choice to learn about them. Personal utility was an important reason for disclosure, and participants believed that managing information is a shared responsibility between professionals and themselves. Broad public input is needed in order to understand and incorporate the public's perspective on management of incidental findings as disclosure guidelines, and policies are developed in clinical and research settings.     

A PSYCHOANALYTIC PERSPECTIVE ON ETHICS,SELF‐DECEPTION AND THE CORRUPT PHYSICIAN

In this paper the authors use a psychoanalytic perspective to understand observations about the modes of self‐deception that operate in physicians who have been dishonest or have engaged in other transgressions of ethics guidelines. They emphasize that it is inaccurate to categorize physicians as simply honest or dishonest, ethical or unethical. Physicians who have been ethical practitioners may rationalize sexual relations with patients, stealing from professional treasuries, lying, or other transgressions while convincing themselves that they have acted in an honourable manner. The authors share their experience of evaluating these phenomena in over 300 physicians who were referred to a specialized treatment centre by licensing boards, hospitals, physician health organizations or ethics committees. They note the high prevalence of defensive compartmentalization, temporal splitting and projective disavowal as means of tolerating behaviours they would generally regard as unethical. They also examine the implications of these modes of self‐deception for psychotherapy.     

Clinical Psychologists in the 2010s: 50 Years of the APA Division of Clinical Psychology

The American Psychological Association's Division of Clinical Psychology constitutes one of the oldest, largest, and most active organizations of clinical psychologists in the world. For 50 years, beginning with E. Lowell Kelly in 1960, researchers have chronicled the evolution of its membership and the transformation of clinical psychology in the United States. In this article, we highlight the continuity and change in clinical psychologists’ demographics, educations, theories, employment, activities, and satisfactions over a 50‐year span. Results from the most recent, 2010 study (N = 588, 46% return rate) are summarized in both contemporary and historical contexts. Among the prominent trends are steady increases in the proportion of female and ethnic minority psychologists, the rise of Psy.D. graduates, the domination of the cognitive orientation, a relative decline in psychological assessment in general and projective testing in particular, the ascendancy of independent practice, and a pattern of high career satisfaction.     

Thymic mucosa‐associated lymphoid tissue lymphoma with immunoglobulin‐storing histiocytosis in Sjögren's syndrome

Mucosa‐associated lymphoid tissue (MALT) lymphoma arising from the thymus is extremely rare. Only 33 cases of thymic MALT lymphoma have been reported to date. We present the case of a 53‐year‐old Japanese woman with Sjögren's syndrome who was diagnosed with thymic MALT lymphoma. In addition, the patient had the characteristic clinical and pathological features of thymic MALT lymphoma, as found in most of the 33 previous cases, except that there was an immunoglobulin G (IgG) phenotype, i.e. Sjögren's syndrome, epithelial cysts, lymphoepithelial lesions, and marked plasmacytic differentiation. The serum IgA levels were also elevated with IgA kappa M protein. This hypergammaglobulinemia remained unchanged after operation. The serological abnormalities may not arise from MALT lymphoma itself and may arise from the immune system hyper‐reactivity evoked by Sjögren's syndrome. Of further interest were marked accumulations of CD68‐positive histiocytes containing abundant eosinophilic globular inclusions in their cytoplasm. These inclusions were immunopositive for IgG‐kappa, suggesting immunoglobulin inclusion bodies. The globular immunoglobulin inclusion bodies have been reported in non‐crystallized immunoglobulin‐storing histiocytosis in only one patient with multiple myeloma. To our knowledge, this is the first case of thymic MALT lymphoma with marked accumulation of histiocytes with immunoglobulin inclusions in a patient with Sjögren's syndrome.     

“The hook‐up”: How youth‐serving organizations facilitate network‐based social capital for urban youth of color

Young people of color residing in distressed urban contexts face challenges in accessing social capital that supports positive development and the transition to educational and employment opportunities. Youth‐serving organizations play potentially important roles for youth participants to access and leverage networks. This ethnographic study draws on qualitative interviews, conducted with adolescents at a youth‐serving organization based in East Oakland, California, to examine how network‐based social capital is activated and sustained for and by urban Black and Latinx youth. We found that relationships with supportive adult staff at the organization put youth in contact with caring, trusted adults of color outside of their families who serve as role models for them. These adults provide loving accountability to young people, serving as critical forces in distressed and stigmatized communities. We also found that adult staff activate social leverage to garner various current and future educational and professional opportunities for the youth there. These unique opportunities serve to boost young people's current self‐esteem and also to prime them to envision positive futures for themselves. Overall, these findings point to the importance of interpersonal pathways embedded within neighborhood institutions in the activation of network‐based social capital.     

Perceptions of safety and subjective well‐being of Brazilian children

Safety is considered an important aspect of life and well‐being. However, few studies have examined the relationship between safety and well‐being among children, especially in Latin American. This study aims at analyzing the relationship between perceptions of safety and children's subjective well‐being, considering children's school, city context, and sex. Participants were 2,200 Brazilian children (10–13 years old) who answered the single item on Overall Life Satisfaction, the Satisfaction With Life Student Scale, and four items regarding safety perceptions. Through analysis of variance and structural equation modeling (SEM), results indicate that children who live in inner cities and study in private schools have significantly higher averages of safety perception. Also, boys present higher averages about how safe they feel. SEM presents a positive and significant relationship between safety perception and children's subjective well‐being and multigroup SEM indicates invariance of the model across groups. Safety is presented as an important component of well‐being. Interventions aimed at promoting safety and community ties can enhance children's well‐being.     

Implementing a stress management training: comparative trainer effectiveness

Participants who were recruited from various organizations were randomly assigned to 1 of 2 stress management training (SMT) conditions or an assessment-only control group. The groups in the 1st SMT condition were led by external clinical psychologists. The groups in the 2nd SMT condition were led by individuals who held posts within the organizations involved, referred to as paraprofessionals. Results show favorable effects of the SMT program both in the short term as well as at 6-month follow-up. Results showed no serious differences in effectiveness between trainers. It is argued that, to be effective, the SMT program does not necessarily have to be given by clinical psychologists only but may instead be given by individuals from other professional orientations.     

Self‐concept and attributions about other women in women with a history of childhood sexual abuse

Self‐concept literature and literature on childhood sexual abuse (CSA) suggests that women with a history of CSA may have particular ways of perceiving themselves, which, as well as impacting upon relationships within their everyday lives, may also have implications for therapy; whether this is on an individual basis or within a group. This research investigated self‐concept and attributions about other women using an adapted version of the self‐concept sorting task. Three groups of women were compared: women with a history of CSA, women experiencing depressed mood but without a history of CSA and a healthy non‐clinical comparison group of hospital staff. To some extent the current findings supported previous studies indicating that women attempting to cope with the consequences of a history of CSA have a negative self‐concept. However, there was evidence to suggest that certain self‐aspects are protective or protected. Similarly, there is some support for previous evidence of difficult relationships with mothers. Possible explanations for these findings were discussed and areas for future research suggested. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Massage: ? Although women with a history of CSA and depression have a negative view of themselves in comparison to a non‐clinical group, there is no qualitative difference between these two groups. ? Nor do women with a history of CSA have a more negative view of other women in general than women who are depressed. ? Therefore, being aware of the likelihood that an individual may preceive herself, but not other women negatively, a therapist may use therapy to actively increase awareness and address this issue.     

Effect of fixatives and tissue processing on the content and integrity of nucleic acids

Clinical and molecular medicines are undergoing a revolution based on the accelerated advances in biotechnology such as DNA microarrays and proteomics. Answers to fundamental questions such as how does the DNA sequence differ between individuals and what makes one individual more prone for a certain disease are eagerly being sought in this postgenomic era. Several government and nonprofit organizations provide the researchers access to human tissues for molecular studies. The tissues procured by the different organizations may differ with respect to fixation and processing parameters that may affect significantly the molecular profile of the tissues. It is imperative that a prospective investigator be aware of the potential contributing factors before designing a project. The purpose of this review is to provide an overview of the methods of human tissue acquisition, fixation, and preservation. In addition, the parameters of procurement and fixation that affect the quality of the tissues at the molecular level are discussed.     

Psychiatric genomics research during the COVID‐19 pandemic: A survey of Psychiatric Genomics Consortium researchers

Between April 20, 2020 and June 19, 2020 we conducted a survey of the membership of the Psychiatric Genomics Consortium (PGC) to explore the impact of COVID‐19 on their research and academic careers. A total of 123 individuals responded representing academic ranks from trainee to full professor, tenured and fixed‐term appointments, and all genders. The survey included both quantitative and free text responses. Results revealed considerable concern about the impact of COVID‐19 on research with the greatest concern reported by individuals in nonpermanent positions and female researchers. Concerns about the availability of funding and the impact of the pandemic on career progression were commonly reported by early career researchers. Recommendations for institutions, organizations such as the PGC, as well as individual senior investigators have been provided to ensure that the futures of early career investigators, especially those underrepresented in academic medicine such as women and underrepresented minorities, are not disproportionately disadvantaged by the COVID‐19 pandemic.     

Blind snakes beneath the surface: Continuing the legacy of Richard Thomas

Blind snakes (Scolecophidia) are small-bodied, enigmatic burrowing reptiles with members found on all continents except Antarctica. This Special Issue on blind snakes honors and advances the foundational studies by a remarkable anatomist, Richard Thomas. Richard is currently one of the living herpetologists to have described the greatest number of herpetofauna species, including many blind snake taxa. Recent interest in scolecophidian research at several conferences led to the development of this Special Issue on blind snake anatomy. This issue spans a diversity of papers, from biographical accounts of Richard's life and works, to a brief history of scolecophidian anatomical studies and the benefits of computed tomography (CT) technology, to a variety of studies on the skull and post-cranial osteology, cranial and jaw biomechanics related to subterranean lifestyles, evolution, and systematics of blind snake taxa from around the globe. This Special Issue will hopefully serve as a valuable resource and contribution to the field of blind snake anatomy research, and a joyful reflection on the life and career of a herpetologist who mentored and inspired a new generation of researchers in this area.     

A majority of parents of children with peanut allergy fear using the epinephrine auto‐injector

Prompt epinephrine administration is crucial in managing anaphylaxis, but epinephrine auto‐injectors (EAIs) are underutilized by patients and their families. Children with peanut allergy were recruited from the Allergy Clinics at the Montreal Children's Hospital, food allergy advocacy organizations and organizations providing products to allergic individuals. Parents of children who had been prescribed an EAI were queried on whether they were fearful of using it and on factors that may contribute to fear. A majority of parents (672/1209 = 56%) expressed fear regarding the use of the EAI. Parents attributed the fear to hurting the child, using the EAI incorrectly or a bad outcome. Parents whose child had longer disease duration or a severe reaction and parents who were satisfied with the EAI training or found it easy to use were less likely to be afraid. Families may benefit from simulation training and more education on the recognition and management of anaphylaxis.