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Cover page of Outcomes of Physicians' Communication Goals During Patient Interactions.

Outcomes of Physicians' Communication Goals During Patient Interactions.


During healthcare visits, physicians may set communication goals such as providing their patient with information about treatment; however, no recommendations exist regarding which goals physicians should prioritize during their often-brief interactions with patients. Two studies examined five communication goals (providing information, reducing distress, increasing patient satisfaction, increasing patient adherence, and encouraging hope) in the context of physician-patient interactions and their relationship with patient and physician outcomes. In Study 1, audio-recordings of physician-patient interactions were coded by research assistants for goal-related content. In Study 2, patients reported their physician's use of each goal during the interaction. In both studies, patients and physicians reported visit outcomes. Within-study meta-analyses suggested that the goal of reducing distress, but not the other goals, was consistently related to improved outcomes in Study 1. All goals were related to improved outcomes in Study 2. We then computed sample-size-weighted meta-analytic effects of each goal on each outcome across both studies. These results suggested that all of the goals had similar-sized positive relationships with patient and physician outcomes across studies. These findings suggest that physicians should generally approach consultations with communication goals in mind, but prioritizing efforts to reduce distress may be particularly beneficial.

Cover page of Engaging stakeholders across a socio-environmentally diverse network of water research sites in North and South America

Engaging stakeholders across a socio-environmentally diverse network of water research sites in North and South America


Maintaining and restoring freshwater ecosystem services in the face of local and global change requires adaptive research that effectively engages stakeholders. However, there is a lack of understanding and consensus in the research community regarding where, when, and which stakeholders should be engaged and what kind of researcher should do the engaging (e.g., physical, ecological, or social scientists). This paper explores stakeholder engagement across a developing network of aquatic research sites in North and South America with wide ranging cultural norms, social values, resource management paradigms, and eco-physical conditions. With seven sites in six countries, we found different degrees of engagement were explained by differences in the interests of the stakeholders given the history and perceived urgency of water resource problems as well as differences in the capacities of the site teams to effectively engage given their expertise and resources. We categorized engagement activities and applied Hurlbert and Gupta's split ladder of participation to better understand site differences and distill lessons learned for planning comparative socio-hydrological research and systematic evaluations of the effectiveness of stakeholder engagement approaches. We recommend research networks practice deliberate engagement of stakeholders that adaptively accounts for variations and changes in local socio-hydrologic conditions. This, in turn, requires further efforts to foster the development of well-integrated research teams that attract and retain researchers from multiple social science disciplines and enable training on effective engagement strategies for diverse conditions.

Cover page of Military, Race, and Urbanization: Lessons of Environmental Injustice from Las Vegas, Nevada

Military, Race, and Urbanization: Lessons of Environmental Injustice from Las Vegas, Nevada


Environmental justice scholarship argues state power perpetrates environmental inequalities, but less is known about the U.S. Military’s impact on local urban environmental inequalities. To evaluate the role of the military in contributing to environmental health disparities, I draw on the case study of Las Vegas, Nevada, a southwestern city with active military sites. The analysis uses environmental health, demographic, and Geographic Information System (GIS) data from federal and county agencies. Findings from spatial error models support environmental inequality and treadmill of destruction hypotheses by demonstrating that census tracts in closer proximity to military areas have greater estimated cancer risk from air toxics. Census tracts with a higher percent of poor and Latinx residents, independent of their proximity to military areas, have an additional increase in exposure to air pollution. The case study of Las Vegas offers important lessons of environmental injustice on Latinx environmental health vulnerability and military sites in urban areas.

Cover page of The protein kinase Ire1 impacts pathogenicity of Candida albicans by regulating homeostatic adaptation to endoplasmic reticulum stress.

The protein kinase Ire1 impacts pathogenicity of Candida albicans by regulating homeostatic adaptation to endoplasmic reticulum stress.


The unfolded protein response (UPR), crucial for the maintenance of endoplasmic reticulum (ER) homeostasis, is tied to the regulation of multiple cellular processes in pathogenic fungi. Here, we show that Candida albicans relies on an ER-resident protein, inositol-requiring enzyme 1 (Ire1) for sensing ER stress and activating the UPR. Compromised Ire1 function impacts cellular processes that are dependent on functional secretory homeostasis, as inferred from transcriptional profiling. Concordantly, an Ire1-mutant strain exhibits pleiotropic roles in ER stress response, antifungal tolerance, cell wall regulation and virulence-related traits. Hac1 is the downstream target of C. albicans Ire1 as it initiates the unconventional splicing of the 19 bp intron from HAC1 mRNA during tunicamycin-induced ER stress. Ire1 also activates the UPR in response to perturbations in cell wall integrity and cell membrane homeostasis in a manner that does not necessitate the splicing of HAC1 mRNA. Furthermore, the Ire1-mutant strain is severely defective in hyphal morphogenesis and biofilm formation as well as in establishing a successful infection in vivo. Together, these findings demonstrate that C. albicans Ire1 functions to regulate traits that are essential for virulence and suggest its importance in responding to multiple stresses, thus integrating various stress signals to maintain ER homeostasis.

Cover page of Revisiting how we operationalize joint attention.

Revisiting how we operationalize joint attention.


Parent-child interactions support the development of a wide range of socio-cognitive abilities in young children. As infants become increasingly mobile, the nature of these interactions change from person-oriented to object-oriented, with the latter relying on children's emerging ability to engage in joint attention. Joint attention is acknowledged to be a foundational ability in early child development, broadly speaking, yet its operationalization has varied substantially over the course of several decades of developmental research devoted to its characterization. Here, we outline two broad research perspectives-social and associative accounts-on what constitutes joint attention. Differences center on the criteria for what qualifies as joint attention and regarding the hypothesized developmental mechanisms that underlie the ability. After providing a theoretical overview, we introduce a joint attention coding scheme that we have developed iteratively based on careful reading of the literature and our own data coding experiences. This coding scheme provides objective guidelines for characterizing mulitmodal parent-child interactions. The need for such guidelines is acute given the widespread use of this and other developmental measures to assess atypically developing populations. We conclude with a call for open discussion about the need for researchers to include a clear description of what qualifies as joint attention in publications pertaining to joint attention, as well as details about their coding. We provide instructions for using our coding scheme in the service of starting such a discussion.

Cover page of An ERP index of real-time error correction within a noisy-channel framework of human communication.

An ERP index of real-time error correction within a noisy-channel framework of human communication.


Recent evidence suggests that language processing is well-adapted to noise in the input (e.g., spelling or speech errors, misreading or mishearing) and that comprehenders readily correct the input via rational inference over possible intended sentences given probable noise corruptions. In the current study, we probed the processing of noisy linguistic input, asking whether well-studied ERP components may serve as useful indices of this inferential process. In particular, we examined sentences where semantic violations could be attributed to noise-for example, in "The storyteller could turn any incident into an amusing antidote", where the implausible word "antidote" is orthographically and phonologically close to the intended "anecdote". We found that the processing of such sentences-where the probability that the message was corrupted by noise exceeds the probability that it was produced intentionally and perceived accurately-was associated with a reduced (less negative) N400 effect and an increased P600 effect, compared to semantic violations which are unlikely to be attributed to noise ("The storyteller could turn any incident into an amusing hearse"). Further, the magnitudes of these ERP effects were correlated with the probability that the comprehender retrieved a plausible alternative. This work thus adds to the growing body of literature that suggests that many aspects of language processing are optimized for dealing with noise in the input, and opens the door to electrophysiologic investigations of the computations that support the processing of imperfect input.

Cover page of The Role of Risk Perceptions and Affective Consequences in COVID-19 Protective Behaviors.

The Role of Risk Perceptions and Affective Consequences in COVID-19 Protective Behaviors.



Slowing the spread of the novel coronavirus (COVID-19) requires behavioral changes such as physical distancing (e.g., staying a 6-foot distance from others, avoiding mass gatherings, reducing houseguests), wearing masks, reducing trips to nonessential business establishments, and increasing hand washing. Like other health behaviors, COVID-19 related behaviors may be related to risk representations. Risk representations are the cognitive responses a person holds about illness risk such as, identity (i.e., label/characteristics of risk), cause (i.e., factors causing condition), timeline (i.e., onset/duration of risk), consequences (i.e., intrapersonal/interpersonal outcomes), behavioral efficacy (i.e., if and how the condition can be controlled/treated), and illness risk coherence (i.e., extent to which representations, behaviors, and beliefs are congruent). The current study applies the Common-Sense Model of Self-Regulation (CSM-SR) to evaluate how risk representations may relate to COVID-19 protective and risk behaviors.


Participants include 400 workers from Amazon's Mechanical Turk aged ≥ 18 years and US residents. Participants completed an online survey measuring risk representations (B-IPQ) and COVID-19 related behaviors, specifically, physical distancing, hand washing, and shopping frequency.


Risk coherence, consequences, timeline, emotional representation, and behavioral efficacy were related to risk and protective behaviors.


Risk representations vary in their relationship to COVID-19 risk and protective behaviors. Implications include the importance of coherent, targeted, consistent health communication, and effective health policy in mitigating the spread of COVID-19.

Cover page of Evolution of the complex transcription network controlling biofilm formation in <i>Candida</i> species.

Evolution of the complex transcription network controlling biofilm formation in Candida species.


We examine how a complex transcription network composed of seven 'master' regulators and hundreds of target genes evolved over a span of approximately 70 million years. The network controls biofilm formation in several Candida species, a group of fungi that are present in humans both as constituents of the microbiota and as opportunistic pathogens. Using a variety of approaches, we observed two major types of changes that have occurred in the biofilm network since the four extant species we examined last shared a common ancestor. Master regulator 'substitutions' occurred over relatively long evolutionary times, resulting in different species having overlapping but different sets of master regulators of biofilm formation. Second, massive changes in the connections between the master regulators and their target genes occurred over much shorter timescales. We believe this analysis is the first detailed, empirical description of how a complex transcription network has evolved.