Demographic and experiential correlates of public attitudes towards cell-free fetal DNA screening.

This study seeks to inform clinical application of cell-free fetal DNA (cffDNA) screening as a novel method for prenatal trisomy detection by investigating public attitudes towards this technology and demographic and experiential characteristics related to these attitudes. Two versions of a 25-item survey assessing interest in cffDNA and existing first-trimester combined screening for either trisomy 13 and 18 or trisomy 21 were distributed among 3,164 members of the United States public. Logistic regression was performed to determine variables predictive of interest in screening options. Approximately 47% of respondents expressed an interest in cffDNA screening for trisomy 13, 18, and 21, with a majority interested in cffDNA screening as a stand-alone technique. A significantly greater percent would consider termination of pregnancy following a diagnosis of trisomy 13 or 18 (52%) over one of trisomy 21 (44%). Willingness to consider abortion of an affected pregnancy was the strongest correlate to interest in both cffDNA and first-trimester combined screening, although markedly more respondents expressed an interest in some form of screening (69% and 71%, respectively) than would consider termination. Greater educational attainment, higher income, and insurance coverage predicted interest in cffDNA screening; stronger religious identification also corresponded to decreased interest. Prior experience with disability and genetic testing was associated with increased interest in cffDNA screening. Several of these factors, in addition to advanced age and Asian race, were, in turn, predictive of respondents' increased willingness to consider post-diagnosis termination of pregnancy. In conclusion, divergent attitudes towards cffDNA screening--and prenatal options more generally--appear correlated with individual socioeconomic and religious backgrounds and experiences with disability and genetic testing. Clinical implementation and counseling for novel prenatal technologies should take these diverse stakeholder values into consideration.

Newborn screening residual dried blood spot use for newborn screening quality improvement.

The outcomes of a meeting that focused on the role of the residual dried blood spots from newborn screening for uses in the improvement of newborn screening are reported. Discussions of policy development, such as this one, begin by identifying the problem to be solved; in this case, it is achieving common ground to develop consistent policies for the use of residual dried blood spots, such that their benefits to the public's health and the health of children are amplified, and harms are minimized. Similarly, the issue must be considered contextually. The example of newborn screening for phenylketonuria was used to highlight the issues in the context of the condition with the longest history in newborn screening. Principles and recommendations for the use of the residual dried blood spot were developed.

The Brain of Dexter Morgan: the Science of Psychopathy in Showtime's Season 8 of Dexter.

This article identifies and discusses on the ways in which biological influences to psychopathy are thematically portrayed in the eighth season of Dexter to describe Dexter's psychopathy, particularly focusing on fatalism and the inevitability of succumbing to one's "biological self." This paper, utilizing traditional content analysis, focuses on seven qualitative themes surrounding "biological fatalism" and psychopathy in this final season of Dexter. As lay theories of psychopathy are thought to originate from the media's conceptualization of the disorder, such thematic portrayals serve to potential affect lay understandings of psychopathy and correspondingly, how the disorder is treated and perceived in the criminal justice process as a modern psychopathy-related "CSI Effect." The conclusion focuses on the messages that this final season of Dexter sends to the lay public about the biological influences to psychopathy and how this may create implications for the criminal justice system.

"Don't Want No Risk and Don't Want No Problems": Public Understandings of the Risks and Benefits of Non-Invasive Prenatal Testing in the United States.

BACKGROUND: The recent availability of new non-invasive prenatal genetic tests for fetal aneuploidy has raised questions concerning whether and how these new tests will be integrated into prenatal medical care. Among the many factors to be considered are public understandings and preferences about prenatal testing mechanisms and the prospect of fetal aneuploidy. METHODS: To address these issues, we conducted a nation-wide mixed-method survey of 2,960 adults in the United States to explore justifications for choices among prenatal testing mechanisms. Open responses were qualitatively coded and grouped by theme. RESULTS: Respondents cited accuracy, followed by cost, as the most significant aspects of prenatal testing. Acceptance of testing was predicated on differing valuations of knowledge and on personal and religious beliefs. Trust in the medical establishment, attitudes towards risk, and beliefs about health and illness were also considered relevant. CONCLUSIONS: Although a significant portion of the sample population valued the additional accuracy provided by the new non-invasive tests, they nevertheless expressed concerns over high costs. Furthermore, participants continued to express reservations about the value of prenatal genetic information per se, regardless of how it was obtained.

In the public interest?

Restrictive patenting and licensing for cell-free fetal DNA testing has serious consequences for technology advances and benefits to public health.