Billing for Medical Genetics and Genetic Counseling Services: A National Survey

In January 2007 the American Medical Association added a new Current Procedural Terminology® (CPT) code, 96040, for “Medical Genetics and Genetic Counseling Services.” In order to identify the impact of having this new code and to identify issues with implementation of the code, the National Society of Genetic Counselors (NSGC) CPT® Working Group surveyed NSGC members using an internet-based survey tool. The majority of respondents (94%) reported being aware of the new code and over half of the respondents (69%) said they were billing for genetic counseling. Approximately 24% of those billing reported using 96040. Many facilities are not using this code and the reported success of billing using 96040 is highly varied. Continued education may be beneficial to encourage reimbursement for 96040 and follow up is needed to assess the ongoing implementation and impact of the new CPT® code.     

Beliefs About Tobacco, Health, and Addiction Among Adults in Cambodia: Findings from a National Survey

There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n = 13,988) of all provinces of Cambodia, we found that (1) 88–93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86–93% believe that the Wat (temple) should be a smoke-free area; (3) 93–95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.     

文化背景与医疗行为:一个少数民族社区中的新型农村合作医疗

现有对民族社区新型农作合作医疗（以下简称新农合）的研究相对较少,同时在研究中忽略了在其独特民族文化背景下对于疾病与医疗的不同认知,这一认知影响了人们的医疗观念和医疗行为,也直接影响了人们对新农合的态度和行为。医学人类学关注文化与疾病、医疗的关系,以云南省福贡县赤恒底傈僳族社区新农合的田野调查为例,应用医学人类学的视角和社区研究方法对其进行研究,以期获得新的认识和理解。     

Test use and assessment practices of school psychologists in the United States: Findings from the 2017 National Survey

Although several studies have examined the specific instruments and procedures used by school psychologists when conducting comprehensive psychoeducational evaluations, the last one was published over 20 years ago (viz., Wilson & Reschly, 1996). Given the substantial theoretical and practical advances in assessment since then, the purpose of the current study was to examine the test use and assessment practices of contemporary school psychologists in the United States. Data from the 2017 National Survey of Assessment Practices in School Psychology revealed that test use and assessment practices have evolved significantly. Much of this change consists of the substitution of tests and practices with limited reliability and validity with those with greater psychometric support. Results of this study also indicate that school psychologists regularly conduct multi-method assessments to prevent, identify, monitor, and remediate child and adolescent learning difficulties and other presenting problems in the schools.     

身体关怀：医学关怀的终极使命

西方关怀思想显现为由“关怀”向“人文关怀”递进、由“人文关怀”向“身体关怀”转向、由“身体关怀”向“医学关怀”迁移的演进过程。廓清、重建和升华医学关怀的理念、认知和行为。医学关怀是对患者的健康状况、身心疾患、身体感受、具身情绪和社会适应给予的关注、关情、关爱。医学人文关怀、医学技术关怀和医学服务关怀构成医学关怀的三个维度,形成以医学人文关怀为纲、医学技术关怀为用、医学服务关怀为媒的整体结构。在医学关怀的“三维一体”的图式中,医学人文关怀给身体以灵魂慰藉、医学技术关怀给身体以物质支撑、医学服务关怀给身体以温暖感受,协同完成医学关怀这一医学的终极使命。     

Counselor Values: A National Survey

A national sample (n = 479) of counselors representative of the 1993 American Counseling Association membership was surveyed regarding their value orientations in four domains: universal values, mental health values, individualistic-collectivistic values, and religious-spiritual values. Results yielded a multifaceted, generally concordant (although by no means unanimous) value profile for professional counselors across these value domains, presenting an overall content pattern that might be globally summarized as a strong core valuing of holistic-humanistic empowerment related to personal development and interpersonal and social concern. Implications for counseling practice, limitations, and suggestions for future research are discussed.     

医学人文与医疗实践结合:人性化的医疗

医学人文与医学科学的结合是当代科学与人文关系的特点和本性,也是医学现实的迫切需求,其目标是实现人性化的医疗;医学人文存在不同水平的三个层次;医疗人性化是一个广阔的领域;营造平台是促进两者结合的重要条件.医学人文具有理论和实践两个向度,医学人文的实践向度是整个医学人文或人文医学的基础,没有实践向度,理论向度就失去了基础,整个医学人文就会成为不着边际的空话.医学人文的理论向度和实践向度,其基础都在临床实践.     

Medical Research: A Midcentury Survey

This article proposes an integrative model for stress management groups for women, representing a biopsychosocial point of view and drawing on theories of psychodynamic group psychotherapy, self-psychology, female development, and stress management. The basis of the model is an eight week traditional stress management group. The novel aspects of this integrative model are that it aims to increase the power of stress management groups for women by providing an articulated frame, attending to group process, promoting curiosity regarding resistance to behavior changes, encouraging the elaboration of affect, and giving importance to the role of relationships in each member's quest for self care and healthy entitlement.     

医护人员对家族性肿瘤患者的人文关怀

家族性肿瘤对患者本人在生理、心理及社会状态等方面都有极为深重的危害,并且由于其家族易感性,对家族其他成员的心理状态也会造成严重影响.本文强调了人文关怀在家族性肿瘤医护工作中的重要性,并分别论述了人文关怀在家族性肿瘤的诊疗和护理工作中的具体实施.     

Integrating early parent-infant psychosocial support into neighborhood health clinics: An ecological intervention

A program of early psychosocial support for low-income parents and infants was established at an inner-city family health center. Such a program meets many of the criteria of successful early psychological intervention by (1) beginning during the prenatal period and extending through the first 3 years of life, (2) providing professional and peer support to the parent-infant system, (3) responding to the social as well as psychological needs of low-income parents, and (4) embedding preventive intervention into an accessible neighborhood setting.     

Decision-making incapacity among nursing home residents: results from the 1987 NMES survey. National Medical Expenditure Survey

Recent legislative and regulatory developments have focused attention on older adults' capacity for involvement in health care decision-making. The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) focused attention on the rights of nursing home residents to be involved in health care decision-making to the fullest extent possible. This article uses data from the 1987 National Medical Expenditure Survey (NMES) to examine rates of incapacity for health care decision-making among nursing home residents. Elements of the Oklahoma statute were used to operationalize decision-making incapacity: disability or disorder, difficulty in decision-making or communicating decisions, and functional disability. Fifty-three percent of nursing home residents had a combination of either physical or mental impairment and an impairment in either self-care or money management. The discussion focuses on the policy and practice implications of significant rates of incapacity among nursing home residents.     

从医疗语言看医学特质

语言是人类的生存方式之一,医学也是人类的生存方式之一.语言与医学的相通和交融,形成了一门新的交叉性、应用性、边缘性学科--医疗语言学.在医疗环境里,透过人类最活跃、最直接、最形象性的语言,可以深切感受到医疗过程中的人文关怀和医学的人文本质.     

Providers' voices on telebehavioral health: Survey of an outpatient counseling agency in Alaska

Hope Counseling Center sought to expand behavioral health services to underserved populations in Alaska by offering telebehavioral health services. Providers completed a questionnaire addressing their experiences, opinions, and training needs as they relate to telebehavioral health. Open conversations about the training needs, limitations, and benefits of telebehavioral health supported program development and led to training on new equipment, rapport building, and telebehavioral health outcome studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Multicultural Issues in Predoctoral Internship Programs: A National Survey

The present study examined the extent to which internship training directors (ITDs) addressed multicultural issues in their predoctoral training programs. Regarding the overall sample, ITDs reported varied levels of attention to specific multicultural issues. By internship agency type, ITDs at university counseling centers reported significantly greater attention to multicultural issues than did ITDs at community mental health centers, state hospitals, medical schools, and private psychiatric hospitals. Results clearly indicated the need for increased attention to multicultural issues in all internship programs.     

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.     

人性化医疗的困境:法律与伦理的冲突与整合

随着现代医学的迅猛发展,加强医学人文教育已成为医学界共识。推进医学人文发展的核心是为了实现人性化的医疗,然而,在当今人性化医疗的进程中仍面临着诸多困境,尤其是医学法律与伦理之间的某些矛盾或混沌状态更为突出,因此,实现医学人文各层面的有机契合是当前医疗改革的一个重要环节,需要医患双方及全社会的共同努力,务必要直面问题和解决问题,在追求和谐的整合原则指导下,努力实现医学法律与伦理之间的无缝契合,推进人性化医疗的系统性整合。     

Women in the National Guard: Coping and Barriers to Care

This study involved interviews with 42 women from the National Guard about their experiences of coping during reintegration into civilian life. Data were analyzed using techniques of conventional content analysis. The 1st theme that emerged regarded barriers to seeking and accessing care (institutional barriers, personal barriers, and stigma). The 2nd theme, coping strategies, consisted of 4 categories (seeking or gaining professional help, seeking social support, using routine activities, and using aspects of religion/spirituality). Implications for clinical work with returning female soldiers are discussed.     

Ambulatory assessment for physical activity research: State of the science,best practices and future directions

Technological and digital progress benefits physical activity (PA) research. Here we compiled expert knowledge on how Ambulatory Assessment (AA) is utilized to advance PA research, i.e., we present results of the 2nd International CAPA Workshop 2019 “Physical Activity Assessment – State of the Science, Best Practices, Future Directions” where invited researchers with experience in PA assessment, evaluation, technology and application participated. First, we provide readers with the state of the AA science, then we give best practice recommendations on how to measure PA via AA and shed light on methodological frontiers, and we furthermore discuss future directions. AA encompasses a class of methods that allows the study of PA and its behavioral, biological and physiological correlates as they unfold in everyday life. AA includes monitoring of movement (e.g., via accelerometry), physiological function (e.g., via mobile electrocardiogram), contextual information (e.g., via geolocation-tracking), and ecological momentary assessment (EMA; e.g., electronic diaries) to capture self-reported information. The strengths of AA are data assessments near real-time, which minimize retrospective biases in real-world settings, consequentially enabling ecological valid findings. Importantly, AA enables multiple assessments across time within subjects resulting in intensive longitudinal data (ILD), which allows unraveling within-person determinants of PA in everyday life. In this paper, we show how AA methods such as triggered e-diaries and geolocation-tracking can be used to measure PA and its correlates, and furthermore how these findings may translate into real-life interventions. In sum, AA provides numerous possibilities for PA research, especially the opportunity to tackle within-subject antecedents, concomitants, and consequences of PA as they unfold in everyday life. In-depth insights on determinants of PA could help us design and deliver impactful interventions in real-world contexts, thus enabling us to solve critical health issues in the 21st century such as insufficient PA and high levels of sedentary behavior.