Newborn Screening: Education,Consent, and the Residual Blood Spot. The Position of the National Society of Genetic Counselors

Newborn screening (NBS) is a minimally invasive lifesaving test. There is currently no federal mandate for NBS, thus states determine their own screening panel based on the recommendations of the Secretary’s Advisory Committee on Heritable Disorders in Newborn and Children (SACHDNC), which was recently re-chartered as the Discretionary Advisory Committee on Heritable Disorders in Newborns and Children (DACHDNC). After NBS is completed, a couple of residual blood spots remain. While some states allow these spots to be used for public health and scientific research purposes, parents are not always informed about these additional uses. This paper addresses the National Society of Genetic Counselors’ (NSGC’s) position about NBS and blood spot storage/use and the rationale for these positions. The National Society of Genetic Counselors strongly supports newborn screening for the uniform screening panel of conditions recommended by the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children. NSGC also supports storage and use of blood spot samples by newborn screening laboratories and transparent policies that govern these activities.     

Barriers Impacting the Utilization of Supervision Techniques in Genetic Counseling

Clinical supervision is an essential element in training genetic counselors. Although live supervision has been identified as the most common supervision technique utilized in genetic counseling, there is limited information on factors influencing its use as well as the use of other techniques. The purpose of this study was to identify barriers supervisors face when implementing supervision techniques. All participants (N?=?141) reported utilizing co-counseling. This was most used with novice students (96.1 %) and intermediate students (93.7 %). Other commonly used techniques included live supervision where the supervisor is silent during session (98.6 %) which was used most frequently with advanced students (94.0 %), and student self-report (64.7 %) used most often with advanced students (61.2 %). Though no barrier to these commonly used techniques was identified by a majority of participants, the most frequently reported barriers included time and concern about patient’s welfare. The remaining supervision techniques (live remote observation, video, and audio recording) were each used by less than 10 % of participants. Barriers that significantly influenced use of these techniques included lack of facilities/equipment and concern about patient reactions to technique. Understanding barriers to implementation of supervisory techniques may allow students to be efficiently trained in the future by reducing supervisor burnout and increasing the diversity of techniques used.     

Hazard function effects on promoting self-control in variable interval time-based interventions in rats

The present experiments investigated properties of time-based interventions used to increase self-control. Rats received impulsive-choice assessments before and after interventions that consisted of different distributions of delays to reinforcement. In Experiment 1, rats received an intervention with an increasing hazard function where delays were more evenly distributed, a decreasing hazard function where delays were mostly short, or a constant hazard function where delays were exponentially distributed. Surprisingly, rats that received the decreasing hazard function made the most self-controlled choices. Response rates during intervention trials showed that rats anticipated reinforcement based on the shape of the distributions they received. In Experiment 2, rats received an intervention with a decreasing hazard function with a steep slope or a shallow slope. Both time-based interventions increased self-control and produced similar response-rate patterns, indicating that the slope of the decreasing hazard function may not play a strong role in intervention efficacy. While this research aligns with previous literature showing that time-based interventions improved self-control, exposure to short delays produced the biggest improvements. Ultimately, exposure to short delays may increase the subjective value of the larger–later choice while occasional long delays may promote the ability to wait, which may have important implications for translational applications.     

Identifying and Treating Race‐Based Trauma in Counseling

This study investigated 106 counseling professionals’ experiences with identifying and treating race‐based trauma and the relationship between training and treatment. Competency was assessed with the Race‐Based Trauma Survey for Counselors. Although most participants reported working with clients who had symptoms associated with race‐based trauma, many had not received training in identifying and treating race‐based trauma among individuals of color. This finding highlights the disparities between health care and the provision of related services. Recommendations for counseling professionals and researchers are included. Este estudio investigó las experiencias de 106 profesionales en consejería con la identificación y el tratamiento de traumas basados en la raza, así como la relación entre la capacitación y el tratamiento. La competencia se evaluó usando la Encuesta para Consejeros sobre Traumas Basados en la Raza. A pesar de que la mayoría de participantes informó que había trabajado con clientes que tenían síntomas asociados con traumas basados en la raza, muchos no habían recibido capacitación para identificar y tratar traumas basados en la raza en personas de color. Este hallazgo resalta las disparidades entre la atención sanitaria y la provisión de servicios relacionados. Se incluyen recomendaciones para profesionales en consejería e investigadores.     

Defend or repair? Explaining responses to in-group moral failure by disentangling feelings of shame, rejection, and inferiority

Research on shame about in-group moral failure has yielded paradoxical results. In some studies, shame predicts self-defensive motivations to withdraw. In other studies, shame predicts pro-social motivations, such as restitution. We think that this paradox can be explained by disentangling the numerous appraisals and feelings subsumed under the label "shame." In 2 studies, we asked community samples of Norwegians about their in-group's discrimination against the Tater minority. Confirmatory factor analysis validated the measures of the appraisals and feelings used in Study 1 (N = 206) and Study 2 (N = 173). In both studies, an appraisal of the in-group as suffering a moral defect best predicted felt shame, whereas an appraisal of concern for condemnation of the in-group best predicted felt rejection. In both studies, felt rejection best predicted self-defensive motivation, whereas felt shame best predicted pro-social motivation. Implications for conceptualizing and studying shame are discussed.     

An evaluation of the reliability and construct validity of eating disorder measures in White and Black women

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.     

Barriers to and Motivations for Physician Referral of Patients to Cancer Genetics Clinics

Although it is well known that under-referral of colon cancer patients to cancer genetics clinics is a chronic problem, no study has yet examined why physicians may be ordering testing independently rather than referring patients to cancer genetics clinics. The current study explored variables which may impact a physician’s preference for ordering testing independently or referring patients to outside cancer genetics experts. An online questionnaire, distributed to the membership of the American College of Gastroenterology and the American Society of Colorectal Surgeons, yielded responses from 298 physicians. Motivations to refer to cancer genetics clinics rather than order testing independently included fear of genetic discrimination and a belief that patients benefit from genetic counseling about the risks, benefits and consequences of testing. These results suggest that in order to increase referrals, genetic counselors must educate physicians about the unique benefits patients receive from participating in genetic counseling.     

Gadd45b knockout mice exhibit selective deficits in hippocampus-dependent long-term memory

Growth arrest and DNA damage-inducible β (Gadd45b) has been shown to be involved in DNA demethylation and may be important for cognitive processes. Gadd45b is abnormally expressed in subjects with autism and psychosis, two disorders associated with cognitive deficits. Furthermore, several high-throughput screens have identified Gadd45b as a candidate plasticity-related gene. However, a direct demonstration of a link between Gadd45b and memory has not been established. The current studies first determined whether expression of the Gadd45 family of genes was affected by contextual fear conditioning. Gadd45b, and to a lesser extent Gadd45g, were up-regulated in the hippocampus following contextual fear conditioning, whereas Gadd45a was not. Next, Gadd45b knockout mice were tested for contextual and cued fear conditioning. Gadd45b knockout mice exhibited a significant deficit in long-term contextual fear conditioning; however, they displayed normal levels of short-term contextual fear conditioning. No differences between Gadd45b knockout and wild-type mice were observed in cued fear conditioning. Because cued fear conditioning is hippocampus independent, while contextual fear conditioning is hippocampus dependent, the current studies suggest that Gadd45b may be important for long-term hippocampus-dependent memory storage. Therefore, Gadd45b may be a novel therapeutic target for the cognitive deficits associated with many neurodevelopmental, neurological, and psychiatric disorders.     

Investigating Interrelationships among Sales Training Evaluation Methods

Today numerous training options are available to sales organizations, and sales training teams use various means to report training effectiveness. This study utilizes Kirkpatrick’s (1959; 1960) training evaluation model and examines the interrelationships among its four levels of sales training evaluation (i.e., reactions, knowledge acquisition, behavior change, and organizational outcomes). Empirical results indicate that sales trainees’ use of training materials at work is positively related to achieving sales training outcomes, including improving (1) organizational commitment, (2) sales effectiveness, and (3) customer relations. Furthermore, trainees who had positive reactions to training were more likely to learn the material, and trainees with higher levels of knowledge retention were more likely to apply the material in the work environment. Implications are discussed that may aid sales firms to better evaluate training solutions provided by vendors and to develop more effective and accountable sales training efforts.