Operationalizing the Reciprocal Engagement Model of Genetic Counseling Practice: a Framework for the Scalable Delivery of Genomic Counseling and Testing

With the advent of widespread genomic testing for diagnostic indications and disease risk assessment, there is increased need to optimize genetic counseling services to support the scalable delivery of precision medicine. Here, we describe how we operationalized the reciprocal engagement model of genetic counseling practice to develop a framework of counseling components and strategies for the delivery of genomic results. This framework was constructed based upon qualitative research with patients receiving genomic counseling following online receipt of potentially actionable complex disease and pharmacogenomics reports. Consultation with a transdisciplinary group of investigators, including practicing genetic counselors, was sought to ensure broad scope and applicability of these strategies for use with any large-scale genomic testing effort. We preserve the provision of pre-test education and informed consent as established in Mendelian/single-gene disease genetic counseling practice. Following receipt of genomic results, patients are afforded the opportunity to tailor the counseling agenda by selecting the specific test results they wish to discuss, specifying questions for discussion, and indicating their preference for counseling modality. The genetic counselor uses these patient preferences to set the genomic counseling session and to personalize result communication and risk reduction recommendations. Tailored visual aids and result summary reports divide areas of risk (genetic variant, family history, lifestyle) for each disease to facilitate discussion of multiple disease risks. Post-counseling, session summary reports are actively routed to both the patient and their physician team to encourage review and follow-up. Given the breadth of genomic information potentially resulting from genomic testing, this framework is put forth as a starting point to meet the need for scalable genetic counseling services in the delivery of precision medicine.     

Task preparation as a mnemonic: The benefits of drawing (and not drawing)

Psychonomic Bulletin & Review - Creating a visual representation of an item through drawing affords that item a substantive memory benefit, relative to several control tasks. Recent findings...     

Feature Binding and Working Memory in Children with ADHD: Evidence of Episodic Buffer Impairment

Research on Child and Adolescent Psychopathology - Previous examinations of working memory impairments in children with attention-deficit/hyperactivity disorder (ADHD) have predominantly focused on...     

Stages of readiness to quit smoking: population prevalence and correlates.

We examined the population prevalence and correlates of stages in smokers' readiness to quit, using data from 1,048 smokers recruited in a self-weighting, multistage, systematic clustered area sample from 0.44% of South Australian dwellings, with an 89% response rate. Smokers in the precontemplation stage comprised 24.1% of the sample, smokers in the contemplation stage comprised 47.2%, and smokers in the preparation stage comprised 28.7%. No sociodemographic variables (i.e., age, sex, marital status, educational level) were found to be significant independent predictors of membership in the different stages. The five significant independent predictors of being in the precontemplation stage (vs. the contemplation stage) were (a) having a higher confidence of quitting, (b) seeing fewer health risks associated with smoking, (c) not having made an attempt to quit, (d) seeing quitting as more difficult, and (e) smoking 25 or more cigarettes a day. The two significant independent predictors of being in the contemplation stage (vs. the preparation stage) were (a) having lower confidence of quitting and (b) not having tried to quit. We discuss implications for the understanding of smoking behavior in populations and also consider how cessation campaigns might address the factors associated with different stages of readiness to quit.     

Person-Environment Fit and its implications for personality development: a longitudinal study

Continuity and change in Person-Environment Fit (PE Fit) and its relation to personality development was studied in a 4-year longitudinal study of college students (N=305). PE Fit demonstrated moderate rank-order stability and small increases in mean-levels over time. Antecedents to PE Fit included gender (being male), high academic ability, low agreeableness, and low neuroticism. Outcomes associated with PE Fit included greater personality consistency and changes in personality in the direction of higher self-esteem and lower agreeableness and neuroticism. The implications of the findings for personality development are discussed.     

Antecedent Priming at Trace Positions in Children’s Sentence Processing

The present study examines whether children reactivate a moved constituent at its gap position and how children’s more limited working memory span affects the way they process filler-gap dependencies. 46 5–7 year-old children and 54 adult controls participated in a cross-modal picture priming experiment and underwent a standardized working memory test. The results revealed a statistically significant interaction between the participants’ working memory span and antecedent reactivation: High-span children (n = 19) and high-span adults (n = 22) showed evidence of antecedent priming at the gap site, while for low-span children and adults, there was no such effect. The antecedent priming effect in the high-span participants indicates that in both children and adults, dislocated arguments access their antecedents at gap positions. The absence of an antecedent reactivation effect in the low-span participants could mean that these participants required more time to integrate the dislocated constituent and reactivated the filler later during the sentence.     

Children's understanding of the war in Iraq: views from Britain and Bosnia

Sixty‐one children (aged 9–17) from the United Kingdom (31) and Bosnia (30) were interviewed about the war in Iraq. Significant differences emerged in their views of the war. The Bosnian children were more affected by the Iraq War, more aware of who is involved in it, had different views about its causes, viewed the consequences of the war with greater gravity, and expressed a greater desire to end war and have peace. Two factors which might account for these differences – recent Bosnian history and the nature of media representations of the war in the two countries – are discussed.     

The aggressive behaviour of personality disordered patients and its relation to personality and perceptual motor performance

The present study investigates the relationship between the frequency of aggressive behaviour of patients in a therapeutic community and socialization, extraversion and perceptual-motor rule-breaking. The subjects were 33 males and 24 females who had been rated by two observers in regard to frequency of aggressive behaviour during the initial part of their stay in the community. Principal component analysis revealed two fairly pure factors, referred to as verbal and physical aggression. In females both factors correlated significantly with extraversion, lack of role-taking ability and perceptual-motor rule-breaking. No significant correlations were obtained in the male sample except that physical aggression correlated positively with perceptual-motor rule-breaking.