Attitudes and Practices Among Internists Concerning Genetic Testing

Many questions remain concerning whether, when, and how physicians order genetic tests, and what factors are involved in their decisions. We surveyed 220 internists from two academic medical centers about their utilization of genetic testing. Rates of genetic utilizations varied widely by disease. Respondents were most likely to have ordered tests for Factor V Leiden (16.8 %), followed by Breast/Ovarian Cancer (15.0 %). In the past 6 months, 65 % had counseled patients on genetic issues, 44 % had ordered genetic tests, 38.5 % had referred patients to a genetic counselor or geneticist, and 27.5 % had received ads from commercial labs for genetic testing. Only 4.5 % had tried to hide or disguise genetic information, and <2 % have had patients report genetic discrimination. Only 53.4 % knew of a geneticist/genetic counselor to whom to refer patients. Most rated their knowledge as very/somewhat poor concerning genetics (73.7 %) and guidelines for genetic testing (87.1 %). Most felt needs for more training on when to order tests (79 %), and how to counsel patients (82 %), interpret results (77.3 %), and maintain privacy (80.6 %). Physicians were more likely to have ordered a genetic test if patients inquired about genetic testing (p?<?.001), and if physicians had a geneticist/genetic counselor to whom to refer patients (p?<?.002), had referred patients to a geneticist/genetic counselor in the past 6 months, had more comfort counseling patients about testing (p?<?.019), counseled patients about genetics, larger practices (p?<?.032), fewer African-American patients (p?<?.027), and patients who had reported genetic discrimination (p?<?.044). In a multiple logistic regression, ordering a genetic test was associated with patients inquiring about testing, having referred patients to a geneticist/genetic counselor and knowing how to order tests. These data suggest that physicians recognize their knowledge deficits, and are interested in training. These findings have important implications for future medical practice, research, and education.     

Young adult drivers' sensitivity to changes in speed and driving mode in a simple vehicle simulator

The study was done to check replication of changes in sensitivity with a simple simulator as had been obtained in an experiment using the real road situation. Another purpose was to control simulator sickness which could have confounded data from testing with a simulator or in actual driving. Sensitivity of the drivers (72 healthy young adults, M age = 24 yr., SD = 5) while performing the driving task was measured in terms of subjective ratings of simulator sickness and affect, and physiological measures (i.e., galvanic skin responses and skin temperature) at different driving speeds and in driving mode conditions, using a simple vehicle simulator. Analysis showed measures of drivers' state, including simulator sickness, physiological indices, and subjective reports, increased with driving speed (30 --> 90 -->120 km/hr.) and driving mode change from the regular speed to sudden increasing to sudden decreasing speeds. Particularly, the results suggest that the increased autonomic nervous activation induces increase of rated simulator sickness. Based upon the same tendency in change of the simulator sickness and physiological state with driving speed and driving mode conditions, it was concluded that, if the results obtained from the simulator experiment can be generalized to the real situation, the simulator sickness must be considered a confounding factor. The results also suggest that the changes in human sensitivity are dependent upon aspects related to speed of a vehicle and driving mode.     

Comparing Self-differentiation and Psychological Well-being between Korean and European American Students

This study examined cross-cultural differences in the relationship of self-differentiation with self-esteem and depressed mood, two indices of psychological well-being. Participants were 427 Korean and 375 European American college students. The main findings were that the levels of all components of self-differentiation were greater for European Americans than for Koreans; self-differentiation was associated with psychological well-being more strongly in American samples than in Korean counterparts; and “I position” was the most powerful predictor on self-esteem in both groups. Results suggest that differentiation is a meaningful construct for understanding psychological adjustment of college students in collectivistic Korean society.This research was supported by the Chonbuk National University funds for overseas research, 2004.     

Rewards of technology: Explaining China’s reverse migration

China rewards Mainlanders with technology who return to China. Among entrepreneurs and scientists, technology is generating today’s reverse migration as the rewards for bringing back technology are significant. Many returnees do not bring the latest international technology; technology that is new for China suffices to create a comparative advantage in the domestic market, making the transfer of technology a key strategy for becoming a successful reverse migrant. This article shows statistically that those who said that they had returned because they possessed a new technology (55% of our sample) were less likely to have a new international technology than a technology that was new only for China. La Chine récompense les Chinois continentaux qui retoument au pays avec des moyens techniques. Les récompenses pour avoir rapporté des éléments technologiques étant significatives, c’est la technologie qui favorise la migration de retour actuelle chez les entrepreneurs et les scientifiques. Nombreux sont les rapatriés qui ne rapportent pas le dernier cri international en technologie; il suffit de revenir avec des moyens techniques qui sont inconnus en Chine pour créer un avantage comparé dans le marché intérieur. Ainsi, le transfert de technologies constitue une strategie privilégiée dans la réussite des rapatriés. Nos statistiques indiquent que chez ceux qui étaient retournés au pays parce qu¡ls y introduisaient une nouvelle technologie (soit 55% de notre échantillon), il était moins probable pour eux d’avoir de nouveaux moyens techniques intemationaux que de moyens techniques qui représentaient une nouveauté en Chine seulement.     

健康、公正和全球性治理

卫生保健在国际水平上的不平等(这些不平等应视为不公正)要求实行全球性体制,依照全球公正的基本原则来实现人类基本的卫生保健需求.     

A Strengths-Based Longitudinal Career Intervention for Junior Secondary School Students with Special Educational Needs: a Mixed-method Evaluation

The mixed-method study reported here was designed to evaluate a strengths-based career intervention program for secondary school students with mild special educational needs (SEN). A sample of 32 SEN students (19 boys: 13 girls) from 5 inclusive schools in Hong Kong were recruited to a treatment group. An additional 32 SEN students (19 boys: 13 girls) were selected to form the control group matched for age, gender and parents’ education level. The special needs exhibited by both groups were in areas of literacy and numeracy, attention deficits, and social-emotional problems, but did not include severe or complex disabilities. Participants in both groups responded to pre- and post-intervention questionnaires covering career development self-efficacy, personal and social development self-efficacy, and meaning in life. As a follow-up, two teachers and three social workers providing support to SEN students, and the 32 participants were interviewed several months after the intervention. Interviews also took place with teachers, social workers and students to evaluate the perceived effects of the intervention. Findings indicated significant interactions between Time 1 and Time 2, and between groups (control vs. treatment) in personal goal-setting, career goal-setting, and the presence of meaning in life. Additionally, several themes were identified from the interviews suggesting that the intervention did have positive effects on SEN students’ career, personal and social development self-efficacy, and acquisition of meaning in life.

     

Multi-family Psychoeducational Psychotherapy (MF-PEP) for Children with High Functioning Autism Spectrum Disorder

This article describes the development and methodology of a novel psychosocial intervention for children with high functioning autism spectrum disorder (HFASD). Originally developed as an adjunctive treatment for children with mood disorders, Multi-Family Psychoeducational Psychotherapy (MF-PEP) has been adapted for children with ASD (MF-PEP-ASD). Consisting of eight sessions, children with ASD and their parents receive psychoeducation and social support, and learn coping, problem-solving, communication, and symptom-management skills in separate and joint sessions. Core treatment components of MF-PEP-ASD include psychoeducation, social skills treatment, cognitive-behavioral therapy, and parent training and involvement. Preliminary qualitative data from parent and child participants have indicated positive and promising findings. Continued evaluation of this treatment using comprehensive outcome and treatment fidelity measures is warranted.