Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.     

An Evaluation of the NAMI Basics Program

This brief report describes results from an evaluation of NAMI Basics, a peer-delivered family education program for family caregivers of children and adolescents with mental illness. Over six classes, family members are given information (e.g. education about mental illness and treatments), skills training (e.g. family communication skills) and advocacy support. We report data from 36 caregivers who completed pre and posttest instruments measuring self-care, empowerment, and family problem-solving and communication skills. Results showed significant improvements in self-care, empowerment, and “incendiary” family communication after participation in the program. Results suggest that NAMI Basics may improve both parental functioning and familial processes. Implications and future directions are discussed.     

Cultural variation in the social organization of problem solving among African American and European American siblings

This study examined the social organization of a problem-solving task among 15 African American and 15 European American sibling pairs. The 30 sibling pairs between the ages of 6 and 12 were video recorded constructing a marble track together during a home visit. African American siblings were observed to collaborate more often than European American siblings who were more likely to divide up the labor and direct each other in constructing the marble track. In addition, older European American siblings made more proposals of step plans than older African American siblings. The findings provide insights into the cultural basis of the social organization of problem solving across African American and European American siblings.     

Heterosexual romantic relationships, interpersonal needs, and quality of life in prison

The purpose of this study was to investigate the moderating effect of having vs. not having a and quality of life. In-person interviews were conducted with 55 male and 64 female inmates from the Topas Penitentiary (Spain). Higher levels of social loneliness and lower levels of sexual satisfaction were associated with lower levels of quality of life. In addition, the interaction between sexual satisfaction and romantic partner status was significant. Higher levels of sexual satisfaction were associated with higher levels of quality of life only for the group without a partner. These findings support a "bad is stronger than good" principle and indicate the detrimental aspects that can be associated with not having a satisfactory sexual life while incarcerated.     

Globalising Love: On the Nature and Scope of Love as a Form of Recognition

This article begins by tracing two issues to be kept in mind in discussing the theme of love as far back as Aristotle: on the one hand the polysemy of the term philia in Aristotle, and on the other hand the fact that there is a focal or core meaning of philia that provides order to that polysemy. Secondly, it is briefly suggested that the same issues are, mutatis mutandis, central for understanding the discussion of love or Liebe by Hegel, the central classic reference in debates on recognition. Thirdly, by pointing out a certain ambiguity in Harry Frankfurt’s recent work on love, the article focuses more closely on the thought that love in the simple sense which Aristotle had pinpointed as the focal meaning of philia, which is arguably at the core of Hegel’s discussion of Liebe, and which still forms at least one of the core senses of the term, is a ‘personifying’ attitude of recognition. Finally, drawing on the above points the article addresses the question whether love as a form of recognition is restricted to intimate relations such as those between family-members, ‘lovers’, close friends and so on, or whether it has applications in interhuman relations more broadly. The answer to this question, it is suggested, is essential for the viability of ethically substantial notions of solidarity beyond circles of close acquaintances, whether within the civil society, across nations, or towards future generations.     

The Hastings Center and the early years of bioethics

The Hastings Center was founded in 1969 to study ethical problems in medicine and biology. The Center arose from a confluence of three social currents: the increased public scrutiny of medicine and its practices, the concern about the moral problems being generated by technological developments, and the desire of one of its founders (Callahan) to make use of his philosophical training in a more applied way. The early years of the Center were devoted to raising money, developing an early agenda of issues, and identifying a cadre of people around the country interested in the issues. Various stresses and strains in the Center and the field are identified, and some final reflections are offered on the nature and value of the contributions made by bioethics as an academic field.     

Specificity of the 21-Item Test in two elderly samples

ABSTRACT The purpose of this study was to measure the specificity of the 21-Item Test for detecting malingering in an elderly sample. The 21-Item Test was administered to 20 community-dwelling elderly individuals with means for age, education, and Short Portable Mental Status Questionnaire (SPMSQ) error scores of 76.25 years (SD?=?7.19), 14.30 years (SD?=?3.89), and 0.30 (SD?=?4.70). None of these healthy elderly participants were cognitively impaired. A second group of 53 nursing home residents had means for age, education, and SPMSQ error scores of 82.79 years (SD?=?8.56), 11.14 years (SD = 2.46), and 3.17 (SD?=?2.46). Approximately 60% of the nursing home participants had cognitive impairment based on the SPMSQ. The cut offs provided by Iverson (1998 , 21 Item Test Research Manual) for interpretation of the forced-choice component of the 21-Item Test were insensitive to age and relatively insensitive to cognitive deficits. Specificity was 100% since no elderly participant from either group scored in the range indicative of sub-optimal effort or biased responding.