Evaluation of a Clinical Genetics Service – A Quality Initiative

Paper-based surveys are an effective means of evaluating the quality of a clinical service. As part of ongoing quality improvement initiatives within our Genetics Program, new patients were invited to participate in a paper-based survey. Issues related to the quality of counseling based on educational/informational aspects (e.g. whether testing was explained fully, testing options, the meaning of normal/abnormal testing), competency, respect and nondirectiveness of counseling in addition to clinical environment/setting were evaluated. Data related to demographics, discipline seen within the program and whether the patient was seen by a physician or genetic counselor were also captured. Five hundred questionnaires were distributed. One hundred and forty-seven questionnaires were returned, with a response rate of 29.4 %. The majority of patients seen were prenatal (pregnant) patients and comprised a heterogeneous group including those seen for advanced maternal age and abnormal maternal serum screening. Overall, 98.6 % of respondents felt their appointment in genetics was a positive experience. Issues related to confidentiality, pros and cons of testing, meaning of an abnormal test result and time allotted for decision making were significantly different in some disciplines between genetic counselor and geneticist. However, when controlling for referral indication, these differences lost significance with the exception of issues relating to confidentiality and perceived time allotted to organize thoughts and questions. This survey provided valuable information to allow for improvement in the quality of the provision of service.     

Making Attentive Citizens: The Ethics of Democratic Engagement,Political Equality,and Social Justice

Much discussion of the ethics of participation focuses on electoral participation and whether citizens are obligated or can be coerced to vote. Yet these debates have ignored that citizens must first pay attention to politics and make up their minds about where they stand before they can engage in any form of participation. This article considers the importance for liberal democracy of citizens paying attention to politics, or attentive citizenship. It argues that the democratic state has an obligation to cultivate interest in politics and that this obligation authorizes means up to and including some forms of coercion. The argument is that when citizens are inattentive to politics, it undermines political equality and social justice because it undermines what John Rawls called the fair value of the political liberties. The importance of these ends for liberal democratic states requires them to take steps to promote attentive citizenship.     

Confirmatory Factor Analysis of the Structure of Adult ADHD Symptoms

Previous research has examined the factor structure of ADHD symptoms in adults using confirmatory factor analysis and there is mixed support for two-factor, three-factor, or more complex bifactor models. The current study re-examines these factor structures on the basis of not only overall model fit, but also criteria such as chi-square difference tests, invariance, reliability, and validity. Three datasets were pooled to form a total sample of 430 adults (50% female). Participants completed questionnaires assessing their ADHD symptoms, education, psychopathology, and parenting (the latter as validity variables). Although the bifactor models demonstrated the best fit, the reliability and construct replicability of specific factors in these models was poor. The three-factor model had good fit and demonstrated good reliability, validity, construct replicability, and some invariance across gender and dataset. Our results replicate previous studies that find superior fit for bifactor models. However, the superior statistical fit may reflect only the increased complexity of these models. The more parsimonious three-factor model may demonstrate stronger validity and clinical utility.     

Using a group game increases preschoolers' step count

Children should engage in at least 60 min of physical activity daily to develop or maintain healthy habits (Centers for Disease Control and Prevention, 2021a). Previous research suggests that contingent attention is a powerful tool for increasing moderate to vigorous physical activity. In this study, the researchers examined the effects of a group game on steps per minute at recess in an inclusive classroom with preschoolers. The researcher taught the game called the T-Rex game in which the game rules (chasing students who were moving) involved contingencies for natural attention to follow moderate to vigorous physical activity. The results showed a functional relation between step count and the group game in which students engaged in higher step counts when the group game was in place than during baseline. These findings extend other work by demonstrating that contingent attention embedded in group games can increase step count.     

Social Problem-Solving Abilities and Health Behaviors Among Persons with Recent-Onset Spinal Cord Injury

Although many persons with spinal cord injuries (SCI) are at risk for preventable complications, very little research has examined the health behaviors of these individuals. In this study, we examined self-reported health behaviors of persons with recent-onset SCI. We also studied the association between health behaviors and social problem-solving abilities. The results indicated that positive problem-solving characteristics were associated with more adaptive wellness and accident prevention behaviors. A negative orientation toward problem solving and avoidant and impulsive/careless styles was associated with increased traffic and substance risk taking. Implications are discussed in terms of health education, research, and prevention programs.     

Peer pressure and poverty: exploring fashion brands and consumption symbolism among children of the ‘British poor’

Attitudes towards fashion brands (trainers/athletic shoes) and their symbolic meanings are explored among a sample of 30 children aged 8–12 years from poor homes in the UK, in an interpretive study using projective methods. The children form stereotypes about the owners of trainers: if the trainers are obviously branded and expensive the children believe the owner to be rich and young, if the trainer is unbranded and inexpensive looking the children believe the owner to be poor and old. If a child is wearing branded trainers they are seen as popular and able to fit in with their peers. These opinions are so strongly held that the children would prefer to talk to someone wearing branded trainers than unbranded trainers. The children also feel pressure to wear the trainers that their friends wear, partly to make friends and fit in and partly because of the teasing experienced if they are wearing unbranded clothes or are clearly from a poor home. Copyright © 2004 Henry Stewart Publications.