Patients’ illness schemata of hypertension: The role of beliefs for the choice of treatment

It has long been believed that adult somatic complaints are associated with early family dysfunction. Yet, few studies have examined this hypothesis in community samples, where medically unexplained symptom complaints are estimated to be very common. Given the potential population-wide impact of subthreshold symptom complaints as well as questions about the extent to which findings with patient populations generalize to broader samples of community adults, the present study examines the influence of distal family factors on current adult somatic complaints relative to demographic and other psychosocial predictors. Results based on multiple linear regression analysis indicated that, after controlling for the other variables, family-of-origin functioning did not predict adult somatic complaints. However, self-reported symptoms of current depressed mood and low internal locus of control were significantly linked to somatic complaints (p?=0.001). These results lend support to questions about the generalizability of findings based on psychiatric groups to broader community samples, highlight the robust relationship between contemporaneous attributions of lower internal control, depressed mood, and somatic complaints, and suggest that early family environment may not be the most important focus of attention for health professionals providing care to adults in the community.     

Attributes of successful approaches to weight loss and control

Most weight loss treatments result in only temporary losses, followed by slow regain. This paper examines those factors that are correlated with the most favorable results in terms of loss and maintenance of loss. Weight loss is positively related to self-monitoring, goal setting, social support, and length of treatment. Maintenance of weight loss is correlated with regular physical activity, self-monitoring, and continued contact with therapists. Regain is associated with inconsistent and restrictive dieting, life stress, negative coping style, and emotional or binge eating patterns. The implications drawn from these findings are (a) normalize eating patterns, (b) emphasize exercise, (c) ensure social support, (d) set realistic goal weights, (e) focus on health rather than appearance, (f) focus on self-esteem, and (g) target binge eating.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.