Ethical issues in genetic counseling: A comparison of M.S. counselor and medical geneticist perspectives

New technologies available in the field of medical genetics have increased the importance of responsible ethical decision-making among genetic counselors. A 1985 national survey of M.D. and Ph.D. genetic counselors assessed ethical attitudes using case scenarios designed to simulate dilemmas faced in genetic counseling (Wertz and Fletcher, 1988b). The current study focuses on attitudes of M.S. genetic counselors using similar scenarios, allowing for effective comparisons. M.S. counselors were more willing than M.D. and Ph.D. counselors to maintain patient confidentiality when screening for Huntington's Disease and occupational diseases, and a greater number would agree to counsel patients pursuing prenatal testing for sex selection. A majority of M.S. counselors would disclose an XY karyotype to a phenotypically female patient. M.S. counselors reasoned that respect for patient autonomy and patient confidentiality justified their decisions in many cases. The importance of these principles is discussed and questioned.     

The Effects of Social Capital and Neighborhood Characteristics on Intimate Partner Violence: A Consideration of Social Resources and Risks

Intimate partner violence (IPV) is a growing public health problem, and gaps exist in knowledge with respect to appropriate prevention and treatment strategies. A growing body of research evidence suggests that beyond individual factors (e.g., socio‐economic status, psychological processes, substance abuse problems), neighborhood characteristics, such as neighborhood economic disadvantage, high crime rates, high unemployment and social disorder, are associated with increased risk for IPV. However, existing research in this area has focused primarily on risk factors inherent in neighborhoods, and has failed to adequately examine resources within social networks and neighborhoods that may buffer or prevent the occurrence of IPV. This study examines the effects of neighborhood characteristics, such as economic disadvantage and disorder, and individual and neighborhood resources, such as social capital, on IPV among a representative sample of 2412 residents of Toronto, Ontario, Canada. Using a population based sample of 2412 randomly selected Toronto adults with comprehensive neighborhood level data on a broad set of characteristics, we conducted multi‐level modeling to examine the effects of individual‐ and neighborhood‐level effects on IPV outcomes. We also examined protective factors through a comprehensive operationalization of the concept of social capital, involving neighborhood collective efficacy, community group participation, social network structure and social support. Findings show that residents who were involved in one or more community groups in the last 12 months and had high perceived neighborhood problems were more likely to have experienced physical IPV. Residents who had high perceived social support and low perceived neighborhood problems were less likely to experience non‐physical IPV. These relationships did not differ by neighborhood income or gender. Findings suggest interesting contextual effects of social capital on IPV. Consistent with previous research, higher levels of perceived neighborhood problems can reflect disadvantaged environments that are more challenged in promoting health and regulating disorder, and can create stressors in which IPV is more likely to occur. Such analyses will be helpful to further understanding of the complex, multi‐level pathways related to IPV and to inform the development of effective programs and policies with which to address and prevent this serious public health issue.     

Associative retrieval processes in the human medial temporal lobe: hippocampal retrieval success and CA1 mismatch detection

Hippocampal subfields CA(3) and CA(1) are hypothesized to differentially support the generation of associative predictions and the detection of associative mismatches, respectively. Using high-resolution functional MRI, we examined hippocampal subfield activation during associative retrieval and during subsequent comparisons of memory to matching or mismatching decision probes. Activity in the dentate gyrus/CA(2/3), CA(1), and other medial temporal lobe subregions tracked associative retrieval success, whereas activity in CA(1) and the perirhinal cortex tracked the presence of associative mismatches. These data support the hypothesis that CA(1) acts as a "comparator," detecting when memory for the past and sensory input in the present diverge.     

Training educators to implement functional analyses

The present study examined the use of an instructional workshop for training educators to conduct functional analyses. Results indicated that 2 of 3 participants met the accuracy criterion following group training, whereas 1 participant required direct verbal feedback. During generalization probes, one participant accurately conducted sessions with a student in her classroom.     

Rehabilitation and recovery: Bulgaria's muslim communities

The Mountains of Serbia: Travels Through Inland Yugoslavia by Anne Kindersley, John Murray, 1976, 286 pp., £6.95.

An Early Soviet Saint ‐The Life of Father Zachariah Anonymous. Translated by Jane Ellis. Mowbrays (Keston Books No. 6), 1976, 111 pp., £4.25.

The Religion of the Russian People by Pierre Pascal. Translated by Rowan Williams. Mowbrays, London and Oxford, 1976, 130 pp. + ix, £2.95.     

Book reviews

Islam and Politics in Central Asia by M. Haghayeghi. London: Macmillan, 1995, 264 pp.

Empire's Edge: Travels in South‐Eastern Europe, Turkey and Central Asia by Scott Malcomson. Boston USA and London: Faber and Faber, 1994, 256 pp. Paperback, £8.99.

The Resurgence of Central Asia: Islam or Nationalism by Ahmed Rashid. London and New Jersey: Zed Books, 1994, x+278 pp. Hardback, £36.95, $59.95; Paperback, £14.95, $25.00.

Pride of Small Nations: The Caucasus and Post‐Soviet Disorder by Suzanne Golden‐berg. London and New Jersey: Zed Books, 1994. xvi+233 pp. Hardback, £36.95, $55.00; Paperback, £14.95, $22.50.

The North Caucasus Barrier: the Russian Advance towards the Muslim World edited by M. Bennigsen Broxup. London: Hurst, 1992, xvii+252 pp. Hardback. Paperback, 1996, £14.95.     

Faith and Mental Health in an Oncology Population

This study compares faith attitudes versus behaviors for their relationship to mental health in current cancer patients and survivors. This cross-sectional survey of ambulatory patients included Hodge’s intrinsic religious motivation scale, Benson & Spilka’s concept of God scale, frequency of prayer, and the mental health subscale of the MOS SF-36. One hundred and fifty-eighty patients, mostly women with breast cancer, completed questionnaires (92% return). Mental health was positively related to a concept of a loving God (P < .001) and negatively related to the concept of a stern God (P < .002). Mental health was unrelated to goal of treatment (cure vs. chemotherapy/palliation), frequency of prayer, intrinsic faith motivation, or physical pain. Viewing God as loving was strongly related to better mental health, even in the presence of a poor prognosis or pain.     

Documents

The Great Revival: the Russian Church under German Occupation by W. Alexeev and T. G. Stavrou, Minneapolis, 1976, xvi+229 pp. No price.

The Religious World ol Russian Culture. Essays in Honour of Georges Florovsky, Vol. 11 Russia and Orthodoxy edited by Andrew Blane, Mouton, The Hague and Paris, 1975, 359 pp. No price.

The Russian Jew under Tsars and Soviets by Salo W. Baron, Macmillan, New York, 1976, $14.96.

The Jews in Russia ‐ their History in Maps and Thotographs by Martin Gilbert, National Council of Soviet Jewry, 78 pp., 8op.

The Baptist Church: Illusions and Reality (Baptizm: illyuzii i realnost) by G. S. Lyalina, “Politizdat”, Moscow, 1977, 175 pp., 37 kopecks.

Questions of Scientific Atheism (Voprosy Nauchnogo Ateizma) No. 17, “Mysl”, Moscow, 1975, 399 pp.