Views of Genetics Health Professionals on the Return of Genomic Results

As exome and whole genome sequencing become clinically available, the potential to receive a large number of clinically relevant but incidental results is a significant challenge in the provision of genomic counseling. We conducted three focus groups of a total of 35 individuals who were members of ASHG and/or NSGC, assessing views towards the return of genomic results. Participants stressed that patient autonomy was primary. There was consensus that a mechanism to return results to the healthcare provider, rather than patient, and to streamline integration into the electronic health record would ensure these results had the maximal impact on patient management. All three focus groups agreed that pharmacogenomic results were reasonable to return and that they were not felt to be stigmatizing. With regard to the return of medically relevant results, there was much debate. Participants had difficulty in consistently assigning specific diseases to ‘bins’ that were considered obligatory versus optional for disclosure. Consensus was reached regarding the importance of informed consent and pretest counseling visits to clarify what the return of results process would entail. Evidence based professional guidelines should continue to be developed and regularly revised to assist in consistently and appropriately providing genomic results to patients.     

Doing and Redoing Emphasized Femininity: How Women Use Emotion Work to Manage Competing Expectations in College Hookup Culture

Sex Roles - Emphasized femininity plays a key role in maintaining gender inequality. Yet, classic conceptualizations of emphasized femininity render it static and inflexible, and obscure...     

The moderating role of pessimism in the association between retrospective relational peer victimization,interpersonal risk factors,and suicide ideation

Peer victimization (PV) is a serious concern for youth and is associated with subsequent suicide ideation in young adulthood. The interpersonal theory of suicide may provide a framework for understanding suicide ideation in this population. Specifically, thwarted belongingness (TB) and perceived burdensomeness (PB) have been significantly associated with suicide ideation among young adults with a history of peer victimization. Additionally, the personality trait of pessimism is associated with elevated suicide ideation. Thus, this study tested the association between self-reported frequency of retrospective relational (i.e., verbal and indirect) PV in primary and secondary school, thwarted interpersonal needs (TB and PB), and current suicide ideation, as well as how these relations may vary based on current pessimism. Participants were 330 undergraduate students. Nonparametric bootstrap moderated mediation procedures were used to test hypotheses. Results indicated significant indirect effects of frequency of retrospective relational PV and suicide ideation through PB and TB. Contrary to predictions, results did not indicate significant moderated mediation; however, the association between PB and suicide ideation was stronger at lower pessimism levels. We also provide supplemental analysis with optimism as the moderator. These findings suggest that clinicians may consider targeting TB, PB, as well as pessimism and optimism among those with a history of relational PV when assessing and intervening on current suicide ideation. Implications, limitations, and future directions are further discussed.     

Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder

A diagnosis of Fetal Alcohol Spectrum Disorder (FASD) ascribes cause to developmental disability; however, there are logical issues in causation with ethical implications. This article focuses on the use of fallacious logic (affirming the consequent) in FASD, focusing on the Canadian Guidelines for diagnosis, and knowledge translation issues from science to practice. The clinician’s logical fallacy is an ethical issue of veracity in the clinician–patient relationship; this then leads to issues of nonmaleficence, because the diagnosis in turn blames the mother for her child’s difficulties. Suggestions for revised diagnostic practices that avoid allusions to causation and responsibility are discussed.     

The Effects of Using a Conditioned Stimulus to Cue DRO Schedules

A reversal design was used to examine the effects of a differential reinforcement of other behavior (DRO) procedure and the presence of a stimulus (i.e., a bracelet), conditioned via discrimination training, on reducing socially maintained non‐contextual vocalizations in an adolescent girl with autism. Initially, a functional analysis determined that non‐contextual vocalizations were maintained by social attention. Then, discrimination training was used to establish the presence of the bracelet as a discriminative stimulus for the absence of vocalizations. Specifically, when the bracelet was on, non‐contextual vocalizations were interrupted, and edible reinforcement was provided for the absence of vocalizations. When the bracelet was off, vocalizations were not interrupted and the teacher provided social attention to the participant (i.e., reciprocated conversation with the participant about the topic). During intervention, a DRO procedure was used. The participant was presented with the bracelet, a timer set for a specified interval, and the instruction to work quietly. If vocalizations did not occur for the entire duration of the interval, the bracelet was removed and the learner was given the opportunity to engage in vocalizations. The DRO interval was systematically increased throughout the intervention. Results are discussed in terms of discrimination training as an effective addition to differential reinforcement procedure. Copyright © 2015 John Wiley & Sons, Ltd.