A Rapid Systematic Review of Outcomes Studies in Genetic Counseling

As healthcare reimbursement is increasingly tied to value-of-service, it is critical for the genetic counselor (GC) profession to demonstrate the value added by GCs through outcomes research. We conducted a rapid systematic literature review to identify outcomes of genetic counseling. Web of Science (including PubMed) and CINAHL databases were systematically searched to identify articles meeting the following criteria: 1) measures were assessed before and after genetic counseling (pre-post design) or comparisons were made between a GC group vs. a non-GC group (comparative cohort design); 2) genetic counseling outcomes could be assessed independently of genetic testing outcomes, and 3) genetic counseling was conducted by masters-level genetic counselors, or non-physician providers. Twenty-three papers met the inclusion criteria. The majority of studies were in the cancer genetic setting and the most commonly measured outcomes included knowledge, anxiety or distress, satisfaction, perceived risk, genetic testing (intentions or receipt), health behaviors, and decisional conflict. Results suggest that genetic counseling can lead to increased knowledge, perceived personal control, positive health behaviors, and improved risk perception accuracy as well as decreases in anxiety, cancer-related worry, and decisional conflict. However, further studies are needed to evaluate a wider array of outcomes in more diverse genetic counseling settings.     

Effects of reducing attentional demands on performance of reading comprehension tests by third graders

The researchers examined the effects of reducing attentional demands on reading comprehension test scores. Third grade students (N=939) completed two forms (T & S) of the Stanford 9 Reading Comprehension Test (54 items, 50 min.) in the spring of 1999. Form T (state-mandated) was administered following standardized procedures in one session. Form S (alternate) was administered in multiple, divided-time sessions, that is, the total test time and items were divided in halves and thirds per session to lessen attentional demands. A repeated-measure analysis of variance yielded significant effects for average and low readers. A resource match explanation and a metacognitive explanation are offered for the results, and educational implications are discussed.     

Mind the gap: interhemispheric communication about emotional faces

This study tested the hypothesis that interhemispheric communication about emotional stimuli is influenced by situational factors that alter emotional relevance. Under evaluative or nonevaluative conditions, participants matched angry and happy faces within a single visual field or across opposite visual fields. An overall across-field advantage (AFA) reflected the benefit of sharing information between the hemispheres. The AFA was greater for angry than for happy faces in the evaluation condition but did not differ for angry and happy faces in the no-evaluation condition. Examination of individual differences indicated that high trait evaluation levels of worry were associated with poorer interhemispheric communication of angry faces, supporting a threat-avoidance conception of worry. Thus, both situational factors and individual differences affected interhemispheric communication about emotional faces.     

Alcohol use among older adults

Alcohol use problems among older adults have been called the "invisible epidemic." As the population of older adults continues to grow, there is an increased need to reexamine alcohol use in this population. The authors provide an overview on alcohol use in the over-60 age group. The main areas of focus included research on the prevalence of drinking in that population, as well as comments on the best practices in assessment and psychological treatment. Several screening assessments have been recommended for use with older adults, such as the CAGE questionnaire, Michigan Alcohol Screening Test-Geriatric version, Alcohol-Related Problems Survey, and the Alcohol Use Disorders Identification Test. The authors note age-appropriate psychological treatment interventions that include brief interventions, family interventions, motivational counseling, and cognitive behavioral therapies. Barriers to assessment and treatment are also discussed.     

Comparative assessment of handedness for a coordinated bimanual task in chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla) and orangutans (Pongo pygmaeus)

Hand preferences for a coordinated bimanual task were assessed in a sample of 31 captive gorillas (Gorilla gorilla) and 19 captive orangutans (Pongo pygmaeus) and were compared with chimpanzee (Pan troglodytes) hand preferences in subjects that were matched on the basis of age, sex, and rearing history. The task required that the apes remove food from the inside edges of a symmetrical polyvinyl chloride pipe presented to them in their home cages. The results indicate significant species differences with chimpanzees showing population-level right-handedness and orangutans showing population-level left-handedness. The gorillas showed a nonsignificant trend toward right-handedness. The results are discussed in terms of possible ecological or biomechanical factors that may influence hand preferences in different ape species.     

WHEN COWORKERS AND MANAGERS QUIT: THE EFFECTS OF TURNOVER AND SHARED VALUES ON PERFORMANCE

We examined the relationship between work unit, direct management, and overall management turnover and performance improvement following an intervention in fifty work units in multiple organizations in eight countries. Direct management turnover was negatively related to performance improvement, while work unit and overall management turnover were not. We also investigated shared values as a moderator of the turnover-performance relationship and found that high shared values buffered the negative effect of overall management turnover on performance improvement. The results are noteworthy, as they point to the importance of examining turnover at different organizational levels and identifying moderators of the turnover-performance relationship.

The effects of a physical activity and nutrition intervention on body dissatisfaction, drive for thinness, and weight concerns in pre-adolescents

The primary aim was to examine the effects of a physical activity and nutrition intervention on Body Dissatisfaction, Drive for Thinness, and Weight Concerns in pre-adolescents. Eighty-four 10–12 years old were studied as part of a larger trial of a family-based physical activity and nutrition intervention. Forty-nine children participated in the 8-week intervention (35 in control group) and completed Body Dissatisfaction, Drive for Thinness, and Weight Concerns measures at baseline and post-test. Participants in both groups showed positive but non-significant changes in body image and Drive for Thinness following the trial, but there were no significant between group differences. This was the first study to examine the effects of a physical activity and nutrition intervention on body image and related variables in pre-adolescents. Body Dissatisfaction, Drive for Thinness, and Weight Concerns were not positively or negatively influenced by the intervention.     

Domain-specific identity, epistemic regulation, and intellectual ability as predictors of belief-biased reasoning: a dual-process perspective

To explore the hypothesis that domain-specific identity development predicts reasoning biases, adolescents and young adults completed measures of domain-general and domain-specific identity, epistemic regulation, and intellectual ability and evaluated arguments that either supported or threatened their occupational goals. Biases were defined as the use of sophisticated reasoning to reject goal-threatening arguments and the use of cursory reasoning to accept goal-supportive arguments. Across two measures of bias, hierarchical regression analyses showed that domain-specific vocational identity and epistemic regulation best predicted reasoning biases. Neither age nor intellectual ability predicted significant variance in biases after vocational identity and epistemic regulation scores were entered into the regression equations. The results support the thesis that biases in specific domains can be explained both by domain-specific personality attributes and by domain-general metacognitive dispositions to monitor reasoning and decontextualize problem structure from superficial contents. A dual-process framework is proposed to explain the relationships among identity, epistemic regulation, age, intellectual ability, and reasoning biases.     

Maternal relationship instability and the school behavior of children from disadvantaged families

This longitudinal study examined the relation between the instability of maternal intimate relationships and the school behavior of 3rd-grade children from economically disadvantaged families. After ecological correlates were controlled, chronic relationship instability predicted externalizing behavior for boys and girls and internalizing behavior for girls, but not academic competence. In addition, past and recent instability had independent effects: Recent instability moderated the relation for past instability, and child adjustment in highly unstable families varied with verbal ability and aspects of the family ecology. The theoretical implications concern conceptualizations of the diverse and dynamic nature of family arrangements experienced by disadvantaged children.