Time Costs for Genetic Counseling in Preconception Carrier Screening with Genome Sequencing

Advances in technology and the promise of personalized health care are driving greater use of genome sequencing (GS) for a variety of clinical scenarios. As health systems consider adopting GS, they need to understand the impact of GS on the organization and cost of care. While research has documented a dramatic decrease in the cost of sequencing and interpreting GS, few studies have examined how GS impacts genetic counseling workloads. This study examined the time needed to provide genetic counseling for GS in the context of preconception carrier screening. Genetic counselors prospectively reported on the time spent in the results disclosure process with 107 study participants who were part of the NextGen study. We found that the median time for results disclosure was 64 min (ranged from 5 to 229 min). Preparation work was the most time-consuming activity. Qualitative data from journal entries, debrief interviews with genetic counselors, and detailed case conference notes provided information on factors influencing time for results disclosure and implications for practice. Results suggest that expanded carrier screening could require significant increases in genetic counseling time, unless we are able to generate new resources to reduce preparation work or develop other strategies such as the creation of new models to deliver this type of service.     

An Intersectional Modeling of Risk for Nonsuicidal Self-Injury among LGBTQ Adolescents

Journal of Child and Family Studies - Non-suicidal self-injury (NSSI) is described as the intentional destruction of one’s own bodily tissue without lethal intent and is a common behavior...     

The WHO/START Study: Promoting Suicide Prevention for a Diverse Range of Cultural Contexts

The WHO/Start Study is introduced and described in its four main components. The study originated as a response to growing concerns about trends of suicide, the prevalence of which in the Western Pacific Region of the World Health Organization is the highest among the six regions of the WHO. So far, nineteen centers have joined the study. This ambitious project is expected to provide important transcultural perspectives on both fatal and nonfatal suicidal behaviors, together with increased awareness for these phenomena and the growth of culture‐sensitive prevention programs.     

The role of attachment in couple relationships described as social systems

The role that attachment plays in adult relationships seems insufficiently elucidated. Of the components of early attachment, proximity seeking and security are of prime importance. Of these two, proximity seeking is also important at the outset of adult relationships. The form of security that is characteristic of adult couple relationships, however, is different from attachment security. Working models of attachment relations also play an important role in new adult relationships. Attachment behaviour may also play a role when, under severe stress, adult coping falls short. In our way of thinking however, the functioning of adult relationships cannot be described in terms of a persistence of attachment qualities but has to be described and explained by the theory of social systems.