Genetic Counseling Assistants: an Integral Piece of the Evolving Genetic Counseling Service Delivery Model

This study explores the potential impact of the genetic counseling assistant (GCA) position on the efficiency of the genetic counseling field, evaluates attitudes regarding expansion of the genetic counseling field to include the GCA, and presents data on GCA endeavors and GCA job tasks as reported by GCAs, certified genetic counselors (CGCs), and program directors (PDs). Data on GCA roles and attitudes toward different aspects of the GCA position were collected via surveys of CGCs who have worked with GCAs, PDs who have and have not had experience with GCAs in their programs, and GCAs. We analyzed responses from 63 individuals: 27 PDs, 22 CGCs, and 14 GCAs. GCAs’ impact on efficiency was calculated via internal analysis of genetic patient volume per genetic counselor within the University of Texas Southwestern (UTSW) patient database prior to, and since the addition of, a GCA to the practice. The response rates for PDs, CGCs, and GCAs were 27 %, 79 %, and 61 %, respectively. Every CGC stated the GCA increased their efficiency. CGCs with a GCA reported a 60 % average increase in patient volume. This figure was congruent with internal data from the UTSW cancer genetics program (58.5 % increase). Appropriate responsibilities for GCAs as reported by CGCs and PDs (>90 %) include: data entry, shipping tests, administrative tasks, research, and ordering supplies. Regarding GCAs delivering test results, there was response variation whether this should be a job duty: 42 % of CGCs agreed to GCAs delivering negative results to patients, compared to 22 % of program directors. Twenty-two percent of PDs expressed concern about the job title “Genetic Counseling Assistant.” Ninety percent of CGCs felt that GCA was a career path to becoming a CGC, compared to 42 % of PDs. Eighty-three percent of GCAs who decided to apply to CGC graduate programs were accepted. We conclude the addition of a GCA to a genetic counseling practice contributes to increased efficiency and is one way to expand the reach of the profession.     

Leisure and health: why is leisure therapeutic?

The purpose of this article is to examine the empirical evidence and describe theoretical perspectives that address under what conditions and why leisure can be therapeutic and contribute to health and well-being. This review of the literature provides empirical evidence that leisure can contribute to physical, social, emotional and cognitive health through prevention, coping (adjustment, remediation, diversion), and transcendence. After examining this empirical evidence, the article addresses why leisure is therapeutic and concludes by presenting two concepts useful to practitioners who desire to provide leisure guidance to help people avoid risk and maximise the therapeutic possibilities of leisure.     

Gender Symmetry and Asymmetry in Violent Relationships: Patterns of Mutuality Among Racially Diverse Women

Three patterns of mutual intimate partner violence (IPV) are proposed, based on frequency and severity: Male primary perpetrator (MPP), female primary perpetrator (FPP), and symmetrical (SYM). Patterns and effects of ethnicity were examined with 445 African American, Euro-American, and Mexican American low-income women experiencing mutual IPV. More relationships were classified as MPP (54%) than SYM (35%) or FPP (11%). Comparing women's and men's perpetration of several types of IPV (e.g., threats, severe physical) indicated MPP-pattern women experienced all IPV types more often and were more likely to sustain injury than their male partners. Fewer gender differences were found in the FPP pattern. Racial/ethnic groups were more similar than different; previously reported differences may be explained by variation in socioeconomic status. The larger part of the study was funded by grant R49/CCR610508 from the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention, awarded to the third author. This article was also made possible by grant 2001-WT-BX-0504 from the National Institute of Justice awarded to the first and third authors. These agencies are not responsible for the results. Portions of this paper were presented by the first and third authors at the International Family Violence Conference in Portsmouth, NH, July, 2003.     

Exploring Indigenous Mental Health Practices: The Roles of Healers and Helpers in Promoting Well‐Being in People of Color

The authors present an extensive literature review and discuss the cultural relevance of indigenous healing practices in promoting psychological, physical, and spiritual well‐being in people of color. Suggestions are also presented for ways counselors might work with indigenous healing resources to promote the well‐being of people of color.     

Heart Rate Reactivity in HAD and LAD Rats during Pavlovian Fear Conditioning

Recently, we reported that High-Alcohol-Drinking (HAD) rats exhibited selective deficits in active avoidance learning under alcohol-naive conditions, and that administration of moderate doses of alcohol (0.5 and 1.0 g/kg) facilitated learning in these rats (Blankenship et al., 2000; Rorick et al., 2003b). We hypothesized that the deficits resulted from excessive fear in the aversive learning context and that the anxiolytic properties of alcohol may have contributed to the improved learning that was observed after alcohol administration. This hypothesis was supported by a recent study in which prolonged freezing in HAD rats was seen after a classical fear conditioning procedure (Rorick et al., 2003a). To provide additional evidence that HAD rats indeed exhibit behaviors consistent with the expression of increased fear in aversive learning contexts, we employed a Pavlovian fear conditioning task to measure heart rate in HAD and Low-Alcohol-Drinking (LAD) rats. In this study, HAD (HAD-1 and HAD-2) and LAD (LAD-1 and LAD-2) rats were assigned to one of three pre-exposure conditions: Context Only, Context/Tone, or Sequential (Context Only followed by Context/Tone) Pre-Exposure. Following pre-exposure, fear conditioning acquisition and extinction procedures were identical for all groups. Results indicated that although no baseline differences were observed between HAD and LAD rats, HAD rats receiving Context-Only pre-exposure exhibited excessive heart rate reactivity to the tone conditional stimulus during fear conditioning acquisition, compared to LAD rats receiving the same pre-exposure conditions. These findings support the hypothesis that HAD rats exhibit behaviors consistent with increased fear in aversive learning contexts, as measured by autonomic conditioning.     

Visual judgments of kinship: an alternative perspective

Following other researchers, we investigated the premise that visual judgment of kinship might be modelled as a signal-detection task, strictly related to similar facial features. We measured subjects' response times to face-pair stimuli while they performed visual judgments of kinship, similarity, or dissimilarity, and examined some priming effects involved. Our results show that kinship judgment takes longer on average than either similarity or dissimilarity judgment-which is compatible with existing models, yet might also suggest that kinship judgments are of a more complex character. In our priming study we observed selective suppression/enhancement of the efficacy of dissimilarity judgments whenever they followed similarity and kinship judgments. This finding confounds the notion, inherent in previous models, of resemblance cues signalling for kinship, since similarity and dissimilarity cannot be considered just as opposite concepts, and observed priming effects need to be explicitly modelled, including dissimilarity cues. To model kinship judgments across faces that are perceived as dissimilar, a new framework may be required, perhaps accepting the perspective of a task-driven use of the visual cues, modulated by experience and cultural conditioning.     

Photograph‐induced memory errors: When photographs make people claim they have done things they have not

Photographs can serve as valuable memory aids but can also contribute to memory inaccuracies. The present studies examine whether photographs can make people claim they performed an action that they did not in fact perform. Participants performed and imagined performing various actions (e.g. break the pencil, open the envelope) and later viewed photographs of actions in their completed states or read the names of the actions without an accompanying photograph. Results showed that participants were more likely to falsely claim to have performed actions that they did not actually perform after having seen a photograph of the completed action. When items were not imagined at all, such photograph‐induced memory errors increased with the number of presentations of the photographs. Actions falsely claimed as performed were rated with high confidence. These findings suggest that photographs can mislead people as to what they did or did not do. Copyright © 2009 John Wiley & Sons, Ltd.     

Workplace Branding: Leveraging Human Resources Management Practices for Competitive Advantage Through “Best Employer” Surveys

Workplace branding has generated more attention in the practitioner community than academia. A contributing factor for the sparse academic research is the fact that the theoretical foundation of workplace branding has not been fully developed. In addressing this need, this article outlines how workplace branding uses a similar approach used in marketing a product or service to build an effective workplace brand. An increasing potent form of workplace branding lies in the new popular annual “best employer” surveys. In reviewing various “best employer” surveys, we identify eight common themes in terms of human resources best practices associated with outcomes ranging from high levels of retention to increased rates of growth in sales and profit. Finally, this article presents several research issues and questions that should be addressed in the future.