Reproductive Endocrinologists’ Utilization of Genetic Counselors for Oncofertility and Preimplantation Genetic Diagnosis (PGD) Treatment of <Emphasis Type="Italic">BRCA1/2</Emphasis> Mutation Carriers

Genetic counselors believe fertility preservation and preimplantation genetic diagnosis (PGD) discussions to be a part of their role when counseling BRCA1/2 mutation-positive patients. This study is the first to explore reproductive endocrinologists’ (REI) practices and attitudes regarding involvement of genetic counselors in the care of BRCA1/2 mutation carriers seeking fertility preservation and PGD. A survey was mailed to 1000 REIs from Reproductive Endocrinology & Infertility (SREI), an American Society for Reproductive Medicine (ASRM) affiliate group. A 14.5 % response rate was achieved; data was analyzed using SPSS software. The majority of participating REIs were found to recommend genetic counseling to cancer patients considering fertility preservation (82 %) and consult with a genetic counselor regarding PGD for hereditary cancer syndromes (92 %). Additionally, REIs consult genetic counselors regarding PGD patient counseling (88 %), genetic testing (78 %), and general genetics questions (66 %). Two areas genetic counselors may further aid REIs are: elicitation of family history, which is useful to determine fertility preservation and PGD intervention timing (32 % of REIs utilize a cancer family history to determine intervention timing); and, interpretation of variants of uncertain significance (VOUS) as cancer panel genetic testing becomes more common (36 % of REIs are unfamiliar with VOUS). Given our findings, the Oncofertility Consortium® created an online resource for genetic counselors focused on fertility preservation education and communication strategies.     

An examination of project aware: The effects on children's attitudes toward themselves,others, and school

The purpose of this study was to determine the impact of Project AWARE on children's attitudes about themselves, peers, teachers, principals, and school. Data were collected on children's sex, race, stanine score on achievement tests, and pretest performance in order to determine the differential effects of the treatment. Eighty students were included in the study, 40 in the experimental group and 40 in the control group. All were from fourth and fifth grade classrooms. The major findings were that children involved in the program achieved greater personal adjustment and accepted responsibility for negative outcomes in social situations (internal control). White children scored higher in personal and social adjustment. Black children evidenced more positive attitudes toward school. Girls scored significantly higher than boys on the social adjustment subtests and attitudes toward peers. Black children in the control group had less positive attitudes toward teachers than white children in the experimental group     

Criminal victimization among primary care medical patients: prevalence, incidence, and physician usage

The study addressed the extent to which primary care physicians encounter crime victims in their practices. Crime prevalence and incidence rates were calculated from responses to a mailed survey of 2,291 women medical patients (45% response rate). The prevalence of crime victimization was 57%. The 12 month incidence of violent crime was 118 per 1,000 patients. Most notable was the finding that rape incidence was approximately 15 times higher than National Crime Survey estimates for women, even after adjustment for telescoping. Post-crime physician usage was documented by medical chart review. Although few crime victims required hospitalization for injuries, virtually all made out-patient physician visits in each of two post-crime years. The findings suggest that physicians are an important potential source of assistance for traumatized crime victims.     

Examining Problems and Assumptions: An Update on Criticisms of Open Theism

Abstract : Open theism, a form of relational theology, has generated a host of criticisms. I examine some of the recent criticisms by analyzing several that center around biblical, doctrinal and philosophical problems. I show how many criticisms miss the mark by failing to recognize and address the underlying assumptions held by open theists.     

The demands and capacities model: Response to siegel

Responses to the recent critical comments of Gerald Siegel to the demands and capacities model are given. A brief history of the model's development is followed by direct explanations of its empirical support and logical development. It appears that Dr. Siegel may have referred only to one of our publications on the model. His concern about difficulties in measuring capacities is also addressed. Finally, the logic of the model is explicated and a misunderstanding regarding the use of direct therapy is clarified.