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.     

A Typology of Youth Participation and Empowerment for Child and Adolescent Health Promotion

Research suggests that increasing egalitarian relations between young people and adults is optimal for healthy development; however, the empirical assessment of shared control in youth–adult partnerships is emerging, and the field still requires careful observation, identification, categorization and labeling. Thus, our objective is to offer a conceptual typology that identifies degrees of youth–adult participation while considering the development potential within each type. We use an empowerment framework, rooted in evidence-based findings, to identify five types of youth participation: (1) Vessel, (2) Symbolic, (3) Pluralistic, (4) Independent and (5) Autonomous. The typology is constructed as a heuristic device to provide researchers, practitioners and policy-makers with a common language for articulating degrees of youth participation for optimal child and adolescent health promotion.     

Team capability beliefs over time: Distinguishing between team potency,team outcome efficacy,and team process efficacy

Teams that have positive beliefs about their capability tend to perform more effectively. However, relatively little is known about the nature and change of different types of team capability beliefs. Team potency and team efficacy are two approaches to understanding team capability beliefs, but few studies have considered these beliefs simultaneously. We investigate their distinctiveness and relative predictive power. Additionally, we propose two types of team efficacy: team outcome efficacy and team process efficacy. In two longitudinal samples of executive MBA study teams (sample 1, N=213 individuals in 41 teams; sample 2, N=360 individuals in 89 teams), we showed that team potency, team outcome efficacy, and team process efficacy are factorially distinct and measure invariant at four time points over 7 months (except for high levels of team outcome efficacy for which factorial invariance emerged). We also show differential predictive validity. Team outcome efficacy was the strongest predictor of objective team performance, whereas team process efficacy was the best predictor of citizenship behaviours. Team potency predicted both outcomes, albeit more weakly. Collectively, the findings show the value of a more fine‐grained approach to teams' capability beliefs, including a new validated measure of team process efficacy.     

Franklin,Holmes, and the Epistemology of Computer Simulation

Allan Franklin has identified a number of strategies that scientists use to build confidence in experimental results. This paper shows that Franklin’s strategies have direct analogues in the context of computer simulation and then suggests that one of his strategies—the so‐called ‘Sherlock Holmes’ strategy—deserves a privileged place within the epistemologies of experiment and simulation. In particular, it is argued that while the successful application of even several of Franklin’s other strategies (or their analogues in simulation) may not be sufficient for justified belief in results, the successful application of a slightly elaborated version of the Sherlock Holmes strategy is sufficient.     

The Effect of Sport Commentator Framing on Viewer Attitudes

An experimental analysis was conducted to determine the effects of involvement, commentator framing, and gender on viewer attitudes toward female athletes. The sample was comprised of 112 students at a mid-western university in the United States. Hypotheses and research questions were tested through a 2 × 3 multivariate analysis of covariance (MANCOVA). Results indicated the overall MANCOVA was significant. Involvement was positively related to viewer attitudes’ towards the dependent variables and explained 27.8% of the variance. Gender explained 39.3% of the variance in attitudes as male viewers had significantly lower mean scores on all dependent variables. Male viewers had significantly lower scores than female viewers in the positive framing condition; the interaction explained 8% of the variance in viewers’ perceptions of respectability of female athletes.     

The Skin as Seen: Thinking Through Racialized Subjectivities and Pedagogy with Levinas

Studies in Philosophy and Education - From a Levinasian perspective, the interaction between two people is an ethical encounter, a face-to-face interaction that calls the subject into question and...     

Single case research results as clinical outcomes

The movement toward evidence-based treatments, interventions, or practices pressures single case research (SCR) to use statistical summaries which have broad credibility. These summaries also need to be easily understood and useful in schools and clinics. To date the effect size families, “proportion of variance” (R², Eta²) and “standardized mean difference” (Cohen's d, Hedges' g) have little popularity in SCR. This paper demonstrates a set of alternative Clinical Outcome indices widely used in the field of medicine: Risk Difference, Relative Risk, Relative Risk Improvement, and Odds Ratio, which compare patients in treatment versus control conditions. Translated to SCR designs, the baseline phase becomes the control condition, the intervention phase becomes the treatment condition, and improvement is defined as non-overlapping data between phases. The positive attributes of Clinical Outcomes are demonstrated: (a) easily interpretable results, (b) close relationship with concept of non-overlapping data, (c) minimal data assumptions, (d) minimal statistical expertise required, (e) multiple contrasts possible for diagnostic understanding, (f) exact confidence intervals for results, and (g) close relationship to Pearson R effect size family.     

Computing the uncomputable; or,The discrete charm of second-order simulacra

We examine a case in which non-computable behavior in a model is revealed by computer simulation. This is possible due to differing notions of computability for sets in a continuous space. The argument originally given for the validity of the simulation involves a simpler simulation of the simulation, still further simulations thereof, and a universality conjecture. There are difficulties with that argument, but there are other, heuristic arguments supporting the qualitative results. It is urged, using this example, that absolute validation, while highly desirable, is overvalued. Simulations also provide valuable insights that we cannot yet (if ever) prove.     

Reduced misinformation effects following saccadic bilateral eye movements

The effects of saccadic bilateral (horizontal) eye movements on memory for a visual event narrative were investigated. In the study phase, participants were exposed to a set of pictures accompanied by a verbal commentary describing the events depicted in the pictures. Next, the participants were asked either misleading or control questions about the depicted event and were then asked to engage in 30s of bilateral vs. vertical vs. no eye movements. Finally, recognition memory was tested using the remember-know procedure. It was found that bilateral eye movements increased true memory for the event, increased recollection, and decreased the magnitude of the misinformation effect. The findings are discussed in terms of source monitoring, dual-process theories of memory and the potential neural foundations of such effects.