Genetic Testing Integration Panels (GTIPs): A Novel Approach for Considering Integration of Direct-To-Consumer and Other New Genetic Tests into Patient Care

There has been a dramatic increase in the number of genetic tests available but few tests have practice guidelines. In addition, many tests have become available outside of clinical settings through direct-to-consumer (DTC) companies and several offer tests not considered standard of care. To address several practical challenges associated with the rapid introduction of clinical and DTC genetic tests, we propose that genetic counselors and geneticists organize expert panels in their institutions to discuss the integration of new tests into patient care. We propose the establishment of Genetic Testing Integration Panels (GTIPs) to bring together local experts in medical genetics, genetic counseling, bioethics and law, health communication and clinical laboratory genetics. We describe key features of this approach and consider some of the potential advantages and limitations of using a GTIP to address the many clinical challenges raised by rapidly emerging clinical and DTC genetic tests.     

An item response theory analysis of the Problem Gambling Severity Index

Increases in the availability of gambling heighten the need for a short screening measure of problem gambling. The Problem Gambling Severity Index (PGSI) is a brief measure that allows for the assessment of characteristics of gambling behavior and severity and its consequences. The authors evaluate the psychometric properties of the PGSI using item response theory methods in a representative sample of the urban adult population in South Africa (N = 3,000). The PGSI items were evaluated for differential item functioning (DIF) due to language translation. DIF was not detected. The PGSI was found to be unidimensional, and use of the nominal categories model provided additional information at higher values of the underlying construct relative to a simpler binary model. This study contributes to the growing literature supporting the PGSI as the screen of choice for assessing gambling problems in the general population.     

Comparison of upright and flipped spoon presentations to guide treatment of food refusal

The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.     

The relationship between the youth psychopathic traits inventory and psychopathology in a U.S. community sample of male youth

The Youth Psychopathic Traits Inventory (YPI) is a self-report measure of juvenile psychopathic traits. Validity data for this measure are limited, especially for nonreferred samples. This report investigated the concurrent validity of the YPI by assessing 171 nonreferred male youth (M age = 12.96 years) with a battery of self-, parent-, and peer-report measures including the Child Behavior Checklist (CBCL), the Reactive-Proactive Aggression Questionnaire (RPQ), the Antisocial Process Screening Device (APSD), and a peer-sociometric measure of aggression. Results confirmed the expected correlations between the YPI and measures of proactive aggression, other externalizing and internalizing behavior, and parent-report psychopathic-like traits. In addition, cluster analyses of YPI scores revealed 2 groups of youth (low vs. high) who scored differently on measures of externalizing behavior. This study supports the utility of the YPI as a research tool for assessing juvenile psychopathic traits.     

Bond to Society,Collectivism, and Conformity: A Comparative Study of Japanese and American College Students

An argument is developed that the purported collectivism in Japanese society generates stronger social bonds in Japan than in the more individualistic United States, which might then explain the lower level of deviance often found in Japan. We test this using survey data from samples of Japanese and American college students on measures of deviance and social bonds. Results indicate that Japanese students engage in significantly less deviance than Americans, and although variables from Hirschi's (1969 Hirschi , Travis. 1969 . Causes of Delinquency . Edison, NJ : Transaction Publishers . [Google Scholar]) social control theory behave similarly across cultures as predictors of deviance, the theory failed to account for the lower level of deviance among Japanese.     

Additional Thoughts on Rethinking Research Ethics

Recently, bioethics has become interested in engaging with narrative, but in this engagement, narrative is usually viewed as a mere helpmate to philosophy. In this precis to his book The Fiction of Bioethics, Tod Chambers argues that narrative theory should not be simply a helpful addition to medical ethics but instead should be thought of as being as vital and important to the discipline as moral theory itself. The reason we need to rethink the relationship of medical ethics to narrative is that ethicists test their ideas by applying them to cases, and cases are a narrative genre. Recognizing the importance that cases have for the way medical ethicists do ethics is essential in order to appreciate the field as a form of applied philosophy. Like other forms of representation, narrative has distinct and defining features, which ethicists, in order to understand the data of their field, must learn to recognize and differentiate. Ethicists need to attend to the way decisions about the discourse of a narrative influences the kind of moral theories judged relevant to it. The author briefly examines six features of narrative discourse that rhetorically condition the way we understand medical ethics cases: filter, reportability, closure, characters, chronotope, and gender.     

One size does not fit all: Exploring how the five-factor model facets predict disordered eating behaviours among adolescent and young adult males and females

There is a wealth of research that has highlighted the relationship between personality and eating disorders. It has been suggested that understanding how subclinical disordered eating behaviours are uniquely associated with personality can help to improve the conceptualization of individuals with eating disorders. This study aimed to explore how the facets of the Five-Factor Model (FFM) predicted restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building among males and females. An online survey assessing disordered eating behaviours, FFM and general psychopathology was completed by 394 females and 167 males aged between 16 and 30 years. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the FFM facets, body dissatisfaction and age predicted behaviour. The results indicated that each of the six disordered behaviours were predicted by a unique pattern of thinking, feeling and behaving. Considerable differences between males and females were found for each path model, suggesting differences between males and females in the personality traits that drive disordered eating behaviours. It was concluded that it is important to take personality into account when treating males and females who engage in disordered eating behaviours.