Incidental Findings from Clinical Genome-Wide Sequencing: A Review

There are several unresolved challenges associated with the clinical application of genome-wide sequencing technologies. One of the most discussed issues is incidental findings (IF), which are defined as discoveries made as a result of genetic testing that are unrelated to the indication for the test. The discussion surrounding IF began in the context of research, which we have used to frame consideration of IF in the clinical context. There is growing consensus that analytically valid and medically actionable IF should be offered to patients, but whether and to what extent clinicians should disclose other kinds of IF is debated. While others have systematically reviewed the literature concerning genetic IF, previous reviews focus on ethical and research-related issues and do not consider the implications for the genetic counseling profession specifically. This review discusses the practical considerations, ethical concerns and genetic counseling issues related to IF, with a particular focus on clinical genome-wide sequencing. To date, the bulk of the literature with respect to IF in the clinical context consists of commentaries, reviews and case reports. There is a need for more empirical studies to provide a foundation for institutional protocols and evidence-based clinical practice standards.     

Rassenschande,Genocide and the Reproductive Jewish Body: examining the use of rape and sexualized violence against Jewish women during the Holocaust?

Rape and sexual violence against Jewish women is a relatively unexplored area of investigation. This article adds to the scant literature on this topic. It asks: how and why did women's reproductive bodies (gender), combined with their status as Jews (race), make them particularly vulnerable during the Holocaust? The law against Rassenschande (racial defilement) prohibited sexual relations between Aryans and non-Aryans. Yet, Jewish women were raped by German men. Providing a more nuanced account than is provided by the dehumanization thesis, this article argues that women were targeted precisely because of their Jewishness and their reproductive capabilities. In addition, this piece proposes that the genocidal attack on women's bodies in the form of rape (subsequently leading to the murder of impregnated women) and sexualized violence (forced abortions and forced sterilizations) must be interpreted as an attack on an essentialized group: woman-as-Jew.     

Religious Problem-Solving Styles and Life Satisfaction: Exploring God,the Will and the Way

Journal of Religion and Health - A proliferation of empirical studies over the past few decades has examined the connection between religiosity and health; an extension of this literature has...     

Psychometric Testing of the Daily Spiritual Experiences Scale (DSES) Among Black Gay,Bisexual, and Other Sexual Minority Men (SMM) and Black Transwomen in the Deep South: The MARI Study

Journal of Religion and Health - Spirituality is a well-established protective psychosocial determinant of health. The current study examined the psychometric properties of the Daily Spiritual...     

Parenting Characteristics Protective Against Substance Use and Deviant Peer Involvement in High-Risk Neighborhoods

Robust research shows that poor parenting practices are related to adverse outcomes among adolescents; however, few have examined the interaction between parenting variables and adolescent outcomes within the context of exposure to relentless crime. The current study examined the combined effects of parental monitoring and discipline on marijuana involvement and deviant peer affiliation among adolescent males living in Los Angeles neighborhoods with concentrated crime. For this study, areas with higher-than-average crime rates were selected based on census data, published statistics, and law-enforcement data. The study included 349 males between 13 and 17 years of age, mostly Latino (70.2%) and African American (28.4%). Data were collected using questionnaires to interview participants and analyzed using logistic regression. Results suggest that among adolescent males in geographic areas of high violence and crime, the interaction between parental monitoring and discipline was significantly related to marijuana involvement and deviant peer affiliation. Follow-up analyses showed parental monitoring was only an effective tool at higher levels of consistent parental discipline. In the absence of consistent discipline, good parental monitoring was ineffective at preventing marijuana involvement and affiliation with deviant peers. Results suggest that if time and resources are limited, clinicians should consider focusing on the use of consistent discipline with parents residing in high-crime neighborhoods.

     

The effect of pre-treatment enquiries on child dental patient's post-treatment ratings of pain and anxiety

Abstract

The aim of this study was to attempt to replicate a study in adults: to determine whether pre-treatment enquiries about anxiety and pain in children, attending the dentist, influenced their subsequent reports of pain and anxiety immediately after treatment. One hundred and ninety five children aged from seven to 16, attending four Community Dental Clinics, were allocated at random to five groups. Before treatment the first group was asked questions about their dental anxiety, expectations and memories of pain. The second group was asked about dental anxiety and expectations of pain. The third group was asked only about dental anxiety; the fourth was asked only about pain. The fifth, the control group, was asked about none of these topics. All the children were asked after treatment to rate 1) their anxiety about dentistry and 2) their experience of pain in the treatment just completed. The children experienced less pain than they had expected. There were no differences between the groups in disruptiveness or in the amount of pain experienced. However, the children who were asked about both pain and dental anxiety (groups one and two) reported significantly less dental anxiety than the control group. These results are consistent with the conclusion that pre-treatment enquiries about both anxiety and pain have no effect on disruptiveness or the experience of pain but do reduce anxiety about dentistry.     

Neuropsychological profiles of six children with anoxic brain injury

Anoxic brain injury (ABI) often results in severe memory impairment and other cognitive and behavioral deficits, although limited information is available regarding pediatric cases. This study reported the neuropsychological outcomes in six children and adolescents who sustained ABI. Profiles were compared by mechanism of injury (ischemic vs. hypoxemic) and three cases were evaluated more than once. Severe intellectual, attention, memory, and behavioral impairments were observed in all six cases although academic achievement, internalizing behavioral problems, and visuospatial deficits were in general less severe than other cognitive and behavioral deficits. The longitudinal case studies varied but showed steady increases in memory and intellectual performance in the younger children with strongest improvement in nonverbal abilities and little change in parent-reported behavior. This study raises several possible hypotheses about specific cognitive and behavioral outcomes observed in pediatric ABI.     

Predictors of Therapist Adherence and Emotional Bond in Multisystemic Therapy: Testing Ethnicity as a Moderator

This study examined the interaction between problem severity and race\ethnicity as a predictor of therapist adherence and family-therapist emotional bond. Data for this study came from a longitudinal evaluation of Multisystemic Therapy (MST) provided by licensed MST provider organizations in community settings. Outcome variables included mid-treatment levels of caregiver report of therapist adherence, changes in caregiver report of therapist adherence over the course of treatment, and overall levels of caregiver-therapist and youth-therapist emotional bond. Hypothesized predictors included race\ethnicity and levels of poly-substance use, externalizing behavior, and youth self-report of delinquency early in treatment as well as pre-treatment number of arrests. Participants were 185 adolescents (M age = 15.35, SD = 1.29) and their caregivers. Of the participating youth, 48 % self-identified as Caucasian, 20 % as African-American, 28 % as Hispanic\Latino, and 4 % as “other.” Two-level Hierarchical Linear Modeling analyses revealed that for Caucasian youth, lower rates of self-reported delinquency were associated with greater increases in caregiver report of therapist adherence over the course of MST. For Hispanic\Latino caregivers, higher externalizing behavior and poly-substance use were associated with reports of lower therapist adherence at mid-treatment and poorer overall levels of emotional bonding with therapists. In contrast, for African-American participants, higher levels of youth externalizing behavior and poly-substance use were associated with higher overall levels of caregiver and youth report of emotional bonding with therapists, respectively. Results provide evidence that race\ethnicity interacts with problem severity in predicting therapist adherence and family-therapist emotional bond within real-world practice settings and suggest possible therapeutic process differences across race.