Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings

An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project’s success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.     

Daily Peer Hassles and Non-Suicidal Self-Injury in Adolescence: Gender Differences in Avoidance-Focused Emotion Regulation Processes

This study aimed to examine the mediating role of rumination, experiential avoidance, dissociation and depressive symptoms in the association between daily peer hassles and non-suicidal self-injury among adolescents. Additionally, this study explored gender differences in these associations and tested whether the proposed model was invariant across genders. The sample consisted of 776 adolescents, of them 369 are males (47.6%) and 407 are females (52.4%), aged between 12 and 18 years old from middle and high schools in Portugal. Participants completed self-report questionnaires to assess daily peer hassles, rumination in its severe component (i.e., brooding), experiential avoidance, dissociation, depressive symptoms and non-suicidal self-injury. Path analysis showed that daily peer hassles indirectly impact on non-suicidal self-injury through increased levels of brooding, experiential avoidance, dissociation, and depressive symptoms. Results indicated significant gender differences in mean scores and path analysis. Male adolescents were more likely to engage in brooding and experiential avoidance in response to external distress (particularly, daily peer hassles), whereas female adolescents were more likely to engage in non-suicidal self-injury in response to internal distress (particularly, depressive symptoms). These findings suggest relevant preventive and intervention actions to address emotion dysregulation in adolescence, by teaching them acceptance and mindfulness skills as a way of coping with stressful experiences and internal distress.     

Youth Subgroups who Receive John F. Chafee Foster Care Independence Program Services

To date over two billion dollars have been invested in the John F. Chafee Foster Care Independence Program (CFCIP) to help youth who are transitioning out of foster care to achieve self-sufficiency through an array of independent living services. Although states are required to report CFCIP service provision to the National Youth in Transition Database (NYTD), the degree of heterogeneity of the aging out population from the service receipt perspective and state implementation is unknown. The CFCIP calls for a deeper understanding of the underlying patterns of services receipt to prepare for youth’s successful transition to adulthood. Based on the population of 68,057 first-time youth who received CFCIP services in FY2011-FY2013 from the NYTD, we used multi-level latent class analysis (MLCA) to identify underlying combinations of service receipt that may be influenced by youth-level and state-level characteristics. We identified the most preferred model based on interpretability, fit statistics, and split-half replication. The optimal model was a three-class, MLCA solution characterized by a high-service receipt profile, an independent living assessment and academic support receipt profile, and a limited service receipt profile. Among male and female youth, age, education level, and whether states serve youth aged 18 or above were significant characteristics associated with LCA profile membership. States could benefit from understanding existing service receipt patterns and gaps to optimize decisions on service delivery in order to meet youth needs and to identify specific services that may prepare youth aging out of foster care towards positive outcomes.     

Finding a Balance: Reconciling the Needs of the Institution,Patient, and Genetic Counselor for Optimal Resource Utilization

The current practice of cancer genetic counseling is undergoing widespread change and scrutiny. While there are clinical resources for genetic counselors (GCs) regarding the delivery of cancer genetic services, there is limited literature regarding effective management of a genetic counseling clinical program. We have developed administrative tools to manage a large team of GCs at a single academic medical center over a period of increasing demand for genetics services, with the initial aim of decreasing wait time for urgent genetic counseling visits. Here, we describe the three main elements of the clinical operations: Balancing patient volume between GCs, scheduling tracks for both routine and urgent appointments, and a team of triaging GCs to ensure appropriate patient referrals. For each of these elements, we describe how they have been modified over time and present data to support the utility of these strategies. The preliminary evidence offered here suggests that these tools allow for an equitable distribution of patient volume between team members, as well as the timely and accurate scheduling of urgent patients. As a result of the experiences presented here, other genetic counseling programs grappling with similar issues should be aware that it is possible to shift clinical operations to serve certain patient populations in a more timely fashion while keeping both providers and GC staff satisfied.     

Emotional Separation,Autonomy in Decision-Making,and Psychosocial Adjustment in Adolescence: A Proposed Typology

Adolescence is critical for learning autonomous behavior; however, little research is available on the most appropriate balance of the emotional and behavioral dimensions of autonomy for psychosocial adjustment during this period. In this study we present a novel autonomy typology that combines both these aspects, which can be implemented as autonomy in decision-making and emotional separation. Specifically, examined age differences in emotional separation and autonomy in decision-making during adolescence. We also assessed differences in psychosocial adjustment associated with profiles of autonomy typology, sex, and age. The participants were 567 adolescents (296 males and 271 females), aged between 12 and 18 years (M?=?14.48; SD?=?1.69), recruited in Spanish high schools. Each participant filled out questionnaires on identity commitment, self-esteem, emotional separation and autonomy in decision-making. The results showed that the most advantageous autonomy profile is ‘autonomous in decisions’ (those showing low emotional separation combined with autonomous behavior in decisions) which was associated with higher levels of self-esteem and occupational and ideological identity commitment. In addition, we also concluded that the balance of autonomy affects adjustment throughout adolescence, although early adolescence may be an especially critical period.     

Adoptive versus Mixed Families: Child Adjustment,Parenting Stress and Family Environment

Recent research in adoption has considered the factors and processes that underlie the adjustment of children and families. However, little research has been conducted on certain types of adoptive families, specifically on families with both adoptive and biological children often designated as mixed families. This subject is addressed by the present study which also analyzes the association between the type of adoptive family and children’s outcomes—prosocial and problem behavior—parenting stress and the relational family environment. It also examines whether children’s gender, age at adoption and the number of children in the home moderate these effects. 102 parents of adoptive children (ACF) 33 parents of both adoptive and biological children (ABCF) and 102 parents of biological children (BCF) participated in the study. Target-children were aged from 6 to 12 years. The Portuguese versions of the SDQ-P, PSI-SF and FES (Interpersonal Relationship dimension) were used. Results showed that the type of adoptive family—ACF and ABCF—significantly explained the variance of children’s behavioral problems and parenting stress. The child’s gender was shown to moderate the relationship between ACF parents and their perception of child’s prosocial behavior. The results give relevant clues as to the importance of distinct outcomes in adoptive families—ACF and ABCF—compared to families with only biological children and should, therefore, be a resource for professionals involved in the adopters’ suitability assessment and adoption intervention.     

Triarchic Model of Psychopathy: A Brief Measure Among Detained Female Youths

The present study examined the psychometric properties of a brief measure of the Triarchic model of psychopathy based on the Youth Psychopathic Traits Inventory (YPI-Tri-S) among a forensic sample of detained female youth offenders (M = 16.41 years; SD = 1.19 years) from Portugal. Results supported the expected three-factor structure and cross-gender measurement invariance. The YPI-Tri-S showed good psychometric properties in terms of factor structure, internal consistency, convergent validity, discriminant validity, and criterion-related validity. Findings suggest that the YPI-Tri-S is a valid and reliable measure of the Triarchic model of psychopathy, which can be used to assess female juvenile offenders.     

Validation of the Visual Analogue Scale for Anxiety-Revised and school refusal across anxiety profiles

Background/Objectives

This paper aimed to validate the Spanish version of scores of the Visual Analogue Scale for Anxiety-Revised (VAA-R) in child population, and to verify the existence of anxiety profiles and to relate them to school refusal.

Models of Public Engagement: Nanoscientists’ Understandings of Science–Society Interactions

This paper explores how scientists perceive public engagement initiatives. By drawing on interviews with nanoscientists, it analyzes how researchers imagine science–society interactions in an early phase of technological development. More specifically, the paper inquires into the implicit framings of citizens, of scientists, and of the public in scientists’ discourses. It identifies four different models of how nanoscientists understand public engagement which are described as educational, paternalistic, elitist, and economistic. These models are contrasted with the dialog model of public engagement promoted by social scientists and policymakers. The paper asks if and in what ways participatory discourses and practices feed back into scientists’ understandings, thus co-producing public discourses and science.     

Zukunftsperspektiven sexualforensischer Psychotherapie

There is a controversial discussion on to what extent sexual forensic psychotherapy has a positive influence on the legal probation of sexually delinquent people. From this the question arises on how treatment with a perspective for success could be structured. This article assumes that such a perspective can only succeed through close cooperation between science and psychotherapeutic practice. Through the analysis of a methodologically elaborate study, considerations on the motivation and the influence of empirically ascertained risk factors are developed and each placed in relation to scientific and therapeutic practice. In this way various problems are tackled, which range from insufficiently described interventions via too little therapeutic flexibility up to limitations in the scientific evaluation. Finally, possible barriers for the development of such a perspective are discussed and the connection to the so-called risk-need-responsivity (RNR) model is explored.