Religion,Statelessness, and Belonging

Before 1948, and stretching back more than 1800 years, the Jewish people suffered all the problems of statelessness. The Zionist movement, 1897–1948, strove to end the condition of Jewish exile and statelessness. The great historical irony and tragedy is that the establishment of the State of Israel brought about the Nakba, the catastrophe, of the Palestinian people. Both the Israelis and the Palestinians see themselves as the victims of the conflict. They seem to be competitors in what I call a “suffering sweepstakes.” One of the problems with victimhood is that it prevents victims from assuming responsibility for their actions, including the victimization of others. In the Israeli–Palestinian conflict, both sides are victims and both sides are victimizers. The least helpful thing people can do – and regrettably many well‐meaning people do this – is to portray the situation in terms of a zero‐sum game, in which, if you’re pro‐Palestinian, you must be anti‐Israeli, and vice versa. We must be both pro‐Palestinian and pro‐Israeli, because we are pro‐people and, therefore, pro‐peace. The achievement of peace necessitates a two‐state solution based on some recognition of the two narratives. The best fulfilment of Zionism will come when there is a Palestinian state alongside the State of Israel.     

Genetic Counseling Considerations in the Evaluation of Families for Lynch Syndrome��A Review

Lynch syndrome is the most common hereditary colorectal cancer syndrome and the most common cause of hereditary endometrial cancer. Identifying and evaluating families for Lynch syndrome is increasing in complexity due to the recognition that: family history-based clinical criteria lack sensitivity and specificity; genetic testing for Lynch syndrome continues to evolve as understanding of the molecular mechanisms underlying it evolves; and the Lynch syndrome phenotype encompasses multiple organ systems and demonstrates overlap with other hereditary cancer syndromes. This document is a summary of considerations when evaluating individuals and families for Lynch syndrome, including information on cancer risks, diagnostic criteria, tumor and genetic testing strategies, and the management of individuals with this condition.     

Code of Ethics of the National Society of Genetic Counselors: Explication of Revisions

The Code of Ethics (COE) of the National Society of Genetic Counselors (NSGC) was adopted in 1992. In 2004, the NSGC leadership appointed the Code of Ethics Work Group (COEWG) to consider revisions to the NSGC COE based on advice from the NSGC legal counsel, and to consider additional changes given growth in the scope of genetic counseling practice since the adoption of the original COE. After input from the NSGC membership, changes to the COE addressing the recommendations of the NSGC legal counsel were approved in December 2004. The COEWG then reviewed ethical codes and codes of professional conduct from 22 professional organizations, deemed to have similar goals and philosophies to the NSGC, searching for themes that encompassed genetic counseling practice that might not yet be addressed in the NSGC COE. Additional revisions to the COE were proposed, and after feedback from the NSGC membership, the revised COE was approved in January 2006 by majority vote of full members of the NSGC. The explications for the 2004 and 2006 revisions are presented.     

Generalization peak shift for autoshaped and operant key pecks.

Pigeons acquired discriminated key pecking between 528- and 540-nm stimuli by either a response-reinforcer (operant group) or a stimulus-reinforcer (autoshaped group) contingency, with other training-schedule parameters comparable over groups. For the birds in the operant group, key pecks intermittently produced grain in the presence of one hue on the key (positive stimulus) but not in the other (negative stimulus). For the birds in the autoshaped group, pecking emerged when grain was intermittently presented independently of key pecking during one key color but was not presented during the other key color. Two independent contingency assays, peck-location comparisons and elimination of differences in reinforcement rate, confirmed the effectiveness of the two training procedures in establishing operant or respondent control of key pecking. After reaching a 10:1, or better, discrimination ratio between key pecks during the two key colors, the birds received a wavelength generalization test. Criterion baseline key-peck rates were comparable for operant and autoshaped groups prior to testing. On the generalization test, performed in extinction, all birds pecked most at a stimulus removed from the positive training stimulus in the direction away from the negative stimulus. In testing, autoshaped "peak" rates (24.5 to 64.9 pecks per minute) were from 33% to 80% higher than rates in the presence of the training stimuli. Respondent peak shift rarely has been reported heretofore, and never this consistently and robustly. These results further confirm the similarity of perceptual processing in classical and operant learning. They are discussed in terms of Spence's gradient-interaction theory and Weiss' (1978) two-process model of stimulus control.     

The Problem of Theodicy and Religious Response to Cancer

The authors studied the religious response to cancer in a group of hematology/ oncology-clinic patients. Method: Patients (N = 45) were surveyed with a self-report questionnaire. Five items were designed to reflect the five major categories of theodicy or modes of reconciling suffering with a morally good God. Results: Of the 45 patients, in response to their illness, 67% (N = 30) increased amount of prayer, 51% (N = 23) gained faith, and 16% (N = 7) increased the frequency of church attendance. The majority of patients across all levels of religious belief endorse a theodicy that claims God has a reason for their suffering, but this reason cannot be explained or understood. Conclusions: Religious cancer patients intensify their religious belief and practice in response to their illness. Despite the elusiveness of an explanation for their suffering in religious terms, patients remain confident in their faith.     

Distortions and deceptions in self presentation: Effects of protracted litigation in personal injury cases

The goal of diagnostic examinations in personal injury lawsuits is to ascertain genuineness and substantiality of claimed impairments so that ‘damages’ can be accurately defined. These examinations require consideration of the potential role of malingering and other deceptive response styles in determining the nature and extent of impairment. Involvement in litigation renders plaintiffs susceptible to stressors and to influences that may lead to increased impairment, biased reportage, and retarded recovery. Underlying personality patterns play a critical role in defining and shaping reactions to trauma, to the stress of litigation, and to treatment interventions. Protracted litigation creates conditions that promote mnemonic and attitudinal distortions, as well as conscious and unconscious motivations for secondary gain. The presence of non-legally relevant factors provides the opportunity for proportionate attribution of causation. An assessment model is proposed for analyzing elements of causation.     

Implementing a Virtual Health Telemedicine Program in a Community Setting

Aurora Health Care in eastern Wisconsin has a clinical genetics program driven by genetic counselors in the cancer/adult and prenatal genetics settings. In 2015, the workforce shortage of genetic counselors left us with 4 open positions for genetic counselors that we were unable to fill. We explored many models of alternative service delivery, and determined virtual health (VH) via telemedicine to be the best option for our system. Historically, telemedicine technologies have been used to provide access to healthcare services to patients in remote areas. We, however, were struggling to find genetics counselors to staff both our remote clinics and urban clinics. To solve this problem, we recruited genetic counselors from across the country to work remotely from their current home or home office utilizing VH to staff our clinics. We then created clinical workflows and an implementation process of virtual health for 9 prenatal and cancer clinics across the eastern Wisconsin footprint of our healthcare system over the course of 12 months. Here we provide our experience and process in establishing a VH program in order to help other institutions that have been affected by the workforce shortage of clinical genetics professionals.     

The regional genetic and newborn screening service collaboratives: the first two years

Newborn screening and genetic technologies are expanding and changing rapidly, increasing the demand for genetic specialty services. Because of the scarcity and geographic maldistribution of genetic specialty services, access to these services is a critical issue. This article discusses some of the efforts initiated by the Maternal and Child Health Bureau of the Health Resources and Services Administration, particularly the establishment of regional genetic and newborn screening collaboratives to improve access to these services and expertise.     

Brain regions activated by endogenous preparatory set shifting as revealed by fMRI

An ongoing controversy concerns whether executive control mechanisms can actively reconfigure the cognitive system in preparation for switching to a new task set. To address this question, we recorded brain activity from 14 healthy participants, using event-related functional magnetic resonance imaging, while they performed a cued attention task. Critically, in any particular trial, the cued task set was either the same as that in the previous trial or switched. As was hypothesized, cue-related, switch-specific preparatory activity was observed in a network of dorsal frontal and parietal brain areas that are typically associated with cognitive control processes. Moreover, the magnitude of switch-specific preparatory activity varied with the number of possible task sets that could be presented in a given trial block. These findings provide compelling support for the existence of top-down, preparatory control processes that enable set switching. Furthermore, they demonstrate that global task structure is a critical determinant of whether switch-specific preparatory activity is observed.