Interactive Genetic Counseling Role-Play: A Novel Educational Strategy for Family Physicians

Background Family physicians (FPs) are increasingly involved in delivering genetic services. Familiarization with aspects of genetic counseling may enable FPs to help patients make informed choices. Purpose Exploration of interactive role-play as a means to raise FPs’ awareness of the process and content of genetic counseling. Methods FPs attending two large Canadian family medicine conferences in 2005 were eligible—93 participated. FPs discussed a case during a one-on-one session with a genetic counselor. Evaluation involved pre and post intervention questionnaires Results FPs’ baseline genetic knowledge was self-rated as uniformly poor. Baseline confidence was highest in eliciting family history and providing psychosocial support and lowest in discussing risks/benefits of genetic testing and counseling process. Post-intervention, 80% of FPs had better appreciation of family history and 97% indicated this was an effective learning experience. Conclusions Role-play with FPs is effective in raising awareness of the process and content of genetic counseling and may be applied to other health disciplines. This research was funded by: The Canadian Institutes of Health Research (CIHR) Institute of Genetics, The Genetics Education Project (funded by the Ontario Women’s Health Council), and GeneSens (funded by a CIHR Interdisciplinary Capacity Enhancement Team Grant).     

Emotional Reaction to Fragile X Premutation Carrier Tests Among Infertile Women

Female fragile X premutation carriers are at ∼10-fold increased risk of premature ovarian failure (follicle stimulating hormone >40 mIU/mL, amenorrhea, age <40). A milder degree of premature ovarian aging (diminished ovarian reserve, where follicle stimulating hormone levels are typically 10–20 mIU/mL) results in infertility. Approximately 10% of fertility clinic patients have this diagnosis. A cohort of 20 women diagnosed with diminished ovarian reserve provided a blood specimen (confidential results), and completed structured questionnaires that assessed emotional reactions to potentially being a premutation carrier (pretest questionnaire, n = 20) and the posttest known carrier status (3 month follow-up questionnaire, n = 18 non-carriers). Responses were measured using 9-point scales, and analyzed with Fisher exact and Wilcoxon exact tests. While most participants did not view fragile X premutations as a serious medical condition, perceptions of seriousness were positively correlated with anger and regret about not knowing sooner of the potential association of these premutations with infertility. Overall, when women (pretest) imagined themselves as carriers, their self-esteem and Health Orientation Scale responses were unchanged with the exception of feeling more afraid (p = 0.004). Despite strongly wishing for negative test results, they were glad to know there might be a medical explanation for their infertility. Financial Support: This work was financially supported by a University of Virginia School of Medicine Research & Development Award.     

Reflections on the Field of School Attendance Problems: For the Times They Are a-Changing?

This article presents reflections on the seven articles included in this special series. The classification of school attendance problems (SAPs) based on structured checklists of SAP types (school refusal, truancy, school withdrawal, and school exclusion) together with functional analysis opens the way for establishing norms and social referents. We discuss how authorized nonattendance can also be problematic if it is persistent, and that it is important to take this type of SAP into account if the field is to effectively understand and respond to the complex range of bio-psycho-socio-cultural determinants of absenteeism. We highlight other gaps in the current literature, one of which is the lack of attention to evidence-based prevention and early intervention strategies. Avenues for future research are suggested, with emphasis on the need for pragmatic approaches to address the complexities of SAPs. Promising work is beginning to address the SAPs that are prevalent in special populations such as those with autism spectrum disorder. Overall, our reflections highlight the incremental changes that have characterized the field, exemplified by this series of articles, and the promise of transformational change in tackling the major challenge of SAPs as research in the field continues.     

Pornography,preference for porn‐like sex,masturbation, and men's sexual and relationship satisfaction

Pornography use, preference for “porn‐like” sex, masturbation, and sexual and relationship satisfaction were assessed among two samples of men (N_{Study 1} = 326, N_{Study 2} = 335). Frequent pornography use was associated with sexual dissatisfaction, greater preference for porn‐like sex, and more frequent masturbation in both studies. Pornography use was associated with relationship dissatisfaction in Study 2 only. The data did not support the notion that pornography negatively impacts sexual or relationship satisfaction via preference for porn‐like sex. In fact, it may bolster sexual satisfaction by promoting sexual variety. The data were consistent with a model in which pornography negatively, indirectly affects sexual and relationship satisfaction via masturbation frequency. Pornography use may have multiple opposing influences on sexual satisfaction.     

Reach/Grasp Times with Lateral Reach Obstructions

When moving to grasp an object having adjacent obstacles that limit the space available for placing the fingers, the time for the reach/grasp is dependent on the distance of reaching and the space available for finger placement. Here we model the time taken in terms of these variables and develop mathematical models for the reach and grasp phases of the task and the location of obstacles. Data show that the movement to the target may be made under visual control and that, when the obstacles are close to the target object, a visually-controlled movement is made that is modeled by a modified form of Fitts' law. The time for the two components of the reach/grasp appear to be independent and linearly additive.     

Age‐related differences in delay discounting: Immediate reward,reward magnitude,and social influence

Delay discounting refers to the tendency of individuals to subjectively devalue rewards that are to be received in the future, with high rates of delay discounting being associated with a variety of maladaptive life outcomes (e.g., unhealthy dietary and exercise behaviors). The current study explored the psychological and social processes involved in adult age‐related differences in delay discounting of monetary rewards. Younger adults exhibited higher levels of delay discounting than older adults. This increased level of patience in older adults was found whether smaller‐sooner rewards were to be received immediately or in the future. However, there was an interaction with reward magnitude, whereby younger adults exhibited higher levels of delay discounting for smaller reward magnitudes but not larger reward magnitudes. Social influence on delay discounting was investigated by having participants complete three phases of the delay‐discounting task: an individual precollaboration phase, a collaboration phase in age‐group‐matched dyads, and an individual postcollaboration phase. A convergence effect was observed in that dyad members' postcollaboration choices were significantly more similar compared to their baseline choices during the precollaboration phase. Moreover, levels of convergence were comparable between younger and older adults, suggesting age invariance in social influence on delay discounting. The current results demonstrate a degree of malleability in delay discounting that extends into older adulthood, making interventions targeting the construct a promising avenue for future research.     

Do you look to the future or focus on today? The impact of life experience on intertemporal decisions

In this research, we investigate the impact of significant life experiences on intertemporal decisions among young adults. A series of experiments focus specifically on the impact of experiencing the death of a close other by cancer. We show that such an experience, which bears information about time, is associated with making decisions that favor the long-term future over short-term interests (Studies 1 and 2). Underlying this effect appears to be increased salience and concreteness regarding one’s future life course, shifting focus away from the present toward the long run (Studies 3 and 4). Finally, we explore the shift caused by a cancer death of a public figure and examine its stability over time (Study 5). Implications for research on intertemporal decision making and the impact of life events on perceptions and preferences are discussed.     

Latina Mothers' Perceptions of Mental Health and Mental Health Promotion

Latina mothers' perceptions of mental health and factors that promote/restore mental health were explored in this qualitative study. Participants discussed the importance of community, safety, and financial stability in addition to conventional factors that are related to mental health. Implications for working with urban Latinas and their families are discussed. En este estudio cualitativo se exploraron las percepciones de las madres Latinas sobre Salud Mental y los factores que la fomentan/restablecen. Las participantes discutieron acerca de la importancia de la comunidad, la seguridad y la estabilidad financiera además de otros factores convencionales relacionados con la salud mental. Se discuten las implicaciones para el trabajo con Latinas residentes en núcleos urbanos y sus familias.     

Children's engagement and competence in personal recollection: effects of parents' reminiscing goals

Parents' goal orientations in parent-child reminiscing were examined in this study, where 28 preschoolers (mean age = 46 months) experienced a standardized event. Dyads discussed the event that evening, with parents randomly assigned to either an "outcome-oriented" or a "process-oriented" condition. Outcome-oriented parents, who were told that children subsequently would be tested on event-related recall, were more controlling in these conversations compared with process-oriented parents, who were told that children's personal perspective would be assessed. Parents did not differ in their provision of structure. Children were interviewed 2 weeks later. Autonomy support in the parent-child conversation predicted children's engagement in the interview. Parental structure predicted children's recall of details and the coherence of their memories. Effects of parental reminiscing styles for children's memory and motivation to reminisce are discussed.     

Evaluative pressure in mothers: effects of situation, maternal, and child characteristics on autonomy supportive versus controlling behavior

This study examined the effects of situational pressure and maternal characteristics (social contingent self-worth, controlling parenting attitudes) on mothers' autonomy support versus control in the social domain. Sixty 4th-grade children and their mothers worked on a laboratory task in preparation for meeting new children, with mothers in either an evaluation (mothers told their child would be evaluated by other children) or no-evaluation (no mention of evaluation) condition. Mothers in the evaluation condition spent more time giving answers to their children. Mothers with controlling parenting attitudes exhibited more controlling behavior. Further, mothers with high social contingent self-worth in the evaluation condition were most controlling. Results suggest the importance of interactions between situations and maternal characteristics in determining levels of mothers' autonomy support versus control and have implications for helping parents support children's autonomy.