Rehabilitating care

The feminist ethic of care has often been criticized for its inability to address four problems--the problem of exploitation as it threatens care givers, the problem of sustaining care-giver integrity, the dangers of conceiving the mother-child dyad normatively as a paradigm for human relationships, and the problem of security social justice on a broad scale among relative strangers. We argue that there are resources within the ethic of care for addressing each of these problems, and we sketch strategies for developing the ethic more fully.     

Chronic sorrow: A content analysis of parental differences

Sixty-eight mothers and 64 fathers of children with a neural tube defect responded to a questionnaire about chronic sorrow. Mothers reported a mood state change in very intense category from more pessimistic at time of diagnosis to more optimistic at current time. Fathers, although indicating a mood change in the very intense category to more optimistic, also had more pessimistic responses. Parental similarities and differences were also reported in both times and events that triggered the sorrow response. Categories across times and events were primarily related to health care, school/development concerns and social significance. Clinical and research implications of these findings are discussed.     

Pre-screening education in multiple marker screening programs: The effect on patient anxiety and knowledge

Previous studies have shown that unexplained deviations in maternal serum multiple marker screening (MMS) generate considerable anxiety during the remainder of pregnancy. While the role of education in decreasing anxiety is documented, to date there has been no prospective evaluation of which educational practices might minimize this emotional stress. In a pilot study, we prospectively examined the effects on anxiety and knowledge by providing information about MMS (1) by genetic counselor, (2) by pamphlet, and (3) by primary physician. Women randomized to one of these three modalities were administered the Spielberger State- Trait Anxiety Inventory [STAI] and knowledge questionnaires at their initial obstetrics visit, at their second visit after educational intervention and 1–2 weeks after MMS results were provided to patients. Education resulted in an increase in knowledge and post-education knowledge was different between educational modalities. Anxiety declined in patients educated through genetic counseling or a pamphlet.     

A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

Violent behavior in adolescents and young adults: A person and environment model

We explore a model that examines how personal and environmental variables explain violent behavior by adolescents. Repeated interviews with youths from 1984–1992 from 10 cities across the United States provided the data. These interviews first occurred with 2,787 youths when they were adolescents (1984–85 and 1986–87) and the interviews were repeated on a subsample of 602 youths when they were young adults (1989–90 and 1991–92). Longitudinal multivariate analyses showed that almost a third of the variance in adolescent violent behaviors was predicted by a combination of personal variables (gender, substance misuse) and environmental variables (history of child abuse, stressful events, traumatic events, and city rates of unemployment). Further, almost a third of the variance in change in violent behaviors from year to year was predicted by prior violent behavior and a combination of personal variables (gender, suicidality, and substance misuse) and environmental variables (stressful events).     

Evidence that blocking is due to associative deficit: Blocking history affects the degree of subsequent associative competition

Rats were trained on an appetitive discriminated operant procedure according to a blocking design, in which training with a compound stimulus (A + B) was given with or without prior training with A alone. Stimulus B was then presented in compound with a new stimulus (B + C compound). The ability of Stimulus B to block acquisition of control by Stimulus C was decreased by B having itself been blocked by A during the prior training. The results imply that the mechanism of blocking during the initial blocking procedure was a reduced association between Stimulus B and the reinforcer, and not a performance deficit such as that postulated by comparator models of learning.     

Varieties of positive and negative priming

Numerous recent investigations have focused on a particular relation between the roles a stimulus plays in successive displays: when a stimulus ignored by a subject on one occasion is to be attended on a succeeding occasion, reaction time to that stimulus is slowed relative to a control condition. But this is but one possible case ofnegative priming. There are other ways in which negative priming might occur, and there are several varieties of positive priming as well. All these possibilities were explored in the present experiment.     

Touch dominates haptic estimates of discordant visual-haptic size

Observers (72 college students) estimated the size of plastic squares that they held in their fingers and simultaneously viewed through a reducing lens that halved the squares’ visual size. The squares were grasped from below through a cloth that prevented direct sight of the hand. Each estimate was a match selected later, either haptically or visually, from a set of comparison squares. Vision dominated the visual estimates and touch dominated the haptic estimates, whether or not the observers knew in advance which type of estimate they would be asked to make. Neither modality inherently dominates perceived size.     

Fetal brain tissue transplants reduce visual deficits in adult rats with bilateral lesions of the occipital cortex

Fetal brain tissue from the occipital or the frontal cortex was implanted into the damaged occipital cortex of adult rats. The animals receiving grafts of embryonic frontal cortex showed partial restoration of brightness discrimination while recipients given homologous implants of occipital cortex were as impaired as those animals with lesions alone. Neither frontal nor occipital grafts aided in the performance of a pattern discrimination problem; both groups of brain-damaged animals were unable to learn the task. Nonetheless, both groups of animals had viable and enlarged grafts with similar neuronal and glial profiles.