The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

Genetics and adoption: Forming a partnership

Genetic issues are demanding more attention in the area of public health. Adoption agencies and policymakers are beginning to address these issues where they relate to the adoption process and to the many families involved in adoption in this country. Genetic counselors need to play an active role as both educators of and consultants for adoption professionals and the families with whom they work. To facilitate a partnership between genetics and adoption we have developed a workshop intended to educate adoption professionals about the lifelong implications of genetic conditions on the adoption triad.     

TOWARD A NEW RELATION BETWEEN HUMANITY AND NATURE: RECONSTRUCTING T'IEN-JEN-HO-I

Abstract. The traditional Chinese idea of t'ien-jen-ho-i (Heaven and humanity in union) implies that humanity has to live in harmony with nature. As science and technology progress, however, the idea appears increasingly outmoded, and it becomes fashionable to talk about overcoming nature. Ironically, though, the further science reaches the more clearly are its limitations exposed. The exploitation of nature not only endangers many life forms on earth but threatens the very existence of the human species. I propose that a reconstruction of the traditional Chinese idea of T'ien-jen-ho-i will help us envisage a new and salutary relation between humanity and nature.     

The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

CLINICAL BEHAVIORAL PHARMACOLOGY: METHODS FOR EVALUATING MEDICATIONS AND CONTINGENCY MANAGEMENT

We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance.     

Deep dyslexia in childhood?

Deep dyslexia is an acquired reading disorder in which semantic substitutions (e.g., city read as town) are made in reading single isolated words. In this paper, evidence for deep dyslexic-type errors is presented from the word-recognition responses of six children, aged 7 years and 0 month to 8 years and 9 months, with severe reading disorders. These semantic substitutions occur in the absence of phonological skills. Therefore, it appears that there exists a small subset of developmental dyslexics who at the beginning of acquisition of reading skills are able to engage in semantic processing, but who show severe impairment of phonological processing. The existence of these reading errors indicate that the use of a phonological code is not necessary to extract meaning from the printed word.     

Effects of simulated stuttering on listener recall

In an investigation of the effects of simulated stuttering on listener recall, a presentation was varied on two factors: degree of stuttering (mild or severe) and information value of stuttered words (low or high). A control presentation featuring non-stuttered speech also was prepared. Five groups of 16 subjects were randomly assigned to, and participated in, one of the five listening conditions. Then they completed a 20-item recall test. A one-way analysis of variance revealed sognificant differences among the five conditions. Two-way analysis of variance disclosed no main effects. However, a significant interaction showed that recall was lowest in the severe stuttering-high information condition. The results are discussed in terms of attention to critical information.     

Message therapy: Language approach to stuttering therapy with children

Message therapy is a clinical procedure designed to be used as a carry-over technique with school-age stutterers or as a sole technique with the preschooler. The focus of therapy is on a unit of communication rather than on the moment or place of stuttering. One of the basic assumptions of the procedure is that the child is beginning to monitor how he/she is speaking rather than what is being communicated (i.e., the “message”)—each task requiring a different cognitive process. The emphasis of the therapy is to redirect the child's attention to “what he/she is saying.” The clinical procedures are discussed as they relate to the specific population.     

INCREASING APPOINTMENT KEEPING BY REDUCING THE CALL-APPOINTMENT INTERVAL

We examined the effect of reducing the interval between a patient's call for an appointment and the appointment itself. In Experiment 1, patients calling a family planning unit of a public health department were assigned appointments within either 1 or 3 weeks of their call. Data on patient “shows” and “no-shows” were recorded weekly for 6 weeks. Show rates for those in the 1-week appointment group were significantly higher than those in the 3-week group. In Experiment 2, patients were assigned to appointment dates either the next operating clinic day (next-day group) or 2 weeks from the call date (2-week group). Show rates for those in the next-day group were significantly better than show rates for patients in the 2-week group. Clinic productivity, time spent with patients, and consumer satisfaction were also assessed. Implications for appointment scheduling are discussed.