Standards for the Reporting of Genetic Counseling Interventions in Research and Other Studies (GCIRS): an NSGC Task Force Report.

As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.

Climate and satellite indicators to forecast Rift Valley fever epidemics in Kenya.

All known Rift Valley fever virus outbreaks in East Africa from 1950 to May 1998, and probably earlier, followed periods of abnormally high rainfall. Analysis of this record and Pacific and Indian Ocean sea surface temperature anomalies, coupled with satellite normalized difference vegetation index data, shows that prediction of Rift Valley fever outbreaks may be made up to 5 months in advance of outbreaks in East Africa. Concurrent near-real-time monitoring with satellite normalized difference vegetation data may identify actual affected areas.

Malaria early warning in Kenya.

Kenya displays large spatiotemporal diversity in its climate and ecology. It follows that malaria transmission will reflect this environmental heterogeneity in both space and time. In this article, we discuss how such heterogeneity, and its epidemiological consequences, should be considered in the development of early warning systems for malaria epidemics.

Overview: the female physician and her marriage.

Previous research has addressed the marital problems of male but not female physicians. The author reviews the literature on women in medicine, reports findings on 16 female physicians with dysfunctional marriages whom he saw as patients, and describes several problem areas: delayed help seeking, self-blaming attitude toward subjective symptoms, ambiguity in self-image, "passivity" in marital communication, role strain, unmet needs in husbands, bilateral competitiveness, and problems with intimacy and sexuality. The author emphasizes a biopsychosocial approach to treatment and discusses transference-countertransference issues.

Forecasting disease risk for increased epidemic preparedness in public health.

Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

Socioeconomic influences on the effects of a genetic testing direct-to-consumer marketing campaign.

Direct-to-consumer marketing of genetic tests is beginning to appear in select markets, and little independent evaluation has been conducted on the effects of this marketing on consumer attitudes or behavior. The purpose of this paper is to identify the effects of socioeconomic status on women's reactions to such a campaign, including knowledge of the test, perceptions of personal risk, communications with others about the test, and interest in pursuing the test. The only United States provider of genetic testing for breast and ovarian cancer susceptibility (BRCA1/2 testing) conducted a pilot marketing campaign that targeted women aged 25-54 and their health care providers in 2 cities, Atlanta, Ga., and Denver, Colo. The design for the evaluation was a post campaign consumer survey, based on a cross-sectional stratified random sample of women in the 2 intervention sites and 2 comparison sites. The campaign had no differential impact by socioeconomic status. However, there was a consistent relationship between socioeconomic status and several outcome variables, including knowledge of the test, beliefs about the test, and desire to know about genetic risk. These data indicate that socioeconomic status may play a role in uptake of genetic services, regardless of response to a media campaign.

Treating troubled marriages.

Specific objectives include provision of a neutral and nonjudgmental atmosphere, ventilation of each partner's concerns, facilitation of improved "communication," attention to issues involving affection (both sexual and nonsexual), new perspectives and suggestions where appropriate, and a supportive attitude and manner to combat demoralization. A useful treatment format involves seeing each partner alone, then both partners together for three or four sessions.

Men sexually assaulted as adults and sexually abused as boys.

Previous research on sexually victimized men has mainly addressed the acute symptoms seen in hospital emergency rooms and psychiatric clinics. Findings are reported on 14 men, all but 1 of whom had been sexually traumatized much earlier in life, as boys or young adults. Several problem areas are described: repression, denial, or normalization of the trauma; self-blame and shame; posttraumatic stress disorder; male gender identity fragility; sexual orientation ambiguity and internalized homophobia; sexual difficulties; mistrustfulness of adult men; and disturbances of self-esteem and body image. Gender issues in treatment are discussed.

Abuse of residents: it's time to take action.

The scientific study of the sexual dynamics that come into play during residency training seems to both fascinate and repel trainees and their supervisors. One of the more provocative and shameful dimensions of this area of inquiry, the abuse of residents, causes a good deal of distress. How do we respond to findings of significant psychological abuse, discrimination on the basis of sex or sexual orientation and sexual harassment in medical settings? How can we ignore over a decade of research? How can we not heed the experience of so many young physicians? Given the uncertain times in Canadian medicine and the insecurity in our professional and personal lives, we must work together to improve the culture of our teaching institutions and implement measures nationally and locally to close this dark chapter.

The professional woman as patient: a review and an appeal.

The unique problems that the professional woman brings to therapy are presented here. It is the author's contention that the career woman's difficulties are not adequately realized or understood by many male therapists. Many of these patients are disappointed with or highly critical of their therapy with male psychiatrists. Two sub-groups of professional women are described: the married professional woman and the unattached professional woman. There are critical sex-role relate issues and countertransference problems which arise with the male therapist: professional woman patient dyad. Other implications for male psychiatrists are outlined and suggestions offered toward therapist enlightenment.

Common psychiatric problems in homosexual men and women consulting family physicians.

This paper describes the commoner psychiatric difficulties of homosexual patients seen in a family practice. It is written primarily to aid general practitioners in deciding who should be referred to a psychiatrist. Recent developments in the study of homosexuality indicate that homosexual persons are no more likely than heterosexuals to suffer psychiatric problems. Practical suggestions are made for management and counseling, and some of the misconceptions about the gay community are dispelled.