An examination of the factors contributing to the expansion of subspecialty genetic counseling.

In recent years, genetic counselors have moved into increasingly varied areas of patient care. Yet limited information is known about how these genetic counselors transitioned from more general clinical practice to subspecialized practice. This study was designed to answer three research questions: (1) What common factors establish a need for a genetic counselor in a subspecialty setting? (2) How do genetic counselors in subspecialties establish their positions? (3) Once established, how do the positions of these genetic counselors evolve as the subspecialty expands? Phone interviews with subspecialized genetic counselors led to the development of an online survey distributed through the National Society of Genetic Counselors ListServ. Sixty-eight of the 144 initial participants met eligibility criteria for participation as subspecialty genetic counselors in a clinical role. Physician interest in hiring a genetic counselor, clinical need, genetic counselor interest in subspecialty area, and available genetic testing were commonly reported as contributing factors to position creation. Most subspecialty genetic counseling positions were created as new positions, rather than evolved from a previous position. Over time, subspecialty positions drew more departmental funding and included increased clinical coordination or administrative responsibilities. The results of this study can encourage genetic counselors to collaborate with their medical institutions to utilize their skill-set in diverse areas of patient care.

[Parabolic parables: predictive genetic testing, social constructions of risk, and the relation between health-care professionals and the mass media]. / Parábolas, parabólicas: testagens genéticas preditivas, construções sociais de risco e a relação profissionais da saúde/meios de comunicação de massa.

The article examines conceptual topics underlying construction of the "new public health" and epidemiology, particularly its molecular branch and the idea of genetic risk, in the face of issues raised by new technologies, globalization, today's vast increase in communication strategies, and the weakening of identity links. Problems related to the creation of new interdisciplinary fields are also considered, such as epidemiology and molecular genetics. The repercussions of the social communication of genetic contents (especially predictive genetic testing and the cloning of mammals) are also analyzed.