Genetics teaching for non-geneticist health care professionals in the UK

OBJECTIVES: It was the aim of this study to describe the structure and content of training in genetics for non-genetics specialist health care professionals in the UK. METHODS: Data were collected by assessment of published syllabi and curricula and through contact with educational leads at responsible organisations. RESULTS: Twenty-six universities, 7 Royal Colleges and various intercollegiate boards and committees are involved in the provision of medical education at various levels, in addition to institutions offering nursing and/or midwifery training. Genetics is taught in variable formats, quantities and contents, and although some institutions are moving to adopt minimum competencies in genetics, this is by no means widespread. CONCLUSIONS: Given the wide number of stakeholders in the field, consensus competencies seem most likely to advance practice, and thus, phase II of the GenEd project will survey professionals to ascertain their priorities for genetic education.     

Genetics education for non-genetic health care professionals in the Netherlands (2002)

OBJECTIVE: The aim of the present study was to investigate whether medical care providers in the Netherlands are adequately educated in genetics by collecting information about the current state of genetics education of non-genetics health care professionals. METHOD: The curricula of the 8 universities providing medical education and of all varieties of specialised medical training were examined for the year 2002. RESULTS: In most universities, the number of hours spent on genetics education is small, and genetics is relatively invisible, being integrated within several courses, comprising only a small proportion of the total course (a mean of 8%). Only 3 of the programmes for medical specialist training and the training of medical doctors for mentally handicapped people indicated a formal genetics education programme. Continued education courses on genetics are offered irregularly. Training in midwifery involves at least 3 weeks of genetics education. Courses on genetics are offered frequently to practicing midwives. CONCLUSION: There appear to be no general, nationally defined final goals for education in genetics for non-genetics health care professionals in the Netherlands. Furthermore, the lack of visibility of genetics in medical education in the Netherlands was striking.     

Role of primary care providers in the delivery of genetics services

Fruits of the Human Genome Project are already transforming health care. Primary care providers, regardless of specialty, will need to integrate new genetics knowledge into routine practice in order to fulfill their role in genetics services delivery. Unfortunately, few are prepared for this revolution, and current educational efforts are inadequate. To effect the changes that are needed, we must teach genetics as an integrative discipline at all stages of professional education and emphasize the value of this knowledge to practice.     

Strengthening genetic services in primary care for Asian Americans and Pacific Islanders

The Association of Asian Pacific Community Health Organizations (AAPCHO) is a national membership organization of community health centers (CHCs) that serve medically underserved Asian Americans and Pacific Islanders (AAPIs) with limited English-speaking proficiency and low income. OBJECTIVES: In 1995, AAPCHO was funded for a 3-year national genetics training project to improve genetics training among primary care providers at CHCs and strengthen linkages with tertiary genetic centers (TGCs). Three model linkages between CHCs and TGCs were documented on the coordination of genetic services for medically underserved AAPIs. METHODS: Guidelines were developed for three CHCs to document their genetic programs and linkages with TGCs. In addition, one clinic conducted a mail survey to assess understanding of prenatal genetic counseling sessions by patients that visited the clinic during the past 2 years. RESULTS: Model linkages between CHCs and TGCs to improve cultural and linguistic accessibility for patients include formal coordination between the CHCs and TGCs for the delivery of genetic services and the provision of varying levels of genetic services at the CHC. From the patient survey, there was a 59% response rate among 70 surveys mailed to former patients. The survey results showed that while a majority of patients understood and recalled key genetic concepts, one-fifth of patients experienced difficulty understanding their genetic counseling sessions. CONCLUSION: Based on model linkages between CHCs and TGCs and the patient satisfaction survey results, the following strategies are recommended to improve accessibility of genetic services for medically underserved AAPIs: (1) genetics education should be developed for all levels of health center staff; (2) counseling should be culturally sensitive and focus on key issues that must be conveyed for appropriate informed consent; (3) genetics education should employ the use of translated audiovisual aids and brochures to improve understanding; (4) genetic services should be coordinated between CHCs and TGCs to provide culturally and linguistically competent care for medically underserved AAPIs, and (5) financial mechanisms should be available to support genetic testing of patients and their families with little or no coverage for genetic services.     

Assessment of two 'low-tech' genetic health care procedures performed by prenatal care providers in Washington state: implications for future policy development activities

Equity in health care demands that patients be treated fairly, impartially and with justice. Health care professionals and others have long been aware of the concept of equity, and the many inequities that exist in our health care system. As part of our analysis of postpartum data collected between 1993 and 1996 by the Washington Pregnancy Risk Assessment Monitoring System (PRAMS) from self-administered patient surveys, we explored equity as it pertains to two 'low-tech' prenatal genetic health care procedures: (1) whether or not prenatal care providers asked their patients about a family history of birth defects/genetic disorders, and (2) whether or not prenatal care providers talked to their patients about prenatal testing for birth defects/genetic disorders. Overall, about 80% of pregnant women reported that they had been asked about their family history of birth defects/genetic disorders, and about 85% said that their prenatal care provider(s) had talked to them about prenatal testing. Maternal characteristics associated with a lower likelihood of receiving these two low-tech genetic health care procedures appeared to be young maternal age, and low education and income levels, regardless of where women with these attributes received their prenatal care (e.g. community, migrant, health department or military health care clinics, private physicians, or health maintenance organizations).     

Personal characteristics of older primary care patients who provide a buccal swab for apolipoprotein E testing and banking of genetic material: the spectrum study

OBJECTIVE: To determine the personal characteristics and reasons associated with providing a buccal swab for apolipoprotein E (APOE) genetic testing in a primary care study. METHODS: The study sample consisted of 342 adults aged 65 years and older recruited from primary care settings. RESULTS: In all, 88% of patients agreed to provide a DNA sample for APOE genotyping and 78% of persons providing a sample agreed to banking of the DNA. Persons aged 80 years and older and African-Americans were less likely to participate in APOE genotyping. Concern about confidentiality was the most common reason for not wanting to provide a DNA sample or to have DNA banked. CONCLUSION: We found stronger relationships between sociodemographic variables of age and ethnicity with participation in genetic testing than we did between level of educational attainment, gender, function, cognition, and affect.     

Nonlinear development of a wave in a boundary layer

In recent years definite progress has been achieved in the construction of theoretical models of nonlinear wave processes which lead to a transition from laminar to turbulent flow [1, 2]. At the same time, there is a shortage of actual experimental material, especially for flows in a boundary layer. Fairly thorough experimental studies have been carried out only on the initial stage of the development of disturbances in a boundary layer, which is satisfactorily describable by the linear theory of hydrodynamic stability. In evaluating the theoretical models of subsequent stages of the transition, investigators have been forced to turn chiefly to much earlier experiments carried out by the United States National Bureau of Standards [3, 4], in which the main attention was concentrated on the three-dimensional structure of the transition region. The present investigation was undertaken for the purpose of obtaining detailed data on the structure of the flow in the transition region when there is disturbance in the laminar boundary layer of a two-dimensional wave. In order to make the two-dimensional nonlinear effects stand out more clearly, the amplitude of the wave was specified to be fairly large from the very outset. In contrast to earlier investigations, the main attention was centered on the study of the spectral composition of the disturbance field.Translated from Izvestiya Akademii Nauk SSSR, Mekhanika Zhidkosti i Gaza, No. 3, pp. 49–58, May–June, 1977.     

Pressure development in a non-Newtonian flow through a tapered tube

Summary The flow of viscous fluids through a tapered tube is very interesting from the standpoint of blood flow in blood vessels. The taper of the tube is an important factor in the pressure development. In the first place, we have given a brief summary of our theory of the steady convergent flow of non-Newtonian fluids characterized by an arbitrary time-independent flow curve through a slightly tapered tube. Based on our general formula for the flow per unit time, explicit formulae of the pressure gradient are obtained in several cases of non-Newtonian fluids specified by particular flow curves: power law fluid,Bingham body, and the fluid obeyingCassons equation. In all these cases it is shown that the pressure gradient is not constant along the axis but increases with decrease in the radius of the tapered tube. If we neglect quantities of order ² (: angle of taper), then the pressure gradient increases linearly with the distance along the axis of the tube.With 2 figures     

Convection development in a liquid layer with a free boundary

In certain calculations of the critical Rayleigh number for a liquid layer with free boundary which is heated from below, the linearization method has been used and it has been assumed that the temperature perturbations disappear at the undisturbed free boundary.Proper linearization shows that the temperature perturbation is proportional to the free surface perturbation, and the latter is proportional to the normal stress perturbation with the proportionality factor F=²/gh³ (g is the free-fall acceleration, is the kinematic viscosity, h is the liquid layer thickness). In §1 we present a formulation of the problem with account for the parameter F; in §2 we consider the linearized equations and the existence of a stability threshold is proved-a positive eigenvalue-and it is established that with an increase in the parameter F/P (P is the Prandtl number) the value of the critical Rayleigh number Ra_* decreases; §3 presents the results of a numerical calculation of Ra as a function of the parameter F/P.Convection development in a liquid layer with a free surface on which a given temperature is maintained was studied in [1, 2]. The value R_*=1100 found for the critical Rayleigh number agrees well with the experimental value. In the calculations made in [1, 2] the linearization method is used, and it is assumed that the temperature perturbations disappear at the undisturbed free boundary. Strictly speaking, this assumption is not correct.Correct linearization shows that the temperature perturbation is proportional to the perturbation of the free boundary, and the latter is proportional to the normal stress perturbation (see below (2.3)).The problem formulation is presented in §1; §2 deals with the linearized equations and the existence (Theorem 2.1) is demonstrated of a stability threshold—which is a simple positive eigenvalue; §3 presents the results of a numerical calculation of R_* as a function of the parameter =F/P.     

Genetics and congenital malformations: interpretations, attitudes and practices in suburban communities and the shamans of ecuador

OBJECTIVES: The purpose of the present article was to evaluate how shamans and the suburban communities of Quito interpret the terminology used in genetics. METHODS: One hundred people living in 5 suburban districts of Quito were surveyed as well as 19 shamans of the Salasaca community. RESULTS: The results show that members of both groups are little informed about genetics. As knowledge about genetics is correlated to educational level, which is very poor in both groups, knowledge and understanding of genetics are either very basic or nonexistent. As for the medical practices in treating genetic alterations, the surveys show that while in very severe cases scientific medicine is sought, in most cases explanations and a cure are given by shamanic medicine. CONCLUSION: There is limited knowledge of genetics and its terminology in the study population. Shamanic and marginal health practices seem to remain prevalent in these communities due to their low costs, the personal attention the individuals receive, and the holistic point of view employed. It is important that the community councils, the medical doctors and the shamans work together to set up community programs on medical education, particularly on genetics.     

Microstructure development in concentrated suspensions in a spinning ball rheometer

The spinning ball rheometer has been proposed as a method to measure the microstructure effect on the bulk rheological properties of concentrated suspensions. Recent experiments have shown that the measured extra torque on the spinning ball decreases as the radius of the spinning ball becomes comparable to the size of the suspended particle. We have performed a series of three‐dimensional boundary element calculations of the rheometer geometry to probe the microstructure effects that contribute to that apparent slip. We present a series of quasi‐static results based on random initial configurations as well as fully three‐dimensional transient calculations, both of which are compared to the available experimental data. For the two cases, the apparent viscosity decreased as the size of the spinning ball decreased relative to the suspended particle. Comparison of the quasi‐static and transient simulations indicates that the microstructure development is critical even at short times. In the transient calculations, the viscosity was observed to increase substantially relative to the torque based on the random initial configuration. Published in 2005 by John Wiley & Sons, Ltd.