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Genetic counselors (GCs) and healthcare interpreters (HIs) are key members of the healthcare team when providing genetic counseling services to patients with Limited English Proficiency (LEP); however, the working relationship between GCs and HIs and the role each member plays within a genetic counseling session is unclear. Previous studies assessing this relationship have been qualitative and limited in sample size (Agather et al., 2018, Journal of Genetic Counseling, 26, 1388; Krieger et al., 2018, Journal of Genetic Counseling, 26, 1388; Lara-Otero et al., 2019, Health Communication, 34, 1608; Rosenbaum et al., 2020, Journal of Genetic Counseling, 29, 352). This study utilized a quantitative approach to allow for sampling of larger populations and to simultaneously understand current perspectives of GCs and HIs regarding each other's and their own roles within a genetic counseling session. GC and HI participants from the United States were recruited via email to complete an online survey with questions regarding interactions prior to a session, roles during a session, and opportunities for collaboration and constraints in the working relationship. Descriptive and inferential statistics were utilized to analyze responses of GCs and HIs. 130 GC and 40 HI participants were included in this study. There were statistically significant differences (p < .001) in responses between GC and HI participants on the expected distribution of roles during a session in advocacy, psychosocial and cultural domains. Additionally, this study identified that HI desired resources and training regarding genetics and genetic counseling are currently not being met. To our knowledge, this is the largest study to simultaneously survey GC and HI perspectives on these topics. Our findings suggest the need for greater communication and collaboration between GCs and HIs to ensure high-quality care for patients with LEP. Integrating a pre-session meeting between the GC and HI for sessions with patients with LEP and increasing education for GCs and HIs on the roles each group brings into a session is warranted to optimize this collaborative relationship and patient care., (© 2022 The Authors. Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Objective: While screening for psychosocial distress is now the standard of care in oncology, little guidance is available on how best to deliver services in response to identified needs. The American Psychosocial Oncology Society (APOS) convened a task force with the goal of creating a framework that could aid in planning services and justifying requests for resources., Methods: Ten experts from multiple disciplines within psychosocial oncology served on the task force, first meeting together as a larger group over 2 days to set an agenda and then subsequently working in smaller teams to execute the goals. The task force used consensus methods for developing recommendations., Results: Three principles were identified for the framework. First, psychosocial oncology is a key component of population health, and population-based approaches to care delivery are required. Second, several key parameters shape psychosocial oncology services: resources, aims, and scope. To guide resource allocation, example priorities were identified for the aims and scope of services. Finally, cancer care centers should strive to ensure the delivery of high-quality psychosocial oncology care across all components of care. A range of practices was ranked by their potential contributions to achieving that goal., Conclusions: This framework may aid in planning, evaluating, and refining the delivery of responsive psychosocial oncology services., (© 2020 John Wiley & Sons, Ltd.)

Culture bump theory provides a practical and goal-oriented framework for addressing cultural differences that can impact communication and patient care. Differences in language and culture, coupled with a lack of knowledge or competency regarding these differences, often contribute to 'culture bumps' between healthcare providers and patients. Interpreters serve the unique role of 'cultural brokers', going beyond bridging the linguistic divide to close cultural gaps. Research from the perspective of interpreters focused on culture bumps and cultural competency within genetic counseling sessions is lacking. We aimed to assess interpreters' experiences with significant 'culture bumps' in genetic counseling sessions, obtain interpreters' perspectives regarding genetic counselors' gaps in cultural competency, and explore interpreters' perceptions of the impact of cultural competency on the genetic counseling sessions. Spanish and Polish interpreters experienced in working in person with genetic counselors were recruited through interpreter supervisors at medical centers, hospitals, and interpreter training and service agencies in the Chicagoland area. Using a semi-structured interview guide, phone interviews were conducted with eligible participants and transcribed verbatim. A codebook was developed between two coders, and inter-rater reliability was assessed (κ = 0.82). Grounded theory was used as a guiding principle to code data. The results of this study revealed significant culture bumps identified by interpreters in genetic counseling sessions in the areas of exchange of information, gender and family dynamics, and incorporation of religious and faith beliefs. Interpreters identified the impact on rapport, both negative and positive, due to gaps and strengths in cultural competency, respectively. These responses offer useful insight for training and providing practicing genetic counselors with tools to promote cultural competency, in order to provide optimal care for patients with limited English proficiency (LEP). Further research is necessary to explore these concepts within other languages and cultures, as well as to determine the most appropriate methods for implementing these suggestions for improvement., (© 2020 National Society of Genetic Counselors.)

Growing demand for and limited geographic access to genetic counseling services is increasing the need for alternative service delivery models (SDM) like telephone genetic counseling (TGC). Little research has been done on genetic counselors' perspectives of the practice of TGC. We created an anonymous online survey to assess whether telephone genetic counselors believed the tasks identified in the ABGC (American Board of Genetic Counseling) Practice Analysis were performed similarly or differently in TGC compared to in person genetic counseling (IPGC). If there were differences noted, we sought to determine the nature of the differences and if additional training might be needed to address them. Eighty eight genetic counselors with experience in TGC completed some or all of the survey. Respondents identified differences in 13 (14.8%) of the 88 tasks studied. The tasks identified as most different in TGC were: "establishing rapport through verbal and nonverbal interactions" (60.2%; 50/83 respondents identified the task as different), "recognizing factors affecting the counseling interaction" (47.8%; 32/67), "assessing client/family emotions, support, etc." (40.1%; 27/66) and "educating clients about basic genetic concepts" (35.6%; 26/73). A slight majority (53.8%; 35/65) felt additional training was needed to communicate information without visual aids and more effectively perform psychosocial assessments. In summary, although a majority of genetic counseling tasks are performed similarly between TGC and IPGC, TGC counselors recognize that specific training in the TGC model may be needed to address the key differences.

Achieving improvements in survival and reducing relapse remains a challenge in acute myelogenous leukemia (AML) patients. This study evaluated the in vitro efficacy of the active form of novel agent sapacitabine, CNDAC, compared to current chemotherapeutic drugs Ara-C and mitoxantrone using two AML cell lines, HL-60 (promyelocytic) and THP-1 (monocytic), as well as bone marrow (BM) and peripheral blood (PB) cells collected from AML patients. Cell lines were exposed to compound for 3-6 days and primary cells for 4 days. The viability of primary cells was additionally evaluated 3, 7, and 31 days after removal of tested compound to determine the durability of the response. Our studies indicate that CNDAC and mitoxantrone have a greater impact on viability than ara-C in primary AML cells and AML cell lines. CNDAC is more effective at reducing viability and inducing apoptosis than ara-C at equivalent concentrations in the THP-1 cell line, which is defined as displaying resistance to ara-C. As sapacitabine has shown in vivo activity at clinically achievable doses, future studies are warranted to assess the potential for combining it with ara-C and/or mitoxantrone, with an emphasis on cells and patients insensitive to ara-C treatment.