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Telephone and televideo have yielded equivalent patient satisfaction and psychosocial outcomes when compared to in-person genetic counseling, yet little is known about how they compare to one another. In this randomized controlled trial, veterans received genetic counseling via telephone or traveled to a clinic to participate via encrypted televideo. Knowledge and visit satisfaction were assessed 2 weeks later. Travel time, mileage, and out-of-pocket costs were calculated for videoconferencing. Qualitative interviews were conducted with patients and counselors to assess acceptability. Of the 20 male patients randomized to telephone, 90% received counseling and provided outcomes; of the 18 randomized to televideo, 67% received counseling and 50% provided outcomes. Telephone patients answered a mean of 4.4 of eight questions correctly at baseline and 4.7 at follow-up; televideo means were 5.6 and 6.5, respectively. Satisfaction was 25.2 out of 30 for telephone and 26.9 for televideo. Televideo patients incurred a median of 2.8 h of travel time, 40 roundtrip miles, and $67.29 in costs. Patients and counselors found both modes acceptable for providing education and answering questions. Although patients liked the flexibility of telephone, counselors felt patients missed more appointments and were distracted when using telephone. A noted advantage of videoconferencing was reading body language. Further evaluation of alternative delivery modes is needed.

The Journal of Genetic Counseling is the literary voice of our profession and our scholarship is only as good as the articles that are accepted. A quality review assists the editor in making publication decisions and enhances the manuscripts that are published, ultimately benefitting our profession and the public. Perhaps you are new to the reviewing process and/or you wonder about the sorts of things that make for a good review. The purpose of this article is to provide general guidance to enhance your experience of peer review. While the focus is research manuscripts, many of the guidelines will be similar for case reports, reviews, or professional issues papers.

They are the Millennials – Generation Y. Over the next few decades, they will be entering genetic counseling graduate training programs and the workforce. As a group, they are unlike previous youth generations in many ways, including the way they learn. Therefore, genetic counselors who teach and supervise need to understand the Millennials and explore new ways of teaching to ensure that the next cohort of genetic counselors has both skills and knowledge to represent our profession well. This paper will summarize the distinguishing traits of the Millennial generation as well as authentic learning and evolutionary scaffolding theories of learning that can enhance teaching and supervision. We will then use specific aspects of case preparation during clinical rotations to demonstrate how incorporating authentic learning theory into evolutionary scaffolding results in experiential evolutionary scaffolding, a method that potentially offers a more effective approach when teaching Millennials. We conclude with suggestions for future research.

Objectives: Expanding the existing Breast Cancer Family Registry (BCFR) to enrol daughters aged 6–17 years in a prospective cohort study named LEGACY (Lessons in Epidemiology and Genetics of Adult Cancer from Youth) offers the opportunity to study the effects of genetic and environmental exposures in youth on adult breast cancer risk. Few studies have assessed parents' willingness to enrol their daughters in genetic epidemiological cohort studies. Since BCFR parents are the gatekeepers of their daughters' future enrolment, it is important to explore their interests and attitudes towards LEGACY. Methods: Semi-structured telephone interviews were conducted with 85 BCFR participant parents at 3 BCFR sites in Ontario, Canada, and in Utah and Northern California. We explored parents' thoughts and feelings (interests and attitudes) regarding their daughters' enrolment in LEGACY and different data collection modalities. Qualitative analysis of audiotaped interviews was carried out utilizing an inductive content analysis. Results: Parents' acceptance of three data collection modalities were 92% (78/85) for questionnaire data, 87% (74/85) for biological samples and 63% (46/73) for physical examination for pubertal staging. The parents' primary motivation for participation was altruistic. Their concerns regarding their daughters' participation centered on exacerbating awkward pubertal feelings, increasing cancer anxiety, respecting autonomy and maturity, privacy and future use of data and logistical impediments. Conclusion: Parents demonstrated a high level of interest in the creation of LEGACY. Their motivation to participate was balanced by their desire to protect daughters from undue harm. These interviews contributed valuable information for the design of LEGACY. Copyright © 2009 John Wiley & Sons, Ltd.

This study examined the impact of a genetics education module provided by Reach to Recovery peer volunteers. Participants included 113 women with confirmed breast cancer diagnoses. Eighty-eight of these women (78%) completed a baseline survey, participated in a peer-led intervention, and completed a follow-up survey. Approximately half of the women received an education module that included a genetic component, while the other half did not. Results indicated that women who received the genetics module had greater increases in genetics knowledge than the group that did not receive the module. However, follow-up interest in genetic testing was not significantly different between the two groups. Results indicate that a peer-led genetics module can increase knowledge about genetics. However, it does not appear to have a differential effect on genetic testing interest.

We report a case involving the disclosure of BRCA1 mutation results to a woman who had placed a child for adoption 30 years prior to learning her mutation status. The disclosure of the mother's genetic test result to the son resulted in unexpected subsequent communications. This article briefly describes the experience and discusses the unique issues that arise in counseling a parent who has relinquished a child who is subsequently at risk to inherit a mutation for an adult onset genetic condition. © 2003 Wiley-Liss, Inc.

Advances in molecular biology and geneticshave led to the identification of the breast/ovarian cancer susceptibility genes BRCA1and BRCA2, along with tests to detect muta-tions in these genes. Although the appropri-ateness of BRCA1/2 genetic testing for chil-dren has been debated in the literature,little is known about the attitudes of indi-viduals who have undergone cancer suscep-tibility testing. The present study focusedon attitudes toward BRCA1 testing for chil-dren among 218 adults from a Utah-basedkindred who had received BRCA1 test re-sults. Results indicated that approximatelyone-fourth of the participants would permitBRCA1 testing for children under the age of18. General attitudes about genetic testingwere predictive of attitudes toward the test-ing of children. In addition, men and indi-viduals without a BRCA1 mutation weremore likely to agree that minors should beallowed BRCA1 testing. Individuals whosemother had been affected with breast can-cer were less likely to permit testing for mi-nors. Among parents of minor children, lessthan one-fifth indicated that they wouldwant BRCA1 testing for their own children;carrier status was not predictive of atti-tudes toward testing their own children. Asbreast/ovarian cancer susceptibility testingcontinues to be disseminated into clinicalsettings, there may be an increase in thenumber of test requests for minors. Thefindings of the present study represent animportant step in exploring attitudes aboutgenetic testing of children among individu-als who have received cancer susceptibilitytest results. Am. J. Med. Genet. 92:25–32,2000.

This study was designed to determine the significance of a single intronic base change (IVS5 -12 GA) found in a family with a history of breast cancer. This change is predicted to form a cryptic splice site resulting in the addition of 11 nucleotides to the BRCA1 transcript. The BRCA1 gene of the relatives and control individuals was sequenced and analyzed using RT-PCR, ASO hybridization, and size fractionation. All patients showed an 11 nucleotide insert at the intron 5/ exon 6 boundary. This variant is likely to form a short protein product incapable of the hypothesized tumor suppressor functions of the BRCA1 gene. This information is important for providing counseling for families with this cryptic splice site and a family history of breast cancer. Am. J. Med. Genet. 80:140–144, 1998. © 1998 Wiley-Liss, Inc.

This article discusses the genetic counseling protocols which were developed and counseling issues that have arisen in the first 2 years of evaluating a large kindred with a BRCA1 mutation. The rationale for the development of the genetic counseling protocols and specific genetic counseling visual aids are presented and discussed. The protocols and counseling aids can serve as models for other programs offering cancer susceptibility testing. The observations of study counselors about study subject concerns and responses to genetic testing at the time of the pretest and posttest counseling sessions are presented.

We have come a long way from the first Journal of Genetic Counseling (JGC) special cancer issue published in 1998. At that time, the articles were geared towards counselors who were new to the field – the majority of us! Since then, genetic counselors have flourished as members of high risk clinics and research teams resulting in numerous articles on cancer genetic counseling, risk assessment, genetic testing logistics, family communication, and psychosocial issues. Many of the articles in our JGC over the last few years have involved cancer counseling, and the Special Interest Group felt it was time to collect and present our current practices and ideas for moving forward. When we began to assemble this “special cancer issue,” we realized that this issue would reflect the dynamic changes and the key differences that make cancer genetic counseling the fascinating field it has become. So what to say about these articles? We have a side bet regarding which of the manuscripts will be read the most. This issue covers the gamut from a personal story to original research, with a few review articles and teaching pieces added for good measure. It includes personal soul searching, spirituality, a new way to look at a standard tool, a disease that we don’t (yet) commonly counsel, and policy suggestions for cancer genetics programs, hospitals, and our profession.