Thu, 21 Aug 2008 07:08:19 BST CiteULike: jasonbobe's Edwards http://www.citeulike.org/user/jasonbobe/author/Edwards CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/jasonbobe/article/1097076 <i>Am J Med Genet C Semin Med Genet, Vol. 142, No. 4. (15 November 2006), pp. 294-303.</i><br /><br />It is increasingly clear that medical genetics has broad relevance in adult clinical medicine. More adult patients with genetic conditions are being recognized, genetic testing for adult-onset genetic conditions is expanding, and children with genetic conditions are now more likely to survive to adulthood. While the number of patients who could benefit from medical genetic services increases, adult care providers are less well educated about clinical genetics and are not sufficiently prepared to meet the growing needs of this population. Genetics professionals may also be ill-suited for this challenge, since geneticists and genetic counselors have traditionally had greater experience in pediatric and prenatal settings. Communication between primary care physicians who treat adults and the genetics community is currently suboptimal and the identification and subsequent referral of adult patients for genetic services need improvement. Finally, published guidelines that address how to deliver genetic services to adult patients are unavailable for many genetic conditions. In this article we address the challenges of transitioning genetics services from traditional, and largely pediatric-based models to paradigms that can best address the needs of adult patients with genetic conditions. Potential solutions and the practicality of implementation of a team-based approach to adult genetic medicine, including the application of genetic counseling, are also discussed. Lost in transition: challenges in the expanding field of adult genetics. MR Taylor JG Edwards L Ku doi:10.1002/ajmg.c.30105 Am J Med Genet C Semin Med Genet, Vol. 142, No. 4. (15 November 2006), pp. 294-303. 2007-02-09T15:01:44-00:00 2006 Am J Med Genet C Semin Med Genet 1552-4868 142 4 294 303 adult-genetics http://www.citeulike.org/user/jasonbobe/article/1889818 <i>J Genet Couns (30 October 2007)</i><br /><br />As an individual's understanding of their genetic risk may influence risk management decisions, it is important to understand the ways in which risk is constructed and interpreted. We systematically reviewed the literature, undertaking a narrative synthesis of 59 studies presenting data on the ways in which individuals perceive, construct and interpret their risk, and the subsequent effects. While most studies assessed perceived risk quantitatively, the combined evidence suggests individuals find risk difficult to accurately quantify, with a tendency to overestimate. Rather than being a stand-alone concept, risk is something lived and experienced and the process of constructing risk is complex and influenced by many factors. While evidence of the effects of perceived risk is limited and inconsistent, there is some evidence to suggest high risk estimations may adversely affect health and lead to inappropriate uptake of medical surveillance and preventative measures by some individuals. A more focused approach to research is needed with greater exploration of the ways in which risk is constructed, along with the development of stronger theoretical models, to facilitate effective and patient-centered counseling strategies. How Risk is Perceived, Constructed and Interpreted by Clients in Clinical Genetics, and the Effects on Decision Making: Systematic Review. Stephanie Sivell Glyn Elwyn Clara Gaff Angus Clarke Rachel Iredale Chris Shaw Joanna Dundon Hazel Thornton Adrian Edwards doi:10.1007/s10897-007-9132-1 J Genet Couns (30 October 2007) 2007-11-09T13:58:21-00:00 2007 J Genet Couns 1059-7700 risk