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Assessing the risk of common, complex diseases requires consideration of clinical risk factors as well as monogenic and polygenic risks, which in turn may be reflected in family history. Returning risks to individuals and providers may influence preventive care or use of prophylactic therapies for those individuals at high genetic risk.To enable integrated genetic risk assessment, the eMERGE (electronic MEdical Records and GEnomics) network is enrolling 25,000 diverse individuals in a prospective cohort study across 10 sites. The network developed methods to return cross-ancestry polygenic risk scores (PRS), monogenic risks, family history, and clinical risk assessments via a Genome Informed Risk Assessment (GIRA) report and will assess uptake of care recommendations after return of results.GIRAs include summary care recommendations for 11 conditions, education pages, and clinical laboratory reports. The return of high-risk GIRA to individuals and providers includes guidelines for care and lifestyle recommendations. Assembling the GIRA required infrastructure and workflows for ingesting and presenting content from multiple sources. Recruitment began in February 2022.Return of a novel report for communicating monogenic, polygenic, and family history based risk factors will inform the benefits of integrated genetic risk assessment for routine health care.

Alumni of foster care are at considerable risk for transitioning to adulthood without supportive parental relationships due to significant disruptions of these relationships and histories of maltreatment. This study investigated key dimensions of parental support (care, dependability and financial support) in relationships with birth parents and parental figures among young adults who received foster care and exited to diverse permanency outcomes. Using Latent Class Analysis, four groups were identified indicating young adults who had (a) connections to both birth parents and parental figures; (b) minimal connections; (c) some connection to parental figure; and (d) some connection to birth parent. Young adults who reported connections with both birth parents and parental figures reported better outcomes, while those who reported minimal connections had least optimal outcomes. An examination of antecedent characteristics indicated a modest role of legal permanence. Results here highlight a need for inclusive child welfare practices that honor the family fluidity that foster youth experience and privilege relationship quality over legal permanence, particularly for older youth in foster care. Greater methodological rigor in the assessment and study of relational permanence and its potential to offset risks among maltreated youth in foster care is called for.

Objective: This article describes the first-year evaluation outcomes of a program developed to increase information technology access and skills among foster children and families within the context of a long-term foster care environment. Method: A sample of 34 foster families who received computers, Internet connection, and supportive services was compared with 30 foster families not in the program using survey methods and a posttest only design. Results: The results indicated after a year in the program, foster families increased their frequency of computer use, confidence in using computers and the Internet, and frequency of e-mail with social workers. Parents and foster children perceived the program to be useful in improving children’s technology skills, homework, grades, and interest in technology-related careers. Conclusion: The program appears to be successful in spite of lack of full implementation of the program model. Implications for future digital divide programs are discussed.

The extent to which foster families utilize social support on the Internet is examined in a sample of 34 foster families in a digital divide intervention program and a comparison sample of 30 foster families who were not part of the program. In spite of increased Internet access, the frequency of using online social support is low. A minority of parents and children increased their use of the Internet to give and receive help, communicate with other foster families and e-mail with their foster care worker. More than half of foster youth have used the Internet to stay in touch with friends and relatives and have “made a new friend” over the Internet. Implications for child welfare practice and for further research are discussed.

Foster parents and children (n = 64 families) who participated in a program to reduce the digital divide among foster children were surveyed about difficulties experienced in use of online communications. Providing Internet access to foster families increased Internet use, but was not perceived by parents or children as taking away time from other family or social relationships. A minority of parents and foster youth, however, reported a variety of problems ranging from benign arguments over access to the computer or frustration over equipment failure to serious concerns about children receiving pornography or meeting a sexual predator online. Although the majority of both parents and social workers were confident in their ability to deal with Internet-related problems, approximately one-third had low confidence in their ability to deal with foster family's Internet-related difficulties. Training foster parents on using filtering software to prevent pornography from coming into the child's experi...

This article describes a program developed to increase information technology access and skills among foster children and families within the context of a long-term foster care environment. The model emphasizes continuity and integration of technology into ongoing service provision for life skills development in foster youth. The authors describe the program development process, then describe a framework for evaluation and identify preliminary implementation issues. Baseline data provide evidence for a “digital divide” within the foster care community and suggest that foster children lag behind biological children in foster families in development of technology skills. Finally, experienced and anticipated implementation challenges are discussed in the context of ongoing evaluation.

The case is advanced that decadal variability of climate in the Pacific sector is driven by tropical atmosphere-ocean interactions and communicated to the extratropics. It is shown that tropical decadal variations in the last century could arise as a consequence of the regional subset of physics contained within an intermediate model of the El Nino-Southern Oscillation. These decadal changes in ENSO and tropical mean climate are more predictable than chance years in advance but even in these idealized experiments forecast skill is probably too small to be useful. Nonetheless, forecasts of the next two decades indicate that, according to this model, the 1998 El Nino marked the end of the post 1976 tropical Pacific warm period. Observations and atmosphere general circulation models are interpreted to suggest that decadal variations of the atmosphere circulation over the North Pacific between the 1960s and the 1980s are explained by a mix of tropical forcing and internal atmospheric variability. This places a limit on their predictability. The ocean response to extratropical atmosphere variability consists of a local response that is instantaneous and a delayed response of the subtropical and subpolar gyres that is predictable a few years in advance. It is shown that the wintertime internal variability of the Aleutian Low can weakly impact the ENSO system but its impact on decadal predictability is barely discernible.

The conventional models used for preparing youth for emancipation from child welfare emphasize independent living services in which youths learn how to find an apartment, apply for jobs or college, and manage money and budget for household expenses. Yet the focus on “independence” for youth leaving the child welfare system does not fit with the developmental tasks of adolescence. A more fitting goal for youth would be “interdependence,” as most young people do not achieve instant independence, but gradually take on the roles of an adult as they navigate through their twenties. During this period they require considerable emotional and practical support from families. Youth become independent and exercise autonomy within these supportive and empowering relationships.

Community coalitions address a wide variety of community problems, espousing a community development processes that promotes individual and collective self-determination. They offer a promising venue for the study of empowerment of individuals and organizations. This study utilizes data from members of 35 community coalitions organized for the prevention of alcohol and other drug problems to address the following questions: What individual characteristics are related to the psychological empowerment of coalition members? What organizational characteristics are related to the collective empowering of members? What organization characteristics are related to a coalition being organizationally empowered to succeed in achieving its objectives? At the individual level, psychological empowerment was most strongly related to individuals' participation levels, sense of community, and perceptions of a positive organizational climate. At the group level, the strongest predictors of collective empowering (our operationalization of the empowering organization) were net benefits of participation, commitment, and positive organization climate. Psychological empowerment and positive organizational climate were the two predictors of organizational effectiveness (the empowered organization). Implications and limitations of these findings are discussed.

This article describes what a private agency expended while addressing the transitional needs of former long-term foster youth and examines the association between expenditures and adult outcomes. Not all young adults accepted supports extended to them. In the sample, 41% of the young adults incurred expenses after age 19. Of those using supports, about two-thirds incurred expenses for higher education, and slightly fewer for continued housing support. Median expenses were generally stable or declining between ages 19 and 21, although almost all declined after age 22. Young adults who received extended supports tended to be better off at follow-up, although some troubled young adults used extensive, expensive services.

Khan, Rene s., Farooq Amin, Peter Powchik, Peter Knott, Marvin Goldstein, Seth Apter, Ben Kerman, Stacey Jaff and Michael Davidson: Increments in Plasma Homovanillic Acid Concentrations after Neuroleptic Discontinuation are Associated with Worsening of Schizophrenic Symptoms. Prog. NeuroPsychopharmacol. & Biol. Psychiat. 1990, 14 : 879–884. 1. 1. Thirty-two male schizophrenic patients participated in this study. 2. 2. Plasma concentrations of the dopamine metabolite, homovanillic acid (pHVA) were assessed once on neuroleptic medication and twice a week for a maximum of six weeks after its discontinuation. 3. 3. Psychiatric symptomatology was assessed once on neuroleptic medication and once a week for a maximum of six weeks after its discontinuation, using the brief psychiatric rating scale (BPRS). 4. 4. pHVA and total BPRS score increased significantly after discontinuation of neuroleptic as compared to baseline. 5. 5. The magnitude of pHVA and BPRS increments after discontinuation of neuroleptic correlated significantly. 6. 6. Results of this study suggest that worsening of schizophrenic symptoms after discontinuation of neuroleptic treatment is associated with increased pHVA concentrations.