The promise of personalized medicine depends on the ability to integrate genetic sequencing information into disease risk assessment for individuals. As genomic sequencing technology enters the realm of clinical care, its scale necessitates answers to key social and behavioral research questions about the complexities of understanding, communicating, and ultimately using sequence information to improve health. Our study captured the motivations and expectations of research participants who consented to participate in a research protocol, ClinSeq, which offers to return a subset of the data generated through high-throughput sequencing. We present findings from an exploratory study of 322 participants, most of whom identified themselves as white, non-Hispanic, and coming from higher socio-economic groups. Participants aged 45-65 years answered open-ended questions about the reasons they consented to ClinSeq and about what they anticipated would come of genomic sequencing. Two main reasons for participating were as follows: a conviction to altruism in promoting research, and a desire to learn more about genetic factors that contribute to one's own health risk. Overall, participants expected genomic research to help improve understanding of disease causes and treatments. Our findings offer a first glimpse into the motivations and expectations of individuals seeking their own genomic information, and provide initial insights into the value these early adopters of technology place on information generated by high-throughput sequencing studies. European Journal of Human Genetics (2011Genetics ( ) 19, 1213Genetics ( -1217 doi:10.1038/ejhg.2011; published online 6 July 2011Keywords: whole-genome sequencing; personalized medicine; early adopters INTRODUCTION Genomics has already revolutionized the biological sciences, and the future application of genomics to health care has the potential to improve prevention, diagnosis, and treatment of disease by refining individual risk in the clinical setting. However, this potential can only be realized through translational and clinical research studies to establish the relationship of disease risk to genomic variants derived from sequencing data. These studies will necessitate the enrollment of thousands of clinical research participants, and thus methods and approaches need to be developed to interact and communicate with participants regarding clinical genomics. As well, these clinical genomics studies will serve as the foundation for the development of approaches to health-care providers' interactions with patients undergoing sequencing in the clinic and hospital wards of the future.High-throughput genomic sequencing can elucidate an enormous range of sequence and copy number variations for a given individual. A typical whole-genome sequence determination yields on the order of 4 000 000 sequence variations that differ from the current human reference sequence. While most are benign or of unknown consequence, some are associated with a significant increased risk of disease for ...

Despite increased media attention on violent acts against others committed by military Veterans, few models have been developed to systematically guide violence risk assessment among Veterans. Ideally, a model would identify which Veterans are most at risk for violence and increased attention could then be turned to determining what could be done to prevent violent behavior. This article suggests how empirical approaches to risk assessment used successfully in civilian populations can be applied to Veterans. A review was conducted of the scientific literature on Veteran populations regarding factors related to interpersonal violence generally and to domestic violence specifically. A list was then generated of empirically-supported risk factors for clinicians to consider in practice. To conceptualize how these known risk factors relate to a Veteran's violence potential, risk assessment scholarship was utilized to develop an evidencebased method to guide mental health professionals. The goals of this approach are to integrate science into practice, overcome logistical barriers, and permit more effective assessment, monitoring, and management of violence risk for clinicians working with Veterans, both in Veteran Administration settings and in the broader community. It is likely that the use of a systematic, empirical framework could lead to improved clinical decision-making in the area of risk assessment, and help reduce violence among Veterans.

There is debate about the most appropriate form of treatment for partial tears of the lateral ligament of the ankle, which are common after inversion injuries. A prospective trial of four forms of treatment was carried out. The forms of treatment used were: no treatment with only a minimal bandage, Tubigrip support, immobilisation in plaster-of-Paris, and physiotherapy. The end point was taken when the patient returned to work or had a low score on an objective clinical scale. Early mobilisation, with or without physiotherapy, was found to offer the most rapid return to functional activity. Patients who had had their ankle immobilised in plaster-of-Paris required more days off work and longer attendance at a follow-up clinic.Inversion injuries are common and cause absence from work and discomfort for the patient. These findings suggest that mobilisation with physiotherapy, although not practical for all patients, is the most satisfactory course of treatment.