The physician as moral entrepreneur

This paper argues that the work of the contemporary physician is at least in part the work of a moral entrepreneur. The effects of religious affiliation and religiosity on the decision making of a modern doctor are examined in an analysis of the responses of 231 physicians to a mailed questionnaire. Decision-making issues were considered to be those with social/moral implications. Religious physicians tend to favor clergy involvement in social and procreative issues. Roman Catholic physicians oppose the involvement of the medical profession in birth control issues.     

Reading Between the Lines: A Comparison of Responders and Non-responders to a Family History Questionnaire and Implications for Cancer Genetic Counselling

Family history questionnaires (FHQ) are useful tools for cancer genetic counseling, providing an informational basis for pedigree construction and individualized cancer risk assessment. Reported return rates of mailed FHQs amongst familial cancer clinics that utilize them are lower than desired however, and it is unknown whether patients perceive required completion of a FHQ as a barrier to access of cancer genetics services. This study critically evaluated the use of a mailed FHQ for all routine new patient referrals to a single hereditary cancer clinic in Quebec, Canada. Reasons for response/non-response to a FHQ and the effect of administration of a questionnaire on patients’ self-reported level of motivation to pursue genetic counseling, were examined. Of 112 eligible individuals referred during the study period, 86 completed a semi-structured telephone survey; of these, 45% had returned the mailed FHQ prior to the telephone survey (Responders) and 55% had not (Non-responders). Overall, the majority of participants indicated a FHQ is an acceptable and understandable method of collecting family history information. Most prevalent reasons for not returning the FHQ were (bad) timing (56%), and difficulty accessing family history information (46%). Non-response was significantly associated with difficulty in asking relatives for the requested information (p = 0.011), and Non-responders cited fewer overall perceived benefits of cancer genetic counseling as compared with Responders (p < 0.0001). One quarter of Non-responders returned the mailed FHQ following administration of the telephone survey, suggesting implementation of a follow-up prompt is a cost-effective way to increase response.     

EVALUATION OF BUSINESS MEMOS: EFFECTS OF WRITER SEX AND ORGANIZATIONAL POSITION, MEMO QUALITY, AND RATER SEX

This study investigated main and interaction effects of memo quality, attributed author sex and organizational position, and rater sex on evaluation of business memos. Alternative questionnaire versions of four memos to be rated anonymously were mailed to about 500 members of a professional personnel association; 48% were returned. A 2×2×2×2 analysis of variance yielded a large main effect for memo quality; an interaction effect of attributed author sex and position and rater sex for two memos; and other interaction effects for single memos. The results are discussed.     

An Evaluation of Prompting and Reinforcement for Training Visual Analysis Skills

This study examined the use of an instructional package consisting of structured criteria, extrastimulus prompts, prompt delay, and reinforcement contingencies to improve decision making based on visual analysis of case-study (A/B) design data. Four participants without backgrounds in behavior analysis received training under two experimental conditions: first, a prompt-delay-plus-accuracy-reward condition and then a prompt-delay-plus-accuracy-and-latency-reward condition. A multiple-baseline-across-participants design was used to evaluate the impact of the instructional package on decision accuracy, response speed, and decision types. Results demonstrated that all participants made substantial improvements in decision accuracy as a function of the instructional package. Gains were highest for three participants who relied on prompts and developed mastery in the prompt-delay-plus-accuracy-reward condition. Generalization to unprompted conditions for all participants was immediate and maintained 1 week after training was concluded. Results are discussed in terms of behavioral mechanisms that appeared to control decision making during instruction, practical applications to applied settings, and needs for future research.     

An Apple II package for computer-assisted telephone interviewing

This paper describes an Apple II (an Apple-compatible) microcomputer package for a computer-assisted telephone interviewing (CATI) system. This system generates random telephone numbers within any number of exchanges that the user supplies, automatically dials the telephone, prompts the interviewer with each question, and records and permanently saves each response. It also provides a printed copy of the collected data by frequency of response in each question category. The Apple II CATI package is readily available, inexpensive, and easy to program in the BASIC language.     

Explicit awareness supports conditional visual search in the retrieval guidance paradigm

In four experiments we explored whether participants would be able to use probabilistic prompts to simplify perceptually demanding visual search in a task we call the retrieval guidance paradigm. On each trial a memory prompt appeared prior to (and during) the search task and the diagnosticity of the prompt(s) was manipulated to provide complete, partial, or non-diagnostic information regarding the target's color on each trial (Experiments 1–3). In Experiment 1 we found that the more diagnostic prompts was associated with faster visual search performance. However, similar visual search behavior was observed in Experiment 2 when the diagnosticity of the prompts was eliminated, suggesting that participants in Experiment 1 were merely relying on base rate information to guide search and were not utilizing the prompts. In Experiment 3 participants were informed of the relationship between the prompts and the color of the target and this was associated with faster search performance relative to Experiment 1, suggesting that the participants were using the prompts to guide search. Additionally, in Experiment 3 a knowledge test was implemented and performance in this task was associated with qualitative differences in search behavior such that participants that were able to name the color(s) most associated with the prompts were faster to find the target than participants who were unable to do so. However, in Experiments 1–3 diagnosticity of the memory prompt was manipulated via base rate information, making it possible that participants were merely relying on base rate information to inform search in Experiment 3. In Experiment 4 we manipulated diagnosticity of the prompts without manipulating base rate information and found a similar pattern of results as Experiment 3. Together, the results emphasize the importance of base rate and diagnosticity information in visual search behavior. In the General discussion section we explore how a recent computational model of hypothesis generation (HyGene; Thomas, Dougherty, Sprenger, & Harbison, 2008), linking attention with long-term and working memory, accounts for the present results and provides a useful framework of cued recall visual search.     

Pastoral Counseling Down Under: A Survey of Australian Clergy

This survey research describes the attitudes and practices of Australian Christian clergy regarding counseling in their pastoral care roles. Data has been collected by use of a mail survey of 1954 Australian clergy residing in the state of Queensland from Dec 2007 until March 2008. 758 useable surveys were returned resulting in a return rate of 40.1%. The clergy’s (a) confidence in handling seven different counseling situations, (b) counseling preparation, (c) professional knowledge about counseling, (d) counseling modality, and (e) demographics were assessed. Australian Christian clergy are thus described with a discussion of a number of implications for training organisations such as Bible Colleges and Seminaries.     

Confidentiality and mandatory reporting

Confidentiality is a cornerstone in the identity of the clergy. Confidentiality makes it safe to disclose sins, but the information received may sometimes cause dilemmas for the clergy. Through pastoral care with people in different circumstances, members of the clergy are on the front line for detecting and reporting child abuse and domestic violence. In this article, I explore how clerics judge dilemmas and determine the right course of action when facing cases of possible child abuse or domestic violence. How do members of the clergy reason through their choices? What grounds do they give for their actions? Data are provided from a mixed methods study with 53 Norwegian parish priests. The clergy’s decision-making will be the primary focus. Confidentiality is frequently associated with trust. The clergy maintain that confidentiality contributes to securing trust in themselves, as well as in the church as an institution. My analysis suggests that the clergy’s reflections on confidentiality conflict with Norwegian mandatory reporting laws and that the clergy may benefit from a reframing of pastoral confidentiality.     

Defining forgiveness: christian clergy and general population perspectives

The lack of any consensual definition of forgiveness is a serious weakness in the research literature (McCullough, Pargament, & Thoresen, 2000). As forgiveness is at the core of Christianity, this study returns to the Christian source of the concept to explore the meaning of forgiveness for practicing Christian clergy. Comparisons are made with a general population sample and social science definitions of forgiveness to ensure that a shared meaning of forgiveness is articulated. Anglican and Roman Catholic clergy (N = 209) and a general population sample (N = 159) completed a postal questionnaire about forgiveness. There was agreement on the existence of individual differences in forgiveness. Clergy and the general population perceived reconciliation as necessary for forgiveness while there was no consensus within psychology. The clergy suggest that forgiveness is limitless and that repentance is unnecessary, while the general population suggests that there are limits and that repentance is necessary. Psychological definitions do not conceptualize repentance as necessary for forgiveness, and the question of limits has not been addressed, although, within therapy, the implicit assumption is that forgiveness is limitless.     

The Effects of Prompts on Minority Children's Screening Attendance at a Community Mental Health Center

This study examined the impact of prompts upon the screening attendence rate at a children's community mental health center (CMHC) serving lower socioeconomic urban minority clients. Subjects (274 children under age 18 and their adult caretakers who contacted the CMHC for screening appointments) were assigned to one of three conditions: (a) a phone prompt one day before the appointment, (b) a letter prompt one to two days before the appointment, and (c) a no-intervention control group. Both phone and letter prompts produced significantly greater attendance than the no-intervention condition. The phone prompt group evidenced a tendency toward greater attendance than the letter prompt group. A cost analysis indicated that the phone prompt generated more net revenue than the other two conditions and had a lower total cost and per subject than the conditon. The data suggest that prompts can be effectively used by mental health facilities to engage minority clients in the intial phase of the treament process.     

Improving return rates for health-care outcome

The objective was to test two methods of reducing loss of data in follow-up by abbreviating the questionnaire and offering a token monetary incentive. Primary data were collected between September 14, 1998 and July 23, 1999 from an adult psychiatric population, representing about 50% of all patients, all of whom agreed to participate in a quality-assurance monitoring program. Briefer components of the SF-36 Health Status Survey were expected to yield higher return rates than would the SF-36 plus a form assessing amount of treatment received. Small monetary incentives were expected to result in higher return rates also. Patients were randomly assigned to the groups (n = 73 each). Abbreviation of the questionnaire and use of a monetary incentive each reduced attrition by 10%. A diminishing returns effect for both methods was observed. Further study of a possible interaction between the questionnaire's length and monetary incentive is recommended.     

Development and Evaluation of a Telephone Communication Protocol for the Delivery of Personalized Melanoma Genomic Risk to the General Population

Communicating personalized genomic risk results for common diseases to the general population as a form of tailored prevention is novel and may require alternative genetic counseling service delivery models. We describe the development and evaluation of a communication protocol for disclosing melanoma genomic risk information to the asymptomatic general population and assess participants’ satisfaction and acceptability. Participants (n?=?117) were aged 22–69 years, living in New South Wales, Australia and unselected for family history. They provided a saliva sample and had genomic testing for melanoma for low to moderate penetrant melanoma susceptibility variants in 21 genes. Participants could choose to receive their results from a genetic counselor via telephone, followed by a mailed booklet or to receive their risk result via mailed booklet only with a follow-up call for those at high risk. A follow-up questionnaire was completed by 85% of participants 3-months later. Most participants (80%) elected to receive their result via telephone. Participants were highly satisfied with the delivery of results (mean 3.4 out of 4, standard deviation 0.5), and this did not differ by delivery mode, risk category, age or sex. On follow-up, 75% accurately recalled their risk category, 6% indicated a preference for a different delivery mode, either electronic or face-to-face. The process of disclosing genomic risk results to the general population over the telephone with accompanying written material was feasible and acceptable, and may be useful for communicating polygenic risk for common diseases in the context of increasing demands for genomic testing.     

Help-Seeking from Clergy and Spiritual Counselors Among Veterans with Depression and PTSD in Primary Care

Little is known about the prevalence or predictors of seeking help for depression and PTSD from spiritual counselors and clergy. We describe openness to and actual help-seeking from spiritual counselors among primary care patients with depression. We screened consecutive VA primary care patients for depression; 761 Veterans with probable major depression participated in telephone surveys (at baseline, 7 months, and 18 months). Participants were asked about (1) openness to seeking help for emotional problems from spiritual counselors/clergy and (2) actual contact with spiritual counselors/clergy in the past 6 months. At baseline, almost half of the participants, 359 (47.2 %), endorsed being “very” or “somewhat likely” to seek help for emotional problems from spiritual counselors; 498 (65.4 %) were open to a primary care provider, 486 (63.9 %) to a psychiatrist, and 409 (66.5 %) to another type of mental health provider. Ninety-one participants (12 %) reported actual spiritual counselor/clergy consultation. Ninety-five (10.3 %) participants reported that their VA providers had recently asked them about spiritual support; the majority of these found this discussion helpful. Participants with current PTSD symptoms, and those with a mental health visit in the past 6 months, were more likely to report openness to and actual help-seeking from clergy. Veterans with depression and PTSD are amenable to receiving help from spiritual counselors/clergy and other providers. Integration of spiritual counselors/clergy into care teams may be helpful to Veterans with PTSD. Training of such providers to address PTSD specifically may also be desirable.     

From Pastor to Pensioner: A Study of Retired Canadian Protestant Clergy from the Continuity Perspective

ABSTRACT

By using the Continuity Perspective, this study investigates how clergy adjust to retirement. Four sets of factors were examined; Situational factors, activities, occupational subculture, and psychological continuity. Methods of data collection include mailed questionnaires and personal interviews. The sample consists of 185 Anglican, Baptist, and United Church retired clergy. It was found that (1) the clergy maintain continuity of their1 lifestyles except when some situational factors force them to alter their way of life; (2) retired ministers tend not to develop new activities, but continue to participate in existing ones; (3) the occupational subculture of Protestant clergy has the function of facilitating their retirement; and (4) clergy appear to maintain a stability in the type of responses they have to changes and crises.     

Current approaches used in studying creativity: An exploratory investigation

The goal of this research was to test whether the kind of question that is used to prompt brainstorming differentially affects individual and group idea generation performance. More specifically, it was examined if prompts that require brainstormers to generate alternate uses for common objects (e.g., other uses for cars) foster more benefits from collaborative ideation than prompts to generate improvements for an object, place, or process (e.g., ways to improve cars). These hypotheses were tested in two experiments using electronic idea exchanges. In Experiment 1, individuals generated ideas about either alternate uses or potential improvements for cars, SUVs, or vans. In Experiment 2, participants brainstormed in response to one of these two prompts in either an interactive group setting (exchanging ideas with two others) or individually (no idea sharing). The results of both experiments showed that alternate uses and improvements prompts indeed differentially affected ideational performance in terms of both idea quantity and quality. The results were also consistent with the well documented “process loss” on the improvements prompt, but the gap between interacting and nominal groups was closed on the alternate uses prompt. Implications for research and practice are discussed.     

Establishing mirror-image discriminations with progressively delayed extra-stimulus prompts.

Progressively delayed extra-stimulus prompts were used to help normal preschool children discriminate left-right mirror-image stimuli. Two issues were addressed, the attention guiding properties of the prompts and the necessity for their gradual elimination. The study consisted of four experiments in which one or multiple prompt conditions were used. Each condition involved three prompts: a reference prompt for indicating the S+ and two superimposed prompts, one on the S+, and one on the S-. The prompts required subjects to respond to the orientation of the S+ (Orientation condition) or to the location of the reference prompt (Location condition); or allowed them to respond to the discriminative shapes of the superimposed prompts (Shape condition). The results showed the following. First, most subjects rapidly learned to respond to the Orientation prompts. Second, delayed orientation prompting was always successful regardless of how the prompts were eliminated. Delay training was never successful in either of the other two conditions. Third, the Orientation condition did not reliably produce learning unless the delayed prompting procedure was used.     

Burnout and Depression Among Roman Catholic Secular,Religious, and Monastic Clergy

Burnout and depression among Roman Catholic secular, religious order, and monastic (Cistercian) priests was investigated using the Maslach Burnout Inventory (MBI) and the Center for Epidemiological Studies-Depression (CESD) scale. Additionally, a Self-Report-Inventory (SRI) was included requesting information on demographics as well as four categories of predictor variables (vocational satisfaction, social support, spiritual activities, and physical environment) associated with burnout and depression. All participants were randomly selected. The survey yielded a return rate of 90.67%. Secular clergy reported significantly greater emotional exhaustion than did monastic clergy. Secular priests also had significantly greater depression (72%), when compared to religious (40.8%) and monastic (39.5) clergy. Overall group comparisons revealed that secular clergy experienced the highest degree of burnout and depression, monastics the least, and religious priests falling in between. The lack of social support and sense of isolation, for secular clergy, were key elements associated with their experience of both burnout and depression. Candidate in Psychology atand a Psychology Intern at the Ohio State University     

Effect of respondent code location on survey response rate

Survey response rates were examined for differences based on the location of the respondent code, a numerical code placed on the survey versus a numerical code placed on the return envelope. A four-page survey on criteria and procedures used when hiring health education faculty members was mailed to program coordinators of university health education programs (N = 223). Half of the coordinators (n = 112) received coded surveys (surveys that had a written overt three-digit code at the top right corner of the first page of the survey). The other half of the coordinators (n = 111) received coded return envelopes (return envelopes with a six-digit code typed directly under the return mailing address). A total of 132 coordinators returned completed surveys (62%). Response rate did not differ significantly based on placement of respondent code. Survey researchers are thus recommended to devote their efforts to other inducement strategies to increase response rates.     

Establishing initial auditory‐visual conditional discriminations and emergence of initial tacts in young children with autism spectrum disorder

Children with autism spectrum disorder (ASD) often display impaired listener skills, and few studies have evaluated procedures for establishing initial auditory‐visual conditional discrimination skills. We developed and evaluated a treatment package for training initial auditory‐visual conditional discriminations based on the extant research on training such discriminations in children with ASD with at least some preexisting skills in this area. The treatment package included (a) conditional‐only training, (b) prompting the participant to echo the sample stimulus as a differential observing response, (c) prompting correct selection responses using an identity‐match prompt, (d) using progressively delayed prompts, and (e) repeating trials until the participant emitted an independent correct response. Results indicated all participants mastered all listener targets, and the two participants for whom we tested the emergence of corresponding tacts showed mastery of most tacts without direct training. We discuss these results relative to prior research on listener skills and tacts.     

DIFFERENTIAL REINFORCEMENT OF CORRECT RESPONSES TO PROBES AND PROMPTS IN PICTURE-NAME TRAINING WITH SEVERELY RETARDED CHILDREN

A systematic sequence of prompt and probe trials was used to teach picture names to three severely retarded children. On prompt trials the experimenter presented a picture and said the picture name for the child to imitate; on probe trials the experimenter did not name the picture. A procedure whereby correct responses to prompts and probes were nondifferentially reinforced was compared with procedures whereby correct responses to prompts and probes were differentially reinforced according to separate and independent schedules of primary reinforcement. In Phase 1, correct responses to prompts and probes were reinforced nondifferentially on a fixed ratio (FR) 6 or 8 schedule; in Phase 2, correct responses to prompts were reinforced on the FR schedule and correct responses to probes were reinforced on an FR schedule of the same value; in Phase 3, correct responses to prompts were reinforced on the FR schedule and correct responses to probes were reinforced on a continuous reinforcement (CRF; every correct response reinforced) schedule; in Phase 4, correct responses to prompts were reinforced on a CRF schedule and correct responses to probes were reinforced on the FR schedule; in Phase 5, a reversal to the conditions of Phase 3 was conducted. For all three children, the FR schedule for correct responses to prompts combined with the CRF schedule for correct responses to probes (Phases 3 and 5) generated the highest number of correct responses to probes, the highest accuracy (correct responses relative to correct responses plus errors) on probe trials, and the highest rate of learning to name pictures.