Factors Which Impact the Delivery of Genetic Risk Assessment Services Focused on Inherited Cancer Genomics: Expanding the Role and Reach of Certified Genetics Professionals

There is tremendous excitement about the promise of new genomic technologies to transform medical practice and improve patient care. Although the full power of genetic diagnosis has not yet been realized, paradigms of clinical decision-making are changing. In fact, recent policy level changes to promote genetic counseling by certified genetics professionals (GP) such as genetic counselors and clinical geneticists, are occurring at both the payer and state level. However, there remain opportunities to develop policies within the United States to: 1) enhance the access to the limited workforce of GPs; 2) revise reimbursement schemes such that costs to deliver these services may be recouped by institutions with GPs; and 3) protect against the potential for discrimination based on genetic information. Although many of these issues predate advances in genomic technologies, they are exacerbated by them, with increasing access and awareness as costs of testing decrease. Consequently, evolving shifts in national policies poise GPs to serve as a hub of information and may be instrumental in facilitating new models to deliver genetics-based care through promoting academic-community partnerships and interfacing with non-GPs. As we acknowledge the potential for genomics to revolutionize medical practice, the expertise of GPs may be leveraged to facilitate incorporation of this information into mainstream medicine.     

An empirical study of the traditional Mach card effect

The traditional achromatic Mach card effect is an example of lightness inconstancy and a demonstration of how shape and lightness perception interact. We present a quantitative study of this phenomenon and explore the conditions under which it occurs. The results demonstrate that observers show lightness constancy only when sufficient information is available about the light-source position, and the perceptual task required of them is surface identification rather than direct colour-appearance matching. An analysis and comparison of these results with the chromatic Mach card effect (Bloj et al 1999 Nature 402 877-879) demonstrate that the luminance effects of mutual illumination do not account for the change in lightness perception in the traditional Mach card.     

“No no no” and Other Types of Multiple Sayings in Social Interaction

Relying on the methodology of conversation analysis, this article examines a practice in ordinary conversation characterized by the resaying of a word, phrase, or sentence. The article shows that multiple sayings such as “No no no” or “Alright alright alright” are systematic in both their positioning relative to the interlocutor's talk and in their function. Specifically, the findings are that multiple sayings are a resource speakers have to display that their turn is addressing an in progress course of action rather than only the just prior utterance. Speakers of multiple sayings communicate their stance that the prior speaker has persisted unnecessarily in the prior course of action and should properly halt course of action.     

Wisconsin Card Sorting Test embedded validity indicators developed for adults can be extended to children

Past studies have examined the ability of the Wisconsin Card Sorting Test (WCST) to discriminate valid from invalid performance in adults using both individual embedded validity indicators (EVIs) and multivariate approaches. This study is designed to investigate whether the two most stable of these indicators—failures to maintain set (FMS) and the logistical regression equation S-B_LRE—can be extended to pediatric populations.

The classification accuracy for FMS and S-B_LRE was examined in a mixed clinical sample of 226 children aged 7 to 17 years (64.6% male, MAge = 13.6 years) against a combination of established performance validity tests (PVTs).

The results show that at adult cutoffs, FMS and S-B_LRE produce an unacceptably high failure rate (33.2% and 45.6%) and low specificity (.55–.72), but an upward adjustment in cutoffs significantly improves classification accuracy. Defining Pass as <2 and Fail as ≥4 on FMS results in consistently good specificity (.89–.92) but low and variable sensitivity (.00–.33). Similarly, cutting the S-B_LRE distribution at 3.68 produces good specificity (.90–.92) but variable sensitivity (.06–.38). Passing or failing FMS or S-B_LRE is unrelated to age, gender and IQ.

The data from this study suggest that in a pediatric sample, adjusted cutoffs on the FMS and S-B_LRE ensure good specificity, but with low or variable sensitivity. Thus, they should not be used in isolation to determine the credibility of a response set. At the same time, they can make valuable contributions to pediatric neuropsychology by providing empirically-supported, expedient and cost-effective indicators to enhance performance validity assessment.     

What makes people cooperate? Individual differences in BAS/BIS predict strategic reciprocation in a public goods game

Heterogeneity in contribution levels within public goods games (PGGs) is indicative of individual self- or other-regarding preferences. Reward and punishment mechanisms have been demonstrated to affect contributions in the PGGs. This paper examines whether dispositional sensitivities to rewards and punishments (BIS and BAS) explain some behavioural heterogeneity in PGGs. Seventy-two participants took part in a sequential PGG, in which, prior to making a decision about contributing, participants received information about how much their co-players had donated, which was manipulated either as high or low. They also completed the Carver and White BIS/BAS scales. Participants contributed more when other members of their group contributed a high proportion of the initial endowment and less when others gave a low amount. When participants knew that their group members had contributed a high amount, BAS Reward Responsiveness was significantly negatively correlated with the contribution levels, while BIS-anxiety was positively related to a lower proportion of zero contributions. The findings are interpreted in relation to strategic responding in the PGGs. Motivational traits, such as those conceptualized in Reinforcement Sensitivity Theory, are proposed to underlie pro-social behavioural preferences.     

Genetic Information,Non-Discrimination,and Privacy Protections in Genetic Counseling Practice

The passage of the Genetic Information Non Discrimination Act (GINA) was hailed as a pivotal achievement that was expected to calm the fears of both patients and research participants about the potential misuse of genetic information. However, 6 years later, patient and provider awareness of legal protections at both the federal and state level remains discouragingly low, thereby, limiting their potential effectiveness. The increasing demand for genetic testing will expand the number of individuals and families who could benefit from obtaining accurate information about the privacy and anti-discriminatory protections that GINA and other laws extend. In this paper we describe legal protections that are applicable to individuals seeking genetic counseling, review the literature on patient and provider fears of genetic discrimination and examine their awareness and understandings of existing laws, and summarize how genetic counselors currently discuss genetic discrimination. We then present three genetic counseling cases to illustrate issues of genetic discrimination and provide relevant information on applicable legal protections. Genetic counselors have an unprecedented opportunity, as well as the professional responsibility, to disseminate accurate knowledge about existing legal protections to their patients. They can strengthen their effectiveness in this role by achieving a greater knowledge of current protections including being able to identify specific steps that can help protect genetic information.     

The Declaration of Interdependence! Feminism,Grounding and Enactivism

Human Studies - This paper explores the issue whether feminism needs a metaphysical grounding, and if so, what form that might take to effectively take account of and support the socio-political...     

Performance on the Test of Memory Malingering in children with neurological conditions

Despite increasing interest in the use of performance validity tests with youth, relatively little is known about how children and adolescents with neurological diagnoses perform on these measures. The purpose of this study was to examine performance on the Test of Memory Malingering (TOMM) in a general pediatric neurologic sample. Data were obtained from 266 consecutive patients (mean age = 13.0, SD = 3.7, range = 5–18) referred for a neuropsychological assessment in a tertiary care pediatric hospital. As part of a broader neuropsychological battery, patients were administered the TOMM. In this sample, 94% of children passed the TOMM. Pass rate was 87% for 5–7 year-olds but was ≥ 90% for all other ages. Children with a history of stroke had the lowest pass rate (86%), with other diagnostic groups scoring ≥ 90%, including epilepsy, traumatic brain injury, and hydrocephalus. Lower TOMM performance was related to slower processing speed and weaker memory performance. The results support using the TOMM with children and adolescents who have neurological diagnoses. Caution may still be warranted when interpreting scores in those who are younger and/or who have more significant cognitive difficulty.     

Development and Validation of an Explicit Aggressive Beliefs and Attitudes Scale

This work outlines the development and validation of a new self-report measure that assesses explicit aggressive beliefs and attitudes within the normal adult population (using 7 samples, total N = 3,533). These explicit aggressive beliefs and attitudes are expected to reflect aggressive biases including hostile attribution, potency, retribution, victimization by powerful others, derogation of target, and social discounting. The resulting scale is reliable with a hierarchical 6-factor structure, and displays convergent and discriminant validity. Criterion-related validity studies indicate incremental effects over socially desirable response bias, related implicit and explicit aggression measures, and is predictive of self-reported and other-reported aggression-related behaviors.