Guidelines for Writing Letters to Patients

Patient letters provide a permanent record of the genetic counseling that was provided and are unique in medical care; rarely do other health care providers send summaries written specifically to their patients and families. We surveyed genetic counseling training program directors and found that while the acquisition of patient letter-writing skills was considered important, there were no specific guidelines made available to students. To develop letter-writing guidelines, we evaluated patient letters, reviewed references on professional correspondence, surveyed the medical literature, and worked with a writing consultant. The guidelines we subsequently developed and present here include a format for writing patient letters, suggestions on presenting medical information in understandable terms, and wording considerations. These patient letter-writing guidelines are intended to serve as a guide for teaching students this important skill and as a resource for practicing health care professionals.     

The Genetic Counseling Workplace—An Australasian Perspective. A National Study of Workplace Issues for Genetic Counselors and Associate Genetic Counselors

Genetic counseling in Australasia (Australia and New Zealand) has been recognized as a profession since the 1980s and has steadily expanded over the past 20 years. The demography of major cities with metropolitan sprawl and sparsely populated rural areas has led to the establishment of 3 types of genetics units: main units in cities, metropolitan outreach, and rural outreach units. A questionnaire was developed to obtain information about the needs, resources, and day-to-day operation of the genetic counselors. The questionnaire addressed the areas of resource availability, professional development, responsibility of genetic counselors in the clinical setting, and their involvement in promotion of the service and public education. Differences observed between the 3 settings in all of these areas included large clinical loads for metropolitan outreach counselors, varying responsibilities in the clinical setting, and a lack of support and resources for rural outreach counselors. Australasian Genetic counselors were found to have a significant interest in developing mechanisms for supervision and were keenly interested in maintaining credentials and professional role development. The results of this study allows genetic counselors themselves to have a better understanding of the roles of their colleagues in the different units; they can also be used by service providers in establishing and supporting genetic counselors, and identifying inequalities and deficiencies in the different practice areas.     

The Indispensability Argument and Multiple Foundations for Mathematics

One recent trend in the philosophy of mathematics has been to approach the central epistemological and metaphysical issues concerning mathematics from the perspective of the applications of mathematics to describing the world, especially within the context of empirical science. A second area of activity is where philosophy of mathematics intersects with foundational issues in mathematics, including debates over the choice of set–theoretic axioms, and over whether category theory, for example, may provide an alternative foundation for mathematics. My central claim is that these latter issues are of direct relevance to philosophical arguments connected to the applicability of mathematics. In particular, the possibility of there being distinct alternative foundations for mathematics blocks the standard argument from the indispensable role of mathematics in science to the existence of specific mathematical objects.     

Discounting in causality and covariation judgements

In two experiments, humans were asked to judge the strength of a moderate contingency between a cue and an outcome in the presence of a second strong contingency between another cue and the outcome. The first experiment replicated the discounting effect whereby a strong contingency causes subjects to reduce or discount judgements of a moderate contingency. This experiment used a video-game procedure in which subjects camouflaged a tank to make it safe from mines. The second causal cue was the presence or absence of a spotter plane. Experiment 1 also ruled out the possibility that judgements might be determined by the number of co-occurrences of the cue and outcome as opposed to the level of contingency. The second experiment used an abstract scenario in which discounting was demonstrated when subjects were asked to judge the relationship between the occurrence of geometric objects. The instructions were neutral to discourage causal hypotheses. These results support the notion that judgements result from associative or connectionist processes and not from a two-step cognitive retrospective process in which an estimate of covariation is calculated between cue and outcome and then in a second step this information is used in a normative manner when a decision is made.     

Self-Efficacy for Enhancing Students’ Career and College Readiness: A Survey of Professional School Counselors

Grounded in Bandura’s (1997) self-efficacy theory and Savickas’s (2011) career construction theory, this study examined school counselors’ beliefs about whether they can perform specific tasks related to supporting students’ career and college readiness. A national sample of school counselors (N = 2,047) completed the School Counselor Self-Efficacy for Enhancing Student Career and College Readiness Scale (Baker, Parikh-Foxx, & Martinez, 2017). Findings from a survey research design indicated that the extent of related training and the challenges associated with implementation of career service delivery were of concern to participants. Recommendations for training, practice, and further research are presented.     

Retroactive interference in rats: Independent effects of time and similarity of the intervening event with respect to acquisition

Events occurring during the retention intervals for a 5-min delayed alternation task were used to investigate the factors that influence retroactive interference. Appetitive reinforcement in an E-maze was employed to train rats on the delayed alternation task consisting of a forced-choice (target event) trial followed by a free-choice (test) trial. Occasional probe trials added a potentially interfering event either at the beginning, middle, or end of the retention period. These events also varied in similarity to the target events, ranging from low similarity to the converse of the target event. Interference increased both with the interval between the target and intervening events and with the similarity between the converse of the target event and the intervening event; however, there was no tendency, significant or otherwise, towards an interaction between stimulus similarity and the interval between the target and intervening events. Control groups demonstrated that the interference was of an associative nature and that the interval between the intervening event and the test trial was little consequence. These results are discussed in terms of two separate types of interference: similarity interference which depends on stimulus similarity of the intervening event to the converse of the target event but not on the temporal location of the intervening event, and processing interference which depends on the temporal location of the intervening event but not on its similarity to the converse of the target event.