Writing Effective Insurance Justification Letters for Cancer Genetic Testing: A Streamlined Approach

The topic of insurance coverage and justification letters for cancer predisposition testing has been the subject of much discussion on the National Society of Genetic Counselors Cancer Special Interest Group (NSGC Cancer-SIG) listserv. Some counselors have stated that they have had difficulty in obtaining insurance coverage for their patients, while others have indicated that they would appreciate seeing examples of successful letters. The purpose of this paper is to provide practical guidance in writing successful letters of justification and to share insurance success stories in the area of cancer genetic testing.     

Intentions to Use the Female Condom Among African American Adults1

The present study tested whether the theory of reasoned action (TRA) and self‐efficacy for female condom use predicted intentions to use the female condom among African American adults. Participants were 137 men and women, 18 to 35 years of age, who were recruited from a community‐based organization. Results indicate that: (a) the TRA model has predictive utility for women's but not for men's intentions to use the female condom with both main and casual sex partners, and (b) the TRA model was a better predictor of intentions to use the female condom with main than with casual partners. Implications for female condom‐use promotion are discussed.     

“Heart Trouble” and Religious Involvement among Older White Men and Women

Objective Few studies examine how older adults’ health status affects spiritual and religious involvement. This study examined the effects of gender and poor cardiac health on older adults’ ends, means, and quest religious motivations and frequency of private devotion. Method Longitudinal data (12 months between the T₁ and T₂ interviews) with 182 older adults sampled from a Northeast city were used to examine in a multivariate analysis of covariance whether gender and the existence of cardiac health problems at T₁ affected older adults’ spiritual and religious involvement at T₂. Findings A gender and cardiac health condition interaction showed older men with heart trouble had more changes in religious involvement—they engaged in more religious doubt, prayed less, and were not as intrinsically oriented at T₂. Discussion The findings strongly suggest that older men with heart trouble may maintain a masculine style and shun seeking divine help.     

Modeling the Bullying Prevention Program Preferences of Educators: A Discrete Choice Conjoint Experiment

We used discrete choice conjoint analysis to model the bullying prevention program preferences of educators. Using themes from computerized decision support lab focus groups (n = 45 educators), we composed 20 three-level bullying prevention program design attributes. Each of 1,176 educators completed 25 choice tasks presenting experimentally varied combinations of the study’s attribute levels. Latent class analysis yielded three segments with different preferences. Decision Sensitive educators (31%) preferred that individual schools select bullying prevention programs. In contrast, Support Sensitive educators (51%) preferred that local school boards chose bullying prevention programs. This segment preferred more logistical and social support at every stage of the adoption, training, implementation, and long term maintenance processes. Cost Sensitive educators (16%) showed a stronger preference for programs minimizing costs, training, and implementation time demands. They felt prevention programs were less effective and that the time and space in the curriculum for bullying prevention was less adequate. They were less likely to believe that bullying prevention was their responsibility and more likely to agree that prevention was the responsibility of parents. All segments preferred programs supported by the anecdotal reports of colleagues from other schools rather than those based on scientific evidence. To ensure that the bullying prevention options available reflect the complex combination of attributes influencing real world adoption decisions, program developers need to accommodate the differing views of the Decision, Support, and Cost Sensitive segments while maximizing the support of parents and students.     

Impact of Behavioral Inhibition and Parenting Style on Internalizing and Externalizing Problems from Early Childhood through Adolescence

Behavioral inhibition (BI) is characterized by a pattern of extreme social reticence, risk for internalizing behavior problems, and possible protection against externalizing behavior problems. Parenting style may also contribute to these associations between BI and behavior problems (BP). A sample of 113 children was assessed for BI in the laboratory at 14 and 24 months of age, self-report of maternal parenting style at 7 years of age, and maternal report of child internalizing and externalizing BP at 4, 7, and 15 years. Internalizing problems at age 4 were greatest among behaviorally inhibited children who also were exposed to permissive parenting. Furthermore, greater authoritative parenting was associated with less of an increase in internalizing behavior problems over time and greater authoritarian parenting was associated with a steeper decline in externalizing problems. Results highlight the importance of considering child and environmental factors in longitudinal patterns of BP across childhood and adolescence.     

Pub and community: The views of Birmingham untreated heavy drinkers

This paper reports the results of a qualitative analysis of semi‐structured interviews with 79 members of the Birmingham Untreated Heavy Drinkers Cohort. The cohort was recruited in 1997 when all participants were drinking 50 or more standard units of alcohol (men) or 35 or more units (women) most weeks. Present interviews were carried out as part of the fourth wave of interviews, held in 2003. The topic was the participants' places of drinking in the community and the functions those places served. The present analysis focused on the relationship between pubs and community. The strongest theme to emerge was that the pub provided for many participants a real sense of community in itself. It did so by enabling participants to meet with like‐minded others, in a setting distinct from home or work, where conversing and confiding could take place in a relaxed atmosphere, with a range of other activities and forms of social support available to many. At the same time, participants were discriminating about which pubs they used, and when, and with whom they chose to interact. There was less consensus about whether the pub served a wider function by contributing to a positive sense of community in the local neighbourhood. It is suggested that English pubs, at least in a large conurbation such as the West Midlands, are very varied, sometimes continuing to serve as ‘the local’ for a community, sometimes being part of a variety of drinking places which between them provide people with a diversity of social niches to meet their increasingly diverse choices and preferences, and sometimes reflecting and even contributing to local community disorganisation. Copyright © 2008 John Wiley & Sons, Ltd.     

I can see it both ways: First- and third-person visual perspectives at retrieval

The number of studies examining visual perspective during retrieval has recently grown. However, the way in which perspective has been conceptualized differs across studies. Some studies have suggested perspective is experienced as either a first-person or a third-person perspective, whereas others have suggested both perspectives can be experienced during a single retrieval attempt. This aspect of perspective was examined across three studies, which used different measurement techniques commonly used in studies of perspective. Results suggest that individuals can experience more than one perspective when recalling events. Furthermore, the experience of the two perspectives correlated differentially with ratings of vividness, suggesting that the two perspectives should not be considered in opposition of one another. We also found evidence of a gender effect in the experience of perspective, with females experiencing third-person perspectives more often than males. Future studies should allow for the experience of more than one perspective during retrieval.     

The Effect of BRCA Gene Testing on Family Relationships: A Thematic Analysis of Qualitative Interviews

Discovery of mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 can have emotional consequences for both the tested individual and his or her relatives. This secondary analysis study investigated how BRCA testing impacts family dynamics and relationships. For the original study, a grounded theory inquiry, participants were recruited from a hereditary breast/ovarian cancer syndrome support website and open-ended interviews were performed asking about individual and family experiences after BRCA testing. All 12 participants whose interviews were included in the secondary analysis had a BRCA mutation. For the secondary analysis, thematic analysis was conducted and revealed three main themes characterizing the effect of BRCA testing on family relationships: 1. That the first in the family to have testing or seek genetic counseling takes on a special family role that can be difficult for them; 2. That discussions in the family often change; and 3. That individuals may feel more or less connected to certain family members. These changes seemed to relate to family cancer history, relationships, coping strategies, communication patterns, and mutation status. Genetic counselors might find it useful to explore these issues in order to prepare clients before BRCA testing and to support them through shifts in family dynamics after disclosure of results.     

Using puns to study contextual influences on lexical ambiguity resolution: Evidence from eye movements

Participants’ eye movements were monitored while they read sentences containing biased homographs in either a single-meaning context condition that instantiated the subordinate meaning of the homograph without ruling out the dominant meaning (e.g., “The man with a toothache had a crown made by the best dentist in town”) or a dual-meaning pun context condition that supported both the subordinate and dominant meanings (e.g., “The king with a toothache had a crown made by the best dentist in town”). In both of these conditions, the homographs were followed by disambiguating material that supported the subordinate meaning and ruled out the dominant meaning. Fixation times on the homograph were longer in the single-meaning condition than in the dual-meaning condition, whereas the reverse pattern was demonstrated for fixation times on the disambiguating region; these effects were observed as early as first-fixation duration. The findings strongly support the reordered access model of lexical ambiguity resolution.