International Genetic Counseling Students’ Perspective on Their Training Experience in the United States

International students face social, psychological and academic challenges upon moving to a foreign country to pursue higher education. Clinical disciplines such as genetic counseling present additional challenges adapting to an unfamiliar health care system and different interactions and expectations with patients and colleagues. This study used semi-structured interviews to identify challenges that international genetic counseling students face during training in the United States. Eight international genetic counseling alumni who graduated from U.S.-accredited programs were interviewed. Participants stated that the U.S. academic system was unfamiliar—class participation and paper-writing required the greatest adjustment. There was a need for help in understanding social norms in academic settings. Clinically, they were unfamiliar with the dynamics and communication style of U.S. families. Non-native English speakers experienced greater difficulty in all areas. Most participants reported that they were uncomfortable asking for help in transitioning to life, study and work. Participants identified mentorship programs for international students as potentially useful in clarifying expectations in academic and clinical settings. These results may assist international students preparing to study genetic counseling in the U.S. and may help genetic counseling training programs identify the academic and clinical challenges faced by international students.     

Perception of symmetry and repetition within and across visual shapes: Part-descriptions and object-based attention

In five experiments, we investigated the detection of symmetry (i.e., translation plus reflection) or repetition (i.e., translation alone) between two vertical jagged contours. The complexity of the two contours was manipulated, as was their figure-ground assignment; the two contours either belonged to a common object "inside" them, to two separate objects "outside" them, or to two separate objects each to the right of one contour. Replicating Baylis and Driver (1994), symmetry judgements were unaffected by contour complexity when made within a single shape, implying a parallel process operating efficiently across contour discontinuities. However, all the other conditions yielded substantially slower judgements as complexity increased, suggesting either effortful point-by-point comparisons, or a highly inefficient parallel process. In agreement with Baylis and Driver (1995a), symmetry perception was harder when figure-ground assignment turned convexities along one contour into concavities along the other contour; and likewise for repetition detection. However, even when convex parts matched between the two contours, judgements were still affected by complexity unless they belonged to a common object. This supports Baylis and Driver's (1993) proposal that effortless comparisons for the layout of multiple convex parts can only be made within single perceptual objects.     

Assessing knowledge-intensive work environment: General versus situation-specific instruments

The aim of the present study is to examine to what extent general and situation-specific work environment instruments capture the salient work characteristics in a knowledge-intensive context. We conducted qualitative open-ended interviews with 30 employees (24 men and six women) from a Norwegian university department. The information from the interviews was content-analysed and coded on the scales of five work environment instruments; two general instruments (the General Nordic Questionnaire for Psychological and Social Factors at Work [QPSNordic] and the Job Diagnostic Survey [JDS]) and three situation-specific instruments (Assessing the climate for creativity [KEYS], Situational Outlook Questionnaire [SOQ], and the Organizational Climate Measure [OCM]). The results showed that situation-specific work environment instruments covered significantly more statements about the work environment than the general instruments. More statements could be categorized on the organization and individual levels, compared to group and leadership levels. The situation-specific instruments covered more statements than general instruments at the organization level. These statements were mainly related to the organizational context, social and relational characteristics, and encouragement of creativity and organizational impediments to creativity. The findings support the value of situation-specific instruments for assessing the work environment in knowledge-intensive organizations.     

The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Introduction

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Methods

We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.

Results

1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).

Conclusions

Moral intuitions shed light on variation in physician judgments about cost issues in health care.

     

Healing Rituals for Couples Recovering from Adultery

Recovery from the trauma of adultery is a process that is full of points where the couple can get stuck. We describe an experiential model that utilizes healing rituals. We start with a general exploration of the use of rituals in marriage and family therapy. The key elements of effective rituals are described. We describe stuck points in these relationships including: 1) knowing the details, 2) releasing the anger, 3) showing commitment, 4) rebuilding trust, and 5) rebuilding the relationship. Ritualized interventions are described for each of these stuck points.     

Distinguishing the cognitive and behavioral consequences of attitude importance and certainty: A new approach to testing the common-factor hypothesis

Some published factor analyses have suggested that attitude importance and certainty are distinct psychological constructs, but other factor analytic investigations have suggested they are largely redundant reflections of a more general underlying construct. This latter sort of finding has led investigators to average measures of importance and certainty together into a composite index and then explore its cognitive and behavioral consequences. In this paper, we report three studies gauging the underlying structure of these strength-related attitude attributes by assessing whether they in fact relate in the same ways to information processing and action tendencies. We found that importance and certainty both independently predicted the likelihood that a person attempted to persuade others to adopt his or her attitude. Importance (but not certainty) was associated with the tendency to seek out information that would enable people to use their attitudes in a subsequent judgment and only importance predicted whether or not they turned out to vote in an election to express their attitudes. Certainty (but not importance) was related to the tendency to find more than one political candidate acceptable. And importance and certainty interacted to predict the frequency with which people performed attitude-expressive behaviors. All this suggests that importance and certainty have distinct effects on thinking and behavior and supports the maintenance of conceptual and empirical distinctions between them in social psychological theory building.     

The Effect of Later Life Parental Divorce on Adult‐Child/Older‐Parent Solidarity: A Test of the Buffering Hypothesis1

The present study examined the effect of later life parental divorce on solidarity in the relationship between the adult child and older parent. This examination was achieved by testing the buffering hypothesis. A cross‐sectional quasiexperimental pre‐post treatment design was used (Cook & Campbell, 1979), with retrospective pretests and data from 100 adult‐child/older‐parent dyads. The ANOVA results show that the mother/adult‐child relationship with a higher degree of predivorce solidarity responded to later life parental divorce with less disruption of affectional solidarity and associational solidarity than those with a lower degree of predivorce solidarity. Thus, the current research provides modest evidence (for the mother/adult‐child relationship) to support the buffering hypothesis. We found no evidence of a buffering effect for the father‐child relationship.     

Infinity Machines and Creation Ex Nihilo

In this paper a simple model in particle dynamics of a well-known supertask is constructed (the supertask was introduced by Max Black some years ago). As a consequence, a new and simple result about creation ex nihilo of particles can be proved compatible with classical dynamics. This result cannot be avoided by imposing boundary conditions at spatial infinity, and therefore is really new in the literature. It follows that there is no reason why even a world of rigid spheres should be eternal, as has been erroneously assumed, especially since the time of Newton. This revised version was published online in August 2006 with corrections to the Cover Date.