Impact of Appointment Waiting Time on Attendance Rates at a Clinical Cancer Genetics Service

The increase in demand for clinical cancer genetics services has impacted the ability to provide services timeously. Given limited resources, this often results in extended appointment waiting times. Over the last 3 years, the Cancer Genetics Service at the National Cancer Centre Singapore has continued to experience a steady increase in demand for its service. Nevertheless, significant no-show rates have been reported. This study sought to determine whether an association exists between appointment waiting times and attendance rates. Data was gathered for all participants meeting inclusion criteria. Attendance rates and appointment waiting times were calculated. The relationship between mean waiting times for those who did and did not attend their scheduled appointments was evaluated using Welch’s t test and linear regression model. The results showed a significant difference in mean appointment waiting times between patients who did and did not attend (32.66 versus 43.50 days respectively; p?<?0.0001). Furthermore, patients who waited for longer than 37 days were significantly less likely to attend. No-show rates increased as the waiting time increased, at a rate of 19.60% per 20 days and 21.40% per 30 days. In conclusion, appointment waiting time is a significant predictor for patient attendance. Strategies to ensure patients receive an appointment within the necessary timeframe at the desired setting are important to ensure that individuals at increased cancer risk attend their appointments in order to manage their cancer risks effectively.     

The Loss of Loss Aversion: Paying Attention to Reference Points

We agree with Gal and Rucker ( 2018 , in press) that loss aversion is not as firmly established as typically assumed. We affirm, however, the more general principle put forward within Prospect Theory (D. Kahneman & A. Tversky, 1979), which is that reference points increase people's sensitivity to objective changes in value. We show how the literatures on counterfactual thought, social comparison, and goal pursuit are consistent with the notion that reference points increase sensitivity to change in value, while not being consistent with loss aversion. We then examine, within the framework of Regulatory Focus theory (E. T. Higgins, 1997, 1998), how different reference points combine with characteristics of the actor and the situation to give rise to loss aversion (more sensitivity to negative outcomes than to positive outcomes) as well as to the reverse pattern (more sensitivity to positive outcomes than to negative outcomes). Our review suggests that the status quo, even when used as a reference point, is not necessarily neutral. It also suggests that anchor points other than the status quo may serve as reference points and that people may use more than one reference point simultaneously. More generally, we call for a critical examination of the “bad is stronger than good” principle.     

Less willing to pay but more willing to buy: How the elicitation method impacts the valuation of a promotion

Willingness to pay (WTP—how much one is willing to pay for something) and willingness to buy (WTB—whether one is willing to buy something at a given price) are two common methods to elicit valuations and normatively should yield the same valuation order between two options. However, this research finds that WTP and WTB can yield opposite valuation orders between the regular offer and the promotional offer of a product. Specifically, it demonstrate that, (a) if the valuation of a product is only elicited with WTP, consumers value the product less when it is offered with a price promotion than when it is not; (b) if the valuation of a product is only elicited with WTB, consumers value the product more when it is offered with a price promotion than when it is not; and (c) if the valuation of a product is first elicited with WTP and then elicited with WTB, consumers always value the product less when it is offered with a price promotion than when it is not. A value‐inference account is proposed for the above findings, according to which, consumers infer the value of a promoted product differently when the valuation is elicited only with WTP or only with WTB. Theoretically, this research extends prior literature on sales promotion, showing that the valuation of a promotion is subject to the elicitation method. Practically, this research suggests how to help consumers manage their purchase intentions for promoted products.     

On the Rationality of Vow‐making

I offer a philosophical account of vowing and the rationality of vow‐making. I argue that vows are most productively understood as exceptionless resolutions that do not have any excusing conditions. I then articulate an apparent problem for exceptionless vow‐making: how can it be rational to bind yourself unconditionally, when circumstances might change unexpectedly and make it the case that vow‐keeping no longer makes sense for you? As a solution, I propose that vows can be rational to make only if they are implicitly conditional on a personal identification or social role that is itself escapable.     

Posttraumatic Growth in Trauma Survivors: Associations With Attachment to God and God Representation

Individuals often turn to religion or spirituality to cope with or make sense of trauma. In this study of 222 university students who reported a history of trauma, we examined whether God representation and attachment to God were associated with posttraumatic outcomes. Trauma outcomes include both the negative impacts of trauma and the perceived posttraumatic growth (PTG) that can occur in trauma survivors. Results revealed that both an authoritarian representation of God and an avoidant attachment to God were predictive of experiences of PTG.