Who Is at Risk for Psychological Distress in Genetic Testing Programs for Hereditary Cancer Disorders?

Presymptomatic identification of disease gene carriers is becoming an increasingly common part of the clinical management of hereditary cancer disorders. With an expected increase in the number of requests for DNA testing and the limited resources for counseling, the amount of time genetic counselors are able to spend with test candidates will decrease. It is therefore important for counselors to identify persons at risk for psychological distress. Based on a review of experiences with Huntington disease and cancer patients, we describe factors likely to evoke distress in genetic cancer candidates. We also discuss the sometimes widely different ways that test candidates and their partners respond to genetic testing. By exploring risk factors for distress in relevant domains of the research, we can offer counselors guidelines for determining who may need extra counseling.     

Assessing risky public investments with MUSTARD

This paper presents a practical implementation of multicriteria methodologies based on the UTA model by Jacquet‐Lagrèze and Siskos and Quasi‐UTA model by Beuthe and Scannella, which are specified with a non‐linear, but piecewise linear, additive utility function. In contrast with the general UTA model, the Quasi‐UTA specification structures the partial utilities as recursive exponential functions of only one curvature parameter. This allows for a reduction of the quantity of information necessary to build the utility function. The software MUSTARD implements different variants of these models. Firstly, it offers the basic deterministic UTA model of disaggregation, but also its first programmed stochastic version. In both cases, the software proceeds stepwise and interactively helping the decision maker to formulate the problem and state preferences between projects; in the stochastic case, the decision maker is even helped to build the criteria distributions. The Quasi‐UTA specification can be introduced in this disaggregation model. Secondly, the software offers an aggregation model whereby the Quasi‐UTA partial utility functions are built separately through specific questioning processes. The questions relating to deterministic criteria are of the ‘direct rating type’, while those of the stochastic criteria are either of the ‘variable probability’ or the ‘variable outcome’ type. The criteria weights can be assessed by the ‘swing weight’ method or by a UTA‐II side‐program. As an example as well as a test of the Quasi‐UTA aggregation approach, the paper presents its application to a real problem of selecting road investment projects in Belgium. Several experts and civil servants were interviewed, and their individual utility functions derived. The projects are ranked according to their rate of return, which is computed on the basis of the projects certain equivalent money value. Copyright © 2002 John Wiley & Sons, Ltd.     

Investigating the roots of the favourite–longshot bias: an analysis of decision making by supply‐ and demand‐side agents in parallel betting markets

This paper offers new insights into the behavioural origins of the ‘favourite–longshot’ bias — an established feature of betting markets, whereby longshots win less often than the subjective probabilities imply and favourites more often. A number of alternative explanations has been offered for this phenomenon but the main debate focuses on whether it is caused by the behaviour of those supplying betting markets (bookmakers) or of the demand‐side agents in these markets (bettors) . This study analyses a new data source which offers detailed information for a large sample of recent UK horseraces on decision‐making behaviour within the parimutuel and the parallel bookmaker‐based betting markets. The results offer strong evidence for the existence of the ‘favourite–longshot’ bias in bookmaker‐based markets, with a corresponding absence of such an effect in the parimutuel case. These results offer support for the view that the origins of the ‘favourite–longshot’ bias lie principally in the decisions of bookmakers rather than in the decisions of bettors. Copyright © 2000 John Wiley & Sons, Ltd.     

Making sense of mentoring or mentoring making sense? Reflections on the mentoring process by adult mentors with young people†

This paper sets out to look at the processes of mentoring from the perspectives of adult mentors who were interviewed as part of a wider study of young people's perceptions and understandings of informal mentoring processes. It seeks to clarify the processes of mentoring within the context of the ‘risk society’ by posing the question, how do young people and mentors perceive these processes? What do mentors get out of the mentoring relationship? Findings from a qualitative study of informal mentoring relationships are drawn on to suggest that the mentors perceive the experience of being identified as a mentor and the processes of mentoring in highly positive terms. It is argued that this provides a form of ‘cultural capital for mentors’ in helping them to make sense of the challenges and dilemmas they face as adults. It is concluded that this finding has important implications for the design of mentoring interventions with young people. Copyright © 2000 John Wiley & Sons, Ltd.     

The affect heuristic in judgments of risks and benefits

This paper re‐examines the commonly observed inverse relationship between perceived risk and perceived benefit. We propose that this relationship occurs because people rely on affect when judging the risk and benefit of specific hazards. Evidence supporting this proposal is obtained in two experimental studies. Study 1 investigated the inverse relationship between risk and benefit judgments under a time‐pressure condition designed to limit the use of analytic thought and enhance the reliance on affect. As expected, the inverse relationship was strengthened when time pressure was introduced. Study 2 tested and confirmed the hypothesis that providing information designed to alter the favorability of one's overall affective evaluation of an item (say nuclear power) would systematically change the risk and benefit judgments for that item. Both studies suggest that people seem prone to using an ‘affect heuristic’ which improves judgmental efficiency by deriving both risk and benefit evaluations from a common source—affective reactions to the stimulus item. Copyright © 2000 John Wiley & Sons, Ltd.     

Accuracy of the DIBELS Oral Reading Fluency Measure for Predicting Third Grade Reading Comprehension Outcomes

We evaluated the validity of DIBELS (Dynamic Indicators of Basic Early Literacy Skills) ORF (Oral Reading Fluency) for predicting performance on the Florida Comprehensive Assessment Test (FCAT-SSS) and Stanford Achievement Test (SAT-10) reading comprehension measures. The usefulness of previously established ORF risk-level cutoffs [Good, R.H., Simmons, D.C., and Kame’enui, E.J. (2001). The importance and decision-making utility of a continuum of fluency-based indicators of foundational reading skills for third-grade high-stakes outcomes. Scientific Studies of Reading, 5, 257–288.] for third grade students were evaluated on calibration (n_S1 = 16,539) and cross-validation (n_S2 = 16,908) samples representative of Florida's Reading First population. The strongest correlations were the third (February/March) administration of ORF with both FCAT-SSS and SAT-10 (r_S = .70–.71), when the three tests were administered concurrently. Recalibrated ORF risk-level cut scores derived from ROC (receiver-operating characteristic) curve analyses produced more accurate identification of true positives than previously established benchmarks. The recalibrated risk-level cut scores predict performance on the FCAT-SSS equally well for students from different socio-economic, language, and race/ethnicity categories.     

Mentoring Nurses in Familial Cancer Risk Assessment and Counseling: Lessons Learned From a Formative Evaluation

Background. As familial cancer genetic services moves into community practice increased numbers of trained health professionals are needed to counsel individuals seeking cancer risk information. Nurses have been targeted to provide cancer risk assessment and counseling. To help prepare nurses for this role, a 5-day training in familial cancer risk assessment and counseling followed by a long-distance mentorship to support continued skill development in the work environment was conducted by Fox Chase Cancer Center, Philadelphia, PA. Methods. Four cohorts (N = 41) have completed the training and were randomized to either an immediate or delayed mentorship. A formative evaluation assessed the nurse’s ability to consult with other genetic health professionals and build self-efficacy in counseling skills via responses to questionnaire. A post-mentorship interview evaluated the usefulness, timing and length of the mentorship. Results. For both groups, there was a statistically significant improvement in self-efficacy for all skills from baseline to 6 months and an increased number of nurses consulting with genetic health professionals. All the nurses reported the value of the mentorship and those with less cancer risk counseling experience prior to the training needed support and resources for further skill and program development. Lessons learned from this formative evaluation are provided.     

计划行为模型在HIV性风险行为领域的应用与发展*

整理和回顾了计划行为模型在HIV性风险行为领域的应用与进展。该模型在不同文化背景、不同样本中,对于HIV性风险行为呈现良好的解释力,但是其整体预测力及内部变量的显著程度仍不时波动。21世纪以来,通过核心变量操作化、新变量引入和结构关系调整,模型获得了较大的扩展和完善。但在模型效度再检验、纳入社会性别视角、克服个体行为模型缺陷,以及强化模型的干预适用性方面仍有较大的发展空间     

浅谈ICU中肺损伤与急性呼吸窘迫综合征的防治

ICU中危重病人较多,急性肺损伤(ALI)与急性呼吸窘迫综合征(ARDS)较普通病房更为常见,常可由严重的感染、误吸、脓毒症、创伤、反复输血以及弥散性血管内凝血等因素引起,病理生理过程十分复杂,治疗也很困难,须从多个方面综合考虑,才能提高病人的生存率,挽救病人生命。     

Evolutionary perspective on indirect victimization in adolescence: the role of attractiveness, dating and sexual behavior

We studied indirect victimization from an evolutionary perspective by examining links between this type of victimization and several indicators of attractiveness (past sexual behavior, dating frequency and physical appearance). Two thousand three hundred and nineteen (56% female) students (ages 13-18) from a region of southern Ontario, Canada, completed self-report measures of indirect victimization, physical appearance, dating frequency, recent sexual behavior (number of partners in previous month) and past sexual behavior (number of lifetime partners minus number of partners in previous month) as well as indexes of depression, aggression and attachment security, which were used to control for psychosocial maladjustment. Consistent with an evolutionary framework, physical appearance interacted significantly with gender, wherein attractive females were at greater risk for indirect victimization, whereas for males physical attractiveness was a protective factor, reducing risk of victimization. Physical appearance also interacted with grade, being inversely related to indirect victimization for younger adolescents and having a nonsignificant association with victimization for older youth. Finally, recent sexual behavior was associated with increased risk of indirect victimization for older adolescents only, which we discussed with regard to peer perceptions of promiscuity and short-term mating strategies. These findings have important implications for the development of interventions designed to reduce peer victimization, in that victims of indirect aggression may represent a rather broad, heterogeneous group, including attractive individuals with no obvious signs of maladjustment.