Client Advocacy and Collaboration with Insurance and Laboratory Testing Agencies: A Case Study Illustrating Genetic Counselor Roles

Genetic counseling and the many roles a genetic counselor must assume to provide quality genetic health care are becoming increasingly complex, especially when the genetic condition is rare, and DNA testing is costly and not yet routinely used. A case study of a couple with a family history of retinoblastoma and their pursuit of DNA testing for prenatal diagnosis is presented. The case study illustrates the instrumental role of the genetic counselor in advocating for clients for genetic services such as DNA testing and in educating insurance companies in the nature and importance of such services to achieve improved client health care outcomes.     

Embodied Knowledge and Making Sense of Prenatal Diagnosis

Open-ended, qualitative interviews with women to whom amniocentesis was offered were analyzed to understand how women made sense of these tests. We found that women, whether tested or not, negotiated with biomedical information. They transformed it through identifiable processes, then wove it with their own instincts and beliefs and with their personal experiences, thereby creating embodied knowledge on which their decisions were based. Women who were and were not tested may have differed from each other when categorized on the basis of a final, binary choice, but they were more alike than unalike in reaching this point. The apparent importance of embodied knowledge suggests the critical role of the listening activities of the genetic counselor and of awareness of the validity and importance of women's complementary ways of knowing and doing in understanding the uses and meanings of prenatal genetic testing.     

Keeping Up with the Cloneses -- Issues in Human Cloning

The advent of cloning animals has created a maelstrom of social concern about the ethical issues associated with the possibility of cloning humans. When the ethical concerns are clearly examined, however, many of them turn out to be less matters of rational ethics than knee-jerk emotion, religious bias, or fear of that which is not understood. Three categories of real and spurious ethical concerns are presented and discussed: 1) that cloning is intrinsically wrong, 2) that cloning must lead to bad consequences, and 3) that cloning harms the organism generated. The need for a rational ethical framework for discussing biotechnological advances is presented and defended.     

Constrained maximum likelihood estimation of two-level covariance structure model via EM type algorithms

In this paper, the constrained maximum likelihood estimation of a two-level covariance structure model with unbalanced designs is considered. The two-level model is reformulated as a single-level model by treating the group level latent random vectors as hypothetical missing-data. Then, the popular EM algorithm is extended to obtain the constrained maximum likelihood estimates. For general nonlinear constraints, the multiplier method is used at theM-step to find the constrained minimum of the conditional expectation. An accelerated EM gradient procedure is derived to handle linear constraints. The empirical performance of the proposed EM type algorithms is illustrated by some artifical and real examples.This research was supported by a Hong Kong UCG Earmarked Grant, CUHK 4026/97H. We are greatly indebted to D.E. Morisky and J.A. Stein for the use of their AIDS data in our example. We also thank the Editor, two anonymous reviewers, W.Y. Poon and H.T. Zhu for constructive suggestions and comments in improving the paper. The assistance of Michael K.H. Leung and Esther L.S. Tam is gratefully acknowledged.     

Predicting elections from the most important issue: A test of the take‐the‐best heuristic

We used the take‐the‐best heuristic to develop a model to forecast the popular two‐party vote shares in U.S. presidential elections. The model draws upon information about how voters expect the candidates to deal with the most important issue facing the country. We used cross‐validation to calculate a total of 1000 out‐of‐sample forecasts, one for each of the last 100 days of the ten U.S. presidential elections from 1972 to 2008. Ninety‐seven per cent of forecasts correctly predicted the winner of the popular vote. The model forecasts were competitive compared to forecasts from methods that incorporate substantially more information (e.g., econometric models and the Iowa Electronic Markets). The purpose of the model is to provide fast advice on which issues candidates should stress in their campaign. Copyright © 2010 John Wiley & Sons, Ltd.     

Commentary on “Mediation analysis and categorical variables: The final frontier” by Dawn Iacobucci

The commentary discusses several topics in Dr. Iacobucci's article on mediation analysis with categorical variables including the lack of equivalency of mediated effect measures, ab, and c–c′, that are algebraically equivalent in ordinary least squares regression models. The commentary raises the issue of correlated mediation coefficients and presents formulas to include the correlation in the test of significance. References to new developments in causal mediation analysis for categorical variables are given and the importance of programs of research to establish a mediation theory is emphasized.     

CREATING AN IPHONE APPLICATION FOR COLLECTING CONTINUOUS ABC DATA

This paper provides an overview and task analysis for creating a continuous ABC data‐collection application using Xcode on a Mac computer. Behavior analysts can program an ABC data collection system, complete with a customized list of target clients, antecedents, behaviors, and consequences to be recorded, and have the data automatically sent to an e‐mail account after observations have concluded. Further suggestions are provided to customize the ABC data‐ collection system for individual preferences and clinical needs.     

Introducing naturalistic cycling data: What factors influence bicyclists’ safety in the real world?

Presently, the collection and analysis of naturalistic data is the most credited method for understanding road user behavior and improving traffic safety. Such methodology was developed for motorized vehicles, such as cars and trucks, and is still largely applied to those vehicles. However, a reasonable question is whether bicycle safety can also benefit from the naturalistic methodology, once collection and analyses are properly ported from motorized vehicles to bicycles. This paper answers this question by showing that instrumented bicycles can also collect analogous naturalistic data. In addition, this paper shows how naturalistic cycling data from 16 bicyclists can be used to estimate risk while cycling. The results show that cycling near an intersection increased the risk of experiencing a critical event by four times, and by twelve times when the intersection presented some form of visual occlusion (e.g., buildings and hedges). Poor maintenance of the road increased the risk tenfold. Furthermore, the risk of experiencing a critical event was twice as large when at least one pedestrian or another bicyclist crossed the bicyclist’s trajectory. Finally, this study suggests the two most common scenarios for bicycle accidents, which result from different situations and thus require different countermeasures. The findings presented in this paper show that bicycle safety can benefit from the naturalistic methodology, which provides data able to guide development and evaluation of (intelligent) countermeasures to increase cycling safety.     

Satisfaction et confort au travail. L’apport de la démarche implicative

A large body of research has investigated the psycho-organizational variables predicting satisfaction at work, but few studies have so far examined variables in the field of environmental psychology. Our study aims first to identify the impact of variables evaluating comfort at work (satisfaction with the work environment, attachment to the workplace) by comparing them with organizational variables known to be related to job satisfaction, and then to rank the relationships between these variables in a pseudo- implication sequence, based on statistical implicative analysis. The study involved 105 bank employees and confirms our theoretical model, showing that job satisfaction can be explained implicatively by the three other variables [(Comfort/Functionality => Control/privacy) => Workplace attachment] => job satisfaction.     

Determinants of ethnic identity development in adulthood: A longitudinal study

Ethnic identity is defined in terms of the interaction between exploration of and commitment to a given cultural background. The present study investigated the effect of individual background, role transitions, and the social environment on the development of ethnic identity in a sample of German adults aged 21–73 years (N = 2,940). Additionally, identity transitions and the moderating effect of disequilibrating life events on identity over time were examined (N = 827). Overall, results are consistent with findings for other identity domains: Respondents could be assigned to one of four identity stages, ranging from unexamined to achieved identity. Particularly, the individual background and the extent of community involvement affected ethnic identity formation in adulthood. Longitudinal analyses revealed that only one-third of respondents had remained in the same identity stage; most individuals had transitioned forward or backward. Changes in ethnic identity were not moderated by disequilibrating life events.