Repeat HIV Testing and HIV Transmission Risk Behaviors Among Sexually Transmitted Infection Clinic Patients

HIV testing and counseling expends considerable HIV prevention resources and offers great opportunities for HIV risk reduction. Individuals who are at risk for HIV and have not been HIV tested are the focus of current targeted testing campaigns and yet persons who are repeatedly tested for HIV often continue engaging in high-risk practices. This study examined HIV testing, risk behaviors, and other medical diagnostic testing practices of men (N = 231) and women (N = 86) attending an inner-city sexually transmitted infections (STI) clinic. Results showed that 75 (23%) participants had not yet been tested for HIV, 45 (14%) had been tested once, and 197 (63%) had been tested two or more times. Patients that had not been tested and those who were repeatedly tested were similar in their risk behaviors; both demonstrated significantly greater risks for HIV than persons tested just once, although repeat testers were more likely to have had a past STI. HIV testing history was minimally associated with other medical testing and health protective practices, such as testicular self-examination, mammography, and having had PAP tests. Results support targeting high-risk untested persons for HIV testing and suggest an urgent need for interventions to reduce risk behaviors among STI clinic patients who repeatedly test for HIV.     

Seemingly Anomalous WISC-IV Full Scale IQ Scores in the American and Canadian Standardization Samples

The American and Canadian standardization samples for the fourth edition of the Wechsler Intelligence Scale for Children were used to ascertain the prevalence of “seemingly anomalous” Full Scale IQ (FSIQ) scores for all possible sums of scaled scores combinations of the Verbal Comprehension Index, Perceptual Reasoning Index, Working Memory Index, and Processing Speed Index. About 1% of FSIQ scores in both samples were anomalous (that is, fell outside the range of the four indices). Interestingly, the prevalence of anomalous scores was higher at the extremes of the FSIQ distribution. Moreover, anomalous FSIQ scores occurring above or below the mean of the FSIQ distribution (that is, 100) were larger or smaller, respectively, than any of the four indices. Furthermore, if the range of the four indices did contain the FSIQ (the non-anomalous case), when the FSIQ was below or above 100 it tended to be located distally in the half-segment of the range furthest below or above 100, respectively. A non-technical intuitive analogy from Olympic sports and a statistical explanation for the findings are provided. Important implications for practitioners are also presented. Portions of this paper were presented March 17, 2006 at the 20th annual Joseph R. Royce Research Conference, Department of Psychology, University of Alberta, Edmonton, Alberta.     

Attitudes Toward Fragile X Mutation Carrier Testing from Women Identified in a General Population Survey

Fragile X syndrome is primarily due to a CGG repeat expansion found in the FMR1 X-linked gene. In a previous study, we conducted focus groups with women to assess their attitudes towards fragile X carrier screening. In this follow-up study, we conducted in-depth interviews of general population reproductive-age women who were identified as carriers. We explored their attitudes toward testing for carrier status of the fragile X mutation. These women underwent screening primarily to participate in a research project rather than in search of a diagnosis for specific symptoms. As such, these women were wholly unprepared for positive carrier results. Their responses about their results and carrier screening, in many cases, were being worked out over the course of the interview itself. The most salient finding of this work is the apparent lack of relevance of carrier status to these women. Many expressed that although the information could be relevant in the future, it is not relevant at this stage of their lives in terms of family planning (either with respect to having unaffected offspring or to premature ovarian failure) and personal relationships. Although issues of abortion seemed prominent in the focus groups, we found that carrier status did not have an apparent effect on women’s attitudes about termination. We hypothesize this may be related to the fact that women had not processed their new carrier status and had not related it to previously-formed personal opinions. The findings of this work have significant implications for genetic counseling and population screening. Genetic counselors should be mindful that general population women may not recognize the immediate importance of their carrier status even when literature is provided and discussed prior to providing a sample. As part of comprehensive genetic counseling, counselors should identify the reproductive life stage of the woman receiving the new information and help her identify when this information would be more meaningful in her life. Counselors can assist in setting up a personalized road map with specific types of services that will be more applicable to the woman as her carrier status becomes more relevant.     

Results of an Intervention for Individuals and Families with <Emphasis Type="Italic">BRCA</Emphasis> Mutations: A Model for Providing Medical Updates and Psychosocial Support Following Genetic Testing

Providing medical management updates and long-term support to families with hereditary cancer syndromes in rural areas is a challenge. To address this, we designed a one-day retreat for BRCA1/2 carriers in our region. The retreat included educational updates about medical management, genetic privacy and discrimination, and addressed psychological and family issues. Evaluations completed at the conclusion of the retreat were overwhelmingly positive with requests for a similar event in the future. The impact of this retreat on a variety of health behaviors was assessed. Eligible participants completed questionnaires before and 6 months after the retreat. Questionnaires focused on lifestyle, cancer screening and prevention practices, psychological history and distress, decision-making regarding genetic testing, and family communication issues. For individuals who completed both the pre and post retreat questionnaires, one-half made lifestyle changes and nearly two-thirds increased cancer screening, initiated chemoprevention, completed or planned to complete preventative surgery in the future. We conclude that this type of forum provides a valuable opportunity for BRCA carriers and their families to receive updated medical information, share personal experiences, provide and receive support, as well as change health behaviors.     

Measuring organisational climate and employee engagement: Evidence for a 7 Ps model of work practices and outcomes

This study presents evidence supporting the psychometric properties of the Voice Climate Survey: an employee opinion survey that measures work practices and outcomes. The tool is tested across 13,729 employees from 1,279 business units representing approximately 1,000 organisations. Exploratory factor analyses, confirmatory factor analyses and internal reliability analyses support 31 lower‐order work practices and outcomes that aggregate into seven higher‐order work systems broadly covering practices and outcomes such as organisational direction, ethics, resources, involvement, recognition, development, teamwork, wellness, work/life balance, change management, customer satisfaction, job satisfaction, organisational commitment and employees' intention to stay. External validation of the tool is demonstrated by linking scores from the employee survey with independent manager reports of turnover, absenteeism, productivity, health and safety, goal attainment, financial performance, change management, innovation and customer satisfaction.     

Item difficulty parameter estimation using the idea of the graded response model and computerized adaptive testing

Abstract:  In test operations using IRT (item response theory), items are included in a test before being used to rate subjects and the response data is used to estimate their item parameters. However, this method of test operation may lead to item content leakage and an adequate test operation can become difficult. To address this problem, Ozaki and Toyoda (2005, 2006 ) developed item difficulty parameter estimation methods that use paired comparison data from the perspective of the difficulty of items as judged by raters familiar with the field. In the present paper, an improved method of item difficulty parameter estimation is developed. In this new method, an item for which the difficulty parameter is to be estimated is compared with multiple items simultaneously, from the perspective of their difficulty. This is not a one-to-one comparison but a one-to-many comparison. In the comparisons, raters are informed that items selected from an item pool are ordered according to difficulty. The order will provide insight to improve the accuracy of judgment.     

Marginally perceptible outcome feedback, motor learning and implicit processes

Participants struck 500 golf balls to a concealed target. Outcome feedback was presented at the subjective or objective threshold of awareness of each participant or at a supraliminal threshold. Participants who received fully perceptible (supraliminal) feedback learned to strike the ball onto the target, as did participants who received feedback that was only marginally perceptible (subjective threshold). Participants who received feedback that was not perceptible (objective threshold) showed no learning. Upon transfer to a condition in which the target was unconcealed, performance increased in both the subjective and the objective threshold condition, but decreased in the supraliminal condition. In all three conditions, participants reported minimal declarative knowledge of their movements, suggesting that deliberate hypothesis testing about how best to move in order to perform the motor task successfully was disrupted by the impoverished disposition of the visual outcome feedback. It was concluded that sub-optimally perceptible visual feedback evokes implicit processes.     

国外关于测试效应的研究概述

测试效应的研究表明,“学习”并非只发生在编码阶段,测试或提取练习除了可评估知识掌握程度之外,在某些情况下它比再次学习能更好地促进长时记忆保持。文章从如下方面概述了国外关于测试效应的研究：（1）在自由回忆、配对联想学习、再认和模拟教育情境等不同性质的实验任务下测试对学习的积极作用;（2）测试可能导致的消极作用,介绍有关提取导致遗忘,测试的消极暗示效应,测试与错误记忆等方面的研究;（3）介绍信息额外呈现理论,过度学习理论,提取努力理论,必要难度理论,迁移适当加工理论等测试效应的有关理论及其发展沿革。最后,结合研究中的争议及教学应用做了思考,并指出有待进一步研究的问题     

结构方程模型检验：拟合指数与卡方准则

讨论了Hu和Bentler（1998,1999）推荐的检验结构方程模型的7个拟合指数准则,对这7个指数的历史、特点和表现做了比较详细的述评。指出了他们基于这7个指数的单指数准则和2-指数准则的不足之处。提出了超低显著性水平下的卡方准则,并部分重复他们的模拟例子,将卡方准则与这7个指数准则比较,结果说明新的卡方准则优于其中的6个,与另一个相当。最后简要说明了应当如何检视拟合指数进行模型检验和模型比较。