A teaching framework for cross-cultural genetic counseling

The increasing diversity of American society has brought growing recognition of the need to bridge cultures in the delivery of genetic counseling services. New immigrants and members of diverse ethnic groups face multiple barriers to genetic counseling services. The need to train genetic counselors to deal with cultural diversity is especially crucial in the new genetic era, given the rapid expansion of available technology, with the resulting social and ethical ramifications. A framework for teaching cross-cultural issues in genetic counseling training programs is presented that can be implemented in step-wise fashion, consistent with available resources. Cross-cultural issues can be incorporated into existing teaching and training modalities by expanding the orientation from monocultural to multicultural. Relevant clinical experience, exploration of students' preconceptions and biases, reading materials, and lectures by invited speakers can all enhance students' knowledge and sensitivity. It is critically important that training programs furnish students with the basic tools necessary for the ongoing process of learning about cultural diversity.     

FUNCTIONAL COMMUNICATION TRAINING WITH AND WITHOUT EXTINCTION AND PUNISHMENT

Functional communication training has been reported to be a promising treatment for severe behavior problems. In this study, functional communication training alone and combined with extinction and/or punishment was evaluated for 4 clients with severe retardation, behavior problems, and communication deficits. The participants were inpatients on a hospital unit for treatment of severe behavior disorders. They received individualized interventions based on functional assessment that included reinforcement of a communication response with the same function as their destructive behavior. Results showed that for some patients, functional communication training was not sufficient to produce clinically significant reductions in destructive behavior, and the combination of training plus punishment produced the largest and most consistent reductions.     

Adaptation, teleology, and selection by consequences

This paper presents and defends the view that reinforcement and natural selection are selection processes, that selection processes are neither mechanistic nor teleological, and that mentalistic and vitalistic processes are teleological but not mechanistic. The differences between these types of processes are described and used in discussing the conceptual and methodological significance of “selection type theories” and B. F. Skinner's radical behaviorist view that “operant behavior is the field of intention, purpose, and expectation. It deals with that field precisely as the theory of evolution has dealt with another kind of purpose” (1986, p. 716). The antimentalism of radical behaviorism emerges as a post-Darwinian extension of Francis Bacon's (and Galileo's) influential view that “[the introduction of final causes] rather corrupts than advances the sciences” (Bacon, 1905, p. 302).     

Linking qualitative and quantitative methods in cross-cultural survey research: Techniques from cognitive science

Survey research with diverse cultural and ethnic minority groups is a complex and challenging endeavor that confronts the researcher with problems related to linguistic and conceptual equivalence and measurement as well as problems related to difficulties that respondents have with the sociocultural dimensions of the survey/interview process. One way to improve the quality of cross-cultural surveys and to insure that the findings are culturally relevant and accurate is to combine qualitative and quantitative methods. This paper proposes that certain qualitative techniques from cognitive science, specifically cognitive anthropology and cognitive psychology, are particularly well suited to being combined with survey research. These techniques provide information corresponding to the underlying thought processes of respondents and enable researchers to better understand how different cultural and ethnic groups construe the world. The information obtained can be used improve the formulation of survey questions, design and structure questionnaire formats to coincide with the way particular groups organize concepts, and help researchers understand difficulties respondents may have with the survey/interview process. In addition, the techniques produce data that are easily codifiable and more manageable than traditional qualitative techniques including participant observation and in-depth interviews.     

IMPROVED CURVEBALL HITTING THROUGH THE ENHANCEMENT OF VISUAL CUES

This study investigated the effectiveness of using visual cues to highlight the seams of baseballs to improve the hitting of curveballs. Five undergraduate varsity baseball team candidates served as subjects. Behavior change was assessed through an alternating treatments design involving unmarked balls and two treatment conditions that included baseballs with 1/4-in. and 1/8-in. orange stripes marking the seams of the baseballs. Results indicated that subjects hit a greater percentage of marked than unmarked balls. These results suggest that the addition of visual cues may be a significant and beneficial technique to enhance hitting performance. Further research is suggested regarding the training procedures, effect of feedback, rate of fading cues, generalization to live pitching, and generalization to other types of pitches.     

IN VIVO VERSUS SIMULATION TRAINING: AN INTERACTIONAL ANALYSIS OF RANGE AND TYPE OF TRAINING EXEMPLARS

We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives.     

Medical education: The training of ethical physicians

This paper suggests that medical education be revised to assist in diffusing potential ethical dilemmas that arise during health care provision. A revised medical education would emphasize the role of the humanities in the training of physicians, especially in light of recent critiques of the canonical scientific model in general, and more specifically in the use of that model for medical training and practice.I wish to thank Dr. Mary Ann Cutter and Melissa M. Amaro for their critical suggestions.     

The myth of science education

It is argued that the manner in which we teach science in the high schools represents an outdated positivistic conception of science. The standard presentation of a year of each of chemistry, biology and physics should be replaced by an integrated science plus history, philosophy, and sociology of science which would take a total of three years to complete. A proper appreciation for the true nature of science is essential to the continued health of the scientific enterprise.     

RELATING THE PHYSICS AND RELIGION OF DAVID BOHM

Abstract. David Bohm's thinking has become widely publicized since the 1982 performance of a form of the Einstein-Podolsky- Rosen (EPR) experiment. Bohm's holomovement theory, in particular, tries to explain the nonlocality that the experiment supports. Moreover, his theories are close to his metaphysical and religious thinking. Fritjof Capra's writings try something similar: supporting a theory (the bootstrap theory) because it is close to his religious beliefs. Both Bohm and Capra appear to use their religious ideas in their physics. Religion, their source for physical hypotheses, provides the motivation to develop and uphold them.     

Whose Gene Is It? A Case Discussion About Familial Conflict over Genetic Testing for Breast Cancer

A multidisciplinary group of genetic and other professionals discuss a complex case of familial conflict over access to genetic information. One twin wishes to know the results of her deceased mother's tests for BRCA1 mutations; a second twin objects to researchers making this information available. As the case discussion unfolds, the apparent facts of this case are called into question and the lines of ethical certainty become less clear.