Acquisition of Related and Unrelated Factual Information Delivered by a Teacher Within an Inclusive Setting

Two secondary students with moderate disabilities (one per classroom) attended Advanced English classes with peers without disabilities in a rural high school. In additional to conducting planned daily instruction, each English teacher also systematically presented three sets of information (two facts per set) to each student with disabilities during the course of the class using a parallel treatments design. Each set of information included a fact related to the English class (e.g., Begin each sentence with a capital letter.) and a fact not related to the English class (e.g., The governor of Kentucky is Paul Patton.). The special education teacher conducted daily probe sessions to document acquisition. Of the six facts presented to each student with disabilities, one student acquired two related facts and one unrelated fact, while the other student acquired two related and two unrelated facts. This investigation implies that students who are fully included can acquire information presented by the regular classroom teacher during the course of a typical class and that teachers can facilitate learning by planning to present such information in a systematic fashion.     

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.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

Recognition Memory for Faces: Reliability and Validity of the Warrington Recognition Memory Test (RMT) in a Neurological Sample

In response to critiques regarding the psychometric limitations of the Warrington Recognition Memory Test for faces (RMT-F), the current study was conducted to examine the test-retest reliability and validity of the measure in a neurological sample. Forty adult outpatients, ages 35–81, were administered the RMT-F as part of their diagnostic exam. A second evaluation was conducted after an average interval of 7 months (range = 2–20 months). Results yielded a Pearson reliability coefficient of 0.81 (p < .001), indicating a clinically satisfactory index of stability. Correlations with other measures were conducted to examine convergent and divergent validity. Results indicate that the facial component of the RMT has adequate reliability for patients with established neurological disease, shows moderate correlations with other measures of complex visuospatial function, and shows no significant correlation with measures of verbal reasoning, visual problem-solving, or verbal fluency. These findings provide additional support for the clinical efficacy of this instrument for use in a diverse neurological patient sample.     

Molecular geneticists and moral responsibility: “maybe if we were working on the atom bomb I would have a different argument”

Senior molecular geneticists were interviewed about their perceptions of the ethical and social implications of genetic knowledge. Inductive analysis of these interviews identified a number of strategies through which the scientists negotiated their moral responsibilities as they participated in generating knowledge that presents difficult ethical questions. These strategies included: further analysis and application of scientific method; clarification of multiple roles; negotiation with the public through public debate, institutional processes of funding, ethics committees and legislation; and personal responsibility.     

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.     

Moral Responsibility, Determinism, and the Ability to do Otherwise

In his classic paper, The Principle of Alternate Possibilities, Harry Frankfurt presented counterexamples to the principle named in his title: A person is morally responsible for what he has done only if he could have done otherwise. He went on to argue that the falsity of the Principle of Alternate Possibilities (PAP) implied that the debate between the compatibilists and the incompatibilists (as regards determinism and the ability to do otherwise) did not have the significance that both parties had attributed to it -- since moral responsibility could exist even if no one was able to do otherwise. I have argued that even if PAP is false, there are other principles that imply that moral responsibility entails the ability to do otherwise, and that these principles are immune to Frankfurt-style counterexamples. Frankfurt has attempted to show that my arguments for this conclusion fail. This paper is a rejoinder to that reply; I argue that he has failed to show this.     

Faulty Judgment,Expert Opinion,and Decision-Making Capacity

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person'scapacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.