Reinforcer identification and evaluation of choice within an educational setting

Current research on preference methodology and the effects of choice with children who are typically developing is limited. This study evaluated two preference methodologies for identifying reinforcers across two choice options within the classroom. These methods include a teacher-generated list of reinforcers, a student-generated list of reinforcers, student choice from both lists, and teacher choice from both lists. Four elementary aged-children with no diagnosed learning or developmental disabilities participated. Both preference methods were effective in identifying reinforcers for all participants. Moreover, both choice options resulted in increases in responding. Results are discussed with respect to reinforcement and the effects of “choice.”     

Risk Perception,Worry and Satisfaction Related to Genetic Counseling for Hereditary Cancer

In this multi center study, genetic counseling for hereditary cancer was evaluated by assessing patients’ worry, perceived risk of developing cancer and satisfaction with genetic counseling. An overall aim was to identify characteristics of vulnerable patients in order to customize genetic counseling. In addition, agreement between patients’ and counselors’ scores was measured. A total of 275 Norwegian patients were consecutively recruited, and 213 completed questionnaires before and after genetic counseling. Patients’ perceived risk decreased after the genetic counseling session. There was incongruence between risk perception expressed as a percentage and in words. Patients were significantly less worried after counseling. Higher levels of worry were predicted by low instrumental satisfaction with counseling, high degree of perceived risk of developing cancer and younger age. In conclusion, counselors met the patients’ psychological needs to a satisfactory degree during counseling. However, patients did not fully understand their risk of developing cancer.     

Bayesian Risk Assessment in Genetic Testing for Autosomal Dominant Disorders with Age-Dependent Penetrance

Risk assessment is an essential component of genetic counseling and testing, and the accuracy of risk assessment is critical for decision making by consultands. However, it has been shown that genetic risk calculations may have high error rates in practice. Risk calculations for autosomal dominant disorders are frequently complicated by age-dependent penetrance and sensitivities of less than 100% in genetic testing. We provide methods of risk calculation for prototypical pedigrees of a family at risk for an autosomal dominant disorder with age-dependent penetrance. Our risk calculations include scenarios in which the sensitivity of genetic testing is less than 100%, and in which the sensitivity of genetic testing varies for different family members at risk. Our Bayesian methods permit autosomal dominant disease probabilities to be calculated accurately, taking into account all relevant information. Our methods are particularly useful for hereditary cancer syndromes, in which genetic testing can seldom achieve 100% sensitivity. Our methods can be applied to many different scenarios, including those where the sensitivity of genetic testing varies for different family members at risk. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.     

Information Processing in the Context of Genetic Risk: Implications for Genetic-Risk Communication

Communicating genetic-risk information is fraught with difficulties, and there are no universally accepted guidelines for clinical practice. In this paper, we suggest that information-processing models may offer some guidance for the communication of genetic risk. The paper reviews selected literature from health and social psychology, including defensive reactions to threatening health information, the Extended Parallel Process Model (EPPM) and Self Affirmation Theory. Ultimately, it presents the Heuristic-Systematic Model (HSM) of information processing as a useful perspective from which to view genetic-risk communication. Through our review of this literature, we identify some of the variables found to influence the systematic or heuristic processing of risk information and note their relevance to genetic counseling contexts. We suggest that systematic information processing is conducive to informed decision-making, as well as improved understanding of risk information. Clinical practice implications derived from our review of these literatures are noted.     

Probability Biases in Genetic Problem Solving: A Comparison of Undergraduates, Genetic Counseling Graduate Students, and Genetic Counselors

Heuristics are mental shortcuts that aid people in everyday problem-solving and decision-making. Although numerous studies have demonstrated their use in contexts ranging from consumers’ shopping decisions to experts’ estimations of experimental validity, virtually no published research has addressed heuristics use in problems involving genetic conditions and associated risk probabilities. The present research consists of two studies. In the first study, 220 undergraduates attempted to solve four genetic problems—two common heuristic problems modified to focus on genetic likelihood, and two created to study heuristics and probability rule application. Results revealed that the vast majority of undergraduates used heuristics and also demonstrated a complete misuse of probability rules. In the second study, 156 practicing genetic counselors and 89 genetic counseling students solved slightly modified versions of the genetic problems used in Study 1. Results indicated that a large percentage of both genetic counselors and students used heuristics, but the counselors demonstrated superior problem-solving performance compared to both the genetic counseling students and the undergraduates from Study 1. Research, training, and practice recommendations are presented.     

Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement

We examined whether clinical progress ratings on the Monthly Treatment and Progress Summary form (MTPS), an idiographic treatment progress measure, were meaningfully related to changes measured by two separate standardized instruments; the Child and Adolescent Functional Assessment Scale (CAFAS) and the Child and Adolescent Level of Care Utilization System (CALOCUS). Validity coefficients were examined at intake and three-, six-, and nine-month follow-up periods. Samples were selected for each measure and follow-up period from the population of youth receiving services through the Hawaii Child and Adolescent Mental Health Division’s (CAMHD) system of care. Significant youth improvement was evident on all three measures across all follow-up intervals. The type of changes measured by the MTPS and CAFAS were more alike over longer follow-up intervals than changes measured by the CALOCUS. The MTPS captures distinct aspects of client change that overlaps somewhat with CAFAS and CALOCUS measures. The MTPS is a brief client-tailored measure that seems to provide valid, sensitive, and nonredundant client specific treatment outcome information that can be collected on a frequent basis within a complex system of care.     

Concurrent Validity of the Multidimensional Health Profile—Health Functioning Scales (MHP-H) in the Pre-operative Assessment of Applicants for Gastric Bypass Surgery

The concurrent validity of a brief screening test, the Multidimensional Health Profile-Health Functioning (MHP-H) was examined in conjunction with a much more lengthy pre-operative assessment procedure in 449 applicants for gastric bypass surgery (GBS). The MHP-H is a 69-item screening inventory that assesses five areas of health functioning: Adult Health History, Health Habits, Health Care Utilization, Health Beliefs and Attitudes, and Response to Illness. The more lengthy procedure included a comprehensive 273-item structured interview plus the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Basic Personality Inventory (BPI), and Beck Depression Inventory (BDI). The MHP-H showed significant correspondence with the more comprehensive assessment on measures of potential relevance to outcome in GBS, supporting the use of the MHP-H as a low-cost alternative to the more extensive procedure. The utility of the MHP-Psychosocial Functioning (MHP-P), a companion instrument to the MHP-H, was demonstrated in an earlier study.     

ORGANON The Web Tutor for Basic Logic Courses

We would like to introduce the web tutor ORGANON, which aimsto support basic logic courses at the University of West Bohemiain Pilsen (Czech Republic). The application was designed tofulfill two requirements. Firstly, it should help students duringtheir study to practice exercises on their own (providing permanentcontrol during students’ practicing exercises as wellas answering students’ questions immediately as they arise).Secondly, it should reduce teachers’ burden (diminishingthe amount of consultations as well as administrating students’homework including correcting and grading). The tutor is availableat http://kfi.zcu.cz/lide/dostalova/organon.     

The Ethics of NIMBY Conflicts

NIMBY (Not In My Backyard) refers to an oppositional attitude from local residents against some risk generating facility that they have been chosen to host either by government or industry. The attitude is claimed to be characteristic of someone who is positive to a facility but who wants someone else to be its host. Since siting cannot be provided if everyone has this attitude, society ends up in a worse situation. The attitude is claimed to be egoistic and irrational. Here it is argued that the NIMBY critique rests on questionable assumptions about the rightness of weighing total benefit against total cost. This weighing-principle will sometimes have to yield so that the rights of individuals can be acknowledged.

Are Newborns Morally Different from Older Children?

Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal care is held to a higher standard of justification. The relative value placed on the life of newborns, in particular the preterm, is less than expected by any objective medical data or any prevailing moral frameworks about the value of individual lives. Why do we feel less obligated to treat the premature baby? Do we put newborns in a special and lesser moral category? We explore this question from a legal and ethical perspective and offer several hypotheses pertaining to personhood, reproductive choices, “precious children,” and probable evolutionary and anthropological factors.