A survey of reimbursement for cystic fibrosis carrier testing

To assess the current status of reimbursement for cystic fibrosis (CF) carrier testing, we surveyed individuals tested in the Mid-Atlantic region. Results show that CF testing was covered by insurance in part or in full for greater than 50% of respondents. The test was nearly always covered when performed during pregnancy because of a positive family history, but it was also covered for more than 50% of pregnant respondents with a negative family history. There were no significant differences in coverage by type of insurance. Many respondents needed to supply additional information about the testing to their insurance company before a coverage decision could be made. Before population-based CF screening programs are initiated, more data are needed on insurance reimbursement for testing, especially when performed pre-conceptually.     

Pupillometry system for use in social psychology

It is now relatively easy to implement pupillometry in social psychological research. We describe a system in which a Macintosh computer presents visual and auditory stimuli to subjects while monitoring an infrared pupillometer. The computer records information on subject, task, and pupil diameter into a data file for input into standard statistical analysis programs. Pupil diameter is measured continuously while subjects respond to stimuli that last for several seconds or minutes. A demonstration experiment verifies the usefulness of the system. The ability of the Macintosh computer to easily handle visual and auditory stimuli and to record responses lasting a considerable length of time makes the system well suited for studying pupil responses to complex social stimuli. This system is also well suited for the researcher initiating a research program using pupillometry. Ease of operation makes using a large number of subjects feasible.     

Affiliation of opposite-sexed strangers

This study examined the effects of a subject's sex and affiliative tendency and the other's physical attractiveness on the cross-sexual interaction of strangers. Although previous studies showed that one's interest in an opposite-sexed other is a function of the other's physical attractiveness, the actual behavior of individuals in the presence of attractive and unattractive others had not been systematically examined. Subjects were individually placed in a 5-min waiting situation with a physically attractive or unattractive target of the opposite sex who behaved in a standard way. Conversations were recorded and subsequently analyzed; subjects also provided their impressions of the targets following the waiting period. Physical attractiveness of the opposite-sexed other did not significantly influence the subject's verbal affiliative behavior, but the combined influence of a subject's sex and affiliative tendency was predictive of cross-sexual affiliation. Although physical attractiveness did not account for differences in affiliative behavior, subjects preferred attractive over unattractive targets as potential dates or marriage partners.     

Stakeholders’ Opinions on the Implementation of Pediatric Whole Exome Sequencing: Implications for Informed Consent

Advances in whole genome and whole exome sequencing (WGS/WES) technologies have led to increased availability in clinical settings. Currently, there are few guidelines relating to the process and content of informed consent for WGS/WES, nor to which results should be returned to families. To address this gap, we conducted focus groups to assess the views of professionals, parents, and adolescents for the future implementation of WES. The discussions assessed understanding of the risks and benefits of WES, preferences for the informed consent discussion, process for return of results, and the decision-making role of the pediatric patient. Professional focus group participants included bioethicists, physicians, laboratory directors, and genetic counselors. Parent focus groups included individuals with children who could be offered sequencing due to a potential genetic cause of the child’s condition. On-line discussion groups were conducted with adolescents aged 13–17 who had a possible genetic disorder. We identified discrepancies between professionals and patient groups regarding the process and content of informed consent, preference for return of results, and the role of the child in decision-making. Professional groups were concerned with the uncertainty regarding professional obligations, changing interpretation in genomic medicine, and practical concerns of returning results over time. Parent and adolescent groups focused on patient choice and personal utility of sequencing results. Each group expressed different views on the role of the child in decision-making and return of results. These discrepancies represent potential barriers to informed consent and a challenge for genetic counselors regarding the involvement of pediatric patients in decision-making and return of results discussions.     

An inkblot for sexual preference: A semantic variant of the Affect Misattribution Procedure

A newly developed Semantic Misattribution Procedure (SMP), a semantic variant of the Affect Misattribution Procedure (AMP), was used in three studies as an indirect measure of sexual interest. Using a known-group approach, homosexual men (Studies 1 and 2), heterosexual men (Studies 1 to 3) and heterosexual women (Study 3) were asked to guess the meaning of briefly presented Chinese ideographs as “sexual” or “not sexual”. The ideographs were preceded by briefly presented primes depicting male and female individuals of varying sexual maturity. As hypothesised, the frequency of “sexual” responses increased after priming with pictures of individuals of the preferred sex and increasing sexual maturation. The SMP showed satisfactory reliability and convergent validity as indicated by correlations with direct and two indirect measures of sexual interest. In two further studies, the hypothesised pattern was replicated whereas a standard AMP with the identical prime stimuli did not produce this result. The potential usefulness of semantic variants of the AMP is discussed.     

Toward a Model Informed Consent Process for BRCA1 Testing: A Qualitative Assessment of Women's Attitudes

As an initial part of a project to develop a model informed consent process for BRCA1 testing, we conducted a series of focus groups. At the groups, women initially expressed great interest in testing, but their interest diminished after learning more. If offered testing, women would most want to learn about test accuracy, practical details of testing, and management options if the result was positive. Perceived benefits of testing included gaining information leading to risk reduction, relief of uncertainty, more responsible parenting, and assisting in research. Perceived risks included the discomfort and cost of the testing process itself, and anxiety after a positive result. The risk of possible insurance discrimination was rarely mentioned spontaneously. Many women would want their providers to make recommendations, rather than be nondirective about testing. We observed that women vary greatly in their informational and counseling needs, and suggest that the informed consent process should be individualized, taking into account a woman's perception and her preferences for how testing decisions should be made.     

An inkblot for sexual preference: a semantic variant of the Affect Misattribution Procedure

A newly developed Semantic Misattribution Procedure (SMP), a semantic variant of the Affect Misattribution Procedure (AMP), was used in three studies as an indirect measure of sexual interest. Using a known-group approach, homosexual men (Studies 1 and 2), heterosexual men (Studies 1 to 3) and heterosexual women (Study 3) were asked to guess the meaning of briefly presented Chinese ideographs as "sexual" or "not sexual". The ideographs were preceded by briefly presented primes depicting male and female individuals of varying sexual maturity. As hypothesised, the frequency of "sexual" responses increased after priming with pictures of individuals of the preferred sex and increasing sexual maturation. The SMP showed satisfactory reliability and convergent validity as indicated by correlations with direct and two indirect measures of sexual interest. In two further studies, the hypothesised pattern was replicated whereas a standard AMP with the identical prime stimuli did not produce this result. The potential usefulness of semantic variants of the AMP is discussed.