Fabry disease in genetic counseling practice: recommendations of the National Society of Genetic Counselors

The objective of this document is to provide health care professionals with recommendations for genetic counseling and testing of individuals with a suspected or confirmed diagnosis of Fabry disease, with a family history of Fabry disease, and those identified as female carriers of Fabry disease. These recommendations are the opinions of a multicenter working group of genetic counselors, medical geneticists, and other health professionals with expertise in Fabry disease counseling, as well as an individual with Fabry disease who is a founder of a Fabry disease patient advocacy group in the United States. The recommendations are U.S. Preventive Task Force Class III, and they are based on clinical experience, a review of pertinent English-language articles, and reports of expert committees. This document reviews the genetics of Fabry disease, the indications for genetic testing and interpretation of results, psychosocial considerations, and references for professional and patient resources. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a healthcare provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Affirmative action. Psychological data and the policy debates

The authors bring psychological research to bear on an examination of the policy of affirmative action. They argue that data from many studies reveal that affirmative action as a policy has more benefits than costs. Although the majority of pro-affirmative action arguments in the social sciences stress diversity, the authors' argument focuses on issues of merit. The merit-based argument, grounded in empirical studies, concludes that the policy of affirmative action conforms to the American ideal of fairness and is a necessary policy.     

White guilt and racial compensation: the benefits and limits of self-focus

In two studies, the authors investigated guilt as a response to group-based advantage. Consistent with its conceptualization as a self-focused emotion, White guilt was based in self-focused beliefs in racial inequality. Thus, guilt was associated with belief in White privilege (Study 1) and resulted from seeing European Americans as perpetrators of racial discrimination (Study 2). Just as personal guilt is associated with efforts at restitution, White guilt was predictive of support for affirmative action programs aimed at compensating African Americans. White guilt was not, however, predictive of support for noncompensatory efforts at promoting equality, such as affirmative action programs that increase opportunities (Study 2). In contrast, the other-focused emotion of group-based sympathy was a more general predictor of support for different affirmative action policies. Our findings demonstrate the benefits and limits of group-based guilt as a basis of support for social equality and highlight the value of understanding the specific emotions elicited in intergroup contexts.     

Timed picture naming: Extended norms and validation against previous studies

Factors affecting word retrieval were compared in a timed picture-naming paradigm for 520 drawings of objects. In prior timed and untimed studies by Snodgrass and Vanderwart (1980) and Snodgrass and Yuditsky (1996), concerns were raised that participants could not reliably name large numbers of items in a single session. We show that reliable results are obtained in a single session for 520 items and validate our method against previous findings by Snodgrass and colleagues for overlapping items. For these items, comparable levels of name agreement and latency are obtained, and we replicate effects of length, frequency, both objective and subjective age of acquisition, and visual complexity on reaction time (RT) and name agreement measures. Name agreement is unaffected by order of presentation, although there is a gradual increase in RTs across the session, requiring use of multiple random orders. Current extensions of our method include cross-linguistic, bilingual, developmental, and neuropsychological studies and comparisons of action naming and object naming.     

Bridging the gap between joint and individual decisions: Deconstructing preferences in relationships

Most choice research has studied how people make decisions within a narrowly defined choice context and has not paid sufficient attention to the role of social context. We commend Simpson, Griskevicius, and Rothman for directing the attention of choice researchers to the study of joint decision making and current theories on relationships. Building on SGR, we propose that a relationship partner's influence varies with the type of decision at hand and with situational factors. We propose four possible types of decision episodes, defined by whether the decision stage and the consumption stage each occur singly or jointly, and explore how the decision type impacts the extent to which a decision maker will take a partner's preferences into account. We further discuss how situational factors, such as the environment in which the decision is made, as well as the mindset and cognitive resources of the decision maker, are likely to influence decision outcomes.     

Citizenship, Co-ethnic Populations, and Employment Probabilities of Immigrants in Sweden

Over the last decades, Sweden has liberalized its citizenship policy by reducing the required number of years of residency to 5?years for foreign citizens and only 2?years for Nordic citizens. Dual citizenship has been allowed since 2001. During the same period, immigration patterns by country of birth changed substantially, with an increasing number of immigrants arriving from non-western countries. Furthermore, immigrants were settling in larger cities as opposed to smaller towns as was the case before. Interestingly, the employment integration of immigrants has declined gradually, and in 2006, the employment rate for foreign-born individuals is substantially lower compared with the native-born. The aim of this paper is to explore the link between citizenship and employment probabilities for immigrants in Sweden, controlling for a range of demographic, human capital, and municipal characteristics such as city and co-ethnic population size. The information we employ for this analysis consists of register data on the whole population of Sweden held by Statistics Sweden for the year 2006. The basic register, STATIV, includes demographic, socio-economic, and immigrant specific information. In this paper, we used instrumental variable regression to examine the ??clean?? impact of citizenship acquisition and the size of the co-immigrant population on the probability of being employed. In contrast to Scott (2008), we find that citizenship acquisition has a positive impact for a number of immigrant groups. This is particularly the case for non-EU/non-North American immigrants. In terms of intake class, refugees appear to experience substantial gains from citizenship acquisition (this is not, however, the case for immigrants entering as family class). We find that the impact of the co-immigrant population is particularly important for immigrants from Asia and Africa. These are also the countries that have the lowest employment rate.     

Sugaring o'er the devil: Moral superiority and group identification help individuals downplay the implications of ingroup rule‐breaking

We examined how a group's claim to moral superiority influences evaluations of rule‐breaking by ingroup members. Moral superiority was manipulated among researchers (Study 1) and British citizens (Study 2), after which group members were presented with ingroup rule‐breakers: a researcher violating ethical rules (Study 1) and British soldiers abusing Iraqi prisoners (Study 2). In both studies, higher and lower identifiers in the control condition perceived the rule‐breaking as equally damaging, evaluated the rule‐breakers equally negatively and recommended equally harsh punishments. When the group had taken the moral high ground, lower identifiers perceived the rule‐breaking as more damaging than did higher identifiers. In addition, higher identifiers evaluated the rule‐breakers less negatively and recommended more lenient punishments. Results of mediation analyses demonstrated that negative evaluations of, and recommended punishment for, the rule‐breakers were explained by the perceived damage that their behaviour caused to the ingroup. Theoretical and practical implications are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

An Exploration of the Relationship Between Spirituality and State and Trait Anger Among Medical Students

There is a dearth of studies exploring spiritual attitudes of medical students from developing countries and its relationship to anger. This study was conducted to assess spiritual attitudes and their relationship with anger in a set of medical students in southern India. In this cross-sectional observational study, medical students who were undergoing clinical rotations were offered participation. Selected demographic data were obtained. The participants were rated using the Spiritual Attitudes Inventory [SAI, which comprises of Duke Religiosity Index, Existential Well-Being Scale (EWBS), Negative Religious Coping and Multidimensional Health Locus of Control scale] and State and Trait Anger Expression Inventory 2. Out of 98 students approached, 82 participated (response rate 83.6 %). The mean age of sample was 20.7 years (±0.9 years) with a slight preponderance of females (54.9 %). SAI scores correlated well significantly with subscale scores. Gender had no difference on the SAI or subscale score. Differences were found between self-reported religion and EWBS scores (Kruskal–Wallis χ ² = 8.891, p = 0.012). Total SAI score had a significant negative correlation with state anger, trait anger and anger expression. High levels of spirituality may be correlated with lower levels of state anger, trait anger and anger expression in medical students.     

Community Gender Norms Change as a Part of a Multilevel Approach to Sexual Health Among Married Women in Mumbai,India

Inequitable gender norms in societies and communities negatively contribute to women’s sexual and reproductive health. While the need for change in gender norms is well recognized, the task is highly challenging in terms of intervention design, implementation and assessment of impact. This paper describes a methodology for identification of gender norms, the design of community level intervention, community participation and the assessment of intervention impact in a low income, predominately Muslim community of 600,000 people in Mumbai, India. Formative research focused on in‐depth interviews with women, men and couples yielding gender normative statements and assessment of community resources to facilitate change. A Gender Equity Scale (GES) based on this formative research was developed and administered annually for a three‐year period to random, cross‐sectional samples in the intervention and control communities, and to community based, non‐governmental organizations (NGO) staff and Imams (religious leaders) in the intervention community. NGO staff disseminated gender oriented messages to their female constituency through their regular outreach activities and through special events and festivals in the community. Imams disseminated gender messages through lectures on social issues for men attending Friday prayers. The results showed that the NGO staff and Imams, assumed more gender equitable attitudes across time. The intervention was associated with a significant improvement in attitudes towards gender equity in the intervention relative to the control community. Men showed a dramatic change in more positive gender attitudes, while women lagged behind in their GES scores. The meaning of these results are explored and the implications assessed for the generalizability of the methodology for other countries, cultures and communities.