Within the context of screening tests, it is important to avoid misconceptions about sensitivity, specificity, and predictive values. In this article, therefore, foundations are first established concerning these metrics along with the first of several aspects of pliability that should be recognized in relation to those metrics. Clarification is then provided about the definitions of sensitivity, specificity, and predictive values and why researchers and clinicians can misunderstand and misrepresent them. Arguments are made that sensitivity and specificity should usually be applied only in the context of describing a screening test’s attributes relative to a reference standard; that predictive values are more appropriate and informative in actual screening contexts, but that sensitivity and specificity can be used for screening decisions about individual people if they are extremely high; that predictive values need not always be high and might be used to advantage by adjusting the sensitivity and specificity of screening tests; that, in screening contexts, researchers should provide information about all four metrics and how they were derived; and that, where necessary, consumers of health research should have the skills to interpret those metrics effectively for maximum benefit to clients and the healthcare system.
When people’s knowledge and awareness are the subject of public health research, the meanings applied to the words knowledge and awareness are often unclear. Although frequently used interchangeably without that being problematic, these words sometimes appear to have different intended meanings but those meanings are not made explicit or, despite the meanings having been made explicit, they are not adhered to. It is necessary to overcome obscurities when knowledge and awareness are intended to represent different domains. This occurs when they are compared with each other; it also occurs when knowledge and awareness are assessed separately in relation to such variables as health behavior; physical, psychological, or socioeconomic statuses; gender; age; and ethnic backgrounds. For those particular research ventures, recommendations are made that knowledge be used to refer to information that is, to a greater or lesser extent, detailed and factual, and that awareness be associated with information that is personally relevant. Some suggestions are made, and issues are raised, about how the psychometric foundations for each of those two domains might be established prior to use in empirical research. Adopting the recommendations and suggestions made in this article provides opportunities for greater conceptual and empirical clarity and success.
This study reports on a survey of 166 gay men in Sydney, Australia, that explores the links between internalized shame, internalized homophobia, and attachment style. These variables were linked to the age of coming out, family and peer acceptance of their sexuality, relationship status, and previous marriage. Findings suggest a strong relationship between shame, internalized homophobia, and anxious and avoidant attachment style. Shame was predicted by internalized homophobia and anxious and avoidant attachment style. A significant proportion of gay men reported that they were not easily accepted when they first came out. There was a significant relationship between coming out and internalized homophobia but not with shame and attachment style. Furthermore, men who had never come out to family and friends reported higher levels of internalized homophobia but not higher levels of shame and attachment style. Of particular significance was the connection between previous marriage and higher levels of shame and internalized homophobia. Finally, gay men who were not currently in a relationship reported higher levels of shame anxious and avoidant attachment style. These findings are related to therapeutic work with gay men who have previously been married and those who are concerned with their current single status.
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