Five studies tested hypotheses derived from the sociometer model of self-esteem according to which the self-esteem system monitors others' reactions and alerts the individual to the possibility of social exclusion. Study 1 showed that the effects of events on participants' state self-esteem paralleled their assumptions about whether such events would lead others to accept or reject them. In Study 2, participants' ratings of how included they felt in a real social situation correlated highly with their self-esteem feelings. In Studies 3 and 4, social exclusion caused decreases in self-esteem when respondents were excluded from a group for personal reasons, but not when exclusion was random, but this effect was not mediated by self-presentation. Study 5 showed that trait self-esteem correlated highly with the degree to which respondents generally felt included versus excluded by other people. Overall, results provided converging evidence for the sociometer model.

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The results suggest that knowledge of genetics and genetic tests is increasing among physicians, particularly among more recent graduates and physicians who are exposed to genetics problems in their practices, but deficiencies remain. Although a medical school course in genetics may improve knowledge, it is not sufficient. Greater emphasis is needed at all levels of medical education to reduce the chance of physician error as more genetic tests become available.

Stakeholder engagement is increasingly common in health research, with protocols for engaging multiple stakeholder groups becoming normative in patientcentered outcomes research. Previous work has focused on identifying relevant stakeholder groups with whom to work and on working with stakeholders in evidence implementation. This paper draws on the expertise of a team from four countries-Canada, Australia, the UK, and the USA-to provide researchers with practical guidance for carrying out multi-stakeholder-engaged projects: we present a list of questions to assist in selecting appropriate roles and modes of engagement; we introduce a matrix to help summarize engagement activities; and we provide a list of online resources. This guidance, matrix, and list of resources can assist researchers to consider more systematically which stakeholder groups to involve, in what study roles, and by what modes of engagement. By documenting how stakeholders are paired up with specific roles, the matrix also provides a potential structure for evaluating the impact of stakeholder engagement.