A major issue facing the health of both minors and young adults in the United States is the often unintentional lack of confidentiality maintained in the provision of sensitive health services. Studies have shown that access to confidential care is crucial for minors seeking preventive care and treatment for sensitive services. Evidence demonstrates that many minors will not seek health care if confidentiality cannot be ensured, which can have significant negative health implications; this finding can be extended to young adults (...) covered under their parents health plans. Young adults, not just minors, also often forgo important sensitive services when they face a breach of confidentiality, which most likely occurs when their parents have access to the adult child's health information.Currently, private insurance companies generally send the policyholder an explanation of benefits whenever a service is provided under a plan. EOBs generally include information identifying the patient, provider, type of care received, total charge for services, amount paid by the insurance company, and any financial obligation of the policyholder. (shrink)

This essay provides an analysis of the role of affectivity in Martin Heidegger's writings from the mid to late 1920s. We begin by situating his account of mood within the context of his project of fundamental ontology in Being and Time. We then discuss the role of Befindlichkeit and Stimmung in his account of human existence, explicate the relationship between the former and the latter, and consider the ways in which the former discloses the world. To give a more vivid (...) and comprehensive picture of Heidegger's account of mood, we focus on the experience of anxiety by articulating both its function within fundamental ontology and, relatedly, its revelatory nature. We conclude by considering the place of emotions in Heidegger's thinking from this period. In a companion essay, ‘Affectivity in Heidegger II: Temporality, Boredom, and Beyond’, we complement our present analysis by revisiting the issue of affectivity in terms of Heidegger's discussion of temporality in Division II of Being and Time. We also expand our present discussion by considering the fundamental mood of boredom and other specific moods that Heidegger considers within his later thinking. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Predatory grooming is a form of abuse most familiar from high-profile cases of sexual misconduct, for example, the Nassar case at Michigan State. Predatory groomers target individuals in a systematic effort to lead them into relationships in which they are vulnerable to exploitation. This is an example of a broader form of epistemic misconduct that Leydon-Hardy describes as epistemic infringement, where this involves the contravention of social and epistemic norms in a way that undermines our epistemic agency. In this chapter, (...) Leydon-Hardy looks at the distinctive epistemic harm caused by epistemic infringement. She argues that this harm cannot be understood simply as the victim’s having a false belief, or even as her being alienated from her belief-forming mechanisms. A deeper understanding of the harm caused by infringement shows that it stems from damage to one’s epistemic agency, and indeed, to one’s personhood. (shrink)

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

Astronauts often report experiences of awe and wonder while traveling in space. This paper addresses the question of whether awe and wonder can be scientifically investigated in a simulated space travel scenario using a neurophenomenological method. To answer this question, we created a mixed-reality simulation similar to the environment of the International Space Station. Portals opened to display simulations of Earth or Deep Space. However, the challenge still remained of how to best capture the resulting experience of participants. We could (...) use psychological methods, neuroscientific methods or philosophical methods. Each of these approaches offer many benefits, but each is also limited. Neurophenomenology capitalises on and integrates all three methods. We employed questionnaires from psychology, electroencephalography, electrocardiography, and functional near-infrared spectroscopy from neuroscience, and a phenomenological interview technique from philosophy. This neurophenomenological method enabled extensive insight in experiencers and non-experiencers of awe and wonder in a simulated space scenario that otherwise would not have been possible. Traditional empirical analyses were completed, followed by individual differences analyses using interview transcriptions paired with physiological responses. Experiencers of AW showed differences in theta and beta activity throughout the brain compared to non-experiencers. Questionnaires indicated that non-experiencers of AW gave more positive responses of religious and spiritual practices than experiencers of AW. Interviews showed that awe and wonder were more likely to occur when watching the simulated Earth view instead of the Deep Space view. Our study is a successful example of neurophenomenology, a powerful and promising interdisciplinary approach for future studies of complex states of experience. (shrink)

Despite pronouncements about the inevitable diffusion of artificial intelligence and autonomous technologies, in practice, it is human behavior, not technology in a vacuum, that dictates how technology seeps into—and changes—societies. To better understand how human preferences shape technological adoption and the spread of AI-enabled autonomous technologies, we look at representative adult samples of US public opinion in 2018 and 2020 on the use of four types of autonomous technologies: vehicles, surgery, weapons, and cyber defense. By focusing on these four diverse (...) uses of AI-enabled autonomy that span transportation, medicine, and national security, we exploit the inherent variation between these AI-enabled autonomous use cases. We find that those with familiarity and expertise with AI and similar technologies were more likely to support all of the autonomous applications we tested (except weapons) than those with a limited understanding of the technology. Individuals that had already delegated the act of driving using ride-share apps were also more positive about autonomous vehicles. However, familiarity cut both ways; individuals are also less likely to support AI-enabled technologies when applied directly to their life, especially if technology automates tasks they are already familiar with operating. Finally, we find that familiarity plays little role in support for AI-enabled military applications, for which opposition has slightly increased over time. (shrink)

This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. (...) Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality. (shrink)

How do technically-skilled women negotiate the male-dominated environments of technology firms? This article draws upon interviews with female programmers, technical writers, and engineers of diverse racial backgrounds and sexual orientations employed in the San Francisco tech industry. Using intersectional analysis, this study finds that racially dominant women, who identified as LGBTQ and presented as gender-fluid, reported a greater sense of belonging in their workplace. They are perceived as more competent by male colleagues and avoided microaggressions that were routine among conventionally (...) feminine, heterosexual women. We argue that a spectrum of belonging operates in these occupational spaces dominated by men. Although white and Asian women successfully navigated workplace hostilities by distancing themselves from conventional heterosexual femininity, this strategy reinforces inequality regimes that privilege male workers. These findings provide significant theoretical insights about how race, sexuality, and gender interact to reproduce structural inequalities in the new economy. (shrink)

Many aestheticians and ethicists are interested in the similarities and connections between aesthetics and ethics (Nussbaum 1990; Foot 2002; Gaut 2007). One way in which some have suggested the two domains are different is that in ethics there exist obligations while in aesthetics there do not (Hampshire 1954). However, Marcia Muelder Eaton has argued that there is good reason to think that aesthetic obligations do exist (Eaton 2008). We will explore the nature of these obligations by asking whether acts of (...) aesthetic supererogation (acts that go beyond the call of our aesthetic obligations) are possible. In this paper, we defend the thesis that there is good reason to think such acts exist. (shrink)

Martin Heidegger is often credited as having offered one of the most thorough phenomenological investigations of the nature of boredom. In his 1929–1930 lecture course, The Fundamental Concepts of Metaphysics: World, Finitude, Solitude, he goes to great lengths to distinguish between three different types of boredom and to explicate their respective characters. Within the context of his discussion of one of these types of boredom, profound boredom [tiefe Langweile], Heidegger opposes much of the philosophical and literary tradition on boredom insofar (...) as he articulates how the experience of boredom can be existentially beneficial to us. In this chapter, we undertake a study of the nature of profound boredom with the aim of investigating its place within contemporary psychological and philosophical research on boredom. Although boredom used to be a neglected emotional experience, it is no more. Boredom’s causal antecedents, effects, experiential profile, and neurophysiological correlates have become topics of active study; as a consequence, a proliferation of claims and findings about boredom has ensued. Such a situation provides an opportunity to scrutinize Heidegger’s claims and to try to understand them both on their own terms and in light of our contemporary understanding of boredom. (shrink)

This paper defends two claims. First, we will argue for the existence of aesthetic demands in the realm of everyday aesthetics, and that these demands are not reducible to moral demands. Second, we will argue that we must recognise the limits of these demands in order to combat a widespread form of gendered oppression. The concept of aesthetic supererogation offers a new structural framework to understand both the pernicious nature of this oppression and what may be done to mitigate it.

We investigate whether the disclosure of a firm’s decision to organize as a benefit corporation (BC) rather than a traditional C corporation (CC) influences investors. We survey 136 investors and 57 MBA students and find that they expect BCs to attain higher future corporate social responsibility (CSR) than CCs even when both have equal CSR ratings. Approximately one third of our sample prefers to invest in BCs when CCs have greater financial returns, indicating a willingness by some investors to sacrifice (...) personal financial gain for social good. Our results suggest that investors weight the information contained in BC disclosures as reliable and value-relevant in their investment decisions. We extend the CSR disclosure literature by indicating how investors weight this new type of CSR information, which may affect how BCs fare as publicly traded companies. (shrink)

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the ‘person’ or ‘patient’ that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken‐for‐granted definitions and assumptions of the ‘person’ from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the ‘person’ in nursing and beyond. Cronenberg's work explores bodily transformation and (...) mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of ‘the person’. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming‐mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles. (shrink)

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at 40 (...) academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

It is assumed that bipolarity in happiness and sadness requires mutual exclusion. However, we present psychometric research to show how coendorsements of happiness and sadness do not necessarily constitute evidence against bipolarity. Because individuals have a tendency to endorse emotion terms close to their current state, individuals whose current state is close to the middle of a bipolar continuum would report both happiness and sadness, despite their current state being best represented by a single point. As such, endorsements of happiness (...) and sadness are theoretically expected when individuals’ current state is in the middle of the continuum. Bipolarity however would be violated if endorsements of extreme levels of happiness and sadness can be demonstrated, which has yet to be shown. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

BackgroundAssisted dying has wide support among the general population but there is evidence that those providing care for the dying may be less supportive. Senior doctors would be involved in implementing the proposed change in the law. We aimed to measure support for legalising physician assisted dying in a representative sample of senior doctors in England and Wales, and to assess any association between doctors' characteristics and level of support for a change in the law.MethodsWe conducted a postal survey of (...) 1000 consultants and general practitioners randomly selected from a commercially available database. The main outcome of interest was level of agreement with any change in the law to allow physician assisted suicide.ResultsThe corrected participation rate was 50%. We analysed 372 questionnaires. Respondents' views were divided: 39% were in favour of a change to the law to allow assisted suicide, 49% opposed a change and 12% neither agreed nor disagreed. Doctors who reported caring for the dying were less likely to support a change in the law. Religious belief was also associated with opposition. Gender, specialty and years in post had no significant effect.ConclusionMore senior doctors in England and Wales oppose any step towards the legalisation of assisted dying than support this. Doctors who care for the dying were more opposed. This has implications for the ease of implementation of recently proposed legislation. (shrink)

Bioethics, Volume 35, Issue 7, Page 696-703, September 2021.

DeStefano, Oey, Brockbank, and Vul explore interdisciplinary collaboration using data‐driven measures of research topics and co‐authorship, constructed from a rich dataset of over 11,000 Cogsci conference papers. Findings suggest the cognitive science research community has become increasingly integrated in the last 19 years.

The concept of scale is useful in analyzing both the strengths and limitations of community food security programs that attempt to link issues of ecological sustainability with social justice. One scalar issue that is particularly important but under-theorized is the scale of social reproduction, which is often neglected in production-focused studies of globalization. FoodShare Toronto's good food box (GFB) program, engages people in the politics of their everyday lives, empowering them to make connections between consumption patterns and broader political-economic, cultural, (...) and political-ecological issues. Community food security (CFS) projects such as the GFB are currently limited in their scope and reach and have been criticized for their inability to deliver food to a larger segment of marginalized, hungry people. A central dilemma for CFS projects is how to engage the majority of urban consumers who still eat “inside the box” of the industrial food system. We argue that the concept of scale helps clarify how CFS projects must “scale out” to other localities, as well as “scale up” to address structural concerns like state capacity, industrial agriculture, and unequal distribution of wealth. This requires the state and the third sector to recognize the importance of multi-scaled food politics as well as a long-term pedagogical project promoting ecological sustainability, social responsibility, and the pleasures of eating locally. (shrink)

Charles Taber and Milton Lodge provide compelling evidence that people's minds may be closed to information that is inconsistent with their prior beliefs. This type of inconsistency has often been termed ?irrational.? However, recent research suggests that being open or closed minded is not an unchanging variable but depends on one's goals, including one's need for closure, which vary from person to person and situation to situation. In this vein, as Taber and Lodge suggest, those who have more political information (...) may, after having been open minded enough to acquire the information, become closed minded by virtue of having acquired it. At the same time, being more open minded to inaccurate information might lead one in the wrong direction; hence, open mindedness does not necessarily enhance the accuracy of one's judgments or the quality of one's decisions. We may need to rethink the concept of an enlightened, well-informed electorate, to the extent that it assumes the unqualified benefits of open mindedness. (shrink)

In “On Avoiding Deep Dementia,” Norman Cantor astutely notes that, for some individuals, the concept of “protracted maintenance during progressive cognitive dysfunction and helplessness is an intolerably degrading prospect.” This cannot be argued with. Cantor's solution, however—that in the wake of a dementia diagnosis, patients should have the option to direct, in advance, instructions for voluntary stopping of eating and drinking should they develop a state of deep dementia—is more ethically challenging than it may first appear.Respect for autonomy is one (...) of the most fundamental principles of bioethics, and it requires that we allow patients with capacity to refuse life‐sustaining treatment, even when that treatment is something as seemingly innocuous as nutrition and hydration. If a capacitated person uses an advance directive to prospectively refuse artificial nutrition or hydration, then that treatment must be withheld if the person develops dementia and loses the ability or willingness to eat. Cantor is incorrect, however, in suggesting that an advance directive can require that nutrition and hydration be withheld from a patient with dementia who actively requests to eat or drink. Regardless of the language in an advance directive, caregivers cannot be compelled to abandon their duty to attend to the person's human dignity, nor can physicians be compelled to sedate a person with moderate or severe dementia because that person continues to be receptive to eating and drinking. (shrink)

Background: The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. Objective: To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. Design: We tested the hypothesis that (...) use of a narrative pedagogy assignment related to ethics would improve student nurse’s perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student’s perception of their role as a patient advocate. Ethical considerations: Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. Setting: School of Nursing at a small liberal arts college in the Northeastern United States. Participants: A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Findings: Results indicated significant differences in student nurse’s perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Conclusion: Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of narrative pedagogy on nursing student’s perception of the nurse’s advocacy role. (shrink)

Aims and hypothesesIn an environment of absolute silence, researchers have found many of their participants to perceive phantom sounds. With this between-subject experiment, we aimed to elaborate on these research findings, and specifically investigated whether–in line with the fear-avoidance model of tinnitus perception and reactivity–fear or level of perceived threat influences the incidence and perceptual qualities of phantom sound percepts in an anechoic room. We investigated the potential role of individual differences in anxiety, negative affect, noise sensitivity and subclinical hearing (...) loss. We hypothesized that participants who experience a higher level of threat would direct their attention more to the auditory system, leading to the perception of tinnitus-like sounds, which would otherwise be subaudible, and that under conditions of increased threat, narrowing of attention would lead to perceptual distortions.MethodsIn total, N = 78 normal-hearing volunteers participated in this study. In general, the study sample consisted of young, mostly female, university students. Their hearing was evaluated using gold-standard pure tone audiometry and a speech-in-noise self-test, which is a sensitive screening test to identify subclinical hearing loss. Prior to a four-minute stay in an anechoic room, we randomized participants block design-wise in a threat and no-threat condition. Participants in the threat condition were deceived about their hearing and were led to believe that staying in the room would potentially harm their hearing temporarily. Participants were asked whether they perceived sounds during their stay in the room and rated the perceptual qualities of sound percepts. They were also asked to fill-out standardized questionnaires measuring anxiety, affect and noise sensitivity. The internal consistency of the questionnaires used was verified in our study sample and ranged between α = 0.61 and α = 0.90.ResultsIn line with incidence rates reported in the literature, 74% of our participants reported having heard tinnitus-like sounds in the anechoic room. Speech-in-noise identification ability was comparable for both groups of participants. The experimental manipulation of threat was proven to be effective, as indicated by significantly higher scores on a Threat Manipulation Checklist among participants in the threat condition as compared to those in the no-threat condition. Nevertheless, participants in the threat condition were as likely to report tinnitus percepts as participants in the no-threat condition, and tinnitus percepts were not rated as being louder or more unpleasant as a function of level of threat. For participants who did experience tinnitus percepts, a higher level of threat was associated with a higher degree of experienced unpleasantness. These associations were absent in those who did not experience tinnitus. Higher negative affect was only slightly associated with higher ratings of tinnitus unpleasantness.ConclusionWhereas our threat manipulation was successful in elevating the level of fear, it did not contribute to a higher percentage of participants perceiving tinnitus-like sounds in the threat condition. However, higher levels of perceived threat were related to a higher degree of perceived tinnitus unpleasantness. The findings of our study are drawn from a rather homogenous participant pool in terms of age, gender, and educational background, challenging conclusions that are applicable for the general population. Participants generally obtained normophoric scores on independent variables of interest: they were low anxious, low noise-sensitive, and there was little evidence for the presence of subclinical hearing loss. Possibly, there was insufficient variation in scores to find effects. (shrink)

The preservation of our planet’s decreasing biodiversity is a global challenge. Human attitudes and preferences toward animals have profound impacts on conservation policies and decisions. To date, the vast majority of studies about human attitudes and concern toward animals have focused largely on western, educated, industrialized, rich and democratic populations. In order to mitigate biodiversity loss globally, an understanding of how humans make decisions about animals from multicultural perspectives is needed. The present study examines familiarity, liking and endorsement of government (...) protection amongst six broad cultural groups living in Qatar for five threatened animal species indigenous to the Arabian Gulf. Our findings highlight similarities and differences across cultures toward animals. Overall, familiarity did not predict endorsement for government protection after liking was accounted for. Liking, however, emerged as an important predictor of endorsement for government protection across cultures, although the degree of animal liking varied culturally. WEIRD and South East Asian participants showed similar and more positive attitudes toward animals compared to the other groups. Participants from the Arabian Gulf, Sub-Saharan Africa, Middle East and North Africa, and South Asia responded similarly toward the animals. Interestingly, the Arabian Gulf group demonstrated significantly less liking and protection endorsement for animals, including those animals which play an important role in their culture. This research highlights intriguing avenues for future research and points to liking as a possible universal human attitude toward animals that influences decision making about conservation across all cultures while suggesting applications for improving education. (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

As we navigate post-pandemic educational recovery and future-oriented design, the Handbook of Research in Online Learning: Insights and Advances emerges as a scholarly authority to illuminate existing questions and catalyze conversations on imperative transformations in education. Tailored for researchers, designers, educators, administrators, and stakeholders, this handbook delves into the nuanced landscape of online learning. Curated by leading experts, each chapter provides a deep exploration of critical online teaching and learning dimensions. Whether you're navigating the complexities of instructional design, exploring the (...) impact of digital learning on diverse student populations, or delving into the transformative potential of AI, each chapter illuminates critical aspects of online education. It merges current significant works with unpublished manuscripts, embodying the interdisciplinary essence of online learning research. Grounded in diverse theoretical frameworks and research methods, it offers theoretical insights and actionable guidance for cutting-edge educational methodologies. This handbook is not just a compendium; it's an indispensable guide for shaping the future of education. Contributors are: Michael Ahlf, Stephen Allen, Tonya Amankwatia, Fatih Ari, Ismahan Arslan-Ari, Michael K. Barbour, Gail Alleyne Bayne, Karen Bellnier, M. Aaron Bond, Victoria Brown, George Bradford, William Cain, Sumie Chan, Lauren Cifuentes, Laura DaVinci, Gina Deckard, Shernette Dunn, Anne Fensie, Holly Fiock, Sara Flowers, Carla Karen Fortune, Theodore Frick, Michael M. Grant, Alexis Guethler, Dan He, Atsusi "2c" Hirumi, Charles B. Hodges, Stephanie Hostetter, Michael Houdyshell, Fethi A. Inan, Frank Jamison, Amir Kalan, Meryl Krieger, Jessica Lantz, Mary Lefaiver, Juhong Christie Liu, Noble Lo, Barbara Lockee, Fatemeh Marzban, Trey Martindale, Sara McNeil, Laura McNeill, Stephanie Moore, Martha Lorena Obermeier, Larisa Olesova, Jennifer Jihae Park, Sanghoon Park, Yujin Park, AnthTony Pina, Drew Polly, Yingxiao Qian, Thomas Reeves, Christiane Reilly, Jennifer Richardson, Aubrey Rogowski, Leanne Rutherford, Kay Seo, Sanga Song, Edwin Teye Sosi, Stefan Stenbom, Sharon Stidham, David Tai, Hengtao Tang, Torrey Trust, Shannon Tucker, Denis Unal, Lucas Vasconcelos, Charles Xiaoxue Wang, Florence Williams, Ying Xie and Fan Xu. (shrink)