Background: Fear of cancer recurrence or progression is a common challenge experienced by people living with and beyond cancer and is frequently endorsed as the highest unmet psychosocial need amongst survivors. This has prompted many cancer organizations to develop self-help resources for survivors to better manage these fears through psychoeducation, but little is known about whether they help reduce FCR/P.Method: We recruited 62 women with ovarian cancer. Women reported on their medical history and demographic characteristics and completed the Fear of (...) Progression Questionnaire-Short Form. They then read a booklet on FCR specifically created for Ovarian Cancer Australia by two of the authors. One week after reading the booklet, 50/62 women completed the FoP-Q-SF and answered questions about their satisfaction with the booklet.Results: More than half of the women scored in the clinical range for FCR/P at baseline. Of the completers, 93% said that they would recommend the booklet to other women. Satisfaction with the booklet was relatively high and more than two-thirds of women rated it as moderately helpful or better. However, FCR/P did not change significantly over the week following reading the booklet [t = 1.71, p = 0.09]. There was also no difference in change in FCR/P between women in the clinical vs. non-clinical range on the FoP-Q. Women high in FCR/P rated the booklet as less helpful in managing FCR/P, but overall satisfaction with the booklet was not associated with degree of FCR/P.Conclusions: These results suggest that a simple online FCR booklet is acceptable to women with ovarian cancer and they are satisfied with the booklet, but, it was insufficient to change in FCR/P levels. These results suggest that such resources are valued by women with ovarian cancer, but more potent interventions are necessary to reduce FCR in this population. (shrink)

BackgroundBody image is a subjective concept encompassing a person’s views and emotions about their body. Head and neck cancer (HNC) diagnosis and treatment affects several psychosocial concepts including body image. Large numbers of HNC patients are diagnosed each year in India but there are no suitable measures in regional languages to assess their body image. This study assessed the psychometric properties of the Body Image Scale (BIS), a measure suitable for clinical and research use in HNC populations, translated into Tamil, (...) Telugu and Hindi and compared body image distress between language groups.MethodsTranslated versions of BIS were completed by HNC patients recruited from three cancer centers across India one time only. Psychometric evaluation was conducted including factor analysis using principal component analysis and internal consistency reliability using Cronbach’s alpha. Patients completed the EORTC Quality of Life Questionnaire (QLQ) C-30 and EORTC QLQ HN-35 measures to enable exploration of convergent and discriminant validity. ANOVA was used to calculate difference in mean values for body image.ResultsOur sample included 621 HNC patients (Tamil = 205, Telugu = 216, Hindi = 200). Factor analysis revealed a one-factor solution and Cronbach’s alpha coefficients ranged between 0.891 and 0.969 indicating good reliability. Hypothesized correlations between similar and different constructs were as expected, supporting construct validity. On the BIS, we found a statistically significant difference (F= 11.0954,P< 0.05) between means of Tamil, Telugu, and Hindi groups, with higher body image scores in Telugu (M= 12.86;SD= 7.65) and Hindi groups (M= 12.52;SD= 7.36) indicating more symptoms/body image distress, when compared to Tamil population (M= 9.28;SD= 10.04).ConclusionThe reliability and validity of the three translated Indian versions of the BIS were maintained, providing a method for assessing body image of HNC population worldwide speaking Tamil, Telugu, and Hindi across the illness trajectory. (shrink)

Traditional forms of farming, herding, and fishing are remarkably adapted to African conditions but these traditional approaches are being overtaken by modern pressures, particularly population growth. According to a report published by the Office of Technology Assessment (OTA), a nonpartisan analytical support agency of the U. S. Congress, one promising way to help African farmers and herders would be for development assistance organizations to focus more attention on the various forms of low-resource agriculture that predominate in Africa.In keeping with OTA's (...) mission and primary audience, “Enhancing Agriculture in Africa: A Role for U. S. Development Assistance” (1988) is a policy-oriented synthesis of available technical information. The report provides Congress with a range of options that, if pursued, could help Africans enhance agriculture, increase their food security, and improve their lives.This paper is drawn from the larger OTA report, and it focuses on the role technology might play in enhancing low-resource agriculture. Readers should see the full assessment (OTA, 1988) for more information on policy considerations; the specific technologies mentioned; or a complete list of advisory panel members, workshops and participants, and commissioned papers.OTA's report comes at a critical time: for a variety of reasons—ranging from changing values to increased budget constraints—U. S. foreign assistance policy is undergoing a fundamental reevaluation. This review of the potential of low-resource agriculture, and options the United States might pursue to enhance this approach, was intended to aid in this reevaluation. (shrink)

The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...) We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

BackgroundFear of cancer recurrence is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society Fear of Cancer Recurrence Special Interest Group were invited to participate in an online Delphi study. Research domains identified in Round (...) 1 were presented and discussed at a focus group to consolidate the domains and items prior to presentation in further survey rounds aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need. (shrink)

There is limited knowledge about cancer patients' experiences of uncertainty while waiting for genome sequencing results, and whether prolonged uncertainty contributes to psychological factors in this context. To investigate uncertainty in patients with a cancer of likely hereditary origin while waiting for genome sequencing results, we collected questionnaire and interview data at baseline, and at three and 12 months follow up. Participants had negative attitudes towards uncertainty at baseline, and low levels of uncertainty at three and 12 months. Uncertainty about (...) genome sequencing did not change significantly over time [t = 0.660, p = 0.510]. Greater perceived susceptibility for cancer [r = 0.14, p < 0.01], fear of cancer recurrence [r = 0.19, p < 0.01], perceived importance of genome sequencing [r = 0.24, p < 0.01], intention to change behavior if a gene variant indicating risk is found [r = 0.29, p < 0.01], perceived ability to cope with results [r = 0.36, p < 0.01], and satisfaction with decision to have genome sequencing [r = 0.52, p < 0.01] were significantly correlated with negative attitudes towards uncertainty at baseline. Multiple primary cancer diagnoses [B = −2.364 [−4.238, −0.491], p = 0.014], lower perceived ability to cope with results [B = −0.1.881 [−3.403, −0.359], p = 0.016] at baseline, greater anxiety about genome sequencing [B = 0.347 [0.148, 0.546], p = 0.0012] at 3 months, and greater perceived uncertainty about genome sequencing [B = 0.494 [0.267, 0.721] p = 0.000] at 3 months significantly predicted greater perceived uncertainty about genome sequencing at 12 months. Greater perceived uncertainty about genome sequencing at 3 months significantly predicted greater anxiety about genome sequencing at 12 months [B = 0.291 [0.072, 0.509], p = 0.009]. Semi-structured interviews revealed that while participants were motivated to pursue genome sequencing as a strategy to reduce their illness and risk uncertainty, genome sequencing generated additional practical, scientific and personal uncertainties. Some uncertainties were consistently discussed over the 12 months, while others emerged over time. Similarly, some uncertainty coping strategies were consistent over time, while others emerged while patients waited for their genome sequencing results. This study demonstrates the complexity of uncertainty generated by genome sequencing for cancer patients and provides further support for the inter-relationship between uncertainty and anxiety. Helping patients manage their uncertainty may ameliorate psychological morbidity. (shrink)

While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence. Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The (...) current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020. A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence or severity. While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: variations in the lived experience of FCR; spirituality and worldview impacting on FCR; the importance of staying positive; complexities around support; and increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655]. (shrink)

There is increased interest in deviant behavior in the workplace. However, research is lacking on the moral economy of such behavior. Moral economy is particularly important in contexts where syncretic forces impinge on deviant behavior. Consequently, we use moral economy reasoning to examine the relationship between ethnic obligation and deviant behavior in the African context. In Study 1, data (_N_ = 27, 148) show an inverted U-shape effect of meta-agency and deviant behavior. In Study 2, difference-in-difference (DID) analysis of data (...) (_N_ = 25,387 in 2005 and _N _= 51,587 in 2013) shows significant DID effect of meta-agency. Primary data from Study 3 (_N_ = 229) shows a U-shaped effect of agency and deviant behavior. In Study 4 (_N_ = 333), a replication shows support for the U-shape effect in Study 3. The four studies thus show complex patterns that reflect U-shape and inverted U-shape relationships between ethnic obligation and deviant behavior as indicated by bribery, corruption, and unethicality. Robustness checks support the curvilinear relationships suggesting that the effects are not due to chance. We discuss implications for research and practice. (shrink)

ABSTRACTThis article analyzes the outcomes of the first medical interpreter vocational training course for Eritrean asylum seekers in Israel. Our study draws on the work of Phyllis Butow et al. on medical interpreters’ perceptions of their role, including the challenges they face; on Elena Ragazzi’s call for a flexible evaluation of vocational training outcomes; and on Pierre Bourdieu’s concept of “cultural capital” as an empowering tool for change. The course was initiated in 2013 in response to difficulties experienced (...) by medical personnel and Eritrean asylum seekers regarding the provision of health services for refugees. The outcomes of the course led to four main conclusions: it was a positive learning endeavor that led graduates to better jobs; it was an empowering experience that enabled graduates to better care for themselves and their loved ones, and enhanced their understanding of their rights as asylum seekers; it was perceived as a project of inclusion that created a safe and reassuring environment within the otherwise hostile reality of state-orchestrated exclusion, yet it also induced a sense of frustration in that it had no impact on the unjust social structure in which the asylum seekers live; and the course was helpful in developing the graduates’ understanding of their complex role as medical interpreters. (shrink)

Open peer commentary on the article “A First-Person Analysis Using Third Person-Data as a Generative Method: A Case Study of Surprise in Depression” by Natalie Depraz, Maria Gyemant & Thomas Desmidt. Upshot: Given the claims of Natalie Depraz regarding what she called in 2004 the “practical turn of phenomenology,” I ask the authors how they conceive the research they presented in their 2017 article, particularly regarding transcendental phenomenology.

One of the primary goals of Religious Education is to make students come together with Qur’an text and religious content seamlessly. In order to reach this goal, religious educators usually support students to have the knowledge of the text and sometimes students only memorize the content. But although “knowing” and “memorizing” stages are important for educational processes, they are not functional enough in the long term. For providing a permanent learning, students should also “understand” the text. Besides, students cannot create (...) their own ideas and interpretations by the ways of knowing and memorizing. Because they can achieve to make their “own” senses only by their understanding. For these reasons, setting “understanding” as a goal for RE and defining the bases of an “understanding focused religious education” are an important responsibility of all.There are lots of bases for understanding focused religious education. One of them is “asking question”. Asking question to the religious texts and questioning the content have crucial effects for understanding processes due to their role of being a chance for having a dialogue with the text and its author. Therefore, it is necessary to determine which types of questions are useful for permanent learning and which types of contributions to understanding are limited. In Religious Education which is a social discipline, in order to reveal the meaning, the questions that are convenient to open a field for individual interpretations of the students can be functional. These questions are mostly open-ended questions and high level cognitive questions offering students an opportunity for their ownevaluations. However, students can establish the healthiest communication with Qur’an text and religious content through contextual and existential questions that they will pose to them. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

"--Brian Greene, Columbia University "This book includes material that is intellectually innovative and comes as a surprise even to specialists in the field.

We attempt to clarify the main conceptual issues in approaches to ‘objectification’ or ‘measurement’ in quantum mechanics which are based on superselection rules. Such approaches venture to derive the emergence of classical ‘reality’ relative to a class of observers; those believing that the classical world exists intrinsically and absolutely are advised against reading this paper. The prototype approach (K. Hepp, Helv. Phys. Acta45 (1972), 237–248) where superselection sectors are assumed in the state space of the apparatus is shown to be (...) untenable. Instead, one should couple system and apparatus to an environment, and postulate superselection rules for the latter. These are motivated by the locality of any observer or other (actual or virtual) monitoring system. In this way ‘environmental’ solutions to the measurement problem (H.D. Zeh, Found. Phys.1 (1970), 69–76; W. H. Zurek, Phys. Rev.D26 (1982), 1862–1880 and Progr. Theor. Phys.89 (1993), 281–312) become consistent and acceptable, too. Points of contact with the modal interpretation are briefly discussed. We propose a minimal value attribution to observables in theories with superselection rules, in which only central observables have properties. In particular, the eigenvector-eigenvalue link is dropped. This is mainly motivated by Ockham's razor. (shrink)

Design: Qualitative interview study. Participants: Fifty-nine patients with a family history of cancer who attend a regional cancer genetics clinic in the UK were interviewed about their current and previous research experiences. Findings: Interviewees gave a range of explanations for research participation. These were categorised as social—research participation benefits the wider society by progressing science and improving treatment for everyone; familial—research participation may improve healthcare and benefit current or future generations of the participant’s family; and personal—research participation provides therapeutic or (...) non-therapeutic benefits for oneself. Conclusions: We discuss the distinction drawn between motives for research participation focused upon self and others, and observe that personal, social and familial motives can be seen as interdependent. For example, research participation that is undertaken to benefit others, particularly relatives, may also offer a number of personal benefits for self, such as enabling participants to feel that they have discharged their social or familial obligations. We argue for the need to move away from simple, static, individualised notions of research participation to a more complex, dynamic and inherently social account. (shrink)

ABSTRACTEmotion regulation comprises attempts to influence when and how emotions are experienced and expressed. It has mostly been conceived of as proactive or reactive, but it may also be retroactive and involve memory. I term such past-oriented activity mnemonic emotion regulation and propose that it involves increasing or decreasing access to or altering the characteristics of a memory. People may increase access to a memory and make it more likely that it will be retrieved in the future, for example by (...) rehearsing a pleasant memory. They may decrease access to a memory and make it less likely that intrusions will be experienced in the future, for example by repeatedly trying to stop an unpleasant memory from being retrieved. Finally, people may alter the characteristics of a memory and change its content or context, for example by replacing a negative impression with a productive interpretation. I discuss how mnemonic emotion regulation may be i... (shrink)

When do two mental items belong to the same life? We could be content with the answer -just when they have certain volitional qualities in common. An affinity is noted between that theory and Berkeley's early doctrine of the self. Some rivals of the volitional theory invoke a spiritual or physical owner of mental items. They run a risk either of empty formality or of causal superstition. Other rivals postulate a non-transitive and symmetrical relation in the set of mental items. (...) They must allow in consequence either for joint ownership of one and the same mental item, or for incompatible simultaneous decisions by one and the same person, or for new forms of death. This makes them disquieting. Another rival invokes a transitive and symmetrical relation defined in terms of co-consciousness. Even that allows for incongruous simultaneities. The volitional theory is free from such disadvantages. (shrink)

Das Vorhandensein bilateraler Asymmetrie bei Organismen ist an und für sich biophysikalisch verständlich. Schwierigkeiten entstehen jedoch beim Versuch die auffallende Ungleichheit in den Häufigkeiten des Vorkommens von Rechts- und Linksasymmetrie biophysikalisch zu deuten. Es werden zwei Möglichkeiten für solch'eine Deutung besprochen. Die eine stützt sich auf die fundamentale Asymmetrie des elektromagnetischen Feldes, und wird als biologisch weniger geeignet angesehen. Die andere, welche dem Verfasser als wahrscheinlicher erscheint, beruht auf der Asymmetrie der organischen Moleküle.L'existence d'une asymétrie bilaterale en général chez des (...) organismes divers n'offre pas de difficulté particulière du point de vue biophysique. Mais les difficultés surgissent quand on tâche de comprendre l'inégalité très prononcée des cas d'asymétrie droite et gauche. Deux possibilités sont discutées dans ce mémoire. L'une repose sur l'asymétrie fondamentale du champs électromagnétique. Cette explication est considérée comme moins probable. Une autre explication qui nous apparaît plus probable, est fondée sur l'asymétrie moléculaire. (shrink)

The sensation of red light falling on your eyes has something in common with the experience of looking at a cartoon in the New Yorker. The phenomenal quality of the sensation and the funniness of the joke are both properties of your subjective take on an external event and both arise in two steps. With sensations, your brain responds to signals from bodily sense organs with an internalized evaluative response; your mind reads this response and represents what it's like as (...) the subjective property of redness. With jokes, the cartoonist creates a clever drawing; your mind takes in the drawing and represents what it's like as the subjective property of funniness. This analogy -- deliberately deflationary -- helps elucidate the nature of phenomenal consciousness and its neural correlates, and exposes the 'hard problem' as a conceptual error. (shrink)

I start with a detailed but partial analysis of a case regarding grade inflation. The case is inspired by the discussion in Crumbley et al. (2010) and its elaboration in Roberts (2016). I supplement the case description by introducing certain facts that are not in the original discussion. The subsequent analysis is based on this enriched case description. I then raise a number of objections against my analysis. An important metaethical, methodological question emerges while responding to these objections. To what (...) extent are characterizations of moral situations and their descriptions independent from moral commitments? Is there a neutral concept of moral relevance? I argue that we do not have a theory-neutral concept of moral relevance, and that case descriptions essentially presuppose moral commitments. From my moral perspective, as this perspective is reflected in the enriched case description I utilize, the original case description of grade inflation already involves utilizing the wrong moral perspective or theory. (shrink)

This article discusses the 2005 OUP biography of Michael Polanyi by William T. Scott and Martin X. Moleski S.J., Michael Polanyi, Scientist and Philosopher . The discussants are N. E. Wetherick, Brian G Gowenlock, and John Puddefoot; Martin X. Moleski, S. J. briefly responds, providing a previously unpulished letter from Polanyi to Reverend Dr. Knox, a Presbyterian mininster.