There is growing interest in tissue procurement for cancer research through autopsy. Establishing an autopsy/tissue donation programme for breast cancer research within an academic medical centre i...

Previous work has shown that concerns of breast cancer patients after finishing radiotherapy are responsive to conversations with radiographers during the treatment period. This study seeks to further understand radiographer and patient experiences, determine shared priorities for improvement in clinical interaction and develop communication guidelines and training to help radiographers support patients.Methods: Using the principles of Experience-Based Co-Design, semi-structured interviews were held with N = 4 patients and N = 4 radiographers, followed by feedback events to validate findings. Patients (...) and radiographers exchanged experiences in a joint co-design session, agreed with shared priorities and generated ideas for further support. A survey was conducted for process evaluation. To scale up findings, UK-wide representatives from patient networks and radiographers and managerial staff provided consultative input utilizing an iterative, adaptive procedure.Results: Radiographers expressed a need for support with “difficult conversations,” especially those on Fear of Cancer Recurrence, and their appropriate management. Important pointers for reassuring communication were identified, including: being treated like a person, knowing what to expect, and space to ask questions. The co-design process was rated positively by both staff and patients. Thematic collation of findings and mapping these on literature evidence resulted in the “KEW” communication guidelines for radiographers: Know, Encourage, Warmth. National stakeholder consultations validated and helped fine-tune the training model. The resulting training package, included: trigger videos, a simulated patient scenario and interactive handouts on fears of cancer recurrence and the patient pathway.Conclusions: The co-design process captured good practice to help standardize quality in empathic communication in the radiotherapy service. The resulting KEW: Know, Encourage, Warmth guidelines, and training package are user-centered as well as evidence-based. Supplementing single-site co-design with national consultative feedback allows for the development of interventions that are relevant to the clinical practice, even in detail, and helps to generate appropriate buy-in for roll out on a wider scale after evaluation.Trial Registration:www.ClinicalTrials.gov ID: NCT03468881. (shrink)

While having a breast reconstruction, women have certain expectations about their future breasted bodies. The aim of this paper is to describe and analyze these expectations in the process of reconstruction. By applying a qualitative, phenomenological study within a longitudinal research design, this paper acknowledges the temporarily complex, contextualized, embodied, and subjective nature of the phenomenon of expectations. The analysis identified expectations regarding three different aspects of women’s embodiment: their gazed body, their capable/practical body, and their felt body. After (...) reconstruction, these women try to reconfigure—adjust, level or retrospectively rewrite—their expectations. Further, some women face what apparently arrives totally unexpected, namely a strange feeling breast or a failed reconstruction. The development of these women’s expectations can be understood as an active, continuously evolving, difficult and sometimes impossible dynamic of expecting the surprise that is a breast reconstruction. Within this dynamic, women formulate and reconfigure—by definition—unrealistic expectations and validate and try to achieve unexpected futures. We suggest that medical professionals can facilitate this dynamic in various ways. (shrink)

Cancer is a chronic disease that causes the most deaths in the world, being a public health problem nowadays. Even though breast cancer affects the daily lives of patients, many women become resilient after the disease, decreasing the impact of the diagnosis. Based on a positive psychology approach, the concept of co-vitality arises understood as a set of socio-emotional competencies that enhance psychological adaptation. In this sense, emotional intelligence is one of the main protective factors associated with resilience. However, (...) it is not always as beneficial as it seems, and can lead to collateral effects on psychological adjustment. Given this controversy, this study aims to find the specific processes through which the dimensions of Perceived Emotional Intelligence can act as a risk or protective factor in the development of resilience. The total sample was 167 women, 46.7% were breast cancer survivors, and 53.3% were healthy controls. The selection of women with breast cancer carries out randomly, recruited through the Oncology Units. The sample completed measures of resilience and PEI, through Resilience Scale and TMMS-24. The results showed that breast cancer survivors showed higher age and greater levels of resilience and mood repair than healthy women. The mediation analysis revealed that breast cancer survival and PEI predicted 28% of the variance of resilience. The direct effects showed that emotional clarity and mood repair increased resilience levels. Although breast cancer did not predict resilience directly, it does through mood repair by an indirect process. Besides, the analysis showed that emotional attention played a role in vulnerability, decreasing mood repair, and resilience. These research support theories that point to a possible dark side of PEI, thus, a great level of emotional attention makes dark the positive effect of mood repair and personal growth if a clear perception of emotions does not complement it. These results provide empirical support concerning the need to work complementary each dimension of PEI to avoid unwanted effects on intrapersonal adjustment. (shrink)

Recently, two prescription drugs have become salient to breast cancer prevention. With the advent of these drugs, referred to as “chemoprevention,” a mandate has emerged to classify certain women as high risk for breast cancer to determine a group of legitimate users of the drugs. This article examines the development and standardization of the model used to create such a group of high-risk women. The author argues that while the model remains uncertain and controversial, it has become (...) the standard tool for the many jobs associated with legitimizing chemoprevention use in the United States. It has become the assumed standard—shaping practices, identities, and definitions—through its organizational embeddedness in the multiple practices and public images of chemoprevention despite its uncertainty and widespread critique. (shrink)

PurposeThis study aims to develop and validate a stigma scale for Chinese patients with breast cancer.MethodsPatients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale’s content validity was assessed by a Delphi study and feedback from (...) patients with breast cancer ; exploratory factor analysis was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale ; internal consistency Cronbach’s α, split-half reliability, and test–retest reliability were used to identify the reliability of the scale.ResultsThe final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale. Exploratory factor analysis revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach’s α for the total scale was 0.86, and each subscale was 0.75–0.882. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.947, and split-half reliability with intra-class correlation coefficients of the total scale was 0.911. The content validity index was 0.73–1.0.ConclusionThe newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China. (shrink)

This paper illustrates a role that bioethics should play in developing and criticizing protocols for breast cancer genetic screening. It demonstrates how a critical bioethics, using approaches and reflecting concerns of contemporary philosophy of science and science studies, may critically interrogate the normative and conceptual schemes within which ethical considerations about such screening protocols are framed. By exploring various factors that influence the development of such protocols, including politics, cultural norms, and conceptions of disease, this paper and the (...) critical bioethics' approach it endorses illuminate and critically assess some of the competing worldviews informing protocol development. One of the frequently neglected worldviews in traditional bioethics' treatment of protocols concerning breast care is constituted by women's own views of their breasts and breast cancer, both within the technologically-oriented social practice of American medicine and in light of the social construction of their breasted experience in American society. This paper attempts to redress and critically assess this neglect on the part of traditional bioethics. Finally, in contrast to traditional bioethics, critical bioethics critically interrogates its own normative and conceptual commitments. In this final capacity, a critical bioethics' approach makes a valuable contribution to the evolution of bioethics. (shrink)

This paper, using modern Darwinian theory, proposes an explanation for the increasingly high incidence of breast cancer found among pre-and post-menopausal women living today in westernized countries. A number of factors have been said to be responsible: genetic inheritance (BRCA-1), diet (specifically the increased consumption of dietary fat), exposure to carcinogenic agents, lifetime menstrual activity, and reproductive factors. The primary aim of this paper is to demonstrate the value of a perspective based on Darwinian theory. In this paper, Darwinian (...) theory is used to explore the possibility that the increased incidence of breast cancer is due primarily to the failure to complete in a timely manner the reproductive developmental cycle, beginning at menarche and continuing through a series of pregnancies and lactation. On the basis of comparative data, we assume that most women in ancestral populations began having children before age 20 or so and tended to remain either pregnant or nursing for most of their adult lives. If a woman did not have a child by age 25 or so, she probably would never have one. Therefore, selection would probably not have acted against deleterious traits, such as cancer, that appeared after that age, just as it does not act against such traits in old age. (shrink)

Twitter integrates with streaming data technologies and machine learning to add new value to healthcare. This paper presented a real-time system to predict breast cancer based on streaming patient’s health data from Twitter. The proposed system consists of two major components: developing an offline building model and an online prediction pipeline. For the first component, we made a correlation between the features to determine the correlation between features and reduce the number of features from the Breast Cancer Wisconsin (...) Diagnostic dataset. Two feature selection algorithms are recursive feature elimination and univariate feature selection algorithms which are applied to features after correlation to select the essential features. Four decision trees, logistic regression, support vector machine, and random forest classifier have been used on features after correlation and feature selection. Also, hyperparameter tuning and cross-validation have been applied with machine learning to optimize models and enhance accuracy. Apache Spark, Apache Kafka, and Twitter Streaming API are used to develop the second component. The best model with the highest accuracy obtained from the first component predicts breast cancer in real time from tweets’ streaming. The results showed that the best model is the random forest classifier which achieved the best accuracy. (shrink)

In liberal moral theory, interfering with someone’s deliberate engagement in a self-harming practice in order to promote their own good is often considered wrongfully paternalistic. But what if self-harming decisions are the product of an oppressive social context that imposes harmful norms on certain individuals, such as, arguably, in the case of cosmetic breast surgery? Clare Chambers suggests that such scenarios can mandate state interference in the form of prohibition. I argue that, unlike conventional measures, Chambers’ proposal recognises that (...) harmful, discriminatory norms entail a twofold collective moral obligation: to eliminate the harmful norm in the long run, but also to address unjust harm that is inflicted in the meantime. I show that these two obligations tend to pull in opposite directions, thus generating a serious tension in Chambers’ proposal which eventually leads to an undue compromising of the second obligation in favour of the first. Based on this discussion, I develop an alternative proposal which, instead of prohibiting breast implant surgery, offers compensation for the disadvantages suffered by individuals who decide not to have surgery. (shrink)

The coronavirus disease 2019 pandemic has strongly affected oncology patients. Many screening and treatment programs have been postponed or canceled, and such patients also experience fear of increased risk of exposure to the virus. In many cases, locus of control, coping flexibility, and perception of a supportive environment, specifically family resilience, can allow for positive emotional outcomes for individuals managing complex health conditions like cancer. This study aims to determine if family resilience, coping flexibility, and locus of control can mitigate (...) the negative affect caused by the pandemic and enhance positive affect in breast cancer patients. One hundred and fifty-four female patients with breast cancer completed the Walsh’s Family Resilience Questionnaire, the Perceived Ability to Cope With Trauma Scale, the Positive-Negative Affect Schedule, and the Mini Locus of Control Scale. Family resilience and internality of locus of control contribute significantly to positive affective responses. Family resilience is responsible for mitigating the negative affect perceived during the pandemic and is enhanced by external locus of control. Evidence suggests that clinical psychologists should develop and propose programs to support oncology patients’ family resilience, coping flexibility, and internal locus of control, allowing for decreased stress and improved adaptability for effectively managing cancer treatment during the pandemic. (shrink)

Introduction: In 2020, according to the Global Cancer Observatory, nearly 10 million people died of cancer. Amongst all cancers, breast cancer had the highest number of new cases and lung cancer had the highest number of deaths. Even though the literatures suggest a possible connection between psychological factors and cancer risk, their association throughout studies remains inconclusive. The present systematic review studied the connection between psychological factors and the risk of breast and lung cancer, prior to a cancer (...) diagnosis. The psychological factors of trauma, grief, and depression were studied.Methods: The current systematic review was carried out across multiple databases in two phases, an initial exploratory research in June 2020, refined with a second electronic research in December 2020. The inclusion criteria included studies describing the association between trauma, posttraumatic stress disorder, grief, and depression with breast and lung cancer risk. The psychological data collection must have been carried out prior to a confirmed breast or lung cancer diagnosis, and accessed through self-report measures, questionnaires, clinical interviews, or clinical diagnoses. Study reports had to contain information about the incidence of cancer and effect size. The exclusion criteria were studies in which psychological factors were collected after cancer diagnosis.Results and Conclusion: A total of 26 studies were included. Although non-consensual, the findings from the present systematic review suggest that, in addition to the known risk factors, psychological factors may play an important role in the etiology of both breast and lung cancer. To include psychological factors as a variable that affects cancer development may be fundamental to opening new avenues for prevention and intervention.Systematic Review Registration: [www.ClinicalTrials.gov], identifier [CRD42020209161]. (shrink)

Research on mastectomy recommends better preoperative counseling to manage struggles with body image. This article problematizes the popular concept of body image and instead describes body imaging as an embodied and ongoing process that involves a multiplicity of body images. More preoperative information cannot ensure an easy shift to favorable body images because body imaging resists and exceeds the scope of medicine and the patient’s cognitive anticipation. Thus, medical professionals should avoid decontextualizing or medicalizing body image and instead recognize that (...) body image construction is not simply an intellectual reframing but develops in everyday embodied living. (shrink)

In this paper we explore the rise of ‘the breast cancer gene’ as a field of medical, cultural and personal knowledge. We address its significance in the Norwegian public health care system in relation to so-called biological citizenship in this particular national context. One of our main findings is that, despite its claims as a measure for health and disease prevention, gaining access to medical knowledge of BRCA 1/2 breast cancer gene mutations can also produce severe instability in (...) the individuals and families affected. That is, although gene testing provides modern subjects with an opportunity to foresee their biological destiny and thereby become patients in waiting, it undoubtedly also comes with difficult existential dilemmas and choices, with implications that resonate beyond the individual and into different family and love relations. By elaborating on this finding we address the question of whether the empowerment slogan, which continues to be advocated through various health, BRCA and breast cancer discourses, reinforces a naïve or an idealized notion of the actively responsible patient: resourceful enough to seek out medical expertise and gain sufficient knowledge, on which to base informed decisions, thereby reducing the future risk of developing disease. In contrast to this ideal, our Norwegian informants tell a different story, in which there is no apparent heroic mastery of genetic fates, but rather a pragmatic attitude to dealing with a dire situation over which they have little control, despite having complied with medical advice through national guidelines and follow-up procedures for BRCA 1/2 carriers. In conclusion we claim that the sense of safety that gene testing and its associated medical solutions allegedly promise to provide proved illusory. Although BRCA-testing offers the potential for protection from adverse DNA-heritage, administered through possibilities for self-monitoring and self-management of the body, the feeling of ‘being in good health’ has hardly been reinforced by the emergence of gene technology. (shrink)

The rapid pace of development over the last few decades in the domain of machine learning mirrors the advances made in the field of quantum computing. It is natural to ask whether the conventional machine learning algorithms could be optimized using the present-day noisy intermediate-scale quantum technology. There are certain computational limitations while training a machine learning model on a classical computer. Using quantum computation, it is possible to surpass these limitations and carry out such calculations in an optimized (...) manner. This study illustrates the working of the quantum support vector machine classification model which guarantees an exponential speed-up over its typical alternatives. This research uses the quantum SVM model to solve the classification task of a malignant breast cancer diagnosis. This study also demonstrates a comparative analysis of distinct forms of SVM algorithms concerning their time complexity and performances on standard evaluation metrics, namely accuracy, precision, recall, and F1-score, to exemplify the supremacy of quantum SVM over its conventional variants. (shrink)

“Breast cancer is all around us.” This is how Robert Aronowitz, a medical doctor, opens his timely Unnatural History: Breast Cancer and American Society. We are all familiar with the truism that “one in eight American women” will develop invasive breast cancer over the course of her lifetime. The pink ribbon has come to symbolize both solidarity and hope. Mammograms and “Self-Breast Examination” have become part of women’s daily routine, if not a spectre haunting their daily (...) lives. Yet the evidence remains contested and the therapeutic promise, the fear and hope associated with this “obstinate” disease as problematic as ever. Unnatural History weaves all these different elements, artifactual and natural, emotional and rational, vital and morbid, in the socio-historical narrative of breast cancer in the American context. In that sense, this is an “unnatural” history, a history of how “fear” and “risk” have been reshaping a disease, which continues to be as elusive as it was two centuries ago. (shrink)

As in other areas of medical practice, relatives accompany patients to genetic consultations. However, unlike in other areas, the consultations may be relevant to the relatives’ health because they may be at risk of developing the same genetic condition as the patient. The presence of relatives in genetic consultation may affect the decision‐making process and it raises questions about the perception of patient autonomy and the way it is practiced in genetics. However, these issues have not been examined in previous (...) empirical studies. This article aims to fill this gap by reporting findings from a qualitative study with clinicians working in the area of inherited breast cancer. The findings indicate that family presence has an impact on the patient's decisions to undergo genetic testing and preventative operations when she is diagnosed as a carrier. The findings further indicate that, unlike in other areas of medical practice, blood relatives who are present in consultations are perceived by clinicians as patients or potential patients, and this in turn increases their involvement in discussions in the consultation room. Finally, the findings indicate that in genetics, a relational approach to autonomy is applied. Decisions are made in a social context, where the relatives’ views are heard and taken into account. The findings suggest that the conventional bioethical approach to autonomy, which perceives the decision‐making unit as comprising a clinician and an individual patient, is challenged in genetics. The findings thus suggest that bioethicists, lawyers and policy‐makers should consider whether this individualistic approach is still valid and applicable. (shrink)

BackgroundCaregivers may play a fundamental role in the clinical pathway of cancer patients. They provide emotional, informational, and functional support as well as practical assistance, and they might help mediate the interaction and communication with the oncologists when care options are discussed, or decisions are made. Little is known about the impact of dyadic dynamics on patient-doctor communication, patient's satisfaction, or adherence to the therapies. This study protocol aims to evaluate the efficacy of a psychological support intervention on patients-caregivers relationship (...) and their alignment in the treatment decision-making process and estimate related improvement in patient' compliance/adherence to treatments.MethodsA total of 102 patients-caregivers' dyads will be involved, among breast and prostate cancer patients. The study entails a pre- post- evaluation through psychological questionnaires, with a randomization of participants in two conditions, the experimental one in which subjects participate in a psychological support consultation, and the control one, where dyads do not receive any intervention. A follow up after 6 months from the enrollment is planned.DiscussionA positive impact of the psychological support intervention on patients' anxiety, depression, distress, and perceived social support is expected. Such improvements can directly affect patients' satisfaction and adherence to treatments. Data gathered from this study may inform health care providers, policy makers, and public health managers about the importance of caregiver's involvement in the cancer care pathway, and the best way to manage it. A further impact is to develop a specific intervention protocol to support caregivers' involvement in cancer care pathway, improve patient's wellbeing, the interaction with physicians and the compliance with the cancer treatment. (shrink)

Chronic post-surgical pain (CPSP) represents a highly prevalent and significant clinical problem. Both major and minor surgeries entail risks of developing CPSP, and cancer-related surgery is no exception. As an example, more than 40% of women undergoing breast cancer surgery struggle with CPSP years after surgery. While we do not fully understand the pathophysiology of CPSP, we know it is multifaceted with biological, social, and psychological factors contributing. The aim of this review is to advocate for the role of (...) response outcome expectancies in the development of CPSP following breast cancer surgery. We propose the Cognitive Activation Theory of Stress (CATS) as an applicable theoretical framework detailing the potential role of cortisol regulation, inflammation, and inflammatory-induced sickness behavior in CPSP. Drawing on learning theory and activation theory, CATS offers psychobiological explanations for the relationship between stress and health, where acquired expectancies are crucial in determining the stress response and health outcomes. Based on existing knowledge about risk factors for CPSP, and in line with the CATS position, we propose the SURGEry outcome expectancy (SURGE) model of CPSP. According to SURGE, expectancies impact stress physiology, inflammation, and fear-based learning influencing the development and persistence of CPSP. SURGE further proposes that generalized response outcome expectancies drive adaptive or maladaptive stress responses in the time around surgery, where coping dampens the stress response, while helplessness and hopelessness sustains it. A sustained stress response may contribute to central sensitization, alterations in functional brain networks and excessive fear-based learning. This sets the stage for a prolonged state of inflammatory-induced sickness behavior – potentially driving and maintaining CPSP. Finally, as psychological factors are modifiable, robust and potent predictors of CPSP, we suggest hypnosis as an effective intervention strategy targeting response outcome expectancies. We here argue that presurgical clinical hypnosis has the potential of preventing CPSP in women with breast cancer. (shrink)

In researching the biomedically-engineered drug Neulasta, a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

Lactation constitutes a major focus for research in international health because of its dramatic impact on child survival; evolutionary biology has investigated lactation as an important aspect of parenting strategy, with implications for understanding parent-offspring conflict. These perspectives are brought together in an attempt to develop integrated models for an issue of key international health concern: the duration of exclusive breast-feeding and the timing of weaning. This analysis highlights the relevance of evolutionary theory for practical problems in public health, (...) and it suggests the utility of public health outcomes for addressing evolutionary questions. (shrink)

SummaryCross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin concentrations are elevated during 15–21 months of lactational amenorrhoea.A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding on demand (...) for a mean of 67 weeks.Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied. (shrink)

Tests for hereditary predispositions to breast and ovarian cancer have figured among the first medical applications of the new knowledge gleaned from the Human Genome Project. These applications have set off heated debates on general issues such as intellectual property rights. The genetic diagnosis of breast cancer risks, and the management of women “at risk” has nevertheless developed following highly localized paths. There are major differences in the organization of testing, uses of genetic tests, and the follow up (...) of patients. This article studies testing practices and ways of managing breast cancer risk in France and compares them with those in the United States and United Kingdom. It shows how the complex interaction between global and local factors shapes the multiple meanings assumed by the phrase cancer risk. (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)

The microbiota-gut-brain field holds huge potential for understanding behavioral development and informing effective early interventions for psychological health. To realize this potential, factors that shape the MGB axis in infancy must be integrated into a systemic framework that considers salient behavioral outcomes. This is best accomplished applying network analyses in large prospective, longitudinal investigations in humans.

ObjectivesThis pilot study sought to develop and evaluate a novel online group-based intervention to help breast cancer survivors make healthy lifestyle changes intended to yield not only beneficial physical outcomes but also greater behavioral, and psychosocial well-being.MethodsAn exploratory single-arm, mixed-method triangulation design was employed to evaluate the feasibility and preliminary effectiveness of the HLM-ABC intervention for overweight BCSs. Fourteen women participated in the 10-week intervention and completed quantitative measures of the above-mentioned outcomes at baseline, post-treatment, 6-month, and 12-month follow-up (...) time points. Qualitative data were obtained post-treatment via semi-structured interviews and a treatment satisfaction questionnaire.ResultsParticipants lost an average of 2.83% of their baseline weight by 1-year follow-up, equal to a small effect size. Despite achieving only modest weight loss, participants achieved meaningful gains in the form of increased physical activity, discovery of gratifying movement, more intuitive eating habits, greater bodily and emotional awareness, and positive shifts in beliefs about being able to make healthy choices regarding food and physical activity. Furthermore, they demonstrated a slight improvement in body image and described feeling more self-compassionate, empowered, and acknowledging of variables beyond control that can present barriers to change.ConclusionAfter completing a 10-week online program, participants achieved meaningful and lasting changes on a number of healthful indicators, even when this did not correspond with a significant reduction in weight. Findings highlight the complex, multifaceted nature of “health” and lend support for promotion of healthier lifestyle following cancer treatment that encompasses not only physical weight, but also behavior, psychosocial well-being, and circumstances such as life-preserving hormonal treatments. (shrink)

In researching the biomedically-engineered drug Neulasta (filgrastim), a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit pathways (...) to ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

The most predominant kind of disease that is normal among ladies is breast cancer. It is one of the significant reasons among ladies, regardless of huge endeavors to stay away from it through screening developers. An automatic detection system for disease helps doctors to identify and provide accurate results, thereby minimizing the death rate. Computer-aided diagnosis has minimum intervention of humans and produces more accurate results than humans. It will be a difficult and long task that depends on the (...) expertise of pathologists. Deep learning methods proved to give better outcomes when correlated with ML and extricate the best highlights of the images. The main objective of this paper is to propose a deep learning technique in combination with a convolution neural network and long short-term memory with a random forest algorithm to diagnose breast cancer. Here, CNN is used for feature extraction, and LSTM is used for extracted feature detection. The experimental results show that the proposed system accomplishes 100% of accuracy, a sensitivity of 99%, recall of 99%, and an F1-score of 98% compared to other traditional models. As the system achieved correct results, it can help doctors to investigate breast cancer easily. (shrink)

This article focuses on a crucial development in genetic research that occurred in the 1990s: the identification of the first two of the genes responsible for hereditary breast and ovarian cancer. Issues addressed touch on the evolution of the subfield, its potential impact on cancer treatment, and industry involvement. The article follows the activities of the various research groups competing in the race to identify the genes and depicts the frequent conflicts between them. Data are derived chiefly from (...) a bibliometric database. The results show a diversity of research practices. Industrial researchers interacted within far more tightly knit networks than their counterparts working in public organizations. The patenting and commercial exploitation of results led to fierce battles, with one group capturing most of the benefits. (shrink)

Interoperability across data sets is a key challenge for quantitative histopathological imaging. There is a need for an ontology that can support effective merging of pathological image data with associated clinical and demographic data. To foster organized, cross-disciplinary, information-driven collaborations in the pathological imaging field, we propose to develop an ontology to represent imaging data and methods used in pathological imaging and analysis, and call it Quantitative Histopathological Imaging Ontology – QHIO. We apply QHIO to breast cancer hot-spot detection (...) with the goal of enhancing reliability of detection by promoting the sharing of data between image analysts. (shrink)

In recent years, the internationalization of music education has become an important topic. Scholars of various research traditions try to find the best solutions for problems in music education theory and practice by taking a look at what other countries do. English as common language seems to facilitate this recent development. However, in spite of this seemingly unproblematic way of communicating, there are various obstacles which make the mutual understanding and the internationalization of music education difficult. This particularly concerns (...) different scholarly cultures and traditions of presenting research, both in written papers and oral presentations. Most scholars realize that there are difficulties, but because they mostly only know one culture of research well, they are not aware of the reasons for these problems. Therefore, it is important to take a critical look at the scholarly traditions in Germany and the United States, examining reasons and suggesting solutions for an internationalization of music education that takes into account the strengths of various traditions, while at the same time fostering international understanding and the improvement of music education all over the world. (shrink)

Health technology assessment (HTA) was developed in the 1970s and 1980s to facilitate decision making on the desirability of new biomedical technologies. Since then, many of the standard tools and methods of HTA have been criticized for their implicit normativity. At the same time research into the character of technology in practice has motivated philosophers, sociologists and anthropologists to criticize the traditional view of technology as a neutral instrument designed to perform a specific function. Such research suggests that the tools (...) and methods of more traditional forms of HTA are often inspired by an ‘instrumentalist’ conception of technology that does not fit the way technology actually works. This paper explores this hypothesis for a specific case: the assessments and deliberations leading to the introduction of breast cancer screening in the Netherlands. After reconstructing this history of HTA ‘in the making’ the stepwise model of HTA that emerged during the process is discussed. This model was rooted indeed in an instrumentalist conception of technology. However, a more detailed reconstruction of several episodes from this history reveals how the actors already experienced the inadequacy of some of the instrumentalist presuppositions. The historical case thus shows how an instrumentalist conception of technology may result in implicit normative effects. The paper concludes that an instrumentalist view of technology is not a good starting point for HTA and briefly suggests how the fit between HTA methods and the actual character of technology in practice might be improved. (shrink)

BackgroundFidelity of implementation reflects whether an intervention was implemented in clinical practice according to the originally developed manual and is a key aspect in understanding intervention effectiveness. To illustrate this process of developing a fidelity measure, this study uses the Mini-AFTERc, a brief psychological intervention aimed at managing breast cancer patients’ fear of cancer recurrence, as an example.ObjectivesTo illustrate the development of an FOI measure through applying this process to the Mini-AFTERc intervention, by including the design of a (...) scoring system and rating criteria; content validating the FOI measure using thematic framework analysis as a qualitative approach; testing consistency of the FOI measure using interrater reliability.MethodsThe FOI measure was developed, its scoring system modified and the rating criteria defined. Thematic framework analysis was conducted to content validate the FOI measure using nine intervention discussions between four specialist cancer nurses and four breast cancer patients, and one simulated breast cancer patient. Intraclass-correlation was conducted to assess interrater reliability.ResultsThe qualitative findings suggested that the Mini-AFTERc FOI measure has content validity as it was able to measure all five components of the Mini-AFTERc intervention. The interrater reliability suggested a moderate to excellent degree of reliability among three raters, rICC = 0.84, 95% CI [0.51, 0.96].ConclusionThe study has illustrated the steps that an FOI measure can be developed through a systematic approach applied to the Mini-AFTERc intervention. The FOI measure was found to have content validity and was consistently applied, independently, by three researchers familiar with the Mini-AFTERc intervention. Future studies should determine whether similar levels of interrater reliability can be obtained by distributing written and/or video instructions to researchers who are unfamiliar with the FOI measure, using a larger sample. Employing developed and validated FOI measures such as the one presented for the Mini-AFTERc would facilitate implementation of interventions in the FCR field in clinical practice as intended.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03763825. (shrink)

Presents historical evidence which reveals the origins of man's moral values and social responsibility in primitive religions and life experiences of the ancient Egyptians of 5000 B.C.

Ana-materialism & the Pineal Eye provides a landmark interpretation of materialism, representation and the image using the Cartesian conceit of a pineal gland and its voracious sexually embedded appetites. Developing the argument via Bataille’s re-invention of the pineal gland as an all-seeing, all- devouring, (pineal) eye, Golding borrows this move to envision a different analytic approach to digital forms of ‘matter’ and artificial forms of ‘life’. From her critical engagement with Bataille, Deleuze and Butler, Golding shows why the tools provided (...) by these modern, contemporary and postmodern approaches to philosophy, image, the body, indeed representation cannot fully explore, let alone develop these new forms of reality/ies except by retreating into traditional binary divides between male and female, good and evil, mother/child and so forth. Ana-materialism and the Pineal Eye introduces a much needed understanding to oddly cathected sensualities, multiversal realities, digital imaginaries with no weight, no volume, no spatiality, but ‘somehow’ making sense, and with it, creating matter, ethics, art. (shrink)

Ana-materialism & the Pineal Eye provides a landmark interpretation of materialism, representation and the image using the Cartesian conceit of a pineal gland and its voracious sexually embedded appetites. Developing the argument via Bataille’s re-invention of the pineal gland as an all-seeing, all- devouring, eye, Golding borrows this move to envision a different analytic approach to digital forms of ‘matter’ and artificial forms of ‘life’. From her critical engagement with Bataille, Deleuze and Butler, Golding shows why the tools provided by (...) these modern, contemporary and postmodern approaches to philosophy, image, the body, indeed representation cannot fully explore, let alone develop these new forms of reality/ies except by retreating into traditional binary divides between male and female, good and evil, mother/child and so forth. Ana-materialism and the Pineal Eye introduces a much needed understanding to oddly cathected sensualities, multiversal realities, digital imaginaries with no weight, no volume, no spatiality, but ‘somehow’ making sense, and with it, creating matter, ethics, art. (shrink)