It is common today to see the world as increasingly unpredictable, and to see that unpredictability as a major source of anxiety. Many of the proposed cures for that anxiety, such as systems like Memex and MyLifeBits, have sought solutions in systems that collect and store a thorough record of events, at a scale from the personal to the global. There the solution to anxiety lies in the ability to play back the record, to turn back the clock and be (...) there then. Both this anxiety and its solution are best seen not simply as remedies for an immediate problem-of terrorism, for example-but rather as evidence of a more deep-seated set of cultural changes, which emerged early in the twentieth century. Paradoxically, the technological solutions offered, whatever the scale, embody the very thing, a lack of a connection to a community, that is both the source of the anxiety and a fundamental impediment to its elimination. (shrink)

IntroductionYounger age at diagnosis is a risk factor for poor health-related quality of life in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer, nor have early changes in HRQOL been fully characterized.MethodsEligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and (...) comorbidities were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores.ResultsHealth-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5. Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points, functional well-being improved 3.0 points, emotional well-being improved 1.9 points, and physical well-being improved 1.5 points, on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being and functional well-being than participants who did not have anxiety/depression at baseline. Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal.ConclusionYoung women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment. (shrink)

With respect to the right of privacy, some of the most difficult concerns arise from the map, and especially the modern, computer-generated map. Maps support a view in which the local--and the private--are unimportant, as they represent the world in ways that make places seem fundamentally alike. By geocoding he location of people, places, and events, maps offer a universal set of identifiers, one much more difficult to regulate than traditional identifiers like the social security number. At the same time, (...) they support the development of a system of geodemographic profiling in a way that creates "digital individuals" over whom most people have little control. And when these data are placed on a map, the problems are exacerbated, just to the extent that the reading of maps is a highly culturally determined practice; different people often interpret the same map in very different ways. This collection of problems suggests that in the context of a rapidly diffusing commercial mapping system, the traditional conception of the right to privacy is under attack, and that in the process that right is being redefined. (shrink)

BackgroundSarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life especially physical and functional wellbeing. Adolescent and young adult patients are an underrepresented population in cancer research and have differing factors influencing QoL.MethodsRetrospective analysis of Young Adult patients enrolled in the Sarcoma Tissue Repository at (...) University of Iowa. QoL was assessed using the self-report FACT-G questionnaire at enrollment and 12 months post-diagnosis; overall scores and the 4 wellbeing subscales were calculated. Linear mixed effects models were used to measure the association between the rate of change in FACT-G subscale scores and baseline clinical, comorbidity, and treatment characteristics.Results49 patients were identified. 57.1% of patients had a malignancy involving an extremity. Mean FACT-G scores of overall wellbeing improved from baseline to 12 months. Social and emotional wellbeing did not differ significantly between baseline and 12 months. Physical wellbeing and functional wellbeing scores improved from baseline to 12 months. No difference was seen for FACT-G overall scores for age, sex, laterality, marital status, performance status, having children, clinical stage, limb surgery, chemotherapy, or tumor size. A difference was demonstrated in physical wellbeing scores for patients with baseline limitation compared to those with no baseline limitation. A difference was demonstrated in social wellbeing based on anatomical site.ConclusionYoung adults with sarcoma treated at a tertiary center had improvements in overall reported QoL at 12 months from diagnosis. Overall baseline QoL scores on FACT-G were lower than the general adult population for YA patients with sarcoma but at 12 months became in line with general population norms. The improvements seen merit further investigation to evaluate how these change over the continuum of care. Quality of life changes may be useful outcomes of interest in sarcoma trials. (shrink)