Objectives: Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. Method: Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, (...) parents and siblings completed the Family Environment Scale, Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. Results: Family functioning and the appraisal of the cancer diagnosis proved to be related to patients’, parents’ and siblings’ cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. Discussion: Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family speak to the need of screening all family members and intervening at the level of the family unit. (shrink)

... We will turn our attention to the current state of pain relief technology and the ethical questions surrounding the use of advanced technology, otherwise referred to as "high-tech," pain relief. It is obvious that pain may decrease the quality of life for cancer patients. The availability of long-acting narcotics, such as MS Contin or methadone, affords cancer patients long-duration pain relief at minimal cost. The use of adjuvant medications may also be important. Clinical examples of the effective (...) use of adjuvant medications include the addition of a nonsteroidal, anti-inflammatory agent to help patients cope with bone pain and the use of a serotonin blocking agent to reduce the transmission of pain impulses in the spinal cord. Only a small percentage of patients are good candidates for high-tech delivery systems for narcotic administration. In our pain management clinic, all patients are initially placed on oral medications. When the side effects of oral medications become excessive, or the patient becomes unable to take oral medications, high-tech modalities are considered for use. (shrink)

This article discusses findings from a mixed method literature review that investigated cancer patients’ perceptions of what constitutes a good nurse. To find pertinent articles, we conducted a systematic key word search of five journal databases (1998—2008). The application of carefully constructed inclusion criteria and critical appraisal identified 12 relevant articles. According to the patients, good nurses were shown to be characterized by specific, but inter-related, attitudes, skills and knowledge; they engage in person-to-person relationships, respect the uniqueness of (...) patients, and provide support. Professional and trained skills as well as broad and specific nursing and non-nursing knowledge are important. The analysis revealed that these characteristics nurtured patient well-being, which manifests as optimism, trust, hope, support, confirmation, safety and comfort. Cancer patients’ perceptions of what constitutes a good nurse represent an important source of knowledge that will enable the development of more comprehensive and practice-based views on good nursing care for such patients. These perceptions help us to understand how nurses effectively make a difference in cancer patient care. (shrink)

Receiving a diagnosis of cancer can be devastating. Cancer continues to be one of the most feared diagnoses, and experiencing pain is a major fear for people diagnosed with cancer. Cancer pain is complex in aetiology and can be acute or chronic and can be caused by various compression, ischaemic, neuropathic or inflammatory processes. Many people with cancer will experience excruciating pain, which is often underreported and undertreated. The reasons for this are complex and include (...) various factors including fears and beliefs held by patients. Cognitive factors are important modulators of pain and the appraisals, meanings and beliefs that people have in relation to illness, cancer, and pain, have implications in regard to help-seeking behaviours and the coping strategies people adopt. Cancer pain can impact a range of psycho-social factors across its course. Cancer pain relates to higher rates of psychological distress, anxiety and low mood, and the perception of pain intensity is, in turn, influenced by psychological factors. Cancer pain can negatively affect psychological health, and psycho-social factors can affect the pain experience. It has been suggested that people with a life-limiting illness experience ‘total pain’, and this can encompass psychological, social, practical, spiritual domains. Research demonstrates that cancer is predominantly an illness affecting older people, yet there is a higher risk of under-treated pain in this age group and there is a paucity of research into the subjective experiences of older people managing their cancer pain. Many older people are required to self-manage cancer pain at home as outpatients, due to drivers to keep people out of inpatient care, such as the high healthcare costs of inpatient treatment, and patients wanting to manage their illness, and die, at home. Our own research into this area found that the self-management of cancer pain involves a sequential and temporal process, which centres on perceptions of control. We describe how the older people in our study experienced a perceived loss of control, followed by a sense of gaining control over pain through various experience of certain internal and external factors. The assessment and treatment of physical pain should be done in combination with assessment and treatment of psycho-social and spiritual pain, and interventions for cancer pain need to focus on increasing positive affect and reducing helplessness. No person should suffer with poorly controlled pain and we argue for the need for further research in this area to ensure adequate treatment for all.Clinical Implications: Assessment and treatment of physical pain in people with cancer needs to be conducted in combination with assessment and treatment of psycho-social issues and spiritual pain. Psychological and behavioural approaches have strong evidence supporting their efficacy for reducing cancer pain. Interventions should target helplessness and focus on increasing positive affect through positive psychological states including fighting spirit and resilience. Person-centred interventions that focus on helping people with the search for meaning may help those with cancer pain derive positive benefits. (shrink)

ABSTRACTWhen faced with hardship, how do we emotionally appraise the situation? Although many factors contribute to our reasoning about hardships, in this article we focus on the role of linguistic metaphor in shaping how we cope. In five experiments, we find that framing a person’s cancer situation as a “battle” encourages people to believe that that person is more likely to feel guilty if they do not recover than framing the same situation as a “journey” does. Conversely, the “journey” (...) frame is more likely to encourage the inference that the person can make peace with their situation than the “battle” frame. We rule out lexical priming as an explanation for this effect and examine the generalizability of these findings to individual differences across participants and to a different type of hardship—namely, an experience with depression. Finally, we examine the language participants produced after encountering one of these metaphors, and we find tendencies to repeat and extend the metaphors encountered.... (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)

Recently, there has been increasing interest in methodological aspects of advanced imaging, including the role of guidelines, recommendations, and experts’ consensus, the practice of self-referral, and the risk of diagnostic procedure overuse. In a recent Delphi study of the European Association for Nuclear Medicine (EANM), panelists were asked to give their opinion on 47 scientific questions about imaging in prostate cancer. Nine additional questions exploring the experts’ attitudes and opinions relating to the procedure of consensus building itself were also (...) included. The purpose was to provide insights into the mechanism of recommendation choice and consensus building as seen from the experts’ point of view. Results: Regarding the factors likely to influence the willingness to refer a patient for imaging, the most voted were incorporation into guidelines and data from scientific literature, while personal experience and personal relationship were chosen by a small minority. Regarding the recommendations more relevant to prescribe an imaging procedure, it resulted the incorporation into guidelines promoted by scientific societies (59% of votes); these guidelines also resulted the more trusted. With respect to patients’ preferences considered when prescribing an imaging procedure, the most voted was accuracy, resulted more important than easy access and time to access to the procedure. The majority of the experts expressed the opinion that there is a scarce use of imaging procedures in prostate cancer. With respect to the most relevant factor to build consensus, it resulted the transparency of the process (52% of votes), followed by multidisciplinarity of contributors. The main obstacle to incorporation of modern imaging procedures into guidelines resulted the lack of primary literature on clinical impact. Conclusions: Firstly, the panelists portray themselves as having Evidence-Based Medicine oriented and scientifically inclined attitudes and preferences. Secondly, guidelines and recommendations from scientific societies, especially clinical ones, are positively taken into account as factors influencing decisions, but panelists tend to consider their own appraisal of the scientific literature as more relevant. Thirdly, in respect of overuse, panelists do not think that advanced diagnostic procedures are overutilized in the specific case of Prostate Cancer, but rather they are underutilized. (shrink)

ObjectivesWomen who underwent chemotherapy for metastatic breast cancer used both adaptive and maladaptive coping strategies but had low implementation levels. The present study explores the qualitative experience of coping strategies for women with MBC undergoing CT in Beijing.MethodsA hermeneutic phenomenological approach was employed on twenty Chinese MBC women undergoing CT. These interviews were transcribed verbatim, coded using thematic analysis, and analyzed using NVivo 11.ResultsThree themes are highlighted: Maintaining hope; Spiritual growth, and Self-perceived support resources.ConclusionThe present study results have led (...) to a greater understanding of the tremendous impact of CT on MBC women’s lives. This research provides insight into the scope of maintaining hope. Spiritual growth and self-perceived support resources were crucial factors to coping strategies among MBC women to improve their quality of life.Clinical RelevanceBy attaining the adaptive coping strategies and further understanding about Chinese MBC women, health care professionals are encouraged to appraise MBC women’s specific problems and adopt effective interventions to improve MBC women’s psychosocial wellbeing. (shrink)

ObjectivesA sample of women with persistent distress following breast cancer previously exhibited attentional bias away from supraliminally presented cancer-or threat-related information, responses consistent with avoidance coping, and showed negative interpretation bias. Here, we attempt to characterize the nature of supraliminal AB and interpretation bias in that sample of women by comparing against healthy controls.MethodsExtending our previous work, we compared AB patterns for supraliminally presented negatively valenced words and cancer-related information assessed by modified dot-probe tasks and negative interpretation (...) bias assessed by an ambiguous cue task between 140 BC women previously identified as featuring low-stable or persistent high anxiety and 150 age-matched non-BC healthy controls having HADS-defined low or high anxiety.ResultsAttentional avoidance of non-cancer-related negatively valenced words was seen among the anxious BC group, while heightened attention toward such words was seen in anxious healthy controls, F = 3.97, p = 0.009. However, all anxious women in both BC and healthy groups directed attention away from CRI under supraliminal conditions. Interpretation bias scores were significantly higher in BC women with high anxiety vs. healthy controls with high anxiety, F = 13.26, p < 0.001.ConclusionWomen with high anxiety generalized conscious attentional avoidance responses to negatively valenced stimuli, indicating a likely hypersensitivity to potential threat in ambiguous cues and exaggerated threat perception. This may cause maladaptive emotional regulation. Attention focus training, reducing threat salience or modifying threat appraisal, may help women alleviate anxiety levels after BC. (shrink)

Certain sections ofJosiah Willard Gibbs's thermodynamics papers might be applicable to biological equilibrium and growth, normal or abnormal.Gibbs added terms⌆ Μ i dm i to the differential of the internal energy dε=tdη−pdΝ, where μi=δεδmi is the potential of substancem i , to provide for chemical as well as thermal and mechanical equilibrium. In this article a further generalization is suggested, to include biological equilibrium by adding to de terms of the form GdN, the variableN being the number of cells, where (...) G=δεδN is a “growth potential” that measures exactly the resistance toward spontaneous growth. The functionG, likeΜ i is intensive in nature except for a conversion factor dMdN ,M=⌆m i , affording possible insight into why incipient abnormal growth is often independent of the number of cells. Useful applications might follow from identities between δGδη,δGδv , or δGδmi and δtδN,−δpδN or δμiδN respectively. The following new function is studied, ζ¯=ζ−GN , a natural generalization of theGibbs free energy function ζ, the possibility of measuring it electrically, and comparison of its role with that of ζ for the possible experimental determination ofG. Gibbs's necessary and sufficient conditions for heterogeneous equilibrium ofn components inm phases are generalized and also modified to include broader restraining conditions like ∑mi=1δNj⩾o ,j=1,f,n, the > being characteristic of only living cellular phases. Careful appraisal of the term “biological stability” is followed by new criteria for stability, instability, and limits of stability, in terms of derivatives ofG, with possible medical applications. Three different sections of Gibbs's works tend to indicate that, for a biological phase, lower pressure usually increases its stability. The equation p′′−p′=σ , where σ=surface tension,p′, p′ = pressures,r, r′=radii of curvature, is applied to possible control of tissue growth at interfaces. Methods of altering the equilibrum between three phasesA, B, C by varying the interfacial tensionsσ AB ,σ BC ,σ AC , using relations like AB <σ AC + BC for stability of theA, B interface, suggest different means for shifting biological equilibrium between normal and abnormal cells through the introduction of new third phases at the interface. Various devices are mentioned for possible control of growth through proper channeling of surface or other equivalent forms of energy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Richard Hofstadter: An Intellectual BiographyBruce KuklickDavid S. Brown, Richard Hofstadter: An Intellectual BiographyChicago: University of Chicago Press, 2006. xxiv+291 pp. Notes, Bibliographic Essay, Sources, Students of Richard Hofstadter, Index. $27.50.In the mid-twentieth century Richard Hofstadter was one the finest historians of the United States. Uncommitted to work in primary sources, he was perhaps not at the level of Perry Miller, Vann Woodward, and Edmund Morgan. But Hofstadter had (...) a greater range and wider influence than these men, and the combination of intellectual and political history that he wrote was unique, as was the penetration of his intellect and his appealing sensibility.Hofstadter was born in Buffalo, New York, the son of a Lutheran mother and a father who was a secular Jew. The son went to the local University of Buffalo. While not as impoverished as this biography is inclined to make him, Dick Hofstadter "married up" after he fell in love with Felice Swados, the daughter of a Buffalo Jewish doctor who was also a student at the University. Swados introduced Hofstadter to the Marxist intellectual left of the 1930s, although he was himself a successful and intelligent student leader. In the years after their graduation, the couple had a tempestuous start to their marriage, but over the next several years they built a life in New York City. Felice became the medical columnist for Time; Dick productively completed a doctoral degree in history at Columbia University. They both continued their radical activities. In the late 1930s he was briefly a member of the American Communist Party, although Dick quickly resigned because of the authoritarian nature of the organization. Even then, however, he was more removed and skeptical than Felice, with more of an historian's impartiality and sense of the tragic. Felice's unambiguous commitments moved him, but Dick was, literally, only half-inclined to the Jewish left.Swados died of cancer in 1945, after they had moved to Washington, D.C., where Hofstadter was teaching at the University of Maryland. But a year later the devastated young man obtained a position at Columbia. At the same time he met and married Beatrice Kevitt, another capable woman with literary and editorial talent.In 1948 Hofstadter published what I still think is his masterwork, The American Political Tradition. A series of sharp portraits of leading politicians, [End Page 574] the book owed much to Hofstadter's leftist background. It was indebted to Marxist analyses, or at least to those of the sort promulgated by the great historian, Charles Beard, who saw economics as central to the study of national life. But Hofstadter did not see a clash between capitalists and their opponents in the United States. He viewed the entire tradition of American politicians as committed to a certain kind of exploitative social system, although his book did not quite have the edge suggested by this last phrase. Hofstadter became known as a "consensus" historian who had a monolithic sense of the American experience, although this monolith was not benign as was that of other practitioners of consensus.In the 1950s Hofstadter, now a prominent Columbia faculty member, moved away from some of the economic preconceptions of The American Political Tradition. Instead, in his two other important books, The Age of Reform (1955) and The Paranoid Style in American Politics (1965), he brought to bear on the American experience a group of concepts that he took from his study of the social sciences. Overall, these two books undermined his previous materialist interpretation of politics. Instead, Hofstadter found that irrational fears, psychological maladjustments, and concerns about status might motivate leaders and movements more than a rational appraisal of self-interest. In retrospect, this 1950s social science does not appear very enlightening, and so Hofstadter's absorption of it is not to be praised. On the other side, so many of his fellow historians attacked him for his interdisciplinary bent that his generous outreach looks more than daring. Hofstadter's own personal politics shifted, too. He became a staunch if critical defender of the social democratic liberalism of Franklin Roosevelt's New Deal and its impulses in the 1950s and 1960s.In... (shrink)

As the COVID-19 pandemic rages on, this June 2021 issue of the JME contains several articles addressing pandemic-related ethical issues, including, discrimination against persons with disabilities,1 collective moral resilience,2 and stress in medical students due to COVID-19.3 It also contains a critical appraisal of the most recent WHO guidance document on the management of ethical issues during an infectious disease outbreak.4 This June issue of JME also addresses several important clinical ethics issues: covert administration of medication in food,5 educational (...) pelvic exams under anesthesia,6 consent to cancer screening,7 care of critically ill newborns when the birth mother is unwell,8–10 and ethical considerations related to recruiting migrant workers for clinical trials.11 Perhaps what is most unique about this issue is its Feature …. (shrink)

Specific inhibition of gene expression by antisense agents provides the basis for rational drug discovery based on molecular targets. Due to the specificity of Watson‐Crick base‐pair hybridization, antisense oligodeoxynucleotides have been used extensively in attempts to inhibit gene expression in both in vitro and in vivo models. Analogues modified from normal phosphodiester oligodeoxynucleotides have entered clinical trials against diseases including AIDS and cancer. Although the precise mechanism of action of these drugs has not been clarified, these oligodeoxynucleotides offer considerable (...) promise as novel molecular therapeutics. We review the recent attempts to harness the therapeutic potential of these oligodeoxynucleotides and appraise the near‐term prospects for antisense technology. (shrink)

Jeff Nisker describes his personal experience of a diagnosis of advanced prostate cancer and the kindnesses he received from friendly doctors. He claims that this narrative account supports the promotion of Prostate Specific Antigen screening for asymptomatic men and impugns statisticians, mistakenly thinking that their opposition to PSA screening derives from concerns about financial cost. The account inadvertently demonstrates the danger of over-reliance on a single ethical tool for critical analysis. In the first part of this response, we describe (...) the statistical evidence. The most reliable Cochrane meta-analyses have not shown that PSA screening saves lives overall. Moreover, the high false positive rate of PSA screening leads to overinvestigation which results in unnecessary anxiety and increased cases of unnecessary sepsis, urinary incontinence and sexual dysfunction. Then we describe how narrative ethics alone is an insufficient tool to make claims about policies, such as PSA screening, which have hidden harms. Although Nisker’s story-telling is compelling and evokes emotions, narrative ethics of this sort have an inherent bias against people who would be harmed by the counterfactual. Particular care must be taken to look for and consider those untellable stories. Ethicists who only consider narratives which are readily at hand risk harming those who are voiceless or protected by the status quo. PSA screening is the wrong tool to reduce prostate cancer deaths and narrative ethics is the wrong tool to appraise this policy. It is vital that the correct theoretical tools are applied to the medical and ethical questions under scrutiny. (shrink)

This is the first book to explore the epistemology and ethics of advanced imaging tests, in order to improve the critical understanding of the nature of knowledge they provide and the practical consequences of their utilization in healthcare. Advanced medical imaging tests, such as PET and MRI, have gained center stage in medical research and in patients’ care. They also increasingly raise questions that pertain to philosophy: What is required to be an expert in reading images? How are standards for (...) interpretation to be fixed? Is there a problem of overutilization of such tests? How should uncertainty be communicated to patients? How to cope with incidental findings? This book is of interest and importance to scholars of philosophy of medicine at all levels, from undergraduates to researchers, to medical researchers and practitioners (radiologists and nuclear physicians) interested in a critical appraisal of the methodology of their discipline and in the ethical principles and consequences of their work. -/- . (shrink)

The rapidly changing field of genetics affects society through advances in health-care and through implications of genetic research. This study addresses the impacts of new genetic discoveries and technologies on different segments of today's society. The book begins with a chapter on genetic complexity, and subsequent chapters discuss moral and ethical questions arising from today's genetics from the perspectives of health care professionals, the media, the general public, special interest groups and commercial interests.

We comment on two articles on social referencing and social appraisal. We agree with Walle, Reschke, and Knothe’s argument that at one level of analysis, social referencing and social appraisal are functionally equivalent: In both cases, another person’s emotional expression is observed and this expression informs the observer’s own emotional reactions and behavior. However, we also agree with Clément and Dukes’s view that, there is an important difference between social referencing and social appraisal. We also argue that (...) they are likely to occur at different stages of emotion process. (shrink)

Publication date: 15 October 2018 Source: Author: Ehiosun O. Marvel NHIS was launched officially on 6th of June 2005. The Scheme is designed to provide comprehensive health care at affordable costs, covering employees of the formal sector, self-employed, as well as rural communities, the poor and the vulnerable groups. However, client satisfaction of services rendered continues to be a major concern for the improvement of NHIS. This study is designed to determine the level and causes of dissatisfaction of clients accessing (...) NHIS clinic at the Kubwa General Hospital, Kubwa, FCT, Abuja. This study employed a descriptive cross sectional survey. 279 NHIS enrollees were recruited for this study at the Kubwa General Hospital. Questionnaires were administered and the level of dissatisfaction and satisfaction of NHIS services were analyzed. The satisfaction rate was 69.2% while the dissatisfaction rate was 22.9%. The respondents were satisfied with the attitude of health workers in NHIS clinic, Kubwa. However, they were dissatisfied with waiting time, attitude of record officers and those in pharmacy department. This study found that the level of dissatisfaction with NHIS services is high despite a high satisfaction level. The Attitude of health workers may influence the dissatisfaction of enrollees. NHIS is still limited to the formal sector. (shrink)

The aim of appraisal theory in the psychology of emotion is to identify the features of the emotion-eliciting situation that lead to the production of one emotion rather than another². A model of emotional appraisal takes the form of a set of dimensions against which potentially emotion-eliciting situations are assessed. The dimensions of the emotion hyperspace might include, for example, whether the eliciting situation fulfills or frustrates the subject’s goals or whether an actor in the eliciting situation has (...) violated a norm. Richard Lazarus’s well-known model of emotional appraisal has six dimensions, and the regions of the resulting hyperspace that correspond to particular emotions are summarized by Lazarus as the ‘core relational themes’ of those emotions. Anger, for examples, is elicited by the core relational theme ‘a demeaning offence against me and mine’, sadness by ‘having experienced an irrevocable loss’ and guilt by ‘having transgressed a moral imperative’ (Lazarus, 1991). (shrink)

Research on diseases such as cancer reveals that primary mechanisms, which have been the focus of study by the new mechanists in philosophy of science, are often subject to control by other mechanisms. Cancer cells employ the same primary mechanisms as healthy cells but control them differently. I use cancer research to highlight just how widespread control is in individual cells. To provide a framework for understanding control, I reconceptualize mechanisms as imposing constraints on flows of free (...) energy, with control mechanisms operating on flexible constraints in primary mechanisms. I argue that control mechanisms themselves often form complex, integrated networks. (shrink)

Background In the last years, there has been an increase in publication of systematic reviews of normative literature or of normative information in bioethics. The aim of a systematic review is to search, select, analyse and synthesise literature in a transparent and systematic way in order to provide a comprehensive and unbiased overview of the information sought, predominantly as a basis for informed decision-making in health care. Traditionally, one part of the procedure when conducting a systematic review is an (...) class='Hi'>appraisal of the quality of the literature that could be included. Main text However, while there are established methods and standards for appraising e.g. clinical studies or other empirical research, quality appraisal of normative literature in the context of a systematic review is still rather a conundrum – not only is it unclear how it could or should be done, but also the question whether it necessarily must be done is not settled yet. Based on a pragmatic definition of “normative literature” as well as on a typology of different types of systematic reviews of normative literature/information, this paper identifies and critically discusses three possible strategies of conducting quality appraisal. Conclusions The paper will argue that none of the three strategies is able to provide a general and satisfying solution to the problems associated with quality appraisal of normative literature/information. Still, the discussion of the three strategies allows outlining minimal conditions that elaborated strategies have to meet in future, and facilitates sketching a theoretically and practically promising strategy. (shrink)

In this paper, I assess Žižek ’s article “No Sex, Please, We’re Post-human!” as a provocative injunction to signal the posthuman ecstasy and deterrence. I seek to expose, rather than express, Žižek ’s posthumanist perspective as a paradoxical intertwining of different aspects of perspectivizing a post-human being from the view of the end of sexuality – the background that informs a posthuman future. Žižek ’s eluding the subject’s confrontation with the question of sexual difference to the apex of the genome (...) project touches the delicate coalescing of the notions of ‘objectivity and subjectivity’ and ‘virtuality and reality’ in the fate of the body. Ultimately, he renders this inception of this tarrying as a traumatic encounter that informs us of the existential birthright of a true posthuman. (shrink)

In clinical research – whether pharmaceutical, genetic or biomarker research – it is important to protect research participants’ autonomy and to ensure or strengthen their control over health-related decisions. Empirical–ethical studies have argued that both the ethical concept and the current legalistic practice of informed consent should be adapted to the complexity of the clinical environment. For this, a better understanding of recruitment, for which also the physician–patient relationship plays an important role, is needed. Our aim is to ethically reflect (...) communication processes by identifying patterns used by physicians to motivate patients’ participation in clinical research and to assess whether patients also use these patterns in formulating their own research motivation. We conducted a secondary analysis with empirical data from a research project involving physicians and patients in a clinical research setting of a biomarker study for rectal cancer treatment. Our empirical data included observations of physician–patient consultations and semi-structured interviews with patients. Overall, we collected 93 interviews. We found two dominant communication patterns, which physicians applied for motivating patients to take part in this research study. Some forms of these patterns tend to mislead patients’ understanding, while others could justifiably be applied in this consultation setting without undermining patients’ autonomy. This insight that the physician–patient communication has a strong influence on patients increases the importance to strengthen physicians’ ethically acceptable communication patterns regarding research participation. We further suggest that there is a need for a critical reflection of the ethics committee’s requirements for information regarding research participation. (shrink)

The First Preface to Kant’s Religion within the Boundaries of Mere Reason contains various characterizations of the distinction between biblical and philosophical theology. Similar characterizations are also found in the Preface to The Conflict of the Faculties. In both, Kant warns the philosopher against trespassing into the purview of the biblical theologian. Yet, in the actual body of both texts, we find numerous occasions where Kant deviates from the rules he initially articulates. The purpose of this paper is to identify (...) these rules, discuss their apparent violations, and consider the implications of this divergence. (shrink)

The proliferation of dimensions of appraisal is both welcome and worrying. The preoccupation with sorting out causes may be somewhat otiose. And the ubiquity of emotions in levels of processing raises intriguing problems about the role of language in identifying and triggering emotions and appraisals.

We present a new framework for combining logic with probability, and demonstrate the application of this framework to breast cancer prognosis. Background knowledge concerning breast cancer prognosis is represented using logical arguments. This background knowledge and a database are used to build a Bayesian net that captures the probabilistic relationships amongst the variables. Causal hypotheses gleaned from the Bayesian net in turn generate new arguments. The Bayesian net can be queried to help decide when one argument attacks another. (...) The Bayesian net is used to perform the prognosis, while the argumentation framework is used to provide a qualitative explanation of the prognosis. (shrink)

ignette and autobiographical recall studies have often been used to test models of the appraisals associated with specific emotions. Recently, critiques of both methodologies have called into question the applicability of appraisal theory to naturally-occurring emotional responses. This study examined supporter's responses to Ross Perot's withdrawal from the 1992 presidential race to assess the extent to which appraisal models accurately capture responses to a naturally-occurring event. Supporters in Riverside County, California (N = 227) completed questionnaires concerning their interpretations (...) of the event, their initial emotional reactions, changes in their reactions in the weeks immediately following Perot's withdrawal, and their plans. Appraisal models correctly predicted the dimensions of agency and coping potential that served to differentiate sadness from anger, and the appraisals and plans associated with hope. Appraisal models did not predict the strong focus of sad supporters on their past goals and beliefs, and the plans associated with sadness and anger. Changes in emotional intensity occurred as a function of changes in goals and plans rather than merely as a function of time. These findings demonstrate the applicability of appraisal theory to naturally-occurring emotional responses, but also show that models may understate the complexity of the planning processes associated with emotions. (shrink)

Our study seeks a better understanding of how Spanish-speaking cancer patients communicate about their personal experiences with cancer. We examine the use of metaphor in narratives contributed to an online forum for Spanish speakers afflicted with various types of cancer. Specifically, we identify, quantify and discuss three categories of metaphors: violence, journey and other. Our study expands prior work on cancer communication by examining a language other than English, by focusing on how cancer victims communicate (...) among themselves, and by examining how cancer narratives discuss concerns about personal experiences with this disease. Research thus far has focused on English. The work also expands on what is known about how people use the metaphor ‘in the wild’. (shrink)

Introduction -- A significant life -- Constructing a methodology -- The method under assault -- Politics as practice -- Political theory as political practice -- Conclusion.

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)

Metaphysical presuppositions are important for guiding scientific practices and research. The success of twentieth-century biology, for instance, is largely attributable to presupposing that complex biological processes are reducible to elementary components. However, some biologists have challenged the sufficiency of reductionism for investigating complex biological phenomena and have proposed alternative presuppositions like organicism. In this article, contemporary cancer research is used as a case study to explore the importance of metaphysical presuppositions for guiding research. The predominant paradigm directing cancer (...) research is the somatic mutation theory, in which mutated genes are presumed to be ultimately responsible for explaining carcinogenesis. This reductionistic approach to cancer has been criticised recently, and an organistic approach has been proposed. The article concludes with a discussion of the reciprocal interaction of metaphysical presuppositions and scientific practices for investigating cancer's complex nature. (shrink)