Respecting the autonomy of cancer patients when talking with their families: qualitative analysis of semistructured interviews with patients.

OBJECTIVE: To discover cancer patients'' views about disclosure of information to their family, their family''s influence over the information given them, and their preferences for doctors'' behaviour if they and their family disagree, as a complement to applied ethical theory. DESIGN: Semistructured interviews followed by qualitative content analysis. SETTING: Mainly urban British general practice. SUBJECTS: 30 patients in whom cancer, excluding basal and squamous cell skin carcinomas, was diagnosed 1-7 years earlier. RESULTS: All subjects wished doctors to respect their views rather than those of their family, should they differ. With their consent, subjects favoured close family receiving information about their illness, all but one mentioning advantage to their family. Without such consent, six unconditionally favoured disclosure of information to their family while seven unconditionally opposed disclosure. Seventeen participants restricted their approval for such disclosure to specific circumstances. Only two participants approved of their family influencing the information that they received about their illness; all but seven wished to receive full information, the exceptions relating to information about bad prognosis. CONCLUSIONS: Subjects favoured openness with their family but most rejected unconditional disclosure of information without their consent and their family influencing what information they would be given. They valued respect for their autonomy more highly than beneficence and considered that their own needs took priority over those of their family.     

Picking battles wisely: plant behaviour under competition

Plants are limited in their ability to choose their neighbours, but they are able to orchestrate a wide spectrum of rational competitive behaviours that increase their prospects to prevail under various ecological settings. Through the perception of neighbours, plants are able to anticipate probable competitive interactions and modify their competitive behaviours to maximize their long-term gains. Specifically, plants can minimize competitive encounters by avoiding their neighbours; maximize their competitive effects by aggressively confronting their neighbours; or tolerate the competitive effects of their neighbours. However, the adaptive values of these non-mutually exclusive options are expected to depend strongly on the plants' evolutionary background and to change dynamically according to their past development, and relative sizes and vigour. Additionally, the magnitude of competitive responsiveness is expected to be positively correlated with the reliability of the environmental information regarding the expected competitive interactions and the expected time left for further plastic modifications. Concurrent competition over external and internal resources and morphogenetic signals may enable some plants to increase their efficiency and external competitive performance by discriminately allocating limited resources to their more promising organs at the expense of failing or less successful organs.     

一品红试管苗移栽驯化期叶片的解剖结构变化

对一品红试管苗移栽驯化,同时研究了驯化过程中叶片结构的变化,结果表明,一品红在珍珠岩基质中成活率达98%,随着移栽时间的延长,表皮细胞增大,排列紧密;叶肉细胞间隙减小,栅栏组织细胞长度增加,主脉增厚,导管数目增加,保水,输水和抗逆能力增强。     

AIDS and the general practitioner: views of patients with HIV infection and AIDS.

An unselected series of outpatients infected with the human immunodeficiency virus (HIV) who attended two London hospitals were interviewed to assess their relationship with their general practitioner. Although most of the 192 patients were registered with a general practitioner, the doctors of only one half knew of the diagnosis. Patients feared a negative reaction from their general practitioner or were concerned about confidentiality. Although those who had told their doctor had received favourable reactions, few general practitioners attempted to counsel or educate their patients. The patients who previously had been open about their homosexuality were not more likely to have told their general practitioner of their HIV infection. Although most did not think that general practitioners were well informed about AIDS, half of the patients wished that general practitioners could take a bigger part in their care.     

My Child Redeems My Broken Dreams: On Parents Transferring Their Unfulfilled Ambitions onto Their Child

From the early days of psychology, theorists have observed that parents sometimes transfer their own unfulfilled ambitions onto their child. We propose that parents are especially inclined to do so when they see their child as part of themselves, more so than as a separate individual. When parents see their child as part of themselves, their child’s achievements may easily come to function as a surrogate for parents’ own unfulfilled ambitions. In the present experiment, 73 parents (89% women, M _age = 43 years) were randomly assigned to reflect on either their own or others’ unfulfilled ambitions. Results showed that, when faced with their own unfulfilled ambitions, parents who see their child as part of themselves want their child to fulfill their unfulfilled ambitions. This study provides the first experimental evidence to suggest that parents may desire their child to redeem their broken dreams.     

Professional and personal attitudes about access and confidentiality in the genetic testing of children: a pilot study

The ability to perform predictive genetic testing of children raises ethical concerns regarding whether and when to test and the disclosure of results. Semi-structured interviews with a convenience sample of pediatricians (12) and geneticists (13) were conducted to see how they would react to parental requests for predictive genetic testing of their children, and their attitudes about testing their own children. We also asked about disclosure attitudes and practices for their patients' relatives and within their own families. Respondents would provide predictive genetic testing for most conditions, yet were less likely to seek this information about their own children. Respondents believed it was very important for patients to share some types of genetic information with relatives, and were directive in their counseling about intrafamilial disclosure, especially within their own families. Although respondents would almost never breach patient confidentiality, many would breach confidentiality within their own families. Health care professionals distinguish between their professional and personal roles with regard to issues of access and confidentiality in predictive testing of children. They are willing to provide greater access and more confidentiality for their patients than within their own families.     

Function and structure of inherently disordered proteins

The application of bioinformatics methodologies to proteins inherently lacking 3D structure has brought increased attention to these macromolecules. Here topics concerning these proteins are discussed, including their prediction from amino acid sequence, their enrichment in eukaryotes compared to prokaryotes, their more rapid evolution compared to structured proteins, their organization into specific groups, their structural preferences, their half-lives in cells, their contributions to signaling diversity (via high contents of multiple-partner binding sites, post-translational modifications, and alternative splicing), their distinct functional repertoire compared to that of structured proteins, and their involvement in diseases.     

The Color of My Skin: A Measure to Assess Children's Perceptions of Their Skin Color

The Color of My Skin is an instrument developed to assess children's internalized idea (abstraction) of the color of their skin; their satisfaction with that color; the desire, if any, to change the color of their skin; and their affect regarding their skin color. The assessment is part of a questionnaire utilized in a 3-year longitudinal study that examines psychosocial development, physical health, and behavioral adjustment of Puerto Rican children (N = 257) reared in the Greater Boston area. The results demonstrate that children's internalized representation of their skin color is a construct that can be reliably and validly measured. The children's ratings of their skin color were not associated with their sex, school grade, ethnic identity, the child's or the parent's nativity, or the racial or ethnic compositions of 3 social contexts: their neighborhood, their classmates, and their closest friends. Puerto Rican children did not show a preference for light-colored skin. Moreover, there were no significant differences in self-esteem based on the child's self-reported skin color. The lack of association between self-esteem and skin color was interpreted in light of a developmental tendency prevalent in early to middle childhood to place a positive value on different aspects of one's self. Whereas almost all children (96%) reported being happy or very happy with their color, 16% of the children would like to change their skin color if they could (51% to a lighter and 46% to a darker color).     

Glycosyltransferases: managers of small molecules

Studies of the glycosyltransferases (GTs) of small molecules have greatly increased in recent years as new approaches have been used to identify their genes and characterize their catalytic activities. These enzymes recognize diverse acceptors, including plant metabolites, phytotoxins and xenobiotics. Glycosylation alters the hydrophilicity of the acceptors, their stability and chemical properties, their subcellular localisation and often their bioactivity. Considerable progress has been made in understanding the role of GTs in the plant and the utility of GTs as biocatalysts, the latter arising from their regio- and enantioselectivity and their ability to recognize substrates that are not limited to plant metabolites.     

The pollution of incontinence and the dirty work of caregiving in a U.S. nursing home

In U.S. nursing homes, it is the job of nursing assistants to tend to residents' basic bodily needs, including elimination and incontinence care. Given their frequent contact with pollutants, aides are very much at risk of becoming "polluted people." In this article, I investigate how nursing assistants' continual contact with contaminating substances impacts their status within the workplace, their relationships with others, and their attitudes toward their work and themselves as workers. I also explore how aides manage their encounters with pollutants and their stigmatized role as "dirty workers." In doing so, I hope to explicate the meaning of elimination and of incontinence caregiving in the United States.     

Role-Reversed Nepotism Among Cubs and Sires in the Spotted Hyena (Crocuta crocuta)

Nepotism is widespread among parents and offspring, and is typically associated with fundamental asymmetries; parents can usually do more to help their offspring than vice versa, and the cost of a given nepotistic behavior is usually less for parents than for offspring. This may not be so among spotted hyenas (Crocuta crocuta); sires never achieve social rank equal to that of their cubs, to whom they provide no obvious paternal care. Nepotism by sires towards their cubs is thus socially constrained. However, the higher social status of cubs might offset cubs’ developmental disadvantages and permit nepotistic treatment of sires by offspring. We therefore sought to determine whether the interactions among spotted hyena cubs and adult males were influenced by kinship, using long‐term observations from one clan of spotted hyenas. Sires exhibited no overt nepotism towards their cubs in most behaviors, but they did associate more closely with their daughters than with unrelated control females. Sires also associated more closely with their daughters than with their sons, with whom they associated no more closely than they did with unrelated control males. Cubs favored their sires by directing less intense aggression towards them than towards unrelated control males. Cubs of both sexes also associated more closely with their sires than with control males after the cubs were independent of the clan's communal den. Although sires evidently recognize their offspring, paternal nepotism by sires towards their cubs is weaker than filial nepotism by cubs towards their sires. The small size and immaturity of cubs thus appear to be weaker constraints on nepotism than is the low social status of their sires.     

The effects of partner togetherness on salivary testosterone in women in long distance relationships

The present study examined whether women's testosterone levels are influenced by being with a sexual and romantic partner after a period of sexual abstinence. Women in long distance relationships (n = 15) provided five saliva samples: at least 1 week before seeing their partner (and at least 2 weeks since their last visit), the day before seeing their partner, when they were with their partner but prior to engaging in sexual activity, the day after their first sexual activity, and 3 days after they were separated from their partners. Salivary testosterone was lowest when participants had been away from their partners for at least 2 weeks and highest the day before they were to see their partners and the day after sexual activity. Results from this study indicated that women's testosterone increased both the day before they were with their partners and they day after they first engaged in sexual activity. However, something about initially reuniting with their partners returned their testosterone to baseline levels, which may be an effect of being in the same location as a partner, or just a state fluctuation due to nervousness or other psychological state.     

Fathers' Influence on Their Children's Cognitive and Emotional Development: From Toddlers to Pre-K

The Color of My Skin is an instrument developed to assess children's internalized idea (abstraction) of the color of their skin; their satisfaction with that color; the desire, if any, to change the color of their skin; and their affect regarding their skin color. The assessment is part of a questionnaire utilized in a 3-year longitudinal study that examines psychosocial development, physical health, and behavioral adjustment of Puerto Rican children (N = 257) reared in the Greater Boston area. The results demonstrate that children's internalized representation of their skin color is a construct that can be reliably and validly measured. The children's ratings of their skin color were not associated with their sex, school grade, ethnic identity, the child's or the parent's nativity, or the racial or ethnic compositions of 3 social contexts: their neighborhood, their classmates, and their closest friends. Puerto Rican children did not show a preference for light-colored skin. Moreover, there were no significant differences in self-esteem based on the child's self-reported skin color. The lack of association between self-esteem and skin color was interpreted in light of a developmental tendency prevalent in early to middle childhood to place a positive value on different aspects of one's self. Whereas almost all children (96%) reported being happy or very happy with their color, 16% of the children would like to change their skin color if they could (51% to a lighter and 46% to a darker color).     

Women's understanding of abnormal cervical smear test results: a qualitative interview study.

OBJECTIVE: To describe how women interpret their experiences of diagnosis and treatment of a cervical abnormality and how healthcare services for such women can be improved. DESIGN: Qualitative study using detailed individual interviews. SETTING: Australian gynaecology clinics. SUBJECTS: 29 Women who had a cervical cytological abnormality and who attended a gynaecologist. MAIN OUTCOME MEASURES: Women''s views on their diagnosis and their information needs. RESULTS: Most women wanted to participate in decisions about their care but found it difficult to get the information they required from doctors because they were confused by what their doctors told them and felt unable to ask questions in the consultation. Medical terms such as wart virus and precancer were difficult to understand. Not being able to see their cervix also made it hard for women to understand what their abnormality meant and what treatment entailed. Most women tried to make sense of their abnormality in the context of their everyday lives. For some women their gynaecological care was not consistent with the way they understood their abnormality. CONCLUSIONS: The inherent power structure of medical practice combined with time pressures often make it difficult for doctors to give the detailed information and reassurance patients need when a diagnosis is distressing or when investigation and treatment are strange and upsetting.     

When the Curtain Falls on a Fieldwork Project: The Last Chapter of a Gay Synagogue Study

Ethnographic texts preserve the historicity and losses of both the people observed and their observer. However, anthropologists rarely inform their readers about the circumstances of their departure from a fieldwork project. Without formally indicating the completion of their research goals, they usually move on to a new field and cease publishing on their former site. This procedure seemed natural enough when anthropologists conducted their studies in remote Third World locations. The constraints of distance, time, and budget made that abrupt separation seemingly inevitable and self-explanatory. But when anthropologists choose fieldwork sites that are close to home or easy to revisit, or conduct long-term research, their relationships with their subjects change radically, both during fieldwork and during the stages of writing and publishing the ethnographic text. Consequently, their eventual exit from the field involves a different process. Based on the experience of a fifteenyear engagement in the study of a gay synagogue in New York, this paper explores the latter process. The issue of exiting presents a methodological, emotional, and ethical problem meriting serious professional consideration.     

Can whole-drawer images measure up? A reply to Johnson et al. (2013)?

Johnson et al. (2013) found that morphometric measurements of dragonfly wings taken from actual specimens and measurements taken from whole-drawer images of those specimens were equally accurate. We do not believe that their conclusions are justified by their data and analysis. Our reasons are, first, that their study was constrained in ways that restrict the generalisability of their results, but second, and of far greater significance, their statistical approach was entirely unsuited to their data and their results misled them to erroneous conclusions. We offer an alternative analysis of their data as published. Our reanalysis demonstrates, contra Johnson et al., that measurements from scanned images are not a reliable substitute for direct measurement.     

Are mAbs different?

Apart from the nifty science behind their development, are monoclonal antibodies (mAbs) different than other new technologies? As highlighted by Cohen and Wilson in their interesting new paper, mAbs are distinctive from most traditional pharmaceuticals in some ways: their relatively high prices; their high costs of development; their mode of administration; the fact that, unlike many other drugs, they offer disease modification not simply symptomatic relief; the frequency of supplemental indications and off-label use – much of it recognized in drug compendia and reimbursable; and the lack of a clear pathway for their generic substitution.     

Contraceptive practice of Irish married and single first-time mothers

This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.     

Latitudinal shifts of introduced species: possible causes and implications

This study aims to document shifts in the latitudinal distributions of non-native species relative to their own native distributions and to discuss possible causes and implications of these shifts. We used published and newly compiled data on inter-continentally introduced birds, mammals and plants. We found strong correlations between the latitudinal distributions occupied by species in their native and exotic ranges. However, relatively more non-native species occur at latitudes higher than those in their native ranges, and fewer occur at latitudes lower than those in their native ranges. Only a small fraction of species examined (i.e. <20% of animals and <10% of plants) have expanded their distributions in their exotic range beyond both high- and low-limits of their native latitudes. Birds, mammals and plants tended to shift their exotic ranges in similar ways. In addition, most non-native species (65–85% in different groups) have not reached the distributional extent observed in their native ranges. The possible drivers of latitudinal shifts in the exotic range may include climate change, greater biotic resistance at lower latitudes, historical limitations on ranges in native regions, and the impacts of humans on species distributions. The relatively restricted distribution of most species in their exotic range highlights the great potential of future spread of most introduced species and calls for closely monitoring their directional spread under climate change.     

Do second-generation Asian Americans face a systematic disadvantage in occupational attainment? Comment on Tran,Lee and Huang

ABSTRACT

We critically review and discuss several methodological problems with their analysis. Their definition of the occupational hierarchy is unclear, and their inadequate statistical models exacerbate the vagueness of their results. They ignore gender interactions, and the age range of their target population seems too narrow for their research concerns. Their interpretation of their own statistical findings on occupational attainment is fundamentally flawed although they refuse to acknowledge it. Their reported results cannot be replicated based on the information that they are willing to reveal about their analysis which suggests additional, undisclosed errors. In our reanalysis of their data using more appropriate methods, we find that rather than being systematically disadvantaged, the occupational attainment of most second-generation Asian Americans has either achieved parity with whites or has exceeded them after controlling for age, educational level, and survey year.