Pan-Africanism and African-American Liberation in a Postmodern World: A Review Essay

This review essay explores Josiah Young's project of developing a liberatory Pan-Africanism that is attuned to cultural diversity and Victor Anderson's advocacy of postmodern cultural criticism in African-American religious thought. After situating African-American religious thought as a branch of Africana thought, the author examines these two religious thinkers' work as an effort to forge a position on African-American religious thought—including its relation to theology—in an age where even theory is treated as a god that is about to die. At the conclusion, secularism emerges as a religious project that normatively undergirds the methodological dimensions of these works.     

Narrative Medicine and Healthcare Reform

Narrative medicine is one of medicine's most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context.     

Assessing hopelessness in terminally ill cancer patients: development of the Hopelessness Assessment in Illness Questionnaire

Hopelessness has become an increasingly important construct in palliative care research, yet concerns exist regarding the utility of existing measures when applied to patients with a terminal illness. This article describes a series of studies focused on the exploration, development, and analysis of a measure of hopelessness specifically intended for use with terminally ill cancer patients. The 1st stage of measure development involved interviews with 13 palliative care experts and 30 terminally ill patients. Qualitative analysis of the patient interviews culminated in the development of a set of potential questionnaire items. In the 2nd study phase, we evaluated these preliminary items with a sample of 314 participants, using item response theory and classical test theory to identify optimal items and response format. These analyses generated an 8-item measure that we tested in a final study phase, using a 3rd sample (n = 228) to assess reliability and concurrent validity. These analyses demonstrated strong support for the Hopelessness Assessment in Illness Questionnaire providing greater explanatory power than existing measures of hopelessness and found little evidence that this assessment was confounded by illness-related variables (e.g., prognosis). In summary, these 3 studies suggest that this brief measure of hopelessness is particularly useful for palliative care settings. Further research is needed to assess the applicability of the measure to other populations and contexts.     

Can We Make Assumptions About the Psychosocial Impact of Living as a Carrier,Based on Studies Assessing the Effects of Carrier Testing?

Receiving the results of genetic carrier testing may have an impact on the psychosocial health of the individual. Numerous studies have been conducted to assess the psychosocial effects of carrier status for a range of conditions. To systematically review research focused on the psychological and social impact of carrier testing on individuals in order to identify factors affecting the impact of carrier testing results, and discern areas where further research is needed. Twenty relevant papers meeting criteria for inclusion in this review were found. The main themes identified across these studies included: anxiety, guilt and stigmatization, effect on family relationships, effect on self image, active coping mechanisms and reproductive issues. Variables related to the psychosocial effect of carrier testing included whether the carrier has an affected child, mode of inheritance, genetic counseling, and life stage. A key finding concerns carriers who already have an affected child; they are more likely to experience guilt and self-blame, and change their reproductive plans compared to carriers without affected children. Additionally, some participants reported clinical features of the disorder for which they were being tested. Genetic counselors may erroneously assume that parents with affected children are aware of their own carrier status in the absence of testing, and they may offer inadequate support. Additionally, counselors should attempt to address patient misconceptions related to their health and carrier status.