How can a realistic ethical imagination about the future of a technology take shape? This article contains a reflection which is based on the experiences of an embedded ethicist in the context of biophysical research conducive to the development of photoacoustic mammography, which is intended for the non-invasive detection of breast cancer. Imagination in this context already informs the activities of the biophysical researchers, but its role is limited: biophysical future scenarios concentrate on the technological advances that photoacoustics could bring about. In this article it is argued that it is advisable to also consider the medical practice and the ways in which this practice is likely to change as an effect of the introduction of photoacoustic mammography into it. On the basis of this more encompassing imaginative endeavor it is possible to get a clearer idea about how new technologies are able to contribute to human well being, which is informative for the setting of research-goals/priorities and a responsible implementation of new technologies into the world. 相似文献
Objectives: Weight cycling is linked with advanced breast cancer diagnosis, increased risk of cancer reoccurrence and cancer-related mortality. While women treated for breast cancer report challenges with navigating their post-treatment body shape and weight, the effects of weight cycling on body image and mental health have not been elucidated. This study examined associations between weight changes and weight cycling on psychological health (i.e. weight-related guilt, shame and depressive symptoms) among women in the first-year post-treatment.
Design and Outcome Measures: Self-reported assessments of pre-cancer weight cycling, post-treatment weight-related guilt, shame and depressive symptoms, and objective assessments of weight were assessed in a longitudinal sample of 173 women treated for breast cancer (Mage = 55.01 ± 10.96 years).
Results: Based on findings from multilevel models, women experienced the most weight-related shame when their weight was heavier than their personal average. Additionally, heavier weight was associated with worse psychological health, particularly for women with a history of stable (vs. cycling) weight pre-cancer.
Conclusions: Weight cycling pre-cancer and post-treatment weight change have important implications for psychological well-being. Due to the potential psychological consequences associated with a history of weight cycling, targeted strategies are needed to improve overall health outcomes for women’s survivorship after breast cancer. 相似文献
Hereditary breast cancer (HBC) accounts for 5–10% of breast cancer cases and it significantly increases the lifetime risk
of cancer. Our objective was to evaluate the sociodemographic variables, family history of cancer, breast cancer (BC) screening
practices and the risk profile of cancer affected or asymptomatic at-risk women that undergo genetic counseling for hereditary
breast cancer in public Brazilian cancer genetics services. Estimated lifetime risk of BC was calculated for asymptomatic
women using the Gail and Claus models. The majority of women showed a moderate lifetime risk of developing BC, with an average
risk of 19.7% and 19.9% by the Gail and Claus models, respectively. The average prior probability of carrying a BRCA1/2 gene mutation was 16.7% and overall only 32% fulfilled criteria for a hereditary breast cancer syndrome as assessed by family
history. We conclude that a significant number of individuals at high-risk for HBC syndromes may not have access to the benefits
of cancer genetic counseling in these centers. Contributing factors may include insufficient training of healthcare professionals,
disinformation of cancer patients; difficult access to genetic testing and/or resistance in seeking such services. The identification
and understanding of these barriers is essential to develop specific strategies to effectively achieve cancer risk reduction
in this and other countries were clinical cancer genetics is not yet fully established. 相似文献
Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic
growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD
symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another.
Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated
with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater
PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should
be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes. 相似文献
Utilization of cancer genetic risk assessment can be profoundly influenced by an individuals’ knowledge of risk assessment,
attitudes regarding illness and healthcare, and affective reactions derived from social norms. Race and ethnicity play a powerful
role in the development of an individual's attitudes and should be considered when attempting to understand a person's openness
to cancer genetic risk assessment (Lannin et al., 1998). Until recently, however, cancer screening and prevention programs have been primarily based on data from studies
conducted with the Caucasian population, yielding data that are not fully applicable to the African American community. In
the last several years, research findings regarding African American's knowledge, attitudes, and feelings about genetic counseling
and testing have grown (Matthews et al., 2000; Singer et al., 2004; Thompson et al., 2003). However, to the authors’ knowledge, these data have yet to be presented in a manner that both summarizes the barriers
that African Americans have reported regarding cancer genetic risk assessment, while at the same time suggesting methods individual
genetic counselors can utilize during community presentations to help address these barriers. This article will first summarize
previous empirical findings regarding African Americans’ knowledge, attitudes, and feelings about cancer genetic risk assessment.
The article will then apply adult learning theory to those findings to provide genetic counselors with practical, theory based
techniques to apply toward community based educational programs with African American groups. 相似文献