Effect of tropical forest disturbance on the competitive interactions within a diverse ant community.

Understanding how anthropogenic disturbance influences patterns of community composition and the reinforcing interactive processes that structure communities is important to mitigate threats to biodiversity. Competition is considered a primary reinforcing process, yet little is known concerning disturbance effects on competitive interaction networks. We examined how differences in ant community composition between undisturbed and disturbed Bornean rainforest, is potentially reflected by changes in competitive interactions over a food resource. Comparing 10 primary forest sites to 10 in selectively-logged forest, we found higher genus richness and diversity in the primary forest, with 18.5% and 13.0% of genera endemic to primary and logged respectively. From 180 hours of filming bait cards, we assessed ant-ant interactions, finding that despite considered aggression over food sources, the majority of ant interactions were neutral. Proportion of competitive interactions at bait cards did not differ between forest type, however, the rate and per capita number of competitive interactions was significantly lower in logged forest. Furthermore, the majority of genera showed large changes in aggression-score with often inverse relationships to their occupancy rank. This provides evidence of a shuffled competitive network, and these unexpected changes in aggressive relationships could be considered a type of competitive network re-wiring after disturbance.

Relationship vulnerabilities during breast cancer: patient and partner perspectives.

OBJECTIVE: Close interpersonal relationships play a crucial role in a woman's adjustment to breast cancer. To date, the literature has focused primarily on characteristics or behaviors of the well spouse that influence a woman's adaptation to the illness. The present qualitative investigation extended this literature by adopting an interactional perspective based on the underlying assumption that relationship partners' coping and distress is mutually influential. The focus of the analysis was patient and partner perceptions of relationship strife or tension over the course of the illness based on the notion that such interactions may be as or more harmful to relationships than supportive exchanges are helpful. METHOD: Nineteen women (at different stages of the illness) and eleven male spouses were interviewed about their experiences in relation to breast cancer. Nine of the men and nine of the women were relationship partners. Interview text was subjected to a thematic analysis and informed by grounded theory principles. RESULTS: Two higher-order categories of Personal Characteristics (both patient and partner) and Relationship Dynamics that impeded couple adjustment defined the overall theme of Relationship Vulnerabilities. CONCLUSIONS: Findings from this study are situated within a broader developmental framework wherein breast cancer is considered a catastrophic life event that challenges the assimilation and accommodation processes of both partners in the relationship. For couples that are able to overcome the relationship challenges associated with the illness, there is the potential for mutual growth, and a deepening and strengthening of the relationship. Implications for clinical practice are discussed.

Survivor dragon boating: a vehicle to reclaim and enhance life after treatment for breast cancer.

The authors investigated the psychosocial impact of dragon boat participation on women who have been treated for breast cancer. Open-ended qualitative interviews were completed by 10 new members recruited from two breast cancer survivor dragon boat teams. Our findings indicate that the women's experience of survivor dragon boating surpassed their expectations and offered them hope and increased strength and the ability to regain control of their lives. Key themes emerging from the in-depth interviews that encapsulate the experiences of women in their first season of dragon boating follow: awakening of the self, common bond, regaining control, being uplifted, and transcending the fear of death. The interview data support the emerging hypothesis that dragon boating is a vehicle for improving women's wellness and post-treatment quality of life.

Restoration of satisfying sex for a castrated cancer patient with complete impotence: a case study.

We present a first-hand account of a fully impotent, testosterone-suppressed prostate cancer patient who has satisfying, multiorgasmic sex using a strap-on dildo. We use his narrative to examine dildos as an alternative to erectile dysfunction treatments for men, such as this patient, who find selective inhibitors of PDE-5 ineffective and surgical intervention unacceptable. We explore what conditions allowed this man to progress from suspicious distrust of the dildo to full acceptance. In terms of making a dildo acceptable to other patients, we contrast offering it to them as a penile prosthesis in a formal medical setting versus treating it as a toy in fantasy sex play. Last, we present a neurobiological hypothesis involving sensory integration to help explain why sex with the strap-on dildo can be satisfying to a male.

'Nothing fit me': nationwide consultations with young women with breast cancer.

OBJECTIVE: There exists little research about the experience of breast cancer for young women in Canada. To address this gap, the Canadian Breast Cancer Network (CBCN) and the Ontario Breast Cancer Community Research Initiative undertook a research project to explore the information and support experiences, needs and recommendations of geographically diverse Canadian young women with breast cancer. SETTING AND PARTICIPANTS: We consulted with 65 young women in 10 focus groups held across Canada. All women had been diagnosed with breast cancer at, or before, 45 years of age. During the consultations the women were asked to discuss their information and support experiences and needs, as well as resource recommendations related to their diagnosis, treatment and survivorship. MAIN RESULTS: The overarching theme, 'Nothing Fit Me', revealed that accessed information, support and programmes/services did not 'fit' or match the women's age or life stage. When we asked for their recommendations the young women suggested that information and support match their age and life stage and that health-care providers create and implement several topical workshops concerning, for example, sexuality, lymphedema and reconstruction. CONCLUSION: The findings will be used by the CBCN as a general platform from which to conduct further research and/or action strategies. The CBCN will also implement the recommendations from this groundbreaking work as this network formulates a national strategy for young women with breast cancer.

The experiences of men receiving androgen deprivation treatment for prostate cancer: a qualitative study.

OBJECTIVE: This exploratory study was intended to investigate men's ways of integrating and understanding experiences with Androgen Deprivation Therapy (ADT), including how hormone treatment affected their sense of identity. PATIENTS AND METHODS: Twelve men, averaging 61 years of age and treated with ADT, participated in a single interview about their experiences with prostate cancer and hormone treatment. In keeping with a qualitative approach, questions were initially open-ended, with patients encouraged to describe experiences in their own words. RESULTS: Seven prominent themes appeared in the interviews: 1) starting on hormones, 2) matching expectations with reality, 3) tracking changes, 4) dealing with changes in sexuality, 5) navigating relationships, 6) putting things in context, and 7) interpreting gender-relevant changes. CONCLUSION: The effects of ADT on men with prostate cancer were varied and often substantial in their impact. Additionally, men often receive insufficient information to prepare them to deal with side effects. While the physiological situation of the men in our study could be described as "liminal" (i.e., straddled between two categories of gender), interview data showed that they refuse their liminality, claiming to be neither less masculine nor more feminine because of treatment. While men are grateful to receive potentially life-extending treatment, the challenge for the health care system is to provide them with the information and clinical support that will make their remaining years the best that they can be.

Travelling for radiation cancer treatment: patient satisfaction.

This study was conducted for the purpose of describing cancer patients' satisfaction with their care when they had to travel unexpectedly away from home for treatment. Ontario initiated a rereferral program for cancer patients who needed radiation therapy when the waiting lists in southern Ontario became lengthy. Patients travelled to the United States or northern Ontario for their care. A standardized survey containing 25 items with five-point Likert scale responses was mailed to all patients who participated in the rereferral program, following completion of their treatment. Items covered patient experiences before leaving home, in preparing for travel, and staying at the cancer facilities away from home. A total of 466 (55.8%) patients returned the survey. Overall, patients were satisfied with their care. However, there were a number of areas identified by patients where improvements could be made. These areas included access to support prior to leaving home, access to information about supportive care services while away from home, and sensitivity to personal needs in making arrangements for travel. Provision of information and support are important to cancer patients having to travel for cancer treatment.

Two Black men with prostate cancer: a narrative approach.

OBJECTIVES: This paper demonstrates the value of a narrative approach for health psychology. It focuses on the lives of two Black men with prostate cancer, drawn from a larger study investigating the links between masculinities and prostate cancer. DESIGN: The study was a qualitative, interview-based study. Each participant was interviewed four times. METHODS AND ANALYSIS: The men were asked to describe and discuss their prostate cancer experience, as well as their lives prior to illness. In order to gain a perspective on individual experiences of men with prostate cancer, we took a narrative approach to gathering and analysing data. Results are reported through two descriptive narratives. CONCLUSIONS: The narratives of the men described in the paper show how the interaction of race with health and illness is neither predictable nor consistent at the individual level. Black men, like all men with prostate cancer, have diverse experiences and are influenced by a wide array of personal and societal factors. While the high risk of prostate cancer among Black men makes proactive interventions advisable, such interventions will be most effective if the heterogeneity of men's experiences are taken into account.

Restoring sexual function in prostate cancer patients: an innovative approach.

It has been extremely difficult for men with prostate cancer to obtain reasonable estimates of the likelihood of remaining potent after first line therapy, partly because of differences in defining potency. If, as in more recent studies, the definition requires that men are usually (not just occasionally) able to get and sustain an erection, then the picture is not encouraging. Additional strategies are needed to help men sustain sexual activity. In this paper we draw on the experiences of a rather remarkable prostate cancer patient to help consider the possibilities for a different kind of intervention for men with ED--use of a strap-on dildo (an external prosthetic penis fastened by a harness around the hips). The dildo is a simple and inexpensive strategy for dealing with impotence and in certain circumstances it can work better than more established medical treatments for ED. Use of a dildo potentially removes the fear of erectile failure, allows for increased stimulation of the glans, facilitates full-body contact between partners, and offers potential satisfaction to one's partner. Urologists (and other health professionals) are encouraged to explore dildos as an option during discussions with patients about sexual rehabilitation. The potential benefits are discussed of specialty sexuality clinics that facilitate introduction of innovative approaches like dildos.

A consultation with Canadian rural women with breast cancer.

OBJECTIVE: Relatively little research has been carried out on the health and supportive care needs of rural women living with breast cancer. In this study, results from a Canadian focus group study are used to highlight issues of importance to rural women. SETTING AND PARTICIPANTS: A total of 276 rural women with breast cancer divided into 17 focus groups participated in the study conducted across Canada. A standardized protocol for discussion was employed. Issues of access to information, support and services were discussed, with women describing their experiences in trying to find appropriate programmes and services. MAIN RESULTS: The major theme identified through analysis of qualitative data was 'becoming aware of and/or gaining access to health care information, support and services.' Other major themes included: (1) dealing with isolation; (2) having to travel; (3) feeling the financial burden and (4) coping with changing work. CONCLUSIONS: Rural women with breast cancer have supportive care challenges related to their circumstances. A series of recommendations were generated through the consultation process which are contributing to the development of a national strategy focusing on the development and extension of programmes for rural women with breast cancer. Although the research on the project was not to specified standards, and suffered from less attention than community capacity building and advocacy, it proved to be of worth and revealed potential benefits from collaborations between researchers and community organizations.

Travelling for radiation cancer treatment: patient perspectives.

Radiation treatment for cancer requires patients to receive frequent administrations and attend the treatment facility on a daily basis for several weeks. Travelling for radiation treatment has the potential to add to the distress an individual may be feeling. This study utilized in-depth interviews to capture 118 patients' perspectives about travelling for cancer treatment. Four themes emerged during the analysis of the data: (1) waiting was the most difficult part of the experience; (2) the idea of travelling for treatment was distressing; (3) travelling for treatment was tiring and posed difficulties for patients; and (4) being away from home had both benefits and drawbacks. Given the inevitability of travelling for radiation treatment, and the issues that arises for patients, supportive strategies need to be designed and implemented.

Utilization of complementary/alternative services by women with breast cancer.

This paper reports on the utilization of complementary/alternative medicine (CAM) services by women with breast cancer. Study participants were women with invasive breast cancer diagnosed 23-36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 20% of respondents used at least 1 CAM service. Among those who responded to a question about whether they would have liked specific services, 39% reported that there was at least one CAM service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Study results speak to the importance of acknowledging that professionals outside of the formal cancer care system play an important role for many patients. Patients would welcome experimentation with service models in which CAM practitioners and cancer specialists collaborate in providing care.

Reactions of health professionals to a research-based theatre production.

BACKGROUND: There is a recent trend in the social sciences--predominantly among researchers engaged with qualitative methodologies--to translate research finding into artistic and narrative forms. In this paper, we describe our work in translating finding about the experiences of men with prostate cancer and their spouses into a dramatic production, No Big Deal? We then report upon, and provide commentary about data from interviews with health professionals who attended a performance. METHODS: Health professionals (N = 26) were interviewed within 2 weeks of attending a performance of No Big Deal? and again 6 months later (N = 23). RESULTS: After attendance at the performance, many study participants reported (at both interview times): new awareness or understanding about the issues facing prostate cancer patients; reinforcements of their positive attitudes and behaviors in relation to patients; an increased sense of connection with ill people; and plans to alter their clinical practices to better meet patient needs. CONCLUSIONS: Narrative and dramatic forms are viable ways to communicate vital information about the possibilities for professionals to be helpful to patients--and they are the wave of the future for educational and dissemination practices.

Supportive care provided by physicians and nurses to women with breast cancer. Results from a population-based survey.

Breast cancer patients' utilisation of supportive care has been understudied. In this paper, results from a population-based survey are used to assess the role of physicians and nurses in providing supportive care to women. Participants for this study were women with histologically confirmed invasive breast cancer diagnosed 23-36 months prior to contact about the study, who were randomly selected from the Ontario Cancer Registry. Patients for whom a physician approved contact were sent a survey questionnaire. There were two follow-up mailings. The survey included items related to patients' perceptions of supportive care involvement of oncologists, surgeons, family physicians and nurses. Among 1,119 eligible patients, 65% returned completed questionnaires. A total of 72% of these women reported having talked with an oncologist about one or more supportive care issues; 78% with a surgeon; 73% with a family physician; and 45% with a nurse. Factors linked to seeking supportive care from physicians and/or nurses included: younger age, working status, higher education, additional health insurance beyond that provided by government, higher household income, and receiving chemotherapy. Results indicate that physicians and nurses were providing important supportive care to most women with breast cancer. In a health care context where specialised supportive care services (e.g. help from dietitians, psychologists, social workers) are often unavailable or difficult to access, supportive care remains largely a responsibility of medical and nursing professionals. Even brief interventions may make an important difference to how patients deal with their illness over time.

Women's experiences with ovarian cancer: reflections on being diagnosed.

The purpose of this qualitative study was to describe the perspectives of women living with ovarian cancer about their experiences with diagnosis, treatment, and follow-up care. A convenience sample of 18 women was interviewed using an open-ended interview guide. This paper will focus on their perspectives during the peri-diagnostic period. Most of the women in this study experienced changes in their bodies--bloating, weight gain around their middles, indigestion, bowel changes, and abdominal pain. The vagueness of the symptoms and lack of awareness by the women and, in the women's opinion, health care professionals caused delays in diagnosis and initial investigations of other body systems. The symptoms were often dismissed by the women as being related to normal body changes such as childbirth, menopause, or stress responses. It was often not until the women's symptoms became severe or included pain that referrals were made to relevant specialists. At this point, many of the women were physically and emotionally spent, leaving them vulnerable and in a weakened state for confronting the diagnosis and coping with the difficult course of treatment. Clearly, the subtle, nebulous nature of the symptoms confounded the diagnosis of ovarian cancer for these women, resulting in patient delays and physician delays.

Active consideration: conceptualizing patient-provided support for spouse caregivers in the context of prostate cancer.

In this study, the authors examine the under-investigated topic of patient-provided support for spouse caregivers. Thirty-four men with prostate cancer and their female partners were interviewed separately three times: before the man's radical prostatectomy, 8 to 10 weeks postsurgery, and 1 year postsurgery. The core category of active consideration encompassed 4 dimensions: easing spousal burden, keeping us up, maintaining connection, and considering spouse. Patient-provided support entails two overlapping tasks: minimizing the practical and emotional impact of the illness and tending to the caregiver's social-emotional needs. A theory expounding on the double bind of being both a patient and an agent in light of masculine socialization practices is articulated and brought to bear on the phenomenon of patient-provided support.

Sexual dysfunction and the preservation of manhood: experiences of men with prostate cancer.

This study explored the experiences of men living with sexual dysfunction as a consequence of having been treated for prostate cancer. An ethnoculturally diverse sample of 18 men (14 heterosexual, and four homosexual) participated in a series of four to five in-depth interviews. These one-on-one interviews were designed to elicit information pertaining to their beliefs, values and performances regarding masculinity vis-a-vis prostate cancer and its treatment. Interview transcripts were analyzed using the grounded theory method. The core category of 'Preserving Manhood' incorporated five major themes: enhancing the odds; disrupting a core performance; baring an invisible stigma; effortful-mechanical sex; and working around the loss. We conclude that men's performances of sexuality and masculinity were highly interwoven; that loss of sexual functioning constituted a focal disruption for participants; and in some instances, posed a significant threat to their masculine identities.

Challenges of participatory research: reflections on a study with breast cancer self-help groups.

OBJECTIVE: To review and discuss issues related to participatory research, as they apply within the arena of cancer control. DESIGN: A participatory research study with breast cancer self-help groups is referred to for description and discussion purposes. That study employed primarily individual and group interviews to assess benefits and limitations of self-help groups. SETTINGS: Four breast cancer self-help groups in Ontario communities provided the core involvement in the participatory research project. RESULTS: The values and practices of mainstream academic research often conflict with those of research emphasizing participation and control of communities under study, leading to a variety of challenges for the latter approaches. Practical constraints faced by many community groups have important implications for participatory research approaches. CONCLUSIONS: A balance needs to be found for participatory research within cancer control - one that ensures that the core aims of participatory research are maintained, while simultaneously acknowledging the various challenges that make a fully participatory project unrealistic. Steps can be taken to achieve a workable balance.

Canadian family physicians and prostate cancer: a national survey.

A sample of family physicians was randomly selected from the membership database of the College of Family Physicians of Canada (CFPC). Potential respondents were mailed a survey questionnaire, and a modified Dillman approach was utilized. A total of 964 completed questionnaires were received, providing a response rate of 50.1%. Although most family physicians were aware of many basic facts about prostate cancer, there were knowledge limitations related to risk factors, relative frequency of the disease (to other cancers), and selected aspects of PSA effectiveness. There was considerable variation in perceived effectiveness of early detection methods, with most physicians taking a conservative approach to PSA utilization. Most family physicians indicated that they have an important role to play in the care of men after they have been diagnosed with prostate cancer. They also expressed a high level of interest in obtaining additional information related to prostate cancer.

Prostate cancer patients' satisfaction with medical information.

A convenience sample of 965 Canadian men with prostate cancer were surveyed about their experience with, and opinions about, prostate cancer illness and treatment. Questionnaires were distributed by urologists, physicians at selected cancer treatment centers, and prostate cancer self-help groups. In this paper, we report on issues related to men's satisfaction with medical information. Most respondents were satisfied with information received, although there was a substantive subsample of dissatisfied men, and indications that many men did not understand information they received. Higher satisfactions with medical information was associated with age over 70 years, nonattendance at support or educational groups, higher educational level, and high satisfaction with urologists' communication style. Men experiencing significant adverse quality of life effects from cancer treatment were more dissatisfied with information. Satisfaction with medical information was also positively associated with satisfaction with information across the domain of supportive care, suggesting the value of a broad-based approach to information that includes contributions from self-help and community groups, as well as supportive care professionals.