Adjusting to Life After Esophagectomy: The Experience of Survivors and Carers

Following surgery for esophageal cancer, patients can experience complex physical, social, and emotional changes. Investigation of these challenges, particularly from the perspective of the patient and his or her carer, has been limited. The current study explored the emotional and cognitive experiences of esophageal cancer survivors and those of their carers, using focus groups conducted with members of a patient support group. Analysis of the patients’ data yielded three themes: coping with a death sentence, adjusting to and accepting an altered self, and the unique benefits of peer support. Analysis of the carers’ data also yielded three themes: the carer as buffer, representations of recovery and recurrence, and normalizing experiences through peer support. Esophageal cancer patients and their carers require holistic support in their efforts to adjust to the social, emotional, and physical consequences of esophagectomy. Peers could be an effective channel for the support of patients and carers.

The experience of cancer cachexia: A qualitative study of advanced cancer patients and their family members

Background
Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective
The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design
An interpretative phenomenological approach was employed.

Setting and participants
A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method
Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results
Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions
Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.

The relationship between counterfactual thinking and emotional reactions to event outcomes: Does one account fit all?

By enabling a comparison between what is and what might have been, counterfactual thoughts amplify our emotional responses to bad outcomes. Well-known demonstrations such as the action effect (the tendency to attribute most regret to a character whose actions brought about a bad outcome) and the temporal order effect (the tendency to undo the last in a series of events leading up to a bad outcome) are often explained in this way. An important difference between these effects is that outcomes are due to decisions in the action effect, whereas in the temporal order effect outcomes are achieved by chance. In Experiment 1, we showed that imposing time pressure leads to a significant reduction in the action but not in the temporal order effect. In Experiment 2, we found that asking participants to evaluate the protagonists (

Social and Subcultural Capital among teenagers in Northern Ireland

This article makes a case for the inclusion of subcultural capital as an indictor of social capital networks in the lives of teenagers. It does so by critiquing approaches that assume that adult measures of social capital can be nonproblematically extended to account for stocks of social capital held by younger generations. To illustrate the fallacy of this approach, this article draws on data from the 2003 Northern Ireland Young Life and Times Survey (NIYLTS) and the indicators used to explore the relevance of social capital in the lives of teenagers. By ignoring concepts such as subcultural capital, surveys such as the NILYTS provide partial frameworks for understanding the complexities of young people's links to social capital networks and their inclusive and exclusive effects.

Informalilty in the Social and Culture Life in the City Centre of Nairobi

We live in a world of advanced technology, stiff global competition and rapid transformation of all facets of life and as a result architecture has not been spared. These transformations affect the social relations, cultural consumption and political economy that have influenced the manner in which people perform in and out of space in the city centres. The residents have adopted strategies for negotiating through the spaces sanitized by authorities and other agents. The public spaces provide the background materials for informal urban practices that are sometimes deemed illegal yet are necessary for animating the city spaces. Cities market themselves ecstatically beyond the baroque with a more visible presence of the contending parties through trademarks, public relations invasively advertised in streets, monuments (signature buildings or projects), and language. This paper comes out of a research carried out in Nairobi in February and March 2007. It examined how the notions of globalisation are reflected in the life in the city centre; the impacts on the quality of life of users of the city centre and how informal urbanism has developed as copying strategy to deal with the transformations due to liberalization and globalization.

Transaction Costs and Organizational Learning in Strategic Oursourcing Relationships

The present paper examines the role of organisational learning and transaction costs economics in strategic outsourcing decisions. Interorganisational learning is critical to competitive success, and organisations often learn more effectively by collaborating with other organisations. However, learning processes may also complicate the process of forming interorganisational partnerships which may increase transaction costs. Based on the literature, the authors develop refutable implications for outsourcing supply chain logistics and a sample of 121 firms in the supply chain logistics industry is used to test the hypotheses. The results show that trust and transaction costs are significant and substantial drivers of strategic outsourcing of supply chain logistics (a strategic flexibility action). Learning intent and knowledge acquisition have no significant influence on the decision to outsource supply chain logistics. The paper concludes with a discussion of the different and often conflicting implications for managing interorganisational learning processes.