Theory of uncertainty in illness in patients with cancer of unknown primary origin: Structure providers as antecedents of uncertainty in a population of cancer patients with an unknown primary diagnosis

Uncertainty has been found to be a major component of the cancer experience and can dramatically affect psychosocial adaptation and outcomes of a patient's disease state (McCormick, 2002). Patients with a diagnosis of Carcinoma of Unknown Primary (CUP) may experience higher levels of uncertainty due to the unpredictability of current and future symptoms, limited treatment options and an undetermined life expectancy. To date, only one study has touched upon uncertainty and its' effects on those with CUP but no information exists concerning the effects of uncertainty regarding diagnosis and treatment on the distress level and psychosocial adjustment of this population (Parker & Lenzi, 2003). ^ Mishel's Uncertainty in Illness Theory (1984) proposes that uncertainty is preceded by three variables, one of which being Structure Providers. Structure Providers include credible authority, the degree of trust and confidence the patient has with their doctor, education and social support. It was the goal of this study to examine the relationship between uncertainty and Structure Providers to support the following hypotheses: (1) There will be a negative association between credible authority and uncertainty, (2) There will be a negative association between education level and uncertainty, and (3) There will be a negative association between social support and uncertainty. ^ This cross-sectional analysis utilized data from 219 patients following their initial consultation with their oncologist. Data included the Mishel Uncertainty in Illness Scale (MUIS) which was used to determine patients' uncertainty levels, the Medical Outcomes Study-Social Support Scale (MOSS-SSS) to assess patients, levels of social support, the Patient Satisfaction Questionnaire (PSQ-18) and the Cancer Diagnostic Interview Scale (CDIS) to measure credible authority and general demographic information to assess age, education, marital status and ethnicity. ^ In this study we found that uncertainty levels were generally higher in this sample as compared to other types of cancer populations. And while our results seemed to support most of our hypothesis, we were only able to show significant associations between two. The analyses indicated that credible authority measured by both the CDIS and the PSQ was a significant predictor of uncertainty as was social support measured by the MOSS-SS. Education has shown to have an inconsistent pattern of effect in relation to uncertainty and in the current study there was not enough data to significantly support our hypothesis. ^ The results of this study generally support Mishel's Theory of Uncertainty in Illness and highlight the importance of taking into consideration patients, psychosocial factors as well as employing proper communication practices between physicians and their patients.^

Production under uncertainty and choice under uncertainty in the emergence of generalized expected utility theory

This paper presents a personal view of the interaction between the analysis of choice under uncertainty and the analysis of production under uncertainty. Interest in the foundations of the theory of choice under uncertainty was stimulated by applications of expected utility theory such as the Sandmo model of production under uncertainty. This interest led to the development of generalized models including rank-dependent expected utility theory. In turn, the development of generalized expected utility models raised the question of whether such models could be used in the analysis of applied problems such as those involving production under uncertainty. Finally, the revival of the state-contingent approach led to the recognition of a fundamental duality between choice problems and production problems.

Uncertainty in a mixed duopoly with quadratic costs

In this paper, we consider a mixed market with uncertain demand, involving one private firm and one public firm with quadratic costs. The model is a two-stage game in which players choose to make their output decisions either in stage 1 or stage 2. We assume that the demand is unknown until the end of the first stage. We compute the output levels at equilibrium in each possible role. We also determine ex-ante and ex-post firms’ payoff functions.

Mitigating uncertainty in logistics outsourcing with ERP systems

Outsourcing is a common strategy for companies looking for cost savings and improvements in performance. This has been especially prevalent in logistics, where warehousing and transporting are typical targets for outsourcing. However, while the benefits from logistics outsourcing are clear on paper, there are several cases companies fail to reach these benefits. The most commonly cited reasons for this are poor information flow between the company and the third party logistics partner, and a lack of integration between the two partners. Uncertainty stems from lack of information, and it can cripple the whole outsourcing operation. This is where enterprise resource planning (ERP) systems step in, as they can have a significant role in improving the flow of information, and integration, which consequently mitigates uncertainty. The purpose of the study is to examine if ERP systems have an effect on a company's decision to outsource logistics operations. Along the rapid advancements in technology during the past decades, ERP systems have also evolved. Therefore, empirical research on the subject needs constant revision as it can quickly become outdated due to ERP systems having more advanced capabilities every year. The research was conducted using a qualitative single-case study of a Finnish manufacturing firm that had outsourced warehousing and transportation operations in the Swedish market. The empirical data was gathered with use of semi-structured interviews with three employees from the case company that were closely related to the outsourcing operation. The theoretical framework that was used to analyze the empirical data was based on Transaction Cost Economics theory. The results of the study were align with the theoretical framework, in that the ERP system of the case company was seen as an enabler for their logistics outsourcing operation. However, the full theoretical benefits from ERP systems concerning extended enterprise functionality and flexibility were not attained due to the case company having an older version of their ERP system. This emphasizes the importance of having up-to-date technology if you want to overcome the shortcomings of ERP systems in outsourcing situations.

Encountering the suffering other in illness narratives : between the memory of suffering and the suffering memory

Cette étude porte sur la dimension intersubjective de la souffrance qui affecte le rapport du souffrant à son corps, au temps et à l’espace vécus de même que son identité narrative et sa mémoire narrative. Mon argument principal est que la voix narrative constitue le rapport intersubjectif dans les récits de maladie que les proches écrivent sur leurs partenaires souffrant de cancer de cerveau ou de la maladie d’Alzheimer. Ma discussion est basée sur l’éthique, la phénoménologie, les théories de l’incorporation, les études des récits de vie, la sociologie et l’anthropologie médicales et la narratologie. L’objet de mon étude est l’expérience incorporée de la souffrance dans les récits de maladie et je me concentre sur la souffrance comme perte de la mémoire et du soi narratif. J’analyse le journal How Linda Died de Frank Davey et les mémoires de John Bayley, Iris: A Memoir of Iris Murdoch et Iris and Her Friends: A Memoir of Memory and Desire. J’explore comment les récits de maladie constituent le rapport éthique à l’Autre souffrant de la rupture de la mémoire. La discussion de la voix est située dans le contexte des récits de vie et se propose de dépasser les limites des approches sociologiques et anthropologiques de la voix dans les récits de maladie. Dans ce sens, dans un premier temps je porte mon attention sur des études narratologiques de la voix en indiquant leurs limites. Ma propre définition de la voix narrative est basée sur l’éthique dans la perspective d’Emmanuel Levinas et de Paul Ricœur, sur l’interprétation du temps, de la mémoire et de l’oubli chez St-Augustin et la discussion levinasienne de la constitution intersubjective du temps. J’avance l’idée que la “spontanéité bienveillante” (Ricœur, Soi-même comme un autre 222) articule la voix narrative et l’attention envers l’Autre souffrant qui ne peut plus se rappeler, ni raconter sa mémoire. En reformulant la définition augustinienne du temps qui met en corrélation les modes temporels avec la voix qui récite, j’avance l’idée que la voix est distendue entre la voix présente de la voix présente, la voix présente de la voix passée, la voix présente de la voix future. Je montre comment la voix du soignant est inscrite par et s’inscrit dans les interstices d’une voix interrompue, souffrante. Je définis les récits de vies comme des interfaces textuelles entre le soi et l’Autre, entre la voix du soi et la voix du souffrant, comme un mode de restaurer l’intégrité narrative de l’Autre.

Assessing macro uncertainty in real-time when data are subject to revision

Model-based estimates of future uncertainty are generally based on the in-sample fit of the model, as when Box-Jenkins prediction intervals are calculated. However, this approach will generate biased uncertainty estimates in real time when there are data revisions. A simple remedy is suggested, and used to generate more accurate prediction intervals for 25 macroeconomic variables, in line with the theory. A simulation study based on an empirically-estimated model of data revisions for US output growth is used to investigate small-sample properties.

Are you sure? the role of uncertainty in career

Although uncertainty is a fundamental human experience, professionals in the career field have largely overlooked the role that it plays in people's careers. The changed nature of careers has resulted in people experiencing increased uncertainty in their career that is beyond the uncertainty experienced in their job. The author explores the role of uncertainty in people's experience of their careers and examines the implications for career counseling theory and practice. A review of the career theory and career counseling literature indicates that although contemporary approaches have been offered to respond to the changed nature of career, none of the approaches have identified uncertainty as a core part of individuals' experience of their career. The broader literature on uncertainty is then reviewed at the societal, organizational, and individual levels.

Probabilistic uncertainty in an interoperable framework

This thesis provides an interoperable language for quantifying uncertainty using probability theory. A general introduction to interoperability and uncertainty is given, with particular emphasis on the geospatial domain. Existing interoperable standards used within the geospatial sciences are reviewed, including Geography Markup Language (GML), Observations and Measurements (O&M) and the Web Processing Service (WPS) specifications. The importance of uncertainty in geospatial data is identified and probability theory is examined as a mechanism for quantifying these uncertainties. The Uncertainty Markup Language (UncertML) is presented as a solution to the lack of an interoperable standard for quantifying uncertainty. UncertML is capable of describing uncertainty using statistics, probability distributions or a series of realisations. The capabilities of UncertML are demonstrated through a series of XML examples. This thesis then provides a series of example use cases where UncertML is integrated with existing standards in a variety of applications. The Sensor Observation Service - a service for querying and retrieving sensor-observed data - is extended to provide a standardised method for quantifying the inherent uncertainties in sensor observations. The INTAMAP project demonstrates how UncertML can be used to aid uncertainty propagation using a WPS by allowing UncertML as input and output data. The flexibility of UncertML is demonstrated with an extension to the GML geometry schemas to allow positional uncertainty to be quantified. Further applications and developments of UncertML are discussed.

Controlling system uncertainty in sport and work

An applied psychological framework for coping with performance uncertainty in sport and work systems is presented. The theme of personal control serves to integrate ideas prevalent in industrial and organisational psychology, the stress literature and labour process theory. These commonly focus on the promotion of tacit knowledge and learned resourcefulness in individual performers. Finally, data from an empirical evaluation of a development training programme to facilitate self-regulation skills in professional athletes are briefly highlighted.

Climate change in game theory

The study provides an overview of the application possibilities of game theory to climate change. The characteristics of games are adapted to the topics of climate and carbon. The importance of uncertainty, probability, marginal value of adaptation, common pool resources, etc. are tailored to the context of international relations and the challenge of global warming.

Neural representations of social and non-social uncertainty in human decision making

The social landscape is filled with an intricate web of species-specific desired objects and course of actions. Humans are highly social animals and, as they navigate this landscape, they need to produce adapted decision-making behaviour. Traditionally social and non-social neural mechanisms affecting choice have been investigated using different approaches. Recently, in an effort to unite these findings, two main theories have been proposed to explain how the brain might encode social and non-social motivational decision-making: the extended common currency and the social valuation specific schema (Ruff & Fehr 2014). One way to test these theories is to directly compare neural activity related to social and non-social decision outcomes within the same experimental setting. Here we address this issue by focusing on the neural substrates of social and non-social forms of uncertainty. Using functional magnetic resonance imaging (fMRI) we directly compared the neural representations of reward and risk prediction and errors (RePE and RiPE) in social and non- social situations using gambling games. We used a trust betting game to vary uncertainty along a social dimension (trustworthiness), and a card game (Preuschoff et al. 2006) to vary uncertainty along a non-social dimension (pure risk). The trust game was designed to maintain the same structure of the card game. In a first study, we exposed a divide between subcortical and cortical regions when comparing the way these regions process social and non-social forms of uncertainty during outcome anticipation. Activity in subcortical regions reflected social and non-social RePE, while activity in cortical regions correlated with social RePE and non-social RiPE. The second study focused on outcome delivery and integrated the concept of RiPE in non-social settings with that of fairness and monetary utility maximisation in social settings. In particular these results corroborate recent models of anterior insula function (Singer et al. 2009; Seth 2013), and expose a possible neural mechanism that weights fairness and uncertainty but not monetary utility. The third study focused on functionally defined regions of the early visual cortex (V1) showing how activity in these areas, traditionally considered only visual, might reflect motivational prediction errors in addition to known perceptual prediction mechanisms (den Ouden et al 2012). On the whole, while our results do not support unilaterally one or the other theory modeling the underlying neural dynamics of social and non-social forms of decision making, they provide a working framework where both general mechanisms might coexist.

On recent developments in the theory of abstract differential equations with fractional derivatives

This note is motivated from some recent papers treating the problem of the existence of a solution for abstract differential equations with fractional derivatives. We show that the existence results in [Agarwal et al. (2009) [1], Belmekki and Benchohra (2010) [2], Darwish et al. (2009) [3], Hu et al. (2009) [4], Mophou and N`Guerekata (2009) [6,7], Mophou (2010) [8,9], Muslim (2009) [10], Pandey et al. (2009) [11], Rashid and El-Qaderi (2009) [12] and Tai and Wang (2009) [13]] are incorrect since the considered variation of constant formulas is not appropriate. In this note, we also consider a different approach to treat a general class of abstract fractional differential equations. (C) 2010 Elsevier Ltd. All rights reserved.