A dyadic approach to understanding the impact of breast cancer on relationships between partners during early survivorship

© 2016 The Author(s). Background: The shared impact of breast cancer for women and their male partners is emerging as an important consideration during the experience of a breast cancer diagnosis, particularly during survivorship. This study aimed to explore the experiences of women and their partners during early survivorship and contributes a range of insights into the lives of those intimately affected by breast cancer. Methods: In-depth interviews were completed with Australian women survivors of breast cancer (n = 8) and their partners (n = 8), between six months and five years following cessation of treatment. Questions included a focus on the women and their partners' daily experiences during early survivorship, including the management of ongoing symptoms, engagement in leisure and social interests, returning to work, communicating with each other, maintenance of the current relationship and other important roles and responsibilities. Thematic analysis was employed to determine key themes arising from the dyadic accounts of women and their partners' experiences during early breast cancer survivorship. Results: Women and their partners experienced many changes to their previous roles, responsibilities and relationships during early breast cancer survivorship. Couples also reported a range of communication, intimacy and sexuality concerns which greatly impacted their interactions with each other, adding further demands on the relationship. Three significant themes were determined: (1) a disconnection within the relationship - this was expressed as the woman survivor of breast cancer needing to prioritise her own needs, sometimes at the expense of her partner and the relationship; (2) reformulating the relationship - this reflects the strategies used by couples to negotiate changes within the relationship; and (3) support is needed to negotiate the future of the relationship - couples emphasised the need for additional support and resources to assist them in maintaining their relationship during early survivorship. Conclusion: It can be concluded that the early survivorship period represents a crucial time for both women and their partners and there are currently limited options available to meet their shared needs and preferences for support. Findings indicate that a suitable model of care underpinned by a biopsychosocial framework, access to comprehensive assessment, timely support and the provision of targeted resources are urgently needed to assist women and their partners during this critical time

Processos de democracia direta: sim ou não? Os argumentos clássicos à luz da teoria e da prática

Regularmente surgem controvérsias sobre os processos de democracia direta, dos quais os mecanismos mais frequentes são a iniciativa popular, o plebiscito e o referendo. Por um lado, há autores que defendem a posição de que essas instituições tornam o jogo político mais lento, caro, confuso e ilegítimo; outros defendem a posição contrária e argumentam que processos de democracia direta são fundamentais para os cidadãos e a qualidade da democracia. O presente estudo analisa esse tema em torno de sete questões, baseadas em considerações teóricas e pesquisas empíricas: 1. A questão entre o minimalismo e o maximalismo democrático; 2. A concorrência entre maioria e minoria; 3. A concorrência entre as instituições representativas e os processos de democracia direta; 4. A questão da competência dos cidadãos; 5. A questão dos efeitos colaterais dos processos de democracia direta; 6. A questão do tamanho do eleitorado; 7. A questão dos custos dos processos de democracia direta. As sete questões são analisadas a partir de uma revisão bibliográfica que considera tanto fontes nacionais como internacionais. O estudo mostra que os processos de democracia direta podem ser um complemento para as instituições representativas em um sistema democrático. O bom desempenho dos plebiscitos, referendos e iniciativas populares depende tanto da regulamentação destes como também do desempenho das outras instituições políticas e da situação socioeconômica de um país. O estudo permite ampliar e aprofundar o debate sobre processos de democracia direta no Brasil

Interest Groups and Direct Democracy

A variety of direct democratic instruments allow “policy-making at the ballot box” (Gerber, 1999, p. 3), with the citizens having the last word on policy adoption and change. Criteria for the classification of direct democracy devices include who initiates a popular vote, who has control over the content of the proposal, whether it addresses statutory or constitutional law, or whether the result is binding or not. Interest groups use two main direct democracy instruments to influence policy-making: the initiative to put a new policy issue on the political agenda and the referendum to veto a policy adopted by the legislature. This chapter scrutinizes the effects of these tools on the policy process, on policy outputs, and on interest group populations. It shows that citizen groups benefit more than business groups from the initiative and referendum

Decision Support Tools for Earthquake Recovery of Businesses

This report summarizes the progress made in the first year of a collaborative project between researchers at Kajima and two CUREe institutions, Caltech and Stanford University. The project is part of Year 2 and Year 3 of Phase ill of the CUREe-Kajima Joint Research Program. The goal of this two-year CUREe-Kajima project is to develop quantitative methodologies and a prototype software package to implement a decision support system (DSS) which can be used by corporate management to enhance the recovery of their business after a disruptive earthquake. In developing this DSS, it is necessary to specify the type of business to which it is to be applied. In the first-year of this project, the focus was on a corporation which owns multiple leased office buildings that have suffered, or may suffer, damage during an earthquake. The core problem that was addressed of determining an optimal strategy for repairing the buildings is also relevant to any company that owns facilities. The basic objective of the project is to show how a DSS can be developed which could be used by management to make better decisions in restoring the state, or health, of their business after an earthquake. It is envisaged that the DSS could be used by the managers of a company to perform complex "what if" analyses to evaluate alternative recovery strategies and to determine the best one, based on post-earthquake information and economic and other constraints. In addition to its use after a damaging earthquake, the DSS could also be used prior to any earthquake to investigate which mitigation actions and planning efforts should be more effective in enhancing the business recovery process

Disentangling Referendums and Direct Democracy: A Defence of the Systemic Approach to Popular Vote Processes

What is the relationship between referendum and initiative processes and democracy? The dominant understanding is that these popular vote processes are institutions associated with a model of direct democracy that stands in opposition to representative democracy. However, this pervasive approach is rarely justified and appears to limit the study of popular vote processes by focusing on implausible ideals, obscuring that many democratic institutions face similar challenges, and encouraging overgeneralising claims that neglect institutional variation in referendum and initiative processes. Previous criticisms of the association of popular vote processes with direct democracy have failed to clearly articulate an alternative. We trace the emergence of a democratic systems approach to popular vote processes and argue that it provides a better conceptual framework to empirically study and normatively discuss these processes