Exploring new forms of intermediation in the forest value chain

This paper proposes a method to restructure the forest value chain using intermediaries when a wider range of forest values should be managed for several stakeholders. This method leads to the definition of the strategic vision of the intermediary, including its value proposition and its required competencies, assuming that actors in the value chain are prepared to revise their business approach to enable effective collaboration and knowledge sharing. The method is used to support management of public forests in the Province of Quebec, in Eastern Canada. Basically, the intermediary, referred to as the integrator-supplier (IS) in the application case, enables several stakeholders, including the government, the forest industry, regional authorities, recreation organizations, and First Nations, to cnmmunicate, to set compatible goals, and to synchronize their activities. These activities and interactions must all be effectively carried out to maximize the overall benefits of forest management. Three critical issues for successful development of the IS are identified. The results present functional descriptions of seven development scenarios for effective use of intermediation in forest value chains

Predicting distress and benefit finding in breast cancer survivors at six-year follow-up

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Preparing Instructional Leaders: Evaluating a Regional Program to Gauge Perceived Effectiveness

An instructional leadership program (ILP) has offered education and support to three cohorts of educational leaders in Nova Scotia, Canada, amounting to approximately 130 participants. Quantitative and qualitative feedback from a convenience sample (n = 90) suggests that the ILP offers an extremely useful practical program; in fact, 95 percent of the sample indicates advances in the categories of professional growth, improved instructional leadership, and tangible progress in administrative effectiveness. Systemic and school environment trends have dictated that educational leaders need a skill set that positions them to respond more aptly to issues of poverty, socioemotional health, and mental health while attending to improved community building both within the school and in the greater public. This study uses surveys, interviews, and focus groups to identify emerging and impending challenges

Can Physical Activity and Healthy Diet Help Long-Term Cancer Survivors Manage Their Fear of Recurrence?

Objective: Fear of cancer recurrence (FCR) adversely affects quality of life, but health behaviors such as physical activity (PA) and fruit and vegetable intake (FVI) may help alleviate FCR for some survivors. This cross-sectional study tested the common-sense model (CSM) of FCR by investigating associations between constructs from the CSM (perceived illness consequences, control over health, and timeline), and survivors’ health behaviors, health self-efficacy, and FCR.Methods: Using wave 3 data from the American Cancer Society Longitudinal Study of Cancer Survivorship-I, path analyses were conducted among mixed-cancer participants (N = 2,337) who were on average 8.8 mean years post-diagnosis.Results: A final good fitting model [χ2 (5, N = 2,337) = 38.12, p < 0.001; SRMR = 0.02; CFI = 0.99; RMSEA = 0.05] indicated that perceiving fewer illness consequences, and greater control over one’s health, were directly associated with higher PA (β = 0.15 and −0.24, p < 0.01, respectively) and higher health self-efficacy (β = 0.24, −0.38, p < 0.01, respectively). Timeline (i.e., perceiving cancer as chronic) was directly associated with lower health self-efficacy (β = −0.15, p < 0.01) and higher FCR (β = 0.51, p < 0.01). Both greater PA and FVI were directly associated with higher health self-efficacy (β = 0.10 and 0.11, p < 0.01, respectively) which in turn showed a direct association with lower FCR (β = −0.15, p < 0.01).Conclusion: Increasing survivors’ sense of control over health, decreasing perceived chronicity of the illness, and mitigating its consequences may increase their health behaviors and health self-efficacy, which in turn could decrease their FCR. Longitudinal and experimental studies are needed to confirm these findings

From normal response to clinical problem : definition and clinical features of fear of cancer recurrence

Research to date on fear of cancer recurrence (FCR) shows that moderate to high FCR affects 22-87 % of cancer survivors and is associated with higher psychological morbidity (Simard et al J Cancer Surviv 7:300-322, 2013). Despite growing research interest in FCR, the lack of consensus on its definition and characteristics when it reaches a clinical level has impeded knowledge transfer into patient services. In order to address these gaps, expert researchers, policy makers, trainees, and patient advocates attended a 2-day colloquium at the University of Ottawa in August 2015. A Delphi method was used to identify the most relevant definition of FCR, and the attendees generated possible diagnostic characteristics of clinical FCR. After three rounds of discussion and voting, the attendees reached consensus on a new definition of FCR: "Fear, worry, or concern relating to the possibility that cancer will come back or progress." Regarding clinical FCR, five possible characteristics were proposed: (1) high levels of preoccupation, worry, rumination, or intrusive thoughts; (2) maladaptive coping; (3) functional impairments; (4) excessive distress; and (5) difficulties making plans for the future. The new proposed definition of FCR reflects the broad spectrum in which patients experience FCR. A consensual definition of FCR and the identification of the essential characteristics of clinical FCR are necessary to accurately and consistently measure FCR severity and to develop effective interventions to treat FCR. We hope this broad definition can encourage further research and the development of inclusive policies for all cancer patients and survivors who are struggling with this issue.PostprintPeer reviewe

Setting an International Research Agenda for Fear of Cancer Recurrence: an online delphi consensus study

This Document is Protected by copyright and was first published by Frontiers. All rights reserved. it is reproduced with permissionBackground: Fear of cancer recurrence (FCR) is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritise research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research. Methods: Members of the International Psycho-oncology Society (IPOS) Fear of Cancer Recurrence Special Interest Group (FORwards) were invited to participate in an online Delphi study. Research domains identified in Round 1 were presented and discussed at a focus group (Round 2) to consolidate the domains and items prior to presentation in further survey rounds (Round 3) aimed at gaining consensus on research priorities of international significance. Results: Thirty four research items were identified in Round 1 and 33 of the items were consolidated into 6 overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2 and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further 4 research items were identified by panellists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panellists. Given the high levels of consensus and stability between rounds no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panellists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions, was the third highest priority identified. Conclusions: The findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment, are based on a flexible approach based on symptom severity and can be delivered within routine clinical care, were identified as research areas to prioritise. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need

Current state and future prospects of research on fear of cancer recurrence

1. Despite a rapidly growing research interest in fear of cancer recurrence, lack of consensus on definition and measurement including clinical fear of cancer recurrence, sparse model development and testing, and limited available clinical interventions have impeded knowledge transfer into patient services. 2. To move forward, a 2-day colloquium was held in Ottawa, Canada in August 2015 to progress knowledge and identify future research directions. 3. A comprehensive research program was proposed, including development of a clinical definition, an updated review of screening measures, and a review of existing interventions. 4. A new special interest group was created with the International Psychosocial Oncology Society to facilitate the implementation of this research program and future international collaborations