Estimation of implicit discount rates for climate change adaptation policies.

This article used evidence from tourists' willingness to pay (WTP) for a set of climate change adaptation policies to estimate implicit discount rates under different discounting structures. A choice experiment with two different split samples framed at two different time horizons was used to analyse how WTP changes as a function of the timing of the expected benefits. Results confirm that individuals are time sensitive to different horizons and provide support for the use of a very low discount rate in the evaluation of policies having effects in the long and very long run and show that the social acceptability of climate change (CC) adaptation policies can be affected by the timing of the benefits and the use of one or another discounting model.

Propuesta de un instrumento para la detección del optimismo estratégico en cáncer de mama / Proposal for an instrument for the detection of strategic optimism in breast cancer

Objetivo: Elaborar un instrumento que nos permita evaluar algunas estrategias cognitivas que formarían parte de las personas optimistas ante una dificultad de salud como el cáncer de mama. Método: 96 pacientes, de ellas 30 se encontraban en una fase de intervalo libre del cáncer de mama, 35 recibiendo tratamiento activo para el cáncer de mama y 31 tenían un diagnóstico de trastorno adaptativo sin historial médico oncológico. Se han comparado los mecanismos cognitivos del instrumento para valorar el optimismo estratégico entre los grupos de salud; se ha efectuado el análisis factorial del instrumento y se ha observado la relación de éste con variables como la calidad de vida y el optimismo disposicional en cada grupo. Resultados: el análisis factorial muestra cuatro componentes del total de ítems del optimismo estratégico: 1) Expectativas de resultado positivo y percepción de control ante la dificultad de salud; 2) Valoración positiva del pasado en el momento actual de salud; 3) Benefit finding a raíz de la enfermedad; y 4 ) Responsabilidad/culpabilidad por la situación de salud. La varianza total explicada por los factores es del 70,67%. Los factores del optimismo estratégico estarían relacionados con una mejor calidad de vida de las pacientes (p <0,01; r= 0,591), mostrando relaciones variables en función de la gravedad de la situación médica. Conclusión: el instrumento aportado para evaluar el optimismo estratégico permite identificar estilos cognitivos, relacionados con el mantenimiento de la calidad de vida en cáncer de mama, que pueden ser de utilidad para potenciar las terapias psicológicas de apoyo

Objective: To elaborate an instrument that allows us to evaluate some cognitive strategies that would be part of the optimistic people facing a health difficulty such as breast cancer. Method: 96 patients, 30 of them were in a breast cancer free interval phase, 35 were receiving active treatment for breast cancer and 31 patients had a diagnosis of adaptive disorder with no oncological medical history. The cognitive mechanisms of the instrument have been compared to evaluate the strategic optimism among the three health conditions. The factorial analysis of the instrument has been carried out and its relationship with variables such as quality of life and dispositional optimism in each group has been observed. Results: the factor analysis shows four components of the total items of strategic optimism: 1) Expectations of positive results and perception of control in front of health difficulties; 2) Positive evaluation of the past in the current health moment; 3) Benefit finding in the wake of the disease; and 4) Responsibility / guilt for the current health situation. The total variance explained by the factors is 70.67%. The factors of strategic optimism would be related to a better quality of life of patients (p<0.01; r = 0.591), showing distinct relationships depending on the severity of the medical situation. Conclusion: The provided instrument to assess strategic optimism allows the identification of specific thoughts related to the maintenance of the quality of life in breast cancer, which may be useful in supportive therapies

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress / Psicoterapia Positiva para supervivientes de cáncer con elevados niveles de malestar emocional: la facilitación del crecimiento postraumático reduce el estrés postraumático

Background/Objective: There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months’ follow-up. Participants’ PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others (AU)

Antecedentes/Objetivo: La evidencia científica muestra la importante presencia de cambios vitales positivos, como el crecimiento postraumático (CPT), tras afrontar un cáncer. Sin embargo, ninguna intervención ha sido específicamente diseñada para facilitar el CPT en pacientes con cáncer. En este artículo, se describen y evalúan los resultados de la Psicoterapia Positiva dirigida a supervivientes de Cáncer (PPC), diseñada para facilitar el CPT como vía para reducir el malestar emocional y estrés postraumático. Utilizamos indicadores interpersonales para validar la autenticidad del CPT. Método: Ciento veintiséis supervivientes de cáncer con elevados niveles de malestar emocional fueron consecutivamente asignados al grupo experimental (PPC) o al grupo de lista de espera. Resultados: El grupo de PPC obtuvo significativamente mejores resultados después del tratamiento que el grupo control, mostrando una reducción del malestar psicológico, de los síntomas de estrés postraumático y un incremento del CPT. Los beneficios se mantuvieron a los 3 y 12 meses. El CPT fue corroborado por los seres queridos de los participantes. Conclusiones: La PPC parece promover de forma significativa el CPT y reduce el malestar emocional y el estrés postraumático en supervivientes de cáncer. Además, la facilitación de CPT inducido por la PPC es corroborada por los seres queridos (AU)

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress.

There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.

ANTECEDENTES/OBJETIVO: La evidencia científica muestra la importante presencia de cambios vitales positivos, como el crecimiento postraumático (CPT), tras afrontar un cáncer. Sin embargo, ninguna intervención ha sido específicamente diseñada para facilitar el CPT en pacientes con cáncer. En este artículo, se describen y evalúan los resultados de la Psicoterapia Positiva dirigida a supervivientes de Cáncer (PPC), diseñada para facilitar el CPT como vía para reducir el malestar emocional y estrés postraumático. Utilizamos indicadores interpersonales para validar la autenticidad del CPT. Método: Ciento veintiséis supervivientes de cáncer con elevados niveles de malestar emocional fueron consecutivamente asignados al grupo experimental (PPC) o al grupo de lista de espera. Resultados: El grupo de PPC obtuvo significativamente mejores resultados después del tratamiento que el grupo control, mostrando una reducción del malestar psicológico, de los síntomas de estrés postraumático y un incremento del CPT. Los beneficios se mantuvieron a los 3 y 12 meses. El CPT fue corroborado por los seres queridos de los participantes. Conclusiones: La PPC parece promover de forma significativa el CPT y reduce el malestar emocional y el estrés postraumático en supervivientes de cáncer. Además, la facilitación de CPT inducido por la PPC es corroborada por los seres queridos.

Do we care about sustainability? An analysis of time sensitivity of social preferences under environmental time-persistent effects.

Environmental cost-benefit analysis has traditionally assumed that the value of benefits is sensitive to their timing and that outcomes are valued higher, the sooner in time they occur following implementation of a project or policy. Though, this assumption might have important implications especially for the social desirability of interventions aiming at counteracting time-persistent environmental problems, whose impacts occur in the long- and very long-term, respectively involving the present and future generations. This study analyzes the time sensitivity of social preferences for preservation policies of adaptation to climate change stresses. Results show that stated preferences are time insensitive, due to sustainability issues: individuals show insignificant differences in benefits they can experience within their own lifetimes compared to those which occur in the longer term, and which will instead be enjoyed by future generations. Whilst these results may be specific to the experimental design employed here, they do raise interesting questions regarding choices over time-persistent environmental problems, particularly in terms of the desirability of interventions which produce longer-term benefits.

Positive psychological functioning in breast cancer: An integrative review.

This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psychosocial factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the women's coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.

Valuing the recreational benefits of wetland adaptation to climate change: a trade-off between species' abundance and diversity.

Climate change will further exacerbate wetland deterioration, especially in the Mediterranean region. On the one side, it will accelerate the decline in the populations and species of plants and animals, this resulting in an impoverishment of biological abundance. On the other one, it will also promote biotic homogenization, resulting in a loss of species' diversity. In this context, different climate change adaptation policies can be designed: those oriented to recovering species' abundance and those aimed at restoring species' diversity. Based on the awareness that knowledge about visitors' preferences is crucial to better inform policy makers and secure wetlands' public use and conservation, this paper assesses the recreational benefits of different adaptation options through a choice experiment study carried out in S'Albufera wetland (Mallorca). Results show that visitors display positive preferences for an increase in both species' abundance and diversity, although they assign a higher value to the latter, thus suggesting a higher social acceptability of policies pursuing wetlands' differentiation. This finding acquires special relevance not only for adaptation management in wetlands but also for tourism planning, as most visitors to S'Albufera are tourists. Thus, given the growing competition to attract visitors and the increasing demand for high environmental quality and unique experiences, promoting wetlands' differentiation could be a good strategy to gain competitive advantage over other wetland areas and tourism destinations.

Desarrollo del cuestionario español para medir necesidades no cubiertas de supervivientes de cancer (CESC) / The development a spanish questionnaire to assess cancer survivors' unmet needs (cesc)

Introducción: Según datos de la SEOM, existen en la actualidad más de un millón y medio de supervivientes de cáncer en España. El objetivo de este estudio es el desarrollo y evaluación de un cuestionario para medir las necesidades no cubiertas de supervivientes de cáncer. Método: Se desarrolló y evaluó un cuestionario auto-administrado para detectar las necesidades no cubiertas de supervivientes de cáncer. Durante la Fase 1 se definió el constructo, se revisó la literatura científica y se consideró un estudio cualitativo desarrollado previamente. La propuesta del Cuestionario Español para Medir Necesidades no Cubiertas de Supervivientes de Cáncer (CESC) se evaluó sucesivamente por un panel de expertos hasta obtener una versión que incluye las propuestas formuladas. En la Fase 2, el cuestionario fue completado por un total de 109 supervivientes de cáncer, a fin de analizar sus propiedades psicométricas. Resultados: El cuestionario CESC incluyó un total de 25 ítems o necesidades relevantes, mostrando tener buenas propiedades de fiabilidad y validez. Como resultado del análisis estadístico se obtuvieron 3 Factores: físico, emocional y laboral-económico. Conclusiones: El cuestionario CESC es un primer instrumento disponible en español, para facilitar la detección de necesidades de servicios específicos dirigidos a la población de supervivientes de cáncer. Los resultados, si bien preliminares, son muy alentadores

Background: To develop and evaluate a questionnaire to measure cancer survivors’ unmet needs.Methods: A self-report measure of cancer survivors’ unmet needs was developed. In Phase I, it was taken into consideration the construct definition, literature review and previous qualitative research that identified needs in survivors. Spanish Questionnaire of Cancer Survivors’ Unmet Needs (CESC) was review by an expert panel up to the final version. In Phase 2, the measure was completed by 109 cancer survivors. Results: CESC questionnaire included 25 need items. Good acceptability, internal consistency and validity were demonstrated. Factor analysis identified three factors: Physical, Emotional and Employment/Economic. Conclusions: The CESC, first instrument in Spanish, will facilitate the evaluation of target services and generation of service delivery recommendations for cancer survivors. Even if it is a preliminary version, results are encouraging

Positive psychology interventions in breast cancer. A systematic review.

OBJECTIVE: Positive psychology is an emerging area of empirical study, not only in clinical, but also in health psychology. The present systematic review aims to synthesize the evidence about the positive psychology interventions utilized in breast cancer. METHODS: Relevant studies were identified via Pubmed, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, Wiley Online Library, TDX, and DIALNET databases (up to April 2013). Only those papers focused on interventions related to positive psychology and carried out on breast cancer patients were included. RESULTS: Of the 7266 articles found through databases, 16 studies were finally included in this review. Five groups of therapies were found: mindfulness-based approaches, expression of positive emotions, spiritual interventions, hope therapy, and meaning-making interventions. These specific interventions promoted positive changes in breast cancer participants, such as enhanced quality of life, well-being, hope, benefit finding, or optimism. However, the disparity of the interventions and some methodological issues limit the outcomes. CONCLUSIONS: Some studies provided relevant evidence about the clear development of positive aspects from the breast cancer experience. Positive interventions applied to patients and survivors of breast cancer were found to be able to promote positive aspects. A global consensus of a positive therapies classification is needed to take one more step in structuring positive psychology.

Eficacia de la terapia de grupo en cáncer de mama: Evolución de las emociones desadaptativas / No disponible

El estado emocional de las mujeres con cáncer de mama puede variar a lo largo del tiempo, en función de las dificultades físicas y psicosociales que se pueden encontrar a lo largo de la enfermedad, y que pueden continuar una vez finalizado el proceso de los tratamientos oncológicos. Cuando la paciente espera volver a recuperar su vida cotidiana, con frecuencia se mantienen emociones negativas como el miedo a las recaídas o sentirse deprimido. El objetivo del presente estudio longitudinal es conocer como evolucionan estas emociones desadaptativas, cuando se participa en una terapia de grupo orientada a mejorar la calidad de vida. La muestra final se compone de 38 mujeres con cáncer de mama que se encuentran en intervalo libre de enfermedad. Los resultados obtenidos indican que el denominado “malestar emocional” mejora a lo largo de la terapia, si bien en algunas pacientes afloran más las emociones negativas durante la terapia que al inicio de la misma. Donde se observa una mayor mejoría es en el aspecto de recuperar las ganas e ilusión por las cosas (p<0,01). También observamos una diminución de la ira, la ansiedad, la depresión, las dificultades de concentración y el miedo. Concluimos que la terapia de grupo de larga duración (8 meses) utilizada, se ha mostrado eficaz para ayudar a la adaptación emocional (AU)

The emotional state of women with breast cancer may vary over time, depending on the physical and psychosocial difficulties that can be found throughout the disease, and that may continue once the process of cancer treatments finished. When the patient expects to recover his everyday life, negative emotions such as fear of relapses or feeling depressed, often remain. The objective of this longitudinal study is to know how these maladaptive emotions progressed, when participating in group therapy aimed at improving the quality of life. The final sample consists of 38 women with breast cancer in disease-free interval. The results indicate that the so-called "emotional distress" improves over therapy, although by many patients negative emotions emerge more during the therapy than at the beginning. There is a greater improvement in the aspect of recovering the motivation and enthusiasm for doing something (p<0,01). We also observed a diminution of anger, anxiety, depression, concentration difficulties and fear. We conclude that the long-term (8 months) therapy has been shown effective to help emotional adjustment (AU)

Focus on relationship between the caregivers unmet needs and other care giving outcomes in cancer palliative car

Objective: Study the relationships between caregivers in palliative care and cancer, which is a first and necessary step to offer adequate supporting intervention. Methods: 59 caregivers participated in a research that examined the care giving outcomes using an Unmet Needs Questionnaire, the Hospital Anxiety and Depression Scale, and the Bakas Care giving Outcomes Scale. Results and conclusions: Results showed a high average of unmet needs, especially emotional ones. One caregiver out of two had significant anxiety levels and one out of four of depression. Care giving outcomes were almost all negative except for the relationship between the patient and the family. Moreover we found a positive and significant relationship between the number of unmet needs and outcomes like burden or emotional outcomes. Finally, the caregivers were interested in receiving a support which, according to their preferences, would have to be brief, group intervention and led by sanitary professionals (AU)

Objetivo: Apreciar y valorar de manera sistemática las posibles relaciones entre las necesidades insatisfechas de los cuidadores primarios y las consecuencias del cuidar, como paso previo y necesario para poder ofrecer programas adecuados de soporte a los cuidadores. Método: 59 cuidadores primarios participaron en una entrevista individual que incluía un cuestionario de posibles necesidades del cuidador, un cuestionario de ansiedad y depresión (HAD), y un cuestionario de sobre carga y cambios en la vida (BCOS). Resultados y Conclusiones: Los resultados revelaron la presencia de un número alto de necesidades insatisfechas sobre todo de tipos emocional y psicológico. Un cuidador de cada dos presentó niveles altos de ansiedad y uno de cada cuatro niveles altos de depresión. Los cambios en la vida del cuidador solieran ser negativos excepto por lo que concernió a la relación con el enfermo y con la familia, que se mantuvo o incluso mejoró. Además se observó una relación significativa entre el número de necesidades y otras consecuencias del cuidar como la sobrecarga y el bienestar emocional. Finalmente, la mayoría de los cuidadores estuvieron interesados en recibir un soporte que fuera breve, preferiblemente de tipo grupal y sobre todo proporcionado por profesionales sanitarios (AU)

Afrontamiento en cáncer de mama: pensamientos, conductas y reacciones emocionales / Coping with breast cancer thoughts, behavioral and emotional reactions

El objetivo de la presente investigación ha sido obtener información básica sobre cómo reaccionan ante su enfermedad las pacientes de cáncer de mama y analizar la posible existencia de relaciones entre diferentes niveles o formas de afrontamiento: cogniciones, conductas y respuestas emocionales. A través de los datos obtenidos de 189 pacientes, se ha realizado un análisis descriptivo y de componentes principales con rotación varimax sobre qué hacen, qué piensan y cómo se sienten las pacientes ante sus problemas de salud. Se obtuvo una estructura de dos factores que denominamos “afrontamiento centrado en uno mismo” y “afrontamiento implicando a los demás” que explicaban un 32,45% de la varianza. Los resultados indican que en situación de enfermedad crónica, la persona se enfrenta a sus problemas de salud mediante formas variadas de afrontamiento, no excluyentes entre sí. Por ejemplo, una misma persona puede tender a comunicarse pero también puede disimular muchas cosas en relación a sus preocupaciones por su salud; o hablar mucho con unas personas y disimular mucho con otras, etc. Los resultados son coherentes con la teoría general del afrontamiento de Lazarus y, en parte, con los estilos propuestos por Moos y colaboradores en el campo de la salud (AU)

The objective of this research has been to obtain basic information about how patients cope with the disease and analyse the possible existence of relations between different ways of coping with illness: cognitive, behaviours and emotional responses. Descriptive analysis and principal components analysis with varimax rotation was performed on a sample of 189 breast cancer women. A two-factor solution emerged explaining 32.45% of variance characterized by “coping focused on oneself” and “coping involving others”. The results indicate that in a situation of chronic illness, the person faces their health problems through various forms of coping, not mutually exclusive. For example, one person may tend to communicate but also can conceal many things in relation to their concerns for his health, or talk a lot with some people and conceal much with others, etc. The results are consistent with the general Lazarus´ theory of coping and partly with the by Moos and colleagues proposed coping styles in the fi eld of the health (AU)

Eficacia de las intervenciones psicológicas en mujeres con cáncer de mama / Efficacy of psychological interventions in women with breast cancer

El objetivo del presente trabajo es revisar la evidencia actualmente disponible sobre la eficacia de diferentes formas de intervención psicológica en cáncer de mama, distinguiendo tres principales enfoques terapéuticos: Intervenciones informativo-educativas, aplicaciones cognitivo-conductuales y psicoterapias de grupo. Se revisan los trabajos desarrollados específicamente con pacientes de cáncer de mama. Los datos aportados por diversos estudios muestran que la intervención informativo-educativa tienen efectos positivos en el campo afectivo y el afrontamiento especialmente al inicio de la enfermedad. Por otra parte, existe suficiente evidencia de que las técnicas cognitivo-conductuales son eficaces para mejorar el control de algunos síntomas, el estado afectivo relacionado con situaciones concretas y el afrontamiento a la enfermedad en sus diversas fases. El enfoque psicoterapéutico de grupo es más efectivo si destaca los aspectos educativos que centrándose únicamente en las emociones. La utilización de diversos formatos incluyendo el soporte telefónico o e Internet deben facilitar que alguna forma de ayuda psicológica complementaria llegue a todas las pacientes. Los efectos beneficiosos de las terapias estructuradas sobre la calidad de vida de las pacientes suelen prolongarse a medio plazo una vez finalizada la misma (AU)

The objective of this study was to review the current evidence for efficacy of different ways of psychological intervention in breast cancer. We distinguish there main therapeutic forms: informational-educational intervention, behavioural-cognitive therapy and group therapy. Only psychological applications with breast cancer patients are reviewed. The data of several studies showed that the information-education approach has positive effects at affective and coping level, especially in the beginning of the disease. On the other hand, the cognitive-behavioural intervention seams to be effective for a better control of disease-related symptoms, affect states related to concrete situations and for coping during the phases of illness. The psychotherapeutic educational group approach seams to be more effective than the emotional one. The different therapy formats, including support by phone and Internet, may facilitate that psychological support arrives to all patients. The benefit of structured therapies for the patients´ quality of life remains at middle-term in the most cases (AU)

Percepción de control y supervivencia en pacientes con cáncer de pulmón avanzado sometidos a tratamiento paliativo / Perceived control and survival in advanced lung cancer patients receiving supportive care

Se evaluó en 90 pacientes con cáncer de pulmón avanzado que participaban en un ensayo clínico, y justo antes de iniciar el tratamiento que les había sido asignado (radioterapia o quimioterapia), el grado en que consideraban que la resolución de su problema de salud dependía de sus propias ganas de curarse y de cumplir las prescripciones médicas. Los resultados indican que los pacientes que reciben radioterapia y que no creen que la evolución de su enfermedad dependa totalmente de lo que ellos hagan, tienen una supervivencia menor (todos habían fallecido al cabo de 18 meses después del diagnóstico) que el resto de pacientes del estudio (alrededor del 20 por ciento continúa con vida 18 meses después del diagnóstico) (AU)