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Abstract: Background: The COVID-19 pandemic involved many uncertainties, including financial uncertainty due to the global financial crisis. Previous research indicates that financial uncertainty is negatively related to mental health and wellbeing. Aims: We tested a model suggesting that the negative impact of financial uncertainty is explained by a restriction of individuals’ view of their future possibilities. Specifically, this longitudinal study explored the relationship of financial uncertainty and anxiety, considering the mediating role of future orientation. Method: Data were collected with questionnaires administered to Israeli citizens in April, June and August 2020. Data analysis comprised 379 respondents who participated in all three times. Results: Future orientation mediated the relationship of financial uncertainty and anxiety over time. Tests of changes across time show that changes in financial uncertainty were related to changes in anxiety levels over time. Limitations: Our sample was biased toward younger ages and the measurement of future orientation referred to a general view of the future rather than specific areas. Conclusion: The results suggest that the stressor of financial uncertainty is generalized to a negative view of future possibilities, thereby increasing anxiety.

Background: Late-life depression is a prevalent mental health problem among older adults. Variations may exist in the intensity of chronic stressors experienced by people in different older age groups and their effects on depressive symptoms.Aim: To examine differences among older adults by age group in the experienced intensity of chronic stressors in relation to depressive symptoms and assess the mediating role of disengaged and engaged coping strategies.Methods: Participants were 114 older adults. The sample was divided into three age groups: 65–72, 73–81, and 82–91. The participants completed questionnaires on coping strategies, depressive symptoms, and chronic stressors. Moderation and mediation analyses were conducted.Results: The lowest levels of depressive symptoms were in the young-old age group and the highest levels were in the oldest-old age group. The young-old age group used more engaged and less disengaged coping strategies than the two other groups. The association between intensity of chronic stressors and depressive symptoms was stronger in the two older age groups compared to the youngest (moderating effect of age groups). The association of stressor intensity with depressive symptoms was mediated by disengaged coping, whereas engaged coping was not associated with depressive symptoms.Conclusion: Differences exist in the relationships among chronic stressors, coping strategies, and depressive symptoms by age groups in the older adult population. Professionals should be aware of these differences between age groups in depressive symptoms and the impact of stressors and coping strategies on depressive symptoms in different older adult age groups.

Purpose The COVID-19 pandemic presents specific challenges for cancer patients attending oncology treatment. Using a mixed-methods design (convergent parallel design), we aimed to assess the experience, perceptions, and reactions of cancer patients during the COVID-19 pandemic. Methods Participants were cancer patients receiving treatment at the hospital during the pandemic (July to August 2020). In study 1, 95 participants filled out a questionnaire measuring COVID-19 experiences and perceptions, psychological distress, and intolerance of uncertainty. In study 2, in-depth interviews were conducted with 10 cancer patients, probing their experience during the COVID-19 period. Results Most participants experienced the COVID-19 pandemic as a major threat that would affect future health, most attended all or most of their scheduled treatments, and their mean level of psychological distress was low. A mild decrease in social support was reported, and remote contacts and support from the community had not compensated for decreased person-to person contacts. In addition, intolerance of uncertainty was related to higher psychological distress, which was partially mediated by perceptions of threat. The analysis of in-depth interviews strengthened the quantitative findings by elucidating the experience of fear of contagion alongside determination to continue treatment. Conclusions and Implications for Cancer Survivors The mixed-methods design enabled us to examine the responses of cancer patients attending treatment. The findings suggest that in times of extreme uncertainty such as COVID-19, health experts need to screen cancer patients and survivors for emotional and instrumental support needs and identify patients and survivors with high intolerance of uncertainty as a risk factor for psychological distress.

Significant proportions of burnout have been reported among both oncologists and oncology nurses. However, these groups have not been compared in a meta-analytic design. It is important to compare how burnout affects different types of health professionals to understand its individual implications and devise ways of minimizing and treating it.The current meta-analysis study aimed to systematically compare burnout prevalence between oncologists and oncology nurses.Authors assessed 34 studies (four included nurses and oncologists and 30 focused either on oncologists or oncology nurses) that used the Maslach Burnout Inventory (MBI) to measure burnout. Both fixed- and random-effects models were used to calculate meta-analytic estimates of the burnout subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA).The pooled sample size was 4,705 oncologists and 6,940 oncology nurses. The average proportions of EE, DP, and PA were 32%, 26%, and 25%, respectively, among oncologists and 32%, 21%, and 26%, respectively, among oncology nurses. Higher DP was found among oncologists compared with oncology nurses, only in the analysis of studies that included samples of both oncologists and oncology nurses. The subgroup analysis showed higher levels of DP in Europe and Asia and lower PA in Asia and Canada. No evidence of publication bias was found.Findings suggest differences in burnout between oncologists and oncology nurses and among geographic regions. This highlights the need for tailored interventions for different professions and regions. Hospitals should provide support and encourage teamwork to improve oncology professionals' well-being and provide optimal care for patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

To improve psychosocial cancer care in Europe, more information is needed on psychosocial function and quality of life (QoL) among cancer patients in European countries.To investigate differences in psychosocial function between cancer survivors and the general population in Europe, in relation to national economic status and personal factors.Data were from the Survey of Health, Ageing and Retirement in Europe (Wave 6). Main outcomes were psychosocial functioning: activity limitations, income adequacy, loneliness, depression, and QoL. Factors possibly associated with the main outcomes were ever having cancer, gross domestic product (GDP), and personal factors (age, gender, education, marriage status, employment status, number of children, number of chronic diseases).The study sample featured 6,238 cancer survivors and 60,961 individuals without cancer aged 50 or older in 17 European countries and Israel. Levels of depression were higher and QoL was lower among cancer survivors compared to individuals without cancer and worse in low GDP countries, whereas differences in income adequacy and loneliness were not statistically significant. The interaction of cancer groups and country groups indicated a significant interactional effect on activity limitations, loneliness, depression, and QoL. In a multivariate regression analysis, personal factors, GDP, and being a cancer survivor predicted the main outcome variables.Cancer has a persistent negative effect on survivors that is related to a country's GDP. Cancer survivors in low-GDP countries are affected by the consequences of cancer intertwined with the hardships of living in a low-GDP country. This article is protected by copyright. All rights reserved.

Summary Following the outbreak of the global COVID-19 pandemic, governments around the world issued guidelines designed to prevent contagion. This longitudinal study explored variables associated with citizens’ adherence to these guidelines. Questionnaires were administered to a panel of Israeli citizens three times: in June (Time 1, n = 896), July (Time 2, n = 712) and August (Time 3, n = 662) 2020. The relationships of perceived loss of resources (e.g. stable employment) at Time 1 with adherence to guidelines at Time 2 and Time 3 were moderated by assumptions about controllability: The relationships were stronger for people who believed that appropriate behavior would lead to positive outcomes and prevent negative outcomes. The results indicate that messages about the pandemic should be accompanied by encouraging messages regarding the ability to control.

Background Heart rate variability (HRV) has been suggested as an indicator of capacity to adapt effectively to physiological or environmental challenges and of physical and psychological health in old age. Aims The study assessed levels of high-frequency HRV (HF-HRV) among older adults in relation to positive and negative affect and the mediating role of positive and negative affect in the association between coping resources (perceived social support and sense of mastery) and HF-HRV. Method Participants were 187 men and women in three assisted-living residences who were independent in activities of daily living (93.4% participation rate). The participants completed sense of mastery, multidimensional scale of perceived social support, and positive and negative affect questionnaires. HF-HRV was derived from electrocardiography data measured by a Holter monitoring device for 15 minutes. Results The empirical model showed good fit indices indicating that higher HF-HRV was associated with lower negative affect, and negative affect mediated the association between perceived social support and HF-HRV. In addition, perceived social support and sense of mastery were associated with higher positive affect and lower negative affect. Conclusions Although this was a cross-sectional study, it suggests that HF-HRV may be a link between affect and health in old age. It also suggests the importance of identification and intervention with older adults and their support systems to reduce negative affect.

BACKGROUND: Research has indicated that managerial contact with cancer survivors during a long absence from work is related to cancer survivors’ inclination to return to work. OBJECTIVE: The present study explored the roles of cancer survivors’ perception of supervisor resistance to return to work (RTW) and symptom severity in the relationship between supervisor-initiated contact during the cancer survivors’ absence from work and successful work sustainability (SWS). METHODS: Israeli cancer survivors (N = 149) who had been working at least 6 months after the termination of treatment completed online questionnaires. The scales measured frequency of contact, perceived supervisor resistance to RTW, SWS, and symptom severity. To test the relationship between perceived and actual resistance, a partial sample of the cancer survivors’ direct supervisors (N = 49) reported their resistance to RTW of cancer survivors. RESULTS: The results show that perceived supervisor resistance mediated the relationship between supervisor-initiated contact during absence and SWS. Symptom severity moderated the negative effect of perceived supervisor resistance on SWS: The relationship was stronger for cancer survivors experiencing severe symptoms. Cancer survivors’ perception of supervisor resistance to RTW was positively related to their supervisors’ self-report of resistance. CONCLUSION: These results suggest the need for clear guidelines and managerial training programs regarding contact and communication with cancer survivors during long absences from work.

Although family members play an important role in various aspects of coping with cancer and are significantly affected by it, little is known about their perspectives regarding return to work (RTW). This study explored attitudes and experiences of cancer survivors' family members related to cancer survivors' RTW. The present study consists of a qualitative research design, employing in-depth semistructured interviews with first-degree family members (N = 21) of cancer survivors who were approached through online social networks: spouses, children, parents and siblings. Grounded theory techniques were used for data analysis. Four themes emerged from the interviews: (a) the family's cautious voice in return-to-work decision making; (b) work-home imbalance; (c) inhibiting or promoting the effect of work on the recovery process and (d) expectations and appreciation of unconditional workplace support. The findings suggest that psychosocial and health care professionals should help family members play an active role in the decision of RTW. Professionals should also prepare family members for potential costs of RTW for the family and help them develop realistic expectations regarding workplace support of the cancer survivor.

This study examined whether clinical experience moderates the relationship between three potential physician biases (patient characteristics; cancer-related beliefs, i.e., traditional and fatalistic beliefs; and attributed barriers to mammogram performance) and clinical decisions (recommending and discussing mammography with Arab women patients). A survey was conducted among 146 randomly sampled (cluster sampling) Arab physicians who serve the Arab population in Israel. We found that the least experienced physicians recommended and discussed mammography to a lesser extent than experienced doctors. Less experienced physicians were also less inclined to discuss and recommend mammography to women with specific characteristics (religious women, women with lower education levels, and women who expressed high fatalistic beliefs) and held significantly higher traditional beliefs concerning cancer. The correlation between patient characteristics and clinical decision making was both direct and moderated by clinical experience (stronger for the least experienced and moderately experienced physicians). Cancer-related beliefs had a direct negative effect on recommending and discussing mammography. The findings suggest that greater clinical experience with Arab women patients might reduce physician bias pertaining to patient characteristics among less experienced doctors who serve patients of the same ethnicity. Nonetheless, the findings imply that anti-stigma interventions should not rely on prolonged contact and should be implemented among all physicians, regardless of their clinical experience.

Research on stress and coping has differentiated the effects of objective stress and subjective perceptions of stress on psychological and physical health, including in old age. This study examined the moderating role of social support in the relationship between objective and subjective stress with depressive and somatic symptoms in the context of Israeli grandparents. This cross-sectional study involved 243 grandparents who provided at least 5 hours a week of assistive regular care to their grandchildren, divided into lower and higher support groups. The results show that the levels of depressive and somatic symptoms were higher in the lower support group. Social support moderated the association between the intensity of care and perceived stress. Social support moderated the association between subjective stress and somatic symptoms. To conclude, the combination of high subjective stress and lower social support constitutes a risk factor for impaired psychological and physical health.

The article discusses quotations as linguistic means for constructing authority. It seeks to attenuate two accepted premises regarding quotations and authority in linguistic research: firstly, that the source of quotation is the (single) source of authority, and secondly, the writer’s dichotomic attitude toward it: reliance or refutation. Two opinion essays in Hebrew were examined, authored by a woman and published in a Maskilic periodical during the 19th century – a time when women were denied the social license to write in Hebrew. The pragmatic micro-analysis shows that the writer uses various linguistic means to construct her authority by means of dialogical conflicts between several external sources: the Jewish canonical texts, her educated peers or prevailing viewpoints of the time.

Background and aims Although previous studies suggested that depressed mood and fatigue among cancer survivors are associated with chronic inflammation, the effect of cytokines on the relation between physical activity and fatigue and depressed mood is characterized by inconsistent results. The aim was to examine levels of pro-inflammatory (IL-6, IL-8, TNFα, IL-12) and anti-inflammatory (IL-10) cytokines in relation to the effects of physical activity on fatigue and depressed mood. Methods Breast cancer survivors (n = 108; stages I-III), aged >20 and who were 1–6 months postchemotherapy were recruited consecutively. Participants completed the Fatigue Symptom Inventory and Center for Epidemiologic Studies Depression Scale and reported physical activity details; 10 cc of blood were drawn for assessment of levels of IL-6, IL-8, IL-10, Il-12, and TNFα in serum. Results Only IL-6 and IL-8 were associated with fatigue and depressed mood. Controlling for background variables, physical activity and IL-6 were significantly associated with fatigue, but only physical activity was significantly associated with depressed mood. A moderated effect of IL-6 and IL-8 was found in the association of physical activity and fatigue, indicating that this association is significant only in individuals with lower levels of IL-6 or IL-8. Conclusions Fatigue and depressed mood are differently associated with pro-inflammatory cytokines. In addition, IL-6 and IL-8 are main cytokines affected by physical activity. The study stresses the need to provide information and tailored guidance for cancer survivors for maintaining an active lifestyle into survivorship and the importance of allocating resources for programs to encourage active lifestyles among cancer survivors. Caution should be exercised in the interpretation of the results due to the cross-sectional design and possibility of bidirectional associations between the study variables.

The COVID-19 pandemic may trigger posttraumatic stress symptoms (PTSS) due to its threat to health, well-being, and survival.We sought to assess levels of change in PTSS at three waves during the COVID-19 pandemic. Our second objective was to examine the role of four objective and subjective predictors salient to COVID-19-loss of resources, sense of loneliness, perceived COVID-19 threat, and uncertainty stress-on the trajectory of PTSS.The study consisted of three waves, a month apart, between June and August 2020, with 903, 718, and 684 participants in each wave, respectively.At T0, participants had a medium level of PTSS (The four predictors of PTSS should be addressed via strengthening resilience of individuals and communities.

OBJECTIVES Tools have been developed to assess the existence and intensity of fatalistic beliefs. Causal attributions of cancer, referring to the foundation for fatalistic views of cancer as being predetermined or reflecting an unavoidable death, are lacking. The aim was to develop and validate the Fatalistic Causal Attributions of Cancer Questionnaire, a measurement tool for studying the causal attributions of cancer. METHODS Three-phase study. Phase I: Item extraction and development based on focus groups (N = 30) and assessment of content validity. Phase II: Assessment of quality of items and construct validity (exploratory factor analysis, confirmatory factor analysis, and convergent validity) of data from 252 participants (aged 50-75). Phase III: Confirmatory factor analysis and assessment of the discriminant validity and reliability of the questionnaire with 127 online respondents (aged 20-70). RESULTS In Phase I, an initial questionnaire was constructed. In Phase II, four factors were identified: Belief in divine providence, belief in personal resilience as a protective factor, belief in chance or luck, and belief in inevitable environmental or genetic factors. The factorial structure of an 18-item version that emerged in the confirmatory factor analysis had good fit indexes and reliability measures. In Phase III, the 18-item questionnaire and its factorial structure and reliability were confirmed. CONCLUSION The findings show acceptable psychometric properties for the questionnaire. We suggest that this questionnaire should be used with an existing questionnaire that assesses the intensity of fatalistic perceptions for a more comprehensive assessment of fatalism in research and in promoting adherence to screening.

Emotion regulation may affect the levels of psychological distress of cancer survivors, but inconsistencies exist among studies regarding the direction of this effect. The systematic review and meta-analysis sought to estimate the associations between emotion regulation patterns (repression, suppression, experiential avoidance and cognitive reappraisal) and psychological distress among cancer survivors. Fifteen studies met inclusion criteria for systematic review, and seven studies focussing on suppression were included in the meta-analysis. The systematic review pointed to a marked variability in associations among the emotion regulation patterns and psychological distress. The three meta-regressions of the relationships between suppression and psychological distress found significant fixed- and random-effect sizes (except marginal significance of a random-effect model for partial correlation). Subgroup analysis showed no moderation effect of time since diagnosis or study quality, but a significant difference (fixed-effect model only, p = 0.005) was found between correlative studies and those controlling for confounders. The current study suggests that suppression is related to elevated levels of psychological distress among cancer survivors, although large inconsistencies exist among studies and publication bias could not be ruled out. Further studies with large samples and a consistent approach are thus required to evaluate the associations of emotion regulation patterns and psychological distress.

Different patterns of emotion regulation have been proposed for dealing with the intense emotions elicited while coping with cancer. The relationships between these different emotion regulation patterns have not yet been studied. This study examined the usage levels of different emotion regulation patterns (repression, suppression, experiential avoidance and cognitive reappraisal), the intercorrelations and clustering of these patterns and their associations with personal coping resources (personal resilience and self-compassion) in a sample of colorectal cancer survivors. This was a cross-sectional study in which 153 colorectal cancer survivors, stages II-III, (47% female, 53% male), aged 26-87, completed the Marlowe-Crowne Social Desirability Scale, the State-Trait Anxiety Inventory-6, the Emotion Regulation Questionnaire, the Acceptance and Action Questionnaire, the Resilience Scale-14 and the Self-Compassion Scale-Short Form. The four emotion regulation patterns were found to be distinct from each other (i.e., low to moderate correlations). Cognitive reappraisal was negatively related to suppression and experiential avoidance and positively associated with self-compassion. Two-step cluster analysis revealed three distinct clusters: Cluster 1-the suppression-avoidance dominant cluster; Cluster 2-the cognitive reappraisal dominant cluster; and Cluster 3-the repression dominant cluster. Repression, suppression, experiential avoidance and cognitive reappraisal were found to differ from each other but able to be organized into distinct clusters of survivors. Healthcare professionals should be aware of these different emotion regulation patterns and the need to identify the patterns used by each survivor.

Conversion of manure into energy products via hydrothermal liquefaction was studied. Hydrothermal reactions, conducted at different temperatures (200–300 °C), were compared on the basis of conversion yields, carbon and energy recoveries and product quality. The results demonstrate how reaction temperatures affect the relative production of biocrude oil and hydrochar. Comprehensive analyses of both biocrude oil and hydrochar suggest that decarboxylation was the dominant mechanism involved in the reaction and was enhanced with temperature. With a relatively high carbon (67–74%) and low oxygen (13–18%) content, biocrude oil seems to provide a better platform to deliver recovered energy, with higher heating values of 30–35 MJ kg−1. An overall energy balance, supported by a sensitivity analysis, demonstrated how the higher temperature enhanced the overall energy return. Twelve scenarios were used to estimate the daily net energy gained in feedlots of different sizes. All scenarios provided a positive energy balance with returned energy found to be 2 to 3 times higher than invested energy. The estimation presented herein highlights the feasibility of hydrothermal technology to return energy by multiple products and, hence, to provide a sustainable waste management practice in confined feedlots.

In dairy cattle, identifying polymorphisms that contribute to complex economical traits such as residual feed intake (RFI) is challenging and demands accurate genotyping. In this study, we compared imputed genotypes (n = 192 cows) to those obtained using the TaqMan and high-resolution melting (HRM) methods (n = 114 cows), for mutations in the FABP4 gene that had been suggested to have a large effect on RFI. Combining the whole genome sequence (n = 19 bulls) and the cows’ BovineHD BeadChip allowed imputing genotypes for these mutations that were verified by Sanger sequencing, whereas, an error rate of 11.6% and 10.7% were encountered for HRM and TaqMan, respectively. We show that this error rate seriously affected the linkage-disequilibrium analysis that supported this gene candidacy over other BTA14 gene candidates. Thus, imputation produced superior genotypes and should also be regarded as a method of choice to validate the reliability of the genotypes obtained by other methodologies that are prone to genotyping errors due to technical conditions. These results support the view that RFI is a complex trait and that searching for the causative sequence variation underlying cattle RFI should await the development of statistical methods suitable to handle additive and epistatic interactions.

Only a few studies have examined the end-of-life experience in the context of the place of living and receiving care. Sense of place consists of emotional bonds, values, meaning, and symbols attached to a place. This study aimed to explore the experience of a sense of place among individuals at the end-of-life receiving care at home via home-hospice or in a hospital. In-depth semi-structured interviews were conducted with 20 cancer patients aged 31-77 near the end-of-life (prognosis of 6 months or less left to live). Data were analysed using thematic analysis. Three main themes emerged: (a) 'This is me stuck inside my body'-the sick body and the body as a place, focused on the experience of estrangement with and disappointment from the body; (b) 'In fantasy, everyone wants to be at home and die at home, but life isn't a fantasy'-the sense of home versus the hospital, focused on the sense of place towards home and hospital; and (c) 'I don't want to meet anyone or to be anywhere'-a lack of sense of place, focused on detachment from physical and social environments and loss of sense of place. The findings demonstrate the complexity of relations with the body as the centre of experience and with the care setting. In conclusion, professional awareness of experiences of sense of place is most relevant to psychosocial interventions with patients near the end-of-life and their families. Interventions focused on improving patients' sense of place should be developed to increase their peace and quality of life and death. Educating families about the various experiences related to the sense of place may foster better understanding and empathy for the person at the end-of-life and allow a more positive experience of separation and bereavement after death.

Improving feed efficiency (FE) is a major goal for the livestock industry. Previously, we have identified 48 SNP markers distributed over 32 genes significantly associated with residual feed intake (RFI) in Israeli Holstein male calves, the most significant of which are located in the bovine FABP4 gene. In the present study, we tested associations of eight of the FABP4 markers with RFI and feed conversion ratio (FCR), along with milk composition and feeding behavioral traits, in 114 lactating Israeli Holstein cows. Large allele effects were found, along with large contributions of FABP4 markers to the phenotypic variation [mean contribution of all significant markers ( P < 0.05), 15.4 and 12.0% for RFI and FCR, respectively] and genotypic variation [means of all significant markers ( P < 0.05), 75.7 and 32.4% in RFI and FCR, respectively]. However, the association of all significant FABP4 markers with FE and milk content traits was found in opposite directions, such that improved FE was accompanied by decreased milk content. Hence, before inclusion in breeding programs, the gain in FE must be economically balanced with the loss in milk contents. On the other hand, these findings imply that in any current improvement program concentrated on milk traits alone, without taking into account the effect on FE, the progress in milk composition is probably accompanied by deterioration of FE. These results, if confirmed in other populations and breeds, set FABP4 as a prime candidate in any marker-assisted selection program targeting FE as a whole and RFI in particular.

OBJECTIVES Inconsistent findings were reported about the course of postchemotherapy symptoms; specifically, the effect of changes in optimism and perception of subjective stress on the evolution of symptoms remains understudied. This prospective study aimed (a) to examine the course of postchemotherapy symptoms of emotional distress, fatigue, and cognitive difficulties among breast cancer survivors and (2) to assess the effect of changes in optimism and subjective stress on the trajectory of these symptoms. METHODS Ninety-eight breast cancer survivors, diagnosed at stages I to III, aged 30 to 74, recruited consecutively (response rate 84.7%) completed fatigue, emotional distress, self-reported cognitive difficulties, optimism, and subjective stress questionnaires at three points in time: upon enrollment (1-6 months after completing treatment, Time 1) posttreatment, 6 months (Time 2), and 12 months (Time 3). A linear mixed-effects model was used to analyze the data. RESULTS Emotional distress decreased between time-points, level of cognitive difficulties remained stable, and a marginal decrease in fatigue was evident. Optimism or subjective stress predicted changes in each of the symptoms (P

The article discusses self-quotations as a strategy of politeness. I maintain that self-quotations fulfill strategies of linguistic politeness, and that the fulfillment of these strategies must be understood through the discourse event standing in the background of the self-quotation. In the corpus – 13 Hebrew articles written by women in eastern Europe in the nineteenth century – 35 self-quotations were found. All of them are “fictional”, i.e. they do not refer to an actual discourse event that occurred in the past. Nevertheless, the fictionality is not identical in all the cases examined, and it arises from the specific characteristics of each case. The examination of the construction of the other discourse event (past, future, or fictional) reveals that it strongly influences the quotation’s pragmatic function, and specifically its “polite” character. The discourse event might be a speech or thought event; it might actually have occurred in the past or only be implied by a future tense or a conditional structure; or sometimes it may be openly declared as a discourse event that will not take place altogether. Self-quotations function as hedging devices, qualifying various aspects of the utterance – its illocutionary force, comprehensiveness, the degree of social authority it expresses, or the act of uttering itself.

Moringa oleifera Lam. (moringa hereafter) is cultivated as a new summer super-forage field crop in Israel, yet no weed control protocol has been developed for it. The objective of the study was to develop an integrated weed management (IWM) practice for the moringa agro-system in arid and semi-arid regions like the Mediterranean basin. We tested various herbicides applied pre (PRE) and post (POST) crop emergence and cultivation methods for weed control, with an emphasis on crop safety. The PRE herbicides were the most effective and safe control mean. Their application resulted in minor (&lt, 5%) crop fresh weight reductions and weed cover area, compared with the control. The POST herbicides were also effective, yet their crop safety level was lower and non-consistent in some treatments. Generally, the finger weeder was less effective than the herbicide treatments and caused higher fresh weight reduction. However, this means was more effective when applied at earlier stages. Management and environmental conditions had a high impact on the moringa growth, hence, these aspects should be considered. Our results show the potential use of different herbicides and non-chemical tools and set the basis for a future IWM protocol for moringa. The wide range of options offered here can ensure economic and environmentally viable solutions for this new crop.

Post-treatment psychological distress among colorectal cancer (CRC) survivors is common, but changes over time. However, data on the effects of emotional factors on changes in psychological distress over time remain limited. The study sought to describe the patterns of change in psychological distress among CRC survivors in the short-term after treatment completion and to identify predictors of the change in psychological distress experienced by CRC survivors. A total of 153 CRC survivors, stages II–III at diagnosis, who were 4–24 months post-diagnosis (participation rate 89.5%) completed the Emotion Regulation Questionnaire, Acceptance and Action Questionnaire, Resilience Scale-14, Self-Compassion Scale–Short Form, and Brief Symptom Inventory-18 (psychological distress scale) at Time 1 (T1). Psychological distress was assessed again at Time 2 (T2), 6 months later. Two patterns of change in post-treatment psychological distress among CRC survivors were identified: One group of patients experienced higher psychological distress at T1, which decreased at T2. A second group experienced lower psychological distress at T1, which increased at T2. Self-compassion and personal resilience predicted higher psychological distress at T2. Lower suppression and self-compassion and higher personal resilience increased the likelihood of being in the increased psychological distress group. Psychological distress evaluation of CRC survivors at different time-points post-treatment is warranted. In addition, awareness is needed that self-compassion may be individually related to psychological distress among participants.

Despite wide recognition of the necessity of an integrative maintenance and return to work (RTW) program for cancer survivors, no such program has been described in the literature. To examine a working model of an integrative multidisciplinary health care approach for promoting RTW, using the Delphi method. A working model for promoting cancer survivors’ RTW by oncology health professionals was subjected to two rounds of evaluation by an expert panel in accordance with the Delphi research method. Twenty-six international experts in oncology (social workers, nurses, psychologists, physicians, and cancer patients) participated in the first round and 16 participated in the second round. The mean score of the working model’s applicability was 6.07 (SD = 1.07, range = 1–7). The model outlines in detail an integrative approach for promotion of RTW according to two axes: the oncology health professionals’ role and the timeline axis featuring four stages of oncology treatment and follow-up. Our proposed model addresses the need for an integrated program that may increase the rate of RTW and improve the quality of life of cancer survivors. The model should be subjected to further evaluation, especially its adaptability to different health systems in different countries.

The principles of fracture management in patients with multiple injuries continue to be of crucial importance. Early treatment of unstable polytraumatized patients with head, chest, abdomen or pelvic injuries, with blood loss followed by immediate fracture fixation (Early Total Care -ETC) may be associated with secondary life threatening posttraumatic systemic inflammatory response syndrome (SIRS). Development of SIRS is typically a function of the type and severity of the initial injury (the "first hit"). Immediate Fracture fixation, using reamed nails or plates, in such unstable patients with multiple injuries is subsequently defined as the "second hit" and may be associated with development of acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF), with relatively high morbidity and mortality. The other alternative for long bone fracture fixation in unstable polytraumatized patients is based on immediate treatment of life threatening conditions related to the injuries, followed by the initial use of minimally invasive modular external frames for long bone fractures and is called Damage Control Orthopedics (DCO) and is widely accepted. In order to refine the DCO concept and to avoid an overuse of external fixation, the "Safe Definitive Surgery" (SDS) concept has been introduced, which is a dynamic synthesis of both strategies (ETC and DCO). The SDS strategy employs clinical parameters and includes repeated assessment of patients. The following paper is going to summarize historical backgrounds and recent concepts in treatment of polytraumatized patients.

Breast cancer is a common cancer among women in the US and cultural barriers and medical mistrust have been associated with breast cancer screening (BCS) rates among minority populations. A heterogeneous sample of Arab women (N = 196) were recruited from across the Detroit metropolitan area and administered a questionnaire. Multiple regression analyses revealed an association between Arab Cultural Specific Barriers (ACSB) to BCS and Group-Based Medical Mistrust Scale. The environmental ACSB to BCS was associated with the medical mistrust—suspicion of HC providers (β = 0.363, p = 0.01), lack of HC provider support (β = 0.396, p = 0.001), and Arab inequities (β = 0.250, p = 0.05). Findings suggest that ACSB to BCS are predictive of medical mistrust for Arab American women. This study illuminates the need to emphasize strategies that will target the medical care system and the cultural barriers to BCS that Arab American women face in the health care system.

Objectives To examine the associations between intensity of providing regular grandchild care and positive affect (PA) and negative affect (NA), heart rate variability (HRV) and somatic symptoms. Methods This was a cross-sectional study involving 104 individuals (aged 59–82) who provide at least 5 h a week of regular care for their grandchildren. The study model was assessed using structural equation modeling. Results Intensity of regular care (mean hours per week: M = 14.8, SD = 11.2) was associated with higher PA and lower NA. Higher perceived role overload, higher NA and lower PA were associated with lower HRV and somatic symptoms. The fit indices indicated a good model fit. Conclusions The results suggest that healthcare professionals should be aware of the positive and negative implications of caring for grandchildren on their older patients, including the increased risk of future morbidity, as indicated by lower HRV.

Adjuvant chemotherapy is recommended in high-risk stage II&ndash, III colorectal cancer (CC). We examine the effect of daily wheatgrass juice (WGJ) intake in addition to chemotherapy on immune parameters, including IL-6, IL-8, IL-10, IL-12, and white blood cells (WBCs) among CC patients. In a controlled prospective trial, 100 stage II&ndash, III CC patients were enrolled. According to patient preference, they were divided into two subgroups, control group and intervention group, 50 patients each, all of whom received the same standard postoperative adjuvant chemotherapy, plus consumption of 60 cc WGJ daily in the intervention group. Blood samples were collected at baseline (T0) and upon treatment termination, 5&ndash, 6 months later (T1). Cytokine concentrations were assessed using ELISA kits. Anti-inflammatory cytokine IL-10 concentrations were significantly higher in the WGJ group than in the control group at T1. The decline in WBC counts between T0 and T1 was significantly lower in the WGJ group. No significant differences were observed in IL-6, IL-8, and IL-12 concentrations between the study groups. The higher levels of IL-10 and the attenuating of WBC decline during chemotherapy may constitute preliminary evidence of the beneficial effects of WGJ on immune parameters, when given as a supplement to standard care. In light of these preliminary results, WGJ supports immunological parameters during adjuvant chemotherapy. Nevertheless, future studies are needed in order to translate those results to clinical recommendations for cancer survivors.

Background:‘Explanatory Models’ (EMs) are frameworks through which individuals and groups understand diseases, are influenced by cultural and religious perceptions of health and illness, and influence both physicians and patients’ behaviors.Aims:To examine the role of EMs of illness (cancer-related perceptions) in physicians’ and laywomen’s behaviors (decision to recommend undergoing regular mammography, adhering to mammography) in the context of a traditional-religious society, that is, the Arab society in Israel.Methods:Two combined samples were drawn: a representative sample of 146 Arab physicians who serve the Arab population and a sample composed of 290 Arab women, aged 50–70 years, representative of the main Arab groups residing in the north and center of Israel (Muslims, Christians) were each randomly sampled (cluster sampling). All respondents completed a closed-ended questionnaire.Results:Women held more cultural cancer-related beliefs and fatalistic beliefs than physicians. Physicians attributed more access barriers to screening as well as fear of radiation to women patients and lower social barriers to screening, compared with the women’s community sample. Higher fatalistic beliefs among women hindered the probability of adherence to mammography; physicians with higher fatalistic beliefs were less likely to recommend mammography.Conclusions:The role of cultural perceptions needs to be particularly emphasized. In addition to understanding the patients’ perceptions of illness, physicians must also reflect on the social, cultural, and psychological factors that shape their decision to recommend undergoing regular mammography.

Purpose: The number of working-age people recovering from cancer is gradually on the rise; yet, cancer survivors have higher rates of unemployment compared to other employees. Cancer survivors returning to work cope with symptoms of fatigue, distress, cognitive difficulties and physical limitations. The present article addresses the supervisor-cancer survivor dyad as the unit of analysis, in an attempt to identify the dyadic resources that underlie the coping of the supervisor-employee unit with return to work. Materials and methods: In-depth, semi-structured individual interviews were conducted with 12 dyads of cancer survivors and their supervisors, representing successful return to work, followed by comparative content analysis of the data. Results: Four themes were revealed: (1) Congruent supervisor-cancer survivor views regarding personalized/standard management of cancer survivors' returning to work; (2) Return to work as a team work approach; (3) Commitment and persistence in the face of obstacles, and (4) Supervisor and cancer survivor mutual appreciation. Conclusions: Joint coping of supervisors and cancer survivors with the difficulties of the return to work process is perceived to contribute significantly to the success of return to work. Training of cancer survivors and supervisors conducted by rehabilitation professionals regarding aspects of the orientation toward return to work is suggested. Implication for rehabilitation Cancer survivors have different preferences regarding standard versus exceptional organizational treatment following return to work. Organizational acknowledgment of the cancer survivor's value for the organizations supports cancer survivors' return to work. Cancer survivors can benefit from a sense of responsibility and involvement in decision making regarding the process of return to work.

ObjectivePsychosocial oncologists may be particularly vulnerable to burnout. This study aimed to assess burnout among Israeli psychosocial oncologists in relation to the Job Demands-Resources model and the coping strategies model.MethodParticipants included 85 of 128 listed psychosocial oncologists currently working with cancer patients. They completed a questionnaire assessing emotional exhaustion, depersonalization, job demands, job resources, work engagement, overcommitment, and perceived value of work.ResultsThe mean level of burnout was low, whereas 16.3% experienced high levels of emotional exhaustion and only 2.4% experienced high levels of depersonalization. According to mediation analysis, overcommitment, partially mediated job demands-burnout associations, and work engagement mediated the perceived value-burnout association. Job resources and burnout were not related, either directly or indirectly.Significance of resultsThe study extended the Job Demands-Resources model to include perceived value as an additional resource, and work-engagement and overcommitment as coping strategies. Two distinct patterns of associations were found between work characteristics and burnout: the positive-protective pattern (perceived value and work engagement) and the negative pattern (job demands and overcommitment). These two patterns should be considered for further research and for implementing preventive interventions to reduce burnout in the workplace setting.

The study explored the experience of fatigue, its effects and ways of coping with fatigue and the role of family and social support among breast cancer patients. In-depth, semi-structured interviews were conducted with 13 breast cancer patients stages I-III, aged 34-67, who were up to one year after the termination of chemotherapy. Two main themes emerged: "Being imprisoned in the body of an 80-year-old," focuses the fatigue experienced by younger and older women, during and post treatment, including the different patterns of fatigue and the various means of coping with fatigue; The "Family's bear-hug" exemplifies the role of the environment in coping with the experience of fatigue and the complexities entailed in receiving support from family and friends. The study provides a comprehensive picture of fatigue in its various contexts during and post-treatment and its impact on family relations and quality of life among younger and older breast cancer patients.

Lower rates of screening for early detection of cancer were reported among ethnic minorities and faith-based communities. The purpose of the article is to assess the effect of a culturally based intervention program intended to increase breast cancer screening adherence among two groups in Israel: ultra-Orthodox Jewish and Arab women. Using a randomized controlled study design, 598 participants completed the 3-month follow-up questionnaire regarding adherence to screening and perceived effect of intervention. Results show that having a lower level of religious beliefs and gaining a better understanding of the importance of screenings were significant predictors of performing breast awareness practice (BAP) and undergoing clinical breast examination (CBE) in both groups. We conclude that interventions should be specifically tailored to cultural groups to reduce barriers stemming from unique beliefs and perceptions, which prevent individuals in these groups from undergoing screening. Special efforts should be made to increase CBE among young women.

SUMMARYMoringa oleifera is a rich source of antioxidants and a promising feed for livestock, due to significant amounts of protein, vitamins, carotenoids and polyphenols, and negligible amounts of anti-nutritional factors. The current study tested whether ensiling would preserve the antioxidant capacity of M. oleifera plants, and assessed whether Moringa silage, fed as a substitute for maize silage, would confer health-promoting traits and affect milk production in dairy cows. To this end, hand-harvested M. oleifera plants were ensiled, with or without molasses and inoculants, in anaerobic jars at room temperature (25 °C) for 37 days. At the end of the storage period the silages were analysed for pH, lactic acid and acetic acid concentrations, aerobic stability, antioxidant capacity, polyphenols and protein content, and tocopherols and carotenoids concentrations. Moringa silages exhibited higher antioxidant capacity compared with fresh and dried Moringa plants, not related to polyphenol content but presumably attributed to accumulation of amino acids and low molecular weight peptides. Based on these findings, a large-scale ensiling protocol was implemented, followed by a feeding trial for dairy cows, in which Moringa silage replaced 263 g maize silage/kg in the diet. Cows fed Moringa silage had higher milk yield and antioxidant capacity and lower milk somatic cell counts compared with controls, during some stages of lactation. These findings imply that ensiling M. oleifera is an appropriate practice by which health and production of dairy cows can be improved.

Studies have shown a lower adherence to health behaviors among women in cultural-ethnic minorities and faith-based communities, especially lower screening attendance for the early detection of breast cancer. This study compares factors related to cancer screening adherence in two distinct cultural-ethnic minorities in Israel: Arab women as a cultural-ethnic minority and Jewish ultra-Orthodox women as a cultural-ethnic faith-based minority.During the year 2014, a total of 398 Jewish ultra-Orthodox women and 401 Arab women between the ages of 40-60, were randomly selected using population-based registries. These women answered questionnaires regarding adherence to mammography and clinical breast examination (CBE), health beliefs and cultural barriers.Arab women adhered more than ultra-Orthodox women to mammography (p .001) and CBE exams (p .01). Religious beliefs, exposure barriers and perceived risk were higher among the ultra-Orthodox women, while social barriers, accessibility barriers and perceived severity were higher among the Arab women (p .01). Adjusting for background factors, higher adherence to CBE and mammography were associated with lower levels of religious beliefs (AOR = 0.90, 95% CI = 0.69-1.17 AOR = 0.62, 95% CI = 0.39-0.82, respectively), perceiving a higher risk of cancer (AOR = 1.93, 95% CI = 1.23-3.04 and AOR = 3.22, 95% CI = 1.53-6.61), and having more fears related to cancer-related losses (AOR = 1.51, 95% CI = 1.19-3.00 and AOR = 1.24, 95% CI = 0.63-1.22). In addition, perceiving greater advantages of CBE was associated with higher adherence to CBE (AOR = 1.82, 95% CI = 1.45-2.29), while not receiving a physician's recommendation was associated with lower adherence to mammography (AOR = 1.82, 95% CI = 1.45-2.29).This study addressed a lacuna in screening behaviors of women from cultural-ethnic and faith-based communities. In order to increase adherence, health care professionals and policymakers should direct their attention to the specific nature of each community.

It is well-recognized, that dietary manipulation can alter the quality of lamb meat. Moringa-oleifera was previously shown to improve livestock product quality. In the current research, we tested the effect of dietary ensiled Moringa oleifera , accounting for 6.8% of TMR, on quality characteristics of longissimus lumborum (LL) muscle of growing Assaf lambs. Steaks of Moringa-fed lambs were tenderer (27.5 ± 4.72 N), comparing to the controls (34.8 ± 4.28N), by means of shear-force (SF; P ≤ 0.01), and characterized by longer sarcomeres (2.24 ± 0.23 and 1.88 ± 0.11 μm, respectively; P ≤ 0.001) and lower intra-muscular fat (IMF) content (3.83 ± 1.60 and 5.94 ± 1.82%, respectively; P ≤ 0.05). No difference was revealed between groups in collagen content (CC). It is suggested that Moringa oleifera based dietary manipulation could be implemented in order to design a tender and lean lamb meat.

Baladi, (B taurus; DAGRIS) a native cattle breed found throughout the entire Southern Mediterranean basin, is known for its high disease resistance and hardiness. Baladi cows in Israel and Southern Mediterranean basin are endangered due to the introduction of larger and more productive European breeds in these regions. In order to promote conservation initiatives of Baladi by stakeholders, the yet unexplored production traits, over their well accepted adaptation to the harsh Mediterranean conditions, were sought in the current study. Aiming at locating the genetic potential of Baladi for meat quality, the allelic and genotypic frequencies of four polymorphisms in CAST, CAPN1, DGAT1, and FASN genes, previously reported to be associated with meat quality traits, were compared to four cattle breeds. The other four breeds included Limousine, Holstein, Simmental and Brahman cattle, which represent beef, dairy, dual-purpose and indicine bovine members, respectively. Relative to the four bovine members, Baladi cattle exhibited high frequencies of the increasing alleles and genotypes in all four SNPs associated with meat tenderness or fat deposition. These findings, along with future phenotyping and genomic profiling of meat quality related markers, and the well-established adaptability to the challenging Mediterranean pasture conditions, may promote conservation initiatives of Baladi cattle by stakeholders.