Finding ‘me’ through wheelchair basketball: an autoethnographic study of finding acceptance of a new identity after acquiring a disability through surgical removal of a sacral chondrosarcoma

Mordecai Richler, a contemporary Canadian Jewish writer, reveals the identity confusion faced by Jewish immigrants in their integration into Canadian society through the description of the life experience of the protagonist Duddy Kravitz in his novel The Apprenticeship of Duddy Kravitz (1959). Meanwhile, in the novel Day (1961), Elie Wiesel, a contemporary American Jewish writer born in Romania, examines how Holocaust survivors lose their identities and attempt to seek identity reconstruction within the context of traumatic memories and guilt through the perspective of the protagonist, Eliezer. This article aims to interpret the manifestations and reasons for identity loss and the possibility of identity reconstruction of the protagonists Duddy Kravitz and Eliezer based on identity theory. Through interpretation, it can be concluded that Duddy is marginalized by mainstream society and blamed for anti-Semitism within the Jewish community, resulting in a significant identity crisis. However, his success in purchasing land offers the possibility for him to escape marginalization and achieve identity reconstruction in mainstream society. Similarly, Eliezer, as a Holocaust survivor, experiences identity loss under the influence of traumatic memories and feelings of guilt, leading to questioning the existence of God and a death wish. Nevertheless, in the later part of the novel, he transitions from an unnamed narrator to “Eliezer”, and the ashes left after his portrait is burned symbolize his completeness, allowing him to regain self-identity.

Athlete identity in para-sport: A comparative study of athletes with congenital and acquired disabilities

This paper describes the impact of chronic illness on self and identity among 35 adults with traumatic spinal cord injury (paraplegic), living in the community. The reconstruction of self and identity post spinal cord injury is conceptualised as a pendulum. The pendulum of self represents a dynamic model of identity reconstruction. The pendulum suggests that identity reconstruction is a process that swings back and forth like a pendulum between the nondisabled and disabled aspects of self. The pendulum depicts five predominant identity views (outcomes). These are: 1) the former self; 2) the supernormal identity; 3) the disabled identity as total self; 4) the disabled identity as an aspect of the total self; and 5) the middle self. These identity views are influenced by five experiences (processes). These are: 1) loss; 2) sustainment; 3) integration; 4) continuity and 5) development of the self. It is suggested that frameworks of identity reconstruction or reconstitution which include both process and outcome components may elucidate more clearly the impact of chronic illness on self and identity. In addition, this pendulum model of identity reconstruction is an alternative approach to traditional sociological conceptions of identity reconstruction.

This research investigates the lived perceptions of South Asian women in coping with the consequences of divorce, a culturally tainted break-up commonly fraught with shame, disposability, and loss of identity. Using narrative approach, from interviews and handpicked personal stories, the research investigates how women interpret post-divorce life in patriarchal, collectivist societies that value marriage as a pillar of feminine moral character. Based on Arthur Frank’s typology of illness stories, specifically the quest narrative, the results indicate that most women reinterpret their trauma as a transformative, resistant, and re-claimed journey. This research, however, explores an expansion of Frank’s model by incorporating the idea of the “agency quest,” where narrative coherence is supplemented by embodied and spiritual practices—journaling, yoga, chanting, and intuitive healing—as a part of identity reconstruction. Spirituality appeared not in the form of passive withdrawal but as an active ethical work by which women rethought the holy, recovered bodily sovereignty, and developed emotional toughness. The analysis locates these practices within paradigms of embodied cognition, feminist theology, and ethical self-cultivation, contending that healing is not just a cognitive or discursive endeavor but one profoundly embedded in sensory, affective, and ritual practice. Notably, the research considers the lack of chaos narratives and the structural limitations that dictate whose narratives get to be heard and told. It demands a feminist praxis affirming not just coherent narratives of development but the messiness, silence, and ambiguity that play a role in identity reconstruction following social disconnection.

Exercise has been proposed as a possible cancer treatment; however, there are an infinite number of clinical oncology settings involving diverse cancer types and treatment protocols in which exercise could be tested as a cancer treatment. The primary purpose of this paper is to propose a conceptual framework to organize and guide research on exercise as a cancer treatment across distinct clinical oncology settings. A secondary purpose is to provide an overview of existing exercise research using the proposed framework. The Exercise as Cancer Treatment (EXACT) framework proposes nine distinct clinical oncology scenarios based on tumor/disease status and treatment status at the time of the proposed exercise treatment. In terms of tumor/disease status, the primary tumor has either been surgically removed (primary goal to treat micrometastases), not surgically removed (primary goal to treat the primary tumor), or metastatic disease is present (primary goal to treat metastatic disease). In terms of treatment status, the extant disease has either not been treated yet (treatment naïve), is currently being treated (active treatment), or has previously been treated. These two key clinical oncology variables—tumor/disease status and treatment status—result in nine distinct clinical oncology scenarios in which exercise could be tested as a new cancer treatment: (a) treatment naïve micrometastases, (b) actively treated micrometastases, (c) previously treated micrometastases, (d) treatment naïve primary tumors, (e) actively treated primary tumors, (f) previously treated primary tumors, (g) treatment naïve metastatic disease, (h) actively treated metastatic disease, and (i) previously treated metastatic disease. To date, most preclinical animal studies have examined the effects of exercise on treatment naïve and actively treated primary tumors. Conversely, most observational human studies have examined the associations between exercise and cancer recurrence/survival in patients actively treated or previously treated for micrometastases. Few clinical trials have been conducted in any of these scenarios. For exercise to be integrated into clinical oncology practice as a cancer treatment, it will need to demonstrate benefit in a specific clinical setting. The EXACT framework provides a simple taxonomy for systematically evaluating exercise as a potential cancer treatment across a diverse range of cancer types and treatment protocols.

Eliminating cancer-related disparities is a global public health priority. Approximately 40% of cancer survivors experience long-term effects of cancer which can lead to activity limitations and participation restrictions; yet discussions of disability are largely absent from clinical and research cancer health equity agendas. The purpose of this study was to explore how cancer survivors experience and make sense of the long-term disabling effects of cancer and its treatments. In this qualitative study, data were collected via in-depth semi-structured interviews with survivors of breast cancer, head and neck cancer, and sarcoma (n = 30). Data were analyzed thematically using a 2-phase iterative process proceeding from descriptive to conceptual coding. Survivors experienced a wide range of long-term physical, sensory, cognitive, and emotional effects, that intertwined to restrict their participation in self-care, work, leisure, and social roles. While the interaction between impairments and participation restrictions meets the definition of disability; participants articulated a range of responses when asked about their disability identity, including (1) rejecting, (2) othering, (3) acknowledging, and (4) affirming. Findings may be indicative of structural and internalized ableism which can impede cancer care and survivorship. To support cancer survivors’ transition to post-treatment life, cancer care providers should implement anti-ableist practices and engage in frank discussions about cancer’s long-term impacts.

Impairment, whether gradual or traumatic, congenital or adventitious, can have an influence on one's own view of the world and his values. Disability has its impact on the disabled as it alienates him from people around him. The alienation that is caused by an impairment is undifferentiated from the one that happens because of other situations of social abuse. There is a relationship between the experience of living with an impairment and the disabled's selfperceptions. This experience helps in the formation of the disabled's identity. This identity has been enforced by the societal prejudices and the personal incapability. These conflicting feelings of alienation and loss of one's own identity are discussed in Lisa Genova's novel Left Neglected and Jean Dominique Bauby's disability memoir The Diving Bell. They show how a sudden accident causes a life-changing collision and how high- achieving people struggle to rebuild themselves and their lives

The development of a robust professional identity is a pivotal aspect of every healthcare professional's educational journey. Critical social perspectives are increasingly influencing the examination of professional identity formation within healthcare professions. While understanding how disabled students and practitioners integrate a disability identity into their professional identity is crucial, we have limited knowledge about the actual formation of their professional identity. This study aims to investigate how disabled students and clinicians in healthcare professions actively shape their professional identity during their educational and professional journeys. We conducted in-depth semi-structured interviews with 27 students and 29 clinicians, conducting up to three interviews per participant over a year, resulting in 124 interviews. Participants represented five healthcare professions: medicine, nursing, occupational therapy, physical therapy, and social work. Employing a constructivist grounded theory approach, our data analysis revealed two prominent dimensions: (a) The contextualization of identity formation processes and (b) The identity navigation dimension in which the professional identity and disability identity are explored. This emerging model sheds light on the dynamic processes involved in identity formation, emphasizing the significance of a supportive environment for disabled students and practitioners. Such an environment fosters the negotiation of both professional and disability identities. Moreover, this study recognizes the importance of a re-examination of the concepts of professionalism and professional identity in healthcare professions. In conclusion, this research underscores the importance of understanding and supporting the multifaceted identity formation processes among disabled individuals within healthcare professions.

Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery

Identity Negotiation and Reconstruction Following a Spinal Cord Injury: A Meta-Synthesis of Qualitative Evidence

A Phase I/II Clinical Trial of Proton Therapy for Chordomas and Chondrosarcomas

BackgroundLow and intermediate grade chondrosarcomas are relative rare bone tumours. About 5-12% of all chondrosarcomas are localized in base of skull region. Low grade chondrosarcoma has a low incidence of distant metastasis but is potentially lethal disease. Therefore, local therapy is of crucial importance in the treatment of skull base chondrosarcomas. Surgical resection is the primary treatment standard. Unfortunately the late diagnosis and diagnosis at the extensive stage are common due to the slow and asymptomatic growth of the lesions. Consequently, complete resection is hindered due to close proximity to critical and hence dose limiting organs such as optic nerves, chiasm and brainstem. Adjuvant or additional radiation therapy is very important for the improvement of local control rates in the primary treatment. Proton therapy is the gold standard in the treatment of skull base chondrosarcomas. However, high-LET (linear energy transfer) beams such as carbon ions theoretically offer advantages by enhanced biologic effectiveness in slow-growing tumours.Methods/DesignThe study is a prospective randomised active-controlled clinical phase III trial. The trial will be carried out at Heidelberger Ionenstrahl-Therapie (HIT) centre as monocentric trial.Patients with skull base chondrosarcomas will be randomised to either proton or carbon ion radiation therapy. As a standard, patients will undergo non-invasive, rigid immobilization and target volume definition will be carried out based on CT and MRI data. The biologically isoeffective target dose to the PTV (planning target volume) in carbon ion treatment will be 60 Gy E ± 5% and 70 Gy E ± 5% (standard dose) in proton therapy respectively. The 5 year local-progression free survival (LPFS) rate will be analysed as primary end point. Overall survival, progression free and metastasis free survival, patterns of recurrence, local control rate and morbidity are the secondary end points.DiscussionUp to now it was impossible to compare two different particle therapies, i.e. protons and carbon ions, directly at the same facility in connection with the treatment of low grade skull base chondrosarcomas.This trial is a phase III study to demonstrate that carbon ion radiotherapy (experimental treatment) is not relevantly inferior and at least as good as proton radiotherapy (standard treatment) with respect to 5 year LPFS in the treatment of chondrosarcomas. Additionally, we expect less toxicity in the carbon ion treatment arm.Trial RegistrationClinicalTrials.gov identifier: NCT01182753

THE ROLE AND IMPACT OF PATHOLOGY REVIEW ON STAGE AND GRADE ASSESSMENT OF STAGES TA AND T1 BLADDER TUMORS: A COMBINED ANALYSIS OF 5 EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER TRIALS

Bereaved spouses reconstruct their identities to make sense of changes in how they understand themselves after loss. For military spouses, identity reconstruction might be particularly challenging since they must also manage changes in their military status. This study included interviews with bereaved U.S. military spouses (N = 9) about their experiences managing identity. Results indicate that participants experienced shifting identities. Individuals managed (a) multiple, conflicting identities and (b) the loss of identities. Findings suggest that participants’ military status added a layer of identity reconstruction, making grief more complex. These results offer insight into how military survivors reconstruct identity following loss.

Military discharge marks a pivotal life transition, often resulting in loss of identity, purpose, and belonging. Negative discharge experiences are further associated with feelings of institutional betrayal. This study explored which aspects of discharge negatively impact veterans during and after their transition. Using Reflexive Thematic Analysis on accounts from Australian veterans (N = 313), three key themes emerged: (1) Discharge Experiences as Institutional Transgressions and Betrayal, with sub-themes: Unceremonious Exits and Lingering Discharges, Left Harmed and Rejected, and Bad Actors and Acutely Harmful Events; (2) Discharge as a Loss of Self; and (3) Negative Discharge Experiences as Negative Centralizing Events and 'Stuck-Points'. Findings revealed that veterans experience harm when they perceive their discharge as an institutional or personal transgression-ranging from bureaucratic disregard to service-related injuries leading to rejection and overt betrayal by bad actors. These events, regardless of severity, undermine veterans' shared military identity and values, posing a psychological threat to their sense of belonging, severing familial-like bonds, and fostering feelings of rejection, diminished self-worth, isolation, and betrayal-hindering transition and identity reconstruction. We argue that the harm stems not from discharge itself but from veterans experiencing these negative experiences as a violation of shared values-values they were required to embody for group membership. In identity-centric workplaces like the military, where enculturation fosters deep, family-like bonds, discharge represents a unique psychosocial hazard. Proactive management is essential to mitigate lasting psychological harm.