Future Regret Research Articles

The experience of transfeminine adolescents and their parents regarding fertility preservation via testicular sperm extraction (TESE): a qualitative study.

How do transfeminine adolescents and their parents experience fertility preservation via testicular sperm extraction (TESE)? Participants experienced the TESE process positively when provided with appropriate guidance to navigate the decisional dilemma between preserving future biological parenthood and the pressure to start puberty suppression early. Sperm banking through ejaculation is not feasible for all transfeminine adolescents due to genital dysphoria and early puberty; for this group, TESE is the only alternative. However, during early puberty, they must postpone or pause puberty suppression until spermatogenesis is fully developed. All consecutive TESE patients in our centre and their parents were invited to participate. Between December 2022 and May 2023, we included 6 adolescents and 10 parents. We used a qualitative approach based on semi-structured interviews to study the experience of the transfeminine adolescents and their parents. Transfeminine adolescents diagnosed with gender dysphoria in early puberty (Tanner stage ≥2) who underwent TESE before the start of puberty suppression or gender-affirming hormones participated in this study. The interviews were recorded, manually transcribed and analysed using reflective thematic analysis focusing on understanding the participants' experiences of puberty and fertility preservation and the various factors and social processes influencing their decision to undergo TESE. Transfeminine adolescents decide to undergo invasive fertility preservation because of a possible, future desire for parenthood. Parents stressed the importance of preventing future decisional regret. They both saw masturbation to obtain a semen sample as unreachable. Even though TESE is a surgical procedure with possible complications and pain afterwards, this alternative seemed less dysphoric to them.Adolescents had to postpone the start of puberty suppression, waiting for spermatogenesis to complete. Given the unpredictable development of puberty, they felt a lot of stress and anxiety during this period and were primarily concerned about the lowering of their voice. Because of this puberty-related stress, they were constantly balancing their motivations for fertility preservation against the early start of puberty suppression to prevent unwanted irreversible pubertal body changes. To support this decisional dilemma, adolescents and their parents need adequate communication with each other and their healthcare providers to reflect on their stress for pubertal change. Furthermore, close, continuous surveillance of their current mental state by their parents, together with their psychologist and pubertal development by their physicians, is needed. Despite the challenging decision and postponement of puberty suppression, they retrospectively experienced it positively without any regret. All adolescents successfully underwent TESE, with viable spermatozoa obtained and without complications. This may result in a more positive reflective experience regarding fertility preservation. Furthermore, the perspectives of adolescents with the intention of TESE but who already started with puberty suppression before the preservation were not included. This study helps healthcare providers improve their counselling and guidance of transfeminine adolescents who consider postponing puberty suppression for fertility preservation via TESE. The adolescents and their parents know more clearly what to expect during fertility preservation. Specific peer-support programs may facilitate the decision process for upcoming adolescents. No external funding was used for this study. None of the authors have any conflicts of interest. Not applicable.

Promoting informed decision making about maternal pertussis vaccination: the systematic development of an online tailored decision aid and a centering-based group antenatal care intervention.

Maintaining and enhancing vaccine confidence continues to be a challenge. Making an informed decision not only helps to avoid potential future regret but also reduces susceptibility to misinformation. There is an urgent need for interventions that facilitate informed decision-making about vaccines. This paper describes the systematic development of two interventions designed to promote informed decision making and indirectly, acceptance of maternal pertussis vaccination (MPV) in the Netherlands. The 6-step Intervention Mapping (IM) protocol was used for the development of an online tailored decision aid and Centering Pregnancy-based Group Antenatal Care (CP) intervention. A needs assessment was done using empirical literature and conducting a survey and focus groups (1), intervention objectives were formulated at the behavior and determinants levels (2), theoretical methods of behavior change were selected and translated into practical applications (3), which were further developed into the two interventions using user-centered design (4). Finally, plans were developed for implementation (5), and evaluation (6) of the interventions. The needs assessment showed that pregnant women often based their decision about MPV on information sourced online and conversations with their partners, obstetric care providers, and peers. Responding to these findings, we systematically developed two interactive, theory-based interventions. We created an online tailored decision aid, subjecting it to four iterations of testing among pregnant women, including those with low literacy levels. Participants evaluated prototypes of the intervention positively on relevance and usability. In addition, a CP intervention was developed with midwives. Using IM resulted in the creation of an online decision aid and CP intervention to promote informed decision making regarding MPV. This description of the systematic development of the interventions not only serves to illustrate design rationales, it will also aid the interpretation of the evaluation of the interventions, the development of future interventions promoting informed decision and acceptance of vaccines, and comparisons with other interventions.

Regrets, I’ve Had a Few: Exploring Factors Associated with Getting Drunk and Regret in an International Study of People Who Drink Alcohol

Background Excessive alcohol consumption is often followed by feelings of regret. This study aimed to explore country differences in experiences of drunkenness and regrets and predictors of experiencing a greater number of regrettable drinking occasions. Methods This study draws on a sample of 82,821 respondents from 31 countries who completed the 2020 Global Drug Survey. Respondents were asked to report how many times in the last year they had been drunk, how many of those times they felt regret afterwards and to complete a range of sociodemographic measures. Results In the last 12 months, the median times drunk was 6 and the median number of regretted occasions was 2. There was an inverse relationship between times drunk and regret. Respondents who got drunk more often regretted it a smaller percentage of the time than those who got drunk less often. Respondents from Argentina and Colombia regretted being drunk the most and Denmark the least. Being younger, in higher AUDIT categories were associated with more times drunk. Being a woman, having mental health conditions were associated with more regretted occasions. Discussion and conclusions: Country variations may reflect relative acceptability of being drunk. Those who drink more, per occasion, may become accustomed to the consequences and feel fewer regrets. Interventions promoting reduced alcohol consumption may benefit from encouraging people to consider their future regret following a drinking occasion but should account for lower levels of regret in those who get drunk more often.

Fertility preservation choices and decisional regret after gender-affirming surgery in transgender men or gender nonbinary persons

To investigate the prevalence of decisional regret regarding preoperative fertility preservation choices after gender-affirming surgery or removal of reproductive organs. Cross-sectional. University-based pratice. A total of 57 survey respondents identifying as transgender men or gender nonbinary with a history of gender-affirming surgery or removal of reproductive organs between 2014 and 2023 with the University of North Carolina Minimally Invasive Gynecology division. Survey or questionnaire. The prevalence and severity of decisional regret regarding preoperative fertility preservation choices were measured with the use of the validated decisional regret scale (DRS) (scored 0-100). Secondary outcomes included patient-reported barriers to pursuing reproductive endocrinology and infertility consultation and fertility preservation treatment. The survey response rate was 50.9% (57/112). "Mild" to "severe" decisional regret was reported by 38.6% (n = 22) of survey respondents, with DRS scores among all respondents ranging from 0-85. Higher median DRS scores were associated with patient-reported inadequacy of preoperative fertility counseling regarding implications of surgery on future fertility or family-building (0vs. 50) and fertility preservation options (0 vs. 12.5). No desire for future fertility at the time of fertility counseling was the most frequent reason (68.4%) for declining a referral to reproductive endocrinology and infertility for additional fertility preservation discussion. Decisional regret regarding preoperative fertility preservation choices is experienced among transgender men or gender nonbinary persons after gender-affirming surgery or the removal of reproductive organs. Preoperative, patient-centered fertility counseling and fertility preservation treatments should be provided to reduce the risk of future regret.

Decision regret among couples experiencing infertility: a mixed methods longitudinal cohort study

BackgroundDecisions for how to resolve infertility are complex and may lead to regret. We examined whether couples and individuals who sought a consultation from a reproductive specialist for infertility later expressed decisional regret about their family-building choices and whether regret was associated with parental role, family-building paths, or outcomes.MethodsThis longitudinal mixed methods study included women and their partners who completed a questionnaire prior to their initial consultation with a reproductive specialist and 6 years later. The six-year questionnaire included the Ottawa Decision Regret Scale referencing “the decisions you made about how to add a child to your family.” A score of 25+ indicates moderate-to-severe regret. Additional items invited reflections on family-building decisions, treatments, and costs. A systematic content analysis assessed qualitative themes.ResultsForty-five couples and 34 individuals participated in the six-year questionnaire (76% retention rate), Half (n = 61) of participants expressed no regret, which was similar by role (median 0 for women and supporting partners, F = .08; p = .77). One in 5 women and 1 in 7 partners expressed moderate-to-severe regret. Women who did not pursue any treatment had significantly higher regret (median 15; F = 5.6, p < 0.01) compared to those who pursued IVF (median 0) or other treatments (median 0). Women who did not add a child to their family had significantly higher regret (median 35; F = 10.1, p < 0.001) than those who added a child through treatment (median 0), through fostering/adoption (median 0), or naturally (median 5). Among partners, regret scores were not associated with family-building paths or outcomes. More than one-quarter of participants wished they had spent less money trying to add a child to their family. Qualitative themes included gratitude for parenthood despite the burdensome process of family-building as well as dissatisfaction or regret about the process. Results should be confirmed in other settings to increase generalizability.ConclusionThis longitudinal study provides new insight into the burden of infertility. For women seeking parenthood, any of the multiple paths to parenthood may prevent future decision regret. Greater psychosocial, financial, and decision support is needed to help patients and their partners navigate family-building with minimal regret.

Motivational stimuli to donate sperm among non-donor students

BackgroundSperm banks face a continuously evolving gap between the increasing demand for sperm donation (SD) vs. limited available reserve. To improve donors’ recruitment and increase supply, motivations towards SD should be investigated specifically among young men who have the potential to become donors. Our aim was to evaluate factors which increase and decrease predisposition to donate sperm among non-donor students, who represent a “potential pool” for possible donors’ recruitment.ResultsNinety-three men fulfilled the questionnaire with mean age of 28.2 ± 4.5 years. The most powerful incentive to donate sperm was financial reward followed by a willingness to help others to build a family (3.8 and 3.4, respectively). The most dominant consideration to decline donation was the fear of anonymity loss and future regret (4 and 3.8). While participants’ willingness for anonymous SD was fair (2.8), the open-identity donation was rated significantly lower (1.75, p < 0.01). Familiarity with recipients and offspring had lower scores (1.9–2.2) as well.ConclusionsYoung single men represent a suitable cohort for anonymous donation. Financial reward and willingness to help others are important positive incentives while anonymity preservation is crucial to maintain their willingness towards SD. Regulatory shifting towards open-identity SD necessitates the establishment of an alternative “potential pool” population as a reliable source to recruit donors.

Past and Future: Backward and Forward Discounting

Abstract We study a model of time preference in which both current consumption and the memory of past consumption enter “experienced utility”—or the felicity—of an individual. An individual derives overall utility from her own felicity and the anticipated felicities of future selves. These postulates permit an agent to anticipate future regret in current decisions, and generate a set of novel testable implications in line with empirical evidence. The model can be applied to disparate phenomena, including present bias, equilibrium savings behavior, anticipation of regret, and career concerns.

Decision regret among women considering planned oocyte cryopreservation: a prospective cohort study.

To (1) prospectively characterize the incidence of decision regret among women considering planned oocyte cryopreservation (planned OC), comparing those who pursued treatment vs those who did not freeze eggs, and (2) to identify baseline predictors for future decision regret. A total of 173 women seen in consultation for planned OC were followed prospectively. Surveys were administered at (1) baseline (< 1week after initial consultation) and (2) follow-up, 6months after planned OC among participants who froze eggs or 6months following consultation in the absence of further communication to pursue treatment. The primary outcome was the incidence of moderate-to-severe decision regret, indicated by a Decision Regret Scale score > 25. We also examined predictors of regret. The incidence of moderate-to-severe regret over the decision to freeze eggs was 9% compared to 51% over the decision not to pursue treatment. Among women who froze eggs, adequacy of information at baseline to decide about treatment (aOR 0.16, 95% CI 0.03, 0.87) and emphasis on future parenthood (aOR 0.80, 95% CI 0.66, 0.99) were associated with reduced odds of regret. Forty-six percent of women who froze eggs regretted not doing so earlier. Among women who did not freeze eggs, the primary reasons were financial and time constraints, correlating with increased odds of decision regret in an exploratory analysis. Among women undergoing planned OC, the incidence of decision regret is low compared to the regret confronting women seen in consultation for planned OC but who do not pursue treatment. Provider counseling is key to offset the regret risk.

U.S. physicians’ perspectives on the complexities and challenges of permanent contraception provision

ObjectivesEvidence shows many misconceptions exist around permanent contraception, and there are numerous barriers to accessing the procedure. This qualitative study explored physician perspectives regarding patients’ informational and decision-support needs, the complexities and challenges of counseling and access, and how these factors may differ for people living on lower incomes. Study designWe conducted 15 semistructured, telephone interviews with obstetrician-gynecologists in three geographic regions of the United States to explore their perspectives on providing permanent contraception counseling and care. We analyzed the interviews using content analysis. ResultsPhysicians discussed a tension between respecting individual reproductive autonomy and concern for future regret; they wanted to support patients’ desire for permanent contraception but were frequently concerned patients did not have the information they needed or the foresight to make high-quality decisions. Physicians also identified barriers to counseling including lack of time, lack of continuity over the course of prenatal care, and baseline misinformation among patients. Physicians identified additional barriers in providing a postpartum procedure even after thedecision was made including lack of personnel and operating room availability. Finally, physicians felt that people living on lower incomes faced more challenges in access primarily due to the sterilization consent regulations required by Medicaid. ConclusionsPhysicians report numerous challenges surrounding permanent contraception provision and access. Strategies are needed to support physicians and patients to enhance high-quality, patient-centered sterilization decision making and ensure that patients are able to access a permanent contraceptive procedure when desired. ImplicationsThis qualitative study demonstrates the various challenges faced by physicians to support permanent contraception decision making. These challenges may limit patients’ access to the care they desire. This study supports the need to transform care delivery models and improve the federal sterilization policy to ensure equitable patient-centered access to desired permanent contraception. DisclaimerAlthough the term permanent contraception has increasingly replaced the word sterilization in clinical settings, we use sterilization in some places throughout this paper as that was the standard terminology at the time the interviews were conducted and the language the interviewed physicians used.

How funerals mediate the psycho-social impact of grief: Qualitative analysis of open-ended responses to a national survey in Japan

BackgroundAs populations age and pandemics continue, grief disrupts the health and productivity of increasingly bereaved populations. While funerals can reconnect old friends and relations to provide psycho-social support, and satisfying funeral participation reportedly reduces such psychiatric complications of grief, the psychological effects of recent restrictions on funerals remains unclear. This first English report of open-ended responses to a Japan-wide survey sheds some light on this by looking at Japanese psychological reflections on their funerals. ObjectivesTo determine what aspects of funerals the Japanese bereaved feel psycho-socially valuable or conversely problematic, and for what reasons. SettingData were collected using anonymized all-Japan postal surveys from 2019 to 2020. Participants288 recently-bereaved chief mourners submitted 353 open-ended responses discussing their experiences and feelings about the funerals they conducted. MethodAnonymized data were divided into positive, regrets, vacillations, and negative comments about the subjects most frequently cited. ResultsMost commonly cited were funeral directors (64), attendees (56), ritual/ceremony (49), and the need for (pre-)planning (40). Respondents profoundly appreciated funeral directors' support, and regretted not having planned better or invited more people to the funeral. Dissatisfaction tended to focus on unexplained expenses and mistakes or offenses in rituals. Many also criticized their doctors for not realistically forecasting their loved ones' demise. ConclusionsResponses validated that responsive funeral directors can significantly support their clients through early acute grief, and that inviting more celebrants to a full funeral facilitates psycho-social support and may obviate future regrets. Rituals too provide memorable means to help survivors deal with grief. Medical professionals should psychologically encourage terminal patients' families to communicate while patients are still coherent; families are strongly advised to discuss funeral plans with their elders before the end of life.

Getting Over Past Mistakes: Prospective and Retrospective Regret in Older Adults.

A considerable number of older people who hold powerful positions in governments and corporate are actively engaged in making decisions that have a far-reaching impact on the community. Some of them have to make decisions on behalf of others, and sometimes, the outcomes of their decisions for others are unfavorable. We experience retrospective regret when the obtained outcome turns out to be less attractive than the counterfactual one. We also actively make choices to avoid regretful outcomes if we prospectively anticipate the regret. In the current study, we investigated how older adults experience regret and how they make choices to avoid potential regret, in the context of making decisions for themselves and on behalf of others. Sixty younger and 60 older participants performed a gambling task in which two types of regret were independently measured: prospective (planning to avoid regret during decision making) and retrospective (feeling of regret following the comparison of alternative outcomes). Our results showed that compared to younger adults, the older adults were less sensitive to regret-inducing outcomes, whereas they demonstrated comparable ability in using prospective regret to guide decisions, regardless of whether they made decisions for themselves or on behalf of others. Our findings indicate that although older adults experience blunted regret, their ability to avoid future regret to guide subsequent choices remains unimpaired. Our research has implications for understanding how older adults cope with regret.

The moderating role of career decision regret in the relationship between visions about the future and proactive career behaviors: Turkey sample

This study was conducted to examine the moderating role of career decision regret in the relationship between university students' visions about the future and proactive career behaviors.The study consisted of a total of 312 university students, including 167 (53.5%) females and 145 (46.5%) males, at a university in the Eastern Mediterranean Region of Turkey. Visions about the Future Scale, Career Decision Regret Scale, and Career Engagement Scale were used as data collection tools. Correlation analysis and regression analysis based on the bootstrap method were employed in data analysis. As a result of the correlation analysis, it was concluded that proactive career behaviors had significant relationships with visions about the future and career decision regret. The result of the regression analysis conducted to determine the moderating effect indicated that career decision regret had a moderating role in the relationship between visions about the future and proactive career behaviors. Promoting individuals’ visions about the future and reducing career decision regret can contribute to increasing proactive career behaviors.Resultsobtainedwere discussed, and suggestions were made for practitioners and researchers.

Impact Bias in Regret: Comparisons Between Within‐Subjects and Between‐Subjects Designs, Kokaishita and Kuyashi, and the Presence and Absence of Reward1,2

AbstractWhen people anticipate future regret, they overestimate its strength compared to experienced regret. Two experiments investigated this impact bias of regret by manipulating regret type (anticipated/experienced) in a within‐subjects design. Regret was measured using the Japanese words kokaishita (後悔した) and kuyashi (悔しい), which are both translated as “regret” in English but differ in nuance in Japanese. We compared the participants' feelings of kokaishita and kuyashi when they failed at tasks in which their decisions did or did not affect the outcome. In Experiment 1 but not Experiment 2, the participants were offered an additional reward for task success. The results suggested that (a) impact bias occurs robustly when the same person both anticipates and experiences regret; (b) kokaishita is felt in response to decision failures, while kuyashi is felt for any kind of task failure; and (c) the presence of additional rewards influences the intensity of kokaishita but not that of kuyashi or impact bias.

Singapore needs to update regulation of frozen egg donation after permitting social egg freezing.

With social egg freezing being permitted in Singapore, there is expected to be an accumulated surplus of unused frozen eggs (vitrified oocytes) available for donation in coming years. A comprehensive update of current healthcare regulations pertaining to frozen egg donation is needed to resolve various pertinent ethical issues. In particular, the issue of egg donor anonymity should be addressed, together with the lack of sharing of medical and family information about the donor to prospective recipient patients and donor-conceived offspring. Rigorous and comprehensive genetic testing of prospective egg donors must be mandated to protect the welfare of recipient patients. Older women above 35years of age should be required to have at least one child, before being allowed to donate their unused frozen eggs, to prevent any future regret and psychological problems of remaining childless, while being unsure of whether they have an unknown genetic offspring out there. New regulations drafted to address these ethical issues must also prevent potential conflicts of interests. For example, fertility doctors soliciting and encouraging former patients to donate their unused frozen eggs face an obvious conflict of interest, because additional medical fees will be earned by performing the egg donation procedure on other patients. A centralized donor registry should be established by the Singapore government to oversee the distribution and allocation of donated unused frozen eggs to infertile IVF patients. Such a registry could also facilitate sharing of vital health information about the donor to recipient patients and donor-conceived offspring.

Continuation of Gender-affirming Hormones Among Transgender Adolescents and Adults.

Concerns about future regret and treatment discontinuation have led to restricted access to gender-affirming medical treatment for transgender and gender-diverse (TGD) minors in some jurisdictions. However, these concerns are merely speculative because few studies have examined gender-affirming hormone continuation rates among TGD individuals. We performed a secondary analysis of 2009 to 2018 medical and pharmacy records from the US Military Healthcare System. We identified TGD patients who were children and spouses of active-duty, retired, or deceased military members using International Classification of Diseases-9/10 codes. We assessed initiation and continuation of gender-affirming hormones using pharmacy records. Kaplan-Meier and Cox proportional hazard analyses estimated continuation rates. The study sample included 627 transmasculine and 325 transfeminine individuals with an average age of 19.2 ± 5.3 years. The 4-year gender-affirming hormone continuation rate was 70.2% (95% CI, 63.9-76.5). Transfeminine individuals had a higher continuation rate than transmasculine individuals 81.0% (72.0%-90.0%) vs 64.4% (56.0%-72.8%). People who started hormones as minors had higher continuation rate than people who started as adults 74.4% (66.0%-82.8%) vs 64.4% (56.0%-72.8%). Continuation was not associated with household income or family member type. In Cox regression, both transmasculine gender identity (hazard ratio, 2.40; 95% CI, 1.50-3.86) and starting hormones as an adult (hazard ratio, 1.69; 95% CI, 1.14-2.52) were independently associated with increased discontinuation rates. Our results suggest that >70% of TGD individuals who start gender-affirming hormones will continue use beyond 4 years, with higher continuation rates in transfeminine individuals. Patients who start hormones, with their parents' assistance, before age 18 years have higher continuation rates than adults.

52. Continuation of Gender-Affirming Hormones Among Transgender Adolescents and Adults in a Medical System With Low- or No-Cost Medical Care

Concerns about the cognitive capacity of minors to provide informed assent for treatments with permanent effects and the risk of future regret if gender identity changes, have led to governmental restrictions on gender-affirming treatment of minors. However, among transgender and gender diverse (TGD) adults, only 13% reported a history of going back to living as their sex assigned at birth at least for a little while, including 8% who discontinued gender-affirming hormones. Only 2% reported fluctuation in gender identity as a reason to discontinue social or medical transition.

Dynamic Regret Avoidance

In a stock market experiment, we examine how regret avoidance influences the decision to sell an asset while its price changes over time. Participants know beforehand whether they will observe the future prices after they sell the asset or not. Without future prices, participants are affected only by regret about previously observed high prices (past regret), but when future prices are available, they also avoid regret about expected after-sale high prices (future regret). Moreover, as the relative sizes of past and future regret change, participants dynamically switch between them. This demonstrates how multiple reference points dynamically influence sales. (JEL C91, G12, G41)

Relationship-based moral judgments: A qualitative study

ABSTRACT The goal of the present study was to explain the pattern of familiar and unfamiliar relationships influencing moral judgments. In this qualitative study, relationship-based moral judgments were examined according to the constructivist theory. The studied sample included 27 individuals, including 14 women and 13 men (both young and old), living in Tehran. A purposeful sampling method was used. In order to collect data, participants were faced with moral dilemmas using semi-structured interviews. The results showed that emotional intimacy, lack of tolerance for loss of loved ones and avoiding future regrets, group loyalty and common goals, and real or symbolic threats and a negative relationship were factors involved in relationship-based moral judgments. These factors, alone or together with cognitive biases, lead to unfair moral judgments, and after recognizing moral concerns related to ignoring the principle of equality, people tend to use Moral Disengagement mechanisms to reduce self-blame.

An automatic mechanism to provide privacy awareness and control over unwittingly dissemination of online private information

Given the increasing popularity of social media and other Internet-related technologies, individuals spend a lot of time across different online activities, such as doing Google searches or credit card purchases, enjoying social networks interactions, performing job finding or travel plannings activities. Unfortunately, very often, individuals unwittingly disseminate a huge amount of personal and sensitive information that fundamentally represents an essential part of their private life. A large part of this information is embedded into text messages typed during online activities. Therefore, there is an increasing need for mechanisms to assist individuals during such activities, raising their awareness about potential violation of privacy at the time of disclosure; however, it is also essential to give them full control on whether and how to manage their data, thereby empowering them to make heedful decisions. The awareness can be realized through simple alert/highlight mechanisms, while the full control can be ensured by allowing users to make the final choice, that is, ignore warnings, or conversely accept them and thus (a) think twice before disseminating data (to avoid future regrets), or (b) anyway send data, but only after their anonymization.In this paper, we propose a novel approach based on machine learning and sentence embedding techniques with the primary goal of providing privacy awareness to users and, as a consequence, full control over their data during online activities. Our approach relies on the definition of four modules: (i) the Keyword module, which identifies personal and sensitive data in a text (from the syntactic point of view); (ii) the Topic module, which is devoted to understand the topic treated in text messages; (iii) the Sensitiveness module, which identifies sensitive information (from the semantic point of view) into text messages; lastly, (iv) the Personalization module, which goal is to learn the personal attitude of a user towards his/her own privacy (through opportune feedback) and therefore report the correct alert messages. We provided an implementation of such an approach, named Knoxly, as a prototype of a Google Chrome extension. The tool has undergone a preliminary experimental study to assess its effectiveness in terms of sensitive information identification accuracy, and its efficiency in terms of impact on user experience.

Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study.

Simple SummaryFertility impairment is common among male childhood cancer survivors and negatively impacts quality of life. Sperm banking, before starting cancer treatment, is an established fertility preservation option, yet it remains underutilized at many pediatric centers. Although survivors often report regret about missed banking opportunities, little is known about short-term decisional satisfaction. The aim of this mixed methods study was to examine decisional satisfaction one month after diagnosis by comparing satisfaction among families of adolescents who did or did not attempt to bank. Quantitatively, families reported satisfaction regardless of the banking decision, while qualitatively, families of adolescents who did not attempt to bank reported potential for future regret. Thus, decisional dissatisfaction may not present after one month but could emerge in the future. The findings underscore the importance of longitudinal research to examine satisfaction over time, and why quantitative and qualitative discrepancies exist, as well as psychosocial support across the care continuum as survivors approach their reproductive years.Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support.