Proactive Character Research Articles

Virtues as protective factors for adolescent mental health.

This paper explores the decline in adolescent mental health and the weakening of traditional moral frameworks, positing education in the virtues as protective of mental health due to the intrinsic link between moral/existential wellbeing and psychological health. By integrating character education into school curricula, a continuous "dosage" of moral guidance may be an optimal way to ensure a gradual and ever-clearer articulation of a life worth living and how to live well. The paper critiques popular clinical and positive psychological approaches to promoting wellbeing, which often miss the existential and moral dimensions of adolescent growth. The conclusion emphasizes the need for integrating moral education into mental health interventions to address the comprehensive existential and moral dimensions of adolescent development. This paper advocates for a proactive character developmental model that nurtures moral and existential growth, recognizing challenges with virtue and meta-virtue development as integral to personal and moral evolution, and enhancing the moral and psychological fortitude of adolescents.

Migrants’ perspectives on environmental change and translocal practices in Morocco, Senegal, and the Democratic Republic of Congo

Abstract This qualitative study takes a translocal perspective by considering migrants’ views on environmental change, migration decisions and translocal practices in favour of environmental adaptation. This article addresses the following question: To what extent do migrants’ perceptions of environmental change in their region of origin influence their translocal practices in favour of adaptation to socio-environmental change? Our data show that while environmental change may not be the primary reason that people migrate, nor do they perceive it as such, their translocal practices may have very concrete impacts in environmentally fragile areas, especially with respect to non-migrants in the place of origin. Most practices (e.g. family economic remittances) are spontaneous and unintentionally adaptive to environmental change. In contrast, collective projects initiated through hometown associations, especially in Senegal and Morocco, often have a more intentional and proactive character, resulting in translocal adaptive socio-environmental dynamics.

Proactive personality literature through scientometric analysis

The proactive personality is designed to seize a behavioral tendency to impose, or change, a person`s environment. This take a look at goals to observe the popularity and role of the visible maps of global studies and the Scopus listed proactive character literature the usage of bibliometric positioning images. The studies turned into carried out the usage of a bibliometric technique. Data evaluation and use of the VOSViewer visualization application and the Scopus characteristic to examine seek results. In this review, the information amassed follow to 496 files posted from 1993 to 2020. The take a look at famous that Renmin University of China and United State is the maximum energetic affiliated and country institutions, scientists and countries within side the proactive character literature. In the proactive character literature, Business, Management and Accounting and Journal of Vocational Behavior are the maximum studied fields and reasserts of dissemination. There is one map of businesses round the arena with collaborative researchers. To discover the frame of expertise produced from thirty- years of publication, this take a look at constructs a convergence axis grouping inclusive of proactive character literature: Personality, Employee, Career, Organization, Manager, and Entrepreneur, abbreviated as PECOME.

Thereby Hangs a Tail: Creation and Procreation in Medieval Werewolf Romances

How do you make a werewolf? Moreover, who makes a werewolf, and why? In medieval romance, the latter questions are often the more pressing, since the transformation of man into wolf is connected less with lunar phases than with human interference—especially the intervention of an unfaithful wife. Following in the pawprints of Marie de France’s lai of Bisclavret, these romances are noted for their “courtly” wolves and antifeminist slant, but they also offer unusual perspectives on procreation. While in Aristotelian thought the generative principle was broadly associated with the male partner, the male werewolf of medieval romance is most often brought into the world through the action and agency of a female character. In this unorthodox form of generation, the male character is not active but rather acted upon (and thereby potentially feminized), while the more proactive character tends to be a women. In several narratives, a wife exploits natural or magical lycanthropy as a means of hiding her husband in order to pursue an affair, counting on her husband’s involuntary lupine disguise to conceal both her adultery and the illegitimacy of any children she bears. By foregrounding the generative capability of female characters, these tales reveal concerns about women who have power over men’s bodies and over succession in families. The remedy in both cases is that the restoration of the werewolf is brought about by the king himself, who transforms the unruly flesh, restores social order, and reimposes gendered reproductive norms. This article explores how five werewolf romances are informed by and engage with medieval anxieties about gender and natural generation on the one hand, and legitimacy and lineage on the other.

Olympic Charter Evolution Shaped by Urban Strategies and Stakeholder’s Governance: From Pierre de Coubertin to the Olympic Agenda 2020

The Olympic Charter is the binding document that rules the Olympic Movement which, among other things, has the role of managing the organization of the biggest and most complex sporting event in the world - the Olympic games. The multi-disciplinary nature of this event implies the involvement of diverse stakeholders, including hosts and respective communities that, besides having different interests, rely on each other to fulfil them. As the owner of the event, the International Olympic Committee has the role of managing these interests through the update and modification of the Olympic Charter. This paper explores the evolution of this document, taking special consideration of the influence that occurrences related with stakeholder’s governance and urban strategies of hosts had on its rules. A cross-referenced review between the historical events within these two fields of study is compared to a systematic review of the Charter’s evolution. The results include a timeline with eight periods identifying the progress of those relationships, showing that the Olympic Charter has had a more reactive than pro-active character: it was highly influenced by hosts and other internal and external governance issues that, together, were responsible for the addition of new rules.

Anticipating futures through models: the rise of Integrated Assessment Modelling in the climate science-policy interface since 1970

Integrated Assessment Models (IAMs) have gained a prominent role in the climate science-policy interface. The article reconstructs the evolution of IAMs and their changing role in this interface, investigating how and why IAMs have become so prominent. Based on literature analysis, quantitative document analysis and semi-structured interviews, we describe the historic evolution of the interactions between IAMs and policy-making between 1970 and 2015. We identify five historic phases in which IAMs played distinct mediating roles between science and policy, succeeding to adjust their scenario efforts to the continuously changing demands for knowledge from the policy community. In explaining the prominent role of IAMs, we differentiate between background conditions (material and sociological) and more contextual factors, most notably the flexible, hybrid and broad nature of IAMs as well as the pro-active character of the IAM community to enhance their policy relevance. We draw on the notion of institutional work to explain this success. In light of the urgency of responding to the climate crisis, we suggest that the IAM community may expand their scope of anticipated futures and consider engaging a wider range of publics and societal stakeholders beyond the science-policy interface.

Road Adaptation to Climate Hazards: Guidelines for Cost-Effective Measures

Climate change and extreme weather events present a significant challenge to the safety, reliability, effectiveness and sustainability of every transportation system. Extreme weather events such as tsunami waves, wildfires, floods and hurricanes constitute a big risk for the integrity of the road transport system, since they can severely harm the infrastructure and its assets. Far more disastrous is the eventual direct impact on passengers, vehicles and goods, suddenly and unforeseeably hit by the weather event while moving on the roadway. In the field of road adaptation to climate threats, different scientific approaches have been developed but they have not produced, so far, the expected results, as the road transport sector still suffers from extreme climate hazards. The present scientific paper investigates the reasons for this failure and suggests a different perspective for realistic and cost-effective measures of proactive character to reinforce the road infrastructure and to increase its resilience to climate threats. It makes distinction between preventive and protective measures, including intercepting engineering assets and digital alarm systems. Moreover, the scientific paper introduces several key-points, in terms of fundamental recommendations of a different perspective of the climate change impact on the road infrastructure. In this regard, it may constitute a useful tool for transport authorities and operators to rationally plan interventions on a road network scale.

The classical criteria application for the decision­making uncertainty risk determination of the preferences system by the air traffic controllers on the characteristic errors hazards

Given the influence of the human factor on decision-making processes by aviation operators of the “leading edge”, therefore, — of the flight safety, individual and group preference systems as formalized representations of air traffic controllers about a number of spectrum ordered by danger have been investigated from n=21 of characteristic errors. That has a pronounced positive proactive character. Explicating their opinions, the air traffic controllers simultaneously form discriminating, memorizing skills, therefore, — avoidance of mistakes in a professional activity: the subjects made one third fewer errors in comparison with other air traffic controllers in the process of simulator training. Group preference systems allow identifying the features of the functioning of individual socie­ties — dispatch shifts, possible group deformations, as well as the impact on their members of the presentation features of the performing technological procedures specifics by instructors. m=37 individual preference systems of the air traffic controllers, which were involved in research, were built by pairwise comparison of the danger of errors and the application of a differential method of distributing the indicator of their total danger. That contributed to conducting of 420 pairwise error hazard comparisons. The implementation of a multi-step procedure for identifying and screening out 10 marginal opinions has led to a statistically consistent group system of preferences: Kendall’s concordance coefficient equals is W=0,700 and it became statistically significant at a high level of significance of a = 1 %. The decision matrix was formed from mА=27 individual preference systems of the air traffic controllers, which, by the definition, is a “cost matrix” and for the solution of which a methodology for the correct application of the classical decision criteria by Wald, Savage, Bayes-Laplace, Hurwitz has been implemented. It revealed the identity of the group systems of preferences obtained by Wald and Savage criterion, as well as the Bayes-Laplace criterion and such a strategy of group decisions as summation and averaging of ranks. The empirical preferences are generally the same: Spearman’s rank correlation coefficients are unusually high (RB–L–W/S=0,8922, RB–L–HW=0,9263, RW/S–HW=0,9477) and statistically gullible at a high level of significance for human factor studies . The following values of the normative indicator of the not distinguishing dangers of error risk in the group preference systems are obtained: R*BL=0 , R*HW=0,19·10-2, R*W/S=5,58·10-2. The value of this indicator for the group is R*g=0,52·10-2.

Украинский кризис и Россия: теоретико-технологические аспекты проблемы

The article deals with the intermediate results of the use of a set of Russian political strategies and technologies in the Ukrainian direction of Foreign Policy since Ukraine gained independence. The research takes into account the peculiarities of the political development of Ukraine. The research objective was to identify the prerequisites, characteristics, and consequences of the Ukrainian political crisis at the turn of 2013–2014 and the resulting political regime and order. A systematic approach and comparative analysis made it possible to formulate a general assessment of the political situation in Ukraine following the so-called "the Revolution of Dignity". On the basis of formal-logical analysis, the author substantiated the need for a comprehensive audit of the amount of Russian technologies through the application of system analysis to certain political circumstances. The author substantiated the increasing role of political technologies of pro-active character in the situation of deep crisis of previously effective political institutions, mechanisms, and norms. The resonant nature of such technologies made it possible to link the latter with the political reflection on the place and role of Ukraine in the system of Russian Foreign Policy, as well as on the peculiarities of the Ukrainian political process and the nature of its political system. The author generalized the experience of Russian influence on the mentioned Ukrainian events and defined the general conditions that can allow Russia to affect a changeable political situation in the post-Soviet countries, taking into account the inconsistency of modern political trends. The scope of the results can be used in the spheres of foreign policy, public administration, and public policy.

ВИЩА АГРАРНА ОСВІТА США: ТЕОРЕТИКО-МЕТОДОЛОГІЧНИЙ АСПЕКТ

The article considers some aspects of higher agrarian education in the USA. It reviles that sustainable agriculture is the fundamental factor in the formation of a new paradigm of higher agricultural education in the United States. The US agricultural higher education is organized in six directions (agendas), i.e. agribusiness, agricultural production processes, agricultural machinery, horticulture, agricultural resources and forestry, agricultural products processing. There are tendencies for further modernization and democratization of higher agricultural American education, changes in the academic background of the educational system. Decentralization of decisions; individual training; elective subjects; considerable attention to diagnostics and forecasting; training has a proactive character; integrated plans and programs; diversification of education; distance training; systematic approach are the main characteristics of higher agrarian education in the USA. The educational programs of higher agrarian institutions are rather flexible; it increases the quality training of specialists in the agricultural sector. The undoubted advantage of American higher education is its extraordinary flexibility in terms of methods, forms and learning styles. Curriculums provide students with a basic agricultural knowledgee. Practical trainings allow students to gain experience at agricultural or industrial enterprise in the agrarian sector.

The Enigmatic but Unique Nature of the Israeli Legal System

The Israeli legal system is unique in that it straddles the two otherwise opposing worlds of tradition and innovation. This creates an enigma for the comparatist, making the exploration of this system an onerous and challenging task. The author wishes to maintain that the system in question is highly innovative and ascribes this quality to the proactive character of the Israeli Supreme Court, whose activism has had a major impact on the character of the domestic system as a whole. While the author explores the reasons why this has been the case, one of his main concerns in this paper will be to examine the innovative character of the Israeli Supreme Court per se, in comparison with equivalent courts in other parts of the world. In addition the author will seek to establish inter alia the character of the Israeli legal system by focusing on the three different elements that co-exist in the Israeli socio-legal structure (the Jewish element vis-à-vis the Arab element; the Liberal element vis-à-vis the Orthodox element within the Jewish community; and the Civilian element vis-à-vis the Common law element). The author wishes to posit that the amalgamation of different legal and cultural traditions in Israel created a sui generis state of affairs for the legal system as a whole. This results in an overall systemic-methodological amalgamation which does not occur elsewhere in the world. The article concludes that the enigmatic and innovative characteristics of the Israeli legal system derive from the novel way in which the legal mix has occurred in this system (as opposed to the ingredients of the elements in the mix). In this respect, Israel may have contributed much to the reinvigoration of the modern comparative law agenda, and it may continue to do so in the future, as the system is not one of legal stasis (a mixed system) but one of legal kinesis (a mixing system).

Case Management for pluripathological chronic patients: Development and validation of a scheduled follow-up intervention in Valencia La Fe Health Department

Introduction : In the past few years, healthcare systems are facing a growing demand related to high prevalence of chronic diseases. Case Management (CM) programs have emerged as a new approach for the management of chronic disease focused on improving individual’s health and serving social needs. Nevertheless, there is no great scientific evidence about the impact on healthcare of using generic CM program for high-complexity chronic patients. Methodology : We evaluated a CM model based on a reengineering care process that has aligned the health care levels implied, providing the attention from a patient centred perspective and promoting the patient empowerment through education and self-care. A retrospective cohort study has been carried out using a sample of 714 adult chronic patients admitted at the Valencia-La Fe Health Department Chronic CM program between January 2012 and January 2015. Results : The results of the one-tailed matched Wilcoxon’s hypothesis test (α=5%), show statistically significant differences for the rate of unplanned admissions and for the rate of emergency room (ER) visits. The rate of admissions in Hospital at Home (HaH) did not show a significant difference. The results showed statistically significant differences for the rate of unplanned hospitalization Length of Stay (LoS) and for HaH. The results of the RR of admission show that the risk of unplanned admission decreases to a 58.4%, and the risk of visits to the ER decreases to a 73.5%. However, the HaH admission relative risk increases in 50.2%. Discussion : The positive results can be based on two facts. Firstly, the proactive character of the intervention through Primary Health scheduled intervention; and secondly, the support of the CM nurses from the Telemedicine Unit and the advanced care at home, developed by the HaH unit when needed. Self-management educational interventions have positive effects on hospital consumption, such as hospital admission. Two studies evaluated a home-based educational intervention on patients with heart failure achieving fewer emergency department visits and unplanned readmissions, improving quality of life and reducing mortality. We may expect that the induction program in our model empowers patients for self-care interventions and early identification of risk situations. Additionally, the close follow-up of patients and families by primary healthcare team could explain our results. The possibility of scheduled home visits and/or consultations performed by general practitioner, staff nurse and community case manager nurse facilitates the accessibility to medical attention. This may explain the relationship between complex chronic CM and the decrease of Hospital admissions, LoS and ER visits. Our model had also the support of the Telemedicine unit led by case manager nurses. Their aim is to promote self-care, early risk identification and an appropriate management of sources when social and clinical needs appear. Studies reflect that the benefit of telephone follow-up is observed regardless of home visits and consultations, concluding that a positive effect could exist between the role of the telemedicine unit and the results. Also, the increase in the number of HaH admissions once the patient is included in the program is a good indicator of appropriate use of Hospital-based home care as an alternative to conventional hospitalization. From the institutional perspective, we can estimate a global bed savings per year. We expect to save around 5 days of a bed per patient. Taking into account that we manage around 243 patients per year in the CM intervention, this may imply a number of around 1,215 bed savings per year. Conclusion : Our CM intervention has a significant hospital resource savings in average with a positive impact on patient admissions and LoS. We suggest that policies and strategies should keep promoting CM interventions both for healthcare network for patients and families and for research. Whether the CM intervention is profitable for reducing the use of hospital resources for other clinical profiles is still a question under study. It seems clear that the CM intervention reduces hospital resources, which of course leads to economic savings. However, the CM intervention also entails new economic costs that should be analyzed. A future step is to carry out a cost-effectiveness analysis to compare if the CM intervention implies economic savings apart from the observed hospital resources savings. The adoption of this type of intervention to a different health center may require a careful implementation according to the characteristics of chronic patients. In elderly patients, the assessment of social environment is an aspect of relevance as well as the cultural aspects and organizational issues.

The Structural Model of Formation and Realization of the Proactive Character Regional Innovative Policy

Abstract The structural model of formation and realization of the proactive character regional innovative policy which constructs with due account for the marketing instruments of management priority role by the enterprise structures innovative activity (the frame of the advancing formation of marketing infrastructure as the element of business innovative activity stimulation), assuming the organization of ramified system of the corrective actions directed on preventive evening-out of the possible declension in the regional innovative development is developed in the article.

The Enigmatic but Unique Nature of the Israeli Legal System

The Israeli legal system is unique in that it straddles the two otherwise opposing worlds of tradition and innovation. This creates an enigma for the comparatist, making the exploration of this system an onerous and challenging task. The author wishes to maintain that the system in question is highly innovative and ascribes this quality to the proactive character of the Israeli Supreme Court, whose activism has had a major impact on the character of the domestic system as a whole. While the author explores the reasons why this has been the case, one of his main concerns in this paper will be to examine the innovative character of the Israeli Supreme Court per se, in comparison with equivalent courts in other parts of the world. In addition the author will seek to establish inter alia the character of the Israeli legal system by focusing on the three different elements that co-exist in the Israeli socio-legal structure (the Jewish element vis-a-vis the Arab element; the Liberal element vis-a-vis the Orthodox element within the Jewish community; and the Civilian element vis-a-vis the Common law element). The author wishes to posit that the amalgamation of different legal and cultural traditions in Israel created a sui generis state of affairs for the legal system as a whole. This results in an overall systemic-methodological amalgamation which does not occur elsewhere in the world. The article concludes that the enigmatic and innovative characteristics of the Israeli legal system derive from the novel way in which the legal mix has occurred in this system (as opposed to the ingredients of the elements in the mix). In this respect, Israel may have contributed much to the reinvigoration of the modern comparative law agenda, and it may continue to do so in the future, as the system is not one of legal stasis (a mixed system) but one of legal kinesis (a mixing system).

The Enigmatic But Unique Nature of the Israeli Legal System

The Israeli legal system is unique in that it straddles the two otherwise opposing worlds of tradition and innovation. This creates an enigma for the comparatist, making the exploration of this system an onerous and challenging task. The author wishes to maintain that the system in question is highly innovative and ascribes this quality to the proactive character of the Israeli Supreme Court, whose activism has had a major impact on the character of the domestic system as a whole. While the author explores the reasons why this has been the case, one of his main concerns in this paper will be to examine the innovative character of the Israeli Supreme Court per se, in comparison with equivalent courts in other parts of the world. In addition the author will seek to establish inter alia the character of the Israeli legal system by focusing on the three different elements that co-exist in the Israeli socio-legal structure (the Jewish element vis-à-vis the Arab element; the Liberal element vis-à-vis the Orthodox element within the Jewish community; and the Civilian element vis-à-vis the Common law element). The author wishes to posit that the amalgamation of different legal and cultural traditions in Israel created a sui generis state of affairs for the legal system as a whole. This results in an overall systemic-methodological amalgamation which does not occur elsewhere in the world. The article concludes that the enigmatic and innovative characteristics of the Israeli legal system derive from the novel way in which the legal mix has occurred in this system (as opposed to the ingredients of the elements in the mix). In this respect, Israel may have contributed much to the reinvigoration of the modern comparative law agenda, and it may continue to do so in the future, as the system is not one of legal stasis (a mixed system) but one of legal kinesis (a mixing system).

Origins of Ship Safety Requirements Formulated by International Maritime Organization

Abstract The International Maritime Organization (IMO) is a specialized agency of the United Nations deals with international shipping. Its primary purpose is to develop and maintain a comprehensive regulatory framework for shipping and its remit today includes: safety, environmental concerns, legal matters, etc. In order to achieve its objectives, the IMO has promoted the adoption of some documents such as conventions, codes and recommendations concerning maritime safety, the prevention of pollution and related matters. Many of these documents include the ship safety requirements. In order to apply them to ships, they first should be generated, prepared and recorded. This paper deals exactly with the origins of ship safety requirements. Depending on the safety requirement origins, the IMO actions can get the reactive or proactive character. Reactive actions are used in response to a particular situation being observed, whereas proactive actions involve acting in advance of a future situation, rather than just reacting. It means taking control and making things happen rather than just adjusting to a situation or waiting for something to happen. In the paper, development of safety technical requirements for ships is presented based on experience of the author as a chairperson of Polish department for Subcommittee of Ship and Equipment Design (DE) of International Maritime Organization.

Proactive orientation and its influence for technology acquisition

PurposeThe purpose of this paper is to analyse the influence of the manager's strategic orientation concerning technology acquisition and its repercussions for the firm's performance.Design/methodology/approachThese relationships are studied using a sample of Spanish engineering consulting firms, most of them small‐ and medium‐sized enterprises.FindingsThe results obtained show that the proactive character adopted by managers will directly influence the decision‐making process concerning technology acquisitions. Managers with a proactive strategic orientation adopt both internal technological development and the external acquisition of technology, but a slight preference is observed for internal development, even though it achieves considerably less satisfactory results than those achieved with external technology acquisition.Research limitations/implicationsThe paper is exploratory in character, and its goal is to show whether interrelations exist between the variables. The sample refers only to engineering consultancies. Another limitation is the cross‐sectional character of the analysis performed.Practical implicationsTo obtain perfect adaptation of the firm to its environment, it is crucial that the manager be committed on both the tactical and the operating strategic levels. The paper shows the important role of the manager's strategic orientation in his or her decisions on technology acquisition. Success in this kind of decision is of vital importance to the firm. The high costs of internal development prevent immediate profits, and external acquisition brings high risks.Originality/valueThe paper seeks to stimulate new lines of research regarding these two variables (technology acquisition and manager's strategic orientation) and their repercussions for the firm.

CONSIDERAÇÕES SOBRE AS FUNÇÕES DA CONTROLADORIA NOS ESTADOS UNIDOS, ALEMANHA E BRASIL

Normal 0 21 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabela normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} The definition of a set of functions is one of the most fundamental issues in any controllership study. However, readers have faced difficulties in this aspect because of unsatisfactory concepts, sometimes confusing and many times controversial, found in specialized literature. Thus, the goal of the present work is to identify a set of controllership functions found in the research published on the subject in the United States, Germany and Brazil. A descriptive work was done through a bibliographical data. The results show that the most quoted functions are planning, with 87%, and controlling, with 83%, in a clear indication that the controller has a pro-active character in organizations. It also shows that the controllership, in its development, has incorporated wider and systemic functions. &nbsp

Denial and Avoidance in an Unusual Case of Death from Breast Cancer

Dear Editor: We recently encountered the case of a woman who died in an atypical way as a result of coping with a breast mass by denial and avoidance. The patient, aged 48 years and white, lived at home with her husband and 2 young children. For 4 to 6 weeks preceding her death, she isolated herself from her family in the basement, explaining that she had personal issues that she was handling alone. She continued to work at her job, where her coworkers noted that she had become withdrawn. She was later found dead in the basement, surrounded by blood-soaked, foulsmelling clothing and gauze. There was a penetrating injury of the right breast and chest wall. An autopsy revealed that the injury was from a large ulcerated breast carcinoma, which eroded the chest wall and opened a large artery. There was no evidence of metastasis, which is the most common cause of death from breast cancer (1,2). Death owing to hemorrhage occurs in only approximately 9% of breast cancer patients (1,2) and is usually a complication of progressive disease. Death from a localized and usually curable primary tumor such as this one is most unusual. We believe the patient's denial and avoidance of her disease were psychosocial factors leading to this atypical mechanism of death from breast cancer. Denial can impede a woman's willingness to undergo screening examination (3). A substantial number of women may not recognize a breast abnormality on their own, before it is found by screening (4,5). They may use avoidant coping mechanisms that prevent them from checking for potential disease (4). Women who experience denial prior to disease identification are also more likely to maintain that denial later in the course of disease (5). After a diagnosis of breast cancer, a woman may experience denial based on fear of changes in self-image or sexuality or on concerns about the effect of the disease on her relationships with her partner or children (6). Coping strategies after diagnosis tend to assume a proactive character (3,7,8), however, and may include such activities as acceptance, positive reframing, use of religion, expressing emotion, adopting a fighting spirit, seeking support, asserting self-control, or diverting energy to other matters (7-9). While proactive coping strategies may seem to caregivers to be more productive in dealing with a serious disease, denial is not inherently a poor coping strategy. It can provide relief of psychological distress during difficult periods of treatment (3,7) and may be associated with remaining recurrence-free or experiencing prolonged duration of survival in women with local disease (3,10,11). …