The development of a web- and a print-based decision aid for prostate cancer screening

Background Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings. Methods We conducted two feasibility studies to assess men\u27s (45-70 years) Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs) and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools. Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men\u27s informed decision making regarding screening. Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not emerge from ongoing prostate cancer screening trials. We have detailed our efforts at developing print- and web-based DAs to assist men in determining how to best meet their PCa screening preferences. Following completion of our ongoing RCT designed to test these materials, our goal will be to develop a dissemination project for the more effective tool

Male breast cancer in BRCA1 and BRCA2 mutation carriers: pathology data from the Consortium of Investigators of Modifiers of BRCA1/2

Background BRCA1 and, more commonly, BRCA2 mutations are associated with increased risk of male breast cancer (MBC). However, only a paucity of data exists on the pathology of breast cancers (BCs) in men with BRCA1/2 mutations. Using the largest available dataset, we determined whether MBCs arising in BRCA1/2 mutation carriers display specific pathologic features and whether these features differ from those of BRCA1/2 female BCs (FBCs). Methods We characterised the pathologic features of 419 BRCA1/2 MBCs and, using logistic regression analysis, contrasted those with data from 9675 BRCA1/2 FBCs and with population-based data from 6351 MBCs in the Surveillance, Epidemiology, and End Results (SEER) database. Results Among BRCA2 MBCs, grade significantly decreased with increasing age at diagnosis (P = 0.005). Compared with BRCA2 FBCs, BRCA2 MBCs were of significantly higher stage (P for trend = 2 × 10−5) and higher grade (P for trend = 0.005) and were more likely to be oestrogen receptor–positive [odds ratio (OR) 10.59; 95 % confidence interval (CI) 5.15–21.80] and progesterone receptor–positive (OR 5.04; 95 % CI 3.17–8.04). With the exception of grade, similar patterns of associations emerged when we compared BRCA1 MBCs and FBCs. BRCA2 MBCs also presented with higher grade than MBCs from the SEER database (P for trend = 4 × 10−12). Conclusions On the basis of the largest series analysed to date, our results show that BRCA1/2 MBCs display distinct pathologic characteristics compared with BRCA1/2 FBCs, and we identified a specific BRCA2-associated MBC phenotype characterised by a variable suggesting greater biological aggressiveness (i.e., high histologic grade). These findings could lead to the development of gender-specific risk prediction models and guide clinical strategies appropriate for MBC management

Secessionist Conflict and Affective Polarization, Survey Data, Catalonia, 2017-2018

Can secessionism be a basis for affective or social polarisation? Despite much research on recent independence movements, their relationship to polarisation, a key mechanism theorised as increasing the risk of violent conflict, remains less understood. We argue that the issue of secession can be a basis of affective polarisation along both policy and ethnic group lines even in the case of non-violent disputes, and posit a number of expectations regarding such secessionist-based polarisation. We test our argument with the case of Catalonia, a substate territory that has experienced a deep secessionist crisis since 2017, using new data from a panel survey and embedded experiments fielded across two key time periods. We find that individuals’ secessionist preferences condition high levels of affective polarisation, with pro and anti-independence advocates having strong negative views and stereotypes of one another. In addition, there is spillover in terms of stereotypes of associated language groups. We also document a group of moderates that exhibit far less polarisation. Finally, we provide evidence on the persistence of these overall patterns. Our results contribute to understanding the underexplored polarisation dynamics of secessionist movements, particularly in contexts where high intensity violence (e.g. terrorism, civil war) has not occurred.The project is organised around three thematic areas: (i) how trust within and between social groups and towards governance institutions emerges and evolves in contexts of rising inequality; (ii) how trust in unequal societies shapes governance outcomes through two intervening factors - political behaviour and social mobilisation; and (iii) the pathways through which changes in such intervening factors may sometimes result in inclusive governance outcomes, but in the breakdown of governance at other times. Each of these areas will incorporate detailed theoretical and empirical analyses at the subnational level in four countries - Colombia, Mozambique, Pakistan and Spain - affected by rising inequalities and characterised by unstable or strained democratic institutions. The absence of systematic qualitative, quantitative and behavioural data has hindered progress in understanding the links between inequality, trust and governance in countries outside North America and Western Europe. The project seeks to compile a number of unexplored data sources and collect new data comparatively across these other countries in order to fulfil this critical gap. This data collection will involve: (i) comparative individual-level surveys to understand contemporaneous levels of trust, and attitudes towards formal and non-formal local governing institutions, (ii) behavioural experiments under different inequality and political contexts to better understand the formation of trust under different scenarios, (iii) indepth interviews with key political actors in government, members of social movements and citizen organisations to understand how inequalities affect perceptions of governance and strategies of political mobilisation, and (iv) detailed compilation of archival data that will allow us to better understand how inequalities and attitudes have evolved across time and how different historical junctures may shape the governance outcomes we observe today.</p

Territorial Conflict in Spain: Preferences and Institutions, 2021

Territorial politics has remained an essential point of contention in Spain, with the accommodation of geographically concentrated minorities being one of the most unresolved challenges in this multinational state. The recent conflict in Catalonia, and the constitutional and democratic crisis resulting from it, illustrate the deficiencies of the institutional system that regulates the territorial distribution of power in Spain. Indeed, several issues, such as the recognition of national minorities or the fiscal treatment of regions, remain unresolved forty-five years after the inception of the Spanish autonomic system. To assess attitudes towards territorial issues among Spaniards, we conducted an online survey in Spain in June 2021 (drawing on a representative sample of the voting-age population) where we embedded a conjoint experiment.The project is organised around three thematic areas: (i) how trust within and between social groups and towards governance institutions emerges and evolves in contexts of rising inequality; (ii) how trust in unequal societies shapes governance outcomes through two intervening factors - political behaviour and social mobilisation; and (iii) the pathways through which changes in such intervening factors may sometimes result in inclusive governance outcomes, but in the breakdown of governance at other times. Each of these areas will incorporate detailed theoretical and empirical analyses at the subnational level in four countries - Colombia, Mozambique, Pakistan and Spain - affected by rising inequalities and characterised by unstable or strained democratic institutions. The absence of systematic qualitative, quantitative and behavioural data has hindered progress in understanding the links between inequality, trust and governance in countries outside North America and Western Europe. The project seeks to compile a number of unexplored data sources and collect new data comparatively across these other countries in order to fulfil this critical gap. This data collection will involve: (i) comparative individual-level surveys to understand contemporaneous levels of trust, and attitudes towards formal and non-formal local governing institutions, (ii) behavioural experiments under different inequality and political contexts to better understand the formation of trust under different scenarios, (iii) indepth interviews with key political actors in government, members of social movements and citizen organisations to understand how inequalities affect perceptions of governance and strategies of political mobilisation, and (iv) detailed compilation of archival data that will allow us to better understand how inequalities and attitudes have evolved across time and how different historical junctures may shape the governance outcomes we observe today.</p

Secessionist Conflict and Affective Polarization, Survey Data, Catalonia, 2017-2018

Can secessionism be a basis for affective or social polarisation? Despite much research on recent independence movements, their relationship to polarisation, a key mechanism theorised as increasing the risk of violent conflict, remains less understood. We argue that the issue of secession can be a basis of affective polarisation along both policy and ethnic group lines even in the case of non-violent disputes, and posit a number of expectations regarding such secessionist-based polarisation. We test our argument with the case of Catalonia, a substate territory that has experienced a deep secessionist crisis since 2017, using new data from a panel survey and embedded experiments fielded across two key time periods. We find that individuals’ secessionist preferences condition high levels of affective polarisation, with pro and anti-independence advocates having strong negative views and stereotypes of one another. In addition, there is spillover in terms of stereotypes of associated language groups. We also document a group of moderates that exhibit far less polarisation. Finally, we provide evidence on the persistence of these overall patterns. Our results contribute to understanding the underexplored polarisation dynamics of secessionist movements, particularly in contexts where high intensity violence (e.g. terrorism, civil war) has not occurred.The project is organised around three thematic areas: (i) how trust within and between social groups and towards governance institutions emerges and evolves in contexts of rising inequality; (ii) how trust in unequal societies shapes governance outcomes through two intervening factors - political behaviour and social mobilisation; and (iii) the pathways through which changes in such intervening factors may sometimes result in inclusive governance outcomes, but in the breakdown of governance at other times. Each of these areas will incorporate detailed theoretical and empirical analyses at the subnational level in four countries - Colombia, Mozambique, Pakistan and Spain - affected by rising inequalities and characterised by unstable or strained democratic institutions. The absence of systematic qualitative, quantitative and behavioural data has hindered progress in understanding the links between inequality, trust and governance in countries outside North America and Western Europe. The project seeks to compile a number of unexplored data sources and collect new data comparatively across these other countries in order to fulfil this critical gap. This data collection will involve: (i) comparative individual-level surveys to understand contemporaneous levels of trust, and attitudes towards formal and non-formal local governing institutions, (ii) behavioural experiments under different inequality and political contexts to better understand the formation of trust under different scenarios, (iii) indepth interviews with key political actors in government, members of social movements and citizen organisations to understand how inequalities affect perceptions of governance and strategies of political mobilisation, and (iv) detailed compilation of archival data that will allow us to better understand how inequalities and attitudes have evolved across time and how different historical junctures may shape the governance outcomes we observe today.</p

Territorial Conflict in Spain: Preferences and Institutions, 2021

Territorial politics has remained an essential point of contention in Spain, with the accommodation of geographically concentrated minorities being one of the most unresolved challenges in this multinational state. The recent conflict in Catalonia, and the constitutional and democratic crisis resulting from it, illustrate the deficiencies of the institutional system that regulates the territorial distribution of power in Spain. Indeed, several issues, such as the recognition of national minorities or the fiscal treatment of regions, remain unresolved forty-five years after the inception of the Spanish autonomic system. To assess attitudes towards territorial issues among Spaniards, we conducted an online survey in Spain in June 2021 (drawing on a representative sample of the voting-age population) where we embedded a conjoint experiment.The project is organised around three thematic areas: (i) how trust within and between social groups and towards governance institutions emerges and evolves in contexts of rising inequality; (ii) how trust in unequal societies shapes governance outcomes through two intervening factors - political behaviour and social mobilisation; and (iii) the pathways through which changes in such intervening factors may sometimes result in inclusive governance outcomes, but in the breakdown of governance at other times. Each of these areas will incorporate detailed theoretical and empirical analyses at the subnational level in four countries - Colombia, Mozambique, Pakistan and Spain - affected by rising inequalities and characterised by unstable or strained democratic institutions. The absence of systematic qualitative, quantitative and behavioural data has hindered progress in understanding the links between inequality, trust and governance in countries outside North America and Western Europe. The project seeks to compile a number of unexplored data sources and collect new data comparatively across these other countries in order to fulfil this critical gap. This data collection will involve: (i) comparative individual-level surveys to understand contemporaneous levels of trust, and attitudes towards formal and non-formal local governing institutions, (ii) behavioural experiments under different inequality and political contexts to better understand the formation of trust under different scenarios, (iii) indepth interviews with key political actors in government, members of social movements and citizen organisations to understand how inequalities affect perceptions of governance and strategies of political mobilisation, and (iv) detailed compilation of archival data that will allow us to better understand how inequalities and attitudes have evolved across time and how different historical junctures may shape the governance outcomes we observe today.</p