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Cancer is a life-changing experience, and side effects from treatment can make it difficult for survivors to return to their pre-cancer “normal life.” We explored the “new normal” and barriers to achieving it among lung cancer survivors who underwent surgery.
Methods
Semi-structured interviews were conducted with 32 recurrence-free non–small cell lung cancer survivors. We asked survivors how life had changed; how they defined the “new normal”; barriers that prevent them from achieving a “normal” life; and unmet needs or support for normalcy. Thematic analysis was performed.
Results
Defining “new normal” subjectively depends on an individual’s expectation of recovery: (1) being able to do what they want without pain or discomfort; (2) being able to do activities they could accomplish before their surgery; and (3) being able to work, earn money, and support their family. We found that (1) persistent symptoms, (2) fear of cancer recurrence, (3) high expectations in recovery, and (4) psychosocial stress and guilty feelings were barriers to achieving a “new normal.” The needs and support for normalcy were information on expected trajectories, postoperative management, and support from family and society.
Significance of results
Survivors defined the “new normal” differently, depending on their expectations for recovery. Informing survivors about the “new normal” so they could expect possible changes and set realistic goals for their life after cancer. Health professionals need to communicate with survivors about expectations for “normality” from the beginning of treatment, and it should be included in comprehensive survivorship care.
This chapter examines China’s investment activities, utilizing project-level data available on greenfield investments that reflect how Chinese firms have responded to the US-China trade war. Investment patterns indicate some degree of anticipation from the private sector. Overall investment patterns drop sharply before the actual start of the trade war. The decline coincides with the start of the Trump Presidency in the United States and the initiation of the Section 301 investigation. Chinese firms, and possibly firms more generally, respond first to the overall political climate and are well ahead of concrete policy changes. There are also notable changes in the regional distribution of Chinese firms’ investments. Asia’s attractiveness as an investment destination grows with the escalation of trade tensions, but there is also increased diversion to Europe for locating Chinese investment. There is a marked decline in greenfield investment in the United States, and Russia emerges as an important recipient of Chinese greenfield investment. Manufacturing, electricity, and construction continue as mainstays of Chinese investment choices, and similarly, real estate; coal, oil, and gas; and metals are top investment sectors for Chinese firms.
This chapter examines China’s investment activities, utilizing project-level data available on greenfield investments that reflect how Chinese firms have responded to the US-China trade war. Investment patterns indicate some degree of anticipation from the private sector. Overall investment patterns drop sharply before the actual start of the trade war. The decline coincides with the start of the Trump Presidency in the United States and the initiation of the Section 301 investigation. Chinese firms, and possibly firms more generally, respond first to the overall political climate and are well ahead of concrete policy changes. There are also notable changes in the regional distribution of Chinese firms’ investments. Asia’s attractiveness as an investment destination grows with the escalation of trade tensions, but there is also increased diversion to Europe for locating Chinese investment. There is a marked decline in greenfield investment in the United States, and Russia emerges as an important recipient of Chinese greenfield investment. Manufacturing, electricity, and construction continue as mainstays of Chinese investment choices, and similarly, real estate; coal, oil, and gas; and metals are top investment sectors for Chinese firms.
The international investment agreement regime (IIA Regime) is composed of thousands of IIAs and a system of investor–state dispute settlement. Historically, high-income developing countries (HIDCs) were part of the global South and thus ‘hosts’ of foreign direct investment (FDI). Increasingly, however, these countries have become ‘home’ to investors who are hosted and exposed to political risk abroad. Representing both home and host country interests simultaneously, how do HIDCs balance these crosscutting pressures? We argue that as the position of an HIDC shifts from mostly a recipient towards a sender of significant amounts of FDI, it will be more willing to provide protection to foreign investors at the expense of state regulatory space in its IIAs, thereby increasing its exposure to the IIA Regime. Employing an original data set that measures this exposure for sixty-four HIDCs over six decades, we first show that the degree of HIDC exposure to the IIA Regime varies a great deal. Using a general method of moments (GMM) analysis and controlling for a host of confounding factors, we demonstrate that, indeed, higher levels of FDI outflows as a share of the national economy result in greater exposure to the IIA Regime.
This chapter investigates the overlapping nature of investment governance, in which BITs and PTAs encode common commitments toward the protection and liberalization of investment. It advances the scholarship on regime complexity, in which non-hierarchical and overlapping institutions regulate investment. The study examines common institutional design across PTAs and BITS, while recognizing that the broader investment regime complex includes legal precedents set through dispute settlement at the WTO and ICSID. Utilizing an original data set of investment provisions in PTAs and for BITS data provided by UNCTAD’s International Investment Agreements (IIA) project, the analysis examines how these two international agreements have co-evolved in terms of institutional design in guiding principles, scope, and enforcement. The hypothesis is that these two types of agreements are largely complementary, where PTAs emphasize liberalization of investment in tandem with other trade-related provisions, and BITs emphasize the protection of investments and investor rights. The results of principal component analysis of provisions in PTAs and BITs support the hypothesis of complementarity. Additional analyses also show that investment provisions in PTAs draw heavily from those of BITs, but BITs draw less from PTAs.
In this paper, we investigate the causes and consequences of institutional design choices in the liberalization of services trade and investment in preferential trade agreements (PTAs). We distinguish between a positive-list and a negative-list approach to services liberalization, and analyze PTAs signed by countries of the Asia-Pacific. We develop an information-based argument that explains why these different types induce path dependence in subsequent choices, and derive hypotheses that capture the “history” effect of choosing either institutional model. In doing so, we examine whether particular “modes of governance” diffuse through the growing network of trade agreements through the adoption of rules by third parties in their own PTAs. The empirical analysis tests these hypotheses using simulation-based dynamic network analysis methods. We find evidence of strong path dependence in the choice of liberalization approach, affecting the evolution of PTA networks in the Asia-Pacific and the diffusion of services liberalization in general. Such path dependence has long-term consequences for the institutional features of the international trade regime.
Reciprocal trade agreements (RTAs) have proliferated rapidly in Asia in recent years, an unprecedented phenomenon in a region in which state-led institution-building efforts were largely unsuccessful during the Cold War years. In this article, we investigate the qualitative provisions of RTAs in Asia, focusing on agreements that are professedly geared toward trade liberalization through reciprocal exchanges of trade concessions. We build on the concept of credible commitment—that states “tie their hands” through international agreements and thus signal strong commitment to trade liberalization. We argue that a broad range of agreement provisions will affect an RTA's ability to achieve its primary objective: trade liberalization. We present a coding scheme that measures the strength of a wide variety of provisions in the legal texts of RTAs. Using quantitative analysis, we analyze the impact of various components of Asia's RTAs on participants' trade flows.
This paper focuses on the variability of judicialization across preferential trade agreements (PTAs) and their impact on trade flows. We develop a categorization of PTAs that contrasts enforcement mechanisms with the level of trade policy discretion allowed by a trade agreement and the degree of flexibility allowed for members. Utilizing an original dataset of PTAs signed by countries in Asia, which has emerged as one of the most active regions of PTA formation and which exhibits wide variability in levels of judicialization, we compare the effects of trade policy discretion, flexibility provisions, and enforcement mechanisms in PTAs on trade flows. We examine the empirical strength of our theoretical framework distinguishing between discretion, flexibility, and enforcement using confirmatory factor analysis. The empirical analysis then goes on to examine their respective effects on trade flows. The results show that agreements with strong commitments, that is, those that remove more trade policy discretion from a government, lead to a greater expansion of trade between signatories. Enforcement and flexibility mechanisms, however, have mixed effects.
Here we introduce a facile method to fabricate a flexible piezoelectric sensor using one-dimensional (1-D) piezoelectric poly(vinylidene fluoride) (PVDF) nanofibers directly produced onto flexible printed electrodes by electro-spinning without an additional poling process. The flexible silver electrodes are fabricated on polyethylene terephthalate (PET) using silver nanowires by easy and cost-effective spraying deposition. The electrospun PVDF nanofibers have uniaxially aligned arrays on the electrodes by using a rotating collector. The fabricated PVDF piezoelectric sensors demonstrate the piezoelectric responses with repeated mechanical stimuli with good flexibility and high sensitivity. We expect that the facile fabrication of PVDF piezoelectric sensors on flexible printed electrodes can be usefully exploited to integrate the piezoelectric sensors into flexible and stretchable functional electronic devices.
We present a rapid and sensitive surface acoustic wave (SAW) immunosensor that utilizes gold staining as a signal enhancement method. A sandwich immunoassay was performed on sensing area of the SAW sensor, which could specifically capture and detect cardiac markers (cardiac troponin I (cTnI), creatine kinase (CK)-MB, and myoglobin). The analytes in human serum were captured on gold nanoparticles (AuNPs) that were conjugated in advance with detection antibodies. Introduction of these complexes to the capture antibody-immobilized sensor surface resulted in a classic AuNP-based sandwich immunoassay format that has been used for signal amplification. In order to achieve further signal enhancement, a gold staining method was performed, which demonstrated that it is possible to obtain gold staining-mediated signal augmentation on a mass-sensitive device. The sensor response due to gold staining varied as a function of cardiac marker concentration.
We have investigated the reliability of the inverted-staggered etch stopper structure oxide-based TFTs under negative gate bias stress combined with 400 nm wavelength light illumination and the relationship between the carrier concentration at the channel and the extent of Vth shift. It was found that the photo-induced holes cause the severe Vth degradation at the beginning of stress and the hole trapping rate of a single hole is not altered with the increase of the hole concentration. In oxide-based TFTs, the hole concentration at the channel is the determinant factor of the reliability.
The effects of the Zr/Ti ratio on the electrical properties of lead zirconate titanate (PZT) thick films prepared by the aerosol deposition (AD) process were investigated to optimize the electrical properties of the thick film. The Zr/Ti ratio was varied among 45/55, 52/48, and 60/40, and the post-annealing temperature was varied from 500 to 900 °C. Microscopic examination of the as-deposited films revealed crack-free and dense microstructures with a thickness of 10 μm. The annealed films showed markedly improved electrical properties in comparison with the as-deposited films with increasing post-annealing temperature. With increasing Zr/Ti ratio, the remnant polarization and coercive field decreased. The dielectric constant and piezoelectric coefficient, d33, were highest for the PZT 52/48 film. This film annealed at 900 °C exhibited the best overall combination of electrical properties, with a dielectric constant, remnant polarization, and piezoelectric coefficient of 1320, 31.1 μC/cm2, and 150 pC/N, respectively.
Using data on bilateral trade flows from both before and after World War II, this article examines the impact of the General Agreement on Tariffs and Trade on trade between its members and on the system of interwar trade blocs. It shows that the distribution of the benefits produced by the GATT was much more highly skewed than conventional wisdom assumes. The article also shows that the gold, Commonwealth, Reichsmark, and exchange-control blocs exerted positive and significant effects on trade after 1945. The authors attribute these effects to the bargaining protocol that governed successive rounds of GATT negotiations, the signature element of the postwar trade regime.