Premenarche bilateral giant juvenile fibroadenoma of breast: literature review with a case report

Fibroadenoma is a common abnormality which every surgeon has been exposed to, and there are several international guidelines regarding its management. However giant fibroadenomas, especially in the premenarche setting has been a rare occurrence, even for the experienced surgeon. Various reports have shown that we need to treat this condition more aggressively than the normal fibroadenoma, and issues of cosmesis in a developing breast along with the aim to preserve lactation functionality becomes an issue. Since these cases remain a single life time experience for most surgeons, there is a sparsity of treatment protocols even in literature. Through this paper we hope to shed some valuable insight to this rare disorder and help surgeon colleagues, when dealing with similar cases.

Scale for Space and Time Experience in Psychosis: Converging Phenomenological and Psychopathological Perspectives

<b><i>Introduction:</i></b> Abnormalities in the experience of space and time are fundamental to understanding schizophrenia spectrum disorders, but the precise relation between such abnormalities and psychopathological symptoms is still unclear. Therefore, the aim of our study was to introduce a novel scale for space and time experience in psychosis (STEP), specifically devised to assess schizophrenia spectrum disorders. <b><i>Methods:</i></b> The STEP scale is a semiquantitative instrument developed on the basis of several items from previous scales and phenomenological reports addressing the experience of space and time. We applied the STEP scale to three groups of subjects (patients with schizophrenia spectrum disorders, patients with predominant affective symptoms, and healthy control subjects), to whom we also applied other more general psychopathological scales, such as the Positive and Negative Syndrome Scale and the Ego-Psychopathology Inventory. <b><i>Results:</i></b> Patients with schizophrenia spectrum disorders scored significantly higher on general psychopatho<X00_Del_TrennDivis>­-</X00_Del_TrennDivis>logical scales relative to subjects belonging to the other groups. The STEP scale provided good psychometric properties regarding reliability. We also tested convergent and divergent validity of the STEP scale and found that space and time subscale scores of STEP significantly correlated with each other, as well as with the remaining general psychopathological scores. <b><i>Discussion/Conclusion:</i></b> We introduced the STEP scale as a novel instrument for the assessment of experience of space and time. Its psychometric properties showed high validity and reliability to identify psychopathological symptoms and enabled to differentiate patients with predominantly psychotic symptoms from those with predominantly affective symptoms. The STEP scale provides a standardized measure for assessing disturbances in the experience of space and time. Furthermore, it probably represents a leap forward toward the establishment of an additional dimension of symptoms proposed as “spatiotemporal psychopathology.”

Finding the Drastic: Exploring Forms of Attention in Piano Performance

<p>While Carolyn Abbate’s essay “Music – Drastic or Gnostic” sets provocative parameters for considering performance, she also makes a bold stand on the mutual exclusivity of the knowing or gnostic mind and active or drastic body in performance. Abbate suggests that when one is involved in the real-time experience of music (i.e. performance) there is no room for thought because conceptual awareness interrupts the real-time experience. Thus, drastic precludes gnostic. Yet many performers speak about the need to negotiate a balance between mind and body in performance. This implies that an imbalance can occur in either direction, that over-thinking the execution is not conducive to flow but that the ultimate experience of the music ‘playing itself’ may also incur an undesirable sense of not being in conscious control. This paper aims to explore the limits of a gnostic approach and the parameters for a drastic performance. My own experience has demonstrated the ways in which too much conscious control - or rather, too much conscious attention on certain tactile aspects of playing - can end up hampering the physical execution. Indeed, Science Daily has summarised recent research in the Journal of Neuroscience that confirms scientifically that over-thinking can be detrimental to performance. Implicit memory (unconscious and expressed by means other than words) and explicit memory (which is conscious and can be described in words) each operate from different parts of the brain; and the implication is that physical performance in most cases requires the deployment of implicit as well as explicit memory. For a pianist, in other words, on the one hand the ‘action’ must become instinctive at some point because one’s attention cannot focus simultaneously on the fingers prior to every sound and on the sound itself. On the other hand, it is also not desirable simply to deliver the action to some level of drastic, or pure ‘doing’ (as the ancient meaning of the word suggests), even to a meta-drastic point where the music ‘plays itself’. Thus it would seem that Abate’s stipulation gnostic or drastic requires further reflection. Through my critical analysis of this discussion, I would like finally to be able to redress the balance between a gnostic and drastic approach in my own performance. Resituating the mind-body balance itself requires a shift in consciousness: a shift that effectively distracts me from overt tactile awareness and places my foreground attention to sound. This shift, ironically, requires an immense conscious effort: in other words, my shift towards the drastic is launched by the gnostic. Through documenting the process of my own journey from gnostic/explicit performance to drastic/implicit performance, I will propose that a specific balanced blend is ideal: that is, I need to move from a cognitive or conscious process that focuses on physical aspects of performance, in order to bring an unfettered consciousness of sound to the foreground attention. If I can suppress my conscious attention to the kinetics of playing the piano and this very suppression permits a focus on sound itself, will that be a shutting down of one kind of excessive cognitive effort and signal a release of the drastic, or simply resituate the gnostic? For myself, finding my way to trusting a drastic approach and yet balance it with a gnostic input is imperative if I am to find music making a pleasure.</p>

Finding the Drastic: Exploring Forms of Attention in Piano Performance

<p>While Carolyn Abbate’s essay “Music – Drastic or Gnostic” sets provocative parameters for considering performance, she also makes a bold stand on the mutual exclusivity of the knowing or gnostic mind and active or drastic body in performance. Abbate suggests that when one is involved in the real-time experience of music (i.e. performance) there is no room for thought because conceptual awareness interrupts the real-time experience. Thus, drastic precludes gnostic. Yet many performers speak about the need to negotiate a balance between mind and body in performance. This implies that an imbalance can occur in either direction, that over-thinking the execution is not conducive to flow but that the ultimate experience of the music ‘playing itself’ may also incur an undesirable sense of not being in conscious control. This paper aims to explore the limits of a gnostic approach and the parameters for a drastic performance. My own experience has demonstrated the ways in which too much conscious control - or rather, too much conscious attention on certain tactile aspects of playing - can end up hampering the physical execution. Indeed, Science Daily has summarised recent research in the Journal of Neuroscience that confirms scientifically that over-thinking can be detrimental to performance. Implicit memory (unconscious and expressed by means other than words) and explicit memory (which is conscious and can be described in words) each operate from different parts of the brain; and the implication is that physical performance in most cases requires the deployment of implicit as well as explicit memory. For a pianist, in other words, on the one hand the ‘action’ must become instinctive at some point because one’s attention cannot focus simultaneously on the fingers prior to every sound and on the sound itself. On the other hand, it is also not desirable simply to deliver the action to some level of drastic, or pure ‘doing’ (as the ancient meaning of the word suggests), even to a meta-drastic point where the music ‘plays itself’. Thus it would seem that Abate’s stipulation gnostic or drastic requires further reflection. Through my critical analysis of this discussion, I would like finally to be able to redress the balance between a gnostic and drastic approach in my own performance. Resituating the mind-body balance itself requires a shift in consciousness: a shift that effectively distracts me from overt tactile awareness and places my foreground attention to sound. This shift, ironically, requires an immense conscious effort: in other words, my shift towards the drastic is launched by the gnostic. Through documenting the process of my own journey from gnostic/explicit performance to drastic/implicit performance, I will propose that a specific balanced blend is ideal: that is, I need to move from a cognitive or conscious process that focuses on physical aspects of performance, in order to bring an unfettered consciousness of sound to the foreground attention. If I can suppress my conscious attention to the kinetics of playing the piano and this very suppression permits a focus on sound itself, will that be a shutting down of one kind of excessive cognitive effort and signal a release of the drastic, or simply resituate the gnostic? For myself, finding my way to trusting a drastic approach and yet balance it with a gnostic input is imperative if I am to find music making a pleasure.</p>

The Night Sky: What have we lost?

<p><b>Over the last 70 years, there has been a dramatic increase in the population living in urban areas across the globe. As a result, the once natural ability to look up at the night sky and ponder our existence has been lost to bigger, brighter and ever-expanding urban development. In our outdoor public spaces, the design tends to focus only on how the space can be enjoyed during the day time, and lighting is placed as a means to allow people to continue this day time experience at night. Yet, often at night our public spaces are empty, as they don’t provide a special night time experience that is different to during the day. We focus on the action of looking forward and around us but never upwards toward the night sky. </b></p> <p>This research addresses how landscape architecture can help facilitate a night time experience so that the naturally dark environment can be enjoyed. It analyzes how the relationship between lighting and the physical elements in an outdoor space can be improved to provide greater visibility of the stars. Wellington, the capital of New Zealand, will be used as a case study. The stars can be seen within the central urban perimeter, and the Milky-Way is visible only a 20 minute drive away. As this research is based in New Zealand, this thesis recognizes Māoritanga and acknowledges the importance of Tatai Arorangi within New Zealand’s history and culture and addresses this within the development of this night time experience. </p> <p>Wellington was split into five different areas based on their differing intensity of lighting as well as typological characteristics. Within three of these areas, a variety of different outdoor public spaces were identified and analyzed using an experiential approach, with fieldwork as the primary method of analysis. </p> <p>The analysis findings resulted in the generation of a design toolkit to test how specific physical features used in landscape design impacted the night time experience. This toolkit was then applied and tested into 3 different sites in Wellington. It was concluded that the design and implementation of lighting, vegetation and seating has not considered the night time experience. This research aims to contribute to this unaddressed area, by attempting to develop a connection to the night sky through looking at these features in a new perspective.</p>

The Night Sky: What have we lost?

<p><b>Over the last 70 years, there has been a dramatic increase in the population living in urban areas across the globe. As a result, the once natural ability to look up at the night sky and ponder our existence has been lost to bigger, brighter and ever-expanding urban development. In our outdoor public spaces, the design tends to focus only on how the space can be enjoyed during the day time, and lighting is placed as a means to allow people to continue this day time experience at night. Yet, often at night our public spaces are empty, as they don’t provide a special night time experience that is different to during the day. We focus on the action of looking forward and around us but never upwards toward the night sky. </b></p> <p>This research addresses how landscape architecture can help facilitate a night time experience so that the naturally dark environment can be enjoyed. It analyzes how the relationship between lighting and the physical elements in an outdoor space can be improved to provide greater visibility of the stars. Wellington, the capital of New Zealand, will be used as a case study. The stars can be seen within the central urban perimeter, and the Milky-Way is visible only a 20 minute drive away. As this research is based in New Zealand, this thesis recognizes Māoritanga and acknowledges the importance of Tatai Arorangi within New Zealand’s history and culture and addresses this within the development of this night time experience. </p> <p>Wellington was split into five different areas based on their differing intensity of lighting as well as typological characteristics. Within three of these areas, a variety of different outdoor public spaces were identified and analyzed using an experiential approach, with fieldwork as the primary method of analysis. </p> <p>The analysis findings resulted in the generation of a design toolkit to test how specific physical features used in landscape design impacted the night time experience. This toolkit was then applied and tested into 3 different sites in Wellington. It was concluded that the design and implementation of lighting, vegetation and seating has not considered the night time experience. This research aims to contribute to this unaddressed area, by attempting to develop a connection to the night sky through looking at these features in a new perspective.</p>

Subjective time compression induced by continuous action

Increasing evidence indicates that voluntary actions can modulate the subjective time experience of its outcomes to optimize dynamic interaction with the external environment. In the present study, using a temporal reproduction task where participants reproduced the duration of an auditory stimulus to which they were previously exposed by performing different types of voluntary action, we examined how the subjective time experience of action outcomes changed with voluntary action types. Two experiments revealed that the subjective time experience of action outcomes was compressed, compared with physical time, if the action was performed continuously (Experiment 1), possibly enhancing the experience of controlling the action outcome, or if the action was added an extra task-unrelated continuous action (Experiment 2), possibly reflecting different underlying mechanisms from subjective time compression induced by the task-related continuous action. The majority of prior studies have focused on the subjective time experience of action outcomes when actions were performed voluntarily or not, and no previous study has examined the effects of differences in voluntary action types on the subjective time experience of action outcomes. These findings may be useful in situations in which people wish to intentionally compress their own time experience of daily events through their voluntary actions.

Love and Time

Although both philosophical and theological traditions have taken a negative view of time, time is understood here as a condition of love that is able to endure. This is again especially clear in Kierkegaard, who understands God’s eternity as God’s power to give time. This makes love essentially hopeful. The chapter shows how ‘kairological’ time-experience is involved in the beginning of love, in its power of ‘abiding’, and in the gift of temporally extended attention that is given in love, attention that is human life’s closest analogy to divine creation. Kierkegaard’s emphasis on the moment is fleshed out with help from Franz Rosenzweig, who highlights the importance of the hour, day, week, and year as forging the communal relationship between divine and human. Edwin Muir is used to further develop these insights and to show the role of eschatology in love.

Real Time Experience of Participants in Higher Education During The Coronavirus: A Case Study

This case study explored the real-time experience of participants in the Arab Academic College for Education in Haifa, Israel, during the coronavirus pandemic. Twenty in-depth interviews were conducted with management, administrative staff, faculty and students. Participants' stories reveal that feelings of stress and isolation gave way to new learning and self-discovery, a new relationship with time, and the creation of new knowledge on the personal and institutional levels. Strong, coordinated leadership, combined with legal and financial security, facilitated the transition to online learning and allowed the college to emerge from the crisis successfully. Implications are drawn for dealing with future crises.

Doing Double Time: Women, Incarceration and Employment Discrimination

People who have served prison time experience a higher unemployment rate than other social groups. Australian law stipulates individuals must not face employment discrimination on the basis of criminal record if unrelated to the job’s inherent requirements, but discrimination remains significant. Female ex-offenders are particularly vulnerable to stigma and discrimination. Nicki’s (pseudonym) account airs injustices facing women seeking rehabilitation post-incarceration. Her experiences highlight structural barriers female ex-offenders face when seeking employment and marginalisation hindering social acceptance.