Stefano Occhipinti

Stigmatising attitudes towards lung cancer exist across cultures based on societal norms and beliefs. However, there is a notable gap in research on lung cancer stigma within Asian cultures such as Malaysia. Our study explored Malaysian public attitudes towards lung cancer through qualitative semi-structured interviews with 32 participants (11 Malays, 11 Chinese, and 10 Indians). Findings highlighted religious beliefs shaped participants’ perceptions, with some seeing cancer as fate or punishment, while gender norms also influenced how lung cancer was perceived, with societal expectations differing for men and women. Participants primarily attributed lung cancer to internal factors such as smoking, leading to moral judgements of personal responsibility, while some acknowledged genetic predispositions and environmental risks. Our study shows how sociocultural factors, including patriarchal and religious values, influence perceptions of lung cancer, underscoring the importance of culturally sensitive approaches to improve public health outcomes of lung cancer.

With the rapid progression of artificial intelligence (AI) development, artificial entities are increasingly making decisions in domains with human moral consequence, including in healthcare settings. Thus, it is crucial to understand how people perceive moral decisions made by AI compared to humans in healthcare. People at times perceive robots powered by AI and humans differently when making the same moral decisions, suggesting that people may hold robots to different moral standards than humans. The visual representation of robots may also affect how people perceive this technology in making moral decisions, with the potential for robots that are perceived as uncanny and approaching human-likeness to be judged as less moral. However, would this moral uncanny valley effect apply to moral dilemmas in healthcare? Past research has found uncanny valley effects in situations such as trolley problem dilemmas, but these dilemmas may differ heavily in terms of plausibility and outcome severity compared to ones in healthcare. Thus, this current study tasked participants with reading vignettes regarding human, human-like robot (i.e., android), and mechanical robot nurses making moral medical decisions regarding either forcefully medicating a patient or respecting the patient’s autonomy, and then rated theses nurses on moral acceptability, moral responsibility, warmth, competence, and trustworthiness. Overall, the mechanical robot nurses were rated lower in general than the human nurse, with the android and mechanical robot nurses being rated similarly. These results suggest that uncanny valley effects are not present in dilemmas involving patient autonomy, and that uncanny valley effects only arise in high-stake moral dilemmas.

This study investigated the impact of task type and proficiency level on second language learners’ task engagement, combing the discourse analytic method with the idiodynamic method. Sixty undergraduate English-as-a-foreign-language learners in China were divided into high- and low-proficiency groups based on their scores on the Oxford Placement Test. The learners were randomly paired with a partner who shared the same proficiency level and completed a narrative task and a decision-making task. Their spoken discourse of task performance was analyzed to explore behavioral, cognitive, and social engagement. The results of the two tasks were compared using multivariate analyses of variance. Emotional engagement was examined qualitatively through stimulated recall interviews, adopting an idiodynamic approach. The findings revealed that both high- and low-proficiency groups were more behaviorally, cognitively, socially, and emotionally engaged in the decision-making task than in the narrative task. The findings also indicate an interaction effect of task type and proficiency level on learner engagement, as high-proficiency learners produced significantly more words and turns during the decision-making task compared to the narrative task. Emotional engagement exhibited five dynamic patterns, with greater fluctuations in decision-making tasks among high-proficiency learners. The findings of this study suggest that decision-making tasks may be more engaging to second language learners, especially those with higher-proficiency levels.

Objective: Lung cancer stigma remains a significant yet underexplored challenge, particularly in non‐Western contexts. Our study aimed to explore how sociocultural factors shape the experiences of Malaysian lung cancer patients, with particular attention to stigma. Methods: We conducted a qualitative study using semi‐structured interviews with 15 lung cancer patients at a local public hospital in Malaysia, which were analysed using coding reliability thematic analysis in conjunction with consensual qualitative research. Results: Our analysis showed that participants' narratives centred on the challenges they faced and the coping strategies they employed, which we mapped to the socio‐ecological model to illustrate the sociocultural influences spanning individual, familial, social and systemic levels. At the individual level, smokers felt guilt, while non‐smokers experienced confusion and distress about their diagnosis. Participants reported physical and emotional challenges, finding solace in faith, acceptance and cultural resilience. Within families, feelings of guilt and fear of burdening others constrained disclosure, yet collectivist norms of obligation and care meant that family members still provided crucial emotional and financial support. At the societal level, stigma associating lung cancer with smoking led to blame and isolation for both smokers and non‐smokers. Systemic issues such as diagnostic delays, poor health care communication and financial burdens compounded these challenges. Conclusion: Our study highlights how sociocultural values, stigma and systemic barriers are deeply intertwined in shaping lung cancer experiences in Malaysia. Interventions should be designed with sensitivity to religious beliefs, filial obligations and norms of emotional restraint while addressing stigma alongside health care barriers.

Missing data occur almost universally in research, especially applied research. This can give rise to problems of both statistical estimation and interpretation. The work of Donald Rubin in the 1970s was highly influential on researchers’ theoretical and practical understanding of ‘missingness’ – the state of being missing. Previously, approaches to missingness tended to exclude all participants with missing responses (e.g., complete case analysis) or to fill missing data with arbitrary values, such as sample means (e.g., mean imputation). These seemed to solve issues of estimation but merely deferred problems of interpretation. Contemporary approaches to missingness begin by classifying the missingness as either ignorable (missing at random or completely at random) or non-ignorable (missing not at random). Consequently, imputation and maximum likelihood approaches can be employed that minimise problems of estimation and maximise the validity of interpretation. However, when missingness is not at random, problems remain. The chapter concludes with recommendations for researchers.

Previous studies found similarities in adults' disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7-9 years), late childhood (10-12 years), adolescence (13-17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (1) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children's disgust responses whereas adolescents and adult responses considered cognitive cues.