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The present study tests the effectiveness of a mindset intervention for negotiators in value-driven conflicts. We hypothesize that this intervention fosters integrative negotiation behaviors and subjective outcomes. In an experimental 2 (motive: value vs. utility) by 2 (intervention: mindset vs. control) design, 253 participants negotiated online with a simulated counterpart. In contrast to predictions, the mindset led to more integrative trade-offs among utility-driven but not value-driven negotiators. However, the results support the effectiveness of the mindset intervention to improve subjective outcomes of value-driven negotiators. Without the intervention, they perceive the negotiation outcome as significantly less positive than utility-driven negotiators with the same objective outcome. In addition, explorative analyses show that without the mindset intervention, value-driven negotiators respect their counterpart less as a person of equal worth than utility-driven negotiators; this is no longer the case after activating the integrative mindset. The implications of these findings for resolving value conflicts and improving tolerance between parties with different value priorities are discussed.

Pancreatic cancer (PC) survival is poor, as detection usually occurs late, when treatment options are limited. Screening of high-risk individuals may enable early detection and a more favorable prognosis. Knowledge gaps prohibit establishing the effectiveness of screening. We developed a Microsimulation Screening Analysis model to analyze the impact of relevant uncertainties on the effect of PC screening in high-risk individuals. The model simulates two base cases: one in which lesions always progress to PC and one in which indolent and faster progressive lesions coexist. For each base case, the effect of annual and 5-yearly screening with endoscopic ultrasonography/magnetic resonance imaging was evaluated. The impact of variance in PC risk, screening test characteristics and surgery-related mortality was evaluated using sensitivity analyses. Screening resulted in a reduction of PC mortality by at least 16% in all simulated scenarios. This reduction depended strongly on the natural disease course (annual screening: -57% for "Progressive-only" vs -41% for "Indolent Included"). The number of screen and surveillance tests needed to prevent one cancer death was impacted most by PC risk. A 10% increase in test sensitivity reduced mortality by 1.9% at most. Test specificity is important for the number of surveillance tests. In conclusion, screening reduces PC mortality in all modeled scenarios. The natural disease course and PC risk strongly determines the effectiveness of screening. Test sensitivity seems of lesser influence than specificity. Future research should gain more insight in PC pathobiology to establish the true value of PC screening in high-risk individuals.

Apologies can have desirable effects on the reduction of anger and may foster forgiveness. Yet, we know little about the effectiveness of apologies across different cultures. In this research, we distinguished two important components of apologies: admission of blame by the self and the expression of remorse for the plight of the other. We investigated how these two components resonate with cultural values associated with dignity and honor. Results revealed that although an apology increased forgiveness in both cultures, honor-culture members tended to forgive less and retaliate more than dignity-culture members, after an apology. This cultural difference was mediated by the extent to which honor-culture (vs. dignity-culture) members perceived the apology to express (less) remorse and thus be (less) sincere.

Objective Endoscopic ultrasonography (EUS) and MRI are promising tests to detect precursors and early-stage pancreatic ductal adenocarcinoma (PDAC) in high-risk individuals (HRIs). It is unclear which screening technique is to be preferred. We aimed to compare the efficacy of EUS and MRI in their ability to detect clinically relevant lesions in HRI.Design Multicentre prospective study. The results of 139 asymptomatic HRI (>10-fold increased risk) undergoing first-time screening by EUS and MRI are described. Clinically relevant lesions were defined as solid lesions, main duct intraductal papillary mucinous neoplasms and cysts >= 10 mm.Results were compared in a blinded, independent fashion. Results Two solid lesions (mean size 9 mm) and nine cysts >= 10 mm (mean size 17 mm) were detected in nine HRI (6%). Both solid lesions were detected by EUS only and proved to be a stage I PDAC and a multifocal pancreatic intraepithelial neoplasia 2. Of the nine cysts >= 10 mm, six were detected by both imaging techniques and three were detected by MRI only. The agreement between EUS and MRI for the detection of clinically relevant lesions was 55%. Of these clinically relevant lesions detected by both techniques, there was a good agreement for location and size.Conclusions EUS and/or MRI detected clinically relevant pancreatic lesions in 6% of HRI. Both imaging techniques were complementary rather than interchangeable: contrary to EUS, MRI was found to be very sensitive for the detection of cystic lesions of any size; MRI, however, might have some important limitations with regard to the timely detection of solid lesions.

Background Screening individuals at increased risk for pancreatic cancer (PC) detects early, potentially curable, pancreatic neoplasia. Objective To develop consortium statements on screening, surveillance and management of high-risk individuals with an inherited predisposition to PC. Methods A 49-expert multidisciplinary international consortium met to discuss pancreatic screening and vote on statements. Consensus was considered reached if ≥75% agreed or disagreed. Results There was excellent agreement that, to be successful, a screening programme should detect and treat T1N0M0 margin-negative PC and high-grade dysplastic precursor lesions (pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm). It was agreed that the following were candidates for screening: first-degree relatives (FDRs) of patients with PC from a familial PC kindred with at least two affected FDRs; patients with Peutz–Jeghers syndrome; and p16, BRCA2 and hereditary non-polyposis colorectal cancer (HNPCC) mutation carriers with ≥1 affected FDR. Consensus was not reached for the age to initiate screening or stop surveillance. It was agreed that initial screening should include endoscopic ultrasonography (EUS) and/or MRI/magnetic resonance cholangiopancreatography not CT or endoscopic retrograde cholangiopancreatography. There was no consensus on the need for EUS fine-needle aspiration to evaluate cysts. There was disagreement on optimal screening modalities and intervals for follow-up imaging. When surgery is recommended it should be performed at a high-volume centre. There was great disagreement as to which screening abnormalities were of sufficient concern to for surgery to be recommended. Conclusions Screening is recommended for high-risk individuals, but more evidence is needed, particularly for how to manage patients with detected lesions. Screening and subsequent management should take place at high-volume centres with multidisciplinary teams, preferably within research protocols.

Research has identified loss aversion as a strong and robust phenomenon, but has also revealed some moderators affecting the magnitude of its effect on decision making. In the current article, we draw attention to the fact that even the measurement of loss aversion itself may affect its magnitude by inducing a focus on either losses or gains. In three studies, we provide empirical evidence for such a measurement-induced focus. In all studies we used coin-toss gambles—in which there is a 50/50 chance to win or to lose—to assess gain/loss ratios as a measure of loss aversion. Participants either filled out the loss side or the gain side of this gain/loss ratio. The studies consistently showed that—using within- and between-subject designs and anticipated and real coin-toss gambles—the strength of loss aversion depended on the measurement format (fill-in-the-loss versus fill-in-the-gain); filling in the loss side increased loss aversion. Moreover, loss aversion was more affected by the stakes of the gamble in the fill-in-the-loss format than in the fill-in-the-gain format.

Pancreatic cancer represents one of the most deadly human malignancies with an overall 5-year survival of less than 5%. Despite improvements in imaging techniques and surgical techniques, survival statistics have hardly improved over the past decades. To improve the dismal outlook it would be highly desirable to develop a program to detect precursor lesions or small asymptomatic early cancers at the time when the disease is still at a curable stage. Screening the general population for disease presence is not feasible at present because of the relatively low disease incidence and the lack of a noninvasive, reliable and cheap screening tool. Targeted surveillance programs, however, in individuals at high risk for developing pancreatic cancer, like mutation carriers of pancreatic cancer prone hereditary (tumor) syndromes or individuals with a strong family history of pancreatic cancer without a known underlying genetic defect, might be feasible. Careful consideration of the criteria put forward by Wilson and Jungner as published by the World Health Organization on the principles and practice of screening for disease, indicate that surveillance in this high-risk population by means of endosonography (EUS) and/or magnetic resonance imaging (MRI) represents a promising development, though experimental. It nicely points out which open questions need to be addressed. Among others, these include how to acquire a better understanding of the natural behavior and progression of precursor lesions towards invasive cancer, how to firmly establish the performance characteristics of EUS and MRI for the detection of (early) lesions in individuals at high risk for pancreatic cancer, and how to determine which lesions can be safely observed with continued surveillance and which lesions justify resection. Copyright (C) 2010 S. Karger AG, Basel

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Contains fulltext : 77079.pdf (author's version ) (Open Access)

Emotions play an important role in conflict resolution. Past work has found that negotiators tend to concede when confronted with anger. We argue and show that this effect occurs in conflicts about interests, but not in conflicts about values. In value conflicts that are more closely tied to a person's values, norms, and identity, expressions of anger are likely to backfire. We demonstrate that people deem expressions of anger more unfair in value conflicts than in interest conflicts (Study 1) and that they are more likely to engage in retaliatory and escalatory behaviours when confronted with an angry reaction in the context of a value issue rather than an interest issue (Study 2).

Most negotiations are interrupted from time to time to reflect on the negotiation or to do other pressing tasks. This study investigated how these breaks and the thoughts during these breaks influence subsequent negotiation behavior. Prosocially motivated dyads, with a tendency to think cooperatively, and proself-motivated dyads, with a tendency to think competitively, engaged in a negotiation in which there was a 3-min break. During this break, either they could reflect upon the negotiation or they did a distraction task. After the reflect break, but not after the distract break, prosocial dyads displayed more concern for other, engaged in more cooperative negotiation, and reached more agreements than proself dyads. We conclude that breaks are constructive if, and only if, negotiators reflect on their negotiation when having a prosocial orientation.