Prophylactic Bilateral Salpingo-Oophorectomy (PBSO) reduces the risk of developing ovarian cancer. However, the psychological mechanisms that may affect post-surgery Quality of Life (QoL) among patients who underwent PBSO are still largely unknown. Thus, this study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer.
Post-surgery psychological QoL was unrelated from any sociodemographic or clinical variable. Cancer anxiety had a significant direct negative effect on psychological QoL, while satisfaction with medical communication had a significant positive direct effect on it. Finally, cancer anxiety significantly mediated the association between satisfaction with medical communication and post-surgery psychological QoL.
Results suggest that post-surgery psychological QoL of patients who underwent PBSO may be increased with interventions, delivered in a genetic counselling setting, targeting quality of medical communication and cancer anxiety.
Volume 13 - 2022 | https://doi.org/10.3389/fpsyg.2022.840931
Background: Prophylactic Bilateral Salpingo-Oophorectomy (PBSO) reduces the risk of developing ovarian cancer
the psychological mechanisms that may affect post-surgery Quality of Life (QoL) among patients who underwent PBSO are still largely unknown
this study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer
Method: Fifty-nine women (mean age: 50.64 ± 6.7 years) who underwent PBSO took part in this cross-sectional study
filling out a sociodemographic and clinical questionnaire
a battery of validated psychological measures and an ad hoc developed scale for the assessment of cancer anxiety
We first examined the correlations among all variables of interest
and then tested if cancer anxiety mediated the association between satisfaction with medical communication and post-surgery psychological QoL
controlling both for time from surgery and education
Results: Post-surgery psychological QoL was unrelated from any sociodemographic or clinical variable
Cancer anxiety had a significant direct negative effect on psychological QoL
while satisfaction with medical communication had a significant positive direct effect on it
cancer anxiety significantly mediated the association between satisfaction with medical communication and post-surgery psychological QoL
Discussion: Results suggest that post-surgery psychological QoL of patients who underwent PBSO may be increased with interventions
delivered in a genetic counselling setting
targeting quality of medical communication and cancer anxiety
anxiety symptomatology specifically related to the worry of developing cancer) may also play a significant role in affecting post-surgery QoL
They further report the need for supportive communications (Babb et al., 2002), in particular relative to the effects of surgical menopause, the link between Hormone Replacement Therapy (HRT) and breast cancer (Meiser et al., 2000), and potential physical and emotional effects of the surgery (Hallowell, 1998)
Literature on this population has several shortcomings. In accordance with Finch and Narod (2011)
well performed follow-up studies on the long-term health and quality of life consequences of BPSO are still missing
very few studies focused on the role of medical communication in the field of genetic counselling or prophylactic surgery
and no studies focused on cancer anxiety after BPSO
nor on the relationship between anxiety and QoL in this population
In order to overcome these limits, we tested a mediation model in a population of PBSO patients, where the association between satisfaction with medical communication (i.e., the level of satisfaction regarding the medical communication received during the surgery pathway) and post-surgery psychological QoL is mediated by cancer anxiety. In accordance with Stark and House (2000)
we hypothesized that a greater satisfaction with medical communication will reduce the overall levels of cancer anxiety
leading to a greater post-surgery psychological QoL
The majority of the participants attended high school (54.2%)
they were mostly diagnosed with a BRCA 1/2 genetic mutation (81.6%) or had a history of breast cancer (67.8%) treated with a mastectomy (66.1%)
and standard deviations for all sociodemographic
and psychological variables examined in our sample of women who underwent Prophylactic Bilateral Salpingo-Oophorectomy (PBSO; N = 59)
Satisfaction with medical communication received in relation to the surgery was assessed through a single item on a Likert-type scale (i.e.
from 0 = “completely unsatisfied” to 10 = “completely satisfied”)
The item asked patients “From 0 (completely unsatisfied) to 10 (completely satisfied)
how much satisfied are you with the medical information you received before and after the prophylactic surgery?”
Cancer anxiety was examined through an ad hoc developed cancer anxiety scale
composed by two Likert-type items investigating both “Cancer rumination” and “Cancer risk perception.” The items asked patients to rate from 0 (“not at all”) to 10 (“very much”) how much they experienced the following mental states: (a) “I have recurring thoughts about cancer” (Cancer rumination); “I have the perception that my life is constantly threatened” (Cancer risk perception)
Cancer anxiety total score is calculated by the mean of the two items and ranges from 0 to 10
Higher scores indicate higher cancer anxiety
Sociodemographic and clinical information were collected using a structured ad-hoc self-report questionnaire
Sexual functioning was assessed through the Italian version of the Female Sexual Function Index (FSFI; α in the current study: 0.96; Filocamo et al., 2014)
The FSFI is a 19-items scale aimed at targeting the six domains of female sexual functioning: desire (two items
are rated on a 6-point Likert-type scale (from 0 to 5)
while the items of the subscales desire and satisfaction are rated on a 5-point Likert-type scale (from 1 to 5)
with higher scores indicating a better sexual functioning
Sexual distress was investigated through the Female Sexual Distress—revised (FSDS-r; α in the current sample: 0.97; Derogatis et al., 2008)
a 13-items scale aimed at assessing distress related to sexuality
Respondents indicate how often each of the listed sexual-related problems (e.g.
absence of desire and feeling of guilty) has caused distress in the previous 7 days on a Liker-type scale from 0 (“never”) to 4 (“always”)
with higher scores indicating greater sexual distress
The Italian translated version provided by the authors (copyright: American Foundation for Urological Disease Inc.) has been used in this research study
Body image distress was assessed through the Italian version of the Body Image Scale (BIS; α in the current sample: 0.93; Cheli et al., 2016)
The BIS is a 10-item measure of different dimensions of body image in cancer patients
It uses a 4-point response scale (from 0 = “not at all,” to 3 = “very much”)
with higher scores indicating worse symptoms and distress or more body image concerns
we aimed at assessing body image beliefs in the last week and in relation to surgery consequences
We performed an a priori power analysis (F test family and linear multiple regression with two predictors as statistical test) using the software G*POWER 3.1. We first extracted effect sizes from a similar study on QoL of women at high risk for breast cancer who underwent a prophylactic surgery (f2 = 0.17; Brandberg et al., 2008)
The a priori power analysis evidenced that 60 participants were required to detect a medium-high effect size (f2 = 0.17) on psychological QoL (α = 0.05; Power = 0.80)
Data were initially screened for assumptions. Thus, we tested for the presence of univariate and multivariate outliers, and examined the univariate normality of all variables of interest (Tabachnick and Fidell, 2007)
We then investigated the possible relationships between sociodemographic
through Pearson’s or Spearman’s r correlation coefficients
The mediation model in the sample of patients who underwent Prophylactic Bilateral Salpingo-Oophorectomy (PBSO; N = 59)
All analyses were run with SPSS version 26 (SPSS, 2019)
and a value of p ≤ 0.05 was considered significant
Preliminary analyses evidenced that all variables were normally distributed
while no univariate or multivariate outliers were identified
the cancer anxiety scale specifically developed for this study evidenced good psychometric properties: a Principal Component Analysis with one extracted component explained 93.65% of the variance
and both items had a saturation of 0.97 with the factor “cancer anxiety.” The internal consistency was also good
Zero-order correlations between post-surgery psychological Quality of Life (QoL) and all variables of interest (N = 59)
cancer anxiety had a significant negative direct effect on post-surgical psychological QoL (β = −0.392
while satisfaction with medical communication was a significant positive predictor of the dependent variable (β = 0.345
cancer anxiety mediated the association between satisfaction with medical communication and post-surgical psychological QoL (β = 0.112
with medium effects This model accounted for approximately 35% of the variance in the dependent variable
This study sought to investigate if cancer anxiety mediated the association between satisfaction with medical communication and post-surgery psychological QoL
a greater satisfaction with medical communication decreases cancer anxiety
which in turn improves post-surgical psychological QoL
very few studies have investigated QoL after BPSO
and even fewer examined the predictors of long-term post-surgery QoL within this sample
Our study provided a significant contribution to this emerging topic
focusing on the needs and shortcomings of the current literature
we hypothesize that a greater quality of medical communication
focused on providing accurate information on (i) the risk condition or genetic predisposition
using an emphatic and patient-centered style
may be associated with a greater satisfaction with medical communication
may enhance both the patients’ self-efficacy competencies and their focus on an internal locus of control (i.e.
the beliefs that the outcomes of one own’s actions are results of one own abilities and choices)
thanks to a greater satisfaction with medical communication
patients who underwent PBSO may experience psychological changes that promote psychological QoL and reduce perceived risk and rumination on cancer
Despite the clinical significance of our findings
the retrospective assessment of the satisfaction with medical communication
and the use of an ad-hoc measure of cancer anxiety may limit the generalizability of our findings
The retrospective assessment of the satisfaction with medical information could have been affected by a recall bias
even if we tried to partially control for this systematic error entering time from surgery as a covariate in our mediation model
satisfaction with medical communication and quality of medical communication are partially overlapping—but still distinct—dimensions
the former may be influenced by other personal or clinical factors (e.g.
not per se reflecting the quality of the communication
satisfaction with medical communication may also be affected by health literacy and education
even if we tried to partially control for this including educational level as covariate in the mediation model
Findings support the importance to guarantee high quality of counselling provided to women undergoing PBSO
it could be helpful (i) to include mental health practitioners within the genetic screening procedure or as part of the pre-surgical evaluation team and (ii) to deliver specific communication-based trainings for the medical team aimed at reducing the cancer anxiety experienced by patients
High-quality medical communication and greater patients’ satisfaction could help those who undergo PBSO to better cope with the long-term psychological sequelae of prophylactic surgery
and increasing—in the long run—their overall sense of wellbeing and QoL
Better satisfaction with BPSO and subsequent greater QoL might be in turn related to a wider diffusion of prophylactic surgical treatments and the maximization of ovarian cancer prevention
The raw data supporting the conclusions of this article will be made available by the authors
The studies involving human participants were reviewed and approved by the Hospital Papa Giovanni XXIII
The patients/participants provided their written informed consent to participate in this study
All authors contributed to the article and approved the submitted version
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
the “Inner Wheel” Association
and the Gorla Utensili SRL for their continuous and generous support
Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies
Life quality of patients who underwent breast reconstruction after prophylactic mastectomy: systematic review
Prophylactic oophorectomy at elective hysterectomy: effects on psychological well-being at 1-year follow-up and its correlations to sexuality
Qualitative evaluation of medical information processing needs of 60 women choosing ovarian cancer surveillance or prophylactic oophorectomy
Psychosocial issues in cancer genetics--current status and future directions
CrossRef Full Text | Google Scholar
The psychological impact of breast and ovarian cancer preventive options in BRCA1 and BRCA2 mutation carriers
and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: a prospective 1-year follow-up study
The course of distress in women at increased risk of breast and ovarian cancer due to an (identified) genetic susceptibility who opt for prophylactic mastectomy and/or salpingo-oophorectomy
Who is prone to high levels of distress after prophylactic mastectomy and/or salpingo-ovariectomy
The Italian version of body image scale reliability and sensitivity in a sample of breast cancer patients
Psicoterapia Cognitiva e Comportamentale 22:42000
Statistical Power Analysis for the Behavioral Sciences
Google Scholar
D’Alonzo
Satisfaction and impact on quality of life of clinical and instrumental surveillance and prophylactic surgery in BRCA-mutation carriers
De Girolamo
Quality of life assessment: validation of the Italian version of the WHOQOL-brief
Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder
Quality of life and psychosexual adjustment after prophylactic oophorectomy for a family history of ovarian cancer
A prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer
Cancer Incidence and Mortality Worldwide: IARC CancerBase No
France: International Agency for Research on Cancer)
Google Scholar
The female sexual function index (FSFI): linguistic validation of the Italian version
The impact of prophylactic salpingo-oophorectomy on quality of life and psychological distress in women with a BRCA mutation
Quality of life and health status after prophylactic salpingo-oophorectomy in women who carry a BRCA mutation: a review
Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families
Prophylactic oophorectomy versus screening: psychosocial outcomes in women at increased risk of ovarian cancer
The communication goals and needs of cancer patients: a review
CrossRef Full Text | Google Scholar
You don’t want to lose your ovaries because you think “I might become a man”
Women's perceptions of prophylactic surgery as a cancer risk management option
doi: 10.1002/(SICI)1099-1611(199805/06)7:3<263::AID-PON307>3.0.CO;2-Q
and Conditional Process Analysis: A Regression-Based Approach
Google Scholar
The psychosexual effects of risk-reducing bilateral salpingo-oophorectomy in female BRCA1/2 mutation carriers: A systematic review of qualitative studies
Quality of life and body image as a function of time from mastectomy
PubMed Abstract | CrossRef Full Text | Google Scholar
A prospective controlled study of sexual function and sexually related personal distress up to 12 months after premenopausal risk-reducing bilateral salpingo-oophorectomy
The impact of risk reducing bilateral salpingo-oophorectomy on sexual function in BRCA1/2 mutation carriers and women with lynch syndrome: A systematic review and meta-analysis
Illness perceptions and quality of life in cancer: does communication with the physician matter
CrossRef Full Text | Google Scholar
Quality-of-life effects of prophylactic salpingo-oophorectomy versus gynecologic screening among women at increased risk of hereditary ovarian cancer
Meijers-Heijboer
Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation
Psychological impact of prophylactic oophorectomy in women at increased risk for ovarian cancer
doi: 10.1002/1099-1611(200011/12)9:6<496::aid-pon487>3.0.co;2-z
A controlled study of mental distress and somatic complaints after risk-reducing salpingo-oophorectomy in women at risk for hereditary breast ovarian cancer
Patient reported outcomes after risk-reducing surgery in patients at increased risk of ovarian cancer
Prophylactic surgery to reduce the risk of developing breast cancer: issues and clinical implications
Decision analysis—effects of prophylactic mastectomy and oophorectomy on life expectancy among women with BRCA1 or BRCA2 mutations
Google Scholar
PubMed Abstract | CrossRef Full Text | Google Scholar
Google Scholar
Psychological impact of prophylactic oophorectomy in women at increased risk of developing ovarian cancer: a prospective study
Factors associated with altered long-term well-being after prophylactic salpingo-oophorectomy among women at increased hereditary risk for breast and ovarian cancer
Patient reported experiences following laparoscopic prophylactic bilateral salpingo-oophorectomy or salpingectomy in an ambulatory care hospital
The effects of pre-operative menopausal status and hormone replacement therapy (HRT) on sexuality and quality of life after risk-reducing salpingo-oophorectomy
van Oostrom
Long-term psychological impact of carrying a BRCA1/2 mutation and prophylactic surgery: a 5-year follow-up study
World Health Organization (1996)
scoring and generic version of the assessment: field trial version
Google Scholar
Keywords: prophylactic bilateral salpingo-oophorectomy
Ventura M and Fruscio R (2022) Cancer Anxiety Mediates the Association Between Satisfaction With Medical Communication and Psychological Quality of Life After Prophylactic Bilateral Salpingo-Oophorectomy
Received: 21 December 2021; Accepted: 21 February 2022; Published: 09 March 2022
Copyright © 2022 Zarbo, Brugnera, Frigerio, Celi, Compare, Dessì, Giordano, Malandrino, Sina, Strepparava, Tessitore, Ventura and Fruscio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
distribution or reproduction in other forums is permitted
provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited
in accordance with accepted academic practice
distribution or reproduction is permitted which does not comply with these terms
*Correspondence: Cristina Zarbo, Y3Jpc3RpbmF6YXJib0BnbWFpbC5jb20=
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher
94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish
"I love to design," writes Andrea Brugnera
"and I like to manufacture by myself the prototypes that I draw
Taking the word "spreads" literally, Treviso-based Brugnera has come up with the Assiduo Outdoor Table
which expands along one axis to roughly double its length
The conventional approach with this type of table is to have two table surfaces that
then have the gap filled in by a leaf concealed within the table; in contrast
The Assiduo is made from larch and ships flat:
The design requires more hardware than the conventional approach—I can't quite tell from the photos
it seems he's using piano hinges—but the mechanicals are simpler
And the user will burn a few more calories folding out eight leaves rather than one
Test it out; it only takes a single click to unsubscribe
Copenhagen Institute of Interaction Design (CIID) is an international hub of creative minds
CARD 79 gives form to future states by converging strategy
Fresco supports world-class brands with world-class design
DesignThink is a full service product development group focused on defining
We partner with teams to deliver fresh thinking and award winning products for passionate audiences...
\"I love to design,\" writes Andrea Brugnera
\"and I like to manufacture by myself the prototypes that I draw
Taking the word \"spreads\" literally, Treviso-based Brugnera has come up with the Assiduo Outdoor Table
Don't have an account? Join Now
Already have an account? Sign In
Please enter your email and we will send an email to reset your password
« Back
You are using an outdated browser. Please upgrade your browser or activate Google Chrome Frame to improve your experience
director of operations for the Obici House
leads a group from Suffolk Sister Cities through the historic residence
Serene Cadamuro and Andrea Brugnera listen on
Four Italian teens on Wednesday took a tour of Suffolk’s famed Obici House as a part of a Suffolk Sister Cities-hosted student exchange
Serena Cadamuro and Andrea Brugnera all hail from around Oderzo
the founder of the Planters Nut and Chocolate Company and the former owner of the house
She walked the guests through each room in the house and told about the house’s construction and the people that lived in it
The house was modeled after a villa in Obici’s native Italy and has many features made from materials brought in from Oderzo
Tagg regaled them with stories of possible ghosts in the house
talking about her experiences with doors creepily opening and slamming shut
Each of the teenagers that came to Suffolk from Italy remarked about how different life in Suffolk is
emphasizing differences ranging from the culture to the architecture
“The whole experience for me is the most different,” Zulianello said
Ghirardo said that another big difference is the openness of the people in America
“The people are a lot more confident,” Ghirardo said
“They will always start a conversation with you.” Ghirardo added that Suffolk is much more spread out
because in Italy one can bike or walk from place to place
Suffolk Sister Cities has made sure that its guests get to experience quintessential American sites
and eaten plenty of American food in the time they have been here
Brugnera and Cadamuro agreed that s’mores were the best American treat they had
also praising hamburgers and fried chicken
they enjoyed the tour and have liked Suffolk so far
and it showed the connection between Oderzo and Suffolk
The teens were accompanied on their tour by Theresa Sims
the vice president of Suffolk Sister Cities; Joe Questore
The airlines are hopping between Suffolk and Oderzo this summer — two Suffolk teens are currently visiting Italy
and a delegation of 26 adults from Oderzo will visit here in August
There are four games on the college basketball schedule on Monday that feature MEAC squads
10-2 MEAC) are traveling to face the North Carolina Central Eagles (12-17
The Miami Heat (28-31) are at home in Southeast Division action against the Washington Wizards (11-48) on Monday,…
The Washington Capitals’ Dylan Strome and the Ottawa Senators’ Tim Stutzle are two of the best players to…
The Norfolk State Spartans (25-4) will look to continue a 14-game winning stretch when visiting the North Carolina…
What we learned about ‘Merchant of Venice’ by staging it in the city where it was set
I read and reread the email from David Scott Kastan
a Shakespeare professor and scholar at Yale
inviting me into The Merchant of Venice Project in the Venice Ghetto in 2016
David had imagined an ingenious and provocative way to wrap together the 500th anniversary of the Ghetto’s origin and the 400th of Shakespeare’s death: to perform The Merchant of Venice in the Ghetto itself
My heart and head pounded with exhilaration and a good measure of trepidation
Merchant is a play freighted with decades of anti-Semitism
The Nazis played it repeatedly to justify their own anti-Jewish killing machines; universities have banned its production; scholars have openly called this play unworthy of its author for its treatment of its larger-than-life character Shylock
And the Ghetto represents both a thriving hub of Jewish world culture and a once-quarantined island
confined and marginalized by the dominant Venetian culture
I found myself wondering whether a performance in this reborn ghetto of 2016
might uncover something new in the play and in the culture
Perhaps the exorcising of Shylock’s ghost might send an urgent message that we need to hear now more than ever
How would the neighbors in the Ghetto respond to an American theatre company taking the lead in this production
The Ghetto is located on a small island in the northeast part of Venice
just as Venice was at its zenith as a trading and commercial city-state
The informal mayor of the reborn Jewish Ghetto
also a Shakespearean professor at Ca’ Foscari University in Venice and the founder of Beit Venezia
is busy reviving the historic fabric of the Ghetto
while trying to infuse it and repopulate it with vibrant cultural life
Kastan and Bassi talked about my directing the play; the mayor was eager for the production not to be imported but rather to be “made in Venice.”
That raised many production considerations: the languages to be spoken for an international audience
both on the creative side and among the acting company
It also afforded us a dream open-air venue
the campo—the piazza at the Ghetto center
with its stone floor resonant of all Ghetto life
when the Ghetto’s inhabitants found their perches at balcony or window
we would also find less welcome guests: the chirping cicadas with their incessant mating calls
a backdrop of sexual longing that permeated the Venetian romantic high jinks of Merchant for the first 30 minutes
They stopped every night abruptly at 9:05 p.m
My theatre company, Compagnia de’ Colombari
had many years of performing in Italy and working with an international ensemble under its belt
and it was partly for this reason that Kastan approached me in the first place
We had performed the medieval mystery plays on Orvieto’s stone streets
and now we were planning to perform on the stone floor of the campo
and I talked about the set being “the thing itself.” Peter approached the set with the same unvarnished urban immediacy
designing a stadium seating for the audience and plunking it down in the campo facing the most interesting architecture: the Italian and German synagogues
each with five expressive shuttered windows looking down
Though Peter and I had much experience together on the island of Manhattan and the cliff town of Orvieto
we never understood until in situ what it meant to build in Venice
The steel traveled from the warehouse to a truck to a canal boat to a hand cart
and finally landed on the campo for construction
all courtesy of our remarkable Venetian technical director
Several knowledgeable Venetians pointed me to Stefano Nicolao
who has a well-appointed atelier just minutes away from the Ghetto on the Fondamenta Misericordia (next to some delectable eating places)
Stefano responded to my aesthetic by pushing past the heavy period costumes and designing with a fluid elegance that honored the Elizabethan silhouette with a very light modern touch
since costume changes would be as open-air as the play
and would be woven into the performance itself
At the invitation of Shaul Bassi and Venice’s Ca’ Foscari University
we took “The Shylock Project” (as we called it) into workshop on Isola San Giorgio in the summer of 2015
There I developed my approach to The Merchant of Venice
my directing assistant; in Venice we found a lively group of 15 Venetian performers
the workshop gave me my first opportunity to sketch out the theatrical approach to Merchant
We developed the play mostly in English with two scenes in Veneziano Italian
In lively preparatory conversations with dramaturg Walter Valeri
we chose an oration by Ruzzante “on love” to be spoken by Launcelot—or Lancillotto
hence starting off the “comedy” on the scent of sexual love
with bits of Spanish (for the Prince of Arragon) and bits of Arabic (for the Prince of Morocco)
passages in French and German in the mockery of Shylock
and heightened moments for each Shylock scene in Ladino
In popular memory the play hangs on two famous speeches: Shylock’s plea for humanity (“Do we not bleed?”) and Portia’s argument for mercy (“The quality mercy is not strained”)
The character of Shylock himself has become iconic over centuries in thematic portrayal
And Portia is often characterized as a smart
Yet the play seems to dig deeper into the dark heart of humankind beneath these two uncompromising poles of justice and mercy; Shakespeare turns us to the mirror and opens the soul of our humanity
For any director the challenge is to tear the play out of the expected
I had considered the possibility of a famous actor to play the role of Shylock
Certainly there have been many memorable performances of Shylock across the boards and on the screen
Was there a 21st-century wavelength that would allow this ancient man
But rather than concentrating the dimensions of Shylock on one actor’s interpretation
and one consistent with my ensemble company: opening up the character to five actors of different age
each actor playing one of Shylock’s five scenes
The point was not to ignore Shylock’s Jewishness
but to unlock and unveil the common humanity of his being
Shylock the Jew is also Shylock the immigrant
a five-actor Shylock would demand more of its audience; but my hope was that the audience would find itself in Shylock
Of course Shylock cannot be painted with a single brushstroke: The play takes us through his keen mind
In the Venice workshop we tested this idea
Five actors played five very different aspects of Shylock: the businessman
In the third scene of the play we meet Shylock for the first time
when Shylock #1 (played by Sorab Wadia) spars with Antonio (played by Reg E
Cathey in workshop and by Stefano Scherini in production)
In the fierce negotiation between these two cynical businessmen of the infamous bond
Both are rivals and players in a high-stakes world
and the other marked as a resident of the Venice Ghetto
both well versed in the commercial law of Venice
both inside this snarling recognition of the Other at the moment that they make the deal
a mutual refusal to break the wall of pride which foretells the play’s tragic climax
The ugly history of tribal enmity that shadows that first Shylock scene is surely one we recognize
and hates this Venetian of the dominant class
as a “Christian” who “rails” on him and his “well worn thrift.” Antonio
embarrassed by his need to go to a social inferior for an exorbitant loan
shall we be beholding to you?” Shylock sarcastically responds
“Is it possible a cur can lend three thousand ducats?” and “Fair sir
you spat on me on Wednesday last.” An odd intimacy infuses their mutual hostility—a Machiavellian respect for the enemy with whom you must ultimately reconcile so that business can resume and life can go on
Both actors are locked in a laser beam of anger
broken only when Shylock suggests the infamous pound of flesh
the “merry sport” which forms the basis of the bond
cackling sound which ignites Shylock to join him
The idea is so ludicrous and transgressive and of a sudden
Both at this point have no doubt that Antonio’s ships will come in to harbor
Long before the famous court scene and Shylock’s demand for his pound of flesh
and the cruel manipulation of justice which follows
Shakespeare has provided the play’s thematic set-up: Antonio’s un-Christian excoriating of the stranger
the cool machinations of Venice’s celebrated commercialism
the reduction of human promise to a written bond
Even the love story of Bassanio (played by Michele Guidi
from Italy) and Portia (played by Linda Powell
Cold mercantilism infuses all the transactions in Merchant: the enmity of borrower and debtor
but also the play’s parallel theme of love and marriage
the manipulative dance of the wealthy Portia and the needy aristocrat
As I understood this play and developed the inner architecture of the production’s themes
wherein the five Shylock actors would come together
unified by the gold sashes which adorned them
In the third Shylock scene comes that first crescendo
at the very instant of Shylock’s desperate moment of the heart
when he discovers his daughter has left him and run away with the Christians
We watch as the humiliations of the marketplace and Venetian citizenship cast upon Shylock devolve into an even more crushing excoriation of family
Daughter Jessica (played by Michelle Uranowitz
U.S.) is drawn into an escape away from the protective
rule-bound hands of her father by the irresponsible and greedy Lorenzo (played by Paul Spera
On its surface we understand the prodigal nature of her revolt: It is a hormone-driven teenage rebellion
Yet the intention of the Christian plotters is to humiliate Shylock—to steal away that which is most dear to him
Jessica flees with Lorenzo and his pals into the carnival night
This unhinging of the play is what I imagined as the first crescendo
At the call of a haunting trumpet (played by composer Frank London) wafting from the rooftop
the five actors playing Shylock emerge for the first time together
forming a huge circle in the Ghetto’s playing space
(Each actor also plays another role.) They are ritualistically dressed by the “black angels” (our visible performing crew) with cloak and thick golden silk sash wound around their torsos to mark them as the Jew
The Venetians circle around the five Shylocks
in the same spirit as that of Antonio earlier (these lines are all taken from the scenes between Salanio and Salarino)
The third Shylock scene emerges from this circle of five
as he discovers what we all have seen: that his daughter has deserted him into the hands of the Christians
The third Shylock is played by a woman (Jenni Lea Jones
cacophony of mockery with a howl that slams the Ghetto into silence
As one audience member remarked of this moment
mournful cry reached something deeper than pain
The gathering of all five Shylocks knit together the cross-human DNA of loss
Jones’s howl was also a kind of prologue to Shylock’s rhetorical questions
after the blood-curdling confrontation in the courtroom
U.S.) enters the scene in certitude demanding strict enforcement for the pound of Antonio’s flesh that belongs to him: “I will have my bond.” What had been agreed upon “in merry sport” now becomes deadly with the loan past due
For the first time in Merchant we hear the word “mercy.” In the trial scene the presiding Duke (played by Jones) calls for it
enters the trial with her wise argument for it
Underlying her argument is her manipulation of the power of the state and Shylock’s impotence before it
Ned and I spoke about how Shylock listens to Portia’s poetic and manipulative argument
in which she appropriates mercy as a Christian virtue
ignoring that it’s a central tenet of Judaism
As the Hebrew prophet Micah put it: “He hath showed thee
what is good; and what doth the Lord require of thee
and to walk humbly with thy God?” In the world of the play
a mercy never expressed for the Jew in the street is conveniently required of the Jew in the court
How must Shylock be listening to this specious argument
What is ultimately cast upon Shylock—by a law that is not judicial
but rooted in power and expressed in cruelty—requires that he give up his wealth
That’s where Shakespeare leaves Shylock—and us
The final scene is all restoration of lost rings and financial gifts
the interplay of women’s wiles and men’s coarse assumptions
I am certainly not the first director to puzzle over Shakespeare’s conclusion
I saw Shakespeare’s gathering of the privileged ruling Venetians in Belmont as a setting for a reprise
where the five Shylocks could enter—one at a time—and take to task the ruling culture by repeating Shylock’s words spoken at the beginning of the trial scene
Referencing animals used as insults against him
The final moment in the Ghetto performance
deals with the mercy left unactivated in the play by the humans
which had silently witnessed so much over the centuries
Rakhamim”—to bring back in this final moment a word
so eloquently spoken of but so categorically abandoned
between those in power and those marginalized outsiders
were brought centerstage all the more clearly and poignantly in two performances that followed immediately upon those in the Ghetto
We performed at the Summer Theater Festival in Bassano del Grappa
and the next day to the marginalized inmates of the Padova Prison
In both cases the attention shown to the performances demonstrated that this Merchant
Now, as we eagerly prepare its next incarnation, a North American premiere at Peak Performances in Montclair
it may reasonably be asked: Will this Merchant speak to contemporary U.S
It’s a play in which money and celebrity are valued above all by the dominant culture
adn in which a marginalized Other is framed to expose the mendacity of the controlling system
Support American Theatre: a just and thriving theatre ecology begins with information for all. Please join us in this mission by joining TCG
which entitles you to copies of our quarterly print magazine and helps support a long legacy of quality nonprofit arts journalism
©2025 Theatre Communications Group
Each gift is a stitch in the tapestry that celebrates our resilience
Donate to TCG!
This website is using a security service to protect itself from online attacks. The action you just performed triggered the security solution. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data.
You can email the site owner to let them know you were blocked. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page.
Picture: Supplied The lockdowns and movement restrictions caused by the COVID-19 pandemic have meant more interactions have moved to the video world than previously thought possible
All articles from our website & appThe digital version of Today's PaperBreaking news alerts direct to your inboxInteractive Crosswords
Sudoku and TriviaAll articles from the other regional websites in your areaContinueDoctors
a cup of tea with your grandmother: 2020 showed all of it could be done with a smartphone camera and internet connection
Now Centrelink is hoping that video technology will also play a part in the future of its interactions with customers
with a virtual service centre in Tuggeranong the first step in offering some services without the need to queue up at a shopfront
Like many businesses and public sector departments
had to completely overhaul its practices in the early days of the pandemic
and keep up with the extraordinary demand on its services
Centrelink offices around the country were faced with queues of people out the door and around the block
While most Centrelink interactions had already moved online
one remained an in-person job - providing documents to prove identity
That requirement was waived in the early days of the pandemic
but now Centrelink if offering the ability to prove identity with documentation through an online video appointment
more than 2000 video appointments have been completed
something the agency says is the first step to incorporating the technology into more elements of service delivery
At a visit to Tuggeranong's virtual service centre
Government Services Minister Stuart Robert said the video appointments were part of the government's promise to deliver services that were "simple
"The pilot is seeing excellent results and it is an innovative approach to service delivery I would like to see expanded to ensure Australians can access the services they rely on
"Services Australia staff are doing an extraordinary job through a difficult period and the Virtual Service Centre pilot is an example of how staff are meeting Australians where they are to get the help they need in a COVID world."
the national manager for Face to Face Transformation
said the locations people had used the service from showed how useful it was
"Customers have participated in video chats from a variety of locations while they're out and about
"People with young children and those working full time have especially appreciated the convenience of video chat
They can access the service at a time and place that suits them
I report on a range of issues in federal politics and the public service, with a real passion for how decisions made in Canberra affect the lives of Australians.
Today's top stories curated by our news team
Don't miss updates on news about the Public Service
Grab a quick bite of today's latest news from around the region and the nation
Catch up on the news of the day and unwind with great reading for your evening
Get the editor's insights: what's happening & why it matters
Your exclusive preview of David Pope's latest cartoon
Join our weekly poll for Canberra Times readers
We've selected the best reading for your weekend
Get the latest property and development news here
tips & travel writing to transport you around the globe
Your weekday morning newsletter on national affairs
Your essential national news digest: all the big issues on Wednesday and great reading every Saturday
Let the ACM network's editors and journalists bring you news and views from all over
reviews and expert insights every Thursday from CarExpert
Your digital replica of Today's Paper
Test your skills with interactive crosswords
For 110m hurdler James Weaver (coach: Laura Turner-Alleyne
2018 has been a topsy-turvy year in his development
A pelvic injury sustained in the 60m hurdles heats in Bratislava in January cut short his season before it had even begun
has ended the season strongly following victories at Manchester International
London Inter Club Challenge and a second place finish at Ospiti Di Gente Unica in Brugnera
After returning to form following a lengthy lay-off
the 21-year-old is hoping to rediscover the enjoyment that competing brings with it and shake off all his injury problems and get a solid season under his belt
He said: “This season has been one of those things
The injury flared up at the start of December ahead of the race at the end of January and I knew heading in it wasn’t right
“It was one of the strangest competitions I’ve ever done
I was on the start line but it didn’t feel as though I was actually there
I did the race and couldn’t walk afterwards
“This isn’t the first time I’ve had that scenario
In 2015 as a second-year junior I blew out my knee in a freak training accident
I fell over and bust my PCL (posterior cruciate ligament) which killed the season
but at the time I don’t think I realised how difficult mentally this rehab process would be compared to 2015
“I’ve thought a lot recently about the mental side of the sport and if you’d have asked me what 2019 holds at the start of the year I’d have said ‘I want to win this & that’ but I’m not joking when I say I just want an injury-free season and to enjoy my athletics again.”
Weaver fell into athletics off the back of a PE lesson where he excelled when the hurdles were placed in front of him
Despite not taking up training properly until his final two years of school
the Enfield & Haringey man enjoyed success at local level
before earning international acclaim in 2016 with his first British vest at the Mannheim Gala
He went into the weekend in Germany having set a personal best 13.53 the month prior in Bedford and shaved 0.2 seconds from that time
returning to the UK ranked joint-second in the world
he has represented the British team in the finals of the IAAF World U20 Championships and the European U23 Championships
“That day when the hurdles were placed in front of us I thought ‘no’
But our teachers showed us all the technique and I could do it really easily
They entered me into all the competitions at district level and I won all of those really easily
I didn’t train and I was fuming because I didn’t win,” he joked
I started training seriously in my last two years of high school and it spiralled from there
Mannheim was when I got my first British vest and that whole weekend was a whirlwind
I went into it with a PB of 13.53 and came out of it ranked joint-second in the world in 13.33
“It really hit me because I thought if I could get a fair run at that season injury-wise
I could really do something but ended up tearing my quad in the semi-finals at world juniors and finishing seventh
“European U23s was a funny one because I tore my quad six weeks before the season started and it was a hotchpotch job to see if we could salvage something
I found my feet late in the season and I was doing things I’d never done before
I was running super-quick but in the final it just didn’t quite come together
“I ran a PB and everyone was telling me I should be pleased but in the back of my head I know I could have run quicker
U23s felt like a shot at redemption after world juniors but it wasn’t meant to be
I came into form really late in the season and then my quad started playing up again.”
Weaver’s exploits led to him earning a place on the British Athletics Futures programme
which has helped to support his training and more recently
The programme has been of major benefit to Weaver and having support and faith invested in him that he can compete amongst elite athletes is something that has given him more drive to succeed in 2019
“For me it’s been massively helpful because of all the injuries I’ve had
The medical cover has been superb and they have helped my coach Laura (Turner-Alleyne) with coaching education and for me
“They’ve enabled me to see the sports psychologist this year as well which has been really beneficial throughout the injury process and it’s been great to have that available
“It means a lot because it gives you the feeling of believing in yourself
My coach believes in me but it’s nice to have external people that also believe in me
but they believe in my ability and that one day can I compete at the top level,” he added
There is added support for the Londoner from his parents
who watch his progress from the stands but Weaver admits they don’t understand fully what he does
he feels having them able to watch him competing at various meets internationally and domestically is a reward to them as much as him for their efforts in getting him to where he is
“I’ve been doing athletics for so many years but he doesn’t really get it
I tell him I’m competing at the weekend and he’ll be like ‘oh right that’s cool’ or I’ll come in and he’ll ask how training was
I’ll explain it and you can see his face get confused because he doesn’t get it
“My mum came to world juniors and then both of them came to Under-23s last year
she comes to all my competitions and stands in the car park
“But it’s nice because it’s a real family affair and they’ve helped me out massively since I first started competing
It’s nice for them now to see me getting into bigger comps and they can see the progression,” he added
Developed by
Mikayla Brightling (bronze) and Kallon McVicar (gold)
Picture: GREG TOTMANTAFE Illawarra has recorded its best result at the Australian leg of the ‘‘trades Olympics’’
with five apprentices now bound for Brazil to test their skills against the world’s best
Sudoku and TriviaAll articles from the other regional websites in your areaContinueTeam Illawarra emerged from the WorldSkills Australia competition in Perth with a record nine medals
Sam Spong (bricklaying) and welder Kallon McVicar
‘‘It’s going to help me in the long term career-wise and with my skills
Illawarra Institute director Dianne Murray said the gold medal haul was the biggest of any team competing in Perth
The long-running contest remained an important industry benchmark and a potentially lucrative launch pad for young tradies
‘‘What does it do for a business to be able to say the very best bricklayer works for me
‘‘This is an internationally recognised competition that used to be called the Skills Olympics
and that’s truly the level at which these young people are competing.’’
Team leader Patrick Rawnsley said his young charges made a close-knit unit
supporting one another during the more stressful moments
‘‘A number of these kids have never been overseas,’’ Mr Rawnsley said.
‘‘It’s going to be a great culture shock for them
who can be headhunted to work at an overseas company.’’
Find out what's happening in local business
Gathering for the cheque presentation: Don Palmer and Pat Tait from the Arnprior and District Food Bank; Oscar Brugnera
MPP John Yakabuski and MP Cheryl Gallant look on in the background
held by Metro brand ambassadors: Member of provincial parliament
Cheryl Gallant; Arnprior Mayor Lisa McGee; Oscar Brugnera
Arnprior Metro celebrated the completion of major renovations at the store with a hefty donation to the Arnprior and District Food Bank
and the information within may be out of date
“The Metro store in Arnprior is proud to donate $10,000 to the Arnprior and District Food Bank to help in their fight against food insecurity,” reads a press release
As part of Metro inc.’s first companywide fundraising campaign
the store is grateful in a large part thanks to the generosity of its customers who donated at the checkout during the 2022 holiday season in December
“We are pleased to share that the Arnprior store raised $7,150 with Metro Ontario donating the remainder of the $10,000 to commemorate the store’s grand reopening,” reads the release
“Metro’s purpose is to nourish the health and well-being of our communities
I would like to thank our Arnprior customers and our store team who were able to help raise much-needed money for the Arnprior and District Food Bank,” said Joe Fusco
The refurbished store represents a major investment by Metro to improve and expand on the products and services its customers expect while tailoring the store to the evolving needs of consumers
“Highlights of the store include homemade artisanal stone-baked pizzas made from fresh ingredients and served on an authentic focaccia crust; choose from one of our many fresh sandwiches and ready-made meal options; select from over 100 varieties of imported and domestic cheeses
many cut right in store; on-site butcher who can provide custom cuts of meat to your specifications and more,” reads the release
The store also proudly supports fresh and dry grocery suppliers from the local Ottawa area through Metro’s Locally Sourced program
“Our goal is to give our customers what they want whether it’s fresh-cut fruit and salads along with our new fresh juice selection made daily
our fresh baked bread or our beautiful floral department for gift ideas
The store has also integrated elements of the community so that our product offering and store decor reflect our neighbourhood,” said Jason Spratt
Customers can shop at the Metro Arnprior store daily from 7 a.m
Your browser is out of date and potentially vulnerable to security risks.We recommend switching to one of the following browsers:
Invalid password or account does not exist
Submitting this form below will send a message to your email with a link to change your password
An email message containing instructions on how to reset your password has been sent to the email address listed on your account
Duty Magistrate Yana Micallef Stafrace presiding
was told by Inspectors Andrew Agius and Ritienne Gauci that both men attempted to carry out this robbery on Wednesday between 8.00 a.m
The accused were also charged with causing 2,500 euro worth of damage to the establishment
stating that both men need help as they are both unemployed and have a drug habit
The Court turned down the request for bail and both men continued to be detained under arrest