bluuebunny/crossref_metadata_2025 huggingface dataset:
The Third-Person Effect in Controversial Product Advertising
Authors: Jensen Keith , Collins Steve
Published: September 2008

This research seeks to determine if there is a third-person effect in the realm of controversial product advertising. Survey participants rated their perceived levels of personal offense to product categories as well as the expected offense levels of other groups of people. The results show a significant third-person effect for five of six product categories where an effect was expected. In the case of advertising for racial extremist groups, a first-person effect existed as predicted. The findings suggest previous studies of controversial products may have overestimated actual levels of offense by ignoring the possibility of a third-person effect.
The Impact of Leadership on Student Outcomes: An Analysis of the Differential Effects of Leadership Types
Authors: Robinson Viviane M. J. , Lloyd Claire A. , Rowe Kenneth J.
Published: September 2008

Purpose: The purpose of this study was to examine the relative impact of different types of leadership on students' academic and nonacademic outcomes.

Research Design: The methodology involved an analysis of findings from 27 published studies of the relationship between leadership and student outcomes. The first meta-analysis, including 22 of the 27 studies, involved a comparison of the effects of transformational and instructional leadership on student outcomes. The second meta-analysis involved a comparison of the effects of five inductively derived sets of leadership practices on student outcomes. Twelve of the studies contributed to this second analysis.

Findings: The first meta-analysis indicated that the average effect of instructional leadership on student outcomes was three to four times that of transformational leadership. Inspection of the survey items used to measure school leadership revealed five sets of leadership practices or dimensions: establishing goals and expectations; resourcing strategically; planning, coordinating, and evaluating teaching and the curriculum; promoting and participating in teacher learning and development, and ensuring an orderly and supportive environment. The second meta-analysis revealed strong average effects for the leadership dimension involving promoting and participating in teacher learning and development and moderate effects for the dimensions concerned with goal setting and planning, coordinating, and evaluating teaching and the curriculum.

Conclusions and Implications for Research and Practice: The comparisons between transformational and instructional leadership and between the five leadership dimensions suggested that the more leaders focus their relationships, their work, and their learning on the core business of teaching and learning, the greater their influence on student outcomes. The article concludes with a discussion of the need for leadership research and practice to be more closely linked to the evidence on effective teaching and effective teacher learning. Such alignment could increase the impact of school leadership on student outcomes even further.
Positioning Qualitative Research as Resistance to the Institutionalization of the Academic Labour Process
Authors: Symon Gillian , Buehring Anna , Johnson Phil , Cassell Catherine
Published: September 2008

The focus of this paper is on the `institutional work' (Lawrence and Suddaby 2006) of disrupting institutions, examining the rhetorical strategies employed to construct and justify meanings and interpretations. This work is explored in the context of the contemporary academic labour process; specifically, research approaches within the management discipline. A total of 45 individuals involved in funding, conducting, publishing and using qualitative management research were interviewed. From our analysis of their arguments, we focus specifically on the discursive positioning of quantitative research as illegitimate institutionalization of academic working practices and of qualitative research as legitimate resistance to this institutionalization. We identify a number of rhetorical strategies which construct and justify these discursive positions including: the undermining of success criteria; the legitimizing of interests (through claims of institutionalized discrimination) and actors (through identity claims); attributions of political action (including the construction of counter-institutions); claims to agency; and the invocation of alternative institutional logics. We argue that examining institutional work as rhetoric adds to our theoretical understanding of the discursive disruption of institutions, particularly with respect to the manipulation of contradictory meanings and the functions of agency—structure discourse; and contributes a political dimension to our understanding of the qualitative—quantitative `divide' within management research.
Embodied Generosity and an Ethics of Organization
Authors: Hancock Philip
Published: September 2008

In this essai I address the subject of organization and ethics. In contrast to both the Kantian legislative tradition, and the idea of organizational virtue, both of which are predominant within contemporary accounts of business ethics, I argue for an ethics of organization based on the principles of recognition. Such an ethics would be both intersubjective and embodied, sensitive to what Diprose (2002) has described as corporeal generosity. In doing so, I lay claim to a set of ontologically a priori conditions in order to provide an alternative ethical foundation for modes of organizing, as well as a retort to more mundane assumptions about the ethical character of organizational life.
Stretching the IR Theoretical Spectrum on Irish Neutrality: A Critical Social Constructivist Framework
Authors: Devine Karen
Published: September 2008

In a 2006 International Political Science Review article, entitled “Choosing to Go It Alone: Irish Neutrality in Theoretical and Comparative Perspective,” Neal G. Jesse argues that Irish neutrality is best understood through a neoliberal rather than a neorealist international relations theory framework. This article posits an alternative “critical social constructivist” framework for understanding Irish neutrality. The first part of the article considers the differences between neoliberalism and social constructivism and argues why critical social constructivism's emphasis on beliefs, identity, and the agency of the public in foreign policy are key factors explaining Irish neutrality today. Using public opinion data, the second part of the article tests whether national identity, independence, ethnocentrism, attitudes to Northern Ireland, and efficacy are factors driving public support for Irish neutrality. The results show that public attitudes to Irish neutrality are structured along the dimensions of independence and identity, indicating empirical support for a critical social constructivist framework of understanding of Irish neutrality.
“Current Pathology Techniques” Symposium Review: Advances and Issues in Neuropathology
Authors: Bolon Brad , Anthony Douglas C. , Butt Mark , Dorman David , Green Michael V. , Little Peter B. , Valentine William M. , Weinstock Daniel , Yan James , Sills Robert C.
Published: September 2008

Our understanding of the mechanisms that incite neurological diseases has progressed rapidly in recent years, mainly owing to the advent of new research instruments and our increasingly facile ability to assemble large, complex data sets acquired across several disciplines into an integrated representation of neural function at the molecular, cellular, and systemic levels. This mini-review has been designed to communicate the principal technical advances and current issues of importance in neuropathology research today in the context of our traditional neuropathology practices. Specific topics briefly addressed in this paper include correlative biology of the many facets of the nervous system; conventional and novel methods for investigating neural structure and function; theoretical and technical issues associated with investigating neuropathology end points in emerging areas of concern (developmental neurotoxicity, neurodegenerative conditions); and challenges and opportunities that will face pathologists in this field in the foreseeable future. We have organized this information in a manner that we hope will be of interest not only to professionals with a career focus in neuropathology, but also to general pathologists who occasionally face neuropathology questions.
Arsenic-Induced Decreases in the Vascular Matrix
Authors: Hays Allison M. , Lantz R. Clark , Rodgers Laurel S. , Sollome James J. , Vaillancourt Richard R. , Andrew Angeline S. , Hamilton Joshua W. , Camenisch Todd D.
Published: September 2008

Chronic ingestion of arsenic is associated with increased incidence of respiratory and cardiovascular diseases. To investigate the role of arsenic in early events in vascular pathology, C57BL/6 mice ingested drinking water with or without 50 ppb sodium arsenite (AsIII) for four, five, or eight weeks. At five and eight weeks, RNA from the lungs of control and AsIII-exposed animals was processed for microarray. Sixty-five genes were significantly and differentially expressed. Differential expression of extracellular matrix (ECM) gene transcripts was particularly compelling, as 91% of genes in this category, including elastin and collagen, were significantly decreased. In additional experiments, real-time RT-PCR showed an AsIII-induced decrease in many of these ECM gene transcripts in the heart and NIH3T3 fibroblast cells. Histological stains for collagen and elastin show a distinct disruption in the ECM surrounding small arteries in the heart and lung of AsIII-exposed mice. Immunohistochemical detection of α-smooth muscle actin in blood vessel walls was decreased in the AsIII-exposed animals. These data reveal a functional link between AsIII exposure and disruption in the vascular ECM. These AsIII-induced early pathological events may predispose humans to respiratory and cardiovascular diseases linked to chronic low-dose AsIII exposure.
Marketing Science
Authors: Fennell Dana
Published: September 2008

The controversy over genetically engineered foods can be seen as a struggle over knowledge, whose version of truth will be accepted. Drawing off frameworks from social studies of science, the following is a qualitative content analysis of the corporate ideology of “life science” companies. The texts of five companies, from the time period of 2000 to 2003, are analyzed. Somewhat paradoxically, companies attempt to juggle the multiple tasks of branding/selling a unique product while acting as a teacher to the general public and presenting seemingly unbiased and objective knowledge. Companies rely on many of the discursive tactics previously outlined by researchers, while appearing to modify them somewhat to respond to public controversy. However, although it has been asserted that modern times have created a postmodern society where science loses its grand authority, companies work to reaffirm modern notions of science as progress even though claiming they are engaging in dialogue with the public.
A Multiattribute Model for Evaluating the Benefit-Risk Profiles of Treatment Alternatives
Authors: Felli James C. , Noel Rebecca A. , Cavazzoni Patrizia A.
Published: September 2008

The assessment of the benefits and risks associated with a medicine's use requires careful consideration of a wealth of information of varying format and quality, ranging from efficacy and safety data derived from randomized clinical trials to statistical results from health outcomes studies to spontaneously reported adverse events. Contrary to the expectations of patients, physicians, and regulators, the literature offers little guidance as to how to strike an appropriate balance between benefit and risk. Although a qualitative listing of a medicine's benefits and risks is useful, much could be gained from a systematic and transparent process to evaluate a medicine's pre- and postmarketing performance. The authors propose a representational model based on multicriteria decision analysis that can incorporate both evaluative judgments from different perspectives (e.g., physician, patient) and quantitative data to inform tradeoffs between multiple benefit and multiple risk elements in a logically consistent and transparent manner. The model is designed to highlight the relative merits and deficits of treatment alternatives in well-defined and specific contexts. It is intended to serve as a common platform to facilitate focused benefit-risk tradeoff discussions between scientists, physicians, regulatory authorities, and pharmaceutical companies, and to assist in the communication of clear and consistent messages regarding those tradeoffs.
Computer and Internet Use in a Community Health Clinic Population
Authors: Peterson Neeraja B. , Dwyer Kathleen A. , Mulvaney Shelagh A.
Published: September 2008

Objective . To determine if patients from a community health clinic have access to computers and/or the Internet and if they believe a computer is useful in their medical care. Methods . A convenience sample of 100 subjects, aged 50 years and older, from a community health clinic in Nashville, Tennessee, completed a structured interview and a health literacy assessment. Results . Of the 100 participants, 40 did not have any computer access, 27 had computer but not Internet access, and 33 had Internet access. Participants with computer access (with or without Internet) had higher incomes, higher educational status, and higher literacy status than those without computer access. Of participants reporting current computer use (n = 54 ), 33% reported never using their computer to look up health and medical information. Of those who ``never'' used their computer for this activity, 54% reported they did not have Internet connectivity, whereas 31% reported they did not know how to use the Internet. Although this group of individuals reported that they were comfortable using a computer (77%), they reported being uncomfortable with accessing the Internet (53%). Conclusions . Not only does access to computers and the Internet need to be improved before widespread use by patients, but computer users will need to be instructed on how to navigate the Internet.
Understanding the Complexities of Annexation
Authors: Edwards Mary M.
Published: September 2008

Annexation is the most common and frequent type of local boundary adjustment. It is a complex process with significant implications for communities. This article summarizes past and recent scholarly research relating to the state requirements guiding annexation, and the fiscal impacts, local motivations, and social and political implications of the process. Its purpose is to integrate literature from across disciplines to better understand the many dimensions of annexation and the challenges that confront planners in planning for or reacting to boundary change. It concludes with suggestions for future research.
Social Networks and Health-Related Quality of Life Among Chinese Older Adults With Vision Impairment
Authors: Wang Chong-Wen , Chan Cecilia L. W. , Ho Andy H. Y. , Zhifan Xiong
Published: September 2008

Objective: This study examines the associations between social networks and vision-specific health-related quality of life (HRQOL) among Chinese older adults. Method: Urban older adults with visual problems ( N = 167) were interviewed using a structured questionnaire to assess self-reported visual functioning, general health, social networks, and vision-specific HRQOL. Objective visual function was clinically measured by ophthalmologists in terms of distance visual acuity. Results: Findings indicate that age-related vision loss is significantly associated with older adults' social networks. Multiple regression analyses show that social networks are mildly related to vision-specific HRQOL even after controlling for other variables, and that friendship network was a significant predictor, independent of family network, of vision-specific HRQOL. Discussion: Previous studies have emphasized the importance of family network, whereas this study finds that friendship network correlates more strongly with HRQOL measures among Chinese visually impaired older adults. This suggests a need to expand intervention beyond the family system.
Fertility Issues of Childhood Cancer Survivors: The Role of the Pediatric Nurse Practitioner in Fertility Preservation
Authors: Zakak Nicole N.
Published: September 2008

The purpose of this review is to discuss the role of the pediatric nurse practitioner (PNP) surrounding the survivorship issue of infertility. The author outlines the effects of treatment, examines available options, explores ethical and legal issues, discusses the role of the PNP, and addresses areas of further research. The issue of postcancer reproductive health is increasing in importance as both the number of cancer survivors and length of survival increases. Approximately 1 out of every 900 individuals in the United States between the ages of 15 and 45 years is a survivor of childhood cancer. In fact, the survival rates for childhood cancer have improved dramatically. Sexual function and fertility in children and adolescents has become a prominent issue, and this review illustrates the gap between care providers and patients and describes how PNPs must fill this gap to manage the adverse effects on fertility and gonadal dysfunction.
The Pediatric Cancer Hospitalization Experience: Reality Co-constructed
Authors: Berríos-Rivera Reinaldo , Rivero-Vergne Alicia , Romero Ivonne
Published: September 2008

Although pediatric cancer treatment has been reviewed by several authors, the lived experiences of children undergoing this process have seldom been discussed in the literature. The data for this article were obtained from a larger qualitative study that provided a collective view of the pediatric cancer experience at San Jorge Children's Hospital in Puerto Rico. In this article, findings that are directly related to the hospitalization process of these young patients are described, including the hospital as a safe haven, dealing with pain, taking control, and thriving in adversity. These findings provide a rationale for the development of a biopsychosocial model of health that emphasizes reciprocal interactions among the biological, psychological, social, cultural, and spiritual dimensions that influence health.
Parents' Viewpoints Concerning the Value of Preschool Summer Camps
Authors: McDowell Carol
Published: September 2008

Using data from a parent survey, the author examined factors that influenced parents to enroll their children in a 5-day summer music camp. Survey questions included (a) What were the determining factors for enrolling your child in the class? (b) What activities did your child enjoy/value the most? (c) What musical activities do you and your child participate in at home? and (d) What activities did the parent participate in at home or while in school? Learning new music activities to share together, developing skills to help their children in day care, and having fun sharing music were the top reasons cited. Musical implications of early childhood teacher training and previous parent involvement are discussed.
Growing Young Musicians
Authors: Thomas Amy E.
Published: September 2008

This article suggests ways early childhood music educators can help parents bring more meaningful music activities into their homes. Suggestions are based on survey results from 50 parents with young children at home. The survey investigated the relationship among parents' perceived musical ability, the amount of time they spent in musical activities with their children, and the types of musical activities in which they were engaged.
Management of Patients with ICDs at the End of Life (EOL): A Qualitative Study
Authors: Kelley Amy S. , Mehta Sonal S. , Carrington Reid M.
Published: September 2008

Purpose. Implantable cardioverter defibrillator shocks at the end of life are distressing and warrant consideration of implantable cardioverter defibrillator deactivation discussions. A nationwide survey collected physicians' comments regarding such discussions.

Methods. Vignettes ascertained respondents' practices regarding implantable cardioverter defibrillator deactivation discussions. Respondents' comments were analyzed to identify themes.

Results. About 177 respondents (32%) provided 310 comments. One third reported that initiating the discussion would depend on specific circumstances, such as do not resuscitate status (35%); 21% advocated life-prolonging therapies; 17% said the patient/family or another physician should initiate the discussion; and 9% expressed inadequate education/awareness about implantable cardioverter defibrillator functions. Geriatricians and general internists expressed inadequate knowledge most frequently (12 writers, 75% in this theme), while electrophysiologists most frequently suggested further treatments/procedures (22 writers, 58%), and another doctor (13 writers, 76%) or the patient (8 writers, 62%) should begin the discussion. Conclusions. Improving the end of life care for patients with implantable cardioverter defibrillators will require additional physician education and increased commitment by subspecialists to deactivation discussions.
Telehospice Acceptance Among Providers: A Multidisciplinary Comparison
Authors: Washington Karla T. , Demiris George , Oliver Debra Parker , Day Michele
Published: September 2008

Telehospice, the delivery of end-of-life care using telecommunications technologies, allows increased interaction between providers and patients. For telehospice to be successful, it must first be accepted by professionals as a useful and user-friendly method of service delivery. Existing research regarding provider acceptance of telehospice has been limited in geographic scope and has often excluded input from key members of the hospice team. This study measured telehospice acceptance in a national sample of hospice professionals from various disciplines (N = 160). Results indicate that acceptance was moderately high overall, although significant differences existed among individuals from different disciplines, with nurses and administrators generally indicating higher levels of acceptance than social workers and chaplains. Findings demonstrate that telehospice interventions will likely be more readily accepted by nursing and administrative staff members, while those employees who address primarily psychosocial issues may be reluctant to use such technology.
The Use of Pediatric Advance Directives: A Tool for Palliative Care Physicians
Authors: Zinner Susan E.
Published: September 2008

Although laws such as the Patient Self-Determination Act encourage individuals to address their end-of-life treatment preferences using advance directives, the wishes of children have traditionally been ignored or, perhaps even worse, overruled. Given that there is a substantial body of research indicating that children are capable of making mature decisions when faced with terminal illness, the author proposes granting minors, especially older minors, the right to participate in making end-of-life decisions. Children who complete advance directives benefit in multiple ways. Adopting this approach could benefit patients by demonstrating respect for patient autonomy and informing parents and providers that the minor may be ready to stop aggressive treatment.
Regional Integration Through Contracting Networks
Authors: Andrew Simon A.
Published: September 2008

This article advances two general hypotheses, bonding and bridging, to explain the process by which local governments decide whether to enter into contracts. The characteristics of goods and services are important factors in these decisions. In high asset-specificity transactions, the bridging hypothesis predicts local governments will establish ties with only a few “high status” actors, whereas in transactions for services with measurement difficulties, the bonding hypothesis predicts local governments will establish ties with partners of their existing partners to pool resources and reduce commitment risks. The general hypotheses are tested using agreements for law enforcement activities linking 66 actors in the Orlando-Kissimmee metropolitan area during five time periods (i.e., between 1986 and 2003). Using simulation investigation network analysis (SIENA) techniques, this study finds strong statistical support for these hypotheses.
Reinvigorating the Concept of Situation in Social Psychology
Authors: Reis Harry T.
Published: September 2008

The concept of situation has a long and venerable history in social psychology. The author argues that recent approaches to the concept of situation have confused certain important elements. Herein, the author proposes that attention to three of these elements will reinvigorate the concept of situation in social psychology: (a) that the analysis of situations should begin with their objective features; (b) that situations should be conceptualized as affordances; and (c) that the interpersonal core of situations, in particular the extent to which they are influenced by relationships, is the proper and most profitable focus for social psychology. These elements are consistent with recent developments in the study of situated social cognition and may help better define social psychology's position within the sciences.
Use of Retroactive Pessimism as a Method of Coping with Identity Threat: The Impact of Group Identification
Authors: Wann Daniel L. , Grieve Frederick G. , Waddill Paula J. , Martin Jennifer
Published: September 2008

Retroactive pessimism involves retrospectively lowering one's evaluations of a group's chances for success after a failed competition. Although past research has substantiated the existence of this strategy, investigators have yet to examine how level of group identification might impact the use of retroactive pessimism. Given that coping with group threat is most prominent among persons with high levels of group identification, we hypothesized that displays of retroactive pessimism would be magnified in persons with strong allegiances to a group. This hypothesis was tested by having supporters of two college basketball teams evaluate the chances for victory for each team both prior to the game between the teams and subsequent to the contest. Regression analyses confirmed expectations (the greatest magnitude of retroactive pessimism was reported by highly identified supporters of the losing team in their evaluations of the winning team). Subsequent analyses revealed that this effect was not mediated by level of disappointment in the outcome.
Seeing Through Their Eyes: When Majority Group Members Take Collective Action on Behalf of an Outgroup
Authors: Mallett Robyn K. , Huntsinger Jeffrey R. , Sinclair Stacey , Swim Janet K.
Published: September 2008

We examined majority group members' collective action on behalf of a minority group, focusing on the role of outgroup perspective taking and group-based guilt. As expected, outgroup perspective taking was positively associated with heterosexuals' collective action in response to hate crimes against non-heterosexuals and Whites' action in response to hate crimes against Blacks (Studies 1 and 2). This association was partially mediated by group-based guilt (Studies 2 and 3). We also examined the role of group-based anger; although it directly related to collective action, it did not mediate the association between perspective taking and collective action. Finally, we manipulated outgroup perspective taking to demonstrate its causal role in the subsequent outcomes (Study 3).
Colorblind and Multicultural Prejudice Reduction Strategies in High-Conflict Situations
Authors: Correll Joshua , Park Bernadette , Allegra Smith J.
Published: September 2008

We tested colorblind and multicultural prejudice-reduction strategies under conditions of low and high interethnic conflict. Replicating previous work, both strategies reduced prejudice when conflict was low. But when conflict was high, only the colorblind strategy reduced prejudice (Studies 1 and 2). Interestingly, this colorblind response seemed to reflect suppression. When prejudice was assessed more subtly (with implicit measures), colorblind participants demonstrated bias equivalent to multicultural participants (Study 2). And, after a delay, colorblind participants showed a rebound, demonstrating greater prejudice than their multicultural counterparts (Study 3). Similar effects were obtained when ideology was measured rather than manipulated (Study 4). We suggest that conflict challenges the tenets of a colorblind ideology (predicated on the absence of group differences) but not those of a multicultural ideology (which acknowledges difference).
The Impact of Loyalty and Equality on Implicit Ingroup Favoritism
Authors: Zogmaister Cristina , Arcuri Luciano , Castelli Luigi , Smith Eliot R.
Published: September 2008

Extending recent investigations into the malleability of implicit ingroup favoritism, three experiments examined the role of indirect activation of equality and loyalty. Results showed that priming equality decreased implicit favoritism, measured through the Implicit Association Test and Go/No-Go Association Task, whereas priming loyalty enhanced it; spontaneous behavior (seating distance) was similarly influenced. A boundary condition was observed, namely change of intergroup setting: the effects of priming equality and loyalty ceased when these were primed after an irrelevant ingroup identity was made salient. In general, implicit favoritism can be reduced or increased after the activation of equality and loyalty respectively, and this underlines the importance of tackling discrimination by both lessening its expression, and removing factors that exacerbate it.
Negative Outgroup Leader Actions Increase Liking for Ingroup Leaders: An Experimental Test of Intergroup Leader-Enhancement Effects
Authors: Pittinsky Todd L. , Welle Brian
Published: September 2008

We conducted two studies to examine how information about outgroup leaders' negative actions affect ingroup leader favorability ratings. Study 1 found that people hold more favorable attitudes toward ingroup leaders (i.e. their own nation's leaders) when learning of negative actions of outgroup leaders (i.e. another nation's leaders). Study 2 replicated the finding, examining social identity strength as a moderator of this effect, and found that participants with strong national identification exhibit this intergroup leader-enhancement effect but participants with weak national identification do not. These data extend previous research on liking for leaders and are consistent with predictions derived from social identity theory. The implications of these findings for intergroup relations research and the psychological study of leadership are discussed.
Choosing None of the Above: Persistence of Negativity after Group Discussion and Group Decision Refusal
Authors: Nijstad Bernard A.
Published: September 2008

Within psychology and other disciplines, group decision making is a much-studied topic. However, the conditions in which groups do not decide but rather refuse to choose among available options have not been studied systematically. This research begins to fill this void, studying the effects of the initial opinions of group members on group decision refusal. Based on the common knowledge effect, it is predicted and found that groups will often refuse all available options when group members are initially negative about the options. It is further found that, when initial opinions are negative, positive information entered during group discussion does not have much impact. The implications of this negativity bias are discussed.
Communication and Group Perception: Extending the `Saying is Believing' Effect
Authors: Hausmann Leslie R. M. , Levine John M. , Tory Higgins E.
Published: September 2008

The saying-is-believing (SIB) effect occurs when tailoring a message to suit an audience influences a communicator's subsequent memories and impressions about the communication topic. Previous studies were restricted to one-person audiences and individuals as the communication topic. The present studies explored the SIB effect with multiple-person audiences and groups as the communication topic. In Study 1, the SIB effect occurred with a 1-person, but not a 3-person, audience. In Study 2, the SIB effect occurred with a 3-person audience when the audience explicitly validated communicators' messages. These findings demonstrate the generalizability of the SIB effect to group contexts, provide further evidence for a shared reality interpretation of this effect, and suggest a potentially important mechanism underlying stereotype development.
Review of the Best Case Series Methodology: Best Case Series Results of East-West Cancer Center
Authors: Hwa Seung Yoo  , Chong Kwan Cho  , Hong Michael S.
Published: September 2008

Purpose. To assess the efficacy of the best case series program methodology as a preliminary evaluation of complementary and alternative programs. Setting. East-West Cancer Center (EWCC) is a traditional oriental cancer center located in Daejeon, Korea. Cancer patients received Wheel balance therapy (WBT), which focuses on rediscovering homeostatic harmony with dietary therapy, metabolism-activating therapy, antiangiogenesis and immune system therapy, and controlled breathing and psychotherapy. Methods. Summaries of 6 cases in which patients showed longer survival without progression and were treated with WBT without conventional treatments were submitted for review to the National Cancer Institute (NCI) Office of Cancer Complementary and Alternative Medicine. Each case was then classified by the NCI review panel with pathologic confirmation of disease and radiologic confirmation of complete response or partial response not attributable to conventional treatments. Results. Two of 6 cases were classified as evaluable NCI best cases; the other 4 cases were classified as unevaluable. Except for a patient with squamous cell lung carcinoma, no patient showed further progression as of July 2007. Conclusion. The best case series program provides a preliminary evaluation of complementary and alternative medicine programs. But the method will only find treatments that have effects similar to those of conventional methods such as surgery, chemotherapy, and radiation therapy. Therefore, in future studies, BCSP reviewers should additionally consider assessing tumor dormancy and efficacy of combination therapies for Best Case qualification.
Therapeutic Actions of Melatonin in Cancer: Possible Mechanisms
Authors: Srinivasan Venkataramanujan , Spence D Warren , Pandi-Perumal Seithikurippu R. , Trakht Ilya , Cardinali Daniel P.
Published: September 2008

Melatonin is a phylogenetically well-preserved molecule with diverse physiological functions. In addition to its well-known regulatory control of the sleep/wake cycle, as well as circadian rhythms generally, melatonin is involved in immunomodulation, hematopoiesis, and antioxidative processes. Recent human and animal studies have now shown that melatonin also has important oncostatic properties. Both at physiological and pharmacological doses melatonin exerts growth inhibitory effects on breast cancer cell lines. In hepatomas, through its activation of MT 1 and MT2 receptors, melatonin inhibits linoleic acid uptake, thereby preventing the formation of the mitogenic metabolite 1,3-hydroxyoctadecadienoic acid. In animal model studies, melatonin has been shown to have preventative action against nitrosodiethylamine (NDEA)-induced liver cancer. Melatonin also inhibits the growth of prostate tumors via activation of MT1 receptors thereby inducing translocation of the androgen receptor to the cytoplasm and inhibition of the effect of endogenous androgens. There is abundant evidence indicating that melatonin is involved in preventing tumor initiation, promotion, and progression. The anticarcinogenic effect of melatonin on neoplastic cells relies on its antioxidant, immunostimulating, and apoptotic properties. Melatonin's oncostatic actions include the direct augmentation of natural killer (NK) cell activity, which increases immunosurveillance, as well as the stimulation of cytokine production, for example, of interleukin (IL)-2, IL-6, IL-12, and interferon (IFN)-γ. In addition to its direct oncostatic action, melatonin protects hematopoietic precursors from the toxic effect of anticancer chemotherapeutic drugs. Melatonin secretion is impaired in patients suffering from breast cancer, endometrial cancer, or colorectal cancer. The increased incidence of breast cancer and colorectal cancer seen in nurses and other night shift workers suggests a possible link between diminished secretion of melatonin and increased exposure to light during nighttime. The physiological surge of melatonin at night is thus considered a “natural restraint” on tumor initiation, promotion, and progression.
A Retrospective Evaluation of the Effects of Deuterium Depleted Water Consumption on 4 Patients with Brain Metastases from Lung Cancer
Authors: Krempels Krisztina , Somlyai Ildikó , Somlyai Gábor
Published: September 2008

Hypotheses. Because of the number of sufferers and high mortality rate, the standard care and new therapeutic options in the treatment of brain metastasis from lung cancer are the subject of intense research. A new concept based on the different chemical and physical behavior of protium and deuterium affecting cell signaling and tumor growth has been introduced in the treatment of cancer patients. The aim of this study was to investigate the impact of deuterium depleted water (DDW) consumption in addition to conventional forms of therapy on the survival of lung cancer patients with brain metastasis. Study design. A series of 4 case histories was retrospectively evaluated. The patients were diagnosed with brain metastasis deriving from a primary lung tumor and started consuming DDW at the time of or after the diagnosis of the brain metastasis, which was inoperable or the surgical intervention did not result in complete regression. The primary objective was survival. Methods. The daily water intake of the patients was replaced with DDW, which complemented the conventional forms of treatment. Patients were consuming DDW for at least 3 months. The treatment was continued with DDW of 10 to 15 to 20 ppm lower deuterium (D) content every 1 to 2 months and thus a gradual decrease was maintained in the D-concentration in the patient's body. Results. DDW consumption integrated into conventional treatments resulted in a survival time of 26.6, 54.6, 21.9, and 33.4 months in the 4 patients, respectively. The brain metastasis of 2 patients showed complete response (CR), whereas partial response (PR) was detected in 1 patient, and the tumor growth was halted (no change or NC) in 1 case. The primary tumor of 2 patients indicated CR, and the lung tumor in 2 patients showed PR. Conclusions. DDW was administered as an oral anticancer agent in addition to conventional therapy, and noticeably prolonged the survival time of all 4 lung cancer patients with brain metastasis. We suggest that DDW treatment, when integrated into other forms of cancer treatment, might provide a new therapeutic option.
Disclosure to Physicians of CAM Use by Breast Cancer Patients: Findings From the Women's Healthy Eating and Living Study
Authors: Saxe Gordon A. , Madlensky Lisa , Kealey Sheila , Wu David P. H. , Freeman Karen L. , Pierce John P.
Published: September 2008

Background. Physician awareness of their patients' use of complementary and alternative medicine (CAM) is crucial, particularly in the setting of a potentially life-threatening disease such as cancer. The potential for harmful treatment interactions may be greatest when a patient sees a CAM practitioner—perceived as a physician-like authority figure—but does not disclose this to their physician. Therefore, this study investigated the extent of nondisclosure in a large cohort of cancer patients. Methods. CAM use in participants of the UCSD Women's Healthy Eating and Living (WHEL) Study, a multicenter study of the effect of diet and lifestyle on disease-free and overall survival in women aged 18-70 years who had completed treatment for invasive breast cancer between 1995 and 2000, is investigated. Data regarding CAM use and disclosure were collected via a telephone-administered questionnaire in 2003-2004. This questionnaire asked about different CAM modalities, including those requiring a “skilled CAM practitioner” (acupuncturist, chiropractor, homeopath, or naturopath) for administration. Demographic data were obtained at the WHEL baseline clinic interview. Modality-specific disclosure rates were determined and a comparison of demographic variables of disclosers versus nondisclosers was conducted using χ2 tests for categorical variables, and t tests for continuous variables. Results. Of 3088 total WHEL participants, 2527 completed the CAM questionnaire. Of these, 2017 reported using some form of CAM. Of these, 300 received treatment from an acupuncturist, chiropractor, homeopath, or naturopath and also provided information on whether or not they disclosed this care to their conventional physician. The highest disclosure rate was for naturopathy (85%), followed by homeopathy (74%), acupuncture (71%), and chiropractic (47%). Among demographic characteristics, only education ( P = .047) and study site ( P = .039) were associated with disclosure. College graduates and postgraduates, in particular, were more likely to disclose CAM use to their physicians than those with lesser education. Conclusion. Overall, moderately high rates of physician disclosure of CAM use for all modalities except chiropractic were observed. Education and study site associations suggest that disclosure may be greater when CAM use is more prevalent and possibly more socially accepted. These findings underscore the importance of open, destigmatized patient—physician communication regarding CAM use.
Challenges of Diagnosis and Management of Tuberculosis and HIV Coinfection in Resource-Limited Settings: A Case Report from Lima, Peru
Authors: Rojas Christian , Solari Lely , Herrera Cesar , Sanchez Eduardo , Young Geoffrey , Bonilla Cesar , Hurtado Rocio , Muñoz Maribel , Zeladita Jhon , Espiritu Betty , Shin Sonya
Published: September 2008

We present a Peruvian human immunodeficiency virus (HIV)-positive patient receiving first-line therapy for tuberculosis who presents with neurological complications to highlight some of the major issues in the diagnosis and management of human immunodeficiency virus—related central nervous system complications in resource-poor settings. These include limited options for diagnosing extrapulmonary and drug-resistant tuberculosis; the importance of central nervous system . imaging; and the management conundrum when faced with a broad differential diagnosis. This patient waswith drug-resistant tuberculosis of the brain, unmasked by immunologic recovery in the setting of recent initiation of antiretroviral treatment. We argue that aggressive and timely empiric multidrug-resistant tuberculosis treatment is important in cases where drug-resistant tuberculosis is suspected. Knowledge gaps include a limited understanding of immune reconstitution and the optimal timing of antiretroviral treatment in the setting of drug-resistant tuberculosis.
Effects of Trunk Restraint Combined With Intensive Task Practice on Poststroke Upper Extremity Reach and Function: A Pilot Study
Authors: Woodbury Michelle L. , Howland Dena R. , McGuirk Theresa E. , Davis Sandra B. , Senesac Claudia R. , Kautz Steve , Richards Lorie G.
Published: September 2008

Background. Poststroke reaching is characterized by excessive trunk motion and abnormal shoulder—elbow coordination. Little attention is typically given to arm—trunk kinematics during task practice. Preventing compensatory trunk motion during short-term practice immediately improves kinematics, but effects of longer-term practice are unknown. Objective. This study compared the effects of intensive task practice with and without trunk restraint on poststroke reaching kinematics and function. Methods. A total of 11 individuals with chronic stroke, baseline Fugl-Meyer Upper Extremity Assessment scores 26 to 54, were randomized to 2 constraint-therapy intervention groups. All participants wore a mitt on the unaffected hand for 90% of waking hours over 14 days and participated in 10 days/6 hours/day of supervised progressive task practice. During supervised sessions, one group trained with a trunk restraint (preventing anterior trunk motion) and one group did not. Tasks for the trunk-restraint group were located to afford repeated use of a shoulder flexion—elbow extension reaching pattern. Outcome measures included kinematics of unrestrained targeted reaching and tests of functional arm ability. Results. Posttraining, the trunk-restraint group demonstrated straighter reach trajectories ( P = .000) and less trunk displacement ( P = .001). The trunk-restraint group gained shoulder flexion ( P = .006) and elbow extension ( P = .022) voluntary ranges of motion, the nonrestraint group did not. Posttraining angle—angle plots illustrated that individuals from the trunk-restraint group transitioned from elbow flexion to elbow extension during mid-reach; individuals in the nonrestraint group retained pretraining movement strategies. Both groups gained functional arm ability ( P < .05 all tests). Conclusion. Intensive task practice structured to prevent compensatory trunk movements and promote shoulder flexion—elbow extension coordination may reinforce development of “normal” reaching kinematics.
Can Routine Neonatal Circumcision Help Prevent Human Immunodeficiency Virus Transmission in the United States?
Authors: Xiao Xu  , Patel Divya A. , Dalton Vanessa K. , Pearlman Mark D. , Johnson Timothy R. B.
Published: September 2008

Primary prevention of human immunodeficiency virus (HIV) continues to pose an important challenge in the United States. Recent clinical trials conducted in Kenya, South Africa, and Uganda have demonstrated considerable benefit of male circumcision in reducing HIV seroincidence in males. These results have ignited debate over the appropriateness of implementing routine provision of neonatal circumcision in the United States for HIV prevention. This article discusses major contextual differences between the United States and the three African countries where the clinical trials were conducted, and cautions that the applicability of the scientific data from Africa to this country must be carefully considered before rational policy recommendations regarding routine neonatal circumcision can be made as a strategy to prevent the spread of HIV in the United States.
African American Men’s Perceptions of Power in Intimate Relationships
Authors: Senn Theresa E. , Carey Michael P. , Vanable Peter A. , Seward Derek X.
Published: September 2008

Power in intimate relationships is an important predictor of sexual risk behavior. The purpose of this study was to better understand African American men’s perceptions of interpersonal power. A total of 20 African American men participated in focus groups to elicit their perceptions of power in intimate relationships; their responses were analyzed using grounded theory. From this analysis, a conceptual framework was developed that, among African American men, power in relationships was largely determined by the contribution of financial resources, and/or withholding sex. These findings were then considered in light of existing social—psychological theories of power in relationships. Future research should consider how to incorporate this understanding of interpersonal power into current theories of sexual risk behavior in order to develop more effective HIV risk reduction programs.