bluuebunny/crossref_metadata_2025 huggingface dataset:
Context and Control in Foreign Subsidiaries: Making a Case for the Host Country National Manager
Authors: Volkmar John A.
Published: August 2007

Conventional wisdom has equated expatriate managers with increased control of foreign subsidiaries of multinational corporations (MNCs). Integrating theory from the control, leadership, and organizational change literatures, this paper develops a model that identifies specific conditions in which Host Country National managers (HCNs) can be expected to afford greater control at the subsidiary level than expatriates. Relevant factors considered in the model include cultural (national, organizational, professional) asymmetry, leadership of organizational change, and parent company legitimacy.
In the Eyes of the Beholder: The Relationship Between Subordinates' Felt Trustworthiness and their Work Attitudes and Behaviors
Authors: Lester Scott W. , Brower Holly H.
Published: August 2007

This study extends the literature on trust and leadership by examining trust from a new perspective. Specifically, we investigate how subordinates' perceptions of their leaders' trust in them, which we label subordinates' felt trustworthiness, influence their performance, organizational citizenship behavior and job satisfaction. Results demonstrated a positive relationship between felt trustworthiness and these dependent measures. Furthermore, felt trustworthiness was a more significant predictor of these outcomes than the subordinates' perceptions of their leaders' trustworthiness. Implications of these_findings are discussed.
The Persistence Process: Development of a Stage Model For Goal-Directed Behavior
Authors: Meier George , Albrecht Maryann H.
Published: August 2007

This paper provides a theoretical framework for persistence as a process in goal-directed behavior. The theoretical foundation builds on the recent formulation of an instability function in planned behavior and develops a stage model of persistence. Stages discussed in this paper include those related to decision-making, implementation and evaluation.
The Ambiguity Tolerance Interface: A Modified Social Cognitive Model For Leading Under Uncertainty
Authors: Lane Michael S. , Klenke Karin
Published: August 2007

This paper proposes a modification of McCormick's (2001) self-regulatory leadership confidence model by including an intervening variable referred to as the Ambiguity Tolerance Interface (ATI). After a review of theoretical approaches relevant to developing a framework of leadership at the interface of tolerance of ambiguity and uncertainty, we introduce the ambiguity tolerance interface (ATI) and discuss a number of variables we identified as focal constructs that comprise the proposed ATI cluster. These variables include ambiguity tolerance, spirituality, creativity, aesthetic judgment and mindfulness. The paper concludes with a discussion of instruments that can be used to operationalize the variables of interest and the implications of ATI for leadership theory and praxis. Finally, we refocused existing research to address the influence of uncertainty on leaders in the dynamic global environment.
Identifying Leader Social Cognitions: Integrating the Causal Reasoning Perspective into Social Cognitive Theory
Authors: Mccormick Michael J. , Martinko Mark J.
Published: August 2007

In this paper we propose a leadership model that combines Bandura's (1997) social cognitive theory with the causal reasoning perspective (Martinko, 2002). The model suggests that leader causal reasoning processes affect leader perceptions of goals, self-efficacy, and leadership task schema that, in turn, affect the leader's selection of strategies and enactment of behaviors. Each leader social cognition is conceptually defined and developed. Particular emphasis is given to describing how the understanding of attributional explanations, dimensions, and biases can aid in the description of the causal reasoning processes that precede self-and member-regulation.
Dispositional Antecedents and Consequences of Emotional Labor at Work
Authors: Yongmei Liu  , Perrewé Pamela L. , Hochwarter Wayne A. , Kacmar Charles J.
Published: August 2007

We examined individual difference variables as antecedents of perceived emotional labor, as well as affective and behavioral consequences. Full time employees who had at least five years of work experience completed two separate surveys. Respondents were asked to indicate negative affectivity and political skill, and perceived emotional labor at time one. Job-induced tension and political behavior were gathered two months later. Results indicated that negative affectivity and political skill were significantly related to employee perceived emotional labor, which further influenced employees' use of political behaviors and job-induced tension. Implications of the current study and directions for future research are discussed.
The Interactive Effects of Politics Perceptions and Trait Cynicism on Work Outcomes
Authors: Hochwarter Wayne A. , James Matrecia , Johnson Diane , Ferris Gerald R.
Published: August 2007

The current study examined the interactive relationship of politics perceptions and trait cynicism on two work outcomes: job satisfaction and citizenship behaviors. Trait cynicism is characterized as a personality trait that is stable across settings. Using a diverse sample of 311 full-time employees drawn from a variety of organizations, trait cynicism moderated the relationship between politics perceptions and both outcomes. Specifically, for those possessing higher levels of trait cynicism, politics perceptions were associated with lower job satisfaction scores and less participation in citizenship behaviors. Implications of these findings, strengths and limitations, and avenues for additional research are provided.
Leadership and Temperament Congruence: Extending the Expectancy Model of Work Motivation
Authors: Humphreys John H. , Einstein Walter O.
Published: August 2007

We integrate theory and research from disparate areas to develop a comprehensive expectancy model of work motivation. Within our model, we: (1) consolidate the motivation, leadership, and personality literatures; (2) effectively incorporate the self-concept and personalities of leaders and followers; (3) provide an expanded view of the dynamics surrounding the concept of effort; (4) specify dyadic temperament congruence as a critical source of goal-directed behavior, and (5) offer a more realistic depiction of the implications of satisfaction and perceived equity.
From Leaders to Leadership: Managing Change
Authors: Ahn Mark J. , Adamson John S.A. , Dornbusch Daniel
Published: August 2007

The accelerating pace of change in globalization, communications, disruptive technologies, capital flows and alliances have created fundamental shifts in business operations. Where many popular leadership models may provide formulae to help solve some business problems, they are insufficient to deal with the pace and polyvalent character of constant, rapid change. Managing change- its impact on organizational structure, group culture, and personal management styles - is one of the most fundamental and enduring aspects of leadership. Paradoxically, while the relative value of the once-celebrated individual leader as superman or woman is being questioned, great leadership has never been more urgent or more difficult.
An Interview with United States Senator Paul S. Sarbanes
Authors: Lucas Nance
Published: August 2007

Senator Paul Spyros Sarbanes is the senior Democrat on the Senate Banking, Housing and Urban Affairs Committee. He was chairman of the committee when Sarbanes-Oxley was enacted. Senator Sarbanes is the longest-serving U.S. senator in Maryland history, having won his fifth term in 2000. He also serves on the Foreign Relations, the Budget and the Joint Economic Committees. He was born in Salisbury, Maryland, holds an undergraduate degree from Princeton and a law degree from Harvard. He was awarded a Rhodes Scholarship that brought him to Oxford, England. After law school, he clerked for Federal Judge Morris A. Soper before going into private practice with two Baltimore City law firms.

In 1966, Sarbanes ran for the Maryland House of Delegates in Baltimore City and won. During his four years as a State Legislator in Annapolis he served on the Judiciary and the Ways and Means Committees. In 1970 he was elected to the United States House of Representatives, the first of three terms. While in the House, from 1971-76, Sarbanes served on the House Judiciary Committee, the Merchant Marine and Fisheries Committee, and the Select Committee on House Reorganization. It was during his service in the House, in August 1974, that Sarbanes was selected by his Democratic colleagues on the House Watergate Committee to introduce the first Article of Impeachment, for obstruction of justice, against President Richard Nixon.

On November 2, 1976, Sarbanes was elected to the United States Senate. He was re-elected in 1982, 1988, 1994, and 2000. Throughout his public service, Senator Sarbanes has worked hard to provide the citizens of Maryland with dedicated, independent representation; representation based upon intelligence and integrity; representation which gives people the confidence that elected officials are there to serve the public interest.

Paul Sarbanes was born in Salisbury, on Maryland's Eastern Shore on February 3, 1933. He is the son of Greek immigrants from Laconia, Greece -- Spyros (deceased 1957) and Matina Sarbanes (deceased 2001) who owned the Mayflower Restaurant on Salisbury's Main Street. The principles Senator Sarbanes learned growing up in Salisbury that have guided his public life are opportunity and fairness - principles that he strongly believes are fundamental to a decent and just society.
Moral Leadership in a Postmodern World
Authors: Thompson Lindsay J.
Published: August 2007

This paper examines the gap between moral purpose and moral performance as a problem created in part by the alienation of spirituality from civic life. We are a nation ofprivatized morality that places corporate and civic leaders in a labyrinth of uncertainty when they try to establish a moral foundation for actions and decisions affecting the public interest. This uncertainty is compounded by an Enlightenment tradition of modern secular pluralism privileging rational discourse as the vehicle of public moral sentiment. In this longstanding intellectual tradition, reason is the highest good (Plato, Aristotle), the defining,feature of human subjectivity (Descartes), the foundation of human freedom (Kant, Hegel, Locke), and the path to moral truth (Kant).

Although much of the intellectual, social, economic, and political energy of the last century has challenged the totalizing assumptions embedded in this tradition (Marx, Foucault, et alia), qualities of neutrality, objectivity, and universality remain as privileged values influencing cultural practices of morality and leadership. Leaders turn to reason, with its assumed qualities of tolerance and respect, in the attempt to cultivate organizational cultures of moral clarity, accountability, and trust without violating the intellectual and spiritual freedom of the individuals and groups who constitute the organizational culture. The problem with this approach is that moral solidarity - and, for that matter, genuine tolerance and respect -- are not a product of the intellect; they are a creation of the human spirit. In the secular tradition, spirituality is a private pursuit with no legitimate role in the public domain.

This paper introduces a framework, the Moral Compass, as a possible approach for creating moral solidarity. The Moral Compass creates a conceptual framework and terminology the enables people to engage in meaningful, authentic moral dialogue and discernment while remaining anchored in the their unique moral traditions.
Keeping it "All in the Family:" Does Nepotism in the Hiring Process Really Benefit the Beneficiary?
Authors: Padgett Margaret Y. , Morris Kathryn A.
Published: August 2007

The purpose of this research was to examine the consequences of being perceived as having benefited from a family connection during the hiring process. One hundred and ninety-seven upper-level undergraduate students reviewed materials describing three candidates for a managerial position. Selection method (merit vs. nepotism) and gender of the person who received the position were manipulated in the materials. Results revealed that not only was nepotism perceived as being less fair than merit-based hiring, but individuals believed to have benefited from a family connection during the hiring process were viewed less favorably than individuals believed to have been hired based on merit.
The Importance of Organizational Context on Employees' Attitudes: An Examination of Worlking in Main Offices Versus Branch Offices
Authors: Clinebell Sharon , Shadwick Gerald
Published: August 2007

Organizational context is important in the determination of attitudes and behaviors (Rousseau, 1978). This paper presents the results of a study conducted with employees of branch banks and main office banks regarding their job-related attitudes. It is hypothesized in this paper that employees in the branch banks will have lower levels of job satisfaction, organizational commitment, job involvement, and partial inclusion and higher levels of role conflict and role ambiguity. The findings are consistent with the findings of Podsakoff, Niehoff, MacKenzie and Williams (1993) who suggested that researchers would be well advised to consider organizational context in future research.
Increasing the Quantity and Quality of School Leadership Candidates Through Formation Experiences
Authors: Busch Joseph R. , O'Brien Thomas P. , Spangler William D.
Published: August 2007

After a review of the relevant school leadership and business management literatures, a leadership program was established based on the formation component of Daresh and Playko's (1992) tridimensional model of administrator preparation. Teachers participated in an eight-month personal and professional development program, which included interpersonal leadership styles analysis, professional action planning, mentoring, reflection, and platform development This is a multimethod research study to determine the effectiveness of this project in enhancing participants' leadership skills and their interest in pursuing educational leadership certification. Quantitative and qualitative methods were used to assess the project on all four levels of Kirkpatrick's (1998) model of assessing training program effectiveness (reaction, learning, behavior, results). The results suggest that the program was effective at all levels of Kirkpatrick's framework. They indicate that formation activities can be useful in addressing issues related to both the quantity and quality of candidates for school leadership positions.
Understanding WorldCom's Accounting Fraud: Did Groupthink Play a Role?
Authors: Scharff M.M.
Published: August 2007

WorldCom, Inc. perpetrated the largest accounting fraud in U.S. history. WorldCom, now called MCI, emerged from bankruptcy protection on April 20, 2004 after being fined $750 million. In total, WorldCom reported accounting irregularities of $11 billion. While employees and investors look for individual culpability, much of WorldCom's organizational structure and culture potentially contributed not only to the fraud but also to the length of time over which it occurred. In many ways, groupthink may help explain some of the issues and fraudulent activities at WorldCom as well as the pressures that were placed on employees extending the period over which the fraud occurred.
An Interview with John H. Zenger on Extraordinary Leadership
Authors: Madsen Susan R. , Gygi Janice
Published: August 2007

John H. (Jack) Zenger writes, teaches, and speaks about extraordinary leadership. Today he is one of most authoritative voices on leadership and performance. He received a degree in psychology from Brigham Young University, an MBA from UCLA, and a doctorate degree in business administration from the University of Southern California. He has been the CEO and President of one of the world's largest performance skills improvement companies, Provant, Inc. In 1977, Jack co-founded Zenger Miller, a leading management and leadership development company. He later became the Chairman of Times Mirror Training, Inc. (which consisted of Kaset, Learning International, and Zenger Miller) for many years. He has authored or coauthored seven books, including The Extraordinary Leader: Turning Good Managers into Great Leaders, The Handbook for Leaders: 24 Lessons for Extraordinary Leaders, Results-Based Leadership (which was honored as the best book of 2000 by the Society of Human Resource Management), and best-selling The New Self Directed Work Teams: The New American Challenge. In 1994, Jack was inducted in the Human Resources Development Hall of Fame.
Antecedents to Temporary Employee's Turnover Intention
Authors: Slattery Jeffrey P. , Rajan Selvarajan T.T.
Published: August 2007

In an exploratory study using temporary workers, a model based on social exchange and social identity theories was developed and tested. Results revealed that, for both the temporary employee attitudes toward the client organization and the temporary employee attitudes toward the temporary agency, there was a positive association between job satisfaction and organization commitment and negative associations between job satisfaction and turnover intention and organizational commitment and turnover intention. Concerning the "crossover effects ", results showed that job satisfaction with the client organization had a weak positive association with organizational commitment for the temporary agency and organizational commitment for the temporary agency had a weak negative association with turnover intention for the client organization. Managerial implications of these results are discussed.
Task and Relationship-Oriented Trust In Leaders
Authors: Sherwood Arthur Lloyd , DePaolo Concetta A.
Published: August 2007

This study examines the relative influence of competence, consistency and motivational intention upon the defined task and relationship dimensions of trust in leaders. A sample of 345 part- and full-time employees provided survey responses regarding their perceptions of their direct supervisors. Results indicate that competence and consistency explain more variance in task than in relationship-oriented trust. Motivational intention explained more variance in relationship than in task-oriented trust. The results, practical implications, limitations and future research opportunities are discussed.
Empowerment in the Context of Transformational Change: A Study of Acquisitions and Privatizations in Eastern Europe
Authors: Gebert Diether , Piske Reiner , Baga Tünde , Lanwehr Ralf , Kearney Eric
Published: August 2007

This paper examines conditions under which empowerment (decision autonomy, dialogic leadership) is connected with positive and negative effects, respectively, in regard to managing transformational change in Eastern Europe. Acquisitions by foreign investors in Poland and Russia (N = 45 companies) and privatizations through employee buy-out in Romania (N = 5 companies) are contrasted in this study. It is shown that empowerment within these two variants of transformational change is connected in different ways with success indicators of crisis management. From these findings, we deduce practical consequences for empowerment and transformational change, along with suggestions for future research.
Responsible Leadership for Performance: A Theoretical Model and Hypotheses
Authors: Lynham Susan A. , Chermack Thomas J.
Published: August 2007

Literature on leadership indicates an absence of general, integrative theory. Much of existing theory focuses on effective leadership, and on leadership processes, at the individual, group, or organizational level. Little emphasis is placed on whole system effect, and less on concerns for both people and performance. The theoretical framework developed and discussed addresses this inadequacy, presenting an integrative and general perspective of leadership that focuses on leadership responsibility to both people and performance.
The Role of Cognitive Style and Risk Preference on Entrepreneurial Self-Efficacy and Entrepreneurial Intentions
Authors: Barbosa Saulo Dubard , Gerhardt Megan W. , Kickul Jill Richard
Published: August 2007

The purpose of the current study is to address the distinctive roles of cognitive style and risk preference on four types of entrepreneurial self-efficacy and entrepreneurial intentions. More specifically, we examine how both cognitive style and risk preference separately and interactively contribute to an individual's assessment of his/her own skills and abilities as well as to his/her own entrepreneurial intentions. This study investigated these relationships using an international sample of 528 entrepreneurial students across three universities. Results indicated that individuals with a high risk preference had higher levels of entrepreneurial intentions and opportunity-identification efficacy, whereas individuals with a low risk preference had higher levels of relationship efficacy, and tolerance efficacy. Individuals with an intuitive cognitive style were also found to have lower perceived self-efficacy concerning the establishment of relationship with investors, the economic management of the new venture, and their capacity to tolerate ambiguity. However, intuitive individuals who had a high preference for risk exhibited higher levels of opportunity identification efficacy. Finally, contrary to our final hypothesis, analytic individuals with a low preference for risk had higher levels of relationship and tolerance self-efficacy than intuitive individuals with a high risk preference. Implications of these findings and directions for future research are discussed.
Adult Developpement and Transformational Leader
Authors: Lucius Randall H. , Kuhnert Karl
Published: August 2007

Executive Summary
A Conversation with Tony Rucci Preparing Future Leaders
Authors: Thompson Kenneth R.
Published: August 2007

Dr. Anthony J. Rucci became dean of the College of Business Administration at the University of Illinois at Chicago (UIC) in 1998. He returned to academia following a twenty-five year career as a business executive and senior corporate officer with two Chicago-based Fortune 100 companies— Baxter International and Sears, Roebuck & Company. While with Baxter, the health care products company, Tony held a number of positions, including six years as senior vice president for human resources and ended his career as a senior vice president for corporate strategy, business development, and media and investor relations.

Between 1993 and 1998, Tony was executive vice president for administration for Sears, which included responsibility for legal, human resources, ethics, administrative services, strategic sourcing, quality and product testing labs, facilities management, and aviation. In addition, from 1995-1997, he was the chairman of the board of directors for Sears de Mexico, Sears' $450 million publicly traded retail business in Mexico. He also served on the boards of Sears Canada, Western Auto, and Grupo Carso's retail board.

In 1995, Tony was elected as a Fellow in the National Academy of Human Resources, in 1996 was named to Human Resource Executive Magazine's Executive of the Year Honor Roll, and in 1997 he was named Executive of the Year by the International Association of College and Professional Recruiters. In 1998 he received Workforce magazine's Optimas Award for General Excellence in Human Resources, awarded to Sears for his efforts in the turnaround there.

I was excited to do this interview with Tony Rucci as here is a person who has had experience in industry who was now in an academic role and he might have some insights to share about the differences in managing in the different environments.
Business Leaders: A Historical Sketch of Eli Whitney
Authors: Wren Daniel A. , Greenwood Ronald G.
Published: August 2007

Eli Whitney's America was a nation just recently emerging from its colonial status, and "Yankee ingenuity" would prove essential for it to move from an agrarian society to an industrial one. Whitney was still in college when America's first census, in 1790, showed a total population of 3,231, 533, with over 90 percent of these people engaged in agriculture. The largest city was New York, with a population of 33,131; next came Philadelphia, with 28,522 persons, and then Boston, with a population of 18,300. Together, the three largest U.S. cities had a population that could comfortably be seated in a modern football stadium.

Born December 8, 1765, in Westborough, Massachusetts, Eli Whitney Jr. was the eldest of Eli and Elizabeth Whitney's four children. Eli's father had a small workshop on their farm, containing basic tools and a lathe for turning chair legs and the younger Whitney learned how to use these tools. He made and repaired violins and demonstrated his entrepreneurial tendencies early. During the Revolutionary War, he discovered that nails brought a high price and talked his father into letting him use the workshop to make nails for resale. After the war, when nails were no longer in such great demand, he noticed that women had started using long pins to keep their hats on their heads and changed his product line to make hat pins.

He aspired to a higher education, but limited family finances delayed his entry into Yale College until 1789, when he was twenty-four years old. His father pledged $1,000 for the four years at Yale, but Eli had to make up the balance of some $600 by tutoring others. At the time, Yale's curriculum provided a classical education, designed to create gentlemen for politics, the ministry, or law, but Eli was not drawn to any of these fields. Unemployed upon graduation in 1792, he was able to gain a tutor's position in the South and traveled to Savannah, Georgia, with another Yale alumnus, Phineas Miller.
Courage to Create and Courage to Lead A Case Study of Artistic Leader Toni Morrison
Authors: Murray Gloria J.
Published: August 2007

Executive Summary This manuscript discusses an expanded view of leadership theory using an artistic perspective linking art, creativity and leadership. To understand the intersection of creativity and leadership a case study of Toni Morrison the writer is presented. The framework for looking at creativity in leaders and understanding the artistic leader is based on the work of developmental psychologist Howard Gardner. Patterns and implications for leadership development and research are discussed.
Leadership Preparation: Designing and Planning for Interprofessional Doctoral Education and Practice
Authors: Aiken Judith A. , Prue Jennifer , Hasazi Susan Brody
Published: August 2007

Executive Summary New directions in the study of leadership preparation are transforming the practices and theories about leaders, especially those who serve in educational and human services organizations (Clark & Clark, 1996; Corrigan, 1998; Dunlap & Schmuck, 1995; Leithwood, Begley, & Cousins, 1992, et al.). In spite of these new directions, few programs have given consideration to the idea of interprofessional leadership and the skills, knowledge, and experiences needed to support the changing roles and relationships that have come to define leadership practice (Browning, 1987; Cunningham, 1990; Corrigan, 1994; Lawson & Hooper-Briar, 1997; Murphy, 1992; et al.). This article explores how one university has reshaped their doctoral leadership program in an effort to build interagency collaboration among professionals from public education, higher education, human services agencies, and health care organizations. A follow-up study of current students and graduates from the program provides insight into how these professionals have come to understand interprofessional leadership, the benefits and challenges for participating in an interprofessional doctoral program, and the extent to which the program has helped them to engage in interprofessional leadership in their own practices.
Providing Leadership in Rural America: A Model for Community Colleges
Authors: Burgraff Donna L.
Published: August 2007

Executive Summary This article describes a community/business/education partnership, which was developed between a community college and a downtown revitalization program. The purpose of the partnership was to provide leadership training throughout an Appalachian community, thereby increasing the leadership in the local area. The process of developing the partnership is outlined, and its successes and lessons learned are also described. This partnership is a model for other rural communities that are suffering from a community-wide lack of leadership. Practical application of leadership theory and development is the focus of this article.
Changing Times: Entrepreneurial Leadership In A Community-Based Nonprofit Organization
Authors: Santora Joseph C. , Seaton William , Sarros James C.
Published: August 2007

Executive Summary This paper investigates the issue of organizational change in a Hispanic community-based nonprofit organization. It provides background information on the organization and its leadership. It discusses the ways a newly appointed entrepreneurial leader introduced change into the organization. This paper discusses the need for a visionary and entrepreneurial leader to transform nonprofit organizations. Finally, it concludes with a discussion of implications and applications and raises questions for future research.
Evaluating Clinical Practice: Using Play-based Techniques to Elicit Children's Views of Therapy
Authors: Jäger Jessica , Ryan Virginia
Published: August 2007

Children's services' drive towards accountability, and children's rights advocates' desire to truthfully represent children's views, are leading to more evaluation of child therapy services. The challenge is to find methods that accurately reflect children's views of their therapy. In this article we argue that play therapy skills have an important place in evaluating child therapy practice. We discuss four different directive play therapy techniques three of which have been piloted in the first author's practice to help children express their views of therapy at the end of their interventions. These are: `The expert show', the miniature playroom technique and puppet and large doll evaluations. Explanations and examples are given from pilot research with 12 children. The issues and challenges inherent in play-based evaluations also are explored. We argue that expressive therapists are in a prime position to evaluate children's services and that children appear well able to express their views of therapy with these child-centred techniques.
Special Section: Learning from Experience
Authors: Bacon Heather
Published: August 2007

The one unique experience of my professional life as a child clinical psychologist was the Cleveland Crisis. Cleveland was characterized by a difficult interface between the essentially private, personally owned, intricate sphere of child clinical work, and what became an intensely political, public, and societal scrutiny of the child protection system in which that work was embedded. I consider myself fortunate to have lived through such an interesting time, which demanded so much learning. The experience fundamentally changed me as a practitioner. I am certain of the need for reflective practice to inform action, because I had an experience of being caught up in events where that was not possible. Over the ensuing years, in reflecting on the impact of the crisis, upon me and upon the children with whom I worked, I have come to a greater understanding and acceptance of the meaning and consequences of that traumatic time.
Special Section: What Can Clinical Psychologists Learn from Reading Novels?
Authors: Marzillier John
Published: August 2007

Clinical psychologists like to think of themselves as `scientist-practitioners' drawing upon scientific knowledge to inform their practice. The assumption is that psychological practice should be based on certainty, something that is to my mind a delusion. Science is not the only source of knowledge about the human condition. Once psychologists accept that clinical practice is a creative and at times uncertain business, other sources of knowledge can be drawn upon. English literature — novels, poetry, plays — is a rich source of such knowledge. Since the very beginning psychoanalysis has delved into literature, mainly to illustrate theory. There is no reason why other psychological traditions cannot do the same. In this article I look at extracts from two novels and one collection of short stories. I show that reading the novel or story could benefit a psychotherapist, each extract illustrating a different application. I suggest that novels and stories provide us with a different sort of knowledge, one that we could usefully draw upon.
Family-focused Treatment for Childhood-onset Depressive Disorders: Results of an Open Trial
Authors: Tompson Martha C. , Pierre Claudette B. , Haber Fawn McNeil , Fogler Jason M. , Groff April R. , Asarnow Joan R.
Published: August 2007

Study objectives were to develop a treatment manual for a family-focused intervention for depressed school-aged children, evaluate its feasibility and acceptability, and complete an initial open trial to examine treatment effects. Nine young people meeting criteria for depression (major depressive disorder, dysthymic disorder, or depression not otherwise specified), completed a 12-week family intervention, and were assessed immediately and at 9 months following treatment completion. The intervention presented an interpersonal model of how depressive symptoms are maintained, and emphasized developing family strategies for altering interpersonal processes, supporting recovery and enhancing resilience. At posttreatment 66% of the young people had recovered from their depressive episodes; by 9 months posttreatment 77% had recovered. Significant improvements in global functioning were noted. There were no relapses in the follow-up period and no instances of suicidal behavior during the intervention or follow-up. Mothers' and fathers' Child Behavior Checklist reports and children's self reports indicated significant symptom reductions. Exploratory analyses suggest particular benefit for young people with parents high in criticism. The family-focused intervention for childhood-onset depression demonstrated gains similar to those seen with empirically supported treatments for depressed adolescents and superior to those seen in naturalistic studies of depression outcomes. This favorable risk/benefit profile supports the value of a randomized controlled trial.
Classroom Drama Therapy Program for Immigrant and Refugee Adolescents: A Pilot Study
Authors: Rousseau Cécile , Benoit Maryse , Gauthier Marie-France , Lacroix Louise , Alain Néomée , Viger Rojas Musuk , Moran Alejandro , Bourassa Dominique
Published: August 2007

This evaluative study assesses the effects of a school drama therapy program for immigrant and refugee adolescents designed to prevent emotional and behavioral problems and to enhance school performance. The 9-week program involved 136 newcomers, aged 12 to 18, attending integration classes in a multiethnic school. Pretest and posttest data were collected from the students and their teachers. The self-report and teacher's forms of the Strengths and Difficulties Questionnaire were used to assess emotional and behavioral symptoms. At the end of the program, although there were no reported improvement in self-esteem or emotional and behavioral symptoms, the adolescents in the experimental group reported lower mean levels of impairment by symptoms than those in the control group, when baseline data were controlled for. Their performance in mathematics also increased significantly compared to that of their control peers. The findings suggest that the workshops may have an impact on social adjustment of recently arrived immigrants and refugees. This drama therapy program appears to be a promising way of working preventively and in a nonstigmatizing manner with adolescents who have been exposed to diverse forms of adversity, among which are war and violence.
Bad news is bad news: let's not make it worse
Authors: Alexander David A , Klein Susan
Published: August 2007

There is no painless way of breaking bad news. However, providing patients and their relatives with information which may be very distressing to them is an important contribution to their coming to terms with a tragedy. Clinicians often seek to avoid being the bearers of ill-tidings, not through malice or a lack of concern but, particularly, through their anxiety about being able to deal with the consequences of giving such information and a natural reluctance to avoid causing distress to others. While confirmatory research data are sparse, clinical experience suggests a number of guidelines for breaking bad news. These always have to be used flexibly and tailored to meet the specific needs and circumstances of those who are to be told.
Long-Range Activation of GREB1 by Estrogen Receptor via Three Distal Consensus Estrogen-Responsive Elements in Breast Cancer Cells
Authors: Sun Jun , Nawaz Zafar , Slingerland Joyce M.
Published: August 2007

The estrogen receptor (ER) binds to estrogen-responsive elements (EREs) to activate gene transcription. The best characterized EREs are located in proximal gene promoters, but recent data indicate that only a minority of ER binding sites lie within proximal promoter regions. GREB1 (gene regulated by estrogen in breast cancer 1) is an ER target gene that regulates estrogen-induced proliferation in breast cancer cells. We identified three consensus EREs, located at −21.2, −9.5, and −1.6 kb upstream of the closest GREB1a transcription start site that appear to mediate long-range GREB1 gene activation by ER. All three ERE sites nucleate ER, steroid receptor coactivator-3 (SRC-3), and RNA polymerase II (Pol II) and undergo histone acetylation in response to estradiol. Estrogen-stimulated ER binding at all three EREs was cyclic and synchronous. SRC-3 and Pol II recruitment to all three EREs was activated by estrogen but not tamoxifen. In contrast, estrogen stimulated only Pol II and not ER or SRC-3 recruitment to the GREB1 core promoter regions. Long-range histone acetylation, centered on the three ERE motifs and the GREB1 core promoters, was observed in response to estrogen but not to tamoxifen. These data suggest that estrogen-stimulated GREB1 transcription may involve coordinated ER binding to all three distal consensus ERE motifs. Long-range activation by ER acting at multiple EREs may be more common than previously appreciated.
Ultrasound-Guided, Vacuum-Assisted Excision in the Diagnosis and Treatment of Clinically Benign Breast Lesions
Authors: Mathew J , Crawford DJ , Lwin M , Barwick C , Gash A
Published: August 2007

INTRODUCTION

Ultrasound-guided, vacuum-assisted biopsy has a definitive role in the diagnosis of breast lesions. Its role in the treatment of benign breast lesions like fibroadenomas has not been established.

PATIENTS AND METHODS

This is a retrospective review of patients undergoing ultrasound-guided, vacuum-assisted biopsy for clinically benign breast lesions. The procedures were performed in all cases by two consultant radiologists with special interest in breast radiology between February 2002 and January 2004. Patients were followed up in the clinic 6 weeks after the procedure.

RESULTS

Seventy-six patients had ultrasound-guided, vacuum-assisted excision of clinically benign breast lesions during this 2-year period. Mean age of the patients was 31 years. Altogether, 86 procedures were performed. Six patients with larger lesions (> 2 cm) had two procedures on separate sitting and 4 patients had separate lesions excised on a later date. Fifty-six patients were identified to have fibroadenomas and had complete excisions as evidenced on scan. Three out of nine patients identified with equivocal disease on fine needle aspiration cytology (FNAC) were found to have cancer following ultrasound-guided, vacuum-assisted excision. One patient who was diagnosed with cancer on FNAC, proved to be fibroadenoma on final histopathology. Four patients developed haematomas following ultrasound-guided, vacuum-assisted excision and all were managed conservatively.

CONCLUSIONS

Our study shows that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative in treatment of fibroadenomas.
Ponseti Treatment in the Management of Clubfoot Deformity – A Continuing Role for Paediatric Orthopaedic Services in Secondary Care Centres
Authors: Docker Charles EJ , Lewthwaite Simon , Kiely Nigel T
Published: August 2007

INTRODUCTION

The Ponseti technique is a well-proven way of managing paediatric clubfoot deformity. We describe a management set-up which spreads the care between secondary and tertiary care with no loss of quality.

PATIENTS AND METHODS

In our audit of the first 2 years of Ponseti casting in the treatment of idiopathic congenital talipes equinovarus (CTEV, clubfoot) deformity, we identified 77 feet having been treated in 50 patients. Forty-nine feet were treated primarily in Oswestry, a tertiary referral centre for paediatric orthopaedic conditions, and 13 feet were treated in conjunction with the physiotherapy department at one of the region's district general hospitals (Leighton Hospital, Crewe, Cheshire).

RESULTS

Similar good results and low requirement for surgical interventions other than Achilles tenotomy, which forms part of the Ponseti regimen, were found in both cohorts.

CONCLUSIONS

This ‘hub-and-spoke’ approach would appear to be efficient in terms of resource utilisation. Additional benefits atients and their carers include ease of access to services and reduced financial and transport burdens.
Dyslipidemia: Reduction in Estimated Risk for Coronary Artery Disease After Use of Ezetimibe with a Statin
Authors: Sampalis John S , Bissonnette Stéphane , Habib Rafik , Boukas Stella
Published: August 2007

Background:

The aim of lipid-lowering treatment is to reduce the risk for cardiovascular events. Patients not at target lipid levels while on hydroxymethylglutaryl coenzyme A reductase inhibitors (statin) monotherapy are at increased cardiovascular risk.

Objective:

To describe the impact of coadministration of ezetimibe with a statin on the estimated 10 year risk for coronary artery disease (E-RCAD) in patients with hypercholesterolemia and above-target low-density lipoprotein cholesterol (LDL-C) levels after statin monotherapy.

Methods:

Post hoc analysis was conducted of a prospective, open-label, single-cohort, multicenter Canadian study of 953 patients who were treated for 6 weeks with ezetimibe 10 mg/day coadministered with their current statin at an unaltered dose. For each patient, E-RCAD at baseline and at 6 weeks was calculated using the Framingham model. The primary outcome measure of the analysis was the change in E-RCAD.

Results:

A total of 825 patients with data at baseline and 6 weeks were included in the analysis. There were 423 (51.3%) patients with hypertension, 107 (13.0%) with diabetes mellitus but not metabolic syndrome, 160 (19.4%) with metabolic syndrome but not diabetes mellitus, and 235 (28.5%) with both diabetes mellitus and metabolic syndrome. After 6 weeks of ezetimibe coadministration with statin therapy, mean E-RCAD was reduced by 4.1% from 15.6% to 11.5%, which is equivalent to a 25.3% risk reduction (p < 0.001). Of the 225 (27.3%) patients with high E-RCAD (≥20.1%) at baseline, 144 (64.0%) converted to a lower E-RCAD category (p < 0.001). Patients with both diabetes mellitus and metabolic syndrome experienced the highest mean percent reduction in E-RCAD of –29.4% (p < 0.001).

Conclusions:

For patients with above-target LDL-C levels while on statin monotherapy, coadministration of ezetimibe with the statin is effective in significantly reducing the E-RCAD.
Diagnosis and Treatment of Extended-Spectrum and AmpC β-Lactamase–Producing Organisms
Authors: Yang Katherine , Guglielmo B Joseph
Published: August 2007

Objective:

To review the laboratory diagnosis of extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase–producing bacteria and evaluate potential treatment options.

Data Sources:

A PubMed search, restricted to English-language articles, was conducted (1966–May 2007) using the search terms ESBL, AmpC, diagnosis, detection, carbapenem, ertapenem, fluoroquinolone, cephalosporin, cefepime, tigecycline, and colistin. Additional references were identified through review of bibliographies of identified articles.

Study Selection and Data Extraction:

All studies that evaluated laboratory methods for the detection of ESBLs and AmpC β-lactamases and/or the treatment of these organisms were reviewed. All articles that were deemed to be clinically pertinent were included and critically evaluated.

Data Synthesis:

Numerous laboratory techniques are available for the detection of ESBLs. In contrast, laboratory techniques for detection of AmpC β-lactamases are limited, particularly for plasmid-mediated AmpC β-lactamases. Routine microbiologic testing may not detect ESBLs or AmpC β-lactamases. Optimal antibiotic treatment options are derived from limited observational studies and case reports. Randomized clinical trials evaluating appropriate antibiotic treatment options are lacking. In vitro susceptibility does not always correlate with clinical outcomes. The use of imipenem was associated with the lowest incidence of mortality in patients with bacteremia due to ESBL-producing organisms.

Conclusions:

Laboratory detection of ESBLs for most organisms is possible with Clinical and Laboratory Standards Institute–recommended testing. However, these tests can be associated with both false negative and false positive results, particularly with organisms that harbor both ESBL- and plasmid-mediated AmpC β-lactamases. No established guidelines exist for the detection of AmpC β-lactamases. Imipenem and meropenem are superior to other antibiotics for the treatment of serious infections due to ESBL and AmpC β-lactamase–producing gram-negative bacteria. While in vitro data demonstrate that tigecycline, ertapenem, and colistin might be potential choices, clinical experience is lacking.
Amlodipine-Induced Bilateral Upper Extremity Edema
Authors: Ganeshalingham Anusha , Wong William
Published: August 2007

Objective:

To report a case of bilateral upper extremity edema associated with amlodipine use in a child.

Case Summary:

A previously well and normotensive 6-year-old girl presented with a generalized vasculitis of unknown origin and severe hypertension. Large vessels predominantly affecting the neck, chest, and abdomen were found to be involved, resulting in abnormal arterial circulation and significant blood pressure differences between the upper and lower extremities. Multiple antihypertensive agents were initially required to control blood pressure. She was stabilized and discharged on amlodipine 10 mg each evening, atenolol 50 mg/day, and warfarin. Three days later she was noted to have facial and bilateral upper extremity pitting edema. Laboratory and radiologic assessments for possible etiologies were negative. Discontinuation of amlodipine resulted in resolution of edema.

Discussion:

As of June 2007, there had been no cases of bilateral upper extremity edema associated with amlodipine use reported in the English literature. Adverse effects of amlodipine, a widely used antihypertensive, have been well reported. These include flushing, headache, and peripheral edema. Lower limb edema is the most common, while periocular and perioral edema have occurred less frequently. Anasarca edema has been described only once in the English literature. According to the Naranjo probability scale, amlodipine was a probable cause of bilateral upper extremity edema in this child.

Conclusions:

Bilateral upper extremity edema has been associated with amlodipine use in a child with an abnormal arterial circulation. The edema resolved upon discontinuation of the drug.