bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physicians' practices related to the use of terminal sedation: Moral and ethical concerns
Authors: POMERANTZ SHERRY C. , BHATT HIMANI , BRODSKY NANCY L. , LURIE DEBORAH , CIESIELSKI JANICE , CAVALIERI THOMAS A. 
Published: April 2008

Objective:Although terminal sedation (TS) has generally been seen as legal and ethically acceptable, ethical and moral issues remain. Little is known about the use of TS in general clinical practice and about how TS is viewed by physicians, given moral and ethical concerns. The objectives of this study are (1) to describe attitudes of physicians regarding terminal sedation; (2) to explore demographic characteristics, such as age, gender, subspecialty, and number of years in practice, that might be related to the use of TS; and (3) to compare physicians who have and have not used TS on the degree to which they view TS as moral and consistent with their professional and personal ethics.Methods:An anonymous survey of New Jersey physicians was conducted at the University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine. A 39-item questionnaire assessing general opinions about, experiences with, and religious, moral, ethical attitudes toward TS and other end-of-life treatments was utilized.Results:A majority of physicians (73%) had used TS for a patient. Most (93%) said there were circumstances under which they would use TS. With regard to questions about whether TS would be “immoral,” “would violate my religious beliefs,” “would violate my professional ethics” and “is inconsistent with the physician's role of preserving life,” approximately 55% of those who have used TS disagreed; for those who have not used TS, approximately 35% disagreed.Significance of results:Professional education and opportunities for discussion appear necessary to help reconcile the conflicts raised in the use of this end-of-life treatment strategy.
Difficulties in screening for adjustment disorder, Part I: Use of existing screening instruments in cancer patients undergoing bone marrow transplantation
Authors: KIRSH KENNETH L. , McGREW JOHN H. , DUGAN MICHAEL , PASSIK STEVEN D. 
Published: April 2008

Objective:Although success rates for bone marrow transplantation (BMT) continue to improve, there is still a high level of morbidity and physical and emotional distress associated with BMT. To date, limited research has focused on the assessment of and screening for specific psychiatric disorders of patients facing BMT. This is especially true with regard to identifying adjustment disorder (AD), despite the fact that AD is the most prevalent psychiatric diagnosis in cancer patients.Methods:A sample of 95 BMT patients were interviewed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID) and completed several commonly used self-report instruments to determine if these tools could be used to identify patients with adjustment disorder in need of further assessment and intervention.Results:Of these patients, 34.7% were diagnosed with adjustment disorder, 11.6% with major depression, and 5.3% with generalized anxiety disorder. The instruments were not found to be predictive of AD. However, the results of a regression analysis showed that the Social Subscale of the Functional Assessment of Cancer Therapy–General (R2Δ = 0.04,F= 4.30,p< 0.05) was a significant predictor of adjustment disorder.Significance of results:We conclude that there is little efficacy in using existing scales for detecting adjustment disorders in cancer patients undergoing bone marrow transplantation, and that other tools for identifying patients with adjustment disorder who might benefit from counseling are needed.
Preparation of residents for death pronouncement: A sensitive and
supportive method
Authors: BAILEY F. AMOS , WILLIAMS BEVERLY ROSA 
Published: April 2008

Objective: To identify factors associated with internal
medicine interns' self-assessed competency in death pronouncement and
to evaluate the effectiveness of a 10-minute death pronouncement module
and pocket card guidelines.Methods: In June 2003 at the Birmingham VAMC, Alabama, 48
internal medicine interns completed a survey of medical school education,
training, and experience in death pronouncement and a self-assessment of
death pronouncement competency. In September 2003, 33 of the 48 interns
completed a follow-up training/education survey and rated their
post-intervention competency. Using chi-square and paired
t-tests, we identified factors associated with variations among
baseline and post-intervention variables and examined pre-post changes in
self-assessed competency levels.Results: At baseline, less than 30% of the interns had
medical school instruction in the process of death pronouncement. More
than 70% reported needing basic instruction/close supervision.
Post-intervention, close to 90% interns needed minimal or no assistance.
Over 50% reported using pocket card guidelines. We found significant
pre-post increases in mean rankings in each of the 5 self-assessed
competencies (p < .001). Factors associated with differences
in baseline and post-intervention assessments included medical school
training/experience and use of the pocket card guidelines.Significance of results: When interns began training, most
had no instruction in death pronouncement and felt unprepared for this
task. With brief instruction, pocket card guidelines, and 3-months
experience, the majority of interns reported needing minimal/no
assistance in pronouncing death. A larger sample from multiple sites is
needed to confirm these findings.
Health-related quality of life and enrollment in Phase 1 trials in children with incurable cancer
Authors: BARRERA MARU , D'AGOSTINO NORMA , GAMMON JANET , SPENCER LYNLEE , BARUCHEL SYLVAIN 
Published: April 2008

Objectives: To investigate health-related quality of life (HRQOL) in children eligible for Phase 1 trials and the reasons why families consider participating in these trials.Methods: Individual, semistructured interviews were conducted with parents (seven mothers, two fathers) and three children, after a child was invited to participate in a clinical trial. Information regarding disease and treatment progression, daily life, and decision making about experimental treatments was elicited. Interviews were recorded, transcribed, and coded for themes.Results: HRQOL themes were grouped into four main domains: physical, psychological, social, and spiritual. Minimal physical restrictions, maintaining normalcy and control, information sharing, and having hope for life seemed to be critical HRQOL components. Hope for a cure and prolonging the child's life were the main reasons for enrolling in Phase 1 trials.Conclusions: Normalcy and control are key end-of-life HRQOL components, and hope for life is a main reason for participating in Phase 1 trials.
Pain management and related factors in advanced cancer patients who initiated opioid therapy in an outpatient setting
Authors: KIMURA RIEKO , HASHIGUCHI SAORI , KAWA MASAKO , MIYASHITA MITSUNORI , SASAHARA TOMOYO , SHIRAI YUKI , KAZUMA KEIKO 
Published: April 2008

Objective:The aim of this study was to clarify the state of pain management in Japanese patients with advanced cancer who initiated opioid therapy in an outpatient setting.Methods:Interview surveys using questionnaires were conducted and medical records were reviewed. Pain relief was defined as >33% decrease in worst pain intensity score, and significance of early pain relief was investigated in terms of changing self-efficacy for activities of daily living (ADL). Factors related to early pain relief were also investigated.Results:The study was conducted between June and December 2003, on 20 patients (13 women, 7 men; mean age, 59 years). Compared to score at initiation of opioid administration (Numerical Rating Scale, 8.3 ± 1.3), pain relief was generally insufficient at 2 weeks (early pain relief ratio was only 42%). Patients with sufficient pain relief at 2 weeks displayed significant improvements in numerous ADL functions and symptom-coping efficacy (p= 0.037), confirming the importance of early pain relief. Early pain relief was associated with high frequency of hospital visits before opioid administration and absence of sudden excavation within the first 2 weeks.Significance of results:Result of this study indicated insufficient pain relief at an outpatients setting with advanced cancer patients. In the meantime, patients had who their pain decrease after 2 weeks also had improved ADL and self-efficacy at the same time. These findings suggest that to achieve early pain relief in an outpatient setting, clinical staff must assess pain earlier and inform patients of possible breakthrough pain following opioid administration and available treatments for such occurrences.
Collective soul: The spirituality of an interdisciplinary palliative care team
Authors: SINCLAIR SHANE , RAFFIN SHELLEY , PEREIRA JOSE , GUEBERT NANCY 
Published: April 2008

Objective:Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals (HCP) experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care.Methods:A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit (TPCU) in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and/or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.Results:Initially participants struggled to define spirituality. Concepts of spirituality relating to integrity, wholeness, meaning, and personal journeying emerged. For many, spirituality is inherently relational. Others acknowledged transcendence as an element of spirituality. Spirituality was described as being wrapped in caring and often manifests in small daily acts of kindness and of love, embedded within routine acts of caring. Palliative care served as a catalyst for team members' own spiritual journeys. For some participants, palliative care represented a spiritual calling. A collective spirituality stemming from common goals, values, and belonging surfaced.Significance of results:This was the first known study that focused specifically on the exploration of a collective spirituality. The culture of palliative care seems to foster spiritual reflection among health care professionals both as individuals and as a whole. While spirituality was difficult to describe, it was a shared experience often tangibly present in the provision of care on all levels.
The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project
Authors: MIDTGAARD JULIE , TVETERÅS ANDERS , RØRTH MIKAEL , STELTER REINHARD , ADAMSEN LIS 
Published: April 2008

Background:Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship.Objective:This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project.Methods:Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale—HADS). Patient statements were selected that best illustrated trends found in the statistical material.Results:There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression.Significance of research:Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.
Art therapy improves coping resources: A randomized, controlled
study among women with breast cancer
Authors: ÖSTER INGER , SVENSK ANN-CHRISTINE , MAGNUSSON EVA , THYME KARIN EGBERG , SJÕDIN MARIE , ÅSTRÖM STURE , LINDH JACK 
Published: April 2008

Objective: Women with breast cancer suffer from considerable
stress related to the diagnosis, surgery, and medical treatment. It is
important to develop strategies to strengthen coping resources among these
women. Research in art therapy has shown outcomes such as an increase in
self-esteem and cohesion, significant improvement in global health, and a
decrease in anxiety and depression. The aim of the present article was to
describe the effects of an art therapy intervention program on coping
resources in women with primary breast cancer.Method: In this article, we report some of the results from a
study including 41 women, aged 37–69 years old, with nonmetastatic
primary breast cancer, referred to the Department of Oncology at
Umeå University Hospital in Sweden for postoperative radiotherapy.
The women represented various socioeconomic backgrounds. They were
randomized to a study group (n = 20) with individual art therapy
for 1 h/week during postoperative radiotherapy or to a control group
(n = 21). The article focuses on changes in coping resources, as
measured by the Coping Resources Inventory (CRI) before and 2 and 6 months
after the start of radiotherapy. The study protocol was approved by the
Umeå University Ethical Committee at the Medical Faculty (archive
number 99–386).Results: There was an overall increase in coping resources
among women with breast cancer after taking part in the art therapy
intervention. Significant differences were seen between the study and
control groups in the social domain on the second and third occasions.
Significant differences were also observed in the total score on the
second occasion.Significance of results: This study shows that individual art
therapy provided by a trained art therapist in a clinical setting can give
beneficial support to women with primary breast cancer undergoing
radiotherapy, as it can improve their coping resources.
The physician's role in the assessment and treatment of spiritual distress at the end of life
Authors: BROWN ANTHONY E. , WHITNEY SIMON N. , DUFFY JAMES D. 
Published: April 2008

Objective:Patients at the end of their life typically endure physical, emotional, interpersonal, and spiritual challenges. Although physicians assume a clearly defined role in approaching the physical aspects of terminal illness, the responsibility for helping their patients' spiritual adaptation is also important.Methods:This article (1) describes the terms and definitions that have clinical utility in assessing the spiritual needs of dying patients, (2) reviews the justifications that support physicians assuming an active role in addressing the spiritual needs of their patients, and (3) reviews clinical tools that provide physicians with a structured approach to the assessment and treatment of spiritual distress.Results:This review suggests that physicians can and should be equipped to play a key role in relieving suffering at the end of life.Significance of results:Physicians can help their patients achieve a sense of completed purpose and peace.
Development of a spiritual pain assessment sheet for terminal cancer
patients: Targeting terminal cancer patients admitted to palliative care
units in Japan
Authors: TAMURA KEIKO , ICHIHARA KAORI , MAETAKI EIKO , TAKAYAMA KEIKO , TANISAWA KUMI , IKENAGA MASAYUKI 
Published: April 2008

Objective: This research explores the potential benefit of a
spiritual pain assessment sheet to clinical practice. With spiritual pain
defined as “pain caused by extinction of the being and meaning of
the self,” the spiritual pain assessment sheet was developed by
Hisayuki Murata from his conceptual framework reflecting the three
dimensions of a human being as a being founded on temporality, a being in
relationship, and a being with autonomy. The assessment sheet was
developed from reviews of the literature and examinations from a
philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan
were interviewed using the assessment sheet. The responses were analyzed
qualitatively. The usefulness of the assessment sheet and the burden
placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment
sheet was the same as that revealed in the earlier research of Morita. The
patients reported that they did not find the use of the assessment sheet a
burden, and more than half reported that it was useful. The burden of the
assessment sheet on the subjects was thus determined to be low. Positive
feedback on the assessment sheet was also received from the nurses who
conducted the patient interviews, who said the assessment sheet made it
easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that
the spiritual pain assessment sheet provided an appropriate assessment of
spiritual pain among terminal cancer patients, showing that such a sheet
could be used as an assessment tool in the future.
BEYOND BLACK AND WHITE: Racial Conflict in the New Multi-ethnic City
Authors: Fox Cybelle 
Published: April 2008

Claire Jean Kim,Bitter Fruit: The Politics of Black-Korean Conflict in New York City. New Haven: Yale University Press, 2000, 300 pages, ISBN 0-300-07406-9, $45.00.Jennifer Lee,Civility in the City: Blacks, Jews, and Koreans in Urban America. Cambridge: Harvard University Press, 2002, 270 pages, ISBN 0-674-00897-9, $35.00.In-Jin Yoon,On My Own: Korean Businesses and Race Relations in America. Chicago: Chicago University Press, 1997, 274 pages, ISBN 0-226-959279-9, $45.00.During the past decade, scholars of ethno-racial relations have increasingly grappled with the thorny issue of Black-Korean conflict. This attention is no doubt the result of a number of high profile, sometimes violent, and often prolonged clashes between Blacks and Koreans in large urban settings. On January 18, 1990, an incident between a Black customer and a Korean storeowner at the Family Red Apple Inc. grocery store touched off a yearlong boycott of two Korean businesses in the Flatbush section of Brooklyn, NY. The 1992 Los Angeles Rebellion, which was originally sparked by the acquittal of four White police officers accused of beating Black motorist, Rodney King, led to three days of looting, arson, and violence. The event quickly became framed in terms of a conflict between Blacks and Koreans, however, as Koreans owned more than half of the stores that were burned or looted. While the evidence of real and often acute tensions between these groups is irrefutable, in many instances the media has tended to distort the nature, scale, and significance of the clashes by over-dramatizing Black-Korean conflict (Lee 2002), obfuscating Korean-Latino conflict (Bobo et al., 1994; Oliver et al., 1993), and ignoring and therefore silencing Korean voices (Abelmann and Lie, 1995). Thankfully, careful, scholarly analyses of these incidents and the tensions that precipitate them are starting to emerge.Civility in the City,Bitter Fruit, andOn My Ownare some of the best recent examples of this new literature and are each valuable attempts to increase understanding about the nature of merchant-customer relations in predominantly Black urban neighborhoods.
ALL THINGS EQUAL?
Authors: Sanders Lynn M. 
Published: April 2008

Michael K. Brown, Martin Carnoy, Elliott Currie, Troy Duster,
David B. Oppenheimer, Marjorie M. Shultz, and David Wellman,
Whitewashing Race: The Myth of a Color-blind Society.
Berkeley: University of California Press, 2003, 349 pages, ISBN
0-520-23706-4, $27.50.Paul M. Sniderman and Thomas Piazza, Black Pride and
Black Prejudice. Princeton: Princeton University Press, 2002, 192
pages, ISBN 0-691-09261-3, $24.95.These two texts represent a somewhat unlikely pairing. What could an
empirically detailed but wide-ranging, really indignant indictment of
new right-wing homilies about racial politics—that's
Whitewashing Race—have in common with what inquiring
minds want to know about Black Pride and Black Prejudice, a
carefully stepping report of results mostly from a 1997 survey, posing
and answering such questions as whether African Americans share the
“larger culture's” values, succumb to conspiratorial
thinking, or are anti-Semitic? At the level of pure geography trivia,
it so happens that all of the authors involved in generating these new
books have some claim to Northern California roots or associations. But
beyond that, do they have anything in common?
THE COMPLEXITY OF RACIAL ATTITUDES: Continuing Progress or the Calm Before the Storm?
Authors: Hutchings Vincent L. 
Published: April 2008

Carol M. Swain,The New White Nationalism in America: Its Challenge to Integration. Cambridge: Cambridge University Press, 2002, 526 pages, ISBN 0-521-80886-3, $30.00.Paul M. Kellstedt,The Mass Media and the Dynamics of American Racial Attitudes. Cambridge: Cambridge University Press, 2003, 174 pages, ISBN 0-521-82171-1, $60.00.Carol M. Swain's book,The New White Nationalism in American: Its Challenge to Integration, is an ambitious and, in many ways, novel blend of traditional social science and social advocacy. At the outset, Swain informs the reader that this book breaks with “… the tradition of impersonal, value-free social science insofar as I do not pretend to be neutral and do not hesitate to interject many personal observations and comments into the body of the text.” She does not disappoint on this score. This nearly 500-page book combines original interviews and survey and focus group data, with Swain's reflections on a range of topics including reparations, affirmative action, racial hate crimes, and the redemptive power of religion. To Swain's credit, she also steps outside her role as a (nominally) dispassionate social scientist to offer a range of policy prescriptions near the end of her book to combat what she views as the potentially alarming growth of the White power movement. In many ways, Swain's passion for her subject is refreshing, and even commendable. Unfortunately, her passion is also the source of the principal weakness of this book: its inability to match its uncompromising rhetoric with persuasive, or even plausible, supportive evidence for readers who do not already agree with her arguments.