A phase II trial of aclacinomycin-A in advanced squamous cell carcinoma of the head and neck

Sixteen patients with advanced squamous cell carcinoma of the head and neck were entered into a phase II trial of Aclacinomycin-A (ACM), 100 mg/M 2 administered by brief infusion every three weeks. All patients had received prior radiation therapy and prior non-anthracycline containing chemotherapy. No clinically significant disease regression was observed in fourteen patients having adequate trials. The major toxicity was myelosuppression; leukopenia occurred in 93% of patients. Gastro-intestinal toxicity was mild and included two patients with transient liver function test abnormalities. No antitumor activity was observed in this patient population which was heavily pre-treated and had a median Karnofsky performance status of only 60%. The results of other phase II trials of ACM-A have been similarly disappointing suggesting that it is not a clinically useful agent in the treatment of solid tumors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45289/1/10637_2004_Article_BF00170763.pd

Phase II trial of methylglyoxal bis-guanylhydrazone (MGBG) in refractory small cell lung cancer

Methylglyoxal bis-guanylhydrazone (MGBG), a potent inhibitor of polyamine synthesis, has demonstrated single agent activity against a number of tumor types including malignant lymphomas and head and neck, esophageal and non-small cell lung cancers. The growth of small cell lung cancer (SCLC) cell lines can be arrested by polyamine inhibition. Therefore a phase II trial was conducted in twenty-four patients with refractory SCLC. MGBG was administered by intravenous infusion at a dose of 500 mg/m 2 per week for four cycles and then every two weeks thereafter. The dose was escalated by 100 mg/m 2 every two weeks in the absence of toxicity ⩾ grade 2. One patient achieved a partial response of objectively measurable lung disease and supraclavicular adenopathy. Three patients had stable disease. Dose limiting toxicity consisted primarily of mild to moderate nausea, vomiting, stomatitis and/or diarrhea. Myelosuppression was uncommon and rarely dose limiting. We conclude that MGBG in the dose and schedule used does not have significant activity as a single agent in previously treated small cell lung cancer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45354/1/10637_2004_Article_BF00171989.pd

Stress, Social Support, and Negative Interaction in Later Life

The aim of this research is to examine the impact of stress on supportive social relationships in later life. Although a number of researchers propose that exposure to life stress increases the amount of assistance provided by significant others, findings from studies with older adults are equivocal. Three potential explanations for these contradictory findings are examined. The results, which are based on a nationwide survey of older people, reveal that the relationship between stress and social support is contingent upon the nature of the stressor as well as the source of support. It was further predicted that negative interaction would play an important role in this process, but consistent findings failed to emerge from the data. The theoretical implications of these findings are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68683/2/10.1177_0164027591133004.pd

Clarifying the Functions of Social Support in Later Life

Research on the stress-buffering properties of social support contains a number of contradictory findings. At least part of this problem may be attributed to the fact that researchers have not developed a well-articulated theory explaining how social support functions in later life. Based on recent developments in identity theory, evidence is presented which suggests that emotional support tends to reduce the deleterious effects of some types of stress (i.e., events arising in salient social roles) but not others (i.e., stressors that emerge in roles that are valued less highly). This theoretical framework is extended by showing that social support operates at least in part by bolstering feelings of control and self-worth that have been eroded by stressful experiences. However, the data indicate that these beneficial effects are restricted to feelings of control and self-esteem that are associated with the same roles in which the stressors emerged.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68722/2/10.1177_0164027594163002.pd

From Participation to Co-production: Widening and Deepening the Contributions of Citizens to Public Services and Outcomes

In recent decades, governments have increasingly accepted the need to engage citizens in public decision-making and public services. This chapter traces the sources of this increased interest in public participation and user and community co-production. Our research suggests that they are important but still under-appreciated by policymakers. While public participation can be effective, even in countries where democracy is still not strong it is not always positive. Similarly, recent research demonstrates that public services are already partly co-produced, as this is not sufficiently recognised by public services, co-production is not being harnessed systematically. More empirical research is needed into what kind of co-production is actually occurring (where, by whom and how?), how it could be further incentivised, and what are its benefits and limitations. In recent decades, governments have increasingly accepted the need to engage citizens in public decision-making and public services. This chapter traces the sources of this increased interest in public participation and user and community co-production. Our research suggests that they are important but still under-appreciated by policymakers. While public participation can be effective, even in countries where democracy is still not strong it is not always positive. Similarly, recent research demonstrates that public services are already partly co-produced, as this is not sufficiently recognised by public services, co-production is not being harnessed systematically. More empirical research is needed into what kind of co-production is actually occurring (where, by whom and how?), how it could be further incentivised, and what are its benefits and limitations