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What Is Market America?
By: Tom Childs
Market America is a dynamic and innovative product brokerage and Internet marketing company specializing in One-to-One Marketing and Mass Customization. They are a thriving multinational corporation with annualized retail revenues approaching $400 million and over 125,000 Distributors worldwide. MORE...
Critical Closing Criteria
Structuring Your Business Properly
10 Things You MUST Do to Drive Massive Traffic to Your Local Small Biz Website
11 Free and Low Cost Marketing Strategies to Turnaround a Cash-Strapped Business
8 Mistakes to Avoid When Naming a Business
Make The Leap To Affiliate Marketing Success!For the HND students, here is a copy of a Research Project Proposal. Albeit, it's not business related but this will give you an idea on how to make your Project Proposal.
Relevance Statement
Practitioners of conventional medicine have justifiably criticized most complementary/alternative medical (CAM) therapies for the relative lack of peer reviewed scientifically conducted analysis. Nevertheless, use of these therapies has increased so dramatically in the US and Europe, that it is unwise for medical science to continue to ignore this potentially harmful situation (Cassileth & Chapman, 1996a; Downer, et al., 1994). Documented use of complementary/alternative therapies in both oncology and non-oncology patients is estimated to be as high as 45% (Cassileth & Chapman, 1996a; Downer, et al., 1994; Eisenberg, et al., 1993; Munstedt, Kirsch, Milch, Sachsse & Vahrson, 1996).
Although several studies on use of complementary therapies in cancer patients have been carried out in North America and Northern European countries, there is a shortage of reliable information about the types of therapies being used, the cost of these therapies, how patients are referred to these therapies, and the reasons for choosing to use complementary therapies. Pervious studies indicate that users tend to be younger, of higher social class and are more likely to be women (Bennett & Lengacher, 1999; Downer, et al., 1994). Therefore, an in-depth study of the patterns of use of complementary therapies in a selected group of women with breast cancer could answer many of these questions.
First this study has relevance to the treatment of breast cancer because it is critical to identify current patterns of use of CAM, to provide information needed to help patients avoid possible harmful side effects and medication interactions. Once patterns of use are identified, the scientific community can examine specific CAM therapies for efficacy, which could impact survival and quality of life.
Second this study has relevance in that although increases in use of individual CAM have been cited in the literature, patterns of use in breast cancer patients has not been adequately documented. Criticisms are related to lack of or improper evaluation of CAM, the practice of some CAM providers discouraging or preventing patients from seeking appropriate medical treatment, potentially harmful side effects from some CAM, and some providers preying on desperate patients.
Third, this study has relevance in that it will show the impact of increasing out of pocket expenses for CAM treatments and insurance coverage costs. Some of the CAM is relatively cost effective, i.e, relaxation guided imagery tapes, and others may be quite costly.
Fourth, this study has relevance in that it will help identify reasons women with breast cancer seek out complementary and alternative therapies, and their relative satisfaction with the specific CAM therapies they have tried. Information from this study will assist traditional medicine to learn more about effective CAM and to offer more integrative services. Results of this study will provide data for further testing of specific therapies, which will give new empirical evidence on the safety and efficacy of these therapies.
Documenting the use, reasons for use, patient reports of benefits gained, and costs of CAM in a group of women with breast cancer can serve as a guide for future studies. Documenting commonly used therapies that are not found to be helpful for women with breast cancer will guide us in patient teaching and help us ask appropriate questions during the admission examination. On the other hand, cost-effective and non-harmful CAM therapies may well prove to have a role in the medical treatment plan by relieving psychological and physical symptoms of cancer, controlling side effects from conventional therapy, and helping patients gain a sense of control while living with breast cancer.
Review of Literature
Background
Alternative/complementary therapies have recently become a multimillion business in the US and several European nations, with many patients paying more in out-of-pocket costs for these treatments than they do for standard medical care. The use of these therapies generate questions related to inadequate evaluation of the costs, risks, and benefits of specific therapies, along with problems related to possible suppression of effective conventional therapies and motivation for profits received from desperate persons seeking self-healing (Brigden, 1995; Guzley, 1992; Fletcher, 1992). Given the ever increasing numbers of herbs, supplements and non-conventional substances that are on the market, knowing which ones our patients are likely to be using and the probable side effects associated with these “popular” supplements will greatly assist health care providers to provide appropriate patient education on this topic, as well as altering us to watch for known side effects and medication interactions (Montbriand, 1999; Zaloznik, 1994).
Trends in Use of Alternative Medicine
Use of alternative therapies has increased in the general population from 33.8% in 1990 to 42.1% in 1997 (Eisenberg, et al., 1998). Complementary/alternative medicine (CAM) has been reported to be used by 25%-50% of the general population as identified in industrialized nations (Cassileth & Chapman, 1996a; Eisenberg, et al., 1993; Lerner & Kennedy, 1992). The reasons for increasing use are very complex, but increased consumer demand for more choice and control, and an increased growth in availability and variety of types of therapies are identified to be factors. In addition, increased use could be reflected in an increasing number of insurers and managed care organizations which offer programs and benefits (Blais, Maiga & Aboubacar, 1997; Eisenberg, et al., 1998). Use can be related to social and cultural reasons, however lack of hope for a medical cure is frequently a primary motivation (Downer, et al., 1994). In two studies of “unconventional medicine” in the United States, most persons reported using non-conventional treatment for non-life threatening chronic conditions, for which there may be no effective medical treatment (Cassileth & Chapman, 1996a; Eisenberg, et al., 1993). The cost of this use of CAM is significant. From the first study completed in 1993 to the second in 1997, there was a 45.2% increase in estimated expenditures for alternative medicine professional services, with an estimate of $12.2 billion paid out of pocket, which was estimated to exceed 1997 out-of pocket expenditures for all hospitalizations. However, many of the studies cited above were not aimed at, nor limited to, persons with cancer (Eisenberg, et al., 1998).
Trends in Use with Oncology Patients
A variety of methods have been used in the past in an attempt to determine complementary/alternative therapy use among persons with cancer. Early studies, while providing some information on the use of alternative therapy, frequently were biased by focusing on what the researchers termed “unorthodox, unconventional or questionable” cancer cures, and did not adequately document participants’ use of complementary therapies to improve well-being and quality of life. Many of these early studies considered a therapy “orthodox” if it was used to improve mental well-being, decrease pain, or improve quality of life, but treated the same therapy as “unorthodox” if the intent was also to improve the physical well-being of the person with cancer (Cassileth, Lusk, Strouse & Bodenheimer, 1984). In a study using a self-developed interview to determine the use of “unorthodox” cancer therapies among US persons with cancer 43% of the participants used conventional therapy alone, 8% used unorthodox therapy alone, and 49% used a combination of conventional therapy and unorthodox treatment. The most popular unorthodox treatments were metabolic therapy 42%, diet therapy 35%, megavitamin therapy 24%, imagery 24%, spiritual/faith healing 19%, and immune therapy (injecting various substances to boost immune function) 15%. Most persons were using more than one type of unorthodox therapy, combined with conventional medical treatment (Cassileth, et al., 1984). The early studies in this area reported that use of alternative therapies among cancer patients range from 9%-50%. However there is indication that these estimates may be low, because patients are reluctant to report use of unconventional therapies. Unconventional alternative therapy methods appeal to patients with advanced stage cancer primarily to improve their quality and length of life (Caudell, 1996; Mahon, Cella & Donovan, 1990). There is also evidence to suggest that oncologists may have less negative attitudes towards use of complementary therapies today, than previously (Andritzky, 1995).
In a review of 21 studies, the range of use in cancer patients was from 7% to 64%. Major problems identified were inconsistent definitions of CAM, with some studies counting conventional psychological methods such as group therapy as CAM, and few studies differentiated between therapies used in an adjunctive mode and those applied towards cure, exclusive of mainstream treatment. Future research needs to center itself on clarifying distinctions between potential harmful alternative cures and potentially beneficial therapies that can be used to as adjuncts to cancer treatment, thus relieving symptoms of cancer or control treatment side effects. In addition, more standardization of questions is needed, to generate more comparable data. In an attempt to increase standardization, items on the instrument used in this study (CTRS II) were taken from the list of complementary/alternative treatments published by Office of Alternative Medicine, National Institute of Health (Bennett & Lengacher, 1998; Bennett & Lengacher, 1999).
Use of CAM in Breast Cancer
An early study of unorthodox treatments in cancer medicine identified that 32% of the breast cancer patients surveyed used conventional along with unorthodox therapies. Persons with breast cancer were the highest users of combined CAM and orthodox treatments in the malignant diseases assessed. Breast cancer was second compared to genitourinary in using unorthodox treatment alone: 23% compared to 30%. In this study, the largest percentage of users of both conventional and unorthodox treatments was women, 68% compared to men (32%) (Cassileth, et al., 1984).
One of the most recent studies was completed in Europe, in which use was examined while attending conventional treatment (Crocerri, et al., 1998). Results from 242 responders showed that 16% were using complementary therapies (CT) one year after diagnosis, compared to 8.7% before diagnosis with breast cancer. The main reason for using CT was physical distress. The most common CAM was homeopathy, manual healing, herbalism and acupuncture. However, rates of use of specific CAM therapies, their usefulness and their cost in the treatment of women with breast cancer has not been well documented.
Theoretical Framework
The theory of reasoned action (Ajzen, 1980) provides a conceptual framework within which to consider the use of complementary therapies by persons with cancer. The theory of reasoned action examines the relationships among subject attitudes, subjective norms, intentions and behaviors. According to the theory, behavior is the result of a specific behavioral intention. In this study, a participant's positive response toward a specific complementary therapy will be regarded as a behavioral intention. A behavioral intention is determined by the attitude toward the behavior and the subjective norm regarding that behavior. A participant's intention to use a complementary therapy is a function of attitude, which can be positive or negative. Attitudes reflect the participant's beliefs about the consequences of participating in the behavior, and evaluations of these consequences. For example, if a participant believes that a specific complementary therapy will help in coping with the disease, the attitude towards that therapy is positive. In addition to attitudes, subjective norms also play a part in the decision making process. Subjective norms are perceptions of what important others are perceived to think about a certain subject. For example, if a participant believes that significant others approve of the choice to participate in a particular complementary therapy, there will be a stronger intention to participate in the therapy. Both attitudes and subjective norms play a part in the development of a behavioral intention. In this study, the Complementary Therapy Rating Scale II (CTRSII) will be used to measure the behavioral intentions of rural persons with cancer towards the use of various complementary therapies.
Methods
This study will use a descriptive, cross-sectional survey design to determine patterns of use of complementary therapies among women with breast cancer. The CTRS II will be distributed to women with breast cancer using a variety of methods, including face to face interview format, phone interview format, and mail surveys for those whom it is not possible to reach using the first two formats. Research assistants for data collection will be recruited from Indiana State University nursing students, as well as oncology staff nurses serving in various hospitals and clinics. The primary researcher will oversee the research process, data coding, data base development, conduct data analysis, and be responsible for the final version of the study report. This will be facilitated by Indiana State University releasing the PI for 10% time as in-kind support. The part-time graduate assistant hired with grant funding will coordinate and facilitate institutional review for the various institutions, data collection, data coding and data entry into the SPSS database.
Sample Description and Inclusion
Criteria A sample of 100 women diagnosed with breast cancer will be recruited from the Inclusion criteria include a clinical diagnosis of breast cancer, all stages of breast cancer and all ages will be included. Participants must have been diagnosed for at least 6 months for inclusion into this study. Participants must be able to speak and understand English well enough to answer the survey questions. Survey data obtained will be linked to the Comprehensive Breast Cancer Data Base.
Procedures for Subject Recruitment, Timeline, and Informed Consent
In the first 3 months of this study, local physicians, nursing staff on oncology units and oncologists will be contacted and asked to assist in this study by allowing our research team to either distribute surveys through their offices, or by posting information concerning our study where appropriate subjects can learn of the study and call for more information. Community support groups for persons with cancer will also be contacted, and asked to assist the researchers in locating appropriate subjects for this study. Snowball subject recruitment methods will also be utilized, where subjects with breast cancer will be asked to pass along study contact information to other persons with breast cancer whom they believe would like to participate. Research subjects will receive a gift basket of self-care items in appreciation of their time and effort spent on this project. Community data collectors not employed by ISU (staff nurses and/or nursing students), will be paid $10 per complete survey form collected, to compensate them for the time involved in subject recruitment and interviewing. Data collection is estimated to take a total of 9 months. Data analysis and the study report will be written in the final 3 months of this 1 year project. A project update will be mailed to the funding agency 6 months into the study. Informed consent will be obtained from all participants, Data will be treated as confidential and only reporting of group data will occur. Each person’s name will be kept confidential, and surveys will be coded to allow survey results to be linked to the Comprehensive Breast Program’s Data Base.
Instrument/Study Measures
The survey instrument to be used in this study is an enhanced version of the Complementary Therapy Rating Scale, which was used in the earlier investigations (Bennett & Lengacher, 1998; Bennett & Lengacher, 1999). See appendix B for copies of articles. Using standardized classifications of complementary therapies from the Office of Alternative Medicine, several new categories have been added to this instrument. Reliability data for the previously published version of the Complementary Therapy Rating Scale was .86 using odd-even split half reliability and .77 using coefficient alpha. The scale has been revised in an effort to obtain more complete data for this study. Additional questions concerning reasons for using CAM, cost of use, and if the patient had informed their physician about their use of CAM have been included. In addition, questions related to patient recommendations for CAM use, how helpful specific CAM therapies are, who provides the CAM treatment and satisfaction with both conventional and CAM therapies have been added.
Preliminary data and plan for dissemination of results of this study
The earlier version of the CTRS was developed and tested in a sample of rural Midwestern cancer patients. The CTRS has subsequently been published (Bennett & Lengacher, 1998), as have the preliminary results obtained with it (Bennett & Lengacher, 1999). However, the original CTRS did not elicit data on use of specific herbal treatments or other alternative therapy options. These treatments tend to be some of the most dangerous and further information is needed on the use of these items. In addition, this study will elicit patient evaluation of specific therapy usefulness, cost of therapy, physician disclosure, and reasons for use of these therapies. The revised instrument adapted for this study will allow for collection of this important data. Results of this study will be disseminated as were the results of our earlier studies: on the internet via the primary researcher’s webpage, through research and community presentations, and will be submitted for publication in an appropriate research journal. The data will also be added to data in the larger study being conducted at the Lee Moffitt Cancer and Research Institute in Tampa Florida.
References
Abu-Realh, M., Magwood, G., Narayan, M., Rupprecht, C., & Suraci, M. (1996). The use of complementary therapies by cancer patients. Nursing Connections, 9(4), 3-12.
Andritzky, W. (1995). [Medical students and alternative medicine a survey]. Gesundheitswesen, 57(6), 345-348.
Beinfield, H., & Beinfield, M. (1997). Revisiting accepted wisdom in the management of breast cancer. Alternative Therapies in Health and Medicine, 3(5), 35-53.
Bennett, M., & Lengacher, C. (1998). Design and testing of the Complementary Therapy Rating Scale. Alternative Health Practitioner, 4(3), 179-198.
Bennett, M., & Lengacher, C. (1999). Use of complementary therapies in a rural cancer population. Oncology Nursing Forum, 26(8), 1287-1294.
Blais, R., Maiga, A., & Aboubacar, A. (1997). How different are users and non-users of alternative medicine? Canadian Journal of Public Health, 88(3), 159-162.
Brigden, M. (1995). Unproven (questionable) cancer therapies. Western Journal of Medicine, 163(5), 463-469.
Cassileth, B., & Chapman, C. (1996a). Alternative cancer medicine: A ten-year update. Cancer Investigations, 14(4), 396-404.
Cassileth, B., Lusk, E., Strouse, T., & Bodenheimer, B. (1984). Contemporary unorthodox treatments in cancer medicine. Annals of Internal Medicine, 101, 105-112.
Caudell, K. (1996). Psychoneuroimmunology and innovative behavioral interventions in patients with leukemia. Oncology Nursing Forum, 23(3), 493-502.
Crocerri, E., Crotti, N., Feltrin, A., Ponton, P., Geddes, M., & Buiatti, E. (1998). The use of complementary therapies by breast cancer patients attending conventional treatment. European Journal of Cancer, 56(3), 324-328.
Downer, S., Cody, M., McClus, P., Wilson, P., Arnott, S., Lister, T., & Slevin, M. (1994). Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment. British Medical Journal, 309, 86-89.
Eisenberg, D., Davis, R., Ettener, S., Appel, S., Wilkey, S., Van Rompay, M., & Kessler, R. (1998). Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. JAMA, 280(18), 1569-1575.
Eisenberg, D., Kessler, R., Foster, C., Norlock, F., Calkins, D., & Delbanco, T. (1993). Unconventional medicine in the United States: Prevalence, costs, and patterns of use. The New England Journal of Medicine, 38, 246-252.
Fletcher, D. (1992). Unconventional cancer treatments: Professional, legal, and ethical issues. Oncology Nursing Forum, 19(9), 1251-1354.
Guzley, G. (1992). Alternative cancer treatments: Impact of unorthodox therapy on the patient with cancer. Southern Medical Journal, 85(5), 519-523.
Lerner, I., & Kennedy, B. (1992). The prevalence of questionable methods of cancer treatment in the United States. CA - A Cancer Journal for Clinicians, 42(3), 181-191.
Mahon, S., Cella, D., & Donovan, M. (1990). Psychosocial adjustment to recurrent cancer. Oncology Nursing Forum, 17(3), 47-52.
Montbriand, M. (1999). Past and present herbs used to treat cancer: Medicine, magic, or poison? Oncology Nursing Forum, 26, 49-60.
Munstedt, K., Kirsch, K., Milch, W., Sachsse, S., & Vahrson, H. (1996). Unconventional cancer therapy--survey of patients with gynaecological malignancy. Archives of Gynecology and Obstetrics, 258(2), 81-88.
Zaloznik, A. (1994). Unproven (unorthodox) cancer treatments: A guide for healthcare professionals. Cancer Practice, 2(1), 19-24.
I have recently opened my blog account with http://www.blogger.com . Once you have registered for a Gmail account http://www.gmail.google.com (Google's free email service), it will be easier to access Blogger. You can open your Gmail account and click the services located at the upper left corner of your computer screen. A new window will open where you can choose several services that Google provides. You can click Blogger and you will be automatically directed to the Blogger.com homepage.
To be able to have access with Blogger.com, you will be required to register. Don't worry because unlike other free blog service providers, Blogger has designed the registrations to be fast and convenient. In fact, you can even register a blogger account even without a Gmail account. However, if you plan to use most of the great services of Google, it's advisable that you open an account with Gmail.
Operating a blog with Blogger is easy and fun. Once you are done with your registration for a Blogger account, you will be directed to the dashboard where you can edit and design your blog according to your preference. I suggest that you spend sometime navigating the dashboard to learn and familiarise yourself with the available features.
You will find lots of free resume / CV writing advice and tips on these pages so please bookmark this site now so that you can return to it in the future. On my other pages you will find tips and advice on how you can successfully find a job and handle interviews, links to over 200,000 jobs and much more.
All that hard work sending out résumés has finally paid off and you've been called in for a face-to-face job interview. Congratulations! This is an important next step in your job search. It's also your only chance to make a lasting first impression.
Interviewing is like being selected to compete in the Olympics: you have outperformed hundreds or thousands of competitors and are down to the final round. You are now competing with the best of the best. How can you leave with the gold? Here are keys to making your interview a day for the champion.
Research your company. How can you convincingly show interest in a position that will take approximately 25% of the hours in your week with no knowledge of the general job description, the company, its goals, or its current events? You can't. Here is how to understand the company with which you will be interviewing:
For every company, you want the following company information checklist:
The Handshake. It tells a story about each person. Do you come from the top and give the power handshake? Do you shake hands very lightly? These examples may seem simple, but it is easy to start off poorly with a bad handshake. Avoid the light delicate handshake and the powerful over-the-top controlling handshake. Give a firm, full-handed handshake with members of both sexes.
Prepare yourself but do not memorize. If you try to memorize a response to the question, "What is your biggest strength?" you will blurt it out, privately congratulating yourself on your memory while the interviewer stares in disbelief at how quickly you answered that question without seeming to give it much consideration. When your interviewer follows with "Why do you consider that your biggest strength?" you realize that you were not prepared for that one. Instead, think of some challenges in your work background -- positive and negative -- and tie your answer to those challenges, your response, and the results. For example,
Now when asked "What is one of your biggest strengths?" your response might be: "My biggest strength is my ability to identify potential problem areas, solve the problem, and produce results. An example of this would be when my division's productivity decreased and it seemed as though we would not meet/exceed our annual goals..." and continue with the story above.
This same scenario would also work if the interviewer had asked, "Describe a difficult situation and how you handled it" or "What would management say about you?" Thinking through specific situations will allow you to choose scenarios most appropriate to the question.
Have questions for the interviewer. Here are some good ones:
Mental Preparation. This may seem hokey, but it is proven to be a good tactic in any high-stress situation. As you arrive early for the interview (at least 15 minutes), and you are waiting to be called in, mentally prepare for your interview. Picture the interview going smoothly, the interviewer asking questions, and your answering them perfectly. Imagine the interviewer telling you that you seem perfect for the job as you leave even more excited about the position. These are some of the things that should be going through your mind. If you are nervous, start your mental preparation by taking deep breaths and thinking "You are" as you inhale and "relaxed" as you exhale. Repeat this procedure until you are relaxed. Avoid thinking, "What if they don't like me?" or "What if I get stumped?" and focus instead on relaxing. Just try it –- mental visualization worked for the Bulls and Phil Jackson, and it will work for you.
Close of the interview. You are ahead of the competition and on your way to the gold medal, but you get a cramp. Do you stop? Not a chance. You have to cross the finish line, just as you have to close the sale of yourself in the interview. The end of the interview is your time to close with "a positive, very interested in what you have learned" close. When the Interviewer is closing with "Well, if you have no further questions, then we are done," that is your cue to say one of the following:
Follow-up. You leave the interview and feel good about the position. Now go to your car and write down what just happened. Write the topics discussed, the characteristics the interviewer described for the position, and other details. This will help you write a thank you letter that shows both your interest and that you are a perfect match for the position.
There are, of course, as many ways to succeed in an interview as there are Olympic gold medal winners. The best advice is to relax and be yourself. Remember that your interviewer once interviewed for his/her job and understands the intensity of the interview process. By being as prepared as possible for your interview, you will enhance the qualities that have already made you a great candidate. Just remember that it takes preparation and knowing how to play the game with strategy and excellence to win.
Q: I suddenly find myself back on the job market after 15 years in continuous employment. I have not had to interview in a long time and I am anxious to know how interviewing etiquette may have changed.
A: The job market may have changed, but the basics good interviewing remain the same. You only have one chance to make a positive first impression. Be prepared, with at least two copies of your resume. Have letters of reference and personal documents like photo identification and social security available in a portfolio. Arrive early so you can be on time. Introduce yourself confidently, and maintain eye contact with the interviewer throughout the interview. Listen carefully to each question, then answer as clearly and specifically as you can without going into unnecessary detail. When the interview concludes, thank the interviewer, and make sure you are clear on any required follow up and next steps. As soon as you arrive home, mail the interviewer a thank you note that is either handwritten or personally signed.
If that all sounds like a lot to ask, remember practice is the key to perfecting the art of interviewing. Set yourself up with a friend or trusted mentor to do some practice interviews, and consider applying for a wide range of jobs if you need more real interview experience. The more practice you get, the more natural you will feel in a real interview situation.
Q: I am a technical recruiter who reads hundreds of resumes every week to select people to interview. I have to make fast decisions, so if I have a hard time getting to the point of a person’s qualifications for the job it is unlikely they will be selected, even if they have the skills I am looking for. Please let your readers know that recruiters want to help, but your resume has to work for you not against you.
Is your resume working against you? Here is a basic checklist to follow every time you send out your resume to help your recruiter choose you for that interview.
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