Mitoxantrone (dihydroxyanthracenedione) is a substituted anthraquinone with a similar spectrum of activity to adriamycin in experimental tumours. One hundred and thirty-four patients with advanced ...breast cancer and no prior chemotherapy for advanced disease were treated with mitoxantrone (14 mg/m2 i.v. q 3 weeks), of whom 99 are presently evaluable for response and all for toxicity. Six patients achieved a complete response and 29 a partial response, the overall response rate being 35% (95% confidence limits, 25-45%). Median time to treatment failure was greater than 46 weeks. Mitoxantrone was well tolerated, myelosuppression being the dose-limiting toxicity. The most frequent nonhaematological toxicities were nausea and vomiting (40%), but these were rarely severe. Total alopecia occurred in only 6 patients. Four patients developed clinically significant evidence of cardiotoxicity after cumulative mitoxantrone doses of 174-256 mg/m2. Mitoxantrone offers comparable efficacy and less acute toxicity than the most active currently available single agents in advanced breast cancer.
Maslow's hierarchy of motivational needs is depicted as a pyramid; various developmental aspects of each step in the pyramid are discussed with respect to the motivation of children. This theoretical ...hierarchy starts with the basic needs for health and well-being at its base, and progresses upward. The increasingly higher needs cover: physical and mental security; social needs (love and affection); esteem (self-respect, independence); knowledge of facts; understanding of relationships among facts; aesthetic needs (art, music, simplicity); and, ultimately, self-actualization (attaining one's full potential) as the highest need. The hierarchy presents 1 approach to understanding youth and helping them motivate themselves. Special attention also is directed towards 2 kinds of incentives: intrinsic (naturally motivating) and extrinsic (incentives motivated by the gain of a reward or privilege). Motivational strategy should be such that children can adjust the level of challenge presented to exactly match their own skills. (wz)
