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Entrepreneurship involves cooperative efforts in which multiple stakeholders and resources are brought together to develop a valuable product or service. Accordingly, one key process through which entrepreneurs make progress exploiting their opportunities is by identifying, selecting, enrolling, and coordinating a network of stakeholders. However, although there is a widespread realization that bringing new ventures to life requires multiple stakeholders, precious little academic research has taken a holistic approach to stakeholder engagement. In this special issue we: (a) suggest that stakeholder theory provides a novel lens for viewing the critical entrepreneurial behavior of engaging stakeholders—and taking shared responsibility for an unmet opportunity, (b) describe the intriguing articles that encompass this special issue, and (c) offer our thoughts on directions for future research at the intersection of stakeholder theory and entrepreneurship.

Background: Parents often suffer reduced mental health after their child’s death; however, the trajectory and risk factors are not well described. Objective: Describe the change in complicated grief, depression, and post-traumatic stress symptoms among parents between 6 and 13 months after their child’s death in a pediatric intensive care unit (PICU), and factors associated with 13-month symptoms. Methods: Parents whose children died in 1 of 8 PICUs affiliated with the Collaborative Pediatric Critical Care Research Network completed surveys 6 and 13 months after their child’s death. Surveys included the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-8 (PHQ-8) for depression, and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT). Parents provided sociodemographics. Charts were reviewed for child characteristics. Results: One-hundred and fifty seven parents of 104 deceased children completed surveys at both time points. Mental health symptoms declined over time (mean (SD)): ICG (33.8 (15.4) vs. 30.5 (15.2), p < 0.001), PHQ-8 (9.0 (6.4) vs. 7.3 (5.8), p < 0.001), and SPRINT (14.1 (8.3) vs. 12.0 (8.2), p < 0.001). After controlling for 6-month scores, higher 13-month ICG was independently associated with sudden unexpected death; higher PHQ-8 with Black race, insecure attachment style, and sudden unexpected death; and higher SPRINT with having a high school level of education (compared to college degree or higher). Conclusion: Mental health symptoms improve among parents during the first 13 months after their child’s death; however, symptoms persist for many. Black parents and those whose children die suddenly may be high risk for poor adjustment during bereavement.

Despite many calls, functional brain magnetic resonance imaging (fMRI) studies are relatively rare in the domain of entrepreneurship research. This methodological brief presents the brain-imaging method of resting-state fMRI (rs-fMRI) and illustrates its application in neuroentrepreneurship for the first time. In contrast to the traditional task-based fMRI approach, rs-fMRI observes the brain in the absence of cognitive tasks or presentation of stimuli, which offers benefits for improving our understanding of the entrepreneurial mind. Here, we describe the method and provide methodological motivations for performing brain resting-state functional neuroimaging studies on entrepreneurs. In addition, we illustrate the use of seed-based correlation analysis, one of the most common analytical approaches for analyzing rs-fMRI data. In this illustration, we show that habitual entrepreneurs have increased functional connectivity between the insula (a region associated with cognitive flexibility) and the anterior prefrontal cortex (a key region for explorative choice) as compared to managers. This increased connectivity could help promote flexible behavior. Thus in brief, we provide an exemplar of a novel way to expand our understanding of the brain in the domain of entrepreneurship. We discuss possible directions for future research and challenges to be addressed to facilitate the inclusion of re-fMRI studies into neuroentrepreneurship.

Objective: Organizational health equity capacity assessments (OCAs) provide a valuable starting point to understand and strengthen an organization’s readiness and capacity for health equity. We conducted a scoping review to identify and characterize existing OCAs. Methods: We searched the PubMed, Embase, and Cochrane databases and practitioner websites to identify peer-reviewed and gray literature articles and tools that measure or assess health equity–related capacity in public health organizations. Seventeen OCAs met the inclusion criteria. We organized primary OCA characteristics and implementation evidence and described them thematically according to key categories. Results: All identified OCAs assessed organizational readiness or capacity for health equity, and many aimed to guide health equity capacity development. The OCAs differed in regard to thematic focus, structure, and intended audience. Implementation evidence was limited. Conclusions: By providing a synthesis of OCAs, these findings can assist public health organizations in selecting and implementing OCAs to assess, strengthen, and monitor their internal organizational capacity for health equity. This synthesis also fills a knowledge gap for those who may be considering developing similar tools in the future.

Background: An ongoing challenge in sports-related concussion (SRC) is determining full recovery. This study examines performance metrics in baseball after an SRC and provides a template for assessment of return-to-performance parameters. Purpose: To determine whether batting performance returns to baseline after an SRC. Study Design: Descriptive epidemiological study. Methods: Participants were all Major League Baseball (MLB) position players with confirmed SRCs that occurred during the 2011-2015 seasons. A retrospective review and assessment of performance metrics before and after injury were conducted as defined relative to the number of plate appearances (PAs) to yield reliable performance statistics. Seven batting metrics were considered as outcomes in longitudinal regressions: batting average, on-base percentage, slugging percentage, on-base plus slugging, bases on balls, strikeouts, and home runs. Metrics were calculated for each player 60, 30, and 14 days before their SRCs, as well as for the 14, 30, and 60 days after returning to play. Other variables controlled for included defensive position, player age at the time of SRC, number of days missed, mechanism of injury, whether the player completed a rehabilitation stint, and year in which the mild traumatic brain injury (MTBI) occurred (2011-2015). Results: A total of 77 MTBI case events occurred in MLB position players over 5 seasons. These injuries resulted in a mean 11.4 days lost to injury. For all performance metrics using 60 or 30 days before MTBI as baseline, no statistically significant differences were found in batting performance. In total, 63 events met PA criteria before injury. Varying the PA cutoff thresholds to be more inclusive or more restrictive yielded similar regression results. For the 48 events that met PA criteria before and after injury, most performance metrics showed no significant performance change after MTBI and, in some events, a slight though mostly nonsignificant performance improvement after MTBI. Conclusions: MLB position players who are medically cleared to return to play after an SRC perform at the same offensive performance levels as their preinjury statistics when an adequate number of PAs is used to compare performance before and after injury.

In this study, we examine how team diversity contributes to team productivity in nascent ventures depending on family relations. Specifically, we explore how bio-demographic diversity influences team productivity using data from a panel of 285 nascent venture teams over 5 years. Results suggest that age and gender diversity have negative impacts on team productivity, but that family relationships positively moderate these effects. To explain the phenomena, we relied on social identity theory and the discussion of the identity confirmation process. Through this novel theoretical framework, we describe how identity confirmation, through identification with a collective (i.e., family), and cross-categorization of family roles mitigate the negative impact of bio-demographic diversity. Our findings provide valuable insights to scholars interested in bio-demographic team diversity, family relationships, and the new venture creation process.

This editorial outlines our perspective on the state of literature as well as suggestions for new contributions to entrepreneurship research in the area of crowd-funded opportunities. Our aim is, first, to outline what we see as best practices for research on crowd-funded entrepreneurial opportunities. Second, we aim to solicit additional articles for the Virtual Special Issue (VSI) on “Crowd-Funded Entrepreneurial Opportunities” in Entrepreneurship Theory and Practice. In contrast to typical editorial articles associated with special issues, we take a prospective approach and outline what we hope (and expect) to see in the literature in the future. Put differently, we are not going to summarize a subset of articles that have been accepted for publication—rather, we are going to delineate the subset of articles to be written that we would, ideally, like to see submitted to top-tier entrepreneurship journals in order to advance the literature. Along the way, we will describe best practices that we anticipate can elevate research in this burgeoning area of inquiry.

We report on the findings from an in-class experiment that represents a learning innovation which can enable classroom-based conversations about bias in the domain of entrepreneurship. More specifically, the present learning innovation explores gender bias in venture funding with regard to entrepreneurship. In an introduction to entrepreneurship class, we randomly assigned students to one of the three experimental conditions—students evaluated an executive summary for a venture either written by a woman, or a man, or one in which the gender was neutral (i.e., the control group). Students acted as if they were considering an investment and reported whether, for example, the executive summary was well written as well as how much equity they would want in the venture as a potential investor. Overall, these results provide evidence consistent with the inference that the students sampled in this study did not use gender as a decision-making heuristic when evaluating entrepreneurial opportunities. We discuss the results of our experiment and describe (a) how to replicate this activity, (b) how to discuss this in the classroom, and (c) how to adapt this activity to explore other types of bias (e.g., race, ethnicity, weight-based, etc.).

Despite mounting interest in growth mindset interventions, this approach has yet to be applied to the domain of entrepreneurship. In the present research, we developed and tested if a growth mindset intervention could be leveraged to promote students’ entrepreneurial self-efficacy and if this, in turn, predicted career development (i.e., academic interest, career interest, task persistence, and academic performance). We report on our findings, from an Open Science Framework (OSF) preregistered study, that is a randomized controlled trial implementing a growth mindset intervention. We randomly assigned undergraduate students ( N = 238) in an introduction to entrepreneurship class to either the growth mindset intervention or to a knowledge-based attention-matched control. Students in the growth mindset intervention, relative to the control, reported greater entrepreneurial self-efficacy and task persistence on their main class project. The intervention also indirectly improved academic and career interest via entrepreneurial self-efficacy. However, the intervention failed to directly or indirectly impact performance on a classroom assignment. Additionally, and somewhat surprisingly, gender and past experience in the field failed to moderate any effects of the intervention on outcomes. Theoretical implications, limitations, and future directions are discussed.

We contend that exploring the construct of bootstrapping could be much more nuanced and interesting than the extant literature has revealed. Unfortunately, the extant literature is stymied by conflicting theoretical as well as empirical landscapes. We address the critical lacunas in the literature by (a) situating the construct of bootstrapping in its historical, chronological context; (b) providing clarity to a construct that is currently lacking; (c) summarizing the theoretical bases which currently apply to bootstrapping; and (d) proposing signaling theory as an appropriate and complementary perspective to use when examining bootstrapping. In addition, our work identifies multiple lines of compelling and novel research that emerge from our approach to the construct of bootstrapping via signaling theory.

Two decades of informative research has asserted that legitimacy attainment is essential to the survival and growth of emerging ventures, yet little empirical research has been conducted to either (a) validate the notion that emerging ventures transition from pre-legitimacy to legitimacy, or (b) identify when such a transition happens for the average new venture. Hence, the present research seeks to begin bridging this substantial gap by introducing and testing the notion that a financial legitimacy threshold (FLT) exists within emerging ventures. Using attainment of financing as a proxy for initial legitimacy, we test our hypothesis that an FLT exists on two large, independent data sets—the 1998 ( N = 3,033) and 2003 ( N = 3,751) Surveys of Small Business Finances. Results indicate that emerging ventures tend to finally transition to legitimacy and, thus, substantially shed external liabilities of newness at 12 years of age, six employees, and $379,000 in sales. Our findings that an FLT exists advance the literature by (a) suggesting that new venture legitimacy is a dichotomous variable that emerging firms either do or do not possess, and (b) articulating a point in size, age, and revenue that average emerging ventures must achieve before they are able to substantially neutralize external newness liabilities via legitimacy attainment.

Food workers’ health and hygiene are common pathways to foodborne disease outbreaks. Improving food system jobs is important to food safety because working conditions impact workers’ health, hygiene, and safe food handling. Stakeholders from key industries have advanced working conditions as an issue of public safety in the United States. Yet, for the food industry, stakeholder engagement with this topic is seemingly limited. To understand this lack of action, we interviewed key informants from organizations recognized for their agenda-setting role on food-worker issues. Findings suggest that participants recognize the work standards/food safety connection, yet perceived barriers limit adoption of a food safety frame, including more pressing priorities (e.g., occupational safety); poor fit with organizational strategies and mission; and questionable utility, including potential negative consequences. Using these findings, we consider how public health advocates may connect food working conditions to food and public safety and elevate it to the public policy agenda.

Publication bias is the systematic suppression of research findings due to small magnitude, statistical insignificance, or contradiction of prior findings or theory. We review possible reasons why publication bias may exist in strategy research and examine empirical evidence regarding the influence of publication bias in the field. Overall, we conclude that publication bias affects many, but not all, topics in strategic management research. Correlation inflation due to publication bias ranged in magnitude from .00, indicating no bias, to .19, representing considerable bias. These results suggest that caution should be exercised when interpreting scientific conclusions regarding certain determinants of firm performance, while greater confidence may be expressed in others. We discuss how publication bias can be addressed both philosophically and empirically in the domain of strategy.

The discussion regarding questionable research practices (QRPs) in management as well as the broader natural and social sciences has increased substantially in recent years. Despite the attention, questions remain regarding research norms and the implications for both theoretical and practical advancements. The aim of the current article is to address these issues in a question-and-answer format while drawing upon both past research and the results of a series of new studies conducted using a mixed-methods design. Our goal is to encourage a systematic, collegial, and constructive dialogue regarding QRPs in management research.

Background: Although mild traumatic brain injury (MTBI) is not as common in professional baseball as in collision sports, it does occur and frequently results in significant loss of time away from the sport. To date, no study has investigated MTBI among an entire cohort of professional baseball players. Purpose: To investigate MTBIs in major and minor league baseball players to determine the most common mechanisms of injury, activity at time of injury, position, level of play, and time lost, as well as ultimately inform prevention efforts. A secondary objective was to document the association between MTBI and return to play using several different measures. Study Design: Descriptive epidemiologic study. Methods: Data were captured from a newly implemented league-wide injury surveillance system that records injuries among all professional baseball players as entered by certified athletic trainers and physicians. The MTBIs were identified with respect to level of play, activity, field location, and mechanism of injury. Time loss was assessed by 3 measures of return to play, and MTBI game rates were reported as injuries per 1000 athlete-exposures. Data were combined over the 2011-2012 seasons for analysis, and results were presented separately for minor and major league players. Chi-square tests were used to test the hypothesis of equal proportions between the various categories of MTBI injury characteristics. Results: There were 41 reported MTBIs in the major leagues and 266 in the minor leagues over the 2-year period under study. The overall MTBI game rate across both major and minor league ball clubs was 0.42 per 1000 athlete-exposures. The median time lost was 9 days. Mild traumatic brain injury accounted for 1% of all injuries resulting in time lost from play. For MTBIs that occurred while fielding, catchers were significantly overrepresented. No differences were noted among the 3 measures of time lost. Conclusion: Mild traumatic brain injury is an important problem in professional baseball players, especially for catchers. This study provides a foundation for future inquiry to reduce the incidence of MTBI in those positions at greatest risk and to provide a baseline as rules and equipment evolve.

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.

Building and using social networks is an important factor in individuals’ personal as well as professional success. In the present work, we examine how individuals’ regulatory focus relates to their networking behavior. Findings from a sample of 300 entrepreneurs across 25 networking groups showed that a general focus on motivations for growth and advancement ( promotion) predicted an increase in out-degree centrality (i.e., how much weekly, business-related contact entrepreneurs had with members in their own networking group), whereas a general focus on motivations for safety and security ( prevention) predicted a decrease in out-degree centrality. Moreover, greater out-degree centrality further predicted an increase in the revenue entrepreneurs generated from members in their networking group. These findings demonstrate how individual differences affect personal motivations for how entrepreneurs’ develop and use their business networks and highlight the importance of motivations for growth and security in relationship formation and maintenance more generally.

We describe the results of a study to determine the prevalence and characteristics of cytomegalovirus (CMV) retinitis among HIV-infected patients in Vietnam. We conducted a cross-sectional prospective study of patients with CD4 lymphocyte count ≤100 cells/mm3 recruited from public HIV clinics. The diagnosis was made by a trained ophthalmologist using slit lamp biomicroscopy and corroborated on fundus photography. A total of 201 patients were screened. The median age was 32 years, 77% were men, median CD4 count was 47 cells/mm3, and 62% were on antiretroviral treatment. Prevalence of CMV retinitis was 7% (14/201, 95% CI 4–11%). CMV retinitis was not associated with age, gender, injection drug use, CD4 count, WHO clinical stage, or antiretroviral treatment status. Blurring of vision and reduced visual acuity 3 or who develop blurring of vision in Vietnam should be screened for CMV retinitis.

Prevailing wisdom across the body of research regarding social ties suggests that quantity matters. However, this logic is less applicable in formal networking groups, which have a bounded (and sta...

Cardiovascular disease (CVD) is the most common cause of on-duty death among U.S. firefighters among whom volunteers comprise 71% of the fire service. We sought to understand CVD risk among volunteer firefighters and to develop a CVD intervention based on their input. To accomplish these aims, we conducted a series of focus groups with volunteer firefighters and firefighters who serve with volunteers in Maryland. We conducted two additional focus groups with fire service leaders. Ninety-eight people participated in 15 focus groups. Participants discussed health and wellness, stress and the demanding nature of the volunteer fire service, and the challenges associated with healthy eating. They talked about food in the firehouse and the lack of quick, healthy, satisfying, and affordable food. Several suggestions for interventions to improve the food environment and firefighters’ ability to choose and prepare healthy meals and snacks emerged. An intervention reflecting the participants’ recommendations resulted. The way volunteer firefighters understand health and wellness and the specific factors that influence their food intake are valuable insights for addressing CVD risks in this population. To our knowledge, this is the first study that systematically brings firefighters into the process of developing an intervention to reduce CVD risk among this high-risk population.

Informal “teacher talk” about students is ubiquitous, but it remains largely unexamined. This study critically examines casual, everyday teacher discourse about students perceived to be racially or culturally “different.” Data were collected through participants’ journal entries, group discussion, and interviews. Findings revealed three dominant deficit-based discursive themes embedded in informal teacher talk about students of color. I argue for the need to heighten educators’ critical awareness of deficit discourse and its relationship to teaching, learning, and issues of equity. This article will likely be of interest to educational administration faculty, teacher educators, K-12 educators, and those studying school culture.

This research addresses the question of what specific entrepreneurs’ behavior increases the propensity for resource acquisition. Within the context of business “pitches,” we explore subtleties in the process via a theoretically derived model linking entrepreneurs’ preparedness behavior, perceived cognitive legitimacy, and amount of funding received. We test this model using data coded from two sources: 14 episodes of the television show “Shark Tank” that aired in 2009, as well as 84 episodes of “Dragons Den” that aired from 2005 to 2010. Within these episodes, we specifically examine the 113 individual business pitches that received funding. Overall, results suggest the relationship between entrepreneurs’ preparedness behavior and the amount of funding received is mediated by cognitive legitimacy. Specifically, entrepreneurs’ increased preparedness behavior was positively related to increased cognitive legitimacy. Cognitive legitimacy, in turn, was positively related to amount of funding received. We offer thoughts regarding implications from both theoretical and practical perspectives.

We examine how entrepreneurs’ behaviors related to credentials and impression management (IM) impact perceptions of new venture (NV) legitimacy. Results from this experiment, as hypothesized, show that entrepreneurs’ credentials and IM behaviors are positively related to legitimacy perceptions. Contrary to expectations, however, findings do not support either interaction hypothesis when credentials are high or low. We discuss how these findings illustrate the importance of entrepreneurs’ behaviors during the NV creation process and outline multiple directions for future research.

Previous research has yielded important understandings of how sexual minorities adjust to living in a heteronormative culture, but scholarly critiques of assimilation and Merton's research on adaptations to deviance suggest value in examining whether there are distinct types of adaptation. Applying Merton's definition of adaptations in anomic environments suggests that different patterns can be defined depending on the importance placed on assimilation and on sexual expression. Using the 1997 Urban Men's Health Study data (n=2,585), four different adaptation patterns are defined: MSM conformist, MSM innovator, MSM nonconformist, and MSM uninvolved. To establish criterion validity, expected correlates of membership in each group are then examined. The distinct groups, each representing from 20 percent to 30 percent of the sample, largely conformed to expectations on measures of sexual self-identification, involvement in gay culture, intimacy and sexual exploration, health, and income. Scholarly and policy implications of the adaptation typology are considered.

Empirically, the confluence of family involvement, ethics, and performance is a sparse research area. The authors explore a rich theoretical framework relating family involvement, ethical focus, and firm performance and empirically test a mediated model using a sample of 526 family businesses. The results illustrated that a firm’s ethical focus mediated the relation between family involvement and financial performance. Specifically, data supported the relation between family involvement and a firm’s ethical focus. And increased ethical focus predicted increased financial performance. The authors discuss the implications of these findings and offer potential areas for future research in family business studies.

HIV prevalence estimates from bathhouse testing programmes differ widely, ranging from 3% to 11%. The observed difference may be a consequence of whether the programme was part of a research project or a community-based programme. A research-funded testing programme was offered at a bathhouse between May 2001 and December 2002. A local community-based organization began a testing programme in July 2006 at the same bathhouse; the data for this analysis cover the period July 2006 through December 2007. County-wide HIV prevalence estimates were available across the two time periods (i.e. 2001–2002 and 2006–2007). The research-funded testing programme recruited fewer men but identified more positive individuals (10.7% of those testing in the research programme) than were identified among men who tested in the area clinics (3.8% of those men who have sex with men [MSM] testing throughout the county in the same time period). However, the community-based testing programme identified about the same proportion of positive MSM (2.6%) as county clinics (2.7%) in the same time period. In conclusion, results confirmed that even in the same venue, a community-based HIV testing programme identified a similar proportion of positive MSM as the area clinics; however, the research-funded programme identified appreciably more. Incentives may contribute to the difference.

In a national survey of institutions with federally assured human research protection programs, we obtained workload and other relevant data on their Institutional Review Boards (IRBs) and management organizations. The number of IRBs increased substantially from 1995 to 2005/06 (491 to 2,728 IRBs) with a further increase in 2008 to 3,853 IRBs. Nationally, IRBs reviewed over a quarter million research applications in the year prior to our survey, of which 35% were new applications requiring full committee review. Compared to estimates from 1995, current IRBs review more new and full committee review applications, but the relative percentage of new and full committee applications remained about the same. High volume research institutions have IRBs with a substantially larger per person workload, relative to smaller volume IRBs (i.e., members spent nearly seven times more hours reviewing new applications outside formal committee meetings). Virtually all IRBs included community representatives as members (92%); however, a small number may not be compliant with federal regulations. The present findings suggest the need for research to (a) examine workload and its effects on review quality, research costs, and faculty morale, (b) develop methods for determining optimal fit between IRB workload demands and institutional labor and financing requirements, (c) construct benchmarks for judging reasonable workload for individual IRB members, and (d) examine if the need to recruit IRB scientific expertise from outside the institution, particularly true for smaller research institutions, causes delays in IRB review, and if a more effective way of locating and recruiting experts would improve quality and time to completion.

We obtained data on institutional Review Boards (IRBs) that review mental health-related applications (MHRAs) in a national survey of institutions with federally assured human research protection programs. Approximately 57% of IRBs review MHRAs, and among these a small percentage may not have mental health experts on their committees (5%). Moreover, mental health experts on IRB committees at high research volume institutions are carrying substantially greater workloads than their lower volume counterparts. In terms of committee demographics, more women (36%) are serving as IRB Chairs on committees that review MHRAs than expected from their representation on medical or university faculties; ethnic minority faculty have lower representation among Chairs than might be expected from their overall faculty representation. Our findings suggest the need for additional studies to (a) examine if the number of mental health experts on IRBs should be increased particularly among IRBs reviewing a high volume of MHRAs, (b) determine if the breadth of expertise among IRB mental health experts corresponds to the range of substantive and methodological approaches represented by the mental health protocols under review, and (c) examine if recruiting IRB scientific expertise from outside an institution, a more common practice among smaller research entities, impacts review quality.

This article argues that the problems facing Iraq could have tremendous consequences for the broader “war on terror,” particularly if they return to or exceed levels seen at the height of the violence in 2006. Salafi militants, followers of an extreme interpretation of Islam who want to use violence to unite Muslims under religious rule, have been fighting in Iraq and may use the country as a base for operations and attacks elsewhere in the region. In addition, refugees from Iraq might spread terrorism, radicalize neighboring populations, and contribute to strife and instability throughout the region. While a U.S. troop withdrawal may inspire fewer young men to take up terrorism against the United States, it would also increase militants' operational freedom in Iraq itself, allowing terrorist groups to recruit, train, and plan with relative impunity. As a result, if the United States withdraws from Iraq without leaving behind a stable Iraqi government, it should still maintain a regional military presence and help bolster other regimes in the Middle East from the threat of terrorism from Iraq.

Xenobiotic efflux pumps at the blood—brain barrier are critical modulators of central nervous system pharmacotherapy. We previously found expression of the ligand-activated nuclear receptor, pregnane X receptor (PXR), in rat brain capillaries, and showed increased expression and transport activity of the drug efflux transporter, P-glycoprotein, in capillaries exposed to PXR ligands (pregnenolone-16α-carbonitrile (PCN) and dexamethasone) in vitro and in vivo. Here, we show increased protein expression and transport activity of another efflux pump, multidrug resistance-associated protein isoform 2 (Mrp2), in rat brain capillaries after in vitro and in vivo exposure to PCN and dexamethasone. The phase-II drug-metabolizing enzyme, glutathione S-transferase-π (GSTπ), was found to be expressed in brain capillaries, where it colocalized to a large extent with Mrp2 at the endothelial cell luminal plasma membrane. Like Mrp2, GSTπ protein expression increased with PXR activation. Colocalization and coordinated upregulation suggest functional coupling of the metabolizing enzyme and efflux transporter. These findings indicate that, as in hepatocytes, brain capillaries possess a regulatory network consisting of nuclear receptors, metabolizing enzymes, and efflux transporters, which modulate blood—brain barrier function.

Research on the effects of sexual orientation on gay male status attainment has been hampered by the use of opportunistic samples and by the inability to control for family background and sexual orienta- tion characteristics. This research uses data from the Urban Men' s Health Study, a multicity probability sample, to examine the status attainment process among men who identify as gay or bisexual ( N 5 2,290). Logistic regression is used to measure the effects of teen sexual orientation and adult expression of sexual orientation on educational achievement and household income. Early decision that one is gay and early homosexual activity are related to reduced educational achievement. Teen sexual orientation and adult expression of sexual orientation are not directly related to income, though education was. These e ndings suggest that the costs of discrimina- tion encountered early in life are an important component of the reduced status attainment of gay males. Although efforts to ban discrimination against gay men and lesbians date back thirty years or more, we know little about status attainment processes specie c to gay men and lesbians or about any costs resulting from homophobic discrimina- tion. The limited research that is available indicates a disjuncture in the answers to this question, with one set of research suggesting that stigma may limit achievement while other research suggests that gay men and lesbians are quite well off in terms of education and employment. Researchers of discrimination suggest that this disjuncture in e ndings is largely a result of problems in sampling gays, though research on educational and work experiences suggests that the

Summary Objectives The objectives of this case study were to develop role models for health in the fire service through knowledge and behaviour change, to improve the role models’ own health, and to facilitate behaviour change in other firefighters through their example. Design Volunteers interested in improving their own health and serving as role models to others in the fire service were identified at a statewide Maryland fire service leadership meeting. Setting Participants worked with the Johns Hopkins Weight Management Center to learn how to improve their own health and shared that knowledge with others in their fire departments. Participants Three Maryland fire service leaders were recruited at a leadership meeting with the goal of improving their own health and becoming role models. One participant dropped out shortly after beginning, while two male participants, aged 57 and 61, completed the study. Main outcome measures Quantitative measures were collected at baseline and 12 months, and included weight, blood pressure and fasting glucose and cholesterol. Semi-structured interviews were conducted approximately 14 months postintervention to determine the participants’ perceptions of their own health and impact on others in the fire service. Results Each participant had biweekly to monthly visits over a one-year period to learn the knowledge and skills that would assist him with improving dietary behaviours, increasing fitness and achieving a healthy weight. Case study participants experienced reductions in body weight (−13% and −11% of total body weight), glucose and blood pressure. Qualitative one-on-one interviews conducted postintervention with the participants revealed that they embraced their status as role models and felt their success inspired other firefighters. Their experiences suggest that role models can play an important role in helping firefighters increase self-efficacy, self-regulation and social support in the workplace environment. Conclusions These findings provide promising evidence for the use of role models to improve health, especially in the workplace.

100 years after the discovery of a bacterial 'endotoxin', 50 years after the introduction of antibiotics and 25 years after the routine use of intensive care units to support septic shock patients, Gram-negative infections continue to account for significant morbidity and mortality. In the coming decade, basic research on the structure/function of LPS, the cytokine cascade, and receptor-mediated intracellular signalling responses to LPS and cytokines will provide a greater understanding of the molecular, cellular and systemic responses to endotoxin and infection. New therapeutic agents now emerging from research, and better designed clinical trials to assess those agents will contribute to the next significant decline in sepsis- and shock-related morbidity and mortality. This article summarizes the findings of a workshop convened at the National Institutes of Health (NIH) to examine current research on endotoxin and Gram-negative septic shock.

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. The introduction of a number of small molecule tyrosine kinase inhibitors has revolutionized the management of metastatic disease. Surgery is the mainstay of management for localized disease. Patients with high risk tumors are treated with adjuvant imatinib. We report the rare presentation of a localized primary small bowel gastrointestinal stromal tumor in association with multiple liver abscesses. Cystic liver lesions should be fully evaluated in gastro intestinal tumor patients to exclude an infective cause. Treatment with intravenous antibiotics resulted in clinical and radiological improvement of the liver abscesses. The small bowel tumor was treated with surgical resection.