US Cancer Centers of Excellence Strategies for Increased Inclusion of Racial and Ethnic Minorities in Clinical Trials

PURPOSE:: Participation of racial and ethnic minority groups (REMGs) in cancer trials is disproportionately low despite a high prevalence of certain cancers in REMG populations. We aimed to identify notable practices used by leading US cancer centers that facilitate REMG participation in cancer trials. METHODS:: The National Minority Quality Forum and Sustainable Healthy Communities Diverse Cancer Communities Working Group developed criteria by which to identify eligible US cancer centers-REMGs comprise 10% or more of the catchment area; a 10% to 50% yearly accrual rate of REMGs in cancer trials; and the presence of formal community outreach and diversity enrollment programs. Cancer center leaders were interviewed to ascertain notable practices that facilitate REMG accrual in clinical trials. RESULTS:: Eight cancer centers that met the Communities Working Group criteria were invited to participate in in-depth interviews. Notable strategies for increased REMG accrual to cancer trials were reported across five broad themes: commitment and center leadership, investigator training and mentoring, community engagement, patient engagement, and operational practices. Specific notable practices included increased engagement of health care professionals, the presence of formal processes for obtaining REMG patient/caregiver input on research projects, and engagement of community groups to drive REMG participation. Centers also reported an increase in the allocation of resources to improving health disparities and increased dedication of research staff to REMG engagement. CONCLUSION:: We have identified notable practices that facilitate increased participation of REMGs in cancer trials. Wide implementation of such strategies across cancer centers is essential to ensure that all populations benefit from advances in an era of increasingly personalized treatment of cancer

Transnational regulation of temporary agency work compromised partnership between Private Employment Agencies and Global Union Federations

This article critically assesses the potential for the international regulation of temporary agency work (TAW) through building partnership between the Global Union Federations (GUFs) and major Private Employment Agencies (PrEAs). Given the limits of existing national and international regulation of TAW, particularly in developing countries, and the current deadlock in dialogue through the International Labour Organization, the argument of this article is that Transnational Private Labour Regulation (TPLR) offers a unique opportunity to establish a basis for minimum standards for temporary agency workers. This article goes on to propose three potential TPLR frameworks that, although compromised, are transparent, fair and sufficiently elastic to accommodate the distributive and political risks associated with partnership. They also offer important gains, namely increasing the competitive advantage of the PrEAs involved, minimum standards for agency workers and ‘field enlarging’ strategies for the GUFs and their affiliates

Balance Retraining In Post Stroke Patients Using A Simple, Effective And Affordable Technique

Purpose Balance impairment is important sequel of stroke that is of primary concern in physiotherapy intervention. This quasi-experimental study evaluated the efficacy of stepper in training balance in post stroke patients; and the effects of change in balance performance on motor function. Subjects Eight individuals (6 males and 2 females) presenting with hemiparesis resulting from first incidence hemispheric cerebrovascular disease (age=61.38 ± 6.04 years) who were receiving physiotherapy on out-patient basis at a tertiary health facility in Nigeria participated in this study. All subjects had attained independent walking status without the use of any assistive device. Methods Subjects performed 60 repetitions stepping exercise on a stepper at own self-determined pace, twice a week for 6 consecutive weeks. Progression of the exercise was by increasing the repetition by 10 every week. Baseline and post-training balance and motor function were assessed using Berg Balance Scale (BBS) and Motor Assessment Scale (MAS) respectively. Results Analyses using the Wilcoxon signed rank test showed significant improvement in some of the BBS activities viz. the tandem standing (z = - 2.42; p=0.01); standing on one leg (z=-2.59; p=0.00); turning trunk with feet fixed (z= -2.07; p=0.03); turning 3600 (z = -2.12;p=0.03); stool stepping (z =-1.89; p=0.05) and reaching forward in standing (z= -2.56; p= 0.01). Significant improvement were also recorded in the moving from supine to side lying (z = -2.06; p=0.03); sitting to standing (z = -2.33; p=0.02); walking (z=-2.40; p=0.01); hand movements (z = -2.44; p=0.01); and advanced hand movements (z = -2.00; p=0.04) on the MAS. Conclusion The outcomes suggest that both balance and motor function could be improved in individuals who have suffered a stroke using the stepper as a training tool. Further studies involving large sampling size is however needed to make a conclusive inference Objectifs Les troubles de l\'équilibre sont des séquelles importantes des accidents vasculaires cérébraux (AVC). Cette étude se propose d\'évaluer l\'efficacité de « stepper » dans la rééducation des troubles de l\'équilibre chez des patients après un AVC et les répercussions sur la fonction motrice. Méthodes Huit patients - 6 hommes et 2 femmes - présentant une hémiparésie en rapport avec un AVC ( âge = 61,38+/- 6,04 ans) ont bénéficié d\'une physiothérapie en ambulatoire dans un centre hospitalier tertiaire au Nigéria. Tous les patients ont eu une marche autonome sans l\'aide d\'une quelconque assistance. Les patients ont effectué 60 séances répétitives de stepping sur un mode auto-adapté, deux fois par semaine et ce durant 6 semaines consécutives. La progression des exercices a été augmentée toutes les dix semaines. L\'évaluation a été réalisée a l\'aide de la Berg Balance Scale (BBS) et la Motor Assessment Scale (MAS) Résultats Les analyses utilisant le test de Wilcoxon ont noté une amélioration significative sur les activités BBS vs la station bipodale (z = - 2.42; p=0.01) station unipodale (z=-2.59; p=0.00); rotation du tronc avec un pied fixe (z = -2.12;p=0.03) ; retournement 3600 (z = -2.12;p=0.03); stool stepping (z =-1.89; p=0.05) et reaching forward in standing (z= -2.56; p= 0.01). Une amélioration significative a été relevée lors du passage de la position couchée en décubitus latéral (z = -2.06; p=0.03);de la station assise à la station debout (z = -2.33; p=0.02); à la marche (z=-2.40; p=0.01); la des mains (z = -2.44; p=0.01); et l\'avancée des mains (z = -2.00; p=0.04) sur le MAS Conclusion L\'évolution atteste que l\'équilibre et la fonction motrice pourraient être améliorées chez les patients ayant eu un AVC en utilisant la méthode du stepper. Toutefois des études plus larges sont nécessaires pour valider cette technique. Keywords: Stroke, Balance, Training, Exercise, Stepper.African Journal of Neurological Sciences Vol. 26 (2) 2007: pp. 39-4

State of Cancer Care in America: Achieving Cancer Health Equity Among Sexual and Gender Minority Communities

In 2017, ASCO issued the position statement, Strategies for Reducing Cancer Health Disparities Among Sexual and Gender Minority Populations, outlining five areas of recommendations to address the needs of both sexual and gender minority (SGM, eg, LGBTQ+) populations affected by cancer and members of the oncology workforce who identify as SGM: (1) patient education and support; (2) workforce development and diversity; (3) quality improvement strategies; (4) policy solutions; and (5) research strategies. In 2019, ASCO convened the SGM Task Force to help actualize the recommendations of the 2017 position statement. The percentage of the US population who publicly identify as SGM has increased dramatically over the past few years. Although increased national interest in SGM health equity has accompanied a general interest in research, policy change, and education around diversity, equity, and inclusion, resulting from public concern over discrimination in health care against Black, Indigenous, and People of Color, this has been accompanied by a surge in discriminatory legislation directly impacting the SGM community. Although much progress has been made in advancing SGM cancer health equity since 2017, more progress is needed to reduce disparities and advance equity. The five focus areas outlined in the 2017 ASCO position statement remain relevant, as we must continue to promote and advance equity in quality improvement, workforce development, patient care, research, and SGM-affirming policies. This article reports on the progress toward reducing SGM cancer disparities and achieving equity across these five areas and identifies future directions for the work that still remains

The ILO, social partners and the G20: New prospects for social dialogue at the global level?

International audienceSince 2011, new fora have emerged such as the Labour 20 (L20) and the Business 20 (B20) which claim to represent social partners at the G20 level. This article shows that these new fora actually derive from three older institutions: the International Labour Organization (ILO), the International Trade Union Confederation (ITUC) and the International Organization of Employers (IOE) which aim at reaffirming their role in the framing of contemporary global social policies as well as reactivating a century-old tradition of social dialogue at the global level. Challenging conventional wisdom on the unity of business interests, the article also insists upon the competition between the IOE, the International Chamber of Commerce and the Davos Forum to represent the voice of Business at the G20. The article ends with an assessment of the representative and democratic character of the G20, B20 and L20 meetings in comparison to the existing structures of social dialogue such as the ILO