Contemporary Fiduciary Investments: Why Maryland Needs the Prudent Man Rule

The problem of how to invest the funds of another is not new. While not intended as an investment guide, this article traces the development of the law in the area of fiduciary investment, analyzing the conflict inherent in balancing the considerations of safety, yield and liquidity with the needs of the beneficiaries. Concluding that most common law and statutory standards are unduly restrictive in light of modern investment practices, the author considers the Maryland experience and suggests that the Maryland legislature adopt a prudent man rule which would enable fiduciaries to effectively utilize contemporary investment vehicles

A qualitative investigation of breast cancer survivors’ experiences with breastfeeding

This is an exploratory, qualitative investigation of breast cancer survivors’ experiences with breastfeeding. Previous studies have focused on the physiology of lactation after surgery and treatment, but have not explored factors influencing breastfeeding decisions and behavior. We used purposeful sampling to identify 11 breast cancer survivors who had a child after their diagnosis and treatment. Participants were recruited from among those in the Women’s Healthy Eating and Living (WHEL) study and a Young Survival Coalition (YSC) affiliate. We conducted semi-structured, open-ended telephone interviews lasting 45–75 min. We used social cognitive theory (SCT) to structure questions regarding influences on breastfeeding behavior. We transcribed interviews and used cross-case, inductive analysis to identify themes. Ten of 11 participants initiated breastfeeding. The following main themes emerged: 1) Cautiously hopeful, 2) Exhausting to rely on one breast, 3) Motivated despite challenges, 4) Support and lack of support, and 5) Encouraging to others. Study participants were highly motivated to breastfeed but faced considerable challenges. Participants described problems that are not unique to women with breast cancer, but experienced these to a much greater degree because they relied mostly or entirely on one lactating breast. This study revealed a need for improved access to information and support and greater sensitivity to the obstacles faced by breast cancer survivors. Results of this qualitative analysis indicate that interventions to support the efforts of breast cancer survivors who are interested in breastfeeding are warranted. Additional research would aid in the development of such interventions

Breast cancer in young women and its impact on reproductive function

BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists

Contemporary Fiduciary Investments: Why Maryland Needs the Prudent Man Rule

The problem of how to invest the funds of another is not new. While not intended as an investment guide, this article traces the development of the law in the area of fiduciary investment, analyzing the conflict inherent in balancing the considerations of safety, yield and liquidity with the needs of the beneficiaries. Concluding that most common law and statutory standards are unduly restrictive in light of modern investment practices, the author considers the Maryland experience and suggests that the Maryland legislature adopt a prudent man rule which would enable fiduciaries to effectively utilize contemporary investment vehicles