Clinicians’ Perspectives on Adopting a Lung Cancer Palliative Care Intervention

Despite the significant progress in implementing palliative care interventions for cancer patients, few intervention studies seek healthcare clinicians’ input prior to implementation. The purpose of this research was then to explore palliative care and oncology clinicians’ (e.g., physicians, nurses, social workers, and chaplains) perspectives on current challenges and useful practices in meeting the quality of life needs of lung cancer patients and family caregivers, and to increase the likelihood of the adoption of a palliative care intervention based on understanding current trends in palliative care delivery at three outpatient oncology sites. The conceptual framework used for this study was the RE-AIM Model: Reach, efficacy, adoption, implementation, and maintenance of intervention research to successfully translate and sustain evidence-based practice. This was a multi-site qualitative study using focus group and key informant interviews with oncology and palliative care clinicians. Focus groups and individual phone interviews were conducted with 19 clinicians, who addressed useful practices and challenges in the following areas: (a) early palliative care; (b) interdisciplinary care planning; (c) symptom management; (d) addressing psychological and social needs; and (e) providing culturally respectful care, including spiritual care. In preparation for the intervention, specific education needs and organizational challenges were revealed through focus group and individual interviews with clinicians. These challenges included timing and staffing constraints, the need for clinician education on palliative care services to increase organizational buy-in and referrals, and support and education in providing spiritual support for patients and family caregivers. These findings highlight an important, often overlooked, step in the translation of palliative care intervention studies and may inform education and training in the areas of palliative care and spiritual care for lung cancer patients. Further, these findings pattern the adoption component of the Re-AIM Model for intervention studies in eliciting organizational support prior to implementation

Learning Conditional Preference Networks from Optimal Choices

Conditional preference networks (CP-nets) model user preferences over objects described in terms of values assigned to discrete features, where the preference for one feature may depend on the values of other features. Most existing algorithms for learning CP-nets from the user\u27s choices assume that the user chooses between pairs of objects. However, many real-world applications involve the the user choosing from all combinatorial possibilities or a very large subset. We introduce a CP-net learning algorithm for the latter type of choice, and study its properties formally and empirically

The Lesson of the 2011 NFL and NBA Lockouts: Why Courts Should Not Immediately Recognize Players\u27 Union Disclaimers of Representation

The NFL and NBA lockouts of 2011 challenged the limits of the balance courts have struck between collective bargaining protections and antitrust liability. In each lockout, the respective players’ union argued that the bargaining relationship with team owners ended once the union disclaimed interest in continuing as its players’ bargaining representative. The players further argued that with the bargaining relationship terminated, the nonstatutory labor exemption no longer shielded owners from antitrust liability for their cooperative agreements and activity. Ultimately, both lockouts settled without courts deciding whether a disclaimer of representation marks what the Supreme Court has described as an “extreme outer boundary” that is “sufficiently distant in time and in circumstances” from the bargaining process such that the nonstatutory labor exemption might no longer protect employers from antitrust liability. This Comment argues that courts should be wary of recognizing disclaimers as terminating the exemption in the wake of the 2011 lockouts. Instead, courts should extend the exemption for a reasonable period following disclaimer. By doing so, courts would reduce the possibility of introducing instability and uncertainty in the bargaining process, which the Court has recognized in the past as a significant concern. Such an extension also would help separate deserving antitrust claims from mere bargaining tactics while allowing the economic pressures facing both sides to shape their ultimate agreement

Hydraulic Fracturing in the Marcellus Shale: The Need for Legislative Amendments to New York\u27s Mineral Resources Law

(Excerpt) In the interest of maximizing the efficacy of the law’s stated policy objectives—a greater recovery of gas, protection of the correlative rights of property owners, and the full protection of the rights of all persons, including producers and the general public—and minimizing the need for court action in addressing potential conflicts, this Note concludes by recommending the following discrete amendments to the current regulatory framework. First, the legislature should adopt a more comprehensive definition of waste that includes environmental waste and disposal. Second, legislators must reconcile the conflict between landowners’ rights and the practice of compulsory integration in one of two ways: either by recognizing that the rights of landowners are subservient to the state’s interest in facilitating the recovery of gas, or by preserving the right of landowners to keep their land free from industrial drilling and ending the practice of compulsory integration. Third, legislators should define the rights of operators on land compulsorily integrated under the present system. Finally, recognizing that the municipality is the political entity most receptive to the will of the public at the local community level, the power of local governments to determine what procedures may be imposed on industry to safeguard their local resources must be made clear. The state legislature should define the term “regulation” in Article 23’s supersession clause to specify how much control local governments may exercise over the location of drilling and the traffic to drilling sites

The Latino Experience in the American Public Education System

Education has long been considered to be the primary enabler of social mobility and personal fulfillment. According to the Pew Research Center, the Hispanic population is the largest ethnic minority in the United States, and currently one in four students enrolled in public education are Latino. The purpose of this research is to review the Latino urban experience within American public schools from the 1960’s to the present. This study specifically examines urban and inner-city educational practices. It will refer principally to the literary works of Almost a Woman, by Esmeralda Santiago; Bodega’s Dream, by Ernesto Quiñónez; and Luis J. Rodriguez’s work, Always Running. These literary narratives are drawn from different Latino ethnic minorities, reflecting the authors’ educational experiences growing up in their respective neighborhoods. By evaluating these narratives, this research seeks to understand the educational formation of Latino youth, and how these experiences have shaped the inner-city Latino culture of the United States. The research will particularly focus upon the impacts of racial profiling, specific opportunities of advancement for Latino youth within public school systems, and government funding for urban education