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Providing safe and informed healthcare for sexual and gender minority (SGM) individuals with cancer is stymied by the lack of sexual orientation and gender identity (SOGI) data reliably available in health records and by insufficient training for staff. Approaches that support institutional learning, especially around sensitive topics, are essential for hospitals seeking to improve practices impacting patient safety and research. We engineered annual institutional retreats to identify and unify stakeholders, promote awareness of gaps and needs, identify initiatives, minimize redundant projects, and coordinate efforts that promote improvements in SGM cancer care, education, and research. The 2022 and 2023 retreats employed a 4-h hybrid format allowing virtual and in-person engagement. Retreat organizers facilitated small-group discussions for brainstorming among participants. We performed descriptive statistics from retreat evaluations. The retreats engaged 104 attendees from distinct departments and roles. Participants expressed robust satisfaction, commending the retreat organization and content quality. Notably, the first retreat yielded leadership endorsement and funding for a Quality Improvement pilot to standardize SOGI data collection and clinical staff training. The second retreat provided a platform for updates on focused efforts across the institution and for receiving direction regarding national best practices for SGM care and research. We report the processes and outcomes of institution-wide retreats, which served as a platform for identifying gaps in organizational healthcare practices and research for SGM individuals with cancer. The strategies described herein may be readily scaled at other cancer hospitals seeking to learn and enact system-wide practice changes that support the needs of SGM patients and families. [ABSTRACT FROM AUTHOR]

During a clinical ethics fellow's first week of independent supervised service, two unhoused patients on the same floor were resisting the medical team's recommendations to discharge. In the team's view, both were medically stable and no longer required hospitalization in an acute setting. The medical team suspected malingering for both. The social worker and case manager had employed their usual means of gentle persuasion and eliminating psychosocial barriers to no avail. Rather than call the police, the attending physician, social worker, and case manager decided to call ethics. These cases lead the fledgling fellow to consider the appropriate role for ethicists in difficult discharge cases. The article analyzes each case, evaluates their similarities and differences in the context of suspected malingering, and comments on ethical issues surrounding cases of suspected malingering. Finally, the authors reflect on the value and importance of developing and maintaining epistemic and professional independence. [ABSTRACT FROM AUTHOR]

PURPOSE: The COVID-19 pandemic has had deleterious effects on oncologist professional and personal well-being, the optimal delivery of quality cancer care, and the future cancer care workforce, with many departing the field. Hence, the identification of evidence-based approaches to sustain oncologists is essential to promote well-being. MATERIALS AND METHODS: We developed a brief, oncologist-centered, virtual group peer support program and tested its feasibility, acceptability, and preliminary impact on well-being. Trained facilitators provided support to peers on the basis of burnout research in oncology with available resources to enhance oncologist resilience. Peers completed pre- and postsurvey assessment of well-being and satisfaction. RESULTS: From April to May 2022, 11 of 15 (73%) oncologists participated in its entirety: mean age 51.1 years (range, 33-70), 55% female, 81.8% Ca, 82% medical oncologists, 63.6% trained ≥15 years, average 30.3 patients/wk (range, 5-60), and 90.9% employed in hospital/health system practice. There was a statistically significant difference in pre- and postintervention well-being (7.0 ± 3.6 v 8.2 ± 3.0, P = .03) with high satisfaction with postgroup experience (9.1 ± 2.5). These quantitative improvements were affirmed by qualitative feedback. These themes included (1) an enhanced understanding of burnout in oncology, (2) shared experience in practice of oncology, and (3) fostering connections with diverse colleagues. Future recommendations proposed included (1) restructuring group format and (2) tailoring groups according to practice setting (academic v community). CONCLUSION: Preliminary results suggest that a brief, innovative oncologist-tailored group peer support program is feasible, acceptable, and beneficial for enhancing well-being dimensions including burnout, engagement, and satisfaction. Additional study is required to refine program components (optimal timing, format) to support oncologist well-being, now during the pandemic and well into recovery. [ABSTRACT FROM AUTHOR]

Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance. [ABSTRACT FROM AUTHOR]

Technetium‐99 is a prevalent fission product from nuclear waste. The long half‐life (211,000 yr) and environmental mobility of pertechnetate (TcO4−) render Tc particularly challenging to isolate and stabilize. Here we present two approaches for development of potential wasteforms using titanium dioxide, TiO2. Approach 1 is a low temperature chemical synthesis of TiO2 doped with Tc(IV) from TcO4− intended to mimic the Tc waste stream from the UREX family of separations and removes 98.5 % of the Tc, mainly present as edge‐shared Tc(IV) pairs. Approach 2 utilizes TiO2 to photocatalytically reduce TcO4− to Tc(IV) stabilized on the surface of or within the TiO2 lattice. The %Tc removed from solution and adsorbed to TiO2 is pH dependent, with the maximum Tc(IV) adsorbed at pH 3–4 as either TcO2 or edge‐sharing Tc(IV) octahedra. The Tc(IV)‐TiO2 composites materials formed by both approaches are suitable for consolidation into a dense wasteform by Hot Isostatic Pressing (HIPing). [ABSTRACT FROM AUTHOR]

Background: The complex relationship between incarceration and cancer survival has not been thoroughly evaluated. We assessed whether cancer diagnosis during incarceration or the immediate post-release period is associated with higher rates of mortality compared with those never incarcerated. Methods: We conducted a population-based study using a statewide linkage of tumor registry and correctional system movement data for Connecticut adult residents diagnosed with invasive cancer from 2005 through 2016. The independent variable was place of cancer diagnosis: during incarceration, within 12 months post-release, and never incarcerated. The dependent variables were five-year cancer-related and overall survival rates. Results: Of the 216,540 adults diagnosed with invasive cancer during the study period, 239 (0.11%) people were diagnosed during incarceration, 479 (0.22%) within 12 months following release, and the remaining were never incarcerated. After accounting for demographics and cancer characteristics, including stage of diagnosis, the risk for cancer-related death at five years was significantly higher among those diagnosed while incarcerated (AHR = 1.39, 95% CI = 1.12–1.73) and those recently released (AHR = 1.82, 95% CI = 1.57–2.10) compared to the never-incarcerated group. The risk for all-cause mortality was also higher for those diagnosed with cancer while incarcerated (AHR = 1.92, 95% CI = 1.63–2.26) and those recently released (AHR = 2.18, 95% CI = 1.94–2.45). Conclusions and relevance: There is a higher risk of cancer mortality among individuals diagnosed with cancer during incarceration and in the first-year post-release, which is not fully explained by stage of diagnosis. Cancer prevention and treatment efforts should target people who experience incarceration and identify why incarceration is associated with worse outcomes. [ABSTRACT FROM AUTHOR]

Background and objectives: Little is known about outcome improvements and disparities in cardiac arrest and active cancer. We performed the first known AI and propensity score (PS)-augmented clinical, cost-effectiveness, and computational ethical analysis of cardio-oncology cardiac arrests including left heart catheterization (LHC)-related mortality reduction and related disparities. Materials and methods: A nationally representative cohort analysis was performed for mortality and cost by active cancer using the largest United States all-payer inpatient dataset, the National Inpatient Sample, from 2016 to 2018, using deep learning and machine learning augmented propensity score-adjusted (ML-PS) multivariable regression which informed cost-effectiveness and ethical analyses. The Cardiac Arrest Cardio-Oncology Score (CACOS) was then created for the above population and validated. The results informed the computational ethical analysis to determine ethical and related policy recommendations. Results: Of the 101,521,656 hospitalizations, 6,656,883 (6.56%) suffered cardiac arrest of whom 61,300 (0.92%) had active cancer. Patients with versus without active cancer were significantly less likely to receive an inpatient LHC (7.42% versus 20.79%, p < 0.001). In ML-PS regression in active cancer, post-arrest LHC significantly reduced mortality (OR 0.18, 95%CI 0.14–0.24, p < 0.001) which PS matching confirmed by up to 42.87% (95%CI 35.56–50.18, p < 0.001). The CACOS model included the predictors of no inpatient LHC, PEA initial rhythm, metastatic malignancy, and high-risk malignancy (leukemia, pancreas, liver, biliary, and lung). Cost-benefit analysis indicated 292 racial minorities and $2.16 billion could be saved annually by reducing racial disparities in LHC. Ethical analysis indicated the convergent consensus across diverse belief systems that such disparities should be eliminated to optimize just and equitable outcomes. Conclusions: This AI-guided empirical and ethical analysis provides a novel demonstration of LHC mortality reductions in cardio-oncology cardiac arrest and related disparities, along with an innovative predictive model that can be integrated within the digital ecosystem of modern healthcare systems to improve equitable clinical and public health outcomes. [ABSTRACT FROM AUTHOR]

Her interventions provide one model for challenging language ideologies not only with pre-service teacher candidates, but also with university instructors engaging in faculty development for LRI. From this perspective, it becomes apparent that, whether acknowledged or not, teaching the language of the discipline is part of bringing students into that community and therefore to a certain extent, all teachers are indeed teachers of language. TESOL faculty in higher education institutions can be an important resource for program planning and faculty development, providing faculty support and development, modeling instructional techniques, and serving as experts to help them unpack the language of their disciplines and develop language-supported learning environments. Doing so requires faculty development in key areas of linguistically responsive instruction (LRI) for university instructors as it has with teachers of elementary and secondary students (e.g. de Jong, Harper, & Coady, 2013). [Extracted from the article]

Data that inform preexposure prophylaxis (PrEP) implementation for women involved in criminal justice (WICJ) systems are scarce. In a survey of PrEP attitudes, acceptability, and barriers across the criminal justice system, incarcerated women (n = 48) were more likely than WICJ on probation (n = 125) to be eligible for PrEP (29% vs. 15%; p = .04) and willing to take PrEP if offered (94% vs. 78%; p = .01). In multivariate models, PrEP eligibility directly correlated with being incarcerated (adjusted odds ratio [aOR] 4.81, 95% confidence interval [CI] 1.76-13.1) and inversely correlated with Hispanic/Latina ethnicity (aOR 0.31; 95% CI 0.10-0.96). Recent partner violence exposure was associated with PrEP eligibility (aOR 3.29; 95% CI 1.54-7.02) and discordant risk perception (aOR 2.36; 95% CI 1.18-4.70). Findings demonstrate high potential for PrEP for all WICJ, though implementation efforts will need to address partner violence. [ABSTRACT FROM AUTHOR]

INTRODUCTION The COVID-19 pandemic is an unprecedented global crisis profoundly affecting oncology care delivery. PURPOSE This study will describe the occupational and personal consequences of the COVID-19 pandemic on oncologist well-being and patient care. MATERIALS AND METHODS Four virtual focus groups were conducted with US ASCO member oncologists (September-November 2020). Inquiry and subsequent discussions centered on self-reported accounts of professional and personal COVID-19 experiences affecting well-being, and oncologist recommendations for well-being interventions that the cancer organization and professional societies (ASCO) might implement were explored. Qualitative interviews were analyzed using Framework Analysis. RESULTS Twenty-five oncologists were interviewed: median age 44 years (range: 35-69 years), 52% female, 52% racial or ethnic minority, 76% medical oncologists, 64% married, and an average of 51.5 patients seen per week (range: 20-120). Five thematic consequences emerged: (1) impact of pre-COVID-19 burnout, (2) occupational or professional limitations and adaptations, (3) personal implications, (4) concern for the future of cancer care and the workforce, and (5) recommendations for physician well-being interventions. Underlying oncologist burnout exacerbated stressors associated with disruptions in care, education, research, financial practice health, and telemedicine. Many feared delays in cancer screening, diagnosis, and treatment. Oncologists noted personal and familial stressors related to COVID-19 exposure fears and loss of social support. Many participants strongly considered working part-time or taking early retirement. Yet, opportunities arose to facilitate personal growth and rise above pandemic adversity, fostering greater resilience. Recommendations for organizational well-being interventions included psychologic or peer support resources, flexible time-off, and ASCO and state oncology societies involvement to develop care guidelines, well-being resources, and mental health advocacy. CONCLUSION Our study suggests that the COVID-19 pandemic has adversely affected oncologist burnout, fulfillment, practice health, cancer care, and workforce. It illuminates where professional organizations could play a significant role in oncologist well-being. [ABSTRACT FROM AUTHOR]

An editorial is presented on the impact of the COVID-19 Pandemic on Oncologist Burnout, Emotional Well-Being, and Moral Distress. Topics include oncologists encountering critical life-and-death patient decision making and sacrificing for bridging gaps in the healthcare system; and abbreviating chemotherapy administrations and substituting potentially inferior oral chemotherapy regimens for intravenous therapies.

This paper describes and reflects on a seminar series in linguistically responsive instruction across academic disciplines, providing faculty in different institutions a model for faculty development in working with international students. [ABSTRACT FROM AUTHOR]

Technetium‐99 (half‐life of 2.1 × 105 yrs, βmax = 0.29 MeV) is a hazardous radiological contaminant, which, in its predominant form of pertechnetate (TcO4–), is highly mobile in the environment. Most strategies for the removal of pertechnetate from the environment involve uptake and/or absorption of pertechnetate using resins, clays, cationic metal‐organic frameworks and even thorium borate ceramic like materials. Alternative approaches have involved the reduction and subsequent sequestration of lower valent technetium species using iron, sulfides, or iron sulfides. Our lab has explored this strategy using the lacunary alpha‐2 Wells–Dawson polyoxometalate (α2‐[P2W17O61]10–) to both reduce and sequester lower valent technetium, and we have reported on the ligand features that stabilize the reduced species. In this work we investigate the potential of "plenary" Keggin POMs (XW12O40n–) (X = P, Si, Al, n = 3, 4, 5, respectively) to both reduce TcO4– and stabilize the reduced Tc species. Specifically, we report on the mechanism by which the reduction of technetium occurs and find that PW12, SiW12, and AlW12 promote the reduction of TcO4– to lower valent states. X‐ray absorption spectroscopy was used to confirm a combination of TcIV {in the form of TcO2·2H2O and Tc2(µ‐O)24+} and TcV, which is subsequently complexed into a POM defect as a TcV=O species. [ABSTRACT FROM AUTHOR]

Oncologist well-being is critical to initiating and maintaining the physician-patient relationship, yet many oncologists suffer from symptoms of burnout. Burnout has been linked to poor physical and mental health, as well as increased medical errors, patient dissatisfaction, and workforce attrition. In this Call to Action article, we discuss causes of and interventions for burnout and moral distress in oncology, highlight existing interventions, and provide recommendations for addressing burnout and improving well-being at the individual and organizational levels to deliver ethical, quality cancer care. [ABSTRACT FROM AUTHOR]

With increasingly mobile and global populations in universities worldwide, it is important that faculty and students share common expectations for student and instructor behaviors. This study focused on international student and faculty perceptions of student language performance and faculty instructional techniques in one U.S. university with recent growth in the international student population. Using responses from two questionnaires administered to faculty and matriculated international students at the university, the authors found a mismatch between faculty and student perceptions. Faculty rated students' linguistic performance poorly, whereas students saw their language skills as adequate for the demands of their classes. In terms of instructional supports for international students, both students and faculty reported using or appreciating visuals, but other strategies such as advance provision of instructional materials or invitations to office hours were appreciated by students but less often used by faculty. The authors discuss the results in terms of developing shared expectations between students and faculty and engaging in intentional language acquisition planning at the institutional level. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder (OUD) is among the most prevalent medical condition experienced by incarcerated persons, yet medication assisted therapy (MAT) is uncommon. Four jail and prison systems partnered with researchers to document their adoption of MAT for incarcerated individuals with opioid use disorders (OUD) using their established treatment protocols. Employing the EPIS (Exploration, Planning, Implementation, and Sustainment) framework, programs report on systematic efforts to expand screening, treatment and provide linkage to community-based care upon release. Results: All four systems were engaged with implementation of MAT at the outset of the study. Thus, findings focus more on uptake and penetration as part of implementation and sustainment of medication treatment. The prevalence of OUD during any given month ranged from 28 to 65% of the population in the participating facilities. All programs developed consistent approaches to screen individuals at intake and provided care coordination with community treatment providers at the time of release. The proportion of individuals with OUD who received MAT ranged considerably from 9 to 61%. Despite efforts at all four sites to increase utilization of MAT, only one site achieved sustained growth in the proportion of individuals treated over the course of the project. Government leadership, dedicated funding and collaboration with community treatment providers were deemed essential to adoption of MAT during implementation phases. Facilitators for MAT included increases in staffing and staff training; group education on medication assisted therapies; use of data to drive change processes; coordination with other elements of the criminal justice system to expand care; and ongoing contact with individuals post-release to encourage continued treatment. Barriers included lack of funding and space and institutional design; challenges in changing the cultural perception of all approved treatments; excluding or discontinuing treatment based on patient factors, movement or transfer of individuals; and inability to sustain care coordination at the time of release. Conclusions: Adoption of evidence-based medication assisted therapies for OUD in prisons and jails can be accomplished but requires persistent effort to identify and overcome challenges and dedicated funding to sustain programs. [ABSTRACT FROM AUTHOR]

Technetium‐99, a prevalent by‐product of the nuclear fuel cycle, is a transition metal with 9 accessible oxidation states and a half‐life of 2.1 × 105 years. 99TcVII has been found in the environment surrounding National Lab sites and fuel reprocessing centers, and its separation and long‐term storage is complicated by its extensive redox chemistry. In our prior work we have reported the synthesis and reduction of TcVO to TcIVO in α1‐ and α2‐Wells–Dawson P2W17O6110– polyoxometalates and reported on the polyoxometalate features that promote reduction and stabilization. In this work we report on the oxidation state stabilization of TcVO, TcVIO and TcVIN within the α‐Keggin PW11O397– polyoxometalate. Both Density Functional Theory and experimental results show that Tc in TBA4[TcVIN‐PW11O39] can be reduced to TcV, but any subsequent electrons reduce the tungsten framework of the polyoxometalate. TBA4[TcVO‐PW11O39] however, can be theoretically reduced down to TcI before reduction of the polyoxometalate occurs. [ABSTRACT FROM AUTHOR]

This article details one teacher education department's process of addressing the social-emotional learning of preservice teachers and, ultimately, their P--12 learners. We used an innovative social-emotional learning framework utilizing the professional learning communities model for faculty development and program implementation. It uses multiple project artifacts to retell the narrative of faculty development and analyze key factors in implementation. The insights shared in this article have implications for others infusing social-emotional learning into their teacher education programs or utilizing professional learning communities for faculty development. [ABSTRACT FROM AUTHOR]

Background Health systems can be integral to addressing population health, including persons with incarceration exposure. Few studies have comprehensively integrated state-wide data to assess how the primary care system can impact criminal justice outcomes. We examined whether enhanced primary care can decrease future contact with the criminal justice system among individuals just released from prison. Methods We linked administrative data (2013-2016) of Connecticut Department of Correction, Department of Mental Health and Addiction Services, Department of Social Service, Court Support Services Division, and Department of Public Health to conduct a quasiexperimental study using propensity score matching of 94 participants who received enhanced primary care in Transitions Clinic to 94 controls not exposed to the programme. The propensity score included 23 variables, which encompassed participants' medical and incarceration history and service utilisation. The main outcomes were reincarceration rates and days incarcerated in the first year from the index date, which was either enrolment in the Transitions Clinic programme or release from prison in the control group. Results The odds of reincarceration, including arrests and new convictions, were similar for the two groups, but Transitions Clinic participants had lower odds of returning to prison for a parole or probation technical violation (adjusted OR: 0.38; 95% CI 0.16 to 0.93) compared with the control group. Further, Transitions Clinic participants had fewer incarceration days (incidence rate ratio: 0.55; 95% CI 0.35 to 0.84) compared with the control group. Conclusions Enhanced primary care for individuals just released from prison can reduce reincarceration for technical violations and shorten time spent within correctional facilities. This study shows how community health systems may play a role in current strategies to reduce prison populations. [ABSTRACT FROM AUTHOR]

The biopsychosocial model is characterized by the systematic consideration of biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery. This model opposes the biomedical model, which is the foundation of most current clinical practice. In the biomedical model, quest for evidence based medicine, the patient is reduced to molecules, genes, organelles, systems, diseases, etc. This reduction has brought great advances in medicine, but it lacks a holistic view of the person. To solve the problem, we propose an early team based approach where the primary care physician leads a group of people that can help her/him address the psychosocial issues while she/he attends to the biomedical issues. This article addresses one case where the clinical ethicist facilitating a team based biopsychosocial model for the care of a patient worked as a bridge between the primary team, the critical care team, and the psychosocial team to advance the argument that good communication among the groups can lead to a true biopsychosocial model where the collaboration of the social worker, psychologist, chaplain, ethicist and the different medical teams can improve the overall patient experience. [ABSTRACT FROM AUTHOR]

Background: Sustained retention in HIV care (RIC) and viral suppression (VS) are central to US national HIV prevention strategies, but have not been comprehensively assessed in criminal justice (CJ) populations with known health disparities. The purpose of this study is to identify predictors of RIC and VS following release from prison or jail.Methods and Findings: This is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, to December 31, 2011, and observed through December 31, 2014 (n = 1,094). Most cohort participants were unmarried (83.7%) men (77.0%) who were black or Hispanic (78.1%) and acquired HIV from injection drug use (72.6%). Prison-based pharmacy and custody databases were linked with community HIV surveillance monitoring and case management databases. Post-release RIC declined steadily over 3 years of follow-up (67.2% retained for year 1, 51.3% retained for years 1-2, and 42.5% retained for years 1-3). Compared with individuals who were not re-incarcerated, individuals who were re-incarcerated were more likely to meet RIC criteria (48% versus 34%; p < 0.001) but less likely to have VS (72% versus 81%; p = 0.048). Using multivariable logistic regression models (individual-level analysis for 1,001 individuals after excluding 93 deaths), both sustained RIC and VS at 3 years post-release were independently associated with older age (RIC: adjusted odds ratio [AOR] = 1.61, 95% CI = 1.22-2.12; VS: AOR = 1.37, 95% CI = 1.06-1.78), having health insurance (RIC: AOR = 2.15, 95% CI = 1.60-2.89; VS: AOR = 2.01, 95% CI = 1.53-2.64), and receiving an increased number of transitional case management visits. The same factors were significant when we assessed RIC and VS outcomes in each 6-month period using generalized estimating equations (for 1,094 individuals contributing 6,227 6-month periods prior to death or censoring). Additionally, receipt of antiretroviral therapy during incarceration (RIC: AOR = 1.33, 95% CI 1.07-1.65; VS: AOR = 1.91, 95% CI = 1.56-2.34), early linkage to care post-release (RIC: AOR = 2.64, 95% CI = 2.03-3.43; VS: AOR = 1.79; 95% CI = 1.45-2.21), and absolute time and proportion of follow-up time spent re-incarcerated were highly correlated with better treatment outcomes. Limited data were available on changes over time in injection drug use or other substance use disorders, psychiatric disorders, or housing status.Conclusions: In a large cohort of CJ-involved PLWH with a 3-year post-release evaluation, RIC diminished significantly over time, but was associated with HIV care during incarceration, health insurance, case management services, and early linkage to care post-release. While re-incarceration and conditional release provide opportunities to engage in care, reducing recidivism and supporting community-based RIC efforts are key to improving longitudinal treatment outcomes among CJ-involved PLWH. [ABSTRACT FROM AUTHOR]

Internationalization trends worldwide have brought more multilingual students into English‐medium university classrooms in the United States and elsewhere. Faculty across the disciplines increasingly have the dual challenge of developing both content and advanced academic language. Ample precedent in P–12 education suggests developing instructors’ knowledge of (a) students as language learners, (b) instructional techniques grounded in second language acquisition theory, and (c) contextual factors necessary for helping instructors implement linguistically responsive instruction (LRI). This study probes the extent to which prior work transfers to the tertiary setting, focusing on participating faculty members’ beliefs about multilingual students, LRI, and context. The authors collected survey data from 197 faculty at a mid‐size comprehensive university in the midwestern United States and analyzed written comments provided by participants. They found that, on the whole, faculty participants displayed deficit views regarding students’ linguistic and academic abilities and questioned the appropriateness and feasibility of several of the LRI techniques. Many rejected the notion that language instruction was within the scope of their responsibilities and expressed a strong preference for support provided outside of class time. The authors discuss the results in terms of the notions of rigor, college readiness, and faculty development in LRI. [ABSTRACT FROM AUTHOR]

Patients and their families have identified the need for ongoing and effective communication as one of the important aspects of medical care, especially when the cessation of disease–modifying therapies is being considered at the end–of–life (EOL). Despite recognizing that this communication is extremely important, clinicians are uneasy and find themselves inadequately trained to "break bad news" and manage emotional responses from the patient/family. The inherent difficulties in accurately predicting prognosis and discussing potential complications make these conversations even more challenging. In most circumstances, patients and their families want to know the truth about their disease and what will be done to make them feel better, and to receive enough information to help them choose a course of action. For many terminally ill patients and their families who have elected to transfer to the palliative care unit (PCU) for EOL care, the assumption is that most of these conversations have already been held, and the ongoing focus becomes managing these patients' physical and psychological sources of distress, validating their and their families' emotional responses and preparing them for what is to come. This case report illustrates the need for cultural understanding and clear communication among physicians, members of the clinical team, and patients and their family members. [ABSTRACT FROM AUTHOR]

This case study considers the clinical ethics issues of medical appropriateness and quality of life for patients who are critically ill. The case involves a terminally ill cancer patient with a profoundly diminished quality of life and an extremely poor prognosis; his spouse desires to bring him home, where she will arrange to keep him alive for as long as possible via life-sustaining interventions. The analysis engages with the complicated notion of medical appropriateness, both in general and as it pertains to life-sustaining interventions in a critical care setting, and considers the ethical implications of the various ways in which one might understand this concept. It also addresses the significance of quality-of-life determinations, emphasizing the role of individualized values in determining the importance of quality of life for clinical decision-making. The discussion concludes with a description of the two strategies employed by the ethics team in helping to alleviate the medical team's concerns about this case. [ABSTRACT FROM AUTHOR]

Recognizing the importance of academic language for students’ success in schools, this article reports on an investigation of how narrative-focused literacy events in the classroom provide opportunities for academic language socialization. Data were collected from one public elementary school in a major metropolitan area in the Mid-Atlantic region of the United States. Participants include an intact kindergarten class of 16 students from culturally and linguistically diverse backgrounds and their teacher. The results of the investigation revealed that sharing time provides opportunities for socialization to academic register through: (1) requiring that students successfully navigate the academic language demands of the interaction, (2) providing differentiated teacher scaffolding that supports students in meeting these demands, and (3) building a linguistic third space. The author discusses how the data and results demonstrate that the roots of mature academic language register are in the emergent academic language used in early childhood classrooms. [ABSTRACT FROM AUTHOR]

In the United States, the phenomenon of mass incarceration has created a public health crisis. One strategy for addressing this crisis involves developing a correctional agency-academic institution partnership tasked with augmenting the quality and quantity of evidence-based healthcare delivered in state prisons and attracting a greater number of health professionals to the field of correctional health research. Using a Connecticut correctional agency-academic institution partnership as a case example, the present paper examines some of the key challenges encountered over the course of a 3-year capacity-building initiative. Particular attention is given to agency and institution characteristics both at the structural level and in terms of divergent stakeholder perspectives. The authors find that future partnership development work in this area will likely benefit from close attention to predictable sources of temporal variation in agency capability to advance project-related aims. [ABSTRACT FROM AUTHOR]

Medical futility is commonly understood as treatment that would not provide for any meaningful benefit for the patient. While the medical facts will help to determine what is medically appropriate, it is often difficult for patients, families, surrogate decision-makers and healthcare providers to navigate these difficult situations. Often communication breaks down between those involved or reaches an impasse. This paper presents a set of practical strategies for dealing with cases of perceived medical futility at a major cancer center. [ABSTRACT FROM AUTHOR]

The article presents abstracts of the ophthalmic literature, including development of motor fusion in patients with a history of strabismic amblyopia treated with bangerter foils, treatment of periocular infantile hemangiomas with propranolol, and development of refractive error in children with Down syndrome.

The purpose of this study is to understand the features of gynecologic oncology patients who receive ethics consults in order to identify areas for physician education and improve patient care. A review of ethics consults for gynecologic oncology patients from 1993 to 2008 was performed. Information on all gynecologic oncology patients treated during the study interval was also collected to define a base population for comparison. Forty-one consults were performed. Compared to the base population, a greater proportion of consult patients had pregnancy-related malignancies (7.9% vs. 0.8%, p < 0.0001) and were African American (33.3% vs. 10.9%, p < 0.0001). The most common clinical case types involved identifying levels of appropriate treatment. Support of the health care team and complex family dynamics were key underlying issues. Ethics consultation provides a substantial resource in identifying relevant issues experienced by gynecologic oncology patients upon which physician educational initiatives may be based. [ABSTRACT FROM AUTHOR]

Background—Improving the survival and quality of life of patients with end-stage heart failure is the primary goal of using a ventricular assist device, generally known as mechanical circulatory support. Ventricular assist devices are a practical longterm surgical option for a select group of patients with end-stage heart failure. Method—A case study is used to demonstrate the process of selection and evaluation of patients with end-stage heart failure for ventricular assist device therapy. Also, a detailed description of all aspects of care of patients before, during, and after implantation of a ventricular assist device is presented. Conclusion—A ventricular assist device is a superior therapeutic option for patients with end-stage heart failure who have become intolerant to medical therapy or in whom medical therapy has been unsuccessful. Advances in device technology through the development of nonpulsatile continuous flow devices are showing favorable long-term outcomes for patients with a ventricular assist device by minimizing complications and enhancing quality of life. [ABSTRACT FROM AUTHOR]

Left ventricular assist devices (LVADs) are slowly gaining acceptance as the treatment of choice in appropriately selected patients with end-stage heart failure who are not transplant candidates. Obesity is a well-known risk factor for increased cardiovascular morbidity and mortality, and frequently can be the reason some patients are turned down for heart transplantation. Because of this experience in transplant patients, many centers have also been reluctant to offer these patients an LVAD for destination therapy (DT). Subsequently, the 1-year outcomes of obese patients receiving LVADs for DT at our center were reviewed. Fifty-eight consecutive patients (83% men) were implanted with HeartMate XVE ( n = 22) or HeartMate II ( n = 36) LVAD. Patients were divided into normal (body mass index [BMI] ≤ 30 kg/m2, n = 38) and obese (BMI ≥ 30 kg/m2, n = 20) groups according to their BMI. Preoperatively, there were statistically significant differences ( P < 0.05) between normal and obese groups in age (65.9 years vs. 54.7 years), weight (72.9 kg vs. 107.5 kg), BMI (24.1 kg/m2 vs. 35.2 kg/m2), and incidence of diabetes (37% vs. 60%). At 1-year follow-up, there were no statistically significant differences ( P > 0.5) between normal and obese groups: creatinine levels (1.4 vs. 1.5), New York Heart Association classification (1.2 vs. 1.6), and survival (63% vs. 65%). Our initial results demonstrate that morbidly obese patients with end-stage heart failure with a contraindication for transplant may successfully undergo implantation of an LVAD for DT. [ABSTRACT FROM AUTHOR]

Presents several abstracts on ophthalmic literature. "Importance of Binocularity in Refractive Surgery," by Arné J-L, L. Lesueur, B. Galan, C. Garabétian; "The Phoropter Trapeze: A Portable Refractive Support for Remote Clinics," by R. W. Arnold; "Dissociated Vertical Deviation Associated With Duane's Syndrome," by H. Bayramlar and M. Borazan.

Presents abstracts of articles which appeared in various ophthalmology journals. "Motor and Sensory Characteristics of Infantile Nystagmus," by A. Bjerre and R.V. Abadi; "Risk Factors for the Development of Accommodative Esotropia Following Treatment for Infantile Esotropia," by E. Birch, S. Fawcett and D. Stager; "The Impact of Dark Adaptation Photoscreening," by A. Cetinkaya, S. Oto and P. Aydin; "Effect of Aging on Human Rectus Extraocular Muscle Paths Demonstrated by Magnetic Resonance Imaging," by R.A. Clarke and J.L. Demer.

Presents several abstracts of studies on ophthalmology. 'Timely Surgery in Intermittent and Constant Exotropia for Superior Sensory Outcome,' by A.D. Abroms, B.G. Mohney, D.P Rush, M.M. Partks and P.Y. Tong; 'Perceptual Components of Psychomotor Tests,' by J.M. Albaret; ' Olfactory Neuroblastoma: An Unusual Presentation,' by Weir C. Cackett.

Presents abstracts of several articles related to ophthalmology. `A Case of Ocular Neuromyotonia With Tonic Pupil,' by N. Abdulla and P. Eustace; `Microvascular Cranial Nerve Palsies in a Arabic Population,' by M. Al Saleh and T.M. Bosley.

The article discusses proposals to meet the Code of Ethics and Professional Responsibilities requirement for health care ethics (HCE) consultants to be competent. Topics covered include proposals for minimum training programs of HCE consultants that would entail systematic education for applying theoretical concepts, participation in ethics consultation and continuing mentorship. Conclusions call for support of leaders in professionalizing HCE consultation through required competency level.