Multidisciplinary care, patient decision aids rarely offered.

by the University of Michigan

ANN ARBOR, Michigan.— Most breast cancer surgeons’ practices do not follow standards associated with the best quality of care, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center. These standards include consulting with other specialists and providing resources and education to help patients make treatment decisions.

“Despite the mantra for multidisciplinary decision-making and care intake for patients, surgeons in the community are reporting relatively little of that in their practices,” says lead study author Steven J. Katz, M.D., M.P.H., professor of internal medicine at the U-M Medical School and professor of health management and policy at the U-M School of Public Health.

Researchers surveyed 318 surgeons who treated breast cancer patients in the Detroit and Los Angeles metropolitan areas. Surgeons were asked about the processes and services available in their practice, including:

• Consulting with medical oncologists, radiation oncologists and plastic surgeons.
• Collecting or reviewing biopsy specimens or mammograms.
• Offering patient education videos or presentations.
• Connecting patients with peers, for example through support groups.

The measures were developed by the researchers based on accepted standards in other areas of chronic care. Results of the study mexicanoappear in the January issue of Medical Care.

About one-quarter to one-third of surgeons reported they had routinely discussed patients’ treatment plans with medical or radiation oncologists. Only 13 percent routinely consulted with a plastic surgeon. About one-third of surgeons said their patients typically participate in patient decision support activities, such as viewing a video or Web-based materials or attending peer support programs.

Surgeons who treated mostly breast cancer patients were more likely to report these services, compared to surgeons who saw fewer breast cancer patients. But a program’s status with the National Cancer Institute or the American College of Surgeons did not correspond with meeting more of the quality of care measures.

­“Either doctors are not convinced these elements matter or there are logistical constraints in terms of building these standards into their practices. What the implications are for patients is unknown. These results suggest patients might find a more integrated practice among surgeons with higher volume. But we don’t know whether that matters with regards to patient decision making, quality of life and satisfaction,” says Katz, who is also co-director of the socio-behavioral program at the U-M Comprehensive Cancer Center.

Breast cancer statistics: 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease, according to the American Cancer Society.

­by the El Reportero’s staff

Advocates ask for expansion of tenant law at City Hall.

Tenants advocates make a last minute push on Monday to convince the Board community organization to expand OMI the Legislation Banning Evictions of Households With Children, which will end most no-fault evictions of children.

The legislation would prohibit the evictions of households with children for the purposes of a landlord or relative moving into their apartment. At press time, a vote on the issue that was scheduled to take place on Jan. 12 was move to February, according to a member of St. Peter’ Housing organization.

The legislation was approved by the Land Use Committee in December but Sup. Sophie Maxwell cast a surprising vote against a measure which would have ended most no-fault evictions of children.

Children advocates have urged that families with children be added as one of these protected classes, as evictions are also especially difficult on children, with numerous studies showing that forced moves impairs learning and childhood development.

by the El Reportero’s news services

Hugo Chávez

­COPENHAGEN — Hugo Chavez accused the Netherlands on Thursday of allowing the United States to use Dutch islands off Venezuela’s Caribbean coast to prepare a possible military attack against his country.

The Venezuelan leader said the U.S. military, to prepare for a possible offensive, has sent intelligence agents, war ships and spy planes to Aruba, Curacao and Bonaire, which are self-governing Dutch islands.

“They are three islands in Venezuela’s territorial waters, but they are still under an imperial regime: the Netherlands,” Chavez said during a speech at a climate change conference in Denmark. “Europe should know that the North American empire is filling these islands with weapons, assassins, American intelligence units, and spy planes ­and war ships.”

In Washington, State Department spokesman Ian Kelly denied that U.S. military personnel in the Caribbean are planning to attack Venezuela.

“These allegations are baseless. These are routine exercises. We seek cooperation with the region,” Kelly said.

Chavez did not offer evidence supporting his accusations, but he blamed the Netherlands and said the European Union should take a stance.

Chile’s Enríquez-Ominami sets terms to Frei

Marco Enríquez-Ominami, the defeated independent candidate in the fi rst round of the elections, has effectively demanded the resignation of two more party leaders as the price for his support for Eduardo Frei, the presidential candidate from the ruling Concertación in the run-off on Jan. 17.

On Dec. 30 the leaders of two of the smaller parties in the quadripartite Concertación resigned.

Enríquez-Ominami immediately demanded that the leaders of the big two parties in the Concertación, Camilo Escalona (Partido Socialista) and Juan Carlos Latorre (Democracia Cristiana) should also go. Frei who finished well behind the rightwinger, Sebastián Piñera, in the fi rst round of the elections on 13 December, needs to attract around 80 percent of EnríquezOminami’s votes to stand any chance of winning the run-off.

by Erick Galindo

WASHINGTON, D.C. — High-stakes political maneuvering is dragging Hispanic advocacy groups here deeper into the battle over the future of the Internet.

As the Federal Communications Commission moves ahead with plans to create a set of rules designed to prevent online monopolies from forming, supportive consumer protection organizations are pressing ethnic advocacy and civil rights groups, including the Urban League, One Economy and National Council of La Raza, to speak out in support of network neutrality.

Some, such as the NAACP, the League of United Latin American Citizens and the Hispanic Technology & Telecommunications Partnership, are following the lead of telecommunication giants Verizon, AT&T and Comcast. Others are avoiding taking a position opposing the trio. Still others, including the National Association of Hispanic Journalists and non-white media groups, are lining up with consumer protection groups and Web giant Google.

On one point all agree: Much is at stake for communities of color. Groups favoring network neutrality are led by the Center for Media Justice. Without it, they fear unequal access and eventual extra costs to poor and non-white communities. Its supporters came from throughout the country in December to try to sway traditional civil rights organizations to back their position. In meetings with several such groups and federal legislators, CMJ encountered minimal opposition to its arguments.

“This was new information to us, that there were civil rights organizations that believed that network neutrality was an essential policy in protecting the rights and power of people of color online,” CMJ executive director Malkia Cyril told Weekly Report. None of them outright opposed the idea, she said.

Cyril, who spearheaded a series of meetings with the groups Dec. 8-10, added that one group’s representative called it “absurd” for any civil rights organization to oppose it.

“They are taking a measured approach to the issue,” Cyril said. ”To them, the issue is whether this should be on par with broadband adoption and other issues.” Cyril noted that the groups invited to the meetings were singled out because of their close partnerships with telecommunications companies and the fact that they had not yet taken a fi rm stance.

Alex Nogales, president of the National Hispanic Media Coalition, which is based in California, told Weekly Report that a lack of information is the root of any rift between consumer protection groups and civil rights groups. Cyril added,

“The leaders of the groups thanked us for meeting with them face-toface and not letting one of the telecommunications companies mediate. So far all the information they have been getting has been coming from the telecom companies. Organizations that have deep relationships in communities of color on the ground in regions and states are much more likely to take a pro-net neutrality stance because they understand the real impact.” LULAC executive director Brent Wilkes argues that just the opposite is true. He told Weekly Report that the average member of the Latino community is more concerned with hackers and viruses.

LULAC’s only opposition to net neutrality is to the non-discrimination clause, which would prevent Internet service providers from favoring content or access.

Wilkes noted that LU-LAC’s concern is with any adverse effect legislation could have on broadband adoption. “What we don’t want net neutrality to do is drive up price. We know that our communities are price-sensitive,” he said, adding that forcing ISPs to provide the same access to other companies’ content would be unfair since ISPs have invested into building the infrastructure.

“The only option these companies could redeem the costs of laying the pipe

would be to charge more ­for the data itself.” Wilkes denied allegations that LULAC’s close relationship to AT&T had any infl uence on the matter. AT&T has donated more than a million dollars to help LULAC gain broadband access to underdeveloped communities and other philanthropic endeavors.

“Obviously we have to raise money from a variety of sources, but we never shy away from standing up for what we believe is right,” he said. “That whole argument is really unfair, especially when it only seems to belevied against minority advocacy groups.”

In this, Nogales agreed with Wilkes. “To say that these organizations are doing this for the money is way off,” Nogales said. “LULAC and these groups do a lot of great things and they have their reasons for opposing net neutrality.”

Nogales and Cyril agreed that broadband prices would not go up under net neutrality. “Our numbers point to the opposite,” Nogales said. Cyril said it would be illegal to pass the cost on to consumers, adding she believes that the FCC will pass net neutrality and remain open to working with LULAC and others.

“There are groups all across the country who are committed to partnering with national civil rights groups in order to promote open networks because we know that’s what empowers communities that can vote, that can advocate forthemselves online,” she concluded.

Weekly Report tried numerous times to contact AT&T without success. Hispanic Link.