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BackgroundStudy populations in clinical research must reflect US changing demographics, especially with the rise of precision medicine. However, racial and ethnic minority groups (REMGs) have low rates of participation in cancer clinical trials.MethodsCriteria were developed to identify cancer centers able to accrue a higher than average proportion of REMGs into clinical trials. Comprehensive interviews were conducted with leaders of these cancer centers to identify operational strategies contributing to enhanced accrual of REMGs.ResultsEight US cancer centers reported a REMG accrual rate range in cancer research between 10 and 50% in a 12-month reporting period and met other criteria for inclusion. Fourteen leaders participated in this assessment. Key findings were that centers: had a metric collection and reporting approach; routinely captured race and ethnicity data within databases accessible to research staff; had operational standards to support access and inclusion; developed practices to facilitate sustained patient participation during clinical trials; had strategies to decrease recruitment time and optimize clinical study design; and identified low-resource strategies for REMG accrual. There was also a clear commitment to establish processes that support the patient's provider as the key influencer of patient recruitment into clinical trials.ConclusionWe have identified operational practices that facilitate increased inclusion of REMGs in cancer trials. In order to establish a sustainable cancer center inclusion research strategy, it is valuable to include an operational framework that is informed by leading US cancer centers of excellence.

Two prevailing theories explain citizen satisfaction with public services from different levels and sizes of government. Reform theory argues that citizens derive the most satisfaction from larger government units because of economies of scale in service delivery. Political economy theory argues that citizens achieve the most satisfaction from smaller local government units since their voice is more likely to be heard. Both theories have been tested yielding mixed findings. An alternative theory argues that citizens have different levels of satisfaction depending upon the specific services received and directly experienced. These theories are tested using Canadian national public opinion survey data. Deux theories predominantes expliquent la satisfaction des citoyens a l'egard des services publics de differents paliers et tailles de gouvernement. La theorie de la reforme soutient que les citoyens tirent le plus de satisfaction des grands services administratifs en raison des economies d'echelle dans la prestation de services. La theorie de l'economie politique soutient que les citoyens obtiennent le plus de satisfaction des petits services administratifs locaux parce que leur voix est plus susceptible d'etre entendue. Les deux theories ont ete testees pour produire des resultats mitiges. Une theorie alternative soutient que les citoyens ont differents degres de satisfaction en fonction des services specifiques recus et directement vecus. Ces theories sont testees a l'aide de donnees tirees d'un sondage d'opinion publique national canadien., Ample research in public administration has examined citizen satisfaction with public service delivery. The majority of this research looks at citizen satisfaction through the theoretical lens of expectation/disconfirmation theory. This [...]

Ethics research has focused on issues such as codes of conduct and ethical values and less on ethics training. This paper examines evidence from a national survey of local governments on what approaches they take to ethics training through the topics they teach. Our analysis showed that they use both of the two common types of training approaches: "compliance-based," focusing on enforceable rules, and "integrity-based," which aims more at instilling values. The research showed that the compliance-based approach was most commonly used, and integrity-based topics were less heavily emphasized. It found that these training topics were most likely to be offered in the Midwest, and managers were given the same training as employees. Population size and form of government did not register much impact. The results support prior research that local governments more often take the "low road" in ethics training and do not teach values and public interest topics.

Higher education is often framed as a means to social mobility and increased earnings. However, the value of university education in the United States is coming under scrutiny in regard to its costs. This article examines a university education's return on investment (ROI) from attending different types of universities in the United States. Unlike previous research, this study focuses on the variation of university institutional characteristics and their impact on ROI. This study analysed data from the US Department of Education College Scorecard, focusing on institutional factors, such as public/private, student body characteristics, research intensity, student diversity and selectivity. The results confirm that highly selective universities have a greater ROI, public universities overall have a better ROI, Research 1 universities have the higher ROI and private Research 1 institutions have the highest ROI. Implications for educational administration and university selection criteria are discussed. [ABSTRACT FROM AUTHOR]

The literature in public administration has advanced various propositions to promote ethical behavior. Local governments have undertaken various efforts in that direction. Those efforts are considered critical for building ethical leadership and culture in the long run. Based on a literature review and use of Social Learning Theory, we identify four building blocks of an ethics infrastructure for public organizations. Employing a comprehensive survey of local governments, this paper shows that displaying awareness and knowledge of ethics, enforcing rules and norms, demonstrating policy support for ethical behavior, and incentivizing the right behaviors are key building blocks of ethics infrastructure that still need improvement in local governments. The reality of ethics infrastructure revealed by the survey is far from the idealism promoted in the literature. We discuss the results and offer several insights and remedies. [ABSTRACT FROM AUTHOR]