NATIONAL LABOR RELATIONS BOARD

NATIONAL LABOR RELATIONS BOARD

United Brotherhood of Carpenters and Joiners of America, Local Union No. 1506 and Eliason & Knuth of Arizona, Inc.; United Brotherhood of Carpenters and Joiners of

America, Local Union No. 1506 and Northwest Medical Center; United Brotherhood of Carpenters and Joiners of America, Local Union No. 1506 and Ra Tempe Corporation.

Cases 28-CC-955, 28-CC-956, 28-CC-957

NATIONAL LABOR RELATIONS BOARD

355 N.L.R.B. 797; 2010 NLRB LEXIS 321; 189 L.R.R.M. 1041; 2010-11 NLRB Dec. (CCH) P15,306; 355 NLRB No. 159

August 27, 2010

SUBSEQUENT HISTORY: [*1] Companion case at United Bhd. & Joiners, Local Union No. 1506, 2010 NLRB LEXIS 364 (Sept. 22, 2010)

JUDGES: By Wilma B. Liebman, Chairman; Craig Becker, Member; Mark Gaston Pearce, Member

OPINION:

DECISION AND ORDER

Introduction

This case presents an issue of first impression for the Board: does a union violate Section 8(b)(4)(ii)(B) of the National Labor Relations Act when, at a secondary employer’s business, its agents display a large stationary banner announcing a “labor dispute” and seeking to elicit “shame on” the employer or persuade customers not to patronize the employer. Here, the Union peaceably displayed banners bearing a message directed to the public. The banners were held stationary on a public sidewalk or right-of-way, no one patrolled or carried picket signs, and no one interfered with persons seeking to enter or exit from any workplace or business. On those undisputed facts, we find that the Union’s conduct did not violate the Act.

Congress intended Section

The language [*2] of the Act and its legislative history do not suggest that Congress intended Section 8(b)(4)(ii)(B) to prohibit the peaceful stationary display of a banner. Furthermore, a review of Board and court precedent demonstrates that the nonconfrontational display of stationary banners at issue here is not comparable to the types of conduct found to “threaten, coerce, or restrain” a neutral employer under Section 8(b)(4)(ii)(B) — picketing and disruptive or otherwise coercive nonpicketing conduct.

Our conclusion about the reach of the prohibition contained in Section 8(b)(4)(ii)(B) is strongly supported, if not compelled, by our obligation to seek to avoid construing the Act in a manner that would create a serious constitutional question. n1 Governmental regulation of nonviolent speech–such as the display of stationary banners–implicates the core protections of the First Amendment. The crucial question here, therefore, is whether the display of a stationary

Page 1

 

DECISION AND ORDER

banner must be held to violate Section 8(b)(4)(ii)(B) or, instead, “whether there is another interpretation, not raising these serious constitutional concerns, that may fairly be ascribed to” the statutory provision. Edward J. DeBartolo Corp. v. Florida Gulf Coast Building & Construction Trades Council, 485 U.S. 568, 577, 108 S. Ct. 1392, 99 L. Ed. 2d 645 (1988). [*3]

n1 See, e.g., Edward J. DeBartolo Corp. v. Florida Gulf Coast Building & Construction Trades Council, 485 U.S. 568, 575, 577, 108 S. Ct. 1392, 99 L. Ed. 2d 645 (1988); NLRB v. Catholic Bishop of Chicago, 440 U.S. 490, 500, 99 S. Ct. 1313, 59 L. Ed. 2d 533 (1979).

As we indicated above, the answer to the question posed by the Supreme Court in DeBartolo is clear in this case. Nothing in the language of the Act or its legislative history requires the Board to find a violation and thus present for judicial review the constitutionality of Section 8(b)(4)(ii)(B) as applied to the peaceful display of a stationary banner. Rather, the display of a stationary banner, like handbilling and even certain types of picketing, n2 is noncoercive conduct falling outside the proscription in Section 8(b)(4)(ii)(B). n3

The General Counsel

n2 See NLRB v. Fruit & Vegetable Packers, Local 760, 377 U.S. 58, 84 S. Ct. 1063, 12 L. Ed. 2d 129 (1964) (Tree Fruits) (applying canon of constitutional avoidance to hold that Sec. 8(b)(4)(ii)(B) does not bar all forms of peaceful consumer picketing); NLRB v. Drivers Local Union No. 639, 362 U.S. 274, 80 S. Ct. 706, 4 L. Ed. 2d 710 (1960) (Curtis Bros.) (applying canon to hold that peaceful picketing for recognition by minority union did not violate the pre-Landrum-Griffin Sec. 8(b)(1)(A)). In both Tree Fruits and Curtis Bros., as well as in DeBartolo, supra, the Supreme Court rejected the Board’s view that unions had committed unfair labor practices.

[*4]

n3 The General Counsel has sought injunctive relief in federal district court under Sec. 10(l) of the Act in four cases involving display of banners. Despite the deferential standard applied to applications for such relief, the district court in each of those cases rejected the contention that display of banners violated the Act. In the one case where the decision was tested on appeal, the United States Court of Appeals for the Ninth Circuit affirmed the district court’s decision. See Overstreet v. Carpenters Local 1506, 409 F.3d 1199 (9th Cir. 2005), affirming Overstreet v. Carpenters Local 1506, 2003 U.S. Dist. LEXIS 19854, 2003 WL 23845186 (S.D. Cal. 2003); Gold v. Mid-Atlantic Regional Council of Carpenters, 407 F.Supp.2d 719 (D. Md. 2005); Benson v. Carpenters Locals 184 & 1498, 337 F.Supp.2d 1275 (D. Utah 2004); Kohn v. Southwest Regional Council of Carpenters, 289 F.Supp.2d 1155 (C.D. Cal. 2003).

For both of those reasons, we dismiss the allegations.

 

Future Trends in Managed Care In the context of COVID 19 Environment

Instructions

The History of Health Insurance and Managed Care
Health insurance began in the early part of the twentieth century as a means to protect an organization’s assets, either its financial assets or its manpower. Since the early days, health insurance evolved into a system of managed care in order to control issues such as overutilization, skyrocketing costs, limited restrictions, and low-quality care.

Based on your research, answer the following questions:
1) Examine the main events in the history of health insurance from the mid-twentieth century to the present.
2) Explain how these events led up to the evolution of managed care organizations.
3) Evaluate the purpose of health care insurance in the early days.
4) Evaluate the evolution of health insurance and managed care.
5) What is the relationship between the two and how has managed care risen to prominence in today’s health care market?
6) Explain how the perspective of health insurance has or hasn’t changed in today’s managed care environment.
7) Analyze the public policy and market forces leading to the growth of managed care.
8) Analyze the current trends in managed care and its future in the context of COVID-19 environment.

Directions to student: Discuss (in no less than 500 words) the current and future trends in managed care in the context of COVID-19 environment into three substantive paragraphs. Make sure you include at least four APA-formatted citations/references, to include an introduction/conclusion.
Submit your work to the Discussion Area.
No Post or Follow-up posts needed.

the Principle of Social Justice

Consider the following scenario: Your city council has approved the placement of a toxic waste dump in a small, low-income community. The company building the dump has hosted informational meetings, but residents rarely attend and are unaware of the proposal. The approval will bring very little economic benefit to the community. The CEO of the company feels that, since no one attended the meetings, the approval is valid. Do you agree with the CEO’s claim? Why or why not? Consider the principal of social justice and include recommendations for what should have been done prior to the council meeting to ensure that the decision was ethical, fair, and valid. Describe two strategies you would implement to engage this community in advocacy for health equity. 300 words minimum

synthesis of the current knowledge

write a (2-3 pages) addressing the sections below of the research proposal.

This week you will submit the Literature Review section of your proposal. Each week you have been adding to your growing body of evidence to support your problem and proposed innovation to address the problem. The review of literature is a critical, analytical summary and synthesis of the current knowledge of your research topic. Thus it should compare and relate different theories, findings, etc., rather than just summarize them individually.

The following resources will help guide you (in addition to our course textbooks):

THE WRITER’S HANDBOOK

Guidelines for writing a literature review

The Writing Center at UNC-Chapel Hill

Writing the Literature Review: Step-by-Step Tutorial for Graduate Students

Writing the Literature Review (Part Two): Step-by-Step Tutorial for Graduate Students

Psychosis and Schizophrenia Assessment

Assessing and Treating Patients With Psychosis and Schizophrenia
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with psychosis and schizophrenia.

TO PREPARE FOR THIS ASSIGNMENT:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with schizophrenia-related psychoses.
THE ASSIGNMENT: 5 PAGES
Examine Case Study: Pakistani Woman With Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)

Psychosis and Schizophrenia Assessment

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Breast Cancer among Hispanic Women in United States

Investigate a specific health disparity. As stated from the National Cancer Institute,Health disparities refer to how frequently a disease affects a group, how many people get sick, or how often the disease causes death.” Another definition from the NIH Working Group on Health Disparities states the following: “…the difference in the incidence (number of new cases) and the prevalence (total number of cases), mortality (death rate), and burden of disease and other adverse health conditions that exist among specific groups in the United States.” Many different populations are affected by disparities.

When investigating this specific health disparity, answer the following questions:

Why is it important to understand this health disparity? Provide a strong case for this research paper. Why is this health disparity a significant consideration? Once you have made a case and found research and data to support the health disparity, look for solutions. Answer the following question:

What are some current solutions to minimizing this health disparity? To answer this question, look for a specific program, community service, non-profit or government agency, specific grant or private funding, etc. that is working to eliminate this specific health disparity.

Finally, you will summarize by re-stating the issue, possible solutions, and future considerations.

Ideally, the health disparity you choose to investigate will be linked with your service learning experience. Investigating an alternate health disparity, unrelated to your Service Learning experience is also acceptable.

Advanced Pathophysiology Kaposi Sarcoma

Advanced Pathophysiology Kaposi Sarcoma

FIRST POST

Kaposi sarcoma though rare, is one of the most common malignancies associated with HIV. And typically develops under immunocompromised circumstances (Tso et al., 2017). Mr. Hohner was found to have HIV and herpes simplex virus. Two conditions that compromise the body’s immune response. Tso et al. (2017) states that there is a link between herpes simplex virus and Kaposi sarcoma. Under normal circumstances, the body would fight off a herpes infection however with HIV the immune system is compromised. And unable to fight off the infection. Mr. Hohner likely developed Kaposi Sarcoma due to prolonged herpes simplex virus and a compromised immune system.

Mr. Hohner’s CD4+ count is so low because he has advanced HIV which indicates a severe compromise of the immune system. Lebelonyane et al. (2020) states that a CD4+ count lower than 200 is indicative of advanced HIV infection. Mr. Hohner falls into this category because his CD4+ count was found to be 180. This low CD4+ count meaning a compromise in the immune system is the reason he developed pneumocystis pneumonia. Pneumocystis pneumonia is a pneumonia caused by a fungal infection of the lungs (Charles & Shellito, 2016). Again, under normal circumstances, the human body would fight this off but given the state of depressed immune system, Mr. Hohner was not able to fight this off.

Kaposi sarcoma and pneumocystis pneumonia

Mr. Hohner has probably had HIV for a long time, likely years. A low CD4+ count, Kaposi sarcoma and pneumocystis pneumonia are all conditions that develop with a severely compromised immune system and indicate an untreated HIV infection has been present for a long time (Charles & Shellito, 2016). Mr. Hohner most likely had HIV well before it was discovered because in a lot of cases symptoms do not present until the disease has progressed (Lebelonyane et al., 2020). Mr. Hohner was also in a long-term relationship with a partner who was HIV negative so he may not have considered that he could have it. Overall, untreated HIV has left Mr. Hohner with a compromised immune system and multiple other related complications.

Charles, T. P., & Shellito, J. E. (2016). Human immunodeficiency virus infection and host defense in the lungs. Seminars in Respiratory & Critical Care Medicine, 37(2), 147-156. https://doi.org/10.1055/s-0036-1572553

Lebelonyane, R., Mills, L. A., Mogorosi, C., Ussery, F., Marukutira, T., Theu, J., Kapanda, M., Matambo, S., Block, L., Raizes, E., Makhema, J., Lockmang, S., Bachanas, P., Moore, J., Jarvis, J. N., & Lockman, S. (2020). Advanced HIV disease in the Botswana combination prevention project: Prevalence, risk factors, and outcomes. AIDS, 34(15), 2223-2230. https://doi.org/10.1097/QAD.0000000000002627

Tso, F. Y., Sawyer, A., Kwon, E. H., Mudensa, V., Langford, D., Zhou, Y., West, J., & Wood, C. (2017). Kaposi’s sarcoma- associated herpes virus infection of neurons in HIV positive patients. Journal of Infectious Disease, 215(12), 1898-1907. https://doi.org/10.1093/infdis/jiw545

SECOND POST

Although a rare cancer, Kaposi sarcoma was developed by the patient due to the infiltration of malignant tumor cells. This cancer type has been associated with human herpesvirus 8 (HHV8) (Liu et al., 2018). Kaposi sarcoma has been closely linked to HIV infection. Individuals diagnosed are immunocompromised hence why Mr. Hohner has contracted pneumonia frequently within the last year.

Studies have shown those affected by HIV who had a higher CD4 count were at lesser risk of contracting KS. However those with lower CD4 counts were at a higher risk. Mr. Hohner’s lab results showed a decrease in CD4 cell count and was unaware of his diagnoses for a period of time (Liu et al., 2018). According to the World Health Organization, CD4 aides in staging, a CD4 cell count <200cells/µl or WHO stage 3 or a 4 event.><200cells/microliter, may indicate a stage 3 or 4 prognosis (Bacchus-Souffan et al., 2021).

Pneumocytosis pneumonia

Individuals who are immunocompromised are unable to fight serious infections. Pneumocytosis pneumonia is caused by a fungus known as pneumocytosis jirovecii. And those who have HIV/AIDS are at a greater risk of contraction (Kolls, 2017). Given Mr. Hohners diagnoses, his CD4 T cells were unable to drive a response in clearance of the pneumocytocisis pneumonia (Otieno-Odhiambo et al., 2019).

With the information presented and the resulted lab findings, Mr. Hohner has most likely been infected with HIV for 5 + years.

Antiretroviral therapies have been largely beneficial to individuals diagnosed with HIV/AIDs. ART has led to a decrease in mortalities and has provided a better quality of life. At times, patients can be unaware of their HIV status as symptoms do not suddenly appear. This unawareness is caused by the virus multiplying at very low levels not causing symptoms known as the latency period (Bacchus-Souffan et al., 2021).

Development of Prevention Oriented Health Policy

Reply to 3 Posts

FIRST POST

Development of Prevention-Oriented Health Policy

Nurses’ influence on prevention-based policy safeguards the quality of care via access to needed opportunities and resources. Evaluating the present condition of preventative-based health policy creates several fundamental research questions that could solve vital gaps (Crowley et al., 2018). Additionally, evidence suggests that certain health promotion interventions and disease prevention, when cautiously developed, well assessed, systematically executed, and intended at a particular health problem could create a difference. There is global evidence that organizational patterns of concerns influence the creation of prevention-linked health policy (Crowley et al., 2018).

Further, the endeavors of the nurse leaders and public health structure should receive good political will. Besides, the public health system should also identify and explore the full potential of new strategies and options for prevention-based policy and action. The socioeconomic situation of clients perpetuates, creates, and influences most health challenges. Consequently, socioeconomic status is a major determinant in the development of health prevention-centered policies. For instance, studies suggest that the most efficient programs for young people and children are made at the national level, aided by the general society, and advance national policies to reduce poverty and improve social equality (Champoux et al., 2020).To be most effective public health interventions should cater for all the indirect and direct influences on the affected population.

Advanced Practice Nurse (APN) Role in Promoting Health and Preventing Disease

Population health has emerged as a leading epidemiological strategy that summarizes both health promotion and public health (Bryant-Lukosius et al., 2017). With their experience and knowledge received in the work environment, APN nurses enjoy better positions in the

health team that facilities their involvement in health policies by allowing effective plans. The nurses can promote health by recognizing policymakers’ major pressing requirements and enabling collaboration with researchers to create policy ideas that could aid the utilization of policy research. Additionally, the nurses’ leaders may pay more attention and become more politically shrewd to political determinants of health at the national level. Health disparities are widening worldwide and the most vulnerable populations face difficulties receiving patient-focused care and accessing the health system. Nurse leaders may, therefore, work together to address health issues at both national and global levels by collaborating with nurse leaders from other nations.

References

Bryant-Lukosius, D., Valaitis, R., Martin-Misener, R., Donald, F., Peña, L. M., & Brousseau, L. (2017). Advanced practice nursing: a strategy for achieving universal health coverage and universal access to health. Revista latino-americana de enfermagem, 25.

Champoux, E., Price, R., Cowdery, J. E., Dinh, M., Meurer, W. J., Rehman, N., … & Skolarus, L. E. (2020). Reach Out Emergency Department: Partnering With an Economically Disadvantaged Community in the Development of a Text-Messaging Intervention to Address High Blood Pressure. Health promotion practice, 21(5), 791-801.

Crowley, M., Scott, J. T. B., & Fishbein, D. (2018). Translating prevention research for evidence-based policymaking: results from the research-to-policy collaboration pilot. Prevention Science, 19(2), 260-270.

Basics of Financial Principles

Wthin the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

You are the chief financial officer (CFO) for an organization and need to discuss with fellow C-suite executives that cost cutting is not the only answer to profitability. Prepare for the next manager’s meeting by responding to the following prompts:

Alnylam Pharmaceuticals Case Study

The Alnylam Pharmaceuticals Case Study describes a commercialization scenario in which Alnylam has filed a lawsuit against the co-owners of a patent pending application. In addition, to addressing the validity of patent(s) pending, the case illustrates the importance of the outcome of the aforementioned litigation on the Company’s corporate strategy. As with the previous case write-up assignments the questions for this Case Study write-up require you to explain critical aspects of the case from a situational perspective, as well as to develop replies to specific questions presented by the case.

Case Study Write-Up Questions

1. In 2-3 paragraphs please present a situational description of the case that addresses: Who is Dr. John Maraganore? Who are the stakeholders involved in the case and what are their roles? Why are they working (or not working) together collaboratively?

2. How do you balance the risks vs. rewards of Alnylam’s licensing strategy? What are its pros and cons? How should Alnylam sustain its IP and licensing strategy? Should Alnylam Pharmaceuticals convert its business model such that it becomes an intellectual property licensing company?

3. Are there specific aspects about RNA interference as a technology platform that

make it easier or harder to develop and subsequently execute an intellectual property strategy to protect it?

4. Why are the co-owners of the Tuschl I patent arguing over the patent’s prosecution?

5. If Merck, through Sirna, has a license to Tuschl I, should it also need a license from Alnylam?

6. At what point, if ever, should Alnylam negotiate with Merck for a license to the latter’s intellectual property

In addressing the questions presented, please feel free to develop and utilize diagrams to support your answers