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Purpose Despite clinical guidelines, palliative care is underutilized during advanced stage lung cancer treatment. To inform interventions to increase its use, patient-level barriers and facilitators (i.e., determinants) need to be characterized, especially among patients living in rural areas or those receiving treatment outside academic medical centers. Methods Between 2020 and 2021, advanced stage lung cancer patients ( n  = 77; 62% rural; 58% receiving care in the community) completed a one-time survey assessing palliative care use and its determinants. Univariate and bivariate analyses described palliative care use and determinants and compared scores by patient demographic (e.g., rural vs. urban) and treatment setting (e.g., community vs. academic medical center) factors. Results Roughly half said they had never met with a palliative care doctor (49.4%) or nurse (58.4%) as part of cancer care. Only 18% said they knew what palliative care was and could explain it; 17% thought it was the same as hospice. After palliative care was distinguished from hospice, the most frequently cited reasons patients stated they would not seek palliative care were uncertainty about what it would offer (65%), concerns about insurance coverage (63%), difficulty attending multiple appointments (60%), and lack of discussion with an oncologist (59%). The most common reasons patients stated they would seek palliative care were a desire to control pain (62%), oncologist recommendation (58%), and coping support for family and friends (55%). Conclusion Interventions should address knowledge and misconceptions, assess care needs, and facilitate communication between patients and oncologists about palliative care.

Purpose Clinical guidelines recommend early palliative care for patients with advanced lung cancer. In rural and underserved community oncology practices with limited resources, both primary palliative care from an oncologist and specialty palliative care are needed to address patients’ palliative care needs. The aim of this study is to describe community oncology clinicians’ primary palliative care practices and perspectives on integrating specialty palliative care into routine advanced lung cancer treatment in rural and underserved communities. Methods Participants were clinicians recruited from 15 predominantly rural community oncology practices in Kentucky. Participants completed a one-time survey regarding their primary palliative care practices and knowledge, barriers, and facilitators to integrating specialty palliative care into advanced-stage lung cancer treatment. Results Forty-seven clinicians (30% oncologists) participated. The majority (72.3%) of clinicians worked in a rural county. Over 70% reported routinely asking patients about symptom and physical function concerns, whereas less than half reported routinely asking about key prognostic concerns. Roughly 30% held at least one palliative care misconception (e.g., palliative care is for only those who are stopping cancer treatment). Clinician-reported barriers to specialty palliative care referrals included fear a referral would send the wrong message to patients (77%) and concern about burdening patients with appointments (53%). Notably, the most common clinician-reported facilitator was a patient asking for a referral (93.6%). Conclusion Educational programs and outreach efforts are needed to inform community oncology clinicians about palliative care, empower patients to request referrals, and facilitate patients’ palliative care needs assessment, documentation, and standardized referral templates.

PACE enables frail older people who are eligible for nursing home care to continue living in the community with the full spectrum of medical, social, and rehabilitative services (Eng et al., 1997). Community leaders contended that a system of day health and social services based on the British day hospital model would enable their neighborhood's frail older adults to delay or even avoid moving to a nursing home. The model was tested through demonstration projects that were begun in the mid eighties by the federal agency responsible for Medicare and Medicaid (at the time, the Health Care Financing Administration, now Centers for Medicare and Medicaid Services).

Effective and value-based healthcare for older people is becoming increasingly important as the number of older adults who require high-quality long-term care for chronic illness continues to increase. How can healthcare providers best serve the needs of those who are both frail and elderly? Models of care must incorporate cost containment without compromising participants’ quality of care or quality of life. Though frail elders say they want to remain at home in their community, frequently, complex medical conditions and lack of financial and community resources may make nursing home placement the only option [1].

Background. Faculty factors not inherently related to teaching effectiveness can influence teaching ratings. No studies have focused on pediatric faculty who possess unique differences from general medical faculty. Methods. We designed a retrospective observational study to compare faculty teaching ratings with measured factors across 3 academic pediatric institutions. Results. Our study included 196 faculty members. The majority (76%) of variation in teaching effectiveness ratings was not accounted for by any measured variable, but 24% was attributed to measurable factors. Increased resident exposure (sequential r2 = .10, P < .0001) significantly affected teaching effectiveness. Variation between resident ratings of pediatric faculty teaching can be partially explained by measured factors not necessarily related to teaching effectiveness. Conclusions. The identification of faculty factors that significantly contribute to rating variation can enhance interpretation of these rating.

Objective. It is unknown whether advanced imaging (AI) is associated with higher quality breast cancer (BC) care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI) or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT) versus mammogram and/or ultrasound (M-US) alone and receipt of guideline concordant care (GCC) using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT) (OR 1.55, 95% CI 1.08–2.26, and p = 0.02 ) and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+) BC (OR 1.74, 95% CI 1.17–2.59, and p = 0.01 ). Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively.

Volkov proved that the artist-in-residence concept works, along with the performances out in the community, Russell said. Remembering Carmen Schenk, who co-owns Jimmy Anderson's Casual Gourmet, a restaurant on Spring Hill Road, with husband, Xaver Wilhelmy, recalled how Volkov and a pianist, Stefan Petrov, played at the restaurant twice in March.

Volkov proved that the artist-in-residence concept works, along with the performances out in the community, Russell said. Remembering Carmen Schenk, who co-owns Jimmy Anderson's Casual Gourmet, a restaurant on Spring Hill Road, with husband, Xaver Wilhelmy, recalled how Volkov and a pianist, Stefan Petrov, played at the restaurant twice in March.

According to Amanda DiMeo, Staunton's registrar, Staunton saw 12 provisional ballots, but her office didn't encounter any problems with voter IDs.

[...]members from local hospitals, police, fire and rescue, local health department and 911 centers will be meeting to come up with more concrete plans and guidance on how to handle a possible outbreak, according to Donna Good, director of the Augusta County Emergency Communications Center. Carroll said the Centers for Disease Control and the Virginia Department of Health requires the hospital and other facilities to ask the required questions of patients who enter with flulike symptoms.