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BACKGROUND: Children with advanced cancer have access to comprehensive cancer care and hospice care if the enroll in concurrent hospice care. However, little is known about the patterns of non-hospice health care services used by these children. OBJECTIVE: To examine the patterns of non-hospice health care services among children with cancer in concurrent hospice care. METHODS: This study was a retrospective cohort analysis of 2011–2013Medicaid claims data from 862 pediatric cancer patients. Data were analyzed using descriptive statistics and latent class analysis (LCA). RESULTS: Children used 120, 388 health care services, including inpatient and outpatient hospital services, labs & x-rays, durable medical equipment, medications, and others. These services clustered into two classes with moderate-intensity (57.49%) and high-intensity (42.50%) health care service use. Children in the high-intensity cluster were more likely to reside in the South with comorbidities, mental/behavioral health conditions, technology dependence, and were less likely to have solid tumors, compared to the moderate-intensity group. CONCLUSIONS: Non-hospice health care services clustered together in two distinct classes providing critical insight into the complexity of the health care use among children with cancer in concurrent hospice care. IMPLICATIONS FOR PRACTICE: Understanding that pediatric patients in concurrent care may have different health care service patterns may assist oncology nurses caring for children with advanced cancer. These findings also have policy implications.

Supplementary Material 1

Supplemental Material, sj-pdf-1-pal-10.1177_08258597211001991 for Caregiver Reported Quality of End-of-Life Care of Adolescent and Young Adult Decedents With Cancer by Erin R. Currie, Emily E. Johnston, Marie Bakitas, Eric Roeland, Lisa C Lindley, Stephanie Gilbertson-White and Jennifer Mack in Journal of Palliative Care

The lberian Península provides an excellent context in which to assess the final impact of population movements entering the European continent from the east as well as prehistoric and historie connections with North Africa. We report new genome-wide data from 271 ancient individuals from Iberia, providing the most comprehensive genetic time transect of any world region over the last 8,000 years. We document population structure in the peninsula's hunter-gatherers, with northwestern but not southeastern individuals showing increased genetic affinity to central European hunter-gatherers in the centuries befare the arrival of farmers. We provide evidence of sporadic contacts from North Africa beginning at least -4,500 years ago, and by -4,000 years ago the replacement of -40% of the autosomal ancestry and 100% of the Y-chromosomes of Bronze Age groups by migrants ultimately originating in the steppe. From the lron Age, we report genome-wide data from individuals excavated in non-lndo-European speaking regions and show that they were genetically similar to contemporaries from an lndo-European-speaking region in harboring substantial proportions of steppe ancestry. With the exception of Basques who remain broadly similar to lron Age populations, during the past 2,500 years lberian populations were affected by additional gene-flow from the central/eastern Mediterranean region, probably associated with the Roman conques!, and from North Africa during the period of Muslim rule but also in earlier periods. Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.

BACKGROUND: Shared decision-making is an important component of patient-centered care and is associated with improved outcomes. To the authors' knowledge, little is known concerning the extent and predictors of the involvement of a patient's family in decisions regarding cancer treatments. METHODS: The Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium is a large, multiregional, prospective cohort study of the cancer care and outcomes of patients with lung and colorectal cancer. Participants reported the roles of their families in decision-making regarding treatment. Multinomial logistic regression was used to assess patient factors associated with family roles in decisions. RESULTS: Among 5284 patients, 80 (1.5%) reported family-controlled decisions, with the highest adjusted rates (12.8%) noted among non-English-speaking Asians. Among the 5204 remaining patients, 49.4% reported equally sharing decisions with family, 22.1% reported some family input, and 28.5% reported little family input. In adjusted analyses, patients who were married, female, older, and insured more often reported equally shared decisions with family (all P

ImportanceShared decision making is associated with improved patient-reported outcomes of cancer treatment, but not all patients prefer to participate in medical decisions. Results from studies of the effect of matching between actual and preferred medical decision roles on patients' perceptions of care quality have been conflicting.ObjectivesTo determine whether shared decision making was associated with patient ratings of care quality and physician communication and whether patients' preferred decision roles modified those associations.Design, setting, and participantsWe performed a population- and health system-based survey of participants in the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) study diagnosed with lung and/or colorectal cancer between 2003 and 2005 (56% with colorectal cancer, 40% with non-small-cell lung cancer, and 5% with small-cell lung cancer). The CanCORS study included 9737 patients (cooperation rate among patients contacted, 59.9%) treated in integrated care delivery systems, academic institutions, private offices, and Veterans Affairs hospitals. The medical records were abstracted between October 11, 2005, and April 30, 2009; all analyses were conducted between 2013 and 2014.InterventionsWe surveyed patients specifically about their preferred roles in cancer treatment decisions and their actual roles in decisions about surgery, chemotherapy, and radiation therapy. We analyzed the responses of 5315 patients who completed baseline surveys and reported decision roles for a total of 10 817 treatment decisions and assessed associations of patients' decision roles with patient-reported quality of care and physician communication.Main outcomes and measuresThe outcomes (identified before data collection) included patient-reported excellent quality of care and top ratings (highest score) on a physician communication scale.ResultsAfter adjustment, patients describing physician-controlled (vs shared) decisions were less likely to report excellent quality of care (odds ratio [OR], 0.64; 95% CI, 0.54-0.75; P

Introduction Relatively little is known about the processing changes that support treatment-induced recovery in aphasia. Visual-world eyetracking has been used to detail language processing deficits in aphasia (Meyer, Mack, & Thompson, 2012; Mirman, Yee, Blumstein, & Magnuson, 2011), and may be useful for detecting processing changes that result from treatment. However, the test-retest reliability of eyetracking has not been fully established. One previous study suggested that eyetracking is a reliable measure of lexical access (Farris-Trimble & McMurray, 2013). However, that study used a large number of trials (n=640), which may be impractical in treatment research. Additionally, no previous studies have examined the reliability of eyetracking for sentence comprehension tasks. The present study tested the reliability of eyetracking for lexical and sentence comprehension tasks, using a practical number of trials. Method Unimpaired college-aged adults (n=21) participated in eyetracking experiments testing lexical access and sentence comprehension, in two sessions one week apart. In the lexical access experiment (n=30 trials), participants viewed arrays of four objects and heard a noun matching one object. In the sentence comprehension task (n=48 trials), participants viewed two drawings with reversed participant roles and listened to an active or passive sentence (e.g. The dog is chasing the cat/The cat is being chased by the dog). Participants were instructed to click on the picture that matched the auditory stimuli. Eye data were analyzed in time windows in which a rise in fixations to the target picture was observed: 300-800 ms from word onset in the lexical access experiment, and 0-500 ms from verb offset in the sentence comprehension experiment. Eye fixation patterns were modeled using mixed effects empirical logit regression, with maximal fixed and random effects. These models tested for effects of test session at the group level. To test for reliability of individual eye fixation patterns, participant-specific parameters from each test session were entered into intraclass correlations (ICCs). Results See Figure. In both experiments, no significant effects of session (main effects or interactions with other variables) were observed at the group level (p’s > 0.05). For both experiments, moderately strong correlations were observed in the rise of fixations to the target picture within individuals across sessions (lexical access: ICC(2,1) = 0.531; p = 0.007; sentence comprehension: ICC(2,1) = 0.582, p = 0.002). Discussion The results indicate that eyetracking is a reliable measure of the latency of lexical access and sentence comprehension, even with a limited number of trials. Therefore, this method may prove useful for investigating lexical access and sentence comprehension changes as a result of treatment for aphasia. Figure 1. Proportion of fixations to the target picture across sessions in (a) lexical access and (b) sentence comprehension trials. Vertical lines indicate windows for statistical analyses.

We report new HST NICMOS and WFPC2 imaging of emission-line nebulae in the central galaxies of 3 clusters of galaxies purported to host massive cooling flows, NGC1275, A2597, and PKS0745. The spectral signature of vibrationally- excited molecular hydrogen (VEMH) has been seen in every galaxy searched so far in a cluster cooling flow with an optical emission line nebula. We have discovered that the VEMH gas extends several kpc from the centers of A2597 and PKS0745, while the vibrationally-excited molecular hydrogen in NGC1275 appears to be mostly confined to its nucleus, with some extended emission 40 km/s) are ruled out by the high H2/H-alpha ratios. If UV heating is the main energy input, a few billion solar masses of molecular gas is present in A2597 and PKS0745. UV irradiation models predict a significant amount of 1-2 micron emission from higher excitation H2 transitions and moderate far infrared luminosities (~1e44/h^2 erg/s) for A2597 and PKS0745. Even in the context of UV fluorescence models, the total amount of H2 gas and star formation inferred from these observations is too small to account for the cooling flow rates and longevities inferred from the X-rays. We note an interesting new constraint on cooling flow models: the radio sources do not provide a significant amount of shock heating, and therefore cannot counterbalance the cooling of the X-ray gas in the cluster cores., 51 pages, 11 figures. Accepted for ApJ, slated date Dec. 2000. Abstract abridged from original. A gzipped PostScript version with figures at full resolution can be found at http://www.stsci.edu/~donahue/