Assessing the Inner Setting among Massachusetts Community Health Centers: Opportunities for Multilevel Investigation and Expansion of Influences on Health Equity.

Background: Implementation science increasingly aims to improve equity in delivery of evidence-based interventions. It is important to expand the conceptualization of the inner setting, organizations like community health centers where interventions are put into place, accordingly. Taking a comprehensive, partnered approach to measuring the inner setting among a network of community health centers engaged in implementation research ensures assessment of the variability among sites and generates centralized contextual data that can be applied across studies.

Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors.

Purpose: Disparities in breast cancer treatment for low-income and minority women are well documented. We examined economic hardship, health literacy, and numeracy and whether these factors were associated with differences in receipt of recommended treatment among breast cancer survivors.

Methods: During 2018-2020, we surveyed adult women diagnosed with stage I-III breast cancer between 2013 and 2017 and received care at three centers in Boston and New York.

Clonal hematopoiesis in older patients with breast cancer receiving chemotherapy.

Background: The expansion of hematopoietic stem cells carrying recurrent somatic mutations, termed clonal hematopoiesis (CH), is common in elderly individuals and is associated with increased risk of myeloid malignancy and all-cause mortality. Though chemotherapy is a known risk factor for developing CH, how myelosuppressive therapies affect the short-term dynamics of CH remains incompletely understood. Most studies have been limited by retrospective design, heterogeneous patient populations, varied techniques to identifying CH, and analysis of single timepoints.

Breast cancer knowledge and understanding treatment rationales among diverse breast cancer survivors.

Purpose: The degree to which breast cancer survivors know about their tumors and understand treatment rationales is not well understood. We sought to identify information gaps within a diverse sample and explore whether knowledge about breast cancer and treatment may impact care.

Methods: We conducted a one-time, interviewer-administered survey of women who were diagnosed with breast cancer during 2013-2017 and received care at one of three centers in Boston, MA, and New York, NY.

'ADVANCE' (a pilot trial) ADjuVANt chemotherapy in the elderly: Developing and evaluating lower-toxicity chemotherapy options for older patients with breast cancer.

Introduction: Older adults with breast cancer receiving neo/adjuvant chemotherapy are at high risk for poor outcomes and are underrepresented in clinical trials. The ADVANCE (ADjuVANt Chemotherapy in the Elderly) trial evaluated the feasibility of two neo/adjuvant chemotherapy regimens in parallel-enrolling cohorts of older patients with human epidermal growth factor receptor 2-negative breast cancer: cohort 1-triple-negative; cohort 2-hormone receptor-positive.

Materials And Methods: Adults age ≥ 70 years with stage I-III breast cancer warranting neo/adjuvant chemotherapy were enrolled.

Perceptions of patients and medical oncologists toward biospecimen donation in the setting of abnormal breast imaging findings.

Purpose: We sought to understand the attitudes of individuals with abnormal breast imaging findings prompting a diagnostic breast biopsy toward donation of blood, excised tissue, or percutaneous biospecimens for research, and to understand medical oncologists' attitudes toward research biospecimen collection in this population.

Methods: We included individuals who presented to a single academic medical center for a clinically indicated, image-guided, percutaneous breast biopsy. We administered a survey prior to knowledge of biopsy results to assess willingness to consider, entirely for research purposes, donating blood or excess excised breast tissue, or having additional biospecimens (AB) obtained during a clinically indicated percutaneous biopsy.

Perceptions of patients with early stage breast cancer toward research biopsies.

Background: The objective of this study was to describe the perspective of patients with early breast cancer toward research biopsies. The authors hypothesized that more patients at academic sites than at community-based sites would be willing to consider these procedures.

Methods: In total, 198 patients with early stage breast cancer were recruited from 3 academic centers (n = 102) and from 1 community oncology practice (n = 96).

Perceptions of Oncologists About Sharing Clinic Notes with Patients.

In a large survey ( = 809) conducted to understand how oncologists differ from nononcologists regarding routinely sharing visit notes with patients, oncologists were less likely to agree patient safety would improve ( = .03) or that patients would be offended after reading notes ( = .01); however, they agreed with nononcologists that sharing notes would lead to less candid documentation (69% vs.

The Grief of Mothers After the Sudden Unexpected Death of Their Infants.

Unlabelled: : media-1vid110.1542/5741323271001PEDS-VA_2017-3651 BACKGROUND: The loss of a child is associated with elevated grief severity, and sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality in the United States. The diagnosis of prolonged grief disorder (PGD) has gained broader acceptance and use.

Delayed Workup of Rectal Bleeding in Adult Primary Care: Examining Process-of-Care Failures.

Background: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding.

Methods: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes.

Working up rectal bleeding in adult primary care practices.

Rationale, Aims And Objectives: Variation in the workup of rectal bleeding may result in guideline-discordant care and delayed diagnosis of colorectal cancer. Accordingly, we undertook this study to characterize primary care clinicians' initial rectal bleeding evaluation.

Methods: We studied 438 patients at 10 adult primary care practices affiliated with three Boston, Massachusetts, academic medical centres and a multispecialty group practice, performing medical record reviews of subjects with visit codes for rectal bleeding, haemorrhoids or bloody stool.

Elements of external validity of tools for health: an intervention for construction laborers.

Purpose: To examine the external validity of an efficacious tailored smoking cessation and nutrition improvement telephone intervention.

Design: Comparison of characteristics of participants and nonparticipants (representativeness); examination of the extent of intervention implementation.

Setting: Cancer center collaboration with a labor union.