Lung cancer remains a leading cause of cancer related mortality worldwide. Despite numerous advances in treatments over the past decade, non-small cell lung cancer (NSCLC) remains an incurable disease for most patients. The optimal treatment for all patients with locally advanced, but surgically resectable, NSCLC contains at least chemoradiation. Trimodality treatment with surgical resection has been a subject of debate for decades. For patients with unresectable or inoperable locally advanced disease, the incorporation of immunotherapy consolidation after chemoradiation has defined a new standard of care. For decades, the standard of care treatment for advanced stage NSCLC included only cytotoxic chemotherapy. However, with the introduction of targeted therapies and immunotherapy, the landscape of treatment has rapidly evolved. This review discusses the integration of these innovative therapies in the management of patients with newly diagnosed NSCLC.
Rates of Human papilloma virus (HPV) vaccination among pediatric survivors of cancer and patients with sickle cell disease are lower than the national average. While recent attention has focused on patient HPV vaccine hesitancy and refusal, less is known about provider-level and system-level barriers to vaccinations in pediatric hematology/oncology (PHO) populations. Applying thematic analysis to qualitative interviews with 20 pediatric hematology/oncology physicians and nurse practitioners, we examine their views regarding HPV vaccination, with a focus on access and barriers to providing HPV vaccination in PHO practices. Results demonstrated that despite 90% of interviewees supporting HPV vaccination in their population, the number of pediatric hematology/oncology providers who reported that they counsel about HPV or provide HPV vaccination was 45%, even in stem cell and sickle cell clinics, where other childhood vaccines are commonly provided. Clinicians identified provider-level, clinic-level, and system-level barriers to giving the HPV vaccination, including but not limited to time/flow constraints, lack of resources, and continued education regarding the HPV vaccine. These barriers impede the ability for pediatric hematology/oncology providers to counsel and provide HPV vaccination to this specialized population.
The results of a national survey of American art museums concerning the implementation of World War II-era provenance research are presented. After outlining the reasons why this research is important to the museum community, background information on the issue of World War II-era looted art is reviewed. The survey process and the twelve questions that were asked in the anonymous survey are then outlined. The results of the survey are then presented and the implica tions of this research are discussed. Specifically, 80% of responding museums reported that one or two people were conducting prove nance research, and 55% did not yet have policy in place. Eighty-seven percent of museums were not receiving outside funding, and more than 75% indicated that they were encountering difficulties. Three central challenges are identified-time, fu nding, and training. Despite these chal lenges, results indicate that the museum community consid ers World War II-era provenance research an important issue.
As of 05/28/2021, SARS-CoV-2 (COVID-19) had caused 3.9 million infections in the United States (US) pediatric population since its discovery in December of 2019. The development and expansion of vaccination has markedly changed the shape of the epidemic. In this qualitative study, we report on pediatric hematology/oncology provider views on the COVID-19 vaccine prior to approval in the adolescent population <16 years of age. Results from interviews with 20 providers across the state of Indiana showed that most were supportive of the COVID-19 vaccine for healthy adults. However, the majority also expressed a need to see more data on the safety and effectiveness of COVID-19 vaccinations in pediatric hematology/oncology populations. While they recognized the public health importance of vaccination, their duty to protect their patients led to a need for more specific safety and efficacy data.
Background: Human papilloma virus (HPV) vaccination prevents the development of HPV-associated malignancies. Adolescent and young adult (AYA) survivors of childhood cancers and patients with sickle cell disease (SCD) are two vulnerable patient populations who would significantly benefit from HPV vaccination. Objective: In this mixed method study we determine the HPV vaccination rate amongst the AYA SCD and childhood cancer survivor populations. We then sought to describe patient and caregiver beliefs regarding HPV vaccination. Design/Method: We performed a retrospective chart review looking at vaccination status for patients seen in our clinics in 2019. Qualitative data was then collected via audio recorded interviews. Interviews were analyzed with a thematic content approach to understand attitudes regarding the HPV vaccination. Results: We found a notable difference between the rate of HPV vaccinations and other age-appropriate vaccinations in our childhood cancers survivors and patients with SCD. Qualitative interviews found that caregivers and AYA’s relied heavily on physician, recommendations for HPV vaccination, with a preference for subspecialist recommendation. A strong recommendation from a trusted subspecialty provider would create reassurance about vaccination and reduce misconceptions and concerns for side effects in the context of a chronic illness. Conclusion: Counseling from subspecialists could have a strong impact on understanding of the HPV vaccine in the context of chronic illness. This would likely help overcome many of the barriers to vaccination that are encountered by patients with SCD or oncology survivors.
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