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ObjectivesThe need for palliative care (PC) will continue to increase in Canada with population aging. Many older adults prefer to “age in place” and receive care in their own homes. Currently, there is a lack of standardized quality indicators (QIs) for PC delivered in the community in Canada.MethodsA one-day workshop collected expert opinions on what should be measured to capture quality PC. Three brainstorming sessions were focused on addressing the following questions: (1) what is important to measure to support quality PC, regardless of setting? (2) Of the identified measures, are any of special importance to care provided in the home? (3) What are the challenges, barriers, and opportunities for creating these measures? The National Consensus Project (NCP) for Quality Palliative Care framework was used as a guide to group together important comments into key themes.ResultsThe experts identified four themes that are important for measuring quality, regardless of care setting, including access to care in the community by a multidisciplinary team, care for the individual with PC needs, support for the informal caregiver (e.g., family, friends), and symptom management for individuals with PC needs. Two additional themes were of special importance to measuring quality PC in the home, including spiritual care for individuals with PC needs and home as the preferred place of death. The challenges, barriers, and potential opportunities to these quality issues were also discussed.Significance of resultsPC experts, through this collaborative process, made a substantial contribution to the creation of a standardized set of QIs for community-based PC. Having a standardized set of QIs will enable health care professionals and decision makers to target areas for improvement, implement interventions to improve the quality of care, and ultimately, optimize the health and well-being of individuals with a serious illness.

Knapp and White provide a timely review of innovations in U.S. domestic migration research and its consequences for the spatial distribution of population. The authors discuss the crucial shift toward migration modeling which includes site attributes such as natural amenities in addition to factors associated with improvement in earnings in the household location decision. Knapp and White address the following contemporary topics in the study of U.S. domestic migration: migrant selectivity, the use of panel data, and life course migration. They illuminate the development of inter-disciplinary U.S. domestic migration research from economics, demography, sociology, and geography. In “Opportunity Seeking Migration in the United States,” Knapp and White conclude that the results of migration research should inform the “people vs. places” policy debate because a better understanding of the determinants of migration will lead to more efficacious public policy. The authors finally assert that changing demographics will have an increasingly important role in migration patterns and regional population dynamics, providing fruitful opportunities for future migration research regarding age group specific locational preferences.

We created a migration and earnings history from the National Longitudinal Survey of Youth to analyze the effects of youth county poverty rates on the adult earnings of white male migrants. We estimate a log wage equation that includes human capital measures, migration types, county poverty rates, and a rural–poverty rate interaction variable. Growing up in a rural county has a negative impact on adult wages independent of youth county poverty rates, but the rural effect is significantly greater for those who grew up in high poverty counties. Youth county poverty rates indirectly affect wages through the returns to migration.

Researchers have been captivated for more than a hundred years by the therapeutic potential that lay in electrically stimulating the brain. As each new method came about, earlier in Europe and later in the US, numerous stimulation waveforms blossomed and faded, each leaving electrical breadcrumbs for the next generation of researchers to follow. This review follows waveforms from their more rudimentary nature to today’s more advanced electrical formulations and focuses on one electrical formulation in particular that opens two exciting new areas of exploration. One of these is the therapeutic potential presented by subcortical stimulation. The second area follows on the heels of research that is systematically unravelling the brain’s complex electrical operating language. This review indicates how today’s advanced waveforms open up the potential for subcortical stimulation to join the brain’s electrical conversations, gently guiding it toward higher functioning.