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Objectives: Health care organizations are taking a greater role in providing social care. Federally qualified health centers (FQHCs) lead these efforts, leveraging investments in technology to manage patient care and information. This study describes the challenges of meeting patient social needs and presents new opportunities for engaging in communitywide activities to address care and quality. Study Design: Sociotechnical systems theory was applied in qualitative research. Methods: Eleven of the 40 Michigan FQHCs were recruited into the study. Twenty-five semistructured interviews were conducted with practice leadership, clinicians, and staff to explore information technology and other resources used for managing social care. Analyses of the interviews were used to organize infrastructural and technological factors that emerged into key themes. Results: Interviews revealed that Michigan FQHCs participated in community-wide activities to develop value-based care practices and quality initiatives using shared data and technology. Study participants revealed that their community-level involvement facilitated improved data management, digital information sharing, and quality improvement efforts. Ultimately, however, limited housing services and inadequate behavioral health care created challenges in connecting patients with essential treatments and social supports. Conclusions: Developing information infrastructure and new technological capabilities to manage patient care and population health is necessary but insufficient. Major investments in both technology and human capital are critical to effectively provide social care and improve quality. Building on the evidence gained from FQHC partnerships and data activities offers public officials and health care leaders insight into the local resources and policy changes that are needed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the benefits, challenges, program characteristics and instructional approaches of an El Sistema inspired (ESI) after-school string program developed as a university-school partnership. Case study methodology was used to examine the program. Fifth-grade students received 75 minutes of after-school instruction four days per week. Two graduate students in music performance and the elementary school orchestra/general music teacher were the program's lead teachers. Eight additional university students gave pull-out lessons. The program featured many "distinguishing characteristics" described in the ESI literature. The learning environment included large ensemble, sectional learning, and individual lessons. The repertoire learned was standard for American beginning string classes. Teachers provided rigorous expectations for the students to strive for excellence, a safe and supportive learning environment, flexible teaching, and peer-mentoring opportunities. Benefits included high levels of musical achievement, increased learning opportunities, perceived benefits of discipline, perseverance, positive attitude, and hard work. Instructional challenges included low attendance, curricular balance, and teacher collaboration. The intensity and frequency of instruction were found to be the source of most benefits and challenges reported by the participants.

The article focuses on the 2023 update to ASCO's guideline on systemic therapy for melanoma, addressing new recommendations for neoadjuvant and adjuvant treatments, especially in patients with stage IIIA cutaneous melanoma. The topics include individualizing decision-making based on sentinel node tumor burden, emphasizing the low recurrence risk for patients with tumor deposits <0.3 mm.

This letter to the editor published in the journal Leukemia & Lymphoma discusses a rare case of a patient with hypereosinophilic syndrome (HES) and leptomeningeal involvement. The letter provides insights into diagnosing and treating hypereosinophilia, highlights unusual presentations of HES in classical Hodgkin Lymphoma (cHL), and presents a case study of a patient with cHL complicated by hypereosinophilia with multi-organ involvement. The patient experienced symptoms such as fatigue, weight loss, and abdominal bloating, and further evaluation revealed significant eosinophilia and lymphadenopathy. The article emphasizes the challenges of managing secondary complications from HES while treating cHL and suggests the need for further research in optimizing treatment for cHL with HES. [Extracted from the article]