Joanna Hart

The ATS and CAPC are proud to introduce a new collaborative series of seven modules on ATS Ed+ for clinicians treating patients with serious illnesses. Earn CME! #pallipulm @anandiyermd.bsky.social @donsullivan.bsky.social @pallipulm.bsky.social

Learn more: atsedplus.thoracic.org/capc/palliat...

I work with Veterans. If I told them that they "killed people and broke things for a living" they would (rightfully) tell me to go to hell.

Those that have had to kill someone in the line of duty most often view it with sadness, regret, and one of the worst experiences of their lives.

SMDM offers short courses, including this one: smdm.org/meeting/smdm...

…of existing in some stranded time zone distinct from all those in the outside world.…except, instead of waiting for a plane, we were waiting for devastation or deliverance.

…on professionals either kindly or officious; the same long walk to unappealing, overpriced commerce; the same creeping exhaustion that enters, like the quality of the air, almost the moment you walk through the door; the same sense of temporal dislocation...

…of the brevity of life and the great looming precipice of eternity as Wordsworth was at Tintern Abbey, yet at the same time you are basically stuck at an airport. There is the same combination of impatience and impotence; the same constant proximity to strangers; the same unavoidable dependence…

Reading Lost & Found by Kathryn Schulz and found her descriptions of ICU life impeccable, eg: “unless you work there, a hospital is no kind of place to spend so much time. Like a storefront church, its physical presence is at odds with its existential responsibilities. In an ICU, you are aware…

🤔 Ever wonder if our ICU families experience trauma? Esp those w a trauma history?

D Ashana & colleagues 👀 at just that thru interviews w 26 family members, just out in #journal_CHESTCritCare:

www.chestcc.org/article/S294...

#OpenAccess

@joannahart.bsky.social
@accpchest.bsky.social

Rural Urban Bridge Initiative The Rural Urban Bridge Initiative invites liberals and progressives to think differently, talk differently, and act differently in order to understand the causes of the rural-urban divide and then do ...

Because all roads to quality of rural life are paved by policy, we're pleased to help spread the word about the @rururbbridge.bsky.social ‪Beyond Resistance Campaign Virtual Launch.

Wednesday, September 10, 2025
7:00pm ET

Find the link to register: ruralurbanbridge.org

JAMA viewpoint: "The One Big Beautiful Bill Act—Implications for Rural Health Care" by M. Bryant Howren and Jed R. Hansen. Published September 3, 2025. doi: 10.1001/jama.2025.13518

Viewpoint: The One Big Beautiful Bill Act's significant #Medicaid cuts threaten rural health care access and economic stability.

ja.ma/3HE9rEo

Why is caregiving so hard in America? The answers emerge in a new film A new documentary on PBS shows what it's like to care for adult family members and recounts the history of caregiving policy in the U.S. revealing why those caring for family are often on their own.

A new documentary on PBS shows what it's like to care for adult family members and recounts the history of caregiving policy in the U.S. revealing why those caring for family are often on their own.

Studies show that just one exposure to tear gas can increase the likelihood of respiratory illnesses. That's why in 2020, the ATS called for a moratorium on the use of tear gas and other chemical agents.

Learn more about the damage tear gas causes (via @wired.com‬): www.wired.com/story/what-t...

Our new @JAMAHealthForum study adds more evidence on how Medicare Advantage plans enrolling veterans are maximizing profits by not paying for care.

Veterans in high-veteran MA plans are much more likely to have surgical care paid by VA than plan itself—even when surgery occurs in non-VA hospitals…

Visual Abstract

Varenicline, combined with behavioral counseling, increased vaping abstinence in youth who vape nicotine and do not regularly smoke tobacco.

https://ja.ma/4jvML5W

☎️ a friend time: looking for folks in ADULT hospital/ICU settings who support patients’ family members who are KIDS. Many places have child life (especially those with co-located peds hospitals)—anyone not have that model? Interested in folks’ experiences on this topic and would love to connect!

Federal Funds for Rural Health Care May Be Cut This Medical News article discusses the impact that proposed federal funding cuts for rural health care programs would have on individuals and their communities.

The White House's 2026 budget proposal recommends eliminating the Health Resources and Services Administration and cutting rural health funding by 25%, posing a threat to health care access and services in rural areas.

jamanetwork.com/journals/jam...

One woman's fight to remove barriers for aspiring doctors with disabilities After her dreams of becoming a doctor were denied, one California woman is working to make the profession more accessible to those with disabilities.

After her dreams of becoming a doctor were denied, one California woman is working to make the profession more accessible to those with disabilities.

Risk of Major Congenital Malformations Following Prenatal Exposure to Smoking Cessation Medicines This cohort study examines whether prenatal use of smoking cessation pharmacotherapies is associated with increased risks of major congenital malformations.

Reassuring data on varenicline in pregancy
jamanetwork.com/journals/jam... @jama.com @btsrespiratory.bsky.social @ashorguk.bsky.social

'I want to live': Coal miners speak out as Trump strips away health protections Even as President Trump vows to reinvigorate America's coal industry, critics say his administration has stripped away key health protections for miners.

I have had the good fortune to visit the Coal Workers Program of NIOSH in West Virginia. The team is incredible - dedicated to protecting generations of workers doing jobs most of us can barely imagine. I’m glad to hear the program has been (temporarily) restored. abcnews.go.com/amp/US/live-...

Recently, the U.S. Department of Justice sent letters to scholarly journals inquiring about their process and principles. As an organization, we respect and support the CHEST journal's editorial leadership and long-standing reputation. Read more here: www.chestnet.org/newsroom/che...

The Effect of Rurality on Time to Surgery and Overall Survival among Women with Breast Cancer - PubMed Although geographic proximity to care mediates the relationship between rurality and prolonged TTS, rurality has an intrinsic protective effect on TTS that is independent of the adverse effect of incr...

A new study finds that for rural breast cancer patients, living farther from care is associated with prolonged time to surgery (TTS). But rurality itself—independent of distance—is associated with shorter TTS.

Read more:
pubmed.ncbi.nlm.nih.gov/40143820/

The crazy thing about firing all of these federal employees is that they tend to be underpaid, super hardworking, in it for the right reasons, idealistic people who could’ve worked in industry or pharma and made way more money but they truly believed in the mission and the good they were doing.

All respect to these authors—I agree expectations are critical in serious illness (for decision making, coping, preparations) but in this case the “prognostic awareness” was reported retrospectively by caregivers of patients who have died, not actual patient perspectives. See my recent thread!

But it sounds like the students aren’t intrinsically motivated by those exposures, so maybe explore that more? Or explain your perspective when they decline those opportunities for patient-based learning.

These sorts of things provide a) amazing first-hand knowledge about that patient the residents won’t have, thus filling a distinct role, and b) learning about collaborative medical care in a way that truly won’t happen after medical school.

If students are feeling “in the way” that’s likely a larger team culture issue — however, a quick fix for this I’ve found is to impress upon students it’s often their only chance to do things like travel with the MICU patient to IR, go with them to the cath lab, help during PT sessions, etc.

NRHA's Journal of Rural Health | National Rural Health Association - NRHA | NRHA NRHA produces several digital and print publications to engage NRHA members and inform rural health professionals. These include our weekly newsletter NRHA Today, our quarterly magazine Rural Horizons...

NRHA’s Journal of Rural Health is launching a special issue focused on rural U.S. military veteran health care and health outcomes. Submit abstracts for consideration by April 30: www.ruralhealth.us/publications... #ruralhealth

4/ We are now looking into this deeper: we’ve expanded to a cohort that includes family members’ expectations (as they may be very different than patients’) and recordings of actual clinic visits so that we can learn more about when and how these future-looking conversations occur

3/ Patients’ self-reports of their future-looking conversations with clinicians were shocking, even to me: over 80% of the patients (with severe COPD!) reporting that they had NEVER discussed their expected lifespan with a clinician.

Accuracy of Expected Symptoms and Quality of Life Among Adults With COPD This cohort study compares what patients with severe chronic obstructive pulmonary disease expect to experience at diagnosis with reported experiences over a 24-month period.

2/ In our longitudinal cohort study of patients with advanced COPD, who predicted their own lifespans and future health and symptom burdens, we found that patients were overoptimistic, which was independently associated with worse quality of life over a 2-year period. jamanetwork.com/journals/jam...