Context Cardiovascular disease (CVD) is the leading cause of death globally and a significant health burden in Kenya. Despite improved outcomes in CVD, palliative care has limited implementation for CVD in low- and middle-income countries. This may be partly due to providers’ perceptions of palliative care and end-of-life decision-making for CVD patients. Objectives Our goal was to explore providers’ perceptions of palliative care for CVD in Western Kenya in order to inform its implementation. Methods We conducted eight focus group discussions as well as five key informant interviews. These were conducted by moderators using structured question guides. Qualitative analysis was performed using the constant comparative method. A coding scheme was developed and agreed upon by consensus by two investigators, each of whom then independently coded each transcript. gp91ds-tat mouse Relationships between codes were formulated and codes were grouped into distinct themes. New codes were iteratively added with successive focus group or interview until thematic saturation was reached. Results Four major themes emerged to explain the complexities of integrating of palliative care for CVD patients in Kenya (1) stigma of discussing death and dying, (2) mismatch between patient and clinician perceptions of disease severity, (3) the effects of poverty on care, and (4) challenges in training and practice environments. All clinicians expressed a need for integrating palliative care for patients with CVD. Conclusions These results suggest attainable interventions supported by local providers can help improve CVD care and quality of life for patients living with advanced heart disease in low-resource settings worldwide.As coronavirus disease 2019 (COVID-19) continues to impact the seriously ill and their families on a global scale, considerations given to marginalized groups amid the pandemic are essential to ensure the provision of high-quality and dignified care. Lesbian, gay, bisexual, transgender, gender-nonconforming, and queer/questioning-identified (LGBTQ+) persons are particularly vulnerable to health inequities across settings, including palliative care and at the end of life. There is a crucial gap in the literature pertaining to palliative care for LGBTQ+ populations during COVID-19. We aim to fill this gap by providing essential health inequity and social support background pertaining to LGBTQ+ persons and practical recommendations for immediate implementation that support inclusive and respectful care for these populations. Using these recommendations is a pragmatic pathway to promote trust, transparency, patient and family engagement, and value concordant care amid the health system strain caused by COVID-19.Context Approximately 170,000 children in need of palliative care die every year in Europe without access to it. This field remains an evolving specialty with unexplored development. Objectives To conduct the first regional assessment of pediatric palliative care (PPC) development and provision using data from the European Association for Palliative Care atlas of palliative care 2019. Methods Two surveys were conducted. The first one included a single question regarding PPC service provision and was addressed by European Association for Palliative Care atlas informants. The second one included 10 specific indicators derived from an open-ended interview and rating process; a specific network of informants was enabled and used as respondents. Data were analyzed and presented in the map of the figure. Results Data on PPC service provision were gathered from 51 of 54 (94%) European countries. Additional data were collected in 34 of 54 (62%) countries. A total of 680 PPC services were identified including 133 hospices, 385 home care services, and 162 hospital services. Nineteen countries had specific standards and norms for the provision of PPC. Twenty-two countries had a national association, and 14 countries offered education for either pediatric doctors or nurses. In seven countries, specific neonatal palliative care referral services were identified. Conclusion PPC provision is flourishing across the region; however, development is less accentuated in low-to-middle-income countries. Efforts need to be devoted to the conceptualization and definition of the models of care used to respond to the unmet need of PPC in Europe. The question whether specialized services are required or not should be further explored. Strategies to regulate and cover patients in need should be adapted to each national health system.Effective prognostication for a novel disease presents significant challenges, especially given the stress induced during a pandemic. We developed a point-of-care tool to summarize outcome data for critically ill patients with COVID-19 and help guide clinicians through a thoughtful prognostication process. Two authors reviewed studies of outcomes of patients with critical illness due to COVID-19 and created a visual infographic tool based on available data. Survival data were supplemented by descriptions of best- and worst-case clinical scenarios. The tool also included prompts for clinician reflection designed to enhance awareness of cognitive biases that may affect prognostic accuracy. This online, open-source COVID-19 Prognostication Tool has been made available to all clinicians at our institution and is updated weekly to reflect evolving data. Our COVID-19 Prognostication Tool may provide a useful approach to promoting consistent and high-quality prognostic communication across a health care system.Context Historically, the focus of prehospital care has been life-saving treatment. Absent a Non-Hospital Do Not Resuscitate (NHDNR) order, prehospital providers have been compelled to begin and continue resuscitation unless or until it was certain that the situation was futile; they have faced conflict when caregivers objected. Objectives The purpose of the study was to explore prehospital providers’ perspectives on how legally binding documents (NHDNR/Medical Orders for Life Sustaining Treatment [MOLST]) informed end-of-life decision-making and care. Methods This exploratory study employed mixed methods in a sequential non-dominant, two-stage convergent QUAN-QUAL design. Phase I involved the collection of survey data. Phase II involved in-person semi-structured interviews. Results Surveys were completed by 239 participants and 50 follow-up interviews were conducted. Survey data suggested that 73.7% felt confident when there was a DNR order and they did not initiate resuscitation and 58.2% felt confident working through family disagreement when CPR was requested but there was a DNR; 66.