Expanding the complex: phylogenomic insights, proposal of sp. nov. and reclassification of two species.

A novel species was isolated as a contaminant in viral transport media at the District of Columbia Department of Forensic Sciences Public Health Laboratory. Phylogenomic and biochemical analyses of the isolate determined that it represented a novel species within . Related strains in public genome databases suggested that this novel species is associated with clinically acquired infections, similar to closely related .

MindBodySpirit Medicine.

Objectives: To present an overview of MindBodySpirit medicine including discussions of the efficacy of select self-care approaches.

Data Sources: Research and clinical articles on select complementary interventions. The model developed by the Center for Mind Body Medicine.

Do-not-resuscitate orders and medical futility.

This report addresses the difficult situation in which a patient or surrogate decision maker wishes cardiopulmonary resuscitation to be attempted even though the physician believes that resuscitation efforts would be futile. It also reviews current controversies surrounding the subject of do-not-resuscitate (DNR) orders and medical futility, discusses the complex medical, legal, and ethical considerations involved, and then offers recommendations as a guide to clinicians and ethics committees in resolving these difficult issues. Conflicts over DNR orders and medical futility should not be resolved through a policy that attempts to define futility in the abstract, but rather through a predefined and fair process that addresses specific cases and includes multiple safeguards.

Advance care planning by proxy for residents of long-term care facilities who lack decision-making capacity.

This report examines whether long-term care facilities should implement policies and procedures to support advance care planning by proxy for residents who lack decision-making capacity. The report focuses on advance care planning in the Department of Veterans Affairs. After reviewing clinical, legal, and ethical perspectives, the authors conclude that advance proxy planning is ethically sound and can improve patient care.