Utilization of Patient Electronic Messaging to Promote Advance Care Planning in the Primary Care Setting.

Background: Advance care planning (ACP) is an instrumental mechanism aimed at preserving patient autonomy. Numerous interventions have been proposed to facilitate the implementation of ACP; however, rates of completed advance directives (ADs) are universally low. Patient electronic portal messaging is a newer tool in patient-provider communication which has not been studied as a method to promote ACP.

Medical condition is related to treatment preference in cancer patients: implications for quality assessment.

Ongoing communication with cancer patients about their treatment preferences is important. A survey assessing treatment preferences was distributed to 100 cancer patients who were newly diagnosed, 100 in remission after therapy, and 60 who had failed therapy/ relapsed; 100 cancer caregivers, and 100 noncancer patients attending the cancer center for benign hematologic problems. Almost 59% of respondents preferred treatment even if the chance of cure was less than 10%.

Diastereoselective proton transfer: a route to enantiomerically pure half-sandwich rhenium complexes.

The diastereomeric methyl rhenium complex [CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}(CH3)] was prepared in two steps from chiral racemic [CpRe(NO)(CO)(NCMe)]BF4 and the chiral racemic phosphine P(Me)(Ph)(2-C6H4NMe2). The unlike diastereomer reacts preferentially with MeSO3H to give the ring-closed ionic complex unlike-[CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}]MeSO3 along with unreacted like-[CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}(CH3)], which is easily separated and converted to like-[CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}]MeSO3. Starting from (R)-P(Me)(Ph)(2-C6H4NMe2), the diastereomerically and enantiomerically pure complexes (RRe,SP)-[CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}]MeSO3 and (SRe,SP)-[CpRe(NO){P(Me)(Ph)(2-C6H4NMe2)}]MeSO3 were obtained.