Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs.

Background: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options.

Objective: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care.

Design: This was a case-control study of cases with ACP who died matched 1:1 with controls.

Deliberate Practice with Standardized Patient Actors and the Development of Formative Feedback for Advance Care Planning Facilitators.

Objective: Multimodal curricular assessment after adding standardized patient (SP) actor-based simulation to an advance care planning (ACP) facilitator training course and development of a formative feedback tool.

Background: ACP represents a highly valued service requiring more and better trained facilitators.

Methods: Participants were primarily nurses and social workers in a large multisite health system.

Draft genome and description of Orrella dioscoreae gen. nov. sp. nov., a new species of Alcaligenaceae isolated from leaf acumens of Dioscorea sansibarensis.

Dioscorea sansibarensis is a monocot species of inedible yam native of tropical Africa and Madagascar. Leaves of D. sansibarensis feature prominent acumen glands that are densely colonized by bacteria.

The genome analysis of Candidatus Burkholderia crenata reveals that secondary metabolism may be a key function of the Ardisia crenata leaf nodule symbiosis.

A majority of Ardisia species harbour Burkholderia sp. bacteria within specialized leaf nodules. The bacteria are transmitted hereditarily and have not yet been cultured outside of their host.

Can ventilation-feedback training augment exercise tolerance in patients with chronic obstructive pulmonary disease?

Rationale: Exercise-induced dynamic hyperinflation contributes to decreased exercise tolerance in chronic obstructive pulmonary disease (COPD). It is unknown whether respiratory retraining (ventilation-feedback [VF] training) can affect exercise-induced dynamic hyperinflation and increase exercise tolerance.

Objectives: To determine whether patients with COPD would achieve longer exercise duration if randomized to a combination of exercise training plus VF training than either form of training on its own.

Effect of ventilation-feedback training on endurance and perceived breathlessness during constant work-rate leg-cycle exercise in patients with COPD.

The purpose of this study was to evaluate the efficacy of a unique program of ventilation-feedback training combined with leg-cycle exercise to improve exertional endurance and decrease perceived dyspnea in patients with chronic obstructive pulmonary disease (COPD). Thirty-nine patients (67.5 +/- 8.