The Impact of Advance Care Planning on End-of-Life Care: Do the Type and Timing Make a Difference for Patients With Advanced Cancer Referred to Hospice?

Purpose: This study aimed to determine the impact of advanced care planning (ACP) on potentially avoidable hospital admissions at the end of life (EOL) among a sample of hospice-referred patients with cancer, in order to present actionable considerations for the practicing clinician.

Methods: This study was designed as a retrospective cohort using electronic health record data that assessed likelihood of hospital admissions in the last 30 days of life for 1185 patients with a primary diagnosis of cancer, referred to hospice between January 1, 2014, and December 31, 2015, at a large academic medical center. Inverse probability treatment weighting based on calculated propensity scores balanced measured covariates between those with and without ACP at baseline.

High-Throughput Three-Dimensional Hydrogel Cell Encapsulation Assay for Measuring Matrix Metalloproteinase Activity.

Three-dimensional (3D) cell culture systems more closely mimic the in vivo cellular microenvironment than traditional two-dimensional cell culture methods, making them a valuable tool in drug screening assays. However, 3D environments often make analysis of cellular responses more difficult, so most high-throughput (HT) 3D assays have been limited to measurements of cell viability. Yet, many other cell functions contribute to disease and are important pharmacological targets.

Age and Sex Differences in Overuse Injuries Presenting to Pediatric Sports Medicine Clinics.

Pediatric overuse injuries present with a gradual mechanism of onset and an underlying pathogenesis of microtrauma. We evaluated the clinical presentation of pediatric sports injuries to determine if differences exist between age and sex. A retrospective chart review was performed over a 6-year period; 6593 overuse injuries were included with the mean age of 13.

Corrections.

This article has been corrected. Please see J Manag Care Spec Pharm, 2018 Sep;24(9-a):S14-S29.

Intrathecal Morphine Administration Does Not Affect Survival After Liver Resection for Hepatocellular Carcinoma.

. Opioids may influence tumor recurrence and cancer-free survival in hepatocellular carcinoma (HCC). The relationship between intrathecal morphine administration, tumor recurrence, and patient survival after hepatectomy for HCC is unknown.

Impaired Postural Control and Altered Sensory Organization During Quiet Stance Following Neurotoxic Chemotherapy: A Preliminary Study.

Individuals diagnosed with chemotherapy-induced peripheral neuropathy (CIPN) demonstrate impaired balance and carry an increased risk of falling. However, prior investigations of postural instability have only compared these individuals against healthy controls, limiting the understanding of impairments associated with CIPN. Therefore, the purpose of this study was to better isolate postural control impairments that are associated with CIPN.

Adjunct Antihyperglycemic Agents in Overweight and Obese Adults With Type 1 Diabetes.

Objective: People with type 1 diabetes often have suboptimal glycemic control. The gold standard of treatment is basal-bolus insulin or subcutaneous insulin infusion via insulin pump. Although insulin therapy improves glycemic control, weight gain and hypoglycemia often limit achievement of hemoglobin A (A1C) goals.

Impact of Casting and Splinting Manipulations on Below-Dressing Pressures: An Experimental Model.

Background: We tested how different applications of casts and splints affect underlying below-dressing pressures and how these dressings respond to swelling.

Methods: A 3-in polyvinyl chloride pipe with an attached 100 mL saline bag to the outer surface was used to simulate a human forearm. A pressure transducer was attached to the bag and connected to a monitor providing continuous pressure measurements.

Cardiovascular Outcomes with Once-Weekly GLP-1 RAs: Clinical and Economic Implications.

Unlabelled: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of atherosclerotic cardiovascular (ASCVD) disease, which is the largest contributor to the economic burden of diabetes. Minimization of disease morbidity through comprehensive management of ASCVD risk factors, including but not limited to hyperglycemia, is a key goal of T2DM therapy. Emerging evidence with some glucagon-like peptide-1 receptor agonists (GLP-1 RAs) points to beneficial effects across a range of atherosclerotic risk factors and possible improvement of some cardiovascular outcomes independent of these effects.

Glycemic Efficacy, Weight Effects, and Safety of Once-Weekly Glucagon-Like Peptide-1 Receptor Agonists.

Unlabelled: This article provides an overview of the efficacy and safety of once-weekly glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the treatment of type 2 diabetes mellitus (T2DM). GLP-1 RAs stimulate pancreatic GLP-1 receptors, which increases insulin secretion, delays gastric emptying, and increases satiety. As a class, GLP-1 RAs lower A1c levels and have been associated with reductions in weight and blood pressure and reduced fluctuations in glucose levels, and they have a low risk of hypoglycemia.

Paid Family Leave to Enhance the Health Outcomes of Preterm Infants.

Prematurity is the largest contributor to perinatal morbidity and mortality. Preterm infants and their families are a significant vulnerable population burdened with limited resources, numerous health risks, and poor health outcomes. The social determinants of health greatly shape the economic and psychosocial resources that families possess to promote optimal outcomes for their preterm infants.

Family Functioning in Pediatric Primary Care Patients.

Introduction: The purpose of this study was to pilot a brief measure of family functioning (Family Assessment Device-General Functioning [FAD_GF]) with caregivers of children aged 2 to 18 years, seen for routine pediatric primary care visits.

Methods: This study evaluated the psychometric properties of the FAD_GF in a pediatric primary care sample of 400 families. Confirmatory factor analysis was used to validate the FAD_GF using R, and WLSMV was used to estimate missing variables.

Who Is Less Likely to Ostracize? Higher Trait Mindfulness Predicts More Inclusionary Behavior.

Despite the pain ostracism (being excluded and ignored) causes, researchers have minimally investigated factors related to reducing its occurrence. We investigated the association between higher trait mindfulness (the tendency to be attentive to the present moment) and lower engagement in ostracism. In Study 1, employed adults scoring higher on trait mindfulness reported ostracizing coworkers less.

Hearing Preservation After Translabyrinthine Vestibular Schwannoma Excision: Audiometry and Electrocochleography Results.

Objectives: To describe a case of inadvertent hearing preservation following a classical translabyrinthine resection of a vestibular schwannoma of the internal auditory canal in an otherwise healthy patient.

Methods: Herein, we describe the case of an otherwise healthy patient who underwent resection of an intracanalicular vestibular schwannoma via a translabyrinthine approach. Furthermore, as part of an ongoing study aimed at characterizing hearing changes due to intraoperative events, cochlear hair cell and nerve activity were monitored using electrocochleography throughout surgery.

Petrous Apex Pneumatization: Influence on Postoperative Cerebellopontine Angle Tumor Cerebrospinal Fluid Fistula.

Objective: Multiple investigators have sought to identify risk factors for cerebrospinal fluid (CSF) leak following cerebellopontine angle (CPA) tumor resection. We evaluated whether pneumatization of the petrous apex (PA) is a risk factor for CSF fistula.

Method: We conducted a retrospective chart review at 2 major tertiary academic institutions undergoing CPA tumor resection and analyzed their respective head or temporal computed tomography (CT) scans if available.

Unconventional Consumption Methods and Enjoying Things Consumed: Recapturing the "First-Time" Experience.

People commonly lament the inability to re-experience familiar things as they were first experienced. Four experiments suggest that consuming familiar things in new ways can disrupt adaptation and revitalize enjoyment. Participants better enjoyed the same familiar food (Experiment 1), drink (Experiment 2), and video (Experiments 3a-3b) simply when re-experiencing the entity via unusual means (e.

Where Did This Thought Come From? A Self-Validation Analysis of the Perceived Origin of Thoughts.

Three experiments examined whether perceiving thoughts as coming from internal versus external origins are more impactful on attitudes. Participants generated either positive or negative thoughts about different attitude objects, including different diets, and plastic surgery. Then, participants were induced to think that their thoughts came from the self or from an external source.

Descriptive Analysis of Associated Factors for Urgent Versus Nonurgent Inpatient Spine Transfers to a Tertiary Care Hospital.

Patients with spine-associated symptoms are transferred regularly to higher levels of care for operative intervention. It is unclear what factors lead to the transfer of patients with spine pathology to level I care facilities, and which transfers are indicated. All patients with isolated spinal pathology who were transferred from 2011 to 2015 were reviewed.

Social Support, Health, and Health Care Access Among Latino Immigrant Men in an Emerging Community.

Objective: To determine the association of social support with alcohol abuse, depression, and health care access among Latino immigrant men in an emerging Latino community (an area with a small yet growing Latino population).

Methods: Cross-sectional baseline data of 140 men prior to a participatory male-to-male community health worker intervention among Latino immigrants were analyzed using logistic regression. Community health workers recruited community participants in Western Pennsylvania between 2011 and 2013.

Impact of a Pharmacist-Provided Spirometry Service on Access to Results in a Primary Care Setting.

Objectives: The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service.

Methods: Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014-September 2015) and after (January 2016-October 2016) the implementation of the pharmacy-provided spirometry service.