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Advance Directive

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1. A Randomized Controlled Trial Comparing the Letter Project Advance Directive to Traditional Advance Directive. (Abstract)

A Randomized Controlled Trial Comparing the Letter Project Advance Directive to Traditional Advance Directive. Simpler alternatives to traditional advance directives that are easy to understand and available in multiple formats and can be initiated by patients and families will help facilitate advance care planning. The goal of this study was to compare the acceptability of the letter advance directive (LAD) to the traditional advance directive (TAD) of the state of California.A web-based (...) , randomized controlled trial was conducted, in which the participants were randomized to one of two types of advance directives (ADs): the LAD (intervention) or the TAD (control). Primary outcomes were participant ratings of the ease, value, and their level of comfort in the AD document they completed.A total of 400 participants completed the study, with 216 randomized to the LAD and 184 to the TAD by a computerized algorithm. Overall, participants preferred the LAD to the TAD (success rate difference

2018 Journal of palliative medicine Controlled trial quality: uncertain

2. Advance directive: does the GP know and address what the patient wants? Advance directive in primary care Full Text available with Trip Pro

Advance directive: does the GP know and address what the patient wants? Advance directive in primary care Due to the rapid changes in the medical world and the aging population, the need for advanced care planning grows. Despite efforts to make this topic discussed, only a minority of patients discusses the advance directive with their general practitioner (GP). This study aimed to map thresholds: What barriers are identified by GPs and patients in preparing and discussing an advance directive (...) ?A cross section survey in patients and GP's was performed. Citizens were recruited by multimedia and by street interviews. GP's were recruited by mailing.Most of the 502 citizens already heard of an advance directive but only 17 had declared one while 21 never want one. Eighty percent wants to take the initiative themselves but half of the participants wants the GP to be actively involved. Thirty percent finds the document too difficult to understand. The need to draw an advance directive grew

2018 BMC medical ethics

3. Comparison of a Web-based Advance Directive to a Standard Advance Directive

Comparison of a Web-based Advance Directive to a Standard Advance Directive Comparison of a Web-based Advance Directive to a Standard Advance Directive - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . Comparison of a Web-based Advance Directive to a Standard Advance Directive The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03676426 Recruitment Status : Recruiting First Posted : September 18, 2018 Last Update Posted

2018 Clinical Trials

4. Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan. Full Text available with Trip Pro

Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan. Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.In

2018 PLoS ONE

5. Advance Care Planning and Advance Directives: A Multimedia Education Program in Community-Dwelling Older Adults. (Abstract)

Advance Care Planning and Advance Directives: A Multimedia Education Program in Community-Dwelling Older Adults. This community-based cluster randomized trial evaluated the efficacy of a 4-week multimedia educational intervention followed by telephone consultations at Weeks 12 and 24 on the selection of a hospice program for end-of-life care and completion of an advance directive (AD) in case of future advanced dementia. One hundred twenty-three cognitively intact older adults from five (...) community centers in Taiwan were randomly assigned to two groups. The study showed that 100% of participants in the intervention group (two community centers, n = 52) selected hospice program care for end-of-life care and signed ADs, whereas those in the control group were less likely to do both ( p < .001). Participants in the intervention group also had a positive change in knowledge, subjective norms, perceived behavioral control, and behavioral intention of advance care planning (ACP) for advanced

2019 Journal of applied gerontology : the official journal of the Southern Gerontological Society Controlled trial quality: uncertain

6. Default Options and their Effect on Patients? Advance Directives

Default Options and their Effect on Patients? Advance Directives "Default Options and their Effect on Patients’ Advance Directives" by Danielle Bendicksen < > > > > > Title Author Date of Graduation Summer 8-12-2017 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Advance directives (ADs) are a way for patients to state their wishes for care in the case that they are unable to express them. Within the US healthcare system (...) , in the absence of ADs or other legal orders, the default is often to sustain life until no longer medically possible. This systematic review analyzes studies that seek to learn how patients >50 years old make decisions for their care on ADs and if default options on the AD form itself could affect their choices. Methods: Exhaustive search of MEDLINE-PubMed, CINAHL, and Web of Science, using the terms “advance directive” and “default.” Relevant studies were assessed for quality using the Grading

2017 Pacific University EBM Capstone Project

7. Physicians and nurses' knowledge and attitudes towards advance directives for cancer patients in Saudi Arabia. Full Text available with Trip Pro

Physicians and nurses' knowledge and attitudes towards advance directives for cancer patients in Saudi Arabia. This study aimed to investigate physicians' and nurses' knowledge and attitudes toward advance directives (ADs) for cancer patients, which empower patients to take decisions on end-of-life needs if they lose their capacity to make medical decisions. A cross-sectional study was conducted using convenience sampling. The outcomes were responses to the knowledge and attitude questions

2019 PLoS ONE

8. Liver-related events and mortality among elderly patients with advanced chronic hepatitis C treated with direct-acting antivirals. Full Text available with Trip Pro

Liver-related events and mortality among elderly patients with advanced chronic hepatitis C treated with direct-acting antivirals. Direct-acting antivirals (DAAs) are effective in patients aged ≥65 years. However, little is known about the effects of DAAs on survival, liver decompensation and development of hepatocellular carcinoma (HCC).To compare the incidence of liver-related events and mortality between patients aged ≥65 and <65 years.Prospective study comparing patients aged ≥65 and <65

2019 PLoS ONE

9. Concordance between Proxy Level of Care Preference and Advance Directives among Nursing Home Residents with Advanced Dementia: A Cluster Randomized Clinical Trial. Full Text available with Trip Pro

Concordance between Proxy Level of Care Preference and Advance Directives among Nursing Home Residents with Advanced Dementia: A Cluster Randomized Clinical Trial. Care consistent with goals is the desired outcome of advance care planning (ACP).The objectives of this study were to examine concordance between advance directives and proxy care preferences among nursing home residents with advanced dementia and to determine the impact of an ACP video on concordance.Data were from Educational Video (...) to Improve Nursing home Care in End-stage dementia, a cluster randomized clinical trial conducted in 64 Boston-area facilities (32/arm) from 2013 to 2017. Participants included advanced dementia residents and their proxies (N = 328 dyads). At the baseline and quarterly (up to 12 months), proxies stated their preferred level of care for the resident (comfort, basic, or intensive) and advance directives for specific treatments (resuscitation, hospitalization, tube-feeding, intravenous hydration

2018 Journal of pain and symptom management Controlled trial quality: uncertain

10. Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs Full Text available with Trip Pro

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options.To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care.This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath (...) . We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs.Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases.The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed

2018 Journal of palliative medicine

11. Locally advanced gastro-oesophageal cancer: Recent therapeutic advances and research directions. (Abstract)

Locally advanced gastro-oesophageal cancer: Recent therapeutic advances and research directions. Gastric (GC) and gastro-oesophageal (GOJC) adenocarcinomas are often considered as a single entity, even though differences exist in epidemiology, clinical presentation, molecular biology and treatment options. Locally advanced, resectable disease represents a particularly challenging scenario, as many critical issues need to be addressed. In both GC and GOJC among Western countries, systemic (...) chemotherapy demonstrated the greatest benefit when administered before and after surgery and perioperative chemotherapy has been set as a standard in this setting. Nonetheless, multiple chemotherapy regimens have been tested and direct comparisons have been only recently presented. Adjuvant chemoradiotherapy is an option as well, but several trials have questioned its role when more effective combination regimens are used. With regards to GOJC, preoperative chemoradiotherapy is an alternative

2018 Cancer Treatment Reviews

12. Stability of end-of-life preferences in relation to health status and life-events: A cohort study with a 6-year follow-up among holders of an advance directive. Full Text available with Trip Pro

Stability of end-of-life preferences in relation to health status and life-events: A cohort study with a 6-year follow-up among holders of an advance directive. Stating preferences about care beforehand using advance care planning and advance directives has become increasingly common in current medicine. There is still lack of clarity what happens over the course of time in relation to these preferences. We wanted to determine whether the preferences about end-of-life care of a person owning (...) an advance directive stay stable after the experience of a life-event; how often advance directives are altered and discussed with family members and physicians over time.A longitudinal cohort study with a population consisting of people owning the most common advance directives in the Netherlands, with a follow-up of 6-years from 2005 until 2011. Respondents were recruited using two associations that provided the advance directives, Right to Die-NL (n = 4463) and the Dutch Patient Organisation (n = 1263

2018 PLoS ONE

13. Constitutional Challenge to Texas Advance Directives Act - Now on Appeal

Constitutional Challenge to Texas Advance Directives Act - Now on Appeal I not a bot. Resume. Are you not a robot? Click on the button to continue: I not a bot. Resume.

2017 MedicalVideos

14. Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study. Full Text available with Trip Pro

Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study. To investigate whether life-sustaining measures in medical emergency situations are less accepted for an anticipated own future of living with dementia, and to test whether a resource-oriented, in contrast to a deficit-oriented video about the same demented person, would increase the acceptance of such life-saving measures.Experimental study conducted between September (...) . This is particularly true if the medical threat can be treated efficiently. These findings have implications for the practice of formulating, revising, and supporting advance directives.

2018 PLoS ONE

15. Are Advance Directives Safe Enough? Top Court to Decide

Are Advance Directives Safe Enough? Top Court to Decide I not a bot. Resume. Are you not a robot? Click on the button to continue: I not a bot. Resume.

2017 MedicalVideos

16. The Genetics and Epigenetics of PTSD: Overview, Recent Advances, and Future Directions Full Text available with Trip Pro

The Genetics and Epigenetics of PTSD: Overview, Recent Advances, and Future Directions This paper provides a brief summary and commentary on the growing literature and current developments related to the genetic underpinnings of posttraumatic stress disorder (PTSD). We first briefly provide an overview of the behavioral genetic literature on PTSD, followed by a short synopsis of the substantial candidate gene literature with a focus on genes that have been meta-analyzed. We then discuss (...) the genome-wide association studies (GWAS) that have been conducted, followed by an introduction to other molecular platforms used in PTSD genomic studies, such as epigenetic and expression approaches. We close with a discussion of developments in the field that include the creation of the PTSD workgroup of the Psychiatric Genomics Consortium, statistical advances that can be applied to GWAS data to answer questions of heritability and genetic overlap across phenotypes, and bioinformatics techniques

2017 Current opinion in psychology

17. Systemic Therapy for Advanced or Recurrent Endometrial Cancer and Advanced or Recurrent Uterine Papillary Serous Carcinoma

Systemic Therapy for Advanced or Recurrent Endometrial Cancer and Advanced or Recurrent Uterine Papillary Serous Carcinoma Evidence-Based Series 4-8 Version 4 A Quality Initiative of the Program in Evidence-based Care (PEBC), Cancer Care Ontario (CCO) Systemic Therapy for Advanced or Recurrent Endometrial Cancer, and Advanced or Recurrent Uterine Papillary Serous Carcinoma Members of the Expert Panel on Endometrial Cancer or Uterine Papillary Serous Carcinoma Guideline 4-8 Version 4 (...) ://www.cancercare.on.ca/ or contact the PEBC office at: Phone: 905-527-4322 ext. 42822 Fax: 905-526-6775 E-mail: ccopgi@mcmaster.ca PEBC Report Citation (Vancouver Style): Gawlik C, Carey M, Faught W, Fung Kee Fung M, Chambers A; Members of the Gynecology Cancer Disease Site Group. Systemic therapy for advanced or recurrent endometrial cancer, and advanced or recurrent uterine papillary serous carcinoma. Covens A, Durocher-Allen L, reviewers. Toronto (ON): Cancer Care Ontario; 2004 Aug 17 [Endorsed 2019 Jul 23

2019 Cancer Care Ontario

18. Bexarotene as maintenance treatment after other than skin-directed therapy in advanced stage mycosis fungoides: a pilot study. (Abstract)

Bexarotene as maintenance treatment after other than skin-directed therapy in advanced stage mycosis fungoides: a pilot study. Advanced-stage mycosis fungoides (MF) and Sézary Syndrome (SS) patients have a poor quality of life and quickly relapse irrespective of the administered treatment. Most of the available therapies do not warrant long-lasting remission. In the last ten years, the need for an MF maintenance treatment has been investigated in the literature, with most of experiences (...) focusing on the early stages and a few on the advanced phases [2,4]. Encouraging results on the chances of achieving lasting responses after the treatment have been reported in patients on Brentuximab Vedotin. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

2019 Journal of the European Academy of Dermatology and Venereology

19. Global children's surgery: recent advances and future directions. (Abstract)

Global children's surgery: recent advances and future directions. Two-thirds of the world's population lacks access to surgical care, many of them being children. This review provides an update on recent advances in global children's surgery.Surgery is being increasingly recognized as an essential component of global and child health. There is a greater focus on sustainable collaborations between high-income countries (HICs) and low-and-middle-income countries (HICs and LMICs). Recent work (...) provides greater insight into the global disease burden, perioperative outcomes and effective context-specific solutions. Surgery has continued to be identified as a cost-effective intervention in LMICs. There have also been substantial advances in research and advocacy for a number of childhood surgical conditions.Substantial global disparities persist in the care of childhood surgical conditions. Recent work has provided greater visibility to the challenges and solutions for children's surgery

2019 Current Opinion in Pediatrics

20. Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial. (Abstract)

Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial. End-of-life (EOL) care for Latinos with chronic illness is a critically important problem. Latinos with chronic illness suffer worse health outcomes and poorer quality of care due to various issues occurring in care delivery systems. Latinos are less likely than non-Hispanic whites to prepare an advance directive (AD) for health-care decision-making (...) that impacts treatment decisions for when EOL is near. Advance care planning (ACP) interventions tailored specifically for Latinos have rarely been implemented.The primary aim examines whether a motivational interviewing (MI) intervention increased rates of AD documentation among older Latinos. The secondary aim was to examine whether MI improved communication with providers and family members.We pilot tested a randomized controlled trial with older Latinos >50 years with one or more chronic illnesses

2019 American Journal of Hospice and Palliative Medicine Controlled trial quality: uncertain

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