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Which patients need anterior cruciate ligament reconstruction after initial treatment with rehabilitation? A scoping review

Purpose: Some patients with anterior cruciate ligament (ACL) injury initially treated with rehabilitation need ACL reconstruction (ACLR); yet, it is unclear what characterizes these patients. This review aimed to describe predictors for ACLR in patients initially treated with rehabilitation. Methods: A systematic literature search was performed in the Cochrane, Embase, Medline, SportsDiscus and We

Tumour immune characterisation of primary triple-negative breast cancer using automated image quantification of immunohistochemistry-stained immune cells

The tumour immune microenvironment (TIME) in breast cancer is acknowledged with an increasing role in treatment response and prognosis. With a growing number of immune markers analysed, digital image analysis may facilitate broader TIME understanding, even in single-plex IHC data. To facilitate analyses of the latter an open-source image analysis pipeline, Tissue microarray MArker Quantification (

Dynamic process simulation for life cycle inventory data acquisition – Environmental assessment of biological and chemical phosphorus removal

In Sweden, phosphorus is commonly removed from municipal wastewater treatment by chemical precipitation (CP). Recently, such alternatives as enhanced biological phosphorus removal (EBPR) have garnered interest due to the increased risk of chemical shortage. In this study, a life cycle assessment (LCA) was performed to compare EBPR and CP in three scenarios: 1) baseline – precipitation chemicals av

Exploring Patients' Experience with Clinicians Who Recognize Their Unmet Palliative Needs : An Inpatient Study

Background: Given the national shortage of palliative care specialists relative to the need for their services, engaging nonspecialists is important to ensure patients with serious illness have an opportunity to share their goals and values with their providers. Hospital medicine clinicians are well positioned to conduct these conversations given they care for many medically complex patients. Yet,

Scaling Implementation of the Serious Illness Care Program Through Coaching

BACKGROUND: We designed group coaching calls to reinforce communication skill acquisition and Serious Illness Care Program uptake in adult primary care.MEASURES: Percentage of primary care physicians (PCPs) who have documented a serious illness conversation in the electronic health record (EHR) approximately three and six months after the coaching intervention. Participant feedback surveys to bett

Understanding and Addressing the Role of Coping in Palliative Care for Patients With Advanced Cancer

Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of

DNR, DNI, and DNO?

The addition of a do-not-operate (DNO) section to current medical orders for life-sustaining treatment (MOLST) and physician orders for life-sustaining treatment (POLST) medical order forms would more completely document patients' wishes for invasive interventions at the end of life. We propose a modification of the MOLST and POLST forms, in addition to hospital and electronic medical records, to

The Surprise Question Can Be Used to Identify Heart Failure Patients in the Emergency Department Who Would Benefit From Palliative Care

CONTEXT: Heart failure (HF) is associated with symptom exacerbations and risk of mortality after an emergency department (ED) visit. Although emergency physicians (EPs) treat symptoms of HF, often the opportunity to connect with palliative care is missed. The "surprise question" (SQ) "Would you be surprised if this patient died in the next 12 months?" is a simple tool to identify patients at risk

Communication Differences between Oncologists and Palliative Care Clinicians : A Qualitative Analysis of Early, Integrated Palliative Care in Patients with Advanced Cancer

BACKGROUND: Growing evidence demonstrates the benefits of early, integrated palliative care (PC) for patients with advanced cancer and their caregivers. Yet, data are lacking on the communication patterns within this model of care.OBJECTIVE: The goals of this study were to describe the content of patient-clinician discussions among patients receiving PC and to compare differences in discussion con

Defining the Elements of Early Palliative Care That Are Associated With Patient-Reported Outcomes and the Delivery of End-of-Life Care

Purpose We describe the key elements of early palliative care (PC) across the illness trajectory and examine whether visit content was associated with patient-reported outcomes and end-of-life care. Methods We performed a secondary analysis of patients with newly diagnosed advanced lung or noncolorectal GI cancer (N = 171) who were randomly assigned to receive early PC. Participants attended at le

"I'd Recommend …" How to Incorporate Your Recommendation Into Shared Decision Making for Patients With Serious Illness

Patients and families facing serious illness often want and need their clinicians to help guide medical decision making by offering a recommendation. Yet clinicians worry that recommendations are not compatible with shared decision making and feel reluctant to offer them. We describe an expert approach to formulating a recommendation using a shared decision-making framework. We offer three steps t

Role of Patient Coping Strategies in Understanding the Effects of Early Palliative Care on Quality of Life and Mood

Purpose The early integration of oncology and palliative care (EIPC) improves quality of life (QOL) and mood for patients with advanced cancer. However, the mechanisms by which EIPC benefits these outcomes remain unclear. We therefore examined whether EIPC improved patients' coping strategies and if changes in coping accounted for intervention effects on QOL and depressive symptoms. Patients and M