Mapping the Landscape of Advance Care Planning in Adolescents and Young Adults Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A 5-Year Retrospective Review

Pennarola, Brian W.; Fry, Abigail; Prichett, Laura; Beri, Andrea; Shah, Nirali N.; Wiener, Lori

doi:10.1016/j.jtct.2021.12.007

Cited by 10 publications

(2 citation statements)

References 37 publications

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“…The multi-level cross-planning matrix of the above design is imported into the layout planning structure of landscape ceramic sculpture to control and guide the sculpture construction. After completing the basic planning, the next step is to integrate the pressure setting requirements of sculpture and the collected data information [18]. Measure the scale of the single sculpture, and calculate the volume value of the sculpture using the NSGA -II algorithm, as shown in Formula 2.3:…”

Section: 3mentioning

confidence: 99%

General Layout Planning Model of Landscape Ceramic Sculpture Based on NSGA - Ⅱ Algorithm

Feng,

Zheng,

Qiao

2023

SCPE

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The current overall layout planning model matrix of landscape ceramic sculpture is generally unidirectional, and the planning efficiency is low, resulting in a decline in the layout optimization ratio of the model. Therefore, the design and verification analysis of landscape ceramic sculpture’s overall layout planning model based on the Nondominated Sorting Genetic Algorithm (NSGA - II) algorithm is proposed. According to the actual planning needs and standards, first set the basic layout points, establish a cross-planning matrix in a multi-level manner, and improve the efficiency of the overall layout planning of the sculpture. The NSGA - II calculation landscape ceramic sculpture layout planning structure is constructed on this basis, and the model design is realized by level conversion. This novel NSGA-II with level conversion performs better layout planning when compared with other conventional models. The final test results show that through three stages of layout optimization processing, compared with the initial planning layout, the optimal layout optimization ratio for the setting of the plaza sculpture can reach more than 60%, indicating that with the help of this method, the layout planning of sculpture has been further improved, the space has been expanded, and has practical application value.

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Section: 3mentioning

confidence: 99%

General Layout Planning Model of Landscape Ceramic Sculpture Based on NSGA - Ⅱ Algorithm

Feng,

Zheng,

Qiao

2023

SCPE

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“…However, many pediatric providers report a lack of ACP communication training ( Dellon et al, 2010 ; Durall et al, 2012 ; Lotz et al, 2013 ; Heckford and Beringer, 2014 ). Unfortunately, when ACP discussions do take place, they often occur too late and typically during an acute clinical crisis, when there is insufficient time to consider individual goals and values ( Davidson et al, 2007 ; Brudney, 2009 ; Durall et al, 2012 ; Snaman et al, 2020 ; Pennarola et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Adolescent and Young Adult Initiated Discussions of Advance Care Planning: Family Member, Friend and Health Care Provider Perspectives

et al. 2022

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Background and AimsEnd-of-life (EoL) discussions can be difficult for seriously ill adolescents and young adults (AYAs). Researchers aimed to determine whether completing Voicing My CHOiCES (VMC)—a research-informed advance care planning (ACP) guide—increased communication with family, friends, or health care providers (HCPs), and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, and whether the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family (47%) and friends (33%) reported a positive change in their relationship with the AYA. Participant descriptions of the experience fell into five themes: positive experience (47%), difficult experience (44%), appreciated a guide to facilitate discussion (35%), provided relief (21%), and created worry/anxiety (9%). Only 1 HCP noted a treatment change. Family (76%), friends (67%), and HCP (50%) did not think the AYA would have discussed EoL preferences without completing VMC.ConclusionsVMC has potential to enhance communication about ACP between AYA and their family and friends, though less frequently with HCPs. Participants reported a positive change in their relationship with the AYA after discussing VMC, and described experiencing the conversation as favorable, even when also emotionally difficult.

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Evolution in Documented Goals of Care at End of Life for Adolescents and Younger Adults With Cancer

Mastropolo,

Cernik,

Uno

et al. 2024

JAMA Netw Open

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ImportanceLittle is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions.ObjectiveTo assess frequency, timing, and evolution of documented GOC among AYA patients with cancer in the last 90 days of life.Design, Setting, and ParticipantsThis cross-sectional study included a retrospective review of medical records from the Dana-Farber Cancer Institute, Kaiser Permanente Northern California, and Kaiser Permanente Southern California of AYA patients with cancer who were 12 to 39 years of age at death and who died between January 1, 2003, and December 31, 2019. Data were analyzed from July 1, 2023, through April 30, 2024.ExposuresStage IV cancer or stage I-III cancer with new metastasis or recurrence.Main Outcome and MeasuresThe primary outcome was documented GOC discussions, categorized by timing before death as initial (&gt;60 days), middle (31-60 days), or late (≤30 days). Goals were classified as palliative, nonpalliative, undecided, or not discussed. Subgroup analysis according to race and ethnicity were also performed.ResultsAmong 1929 AYA patients with a mean (SD) age at cancer diagnosis of 28 (8) years, 1049 (54.5%) were female; 5 (0.3%) were American Indian or Alaska Native, 227 (11.8%) were Asian, 157 (8.1%) were Black or African American, 14 (0.7%) were Native Hawaiian or Other Pacific Islander, 1184 (61.4%) were White, 11 (0.6%) were of more than 1 race, 38 (2.0%) were categorized as other race, 293 (15.2%) were without documented race, 514 (26.6%) were Hispanic or Latino, 762 (39.5%) were not Hispanic or Latino, and 653 (33.9%) had no documented ethnicity. Few AYA patients had palliative goals documented in the initial period (139 [7.2%]), increasing to 331 (17.2%) in the middle period and 1113 (57.7%) in the late period. In total, 393 patients (20.4%) transitioned from documented nonpalliative goals in the initial or middle periods to palliative goals by the late period. Many patients had no documented GOC discussion until close to death (initial, 1364 [70.7%]; middle, 969 [50.2%]; and late, 322 [16.7%]). Among the 1929 patients, non-White patients were disproportionately represented among those not having documented GOC discussions (Black, 30 of 157 [19.1%]; Asian, 45 of 227 [19.8%]; and other or undocumented race, 80 of 361 [22.2%]) compared with White patients (167 of 1184 [14.1%]) (P &lt; .001) as were Hispanic or Latino patients (116 of 514 [22.6%]) compared with non-Hispanic patients (93 of 762 [12.2%]) (P &lt; .001) and individuals with no ethnicity documented (113 of 653 [17.3%]) (P &lt; .001).Conclusions and RelevanceIn this cross-sectional study of AYA patients who died of cancer, palliative goals were rarely documented before the last month of life, highlighting the need for timely and ongoing GOC discussions.

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Mapping the Landscape of Advance Care Planning in Adolescents and Young Adults Receiving Allogeneic Hematopoietic Stem Cell Transplantation: A 5-Year Retrospective Review

Cited by 10 publications

References 37 publications

General Layout Planning Model of Landscape Ceramic Sculpture Based on NSGA - Ⅱ Algorithm

General Layout Planning Model of Landscape Ceramic Sculpture Based on NSGA - Ⅱ Algorithm

Adolescent and Young Adult Initiated Discussions of Advance Care Planning: Family Member, Friend and Health Care Provider Perspectives

Evolution in Documented Goals of Care at End of Life for Adolescents and Younger Adults With Cancer

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