North Carolina medical journal
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Advance care planning maximizes the patient's chances of receiving the care he or she wants and minimizes confusion. Frank discussion, time, and persistence are needed to optimize this shared decision-making process. This article discusses the important components of advance care planning and the recommended documentation.
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Most cancer survivorship initiatives are designed for patients whose treatment is intended to be curative. For patients living with advanced cancer, in contrast, survivorship research efforts and programs are far less common. This neglected aspect of cancer survivorship requires particular emphasis on active symptom management and clarification of goals of care.
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This study examined trends in premature mortality--defined as years of potential life lost before age 75 years--in North Carolina during the period 2000-2010. ⋯ Public health professionals should focus attention on counties in which premature mortality is increasing or remaining constant and should address the specific underlying causes of such deaths. In counties in which premature mortality among whites is increasing, community health efforts should focus on prevention of smoking, suicide, and injury. In counties with large nonwhite populations, programs should focus on prevention of stroke, heart disease, diabetes, homicide, and kidney disease.
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The health care industry is grappling with the challenges of working with and analyzing large, complex, diverse data sets. Blue Cross and Blue Shield of North Carolina provides several promising examples of how big data can be used to reduce the cost of care, to predict and manage health risks, and to improve clinical outcomes.