South Carolina Coalition for Care of Serious Illness (SCC CSI) sponsors development of Physician Orders for Scope of Treatment (POST) in South Carolina. The SC POST follows the national POLST (www. polst.org) paradigm creating an advance treatment planning physician order that migrates as valid across institutional boundaries: from physician office, to home/nursing home/hospice to EMS to hospital emergency/inpatient services. The POST form encourages a conversation between a physician and the patient regarding treatment options available to seriously ill patients for whom death within a year would not be a surprise. These choices primarily include whether to attempt cardiopulmonary resuscitation in the event of cardiac or pulmonary arrest or not (a ?DNR? or ?Allow Natural Death? order) and whether during acute illness to provide full treatment including endotracheal intubation and intensive care, supportive treatment such as noninvasive ventilation and no intensive care, or comfort care only. The Charleston and Greenville areas will pilot POST. Investigators by area will survey providers completing POST documents for patients or treating patients with POST about the utility of this form and how use of the form affected their patient's treatment. A chart reviews of patients presenting with a POST form to a hospital emergency or inpatient unit will address whether providers respected patient treatment choices. SCC CSI plans to publish the results of the pilot in appropriate journals and present the results at medical meetings and to interested persons. The results of the study may provide the supporting documentation for subsequent legislation supporting POST. POST represents a coordinated statement of a seriously ill patient?s treatment choices to be honored across multiple treatment settings.
The purpose of this study is to survey young adults (18-25) on their attitudes about HIV and pregnancy prevention, and about the use of the withdrawal method to prevent pregnancy and HIV infection. Researchers hope that the information that is gathered from the study will help to develop better risk reduction counseling that can be used in the future to help educate at-risk young adults.
Shoulders dystocia (SD) is an obstetric emergency resulting from a discrepancy in size between the fetal shoulders and maternal pelvic inlet, resulting in impaction of the fetal shoulder(s) against maternal pelvic bone(s) following delivery of the fetal head.
Obstetric providers need to be adequately trained to manage this emergency effectively. Traditionally, trainees are taught how to perform these maneuvers with lectures/articles describing maneuvers with pictorial representations. There is no currently accepted ?best practice? regarding which sequence of alleviating maneuvers is preferred to resolve a shoulder dystocia.
What is needed is an effective method to train providers for management of shoulder dystocia. Additionally, there are tools needed to assess the competency of providers in the management of shoulder dystocia. Theoretically, stimulation training could fulfill both of these roles. This study will assess the simulation of shoulder dystocia during vaginal delivery.
The goal of this study is to determine the safety and efficacy of a chemotherapy regimen known as Modified FOLFIRINOX (mFFX) alone or with the addition of Stereotactic Body Radiotherapy (SBRT). SBRT is a type of highly focused and precise x-ray treatment done in a total of 5 treatments. We hope to learn if this new treatment combination helps to control the disease and improve survival for patients with locally advanced pancreatic cancer.
The goal of this study is to receive Veteran feedback on an intervention being developed for female Veterans to reduce their risk of alcohol misuse and sexual assault. We are recruiting 20 female Veterans who engage in alcohol misuse to receive feedback on the intervention content. Feedback will be integrated into the intervention prior to being used with female Veterans.
This study is for patients that have been diagnosed with previously untreated Intermediate or High-risk myelodysplastic syndrome (MDS). The investigational drug in this study is vadastuximab talirine (SGN-CD33A). The purpose of this study is to evaluate escalating doses of vadastuximab talirine and compare the overall response rate between 2 study arms. Participants can expect to be in the study for up to approximately 39 months.
This study is enrolling male and female patients with a diagnosis of advanced solid tumor. The purpose of this research study is to learn about the effects of and to find the best dose of the study drug, PF 05212384, when given in combination with other drugs. This study will determine the highest dose of PF-05212384 that can be tolerated when given in combination with other drugs; this PF-05212384 dose is called the maximum tolerated dose or MTD. Enrolled patients can expect to be in this study for about 6 months. They will need to visit the research site at least 12 times during the study. Patients may stay in the study until the disease gets worse or they decide to stop participating.
The purpose of this study is to determine if a pessary, a silicone device placed within the vagina to support the cervix, could be a good way to help pregnant women who are at risk for preterm delivery. The pessary that is used in this study, called the Arabin pessary, has not been approved by the United States Food and Drug Administration (FDA) for the prevention of preterm delivery. It is an investigational device, which means it is still being studied to find out whether or not it is safe and effective in patients with a short cervix who are at risk for preterm delivery.
The primary purposes of this study are to:
?Provide access to cord blood units for recipients whose best choice for a cord blood unit(s) do not meet all FDA standards, but do meet standards set by the NMDP on this study.
?Assess how well and how quickly blood counts return to normal after transplant in recipients on this study.