Literature Review

Don’t let yesterday take up too much of today. ~ Will Rogers

New FDA policies could limit the full value of AI in medicineJAMA Health Forum; Scott Gottlieb, MD; 2/25Some experts within the [AI] field predict that in the next several years, developers may realize artificial general intelligence (AGI)—a revolutionary form of AI capable of understanding, learning, and applying knowledge across various tasks with human-like proficiency. Unlike today’s narrow AI systems that excel at tasks such as image recognition or language translation, AGI can tackle any intellectual challenge a human can, demonstrating a deep comprehension of diverse disciplines. Artificial intelligence tools with advanced analytical capabilities used in clinical practice, especially tools that synthesize complex clinical information from distinct sources, may automatically be classified as medical devices ... [by the US Food and Drug Administration]. This could deny health care clinicians access to AI tools that have the potential to transform the productivity and safety of medical care. 

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.

“You sure feel like you’re alone, kind of flailing away out there”: Family caregiver perspectives of caring for an individual with glioblastoma multiformeCambridge University Press; by Christy Muasher-Kerwin, Abby Baumbach, Yujun Liu, M. Courtney Hughes; 2/25Glioblastoma multiforme (GBM) is the most common and aggressive form of brain cancer... Nineteen current and former family caregivers for individuals with GBM participated in semi-structured interviews from October 2023 through January 2024... Three themes emerged from the interview analysis: (1) overwhelming caregiver burden, (2) difficulties coping with the caregiver role, and (3) gaps in caregiver support... Family caregivers for individuals with GBM desire more straightforward and proactive information and education about their care recipients from their medical providers. There is an opportunity for more utilization of hospice, palliative, and rehabilitation services to provide necessary training to GBM patients and their caregivers.

[UK] Supporting the bereaved child in the adult ICU: A narrative reviewIntensive Care Medicine; Annelies Rowland, Carole Boulanger, Louise Dalton; 2/25Childhood bereavement is a significant issue globally, affecting millions of children each year, with incidence rates significantly increasing following the COVID-19 pandemic. The loss of an important adult, particularly in the ICU environment, can lead to lasting psychological and behavioural challenges for children. Both families and healthcare professionals (HCPs) often feel unprepared and uncomfortable engaging in honest, supportive conversations with children about bereavement, further complicating children's grief processing. This narrative review examines the pivotal role ICU HCPs can play in facilitating child-centred bereavement support, focusing on promoting honest communication, supportive visitation practices, creating a child-friendly and humanised ICU environment, and encouraging child involvement during end-of-life care. The review also advocates for specialised training to equip ICU staff with the necessary skills to support grieving children and families.

The evolution of serious health-related suffering from 1990 to 2021: an update to The Lancet Commission on global access to palliative care and pain reliefThe Lancet: Global Health; by Felicia M Knaul, Héctor Arreola-Ornelas, Xiaoxiao J Kwete, Afsan Bhadelia, William E Rosa, Michael Touchton, Oscar Méndez-Carniado, Valentina Vargas Enciso, Tania Pastrana, Joseph R Friedman, Stephen R Connor, Julia Downing, Dean T Jamison, Eric L Krakauer, David Watkins, Renzo Calderon-Anyosa, Rodrigo Garcia-Santisteban, Renu S Nargund, Jim Cleary, Liliana De Lima, Nahla Gafer, Liz Grant, Christian Ntizimira, Pedro E Pérez-Cruz, M R Rajagopal, Dingle Spence, Paul Vila, Lukas Radbruch; 3/25The Lancet Commission on global access to palliative care and pain relief introduced the concept of serious health-related suffering (SHS) to measure the worldwide dearth of palliative care. This Article provides an extended analysis of SHS from 1990 to 2021 and the corresponding global palliative care need... The SHS global burden increased by 74% between 1990 and 2021 to almost 73.5 million individuals, with population growth accounting for only half of that increase. Low-income and middle-income countries (LMICs) accounted for 80% of SHS, with an increase of 83% from 1990 to 2021 compared with a 46% increase in high-income countries... SHS and the associated need for palliative care is a major and persistent but not insurmountable challenge for health systems worldwide. Our findings highlight the urgency to both reduce the avoidable SHS burden through prevention and treatment, and guarantee comprehensive, universal access to palliative care as an equity and health system imperative, especially in LMICs.

[Australia] Practice recommendations for culturally sensitive communication at the end of life in intensive care: A modified eDelphi studyIntensive and Critical Care Nursing; Laura A Brooks, Elizabeth Manias, Bodil Rasmussen, Melissa J Bloomer; 2/25Clinicians need specific knowledge and skills to effectively communicate with patients and their family when a patient is dying in the ICU. End-of-life communication is compounded by language differences and diverse cultural and religious beliefs. Recommendations prioritising use of professional interpreters and nurse involvement in family meetings achieved near perfect agreement amongst participants. Recommendations to facilitate family in undertaking cultural, spiritual and religious rituals and customs, advocate for family participation in treatment limitation discussions, and clinician access to professional development opportunities about culturally sensitive communication also achieved high level consensus. These practice recommendations provide guidance for ICU clinicians in their communication with patients and families from culturally diverse backgrounds. 

I’ve missed more than 9,000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed. ~ Michael Jordan Honoring Black History Month 2025

House sets up potential Medicaid cuts with budget bill passage Modern Healthcare; by Michael McAliff; 2/25/25 Republicans in the House took the first step Tuesday [2/25] toward steep potential healthcare cuts, passing a budget resolution that aims to trim spending by at least $1.5 trillion while also adding trillions to the debt to fund tax cuts. The House voted 217-215 on nearly party lines to begin what is known as budget reconciliation, passing a budget resolution that instructs committees to come up with cuts or extend tax cuts that largely benefit the wealthy. The bill mandates the House Energy and Commerce Committee, which oversees Medicaid and Medicare, come up with the majority of the savings, and cut $880 billion.

Amedisys sees hospice growth as DOJ-UnitedHealth Group lawsuit looms Hospice News; by Jim Parker; 2/27/25 Amedisys Inc. (Nasdaq: AMED) saw hospice revenue growth during the fourth quarter of 2024 despite merger-related costs associated with its pending acquisition by UnitedHealth Group (NYSE: UNH). The company’s hospice business saw net service revenues of $21.29 million during the fourth quarter of 2024, up from $20.6 million year over year. For the full year 2024, net service revenue reached $82.58 million, an increase from $79.8 million in 2023. ... On a consolidated basis, company-wide net service revenue hit $59.8 million in Q4, up from $57 million in the prior year’s period. These results come as Amedisys and UnitedHealth Group are embroiled in a lawsuit by the U.S. Justice Department intended to block their potentially forthcoming acquisition due to antitrust concerns.

Local veterans to be honored at pinning ceremonies Call & Times, East Providence, RI; by John Baker, Pawtucket Times; 2/26/25 It never gets old for Christine Miller. Whenever she places a commemorative pin on a Vietnam War veteran and sees their reaction to it, it warms her heart, sometimes even bringing her to tears. That’s one of the best parts of her job as Beacon Hospice Care Community Engagement Coordinator, which later filtered into her becoming the president of the Rhode Island Hospice Veterans Partnership, which she herself founded. Miller, a Pawtucket resident, announced recently that, with Vietnam War Veterans Day coming up on Saturday, March 29, she will conduct a few [pinning ceremonies] ... Editor's note: Access to the full article may be limited. Pair this with today's post, National Vietnam War Veterans Day, March 29, 2025.