Literature Review

Medically recommended vs nonmedical cannabis use among US adultsJAMA Psychiatry; Beth Han, MD, PhD, MPH; Wilson M. Compton, MD, MPE; Emily B. Einstein, PhD; Nora D. Volkow, MD; 1/25With increases in cannabis use for medical purposes and its perceived benefits, patients and clinicians need to be aware of its potential risks. Results showed that adults aged 18 to 49 years reporting medical-only or medical-nonmedical cannabis use vs nonmedical-only use had higher prevalence of CUD [cannabis use disorder] at all severity levels and reported more frequent cannabis use. These findings suggest that medically recommended cannabis is not associated with reduced addiction risk compared with nonmedical use. Clinicians should consider addiction risk before recommending medical cannabis and, if they do, should monitor for CUD emergence.

Assessment of organ donation knowledge and attitudes among patients visiting the nephrology outpatient clinic at a tertiary healthcare facilityOmega-Journal of Death and Dying; Ezgi Yarasir, Mehtap Gomleksiz, Muhammet Ridvan Gomleksiz, Ayhan Dogukan; 1/25This study aims to assess the knowledge levels, attitudes, and influencing factors related to organ donation among patients who visited the Nephrology outpatient clinic. A total of 37.5% of the participants stated that they were considering organ donation. Participants with a high school education or higher, those who believed they had sufficient knowledge about organ donation, and those who had a family member awaiting organ transplantation demonstrated a positive attitude toward organ donation ... Understanding societal knowledge and attitudes about organ donation is crucial for assessing individual awareness of this issue.

What matters to older Native Hawaiians?: A qualitative study of care preferencesJournal of Palliative Medicine; by Miquela Ibrao, Rachel Burrage, Shelley Muneoka, Keilyn L Kawakami, Tarin T Tanji, Leslie Tanoue, Kathryn L Braun; 12/24Formal assessment of What Matters in end-of-life care is often done in medical settings through legal forms. Past research indicates that Native Hawaiians are less likely to complete these forms than Whites. The purpose of this study was to explore health care preferences among Native Hawaiian elders and to identify cultural themes that may impact quality care at end of life. Themes suggest the criticality of: (1) incorporating cultural traditions into health care routines; (2) involving family in health and end-of-life decisions; (3) supporting home-based care at the end of life; and (4) building strong patient-provider relationships. Although findings parallel preferences expressed in other populations, the data provide additional insights into the preferences of Native Hawaiian elders anticipating end-of-life care. Recommendations for culturally competent care include: (1) develop relationships with Native Hawaiian patients well before end-of-life care is needed to facilitate discussions of care preferences; (2) work collaboratively with the patient and the patient's defined family; (3) ask about cultural practices and engage traditional healers as directed by the patient; and (4) provide services in patients' homes and communities.

Palliative care initiated in the Emergency Department-A cluster randomized clinical trialJAMA; Corita R. Grudzen, MD, MSHS; Nina Siman, MA, MSEd; Allison M. Cuthel, MPH; Oluwaseun Adeyemi, MBBS, PhD; Rebecca Liddicoat Yamarik, MD; Keith S. Goldfeld, DrPH, MS, MPA; PRIM-ER Investigators; 1/25Question-What is the effect of a multicomponent intervention to initiate palliative care in the emergency department on hospital admission in older adults with serious, life-limiting illness? In this cluster randomized clinical trial, which was conducted at 29 US emergency departments and included 98,922 initial visits, there was no difference in the rate of hospital admission in older adults with serious, life-limiting illness receiving care before (64.4%) vs after (61.3%) emergency department clinical staff receipt of a multicomponent primary palliative care intervention. Relevance-This multicomponent intervention to initiate palliative care in the ED did not have an effect on hospital admission, subsequent health care use, or short-term mortality in older adults with serious, life-limiting illness.

Study explores Native Hawaiian end-of-life careNational Indigenous Times; by Joseph Guenzler; 2/4/25A study by the University of Hawaiʻi at Mānoa's Hā Kūpuna – National Resource Center for Native Hawaiian Elders has examined the end-of-life care preferences of Native Hawaiian kūpuna (Elders). Led by Laguna Pueblo and Quechan woman, Assistant Professor Miquela Ibrao, researchers from UH and ALU LIKE, Inc. identified culturally specific approaches to support kūpuna values in healthcare. "Death is not an end but a transition that honors relationality, ancestors and the land,' Assistant Professor Ibrao said. "Decolonizing end-of-life care means respecting cultural beliefs and embracing Indigenous wisdom about healing and living well." The study, published in the Journal of Palliative Medicine, is based on interviews with 20 kūpuna aged 60 and over from rural areas across Hawaiʻi. It highlights four key themes.

[UK] Identifying challenges related to the management of comorbidities in people with dementia in residential care: Expert delphi consensus exerciseJournal of Applied Gerontology; Serena Sabatini, Frances Hawes, Kelechi Eluigwe, Eugene Y. H. Tang; 1/25Improving early detection, management, and treatment of comorbid conditions to dementia in residential care could slow down cognitive and functional decline, and increase residents’ quality of life. ... Mental illnesses, delirium, and sensory impairments were identified as the most difficult comorbidities to dementia to deal with. Medication management, symptom management, shortage of staff, lack of training among staff, and limited resources from the broader healthcare system were identified as the most difficult issues when dealing with dementia comorbidities. To address disparities between different residential care homes there is the need of mandatory standards of care across UK residential care homes, and of clear guidelines on topics such as pathways of care for residents’ medical problems, staff to resident ratios, and minimum wages.

Well-being and choosing the best job for youJAMA Internal Medicine; Jamile A. Ashmore, PhD; J. Michael DiMaio, MD; 1/25Well-being is emerging as the catch-all term describing the field dedicated to understanding and addressing the way in which the health care system, work environment, and individual interact to influence the fulfillment and meaning that health care workers derive from their work. Clinician well-being is often led by a chief wellness officer (CWO) or other executive leader who is compensated to focus on well-being. In addition to strategic planning and oversight, the CWO’s role is to ensure that well-being is considered in administrative and operational decisions including in those related to governance, rewards systems, and culture. Health care systems’ moving from the triple to the quadruple aim are signaling that they are committed to taking care of those that care for the patients. Indeed, health care systems cannot have optimal patient care without a healthy and fulfilled workforce. 

Digital meditation to target employee stress-A randomized clinical trialJAMA Network Open; Rachel M. Radin, PhD; Julie Vacarro, MA; Elena Fromer, BA; Sarah E. Ahmadi, BA; Joanna Y. Guan, BA; Sarah M. Fisher, MS; Sarah D. Pressman, PhD; John F. Hunter, PhD; Kate Sweeny, PhD; A. Janet Tomiyama, PhD; Lauren Tiongco Hofschneider, PhD; Matthew J. Zawadzki, PhD; Larisa Gavrilova, PhD; Elissa S. Epel, PhD; Aric A. Prather, PhD; 1/25Mental health is at an historic low in the US, and work stress may be a primary contributor. Work stress is associated with poorer emotional and physical well-being, as well as high absenteeism and low presenteeism. Participants were randomized 1:1 to a digital meditation program or the waiting list control condition. Participants in the intervention group were instructed to complete 10 minutes of meditation per day for 8 weeks. The findings suggest that participating in a brief digital mindfulness-based program is an effective method for reducing general and work-related stress in employees. 

Nurses' perspectives on end-of-life care for Black/African American patientsJournal of Hospice & Palliative Nursing; Aaron, Siobhan P. PhD, RN, FNP-BC; Supiano, Katherine PhD, LCSW, FT, FGSA, APHSW-C; DeSimio, Samantha BS; 2/25In this qualitative examination of health care disparities based on race and ethnicity, the accounts of Black/African American nurses shed light on a range of critical issues within the health care system. These issues encompass stereotyping, bias, and a notable absence of cultural competence among health care providers, which often result in unequitable treatment for patients of color. Socioeconomic factors, including insurance and income disparities, further exacerbate these inequalities. Discrimination, whether implicit or explicit, continues to affect diagnosis and treatment, with a particular focus on disparities in pain management. Furthermore, the cultural perspectives and historical context surrounding treatment preferences were explored, emphasizing the profound impact of health care literacy, cultural viewpoints, and historical mistrust, especially within the Black/African American community.

Defining spine cancer pain syndromes: A systematic review and proposed terminologyGlobal Spine Journal; Markian Pahuta, MD, PhD, FRCSC; Ilya Laufer, MD; Sheng-fu Larry Lo, MD; Stefano Boriani, MD; Charles Fisher, MD, MHSC, FRCSC; Nicolas Dea, MD, MSc, FRCSC; Michael H. Weber, MD, MSc, PhD, FRCSC; Dean Chou, MD; Arjun Sahgal, MD, FRCPC; Laurence Rhines, MD; Jeremy Reynolds, MB.ChB, BSc (Hons), FRCS; Aron Lazary, MD, PhD; Alessandro Gasbarrinni, MD; Jorrit-Jan Verlaan, MD, PhD; Ziya Gokaslan, MD, FACS; Chetan Bettegowda, MD, PhD; Mohamed Sarraj, MD; Ori Barzilai, MD; AO Spine Knowledge Forum Tumor; 1/25The spine is the most common site of osseous metastasis, and over one-third of patients with carcinoma or hematological malignancy will develop spinal metastases. Vertebral metastases have a negative impact on patient function and heath related quality of life (HRQoL). We consolidate the terminology used in the literature and consolidated into clinically relevant nomenclature of biologic tumor pain, mechanical pain, radicular pain, neuropathic pain, and treatment related pain. This review helps standardize terminology for cancer-related pain which may help clinicians identify pain generators.

Outpatient palliative care and end-of-life care intensity: Linking Massachusetts Cancer Registry with all-payer claimsJNCI Cancer Spectrum; Nancy L Keating, Joel S Weissman, Alexi A Wright, Robert Wolf, Susan Gershman, Richard Knowlton, John Z Ayanian; 1/25Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks. End-of-life care intensity varied across provider networks. Patients with palliative care visits had lower adjusted odds of receiving intensive end-of-life care ... 

The iatrogenic consequences of medicalising grief: Resetting the research agenda Sociology of Health & Illness: by Sarah Gurley-Green, Lisa Cosgrove, Milutin Kostic, Lauren Koa, and Susan McPherson; published 11/28/25, distributed via Evermore 1/28/25When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed “complicated grief” designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 “prolonged grief disorder” (PGD) was officially included in the DSM-5-TR in the trauma- and stressor-related disorders section. ... As human rights activists have argued, bereavement support is an inalienable human right, one that is centered on the right to health and well-being, for “bereavement health is as intrinsic to our humanity as any other aspect of health and citizenship” (Macaskill 2022). That is why there are increasing calls for investing in bereavement as a public good and for “cultivat[ing] a bereavement-conscious workforce.” (Lichtenthal et al. 2024, e273). As Lichtenthal notes, it is not only clinicians but also institutions and systems that must “shift bereavement care from an afterthought to a public health priority.”Editor's note: "Iatrogenic" refers to unintentional consequences/condition from a medical intervention. In the hospice context, this means bereavement/grief from the hospice death. How many patients do you serve? The CMS Hospice Conditions of Participation identify "bereavement" and/or "grief" 155 times. What priority do you give to bereavement care before, at and after your patients' deaths?

Stories of bereavement: Examining medical students’ reflections on loss and griefOmega-Journal of Death and Dying; Johanna Shapiro, Nicholas Freeman, Alexis Nguyen, Nancy Dang, Yasaman Lorkalantari; 12/24Medical students in this study reported similar reactions to personal and professional loss, with some expected differences, such as students who experienced professional loss more often noting compassion for others and more frequently discussing managing the feelings of others, the importance of skill acquisition, processing personal emotions and team support. Students experiencing personal loss understandably appeared more focused on their own grief and more often commented about feelings of helplessness and numbness. Students in both groups reported little about how they coped with their grief or about receiving either informal or institutional support. The similarity of the essays, while due to many factors, may suggest internalizing pressures to conform to socially desirable narratives. Medical educators and clinical supervisors should help students develop effective coping skills in response to loss, provide better institutional support, and encourage students to tell authentic stories about their experiences of loss and grief.