Literature Review

The role of mindfulness and resilience in Navy SEAL trainingMilitary Psychology; by Andrew Ledford, Celeste Raver Luning, Deirdre P. Dixon, Patti Miles, Scott M. Lynch; 5/24Mindfulness and resilience are thought to be essential qualities of the military’s special operations community. Both are tested daily in Special Operations Forces (SOF) assessment and selection efforts to prepare candidates to persist through grueling training and complex combat situations; but these qualities are rarely measured. While military leadership places value on the concepts of mindfulness and resilience, there is minimal empirical research examining the role that they play in the completion of training. This longitudinal study followed three classes of SEAL candidates at Basic Underwater Demolition/SEAL (BUD/S) training over their six-month selection program. We estimated logit models predicting successful completion of BUD/S and specific types of failure in that training environment with indexes of mindfulness and resilience at the start of the program as predictors of completion. The results indicate that mindfulness is generally unrelated to completion, while resilience generally predicts completion.Publisher's note: A leadership-oriented article from another field (the military) that can be applied to healthcare.

Inpatient palliative care and healthcare utilization among older patients with Alzheimer's Disease and Related Dementia (ADRD) and high risk of mortality in U.S. hospitalsAmerican Journal of Hospice and Palliative Care; by Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong; 5/24PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.

Textures of Black sound and affect: Life and death in New OrleansAmerican Anthropologist; by Matt Sakakeeny; 6/24In a traditional New Orleans jazz funeral, the characteristic shift from mourning to joy is propelled by brass band musicians weaving melodies and rhythms together. This article is about how these thickly layered textures of sound elicit shared sentiments of lament and of joy.

Making end-of-life health disparities in the U.S. visible through family bereavement narrativesPEC Innovation; by Cassidy Taladay-Carter; 4/24End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. ... Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond.

"It's a heavy thing to carry": Internal medicine and pediatric resident experiences caring for dying patientsAmerican Journal of Hospice and Palliative Medicine; by Lindsay M Gibbon, Laura Buck, Lauren Schmidt, Jori F Bogetz, Amy Trowbridge; 5/24Our data suggests a model for the process by which residents learn affective skills critical to EOL care: residents (1) notice strong emotion, (2) reflect on the meaning of the emotion, and (3) crystallize this reflection into a new perspective or skill. Educators can use this model to develop educational methods that emphasize normalization of physician emotions and space for processing and professional identity formation.

Time to rethink assisted dying?Bioethics; by Udo Schuklenk; 5/24... But who should be tasked with the provision of such services [assisted suicide and / or voluntary euthanasia], given that it would no longer be the case that only people defined as patients would be eligible for an assisted death. Healthcare professionals might object to providing such services to people who aren't patients. Different societies could decide to introduce permissive assisted dying regimes tasking different professionals with the provision of such services. If doctors are the profession tasked with the provision of such services in a particular jurisdiction, they ought to provide it to those eligible in that society. However, it is worth considering whether a newly created assisted dying profession, that is equally tightly regulated, may be a preferable way forward.

Hospice satisfaction among patients, family, and caregivers: A systematic review of the literatureAmerican Journal of Hospice and Palliative Medicine; Timothy Hoff, PhD, Kathryn Trovato, MPH, Aliya Kitsakos, BA; 6/24Thirty-eight studies were included in the review. Key findings were: (a) higher levels of hospice care satisfaction among patients, families, and other caregivers; and (b) correlates of hospice care satisfaction falling into the categories of communication, comfort, and support. The published literature had fewer findings related to demographic correlates of satisfaction such as age or race/ethnicity and was lacking in comparative research examining satisfaction across different types of hospice care settings.

Dana-Farber retracts string of studies in systematic review of data integritySTAT+, by Angus Chen; 4/18/24An ongoing investigation into data integrity at Dana-Farber Cancer Institute has resulted in a string of retractions, the latest of which is a 2006 Science paper co-authored by institute president and CEO Laurie Glimcher. The retraction notice, published in Science on Thursday, noted that the authors had become aware of discrepancies in key scientific images that led them to lose confidence in key figures in the study, although the study’s lead author opposed the retraction. The issues with this paper, along with concerns with more than 50 other articles co-authored by four of Dana-Farber's top researchers, were highlighted in a January blog post by the scientific sleuth Sholto David.

Formal training in palliative care for the trauma surgeon: Hospice and Palliative Medicine FellowshipCurrent Trauma Reports, by Alison Haruta, Ian McCurry, Allyson Cook Chapman; 4/24Palliative care aims to alleviate suffering across multiple domains and treat the patient and family as a unit to provide goal concordant care. Utilization of palliative care principles in trauma surgery has emerged as a crucial component of comprehensive patient care. We discuss formal hospice and palliative medicine training, the benefits of this fellowship, and how surgeons integrate this into their careers.

How do people in prison access palliative care? A scoping review of models of palliative care delivery for people in prison in high-income countriesPalliative Medicine, by Emma Gilbert, Nick De Viggiani, Joana de Sousa Martins, Tanuka Palit, Jessica Sears, Daniel Knights, Audrey Roulston, Mary Turner, Lucy E Selman; 4/24We identified a typology of three models of care delivery for people in prison in high-income countries: (1) Embedded hospice model, typified by an interdisciplinary team and volunteer caregivers providing care on-site; (2) Outsourcing Care model, in which end-of-life care is provided outside the prison; (3) Collaborative community model, which involves prisons engagement with other healthcare facilities or practitioners. ... Embedded hospice models in the USA are prevalent and demonstrate promising evidence for enhancing the care experience for recipients and peer caregivers. Chaplains, social workers and peer caregivers provide psychosocial support, yet documented assessment and strategies for managing the distinctive needs of this group and their families are lacking, despite their acknowledged complexity.

Automated electronic health record score to predict mortality risk at the US Department of Veterans AffairsAmerican Journal of Hospice and Palliative Medicine, by Thomas F Osborne, Zachary P Veigulis, Anna Ware, David M Arreola, Catherine Curtin, Marianne Yeung; 4/24A readily available risk score, automatically calculated from EHR data, was able to identify patients at high risk for 30-day mortality in the acute care setting. Next steps will be to assess how the CAN score can be utilized to in improve end of life care for high-risk hospitalized Veterans.

Value of a multidisciplinary geriatric oncology committee on patient care in a community-based, academic cancer centerJournal of Geriatric Oncology, by Gurbani Singh, Lena Morant, McKenzie Bedra, Jennifer Emel, Kelly Harris, Yudhishtra Markan, Christopher de Borja, Monica Tong, Patrice Downs, Cherif Boutros; 5/24The present study demonstrates the profound impact that the complexities in health status and frailty among older individuals can have during cancer management. The Geriatric Oncology Program at the University of Maryland Baltimore Washington Medical Center maximized treatment outcomes for older adults through the provision of standard oncologic care therapies and optimization services, while also minimizing unnecessary interventions on an individual patient-centric level.