Research priorities in neuropalliative care-A consensus statement from the International Neuropalliative Care Society
JAMA Neurology; Winnie K. Lau, MD; Corey R. Fehnel, MD, MPH; Zachary A. Macchi, MD; Ambereen K. Mehta, MD, MPH; Manon Auffret, PharmD, PhD; Jori F. Bogetz, MD; Jori E. Fleisher, MD, MSCE; Jerome J. Graber, MD, MPH; Heather E. Leeper, MD, MS; Heena R. Manglani-Terranova, PhD; Susanne Muehlschlegel, MD, MPH; Emily L. Mroz, PhD; Elizabeth J. Pedowitz, MD; Usha Ramanathan, MSc, MD; Max Sarmet, SLP, MSc; Nathan A. Shlobin, BA; Leonard Sokol, MD; Susan Allyson Weeks, MA; Jiayun Xu, PhD, RN; Helen Bundy Medsger; Claire J. Creutzfeldt, MD; Ana-Maria Vranceanu, PhD; Darin B. Zahuranec, MD, MS; David Y. Hwang, MD; 2/25
The International Neuropalliative Care Society Research Committee convened an interdisciplinary panel of experts, including clinicians, scientists, people with neurologic disease, and care partners, to identify priority research areas for the advancement of neuropalliative care as a field. Three priority areas highlighted in this review include (1) patient- and care partner–centered symptoms and outcomes specific to neurologic illness and tools for their assessment, (2) development of effective neuropalliative care interventions and delivery models, and (3) methods to support the ability to foster, deliver, and measure goal-concordant care over time.

Measures to prevent and control COVID-19 in skilled nursing facilities-A scoping review
JAMA Health Forum; Benjamin E. Canter, OTD; Agne Ulyte, MD; Brian E. McGarry, PhD; Michael L. Barnett, MD, MS; 1/25
Skilled nursing facilities (SNFs) experienced high mortality during the COVID-19 pandemic, leading them to adopt preventive measures to counteract viral spread. This scoping review identified 16 preventive measures, both nonpharmacologic (eg, staffing, visitor restrictions) and pharmacologic (eg, vaccines, antivirals) interventions. Nonpharmacologic measures were widely implemented but lacked evidence for effectiveness, whereas vaccinations and antivirals showed substantial benefits but were underutilized; up-to-date vaccination status was suboptimal in residents and staff and only a minority of infected residents received antiviral treatment.

Impact of patient and caregiver beliefs on utilization of hospice and palliative care in diverse patients with advanced lung cancer
American Journal of Hospice and Palliative Care; Melanie Besculides, Melissa B Mazor, Carolina Moreno Alvarado, Mayuri Jain, Lihua Li, Jose Morillo, Juan P Wisnivesky, Cardinale B Smith; 2/25
A prospective cohort study of newly diagnosed patients ≥18 years old with advanced lung cancer and their caregivers was conducted. Participants completed validated surveys at multiple points and electronic health records were reviewed to evaluate utilization. Minoritized lung cancer patients held more negative beliefs about HC/PC [hospice care/palliative care] yet were more likely to receive HC/PC. Further work is needed to understand factors that impact utilization among diverse patients with advanced cancer.

Risk factors for and health status of socially isolated adults
JAMA Network Open; Tarun Ramesh, BS; Kushal Kadakia, MSc; Marcela Horvitz-Lennon, MD, MPH; Joshua Breslau, PhD, ScD; Hao Yu, PhD; 1/25
In 2023, the Surgeon General issued an advisory on the epidemic of loneliness and social isolation, calling for more research and policy interventions to address these challenges. The overall prevalence of social isolation in our study was 3%, which is lower than other determinants of health, such as smoking, poverty, and inadequate health insurance. Our results indicate 3 broad and likely interrelated populations at risk for social isolation, including racial and ethnic minority groups, those with financial insecurity (ie, unemployed, uninsured, lower income), and those with chronic health conditions, with depression being a large factor. We also found that the socially isolated adults reported worse health status compared with those without social isolation.

Emphasis on financial vs nonfinancial criteria in employer benefits’ measurements
JAMA Health Forum; Jeffrey Pfeffer, PhD; Esther Olsen, MHA; Sara J. Singer, PhD; 1/25
According to KFF, “60.4% of people [in the US] under age 65, or about 164.7 million people, had employment-sponsored health insurance in 2023.” Given employers’ large role in the health care ecosystem, what employers measure may affect access to care and how employees and their families interact with health care professionals. In a representative sample of 221 respondents involved in employer health benefits oversight, employers and their health benefits consultants focus more on financial than nonfinancial performance dimensions in both decision-making and measurement. To improve broader aspects of health plan performance, employer measurement and decision-making must emphasize nonfinancial as well as financial criteria.

Pursuing equity with artificial intelligence in health care
JAMA Health Forum; Kevin B. Johnson, MD, MS; Ivor B. Horn, MD, MPH; Eric Horvitz, MD, PhD; 1/25
The National Academy of Medicine defines equitable AI as “applications accompanied by proof of appropriate steps to ensure fair and unbiased development and access to AI-associated benefits and risk mitigation measures.” Health care–providing organizations deploying AI must take responsibility for monitoring and achieving equitable performance. There is much to learn as we face the challenge of understanding how AI applications affect long-standing inequities and discovering the best ways to harness AI to address them. By embedding equity considerations at every stage of AI development and deployment, the US can start to take meaningful steps toward using AI’s growing capabilities to tackle pressing problems in health care. 

Health policy challenges for 2025 and beyond
JAMA Health Forum; Lanhee J. Chen, JD, PhD; 1/25
Despite multiple reform attempts, the US health care system is still burdened by high costs, limited access to quality care, and policies that have resulted in the inefficient delivery of care. However, technological advances, insights from the COVID-19 pandemic, and approaching policy deadlines, such as expiration at the end of 2025 of enhanced coverage subsidies available through the Affordable Care Act (ACA), offer policymakers a reason to act. The next few years will present policymakers with opportunities to address key health care challenges, including the future of Medicare, the continuing implementation of the ACA, and the health care provisions included in the federal tax code. The new administration and Congress will have their hands full in 2025 because the expiring tax and subsidy provisions are action-forcing events. Lawmakers will face a unique opportunity to reform the system in a way that improves accessibility and affordability and enforces some measure of fiscal discipline, and to make decisions that could positively affect the future of health care for millions of individuals in the US.

Proposed framework for setting practical and ethical boundaries in medicine
JAMA Internal Medicine; Sarah C. Hull, MD, MBE; Nancy R. Angoff, MD, MPH, MEd; 2/25
At a national conference session addressing challenges for women in cardiology, one of us (S.C.H.) was struck by a junior attending physician’s account of her struggle to establish boundaries, expressing her desire to be helpful and collaborative as well as her reticence to decline requests lest she appear unkind. Reflecting on my own experience, I realized that women are often socialized to avoid saying no for fear of disappointing others or appearing selfish, but this socialization has not served us well. Indeed, this is a common refrain we have heard from young women entering the medical profession. Our anecdotal experience matches data suggesting that, compared with men, women are more likely to be asked and less likely to decline low-promotability task requests.

[Turkey] Actual roles of occupational therapists in palliative and hospice care: A scoping review
American Journal of Hospice and Palliative Medicine; Güleser Güney Yılmaz, PhD, OT; Hülya Yücel, PT, PhD; Milda Gintiliene, MD; 1/25
Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

[UK] Efficacy of music-based intervention for people living with dementia in an inpatient setting: A pilot study
Journal of Alzheimer's Disease; Neha Abeywickrama, Mel N Ellul Miraval, Hari Subramaniam, Qadeer Arshad, Stephanie Pollard, Geeta Chauhan, Shifa Jussab, Elizabeta B Mukaetova-Ladinska; 1/25
Pharmacological treatment of behavioral and psychological symptoms of dementia is of limited benefit. The addition of non-pharmacological interventions is often essential for optimal symptom control. Clinical professionals can successfully deliver music-based intervention to inpatients with advanced dementia to help manage their behavioral symptoms in the short term. Music-based interventions' use for inpatient wards must be further investigated as an economical and personalized non-pharmacological therapeutic tool for patients with dementia.
Editor's note: For a wealth of additional research on music therapy and dementia, explore the Journal of Music Therapy, published by Oxford University Press. Type "dementia" in its search engine, and sort by "Date - Newest First." 

It always seems impossible until it’s done. ~Nelson Mandela