Literature Review

Proposed framework for setting practical and ethical boundaries in medicineJAMA Internal Medicine; Sarah C. Hull, MD, MBE; Nancy R. Angoff, MD, MPH, MEd; 2/25At 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.

Pursuing equity with artificial intelligence in health careJAMA Health Forum; Kevin B. Johnson, MD, MS; Ivor B. Horn, MD, MPH; Eric Horvitz, MD, PhD; 1/25The 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. 

Risk factors for and health status of socially isolated adultsJAMA Network Open; Tarun Ramesh, BS; Kushal Kadakia, MSc; Marcela Horvitz-Lennon, MD, MPH; Joshua Breslau, PhD, ScD; Hao Yu, PhD; 1/25In 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.

Measures to prevent and control COVID-19 in skilled nursing facilities-A scoping reviewJAMA Health Forum; Benjamin E. Canter, OTD; Agne Ulyte, MD; Brian E. McGarry, PhD; Michael L. Barnett, MD, MS; 1/25Skilled 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.

Partnership grows to help more clinicians of color find community in Vermont Vermont Business Magazine - Vermont Biz (VB), South Burlington, VT; by Tim, The University of Vermont Medical Center; 2/18/25 A growing partnership between University of Vermont Medical Center and the Vermont Professionals of Color Network (VT PoC) aims to help people of color adjust to life in Vermont and build the personal and professional relationships community leaders say are crucial to both individual wellbeing and keeping residency students in the state after they complete their clinical training. “During my 20 plus years here, I have heard from so many black and brown people about how difficult it can be to adjust to life in Vermont – and this goes for medical residents too,” said Tino Rutanhira, co-founder and co-executive director of VT PoC. "... Without support, many of these professionals decide to leave Vermont at a time when our state desperately needs young, skilled and diverse people to help it grow.” Editor's note: Parteners listed include The University of Vermont Health Network - Home Health & Hospice.

New tech, new problems: Why application development needs a big-picture view Software Development Times (SD Times); by Sharul Sangl; 2/19/25... [Many] organizations have approached [technology] innovation without a comprehensive strategy or holistic view of their applications, simply focusing on adding the latest features or trendy tools. As a result, they are facing challenges related to application performance, scalability, efficiency, and security. To ensure the success of application innovation, enterprises must maintain a big-picture view of their applications.  ... When approached strategically, organizations are in a prime position to capitalize on current technologies to truly innovate. ...

[UK] Campaign focuses on hospice's work: [This is Hospice Care] The Free Library; by Sam Volpe; 2/17/25 Tyneside Hospice is taking part in a new national campaign highlighting their "vital role" - while one son has paid tribute to the care his mother received in her final days. St Oswald's Hospice in Newcastle is one of more than 140 hospices taking part in a new campaign called "This is Hospice Care" which is designed to demystify the role hospices play in our communities. [England, Scotland and Wales] Click here for "This is Hospice Care | UK," on the St. Oswald's Hospice website.

Hospice finance 101 and the gift of mortalityPost Independent; by Peter Schoomaker, Homecare & Hospice of the Valley CFO; 2/19/25... [Practical information about hospice expenses, like labor and mileage reimbursement with. "For our agency, we estimate our clinicians will drive more than 250,000 miles in 2025, slightly more than the distance from the Earth to the Moon."] And now a more personal note … I am grateful for the last seven years of my career working in hospice care. Most importantly, I am grateful for the opportunity to integrate into the clinical experience of hospice. When I shadow an admission visit or attend the hospice interdisciplinary meeting, I am reminded that hospice is a world of YET (You’re Eligible Too). The only thing that separates me, and our hospice patients, is time. My relative physical strength will eventually shrink. My mental faculties will fade. And there is a large possibility, at some point in my life, that I will depend almost entirely on others to help with most activities of daily living. This is true for all of us. ... ... Recognizing this truth opens a path to humility. A path to step away from the ego, even for a moment, and really let go. ... When I reflect on this, I realize what a gift our mortality is. To know that our choices matter because we never know much time we have left. A sincere thank you to all our hospice, homecare and private duty clinicians — and our administrative teams that support them. It is genuinely noble work.Editor's note: "A sincere thank you" to Peter Schoomaker, Homecare & Hospice of the Valley CFO

Historic flooding hits Kentucky: Death toll rises to 14 as recovery efforts continue NBC WLWT-5, Cincinnati, OH; by Emily Sanderson; updated 2/18/25The death toll is continuing to rise across Kentucky amid devastating flood conditions. Beshear says at least 14 people have died due to the severe flooding, weather. The deaths include a mother and her child who were swept away by flood waters in their car. The governor confirmed hundreds of people have been displaced. Swift Water Boat Teams and 146 Kentucky National Guard soldiers have been activated. Beshear says there have been over 1,000 water rescues already. Ohio Task Force 1 has also been activated as a Type III team in response to heavy flooding in Kentucky and surrounding states. [Additionally, snow is expected with temperatures] set to drop significantly, with wind chills dropping below zero. Officials said 300 roads are still impacted or closed, with standing water still an issue across the state. ... The governor also started a donation fund for those impacted by flooding. Donations can be made at TeamKyReliefFund.ky.gov. Beshear stressed the first things the fund will be used for is funerals for victims. ... 

'Fast and furious' AI sparks health system refocus Becker's Health IT; by Laura Dyrda; 2/19/25Health systems are beginning to hire chiefs of artificial intelligence and other AI leaders to bring new expertise into the system with the goal of becoming a more sophisticated, data-driven organization. Lisa Stump, executive vice president, chief digital information officer and vice dean of information technology at Mount Sinai Health System and Icahn School of Medicine at Mount Sinai in New York City, participated in the search and hiring process for Girish Nadkarni, MD, Mount Sinai's first chair of artificial intelligence and human health to create a formal department at the Icahn School of Medicine dedicated to AI. She now partners with him and the system's chief clinical officer – calling themselves the "digital and technology partners" group – to structure a center of excellence around AI and digital health, focusing on the patient and consumer experience.

Over a quarter of adolescents, young adults with cancer who want to die at home do not Healio; by Jennifer Byrne; 2/20/25 More than one-fourth of adolescents and young adults with cancer who wished to die at home did not attain this goal, according to research published in JAMA Network Open. Researchers conducted a retrospective cohort study that included adolescents and young adults (AYA; age range, 12 to 19 years) with cancer who died between 2003 and 2019. The cohort included patients treated at Dana-Farber Cancer Institute, Kaiser Permanente Northern California or Kaiser Permanente Southern California. ... Healio spoke with Odejide about the rationale for the study, the importance of the findings, and strategies oncologists can employ to ensure more goal-concordant end-of-life care for AYA patients with advanced cancers. [Click here for Helio's discussion with the lead researcher, Oreofe O. Odejide, MD, MPH, associate professor of medicine at Dana-Farber Cancer Institute.]  Editor's note: Examine this JAMA article, which we posted in our Saturday Research issue, 1/18/25: "Preferred and actual location of death in adolescents and young adults with cancer."

Harley Owners Group & Community make splash for JRMC Hospice NewsDakota.com, Jamestown, ND; by Steve Urness; 2/18/25 The spirit of generosity and adventure was alive and well at the 19th annual Polar Pig Walk the Plank & Chili Cook-off, held Feb. 1 at Stutsman Harley-Davidson. ... This year, Polar Pig reached an incredible milestone—surpassing $300,000 raised for JRMC Hospice since its inception. ... This year alone, $19,405 was raised, directly benefiting the care provided by the JRMC Hospice team. Braving the winter air, dozens of participants in a wide variety of costumes took the plunge, leaping into the water in the name of hospice care. Spectators cheered as JRMC team members, community members and families joined in the fun, embracing the cold for a cause. The event also featured a chili cook-off and silent auction.Editor's note: We don't know the temperature for this North Dakota polar plunge on Feb 1. However, the weather on Thu 2/20 in Jamestown, ND is -8°.  Bravo to these brave souls!