Literature Review

Mindfulness and tai chi improve mood in cancer survivors Medscape, reposted in AAHPM; ed. by Gargi Mukherjee; 6/25/25 Both Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ) significantly improved mood in survivors of cancer, whether participants selected their preferred program or were randomly assigned to either type of program. MBCR had greater benefits in reducing tension and anger, while TCQ was particularly effective in reducing depression and boosting vigor.

Artificial intelligence and health care waste—Promise or peril?JAMA Health Forum; William H. Shrank, MD, MSHS; Suhas Gondi, MD, MBA; David J. Brailer, MD, PhD; 6/25One obvious target of AI [artificial intelligence] tools in health care is the reduction of waste. While LLM [large language model] applications to health care are still nascent—many still make errors, and more rigorous evaluations are needed—most agree that the long-term opportunity for AI in health care is tremendous. A recent study estimated that widespread adoption of AI could lead to savings of 5% to 10% of total US health care spending. Realizing even a fraction of this potential would increase the affordability of care for people in the US and free substantial societal resources to make other valuable investments. But getting there will require deliberate choices from leaders and policymakers and careful attention to risks that could set back progress.

Zuranolone in palliative care: Promise and practicality for the rapid treatment of depressionThe American Journal of Hospice & Palliative Care; Eric Prommer; 6/25Zuranolone is an orally available antidepressant classified as a neuroactive steroid. Neuroactive steroids act as positive allosteric modulators for both synaptic and extrasynaptic GABA, making them distinct from currently available drugs targeting major depression and insomnia. By modulating GABA binding sites, neuroactive steroids enhance the function of GABA, which is depressed in major depression. The drug has a rapid onset of action, which differs from currently available antidepressants that are used in palliative care. [This] ... paper will review the pharmacology, pharmacodynamics, safety profile, and clinical studies showing its effectiveness in major depression and how it can potentially be helpful in the palliative care population.

Unanswered questions on private equity in gastroenterologyJAMA Network; by Jane M. Zhu; 6/25A growing literature on private equity (PE) acquisitions of physician practices has found associated increases in health care prices and utilization, but evidence specific to gastroenterology remains relatively new despite the specialty being a popular target for PE. More than 1 in 8 gastroenterology practices are now owned by PE, with practice fragmentation, lucrative procedural reimbursements, and an aging population factoring into continuing investor interest... Taken together with observations of increased utilization, there may be 2 interpretations of the data presented by Arnold and colleagues. One interpretation of the findings may be that PE acquisition may focus on reducing inefficiencies, improving access by expanding practice capacity, and increasing throughput. Another interpretation may be that PE acquisition is focused on the strategic exploitation of market and pricing power. The latter may have less of an impact on clinical measures like quality of care, but potentially, both strategies could be at play.Publisher's note: Similar questions being asked across hospice, gastroenterology, physician practices, and other areas of healthcare.

Physicians' preferences for their own end of life: A comparison across North America, Europe, and AustraliaJournal of Medical Ethics; Sarah Mroz, Sigrid Dierickx, Kenneth Chambaere, Freddy Mortier, Ludovica De Panfilis, James Downar, Julie Lapenskie, Koby Anderson, Anna Skold, Courtney Campbell, Toby C Campbell, Rachel Feeney, Lindy Willmott, Ben P White, Luc Deliens; 6/25Setting: Eight jurisdictions: Belgium, Italy, Canada, USA (Oregon, Wisconsin, and Georgia), Australia (Victoria and Queensland). Participants: Three physician types: general practitioners, palliative care physicians, and other medical specialists. Conclusion: Physicians largely prefer to intensify alleviation of symptoms at the end of life and avoid life-sustaining techniques. In a scenario of advanced cancer or Alzheimer's disease, over half of physicians prefer assisted dying. Considerable preference variation exists across jurisdictions, and preferences for assisted dying seem to be impacted by the legalisation of assisted dying within jurisdictions.

Serious illness conversations in the Emergency Department for older adults with advanced illnesses - A randomized clinical trialJAMA Network; by Kei Ouchi, Susan D. Block, Dorene M. Rentz, Donna L. Berry, Hannah Oelschlager, Youkie Shiozawa, Sarah Rossmassler, Amanda L. Berger, Mohammad A. Hasdianda, Wei Wang, Edward Boyer, Rebecca L. Sudore, James A. Tulsky, Mara A. Schonberg; 6/25Does an emergency department (ED)–based intervention to discuss serious illness care goals improve advance care planning outcomes for older adults with advanced illnesses? In this randomized clinical trial including 141 patients in the ED, a nurse-led intervention to discuss serious illness care goals did not significantly improve patient-reported engagement in advance care planning but did increase subsequent clinician-documented serious illness conversations in the medical records. These findings suggest that ED visits may serve as a critical access point for serious illness conversations in clinically stable older adults with advanced illnesses.

[Bogota, Columbia] Anxiety, depression, and quality of life of caregivers of palliative care patients with cancerRevista Cuidarte; by Alejandra María Alvarado García, Lina María Vargas-Escobar, Mauricio Arias-Rojas, Carlos Javier Avendaño-Vásquez, Cesar Antonio Consuegra-Pareja; 2/25Caregivers with moderate or severe depression were more likely to report symptoms of sadness, punishment feelings, self-dislike, suicidal thoughts or wishes, indecisiveness, irritability, changes in appetite, concentration difficulty, and tiredness or fatigue. Among caregivers with mild depression, loss of interest in sex, agitation, and past failure were identified. Strategies for psycho-emotional counseling, education, and support for caregivers are needed.

My one wild and precious life—The purpose of medical careJournal of Pain and Symptom Management; by Abinav K. Jyotis; 7/25“My One Wild and Precious Life - The Purpose of Medical Care”, contains reflections of a medical student as a naive little boy, inspired by his late grandfather, pinning to becoming a physician, who later struggles to find purpose in the unidealistic world of the current healthcare system. But, through his exposure to “Pallium India”, a non-profit palliative care organization in Kerala, India, healthcare once more gains meaning and signifies the importance of love and care amidst a patient's journey through pain and suffering.

Palliative care in liver transplantationCurrent Transplantation Reports; Michelle Ng, Elliot Tapper; 5/25 Palliative care is an underutilized resource due to the misconception that being a liver transplant candidate precludes patients from accessing these services. However, early integration of palliative care has become increasingly important for both pre- and post-liver transplant patients as it not only improves patient outcomes, but also promotes quality of life that extends beyond graft or patient survival. We discuss strategies to manage pain, ascites, hepatic encephalopathy, pruritis, muscle cramps, sexual dysfunction, depression, anxiety, insomnia, and malnutrition. These symptoms are best addressed with a multi-modal approach with non-pharmacologic therapies as an adjunct. 

Caring beyond cure-Perspectives of pediatric oncology nurses on end-of-life careJournal of Hospice & Palliative Nursing ; Scarperi, Peter BSN, RN; MacKenzie Greenle, Meredith PhD, RN, ANP-BC, CNE; June, 2025In a sample of nursing students and nurses working in pediatric oncology, this mixed-methods study aimed to describe attitudes toward and experiences of providing end-of-life care and examine the relationship between education, work experience, and attitudes. Overall, participants held positive attitudes toward end-of-life care, with staff nurses more positive than student nurses. All participants had provided end-of-life care, yet only 2 (5.41%) thought their education thus far prepared them. Age, education, experience, and burnout were associated with attitudes toward providing end-of-life care. Qualitative themes included challenges of preparedness and training, the nurse’s role, and parent team barriers. Training in pediatric end-of-life care is crucial to improve nurses’ comfort with providing this care.

Examining education models for clinical staff working with people with intellectual and developmental disabilities in hospice and palliative care: A narrative literature reviewAmerican Journal of Hospice and Palliative Care; Caitlyn M Moore; 5/25Despite individuals with intellectual and developmental disabilities (IDD) living longer with serious illness, healthcare professionals report inadequate training in this area. Additionally, IDD specialists consistently express discomfort and limited knowledge regarding HAPC [hospice and palliative care]. Findings indicate that while several studies demonstrate positive outcomes regarding knowledge, self-efficacy, and satisfaction among participants, there is a lack of standardized training and patient-centered metrics. Existing interventions largely focused on improving the knowledge of IDD staff regarding HAPC, with limited attention given to educating HAPC professionals on the nuances and complexities needs of people with IDD. This review underscores the importance of developing and implementing evidence-based and standardized training programs that encompass the needs of both HAPC and IDD specialists.

Cocota's story: Life lessons in aging, resilience, and end-of-life agency from a Brazilian matriarchJournal of the American Geriatrics Society; Thiago J Avelino-Silva, Niousha Moini; 6/25In Cocota's case, a hip fracture in her 80s did not lead to permanent disability; rather, she reclaimed her daily routines, demonstrating the interplay between physical robustness and unwavering determination. Equally telling was her decision to "stop eating and drinking" near life's end, exemplifying resilience as a final expression of agency. We further explore how her experiences align with deeper forms of well-being, marked by purpose and prosocial behavior, and practical wisdom, including emotional regulation and sound moral judgment. By examining her life journey, clinicians and community partners can better appreciate how resilience spans physical, cognitive, psychosocial, and spiritual domains, ultimately guiding more integrated strategies to support older adults. The lessons learned have direct relevance for clinical interventions, community programs, and public health initiatives aimed at fostering autonomy and meaningful engagement in later life.