Abstract
Letter to the Editor
Across academic medical centers, there is now a broader movement toward establishing relative value unit targets for advanced practice providers, following national trends in benchmarking and compensation practices. While such targets provide structure, their implications in academic medicine remain nuanced. (page 577)
Brief Report
A pre-planned sub-study of a randomized clinical trial aimed to evaluate whether there were subjective symptoms of opioid withdrawal in people as they completed a study of regular, low-dose, sustained-release morphine. (page 651)
Fast Facts
#524: Radiation Dermatitis. (page 692)
#525: Provider-Assisted Death By Prescription in the U.S.: Part I. (page 694)
Personal Reflection
In situations of this sort, I’ve learned to avoid repeating bad news. Mother Nature, over time, speaking through the accumulating burdens of illness, is usually better at conveying hard truths. In the meantime, with Kerry’s insistence, we persisted, creating care plans to keep Mariah alive. (page 696)
Case Discussions
Authors present two cases involving incapacitated incarcerated persons (IP) in an acute care setting at an academic medical center. These cases highlight the ethical challenges regarding surrogacy and providing optimal interdisciplinary palliative care to IPs and their surrogates. (page 700)
Book and Media
(page 704)
Original Article Key Points
This study represents the first randomized controlled trial designed to examine the impact of the MT+VR combination in patients undergoing palliative care. Author reveal a significant decrease in symptoms after patients receive intervention. The qualitative analysis reveals that immersion, projection, and musical entrainment mechanisms likely contribute to these therapeutic effects. (page 594)
Narrative medicine is a promising approach to support caregivers of pediatric patients with complex or serious conditions. Early findings are encouraging, but long-term outcomes require further study. Structured workshops and trained facilitators may enhance caregiver well-being and help reduce psychological burden. (page 585)
The Respiratory Distress Observation Scale is a practical and reliable tool for identifying respiratory distress in cancer patients unable to self-report. Its correlation with symptom burden and functional decline supports its integration into palliative care to improve early detection and management of dyspnea in vulnerable patient populations. (page 602)
This study highlights how hospice research has shifted in response to evolving societal needs. The findings offer researchers, clinicians, and policymakers valuable insight into how scholarly focus aligns with changing care priorities, while also identifying underexplored areas to guide future research. (page 610)
Complementary and integrative medicine was well accepted by health care professionals, patients, and relatives in a Swiss palliative care unit. The study identified key challenges and opportunities for implementation and led to the development of a structured framework supporting sustainable integration, offering valuable insights for future implementation in palliative care. (page 619)
Virtual reality social support groups are a feasible and acceptable method of offering adolescents living with serious illness a supportive, engaging, and safe space that encourages peer-to-peer fun and conversation where they can experience a sense of connection and belonging. (page 632)
An embedded, social worker—and nurse practitioner—led palliative care model within hospital medicine provided earlier, needs-based support. Their patients had lower ICU use and shorter stays, comparable demographic diversity, and consistent outcomes over time, demonstrating improved access, reduced acute utilization, cultural responsiveness, and sustainability in inpatient settings. (page 626)
This study introduces a visual, three-dimensional ultrasound biomarker space to reframe pediatric frailty in palliative care. By translating muscle quality into objective metrics, ultrasound may serve as an accessible gateway toward future quantitative, image-based approaches to vulnerability in children with life-limiting conditions. (page 639)