Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2020
Deep natural language processing to identify symptom documentation in clinical notes for patients with heart failure undergoing cardiac resynchronization therapy.
Clinicians lack reliable methods to predict which patients with congestive heart failure (CHF) will benefit from cardiac resynchronization therapy (CRT). Symptom burden may help to predict response, but this information is buried in free-text clinical notes. Natural language processing (NLP) may identify symptoms recorded in the electronic health record and thereby enable this information to inform clinical decisions about the appropriateness of CRT. ⋯ A deep NLP algorithm can be trained to capture symptoms in patients with CHF who received CRT with promising precision and recall.
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J Pain Symptom Manage · Nov 2020
ReviewGaining Palliative Medicine subspecialty recognition and Fellowship Accreditation in Jordan.
Palliative medicine (PM) has gained subspecialty recognition in many countries during the past two decades. Jordan is one of the first Arab countries to gain accreditation for the specialty. ⋯ Key factors enabling accreditation to happen in Jordan were strong leadership, persistence, collaboration with major stakeholders, and seeking out opportunities to promote the specialty. Our experience and lessons learnt are transferable to other countries and may prove beneficial to others aiming to gain subspecialty recognition for PM.
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Keepsakes are a relatively unexplored form of bereavement support that is frequently provided as part of the 3 Wishes Project (3WP). The 3WP is a palliative care intervention in which individualized wishes are implemented in the adult intensive care unit for dying patients and their families. ⋯ Keepsakes are common wishes that clinicians in the intensive care unit are able to provide and sometimes cocreate with families when patients are dying. Both the offering to create the keepsake and receipt of the final product are perceived by family members as helpful.
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Is oncology a spiritual practice? It is important, if not essential, to recognize how patients contextualize their illness. Medical education does not prepare us for the tangential effects of illness, and we therefore miss opportunities to treat the spiritual domains of human suffering. Through experiences from mentors, both within medical oncology and palliative care, I learned what true patient centered medicine entails-lcaring for patients-lbody and soul.
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J Pain Symptom Manage · Nov 2020
Pediatric Chronic Critical Illness: Training teams to address the communication challenges of patients with repeated and prolonged hospitalizations.
Children with chronic critical illness (CCI) have repeated and prolonged hospitalizations. Discrete communication challenges characterize their inpatient care. ⋯ Interdisciplinary communication training regarding long stay patients is feasible and valued by novice and seasoned clinicians. The novel integration of intrateam communication skills alongside team-family skills reflects the reality that the care of children with CCI challenges clinicians to communicate well with each other and families. Teaching interdisciplinary teams to share communication skills has the potential to overcome reported limitations of existing inpatient discussions, which can be dominated by one or two physicians and lack contributions from diverse team members.