Detecting goals of care conversations in clinical notes with active learning.

Objective: Goals of care (GOC) discussions are an increasingly used quality metric in serious illness care and research. Wide variation in documentation practices within the Electronic Health Record (EHR) presents challenges for reliable measurement of GOC discussions. Novel natural language processing approaches are needed to capture GOC discussions documented in real-world samples of seriously ill hospitalized patients' EHR notes, a corpus with a very low event prevalence.

A Clinical Nurse Specialist-Led Emergency Department Naloxone Distribution Program.

Purpose: This article describes the implementation of a clinical nurse specialist-led emergency department overdose education and naloxone distribution program. The program's purpose is to increase naloxone availability to reduce opiate overdose mortality rates within the local community.

Description Of Program: The program distributes naloxone kits to patients in the emergency department after an opioid overdose.

Gun Violence: Two Medical Students' Hometown Connection to This Public Health Crisis.

The school shooting in Parkland, Florida in February 2018 left 17 people dead and countless other children and teachers with physical and psychological trauma that will require decades of healing. As Marjory Stoneman Douglas High School alumni and current medical students, the authors of this Invited Commentary contend that they are in a unique position to advocate on behalf of their neighbors, classmates, and future patients. Since the authors began medical school in 2015, there have been 19 mass shootings in the United States, resulting in 253 deaths.

Sport-related concussive convulsions: a systematic review.

Objectives: The incidence of sport-related concussion (SRC) continues to rise. Presentations of concussed athletes vary from subtle symptoms to notable signs. Between the 4th and 5th iterations of the Concussion in Sport Group (CISG) guidelines, concussive convulsions were removed as a modifying factor, but little evidence or discussion supported this change.

Severe bradycardia associated with suspension laryngoscopy.

Suspension laryngoscopy is one of the most common procedures performed for visualizing and diagnosing diseases of the larynx. A relatively uncommon yet potentially life-threatening complication is that of severe bradycardia or asystole during manipulation of the larynx. This case report highlights the occurrence of this complication during a routine removal of a true vocal fold lesion at a tertiary medical center and discusses the potential pathophysiological mechanisms and proposed management options for this phenomenon.