Jama
(Source: JAMA)
Source: JAMA - October 13, 2020 Category: General Medicine Source Type: research

How Workplace COVID-19 Outbreaks Affect Workers of Color
Almost three-quarters of the people in Utah who acquired coronavirus disease 2019 (COVID-19) at work earlier this year were Hispanic or non-White, even though they make up only about a quarter of the state ’s workforce, according to a recent analysis. (Source: JAMA)
Source: JAMA - October 13, 2020 Category: General Medicine Source Type: research

Overdose Education and Naloxone Distribution Expanded
A marked increase in the number of US syringe service programs that offer opioid overdose education and medication occurred between 2013 and 2019, according to a recent national survey. (Source: JAMA)
Source: JAMA - October 13, 2020 Category: General Medicine Source Type: research

Emergency Use Authorizations During the COVID-19 Pandemic —Lessons From Hydroxychloroquine for Upcoming Vaccine Approval
This Viewpoint uses the FDA ’s Emergency Use Authorization (EUA) of hydroxychloroquine for COVID-19 treatment to emphasize the costs of premature regulatory authorizations to public health and trust, and proposes the use of advisory committees, requirements for postmarketing surveillance, and adherence to standards of transp arency for any future EUAs. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Insight on Sex-Based Immunity Differences, With COVID-19 Implications
Women and men have striking differences in their autoimmune disease risk, their predisposition to and prognosis with various cancers, and their ability to respond to some infections —including the novel coronavirus. New research offers a potential explanation for these distinctions: sex-based differences in neutrophils, humans’ most common circulating immune cells. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Incorrect Corresponding Author Address
This article was corrected online. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

New Disease Cases, Deaths Related to Breast Implants
During the last half of 2019, the FDA added 160 new cases of disease and 3 deaths to its data set of adverse events related to breast implants. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Therapy Approved for Rare Neurological Autoimmune Disorder
Another treatment for certain patients with the rare autoimmune disease neuromyelitis optica spectrum disorder (NMOSD) has received FDA approval. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Deceptive Hand Sanitizer Packaging
The FDA has warned that alcohol-based hand sanitizers are being packaged in containers that resemble food or drinks, endangering people who might accidentally ingest them. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Medicare Advantage for All, Perhaps?
The coronavirus disease 2019 (COVID-19) pandemic is forcing a much-needed questioning of the US health system. What is the right balance of authority between the federal government and the states? How should the profound inequities and gaps in the system be better addressed? Should emergency regulations, like those allowing more telemedicine and flexible funding, become permanent features of the system? (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

The Segregation of Pneumonia
The study of means for the protection and care of the child has received a tremendous impetus from the World War, and never before has the attention of so many agencies been concentrated upon its problems. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Continuous Pulse Oximetry Monitoring in Bronchiolitis Patients Not Receiving Oxygen
To the Editors Dr Bonafide and colleagues found variability among hospitals in the use of pulse oximetry after discontinuation of oxygen therapy in children hospitalized for bronchiolitis. They suggested that oxygen monitoring should be deimplemented. We have 3 concerns. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Biomechanical Footwear for Osteoarthritic Knee Pain
To the Editor Dr Reichenbach and colleagues reported that among participants with knee pain from osteoarthritis, use of biomechanical footwear compared with control footwear resulted in an improvement in pain after 24 weeks of follow-up. There are several issues regarding the trial that are worth considering. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Delayed Antibiotic Prescriptions
To the Editor Drs Rowe and Linder argued too strongly that when clinicians prescribe delayed antibiotics, they are abdicating their responsibility and doing harm, and they did not cite relevant evidence. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Continuous Pulse Oximetry Monitoring in Bronchiolitis Patients Not Receiving Oxygen —Reply
In Reply Dr Keim-Malpass and colleagues raise interesting points about our study of continuous pulse oximetry monitoring in bronchiolitis. First, they comment that the evidence underlying the American Academy of Pediatrics recommendation against continuous pulse oximetry is weak and that parents find physiologic monitoring reassuring; therefore, calls for deimplementation are unwarranted. This logic suggests that weak evidence of harm (without evidence of benefit) and parent preference justify implementation of a medical intervention. We disagree. Similar logic likely contributed to the overprescribing of antibiotics for m...
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Biomechanical Footwear for Osteoarthritic Knee Pain —Reply
In Reply Dr Lei and colleagues correctly state that the positioning of the external pods of the biomechanical footwear in our trial was individually adjusted. The treatment protocol for adjusting the pods was described in detail in Supplement 3 in the article. This is considerably more detail than most physical therapy or exercise intervention trials provide. Adjustments were done according to this protocol by experienced and trained technicians based on gait patterns and patient-reported symptoms. The attempt to shift the center of pressure in the shoe and foot laterally in patients with medial knee osteoarthritis has bee...
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Delayed Antibiotic Prescriptions —Reply
In Reply Dr Little disagrees with our Viewpoint and accuses us of arguing too strongly against the use of delayed antibiotic prescriptions. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

courvoisier's law
she was 37 and i was 26 and she was going to die and i was not and i think i am supposed to tell you something about it with meaning and emotion and hope against the lack of hope and how there are waterfalls in the world that are not discovered where the rivers are still warm and the flows tumble like soft hair on a ceaseless summer's day and there are times when just before the total folding just before the top meets the bottom in complete collapse there is mist that can kiss a face full of a happy life yet all i have is this and she does not and both of these are too soon an end (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Calming the Storm —Managing Anxiety-Related Somatic Symptoms
In this narrative medicine essay a cardiology fellow shares his deep appreciation for a primary care physician who recognized his chest pain as anxiety related and draws lessons for how physicians of all specialties can help patients with somatic symptoms from COVID-19 pandemic-related uncertainties. (Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Jama
(Source: JAMA)
Source: JAMA - October 6, 2020 Category: General Medicine Source Type: research

Graduate Medical Education, 2019-2020
This Appendix presents 2019 National GME Census data detailing the numbers and types of ACGME-accredited training programs and the residents and fellows in them. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Medical Schools in the United States, 2019-2020
This Appendix presents data from the 2019-2020 Liaison Committee on Medical Education (LCME) annual questionnaire detailing information on the number of students, student demographics, curriculum content, and enrollment at US medical schools. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

The COVID-19 Pandemic and the JAMA Network
Journal editors sit at the crossroads of new ideas and findings, deciding which are worth refining and making public in their journals and which are best saved for another time and place. The global arrival of coronavirus disease 2019 (COVID-19) has brought an increase in manuscript submissions describing and evaluating the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its morbidity and mortality, distilling what seems like years of science and policy into several months. JAMA Network editors were quickly reeducated in principles of epidemiology and public health related to epidemics ...
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Declines in Lung Cancer Deaths Linked to Treatment Advances
Mortality from non –small cell lung cancer (NSCLC) in the US decreased between 2013 and 2016, a period corresponding with the approval of several targeted therapies for the disease, National Cancer Institute (NCI) researchers recently reported. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Buprenorphine Implants, Injections Are Underused
Injectable and implantable forms of buprenorphine to treat patients with opioid use disorder (OUD) are less likely to be diverted than oral formulations but they ’re rarely prescribed, according to a recent US Government Accountability Office (GAO) report. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

VA Partners With OnStar to Increase Access to Suicide Prevention Services
OnStar, perhaps best known for providing emergency services for people involved in motor vehicle crashes, recently partnered with the US Department of Veterans Affairs (VA) to improve access to suicide prevention services. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Safely Recognizing and Responding to Intimate Partner Violence
This JAMA Insights Clinical Update reviews clinical indicators of intimate partner violence (IPV) and ways that clinicians can ask about and begin to assist individuals who experienced IPV in phased, sensitive approaches that do not encourage patients to act before they are ready or compromise their autonomy or safety. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Life as It Is
In the symposium entitled “Man and Life,” Barzun, writing on “the quality of life,” notes that the term “life” is imprecise and susceptible of varied interpretation. He bases his discussion of its quality principally on the question, “Is life worth living?”—a question that can be answered only personally or , if you will, individually. Nevertheless, he finds signs in our modern industrial-democratic society that the question is being answered in the negative, and he propounds a number of characteristics that have caused deterioration of life’s quality. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Geographic Distribution of US Cohorts Used to Train Deep Learning Algorithms
This study describes the US geographic distribution of patient cohorts used to train deep learning algorithms in published radiology, ophthalmology, dermatology, pathology, gastroenterology, and cardiology machine learning articles published in 2015-2019. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

CMS Quality Measure Development
To the Editor The study by Dr Wadhera and colleagues stated that the Centers for Medicare& Medicaid Services (CMS) has invested more than $1.3 billion in quality measure development of more than 2300 measures, of which 788 are being used in CMS quality, reporting, and payment programs, and concluded that CMS lacks a strategy to systematically evaluate whether their quality measures improve the delivery of care and health outcomes. Some issues require clarification. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Physicians and Social Determinants of Health
To the Editor In their Viewpoint, Drs Maani and Galea considered how physicians can most effectively support societal efforts to alleviate adverse social determinants of health to improve the health of individuals in the United States. The authors suggested that physician-level interventions distract from what ultimately must be systemic efforts —a proposition we believe overlooks the profound mitigating effect physicians can have on social determinants of health. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Physicians and Social Determinants of Health
To the Editor Drs Maani and Galea argued that physicians must engage more heavily in addressing the social determinants of health because these factors significantly drive patients ’ health. The authors focused on 2 major areas: policy action and physician training. Of course, health and health care are different, and the authors made this distinction: “Addressing social determinants in the context of clinical practice devalues and medicalizes the complex burden and barrie rs encountered by those affected by discrimination or poverty.” However, while their argument for engaging physicians in policy soluti...
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Physicians and Social Determinants of Health
To the Editor The perspective offered by Drs Maani and Galea regarding physicians ’ role in social determinants of health highlights the limitations and potential unintended consequences of physicians’ attempts to interface with them. While their conclusion that “[p]hysicians’ most enduring effect may be in changing the conversation around health and responsibility for it ” may prove true, their proposal for how physicians use their voices is more likely to hinder rather than promote efforts to address social determinants of health for 2 reasons. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

CME Quality Measure Development —Reply
In Reply In response to our study, Dr Duseja and colleagues assert that CMS value-based programs, which link quality measures to reimbursement, have led to declines in hospital-acquired conditions, readmissions, and “significant improvements and cost savings.” Although we agree that CMS’s focus on quality and costs has been meaningful to hospitals and patients nationwide, we believe a more nuanced assessment of the programs’ effects is warranted. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Physicians and Social Determinants of Health —Reply
In Reply We are heartened to see that all 3 letters agree in various ways with the principle expressed in our Viewpoint that the social determinants of health should not be overmedicalized and that the drivers of poor health largely sit outside the health care system, rooted in societal structures, power, and money. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Novel Device Improves Barrett Esophagus Diagnosis in Primary Care
Testing with a spongy device that ’s swallowed to collect esophageal cells and retrieved via a thread attached to it improved general practitioners’ detection of Barrett esophagus among patients with gastroesophageal reflux, according to a trial in The Lancet. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Baloxavir Protects Against Household Influenza Spread
Baloxavir marboxil, a polymerase acidic protein endonuclease inhibitor, prevented influenza from spreading in households with a confirmed case, a trial in The New England Journal of Medicine reported. Baloxavir is approved as treatment for uncomplicated influenza A and B and for patients at risk for complications. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Shared Decision-making Doesn ’t Change Anticoagulation Treatment
Physician satisfaction and patient engagement improved when they used a shared decision-making (SDM) tool for anticoagulant treatment. But their treatment decisions didn ’t differ from patients receiving standard care, a trial in JAMA Internal Medicine reported. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Intravenous Ibuprofen Caldolor Reduces Opioids After Orthopedic Trauma
Intravenous (IV) ibuprofen adequately relieved acute pain and minimized opioid use in the first 48 hours after an orthopedic trauma, a trial in the Journal of Orthopaedic Trauma reported. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Mixed Results for Progesterone for Miscarriage Prevention
Progesterone therapy in the first trimester of pregnancy did not result in a greater rate of live births among women with a high risk of miscarriage, according to a trial in Health Technology Assessment. Women with previous miscarriages, however, benefited from progesterone therapy. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Negative Pressure Wound Therapy vs Standard Dressing and Infection in Obese Women After Cesarean Delivery
This open-label randomized trial compares the effects of preventive negative pressure wound therapy vs standard wound dressing on surgical site infection among obese women after cesarean delivery. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Patient Information: High Blood Pressure
This JAMA Patient Page explains what high blood pressure is, why it is important to control, the difference between the top (systolic) and bottom (diastolic) numbers, and how it is best treated and prevented. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

The Exact Shade of Code Grey —Sutter Psych Hospital
What anomalous culture were we, the thinning pebbles under a river, or amethyst-black pearls? The shade of code meant women, a girls ’ fight on cold stone cement, or stainless steel sink, silver slicked with shad scales, surfaces we shrank from so that hearing it PA’d we’d back into shared rooms we’re territorially squeezed to get along in, like manx-gray cats in factory-ratty industrial grass. Let the women brawl, the ni cotine-patched princesses, the breast-biters, and try to fuzz over the trauma with pewter lavender of a Weimaraner— coat and eyes paler and more plaintive than Code Black, wa...
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Jama
(Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Neurology and COVID-19
In this Viewpoint, JAMA Neurology editors review the journal ’s more important articles advancing scientific understanding of COVID-19 in the first 6 months of the pandemic, including surveys of neurologic manifestations of the infection and identification of potential direct viral involvement in the central nervous system. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Psychiatry and COVID-19
In this Viewpoint, JAMA Network ’s psychiatry editors review how the coronavirus disease 2019 (COVID-19) pandemic has affected the practice of psychiatry in its first 6 months, for example, through disruptions of care provided in group settings, provision of telehealth, and widespread anxiety and health care worker burnout and d epression. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Pediatrics and COVID-19
In this Viewpoint, the editor of JAMA Pediatrics summarizes the effect on children of the first 6 months of the COVID-19 pandemic, reviewing evidence for why they seem not to become ill or as sick as adults and discussing the pandemic ’s likely long-term effects on child development and psychological health. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research

Cardiology and COVID-19
In this Viewpoint, JAMA Cardiology editors review the journal's more inportant articles advancing the scientific understanding of COVID-19 and the heart in the first 6 months of the pandemic, including evidence of direct myocardial injury and indirect effects of the pandemic on outcomes for patients with CVD postponing care for fear of contracting the virus. (Source: JAMA)
Source: JAMA - September 22, 2020 Category: General Medicine Source Type: research