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Journal Cover   JAMA The Journal of the American Medical Association
  [SJR: 6.278]   [H-I: 491]   [1029 followers]  Follow
   Full-text available via subscription Subscription journal
   ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
   Published by American Medical Association Homepage  [11 journals]
  • JAMA
    • PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Alzheimer Disease
    • Authors: Jin J.
      Abstract: Alzheimer disease is a common cause of dementia in older adults.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Suffering
    • Authors: Taub A.
      Abstract: I shuffle through the bustling hallsto room 184.I got a call I say,and a diligent nurse points to a shut door.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Is the Physician an “Easy Mark”?
    • Abstract: Regularly there drift into the office of The Journal the sad complaints of physicians who have trusted their fellow men, not wisely but too well. At least every third or fourth issue carries the old familiar heading "A Warning" and a detailed description of the latest species of the genus "fraud." The types of impostors are varied, at times, even amusing. A late specimen, leaping here and there over the country, offered to physicians, for the small sum of three dollars, a year’s subscription to any of the best magazines and a set of the complete works of any of the most prolific authors. A moment of thought would have shown the willing victims that the material offered could not possibly be sold for ten times the sum. Another engaging young man packed a sample case with the latest models of medical apparatus, offered to accept orders, at half the usual price, and allowed a special discount of 10 per cent. for cash with the order. The latter saving appealed so greatly to the economical physician that the suave gentleman used up his order book before he left the town. Strange to relate, neither the syringes, hypodermics and thermometers nor the money advanced were ever seen again.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Higher Standards for Government-provided Maternity Care
    • Authors: Rubin R.
      Abstract: Sen Debbie Stabenow (D, Mich) and Sen Chuck Grassley (R, Iowa) on February 12 introduced the Quality Care for Moms and Babies Act of 2015 to improve maternity care and reduce health care costs.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Special Open Enrollment for Pregnant Women
    • Authors: Rubin R.
      Abstract: Three dozen Democratic senators wrote Department of Health and Human Services Secretary Sylvia Mathews Burwell on March 3 to urge her to institute a special open enrollment period for women to enroll in health coverage when they learn they are pregnant (
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Hepatitis A Transmission Hits Group Homes for the Disabled
    • Abstract: Thanks to a rapid response, public health officials in 2013 contained a 3-month hepatitis A virus (HAV) outbreak among people with developmental disabilities living in 5 group homes in southeastern Michigan. Among 8 who were infected, 1 died of fulminant liver failure.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Surgical Patients Acquire HCV
    • Abstract: Contaminated medical equipment and supplies used during surgical procedures have been implicated in 2 cases of hepatitis C virus (HCV) infection.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • The Girls on the Bridge
    • Authors: Cole TB.
      Abstract: Åsgårdstrand is a village on the Oslofjord, an inlet that reaches from the Skagerrak Strait at the southern tip of Norway to the capital city of Oslo. At the turn of the 20th century, vacationers and artists came to Åsgårdstrand to linger on the piers in the long twilight of the summer months. The Norwegian artist Edvard Munch (1863-1944) painted The Girls on the Bridge from a pier in the harbor of Åsgårdstrand, probably in the year 1901. In this painting, a few simple shapes—blocky houses, a spherical tree, and a white fence—anchor the image of three girls in long dresses who look out over the water. The road behind them wavers uneasily as it joins the shoreline before climbing the hill. In Munch’s paintings, distortions of the landscape are reminders that perception can be altered by one’s mood. The steep perspective pulls the pier into the picture plane, establishing a connection between the viewer and the girls. The ambience of the painting has been described as lyrical, mysterious, nostalgic, ominous, elegiac, haunting, and tense. Many of Munch’s paintings, such as The Sick Child (JAMA cover, December 11, 1987), Starry Night, and The Scream (JAMA cover, January 18, 1971), are images of foreboding and sorrow, but the somber tone of The Girls on the Bridge may have less to do with the subject than with its Scandinavian latitude.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Reforming WHO After Ebola
    • Authors: Gostin LO.
      Abstract: In September 2014, at the height of the West Africa Ebola epidemic, Margaret Chan, MD, DSc, director-general of the World Health Organization (WHO), downplayed the agency’s role in taking a lead in fighting the outbreak in an interview with the New York Times ( WHO “is a technical agency,” Chan said, adding that it is governments that “have the first priority to take care of their people.” In January 2015, the Chan again deflected responsibility, saying she was following protocol, leaving it to the WHO’s Regional Office for Africa (AFRO) to respond ( Yet, Guinea, Liberia, and Sierra Leone—among the world’s poorest countries—could not have contained the outbreak on their own.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • GAO: Cut Antipsychotic Prescriptions for Older Patients
    • Authors: Rubin R.
      Abstract: The Department of Health and Human Services (HHS) needs to expand efforts to reduce the use of antipsychotic drugs by older adults with dementia, according to a Government Accountability Office (GAO) report publicly released March 2.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Law Would Require Paid Sick Leave for Workers
    • Authors: Rubin R.
      Abstract: The Healthy Families Act, reintroduced February 12 by Sen Patty Murray (D, Wash) and Rep Rosa DeLauro (D, Conn), would allow workers to earn paid sick leave to take when they are sick or need to care for a sick family member; to obtain preventive care; or to deal with domestic violence, stalking, or sexual assault (
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Racial and Ethnic Differences in Breast Cancer Diagnosis
    • Authors: Braun L; Tsai J, Ucik L.
      Abstract: To the Editor Dr Iqbal and colleagues reported that black women with breast cancer had worse outcomes compared with other groups. The authors concluded that “much of the difference could be statistically accounted for by intrinsic biological differences such as lymph node metastasis, distant metastasis, and triple-negative behavior of tumors.”
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Racial and Ethnic Differences in Breast Cancer Diagnosis
    • Authors: Iqbal J; Rochon P, Ginsburg O.
      Abstract: In Reply Dr Braun and colleagues raise several important points. In our study, we did not wish to imply that the natural history of breast cancer is simple or easily understood. Many studies remain to be done.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Incorrect Data in Text and Table
    • Abstract: In the JAMA Clinical Evidence Synopsis entitled “Antibiotics for Acute Bronchitis,” published in the December 24/31, 2014, issue of JAMA (2014;312[24]:2678-2679. doi:10.1001/jama.2014.12839), the adverse effects should be 24 for the number needed to treat in the Summary of Findings and in the Table. This article was corrected online.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Is There an App to Solve App Overload?
    • Authors: Kuehn BM.
      Abstract: Like many physicians, Suzanne Clough, MD, struggled to meet her patients’ needs regarding their type 2 diabetes in a few 12-minute visits each year. But too often, patients’ concerns about day-to-day condition management weren’t fully addressed. Many were frustrated, and some didn’t follow her guidance because they weren’t seeing results.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Aspirin for Cardiovascular Event Prevention in Older Japanese Adults
    • Authors: Spence J.
      Abstract: To the Editor The study by Dr Ikeda and colleagues on low-dose aspirin for primary prevention in patients who are at risk of cardiovascular events was stopped early for futility with regard to the primary outcome, which was “a composite of death from cardiovascular causes (myocardial infarction, stroke, and other cardiovascular causes), nonfatal stroke (ischemic or hemorrhagic, including undefined cerebrovascular events), and nonfatal myocardial infarction.”
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Aspirin for Cardiovascular Event Prevention in Older Japanese Adults
    • Authors: Ikeda Y.
      Abstract: In Reply As stated in our article, there was a significant reduction in the incidence of nonfatal myocardial infarction and transient ischemic attacks, which were predefined secondary end points. Because we did not find a significant reduction in the primary end point, the study has to be interpreted as negative.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Long-term Survival Following Bariatric Surgery in the VA Health System
    • Authors: Murali SB.
      Abstract: To the Editor The study by Dr Arterburn and colleagues found lower mortality among obese patients in the Veterans Affairs (VA) health system receiving bariatric surgery compared with matched controls not receiving surgery. The authors did not account for several relevant sources of selection bias introduced by the VA bariatric surgery eligibility criteria.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Long-term Survival Following Bariatric Surgery in the VA Health System
    • Authors: Arterburn DE; Eid G, Maciejewski ML.
      Abstract: In Reply Retrospective studies relying on data derived from administrative claims and electronic health records often have incomplete capture of some patient-level covariates. These data are typically not captured to support research but to document clinical care and billing. Nevertheless, modern statistical techniques, such as sequential stratification used in our study, reduce biases induced by nonrandom treatment assignment.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • FDG-PET/CT Imaging for Mediastinal Staging in Patients With NSCLC
    • Authors: Schmidt-Hansen M; Baldwin D, Zamora J.
      Abstract: This JAMA Clinical Evidence Synopsis summarizes a Cochrane review of the accuracy of 18F-fludeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) for distinguishing potentially resectable from nonresectable non–small cell lung cancer (NSCLC).
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Screening for Osteoporosis
    • Authors: Altkorn D; Cifu AS.
      Abstract: This JAMA Clinical Guidelines Synopsis article summarizes the most recent National Osteoporosis Foundation guidelines on screening older men and postmenopausal women for osteoporosis.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Data Breaches of Protected Health Information
    • Authors: Liu V; Musen MA, Chou T.
      Abstract: Reports of data breaches have increased during the past decade. Compared with other industries, these breaches are estimated to be the most costly in health care; however, few studies have detailed their characteristics and scope.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Acute Stroke Intervention: A Systematic Review
    • Authors: Prabhakaran S; Ruff I, Bernstein RA.
      Abstract: This systematic review summarizes the pathophysiology of acute brain ischemia and infarction and available reperfusion treatments.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Comprehensive Injury Research
    • Authors: Holcomb JB; Hoyt DB.
      Abstract: JAMA SurgeryChanging Patterns of In-Hospital Deaths Following Implementation of Damage Control Resuscitation Practices in US Forward Military Treatment FacilitiesNicholas R. Langan, MD; Matthew Eckert, MD; Matthew J. Martin, MDImportance Analysis of combat deaths provides invaluable epidemiologic and quality-improvement data for trauma centers and is particularly important under rapidly evolving battlefield conditions.Objective To analyze the evolution of injury patterns, early care, and resuscitation among patients who subsequently died in the hospital, before and after implementation of damage control resuscitation (DCR) policies.Design, Setting, and Participants In a review of the Joint Theater Trauma Registry (2002-2011) of US forward combat hospitals, cohorts of patients with vital signs at presentation and subsequent in-hospital death were grouped into 2 time periods: pre-DCR (before 2006) and DCR (2006-2011).Main Outcomes and Measures Injury types and Injury Severity Scores (ISSs), timing and location of death, and initial (24-hour) and total volume of blood products and fluid administered.Results Of 57 179 soldiers admitted to a forward combat hospital, 2565 (4.5%) subsequently died in the hospital. The majority of patients (74%) were severely injured (ISS > 15), and 80% died within 24 hours of admission. Damage control resuscitation policies were widely implemented by 2006 and resulted in a decrease in mean 24-hour crystalloid infusion volume (6.1-3.2 L) and increased fresh frozen plasma use (3.2-10.1 U) (both P 
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Maternal Diabetes and Autism in Offspring
    • Authors: Xiang AH; Wang X, Martinez MP, et al.
      Abstract: This cohort study reports that exposure to maternal gestational diabetes mellitus diagnosed by 26 weeks was associated with risk of autism spectrum disorders in offspring born after 28 weeks.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Bioprosthetic vs Mechanical Mitral Valve Outcomes Among Older Patients
    • Authors: Chikwe J; Chiang YP, Egorova NN, et al.
      Abstract: In this cohort study, there was no survival difference at 15 years among older patients who underwent mechanical prosthetic vs bioprosthetic mitral replacement.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Factors Associated With Dabigatran Adherence in the US VA System
    • Authors: Shore S; Ho P, Lambert-Kerzner A, et al.
      Abstract: This hospital epidemiology study assessed varion in dabigaran adherence across 67 Veterans Health Administration sites and system practices associated with higher adherence.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • The Ethics of Patient Care
    • Authors: Branch WT; Jr.
      Abstract: Early morning, I lay on a narrow table. An anesthesiologist, whom I had never met, was peering over me. I had been waiting anxiously to tell the anesthesiologist about my huge cervical spinal bone spur. A wrong positioning of the cervical spine could produce intense pain, the kind I’d experienced before, or worse, result in a weak arm, also experienced before. I began to explain but fully expected the anesthesiologist would dismiss my concerns with a “Don’t worry. We handle this all the time.” Instead, he listened. “So you have difficulty extending your cervical spine. Show me, slowly, how far you can comfortably extend.” He gently extended my neck. “Does this hurt? Is it comfortable? Can you do this much?” I felt an enormous relief. The man had taken me seriously.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Race, Poverty, and Medicine in the United States
    • Authors: Bauchner H.
      Abstract: I spent most of my career at the Boston City Hospital, now known as Boston Medical Center, that has emphasized “exceptional care without exception.” At Boston City Hospital the 2 worlds of race and poverty collide on an almost daily basis. Under the 4-decade leadership of 2 pediatric chairs, Joel Alpert, MD, and Barry Zuckerman, MD, and continuing under the current chair Robert Vinci, MD, the Department of Pediatrics expanded the boundaries of traditional medicine. In addition to providing care for medical problems such as asthma, HIV/AIDS, seizures, prematurity, and sickle cell disease, the department is committed to addressing issues of poverty, violence, poor housing, and food insecurity.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Keeping Personal Health Information Safe
    • Authors: Blumenthal D; McGraw D.
      Abstract: The personal health information of patients in the United States is not safe, and it needs to be. The vulnerability of health data is clear from the research letter by Liu and colleagues in this issue of JAMA. Organizations for which the management of health information is regulated under the Health Insurance Portability and Accountability Act (HIPAA), which are so-called covered entities, must promptly report data breaches affecting more than 500 individuals to the US Department of Health and Human Services. Examining these reports for 2010 through 2013, the authors found 949 events affecting 29.1 million records, with increasing numbers of breaches over time. Two-thirds of data breaches involved electronic data, almost three-fifths theft, and nearly 10% (in 2013) hacking.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Achieving Health Equity by Design
    • Authors: Wong WF; LaVeist TA, Sharfstein JM.
      Abstract: This Viewpoint discusses motivating health care organizations to consider a new set of tools and approaches to disparities in health outcomes by race/ethnicity and income status such as payment systems that reward better outcomes and building equity into program design.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Health CO-OPs of the Affordable Care Act
    • Authors: Joseph AM; Adashi EY.
      Abstract: This Viewpoint discusses tenets of the Consumer Operated and Oriented Plan program and challenges related to its implementation.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • The Health of Young African American Men
    • Authors: Martin SA; Harris K, Jack BW.
      Abstract: This Viewpoint discusses reimagining and repurposing efforts in American health care for the benefit of marginalized communities.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Highlights for April 14, 2015
    • PubDate: Tue, 14 Apr 2015 00:00:00 GMT
  • Regenerative Medicine
    • Authors: Atala A; Murphy S.
      Abstract: This Viewpoint describes how regenerative medicine through advances in cell biology, biomaterial science, and biological molecule discovery can replace or regenerate human cells, tissues, and organs harmed by disease or injury.
      PubDate: Tue, 14 Apr 2015 00:00:00 GMT
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