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Measures of the Burden of Medical Expenses

Mar, 17/04/2018 - 02:00
To the Editor Dr Emanuel and colleagues highlighted the great burden of health care costs on US families with their proposed Affordability Index and Comprehensive Affordability Index.

Measures of the Burden of Medical Expenses—Reply

Mar, 17/04/2018 - 02:00
In Reply No summary measure is perfect. For instance, gross domestic product and poverty rates have been used for decades, despite persistent debate over how well these indices assess the economy and the correct way to measure them. The gross domestic product does not include parents’ uncompensated caregiving of children, which is vital to a healthy society. Despite their flaws, such measures serve invaluable functions.

Incorrect Wording in a Table

Mar, 17/04/2018 - 02:00
In the Narrative Review entitled “The Diagnosis and Management of Thyroid Nodules: A Review,” published in the March 6, 2018, issue of JAMA, Table 1 included incorrect language. The word risk in definitions in the “Very low-suspicion” and “Low suspicion” rows of the “ATA, 2015” column, the “Low risk” row of the “Eu-TIRADS 3” column, and the “Mildly suspicious” row of the “ACR TIRADS, 2017” column should have been deleted. This article has been corrected online.

Nondrug Approaches to Pain Management

Mar, 17/04/2018 - 02:00
This Medical News article is an interview with Robert Kerns, PhD, on a research collaboration at military and veteran health facilities.

Redesigning Medicaid Managed Care

Mar, 17/04/2018 - 02:00
When it comes to health care, California is often considered a bellwether state. California has experienced the largest gain of any state in the number of individuals who are covered by insurance following the implementation of the Affordable Care Act (ACA). It has also been a leader in the use of managed care. As of 2016, almost 23 million Californians (58% of the population) received care delivered through a health maintenance organization (HMO). This includes the state Medicaid program (Medi-Cal), through which 10.3 million beneficiaries (about 80%) receive services through managed care. Nationwide, 1 in 5 Medicaid beneficiaries who are in managed care reside in California.

Urgency to End Newborn Deaths

Mar, 17/04/2018 - 02:00
Around the world, 2.6 million infants die before they reach the age of 1 month, but the majority of these deaths are preventable, according to a new report from UNICEF. In addition, the report notes that every year an additional 2.6 million infants are stillborn, mostly in low- and middle-income countries. Half of these infants were alive at the beginning of labor.

WHO Issues New Guidelines for LTBI

Mar, 17/04/2018 - 02:00
The World Health Organization (WHO) issued updated and consolidated guidelines for people with latent tuberculosis infection (LTBI) that aims to expand testing and improve treatment. The WHO simultaneously released a mobile application to support systematic monitoring and evaluation of patients with LTBI that can be adapted to meet country-specific contexts, such as national surveillance systems.

Yaws Eradication Requires Improved Approach

Mar, 17/04/2018 - 02:00
More than 1 round of mass administration of azithromycin may be needed to eradicate yaws, an infectious disease caused by the bacterium Treponema pallidum subspecies pertenue, according to a report published in the Lancet.

A Comeback for European Shellfish

Mar, 17/04/2018 - 02:00
Decades after the United States halted shellfish imports from European countries, the FDA is taking steps to reestablish molluscan shellfish trade with the European Union (EU). Resuming trade hinges on finalizing an “equivalence determination” to show that European shellfish safety systems are comparable with those in the United States.

Duodenoscope Warning

Mar, 17/04/2018 - 02:00
The FDA has warned 3 duodenoscope manufacturers that they’ve failed to comply with a federal requirement to assess whether current cleaning and disinfecting methods effectively reduce infection risk.

New Option for Drug-resistant HIV

Mar, 17/04/2018 - 02:00
Combination antiretroviral (AR) therapy has allowed most—but not all—people with HIV to manage their infection as a chronic disease. But for those with multidrug-resistant (MDR) HIV-1 that hasn’t responded to multiple treatment regimens, the FDA has approved a new treatment.

Exploring the Surgical Gaze Through Literature and Art

Mar, 17/04/2018 - 02:00
This Arts and Medicine essay describes the teaching of narrative medicine techniques to surgical trainees, and how close readings of the painting In Hospital (The Operating Room) in seminars and Surgical Grand Rounds revealed truths about the importance of perspective to the surgeon’s professionalism and compassionate care.

Still Life Without Skull

Mar, 17/04/2018 - 02:00
The infusions were pulsed too fast,and the doctor admitted her mistake,but the jack-hammering in my child’s headwent on for days, not to be medicated away.I watched my girl writhe on the floor like a wormcut in half, and felt I was a captive in a new,infernal circle. And though I can’t seeor hold death in my arms, it ticksin us; and I think of old Dutch paintingsthick with vermillion, pomegranates,over-ripe grapes bloomingfrom true black. Half-eaten meats housea congregation of flies, tenaciousstrings of gristle dangle and lemons peelover the table’s edge. Here, there is no skull,but the sparrow’s eye flickers,a watch chain in its mouth.

Editorials

Mar, 17/04/2018 - 02:00

Vitamin D and Calcium Supplements for Preventing Fractures

Mar, 17/04/2018 - 02:00
This JAMA Patient Page discusses recommendations on use of vitamin D and calcium supplements to prevent fractures in adults.

JAMA

Mar, 17/04/2018 - 02:00

Highlights for April 10, 2018

Mar, 10/04/2018 - 02:00

The Proposal to Lower P Value Thresholds to .005

Mar, 10/04/2018 - 02:00
In this Viewpoint, John Ioannidis discusses the potential effects on clinical research of a 2017 proposal to lower the default P value threshold for statistical significance from .05 to .005 as a means to reduce false-positive findings and reviews alternative solutions for improving the accuracy and relevance of statistical inference.

Importance of Novel Vaccine Technologies in Response to Emerging Viral Diseases

Mar, 10/04/2018 - 02:00
In this Viewpoint, Anthony Fauci and colleagues review modern technological advances that facilitate acceleration of vaccine development in response to new and emerging viral disease threats, and argue for investment in surveillance in developing countries to expedite pathogen identification and jump-start the vaccine development process.

Driving Under the Influence of Cannabis

Mar, 10/04/2018 - 02:00
This Viewpoint reviews evidence that cannabis use impairs driving performance and emphasizes the importance of developing policies and legislation to address the resulting safety risks.

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