Brain Imaging Associated With Change in Management of Patients With Dementia, Cognitive Impairment

Posted March 28, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 2, 2019

Media advisory: To contact corresponding author Gil D. Rabinovici, M.D., email Nicholas Weiler at nicholas.weiler@ucsf.edu. The full study and editorial are linked to this news release.

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Bottom Line: Amyloid (abnormal protein) plaques in the brain are a feature of Alzheimer disease and imaging the brain with positron emission tomography (PET) can detect them. This study examined whether such imaging is associated with changes in patient care, although amyloid deposits also occur with other neurological disorders and in cognitively normal older adults. This study included about 11,400 Medicare beneficiaries with dementia or mild cognitive impairment (MCI) of uncertain cause who underwent amyloid PET. Results were positive in 55 percent of patients with MCI and 70 percent of patients with dementia. Researchers report the use of amyloid PET was associated with changes in the clinical management of patients within 90 days. The observational design of this study limits attributing changes in patient care to the imaging results and further research is needed to determine whether amyloid PET is associated with improved clinical outcomes.

Authors: Gil D. Rabinovici, M.D., University of California, San Francisco, and coauthors

(doi:10.1001/jama.2019.2000)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Are the Uninsured and Medicaid Patients More Likely to be Transferred to Another Hospital?

Posted March 28, 2019 by Jim Michalski

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 1, 2019

Media advisory: To contact corresponding author Arjun K. Venkatesh, M.D., M.B.A., M.H.S., email Ziba Kashef at ziba.kashef@yale.edu. The full study and commentary are linked to this news release.

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Bottom Line: This study analyzed 215,000 emergency department (ED) visits to 160 U.S. hospitals to see if patients with the common conditions of pneumonia, chronic obstructive pulmonary disease (COPD) or asthma were more likely to be discharged from the ED or transferred to another hospital after being stabilized based on their insurance status. Researchers report differences based on insurance. After adjusting for other factors, uninsured patients and patients insured by Medicaid were at higher risk of being transferred to another hospital than privately insured patients. Uninsured patients were more likely to be discharged than privately insured patients but Medicaid patients had similar risk of discharge. A limitation of the study is its use of administrative data, which lacked details on the severity of illness and hospital bed availability.

Authors: Arjun K. Venkatesh, M.D., M.B.A., M.H.S., Yale University School of Medicine, New Haven, Connecticut, and coauthors

(doi:10.1001/jamainternmed.2019.0037)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Changes in Public Perception of e-Cigarettes, Cigarettes

Posted March 26, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 29, 2019

Media advisory: To contact corresponding study author Jidong Huang, Ph.D., email Jennifer Rainey Marquez at jmarquez@gsu.edu. The full study and editorial are linked to this news release.

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: An analysis of data from two nationally representative surveys reports a greater proportion of U.S. adults perceived electronic cigarettes to be as, or more, harmful than cigarettes and a decreasing proportion of U.S. adults perceived e-cigarettes to be less harmful than cigarettes. The findings underscore the need to accurately communicate the risks of e-cigarettes to the public because the authors suggest some cigarette smokers may have been deterred from using or switching to e-cigarettes.

Authors: Jidong Huang, Ph.D., Georgia State University, Atlanta, Georgia, and coauthors

(doi: 10.1001/jamanetworkopen.2019.1047)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Visual Abstract

Posted March 26, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 29, 2019

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Visual Abstract:

(doi: 10.1001/jamanetworkopen.2019.1011)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Smoking and Mortality in Asia

Posted March 26, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 29, 2019

Media advisory:To contact corresponding study author Wei Zheng, M.D., Ph.D, email Craig Boerner at craig.boerner@vumc.org. The full study and invited commentary are linked to this news release.

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: In this analysis of data from 20 studies conducted in China, Japan, South Korea, Singapore, Taiwan and India with more than 1 million participants, deaths associated with smoking continued to increase among men in Asia grouped by the years in which they were born. Among the study participants, there were 144,366 deaths (with 9,158 from lung cancer) during an average follow-up of almost 12 years. Tobacco smoking was associated with 12.5 percent of total deaths and 56.6 percent of lung cancer deaths in men born before 1920, 21.1 percent of total deaths and 66.6 percent of lung cancer deaths in those born in the 1920s, and 29.3 percent of total deaths and 68.4 percent of lung cancer deaths among men born in 1930 or later. The study findings suggest tobacco smoking will remain a significant public health concern in Asia.

Authors: Wei Zheng, M.D., Ph.D., Vanderbilt University Medical Center, Nashville, Tennessee, and coauthors

(doi: 10.1001/jamanetworkopen.2019.1474)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Here’s a full-text link to embed in your story

Posted March 21, 2019 by Deanna Bellandi

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Here’s a full-text link to embed in your story

Posted March 21, 2019 by Deanna Bellandi

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Factors Associated with Increased Survival Among U.S. Military Combat Casualties in Afghanistan, Iraq

Posted March 25, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 27, 2019

Media advisory: To contact corresponding author Jeffrey T. Howard, Ph.D., email Kara Soria at kara.soria@utsa.edu. The full study and commentary are linked to this news release.

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Bottom Line: This study analyzed combat casualty statistics to look at factors associated with reductions in mortality during the current conflicts in Afghanistan and Iraq. The analysis of nearly 57,000 U.S. military casualties from October 2001 through 2017 suggests survival among the most critically injured has increased and that three interventions were associated with a large part of that reduction in deaths: the use of tourniquets, blood transfusions and more rapid prehospital transport times. The study acknowledges other factors, both medical and nonmedical, played a role in reducing mortality but adequate measurement of these other factors doesn’t exist.

Authors: Jeffrey T. Howard, Ph.D., University of Texas at San Antonio, and coauthors

(doi:10.1001/jamasurg.2019.0151)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Outcomes for Smallest Infants Born Weighing Less Than 400 Grams

Posted March 21, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MARCH 25, 2019

Media advisory: To contact corresponding author Edward F. Bell, M.D., email Thomas Moore at thomas-moore@uiowa.edu. The full study and editorial are linked to this news release.

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Bottom Line: This observational study adds to information about outcomes for the smallest infants born weighing less than 400 grams, which is less than a pound. The primary outcome of the study of 205 infants was survival to discharge among the infants who received any potentially lifesaving intervention after being born.

Authors: Edward F. Bell, M.D., of the University of Iowa, Iowa City, Iowa, and coauthors

(doi:10.1001/jamapediatrics.2019.0180)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Does Wearable Behavioral Intervention Improve Social Behavior in Kids With Autism Spectrum Disorder?

Posted March 21, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MARCH 25, 2019

Media advisory: To contact corresponding author Dennis P. Wall, Ph.D., email Erin Digitale at digitale@stanford.edu. The full study is linked to this news release.

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Bottom Line: This randomized clinical trial of 71 children with autism spectrum disorder (ASD) tested a wearable behavioral intervention deployed on Google Glass and worn by children at home to reinforce facial engagement and emotion recognition to improve social behavior.

Authors: Dennis P. Wall, Ph.D., of Stanford University, California, and coauthors

(doi:10.1001/jamapediatrics.2019.0285)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Study Examines Racial Segregation, Inequality of Care in NICUs

Posted March 21, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MARCH 25, 2019

Media advisory: To contact corresponding author Erika M. Edwards, Ph.D., email Drew Arnold at DArnold@VTOXFORD.org. The full study and editorial are linked to this news release.

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Bottom Line: This observational study looked at the extent of racial segregation and inequality of care for very low-birth-weight and very preterm infants at neonatal intensive care units (NICUs) across the United States. Nearly 118,000 black, Hispanic, Asian and white infants (born at 401 grams to 1,500 grams or 22 to 29 weeks’ gestation) were included in the study that defined two indices: one for segregation (uneven distribution of racial or ethnic groups across NICUs) and one for inequality (concentration of racial or ethnic groups in lower-quality NICUs). Explaining the study findings involves understanding sociodemographic factors along with hospital quality, access and choice for minority women and their babies.

Authors: Erika M. Edwards, Ph.D., of the Vermont Oxford Network, Burlington, Vermont, and coauthors

(doi:10.1001/jamapediatrics.2019.0241)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract

Posted March 19, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 22, 2019

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Visual Abstract:

(doi: 10.1001/jamanetworkopen.2019.0874)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Here’s a full-text link to embed in your story

Posted March 19, 2019 by Deanna Bellandi

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Here’s a full-text link to embed in your story

Posted March 19, 2019 by Deanna Bellandi

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Here’s a full-text link to embed in your story

Posted March 19, 2019 by Deanna Bellandi

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Here’s a full-text link to embed in your story

Posted March 19, 2019 by Deanna Bellandi

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Here’s a full-text link to embed in your story

Posted March 19, 2019 by Deanna Bellandi

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Financial Incentives Didn’t Improve Response Rates to Mailed Colorectal Cancer Screening Tests

Posted March 19, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 22, 2019

Media advisory: To contact corresponding author Shivan J. Mehta, M.D., M.B.A., M.S.H.P., email Frank Otto at francis.otto@uphs.upenn.edu. The full study and commentary are linked to this news release.

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Financial incentives didn’t increase completion rates of colorectal cancer screening tests mailed to patients. In a randomized clinical trial of almost 900 patients, none of the incentives (an unconditional $10, a promised $10 upon completion of the fecal immunochemical test (FIT) kit to test for blood in a stool sample or chance at a lottery with a 1-in-10 chance of winning $100) was statistically better than no financial incentive to entice patients to complete the FIT. The overall FIT completion rate at six months was nearly 29 percent but the incentives used in this study may have been too small to improve response rates.

Authors: Shivan J. Mehta, M.D., M.B.A., M.S.H.P., Perelman School of Medicine, University of Pennsylvania, Philadelphia, and co-authors.

(doi:10.1001/jamanetworkopen.2019.1156)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations@jamanetwork.org.

Study Examines Calcium Intake, Age-Related Macular Degeneration Progression Risk

Posted March 19, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MARCH 21, 2019

Media advisory: To contact corresponding author Emily Y. Chew, M.D., email Kathryn DeMott at neinews@nei.nih.gov. The full study and commentary are linked to this news release.

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Bottom Line: This study looked at the association of calcium intake (dietary and supplementation) with the risk and progression of age-related macular degeneration (AMD), a leading cause of blindness. Previous research has had mixed results about the role of calcium in AMD progression. This study, a secondary analysis of 4,751 randomized clinical trial participants, found higher calcium intake was associated with lower risk of progression to late AMD but there was an inconsistent association between calcium intake and different stages of AMD.

Author: Emily Y. Chew, M.D., National Institutes of Health, Bethesda, Maryland, and coauthors

(doi:10.1001/jamaophthalmol.2019.0292)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Moms of Kids With Eczema Report Sleep Troubles

Posted March 18, 2019 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 20, 2019

Media advisory: To contact corresponding author Katrina Abuabara, M.D., M.A., M.S.C.E., email Suzanne Leigh at suzanne.leigh@ucsf.edu. The full study and a podcast are linked to this news release.

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Bottom Line: Eczema (atopic dermatitis) is a common childhood condition and this study reports sleep disturbances were common among mothers of children with eczema. This analysis used data from 11,649 mother-child pairs followed through age 11 and it suggests having a child with eczema was associated with reported difficulty falling asleep, subjectively insufficient sleep, and increased daytime exhaustion for mothers. The severity of a child’s eczema was associated with worse sleep outcomes for mothers. However, sleep disturbances for children didn’t completely explain sleep disturbances for mothers so more research is needed to investigate other possible causes. Self-reported sleep information is a limitation of the study.

Authors: Katrina Abuabara, M.D., M.A., M.S.C.E., of the University of California, San Francisco, and coauthors

(10.1001/jamadermatol.2018.5641)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Podcast Available

Posted March 13, 2019 by Jim Michalski

Summary Video Available

Posted March 13, 2019 by Jim Michalski

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=6004760513001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Disclosure of Religious Identity, Health Care Practices on Catholic Hospital Websites

Posted March 13, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 15, 2019

Media advisory: To contact corresponding author Maryam Guiahi, M.D., M.Sc., email Julia Milzer at julia.milzer@ucdenver.edu. The full study is linked to this news release.

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Bottom Line: Some patients seek care at Catholic hospitals but others may not because aspects of reproductive and end-of-life care can be limited by ethical and religious directives for Catholic hospitals based on the church’s moral teachings. This research letter analyzed the websites of 646 hospitals listed in the Catholic Health Care Directory to see whether the hospitals described their religious identity and associated health care practices.

Authors: Maryam Guiahi, M.D., M.Sc., University of Colorado School of Medicine, Aurora, and coauthors.

(doi:10.1001/jama.2019.0133)

Editor’s Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract

Posted March 12, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 15, 2019

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Visual Abstract:

(doi: 10.1001/jamanetworkopen.2019.0554)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

What is Association of Dietary Cholesterol or Eating Eggs With Risk of Cardiovascular Disease, Death?

Posted March 13, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 15, 2019

Media advisory: To contact corresponding author Victor W. Zhong, Ph.D., email Marla Paul at marla-paul@northwestern.edu. The full study and editorial are linked to this news release.

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Bottom Line: Eggs are a source of dietary cholesterol. This observational study pooled data from six study groups for more than 29,000 people to determine the associations of consuming dietary cholesterol or eating eggs with risk of cardiovascular disease (CVD) and death.

Authors: Victor W. Zhong, Ph.D., Northwestern University Feinberg School of Medicine, Chicago, and coauthors.

(doi:10.1001/jama.2019.1572)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

What Is Association Between Singing in Choir, Voice Disorders Among Children?

Posted March 12, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MARCH 14, 2019

Media advisory: To contact corresponding author Pedro Claros, M.D., Ph.D., email clinica@clinicaclaros.com. The full study and commentary are linked to this news release.

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Bottom Line: This study looked at whether singing in a children’s choir was associated with developing voice disorders. Nearly 1,500 children from Spain (ages 8 to 14) were included, 752 children who sang in choirs and 743 who didn’t. Children were examined for vocal cord problems; their parents, choir directors and teachers of the children who didn’t sing were surveyed. Nearly 24 percent of children had a voice disorder and voice disorders were less common among children who sang in choirs, possibly because of good voice care. Limitations of the study included whether results were influenced by children who didn’t understand researchers’ instructions or the clarity of survey responses from adults.

Authors: Pedro Claros, M.D., Ph.D., Claros Otorhinolaryngology Clinic, Barcelona, Spain, and coauthors

(doi:10.1001/jamaoto.2019.0066)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Cardiovascular Disease in China

Posted March 11, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 13, 2019

Media advisory: To contact corresponding author Maigeng Zhou, Ph.D., email maigengzhou@126.com. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/2727339?guestAccessKey=01848ee4-a949-44d3-9a40-a2c875530501&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031319

Bottom Line: This study analyzed data from the Global Burden of Disease Study to look at the rate of cardiovascular disease (CVD) in China along with death and disability from CVD from 1990 to 2016. The proportion of people in the population with CVD increased 14.7 percent during that time from 5,265 per 100,000 to 6,037 per 100,000 with nearly 94 million cases in 2016. The overall death rate from CVD dropped nearly 29 percent from 431 per 100,000 to 308 per 100,000. There was a decrease in the burden of CVD, as measured by years lost to illness, disability, or premature death. A limitation of the study was its inability to capture the most recent changes in health status because of time lags in health information reported by national authorities. Geographically targeted strategies for CVD control and prevention are needed and these results may help tailor health priorities and programs to the needs of China and its provinces.

Authors: Maigeng Zhou, Ph.D., Chinese Center for Disease Control and Prevention, Beijing, and coauthors.

(doi:10.1001/jamacardio.2019.0295)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Opioid Prescribing Across United States

Posted March 12, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 15, 2019

Media advisory: To contact corresponding study author Lyna Z. Schieber, M.D., D.Phil. (Oxon), email media@cdc.gov. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0665?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=031519

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: National and state trends for opioid prescriptions filled at U.S. retail pharmacies are estimated from 2006 through 2017 in this analysis of data from outpatient prescribing records. Each year an average of nearly 234 million opioid prescriptions were filled. Several key measures of opioid prescribing varied among states. Two-to-three-fold variation was found among states for five of six key prescribing metrics studied. Two-to-three-fold variation was found among states for five of six key prescribing metrics studied. Researchers suggest their findings may help states as they create laws, policies, communications and interventions tailored to their specific opioid-related problems.

Authors: Lyna Z. Schieber, M.D., D.Phil. (Oxon), Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

(doi: 10.1001/jamanetworkopen.2019.0665)

Editor’s Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Outcomes of Intervention to Improve Communication Between Clinicians, Patient With Advanced Cancer

Posted March 12, 2019 by Deanna Bellandi

JAMA Internal Medicine & JAMA Oncology

EMBARGOED FOR RELEASE: 1:30 P.M. (ET), THURSDAY, MARCH 14, 2019

Media advisory: To contact corresponding authors Joanna Paladino, M.D., and Rachelle Bernacki, M.D., M.DS., email Deborah O’Neil at doneil@ariadnelabs.org. The full studies and editorial are linked to this news release.

Want to embed a link to this study in your story? These full-text links will be live at the embargo time.

Bernacki et al study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2728430?guestAccessKey=191157d2-e0f1-4e7d-aa83-3abe55c0d8fc&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031419

Paladino et al study: https://jamanetwork.com/journals/jamaoncology/fullarticle/2728562?guestAccessKey=45dc82a4-1b80-4dff-b4f1-0c143b15139d&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031419

Bottom Line: These studies report on the outcomes of a clinical trial that evaluated a quality-improvement intervention for communication between oncology clinicians and patients with advanced cancer. The studies are being published to coincide with presentation at a meeting. The clinical trial was conducted at the Dana-Farber Cancer Institute, Boston, and included 91 clinicians and 278 patients with advanced cancer.

Authors: Rachelle Bernacki, M.D., M.S., and Joanna Paladino, M.D., of Ariadne Labs, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, Boston, and coauthors

(doi:10.1001/jamaoncol.2019.0292) and (doi:10.1001/jamainternmed.2019.0077)

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Light Physical Activity Associated With Reduced Risk of Heart Disease in Older Women

Posted March 12, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 15, 2019

Media advisory: To contact corresponding study author Andrea Z. LaCroix, Ph.D., M.P.H., email Michelle Brubaker at mmbrubaker@ucsd.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0419?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=031519

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: An observational study of nearly 5,900 older women (ages 50 to 79) that used data from accelerometers to measure light physical activity suggests all movement during the day may have a role in reducing risk for coronary heart disease (CHD) and cardiovascular disease (CVD). A greater reduced risk was associated with the highest level of light physical activity (more than 5.6 hours per day) compared with the lowest level of light physical activity (less than 3.9 hours per day). These reduced risks were maintained after accounting for physical functioning and other measures of women’s health status. Among the women, 143 new cases of CHD (including heart attack and coronary death) and 570 new cases of CVD (including CHD, revascularization, carotid artery disease, hospitalized angina, congestive heart failure, stroke or death from other cardiovascular disease) occurred during an average follow-up of 3.5 years. Longer studies that include men are needed to increase the strength of the evidence around light physical activity to prevent CVD. The authors suggest these findings support the 2018 Physical Activity Guidelines for Americans about replacing sedentary behavior with light physical activity.

Authors: Andrea Z. LaCroix, Ph.D., M.P.H., University of California, San Diego, and coauthors

(doi: 10.1001/jamanetworkopen.2019.0419)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Study Examines Use of Video-Assisted Surgery for Known, Suspected Lung Cancer in VA

Posted March 11, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 13, 2019

Media advisory: To contact corresponding author Eric L. Grogan, M.D., M.P.H., email Craig Boerner at craig.boerner@vumc.org. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/2727989?guestAccessKey=5d4f6ec1-e386-4cee-84e2-b0afc52cfdbf&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031319

Bottom Line: A video-assisted thoracoscopic lung resection is a minimally invasive surgical procedure to remove part of a lung in patients with known or suspected lung cancer. This study used Veterans Affairs data for about 11,000 veterans who had lung resections from 2002 to 2015 to examine adoption of the procedure. There were 7,095 open lung resections and 3,909 video-assisted thorascopic resections. The proportion of video-assisted thorascopic lung resections increased from 15.6 percent in 2002 to 50.6 percent in 2015 across the entire Veterans Health Administration system but varied by VA region. A limitation of the study is its reliance on data not originally collected for research purposes.

Authors: Eric L. Grogan, M.D., M.P.H., Vanderbilt University Medical Center, Nashville, Tennessee, and coauthors

(doi:10.1001/jamasurg.2019.0035)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Visual Abstract

Posted March 7, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 8, 2019

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0393?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=030819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Visual Abstract:

(doi: 10.1001/jamanetworkopen.2019.0393)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Follow-Up of Children for Asthma After Vitamin D Supplementation in Moms During Pregnancy

Posted March 7, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MARCH 12, 2019

Media advisory: To contact corresponding author Hans Bisgaard, M.D., D.M.Sc., email bisgaard@copsac.com. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2727449?guestAccessKey=cd9d9b16-30f5-4aca-a8ca-8aa841bff65b&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031219

Bottom Line: This research letter reports on the follow-up of children for asthma whose mothers participated in a randomized clinical trial where they received high-dose vitamin D (2,400 IU/day) during the 24th week of pregnancy or placebo plus the recommended dose of 400 IU/day of vitamin D. Some evidence has suggested low vitamin D levels in utero may be associated with the risk of asthma in children. High-dose compared with standard-dose vitamin D supplementation during pregnancy wasn’t associated with a child’s risk of asthma by age 6. There were 545 of 581 children available for the analysis at age 6. The study had reduced statistical power because the target sample size wasn’t reached. Future studies should look at whether the effect of prenatal vitamin D supplementation is affected by environmental, dietary or genetic factors.

Authors: Hans Bisgaard, M.D., D.M.Sc., Herlev and Gentofte University Hospital, Copenhagen, Denmark, and coauthors.

(doi:10.1001/jama.2019.1432)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Was Diet Quality in Midlife Associated With Later Risk for Dementia?

Posted March 7, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MARCH 12, 2019

Media advisory: To contact corresponding author Tasnime N. Akbaraly, Ph.D., email tasnime.akbaraly@inserm.fr. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2727449?guestAccessKey=1abbcb7e-2eec-43b3-a335-bc80158b0a4a&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031219

Bottom Line: The quality of diet for adults in midlife (average age 50) wasn’t associated with later risk of dementia in a study that included adults followed for more than two decades. Other observational studies have suggested diet may be linked to cognitive health but those studies often had short follow-up periods that could not cover the long preclinical period before dementia diagnosis. In this study, about 8,200 adults were without dementia in 1991-1993 and 344 cases of dementia were recorded during nearly 25 years of follow-up. During that time, the adults completed diet questionnaires to assess the quality of their diets, with a higher consumption of vegetables, fruits, whole grains, nuts and legumes, omega-3 fatty acids and most polyunsaturated fatty acids indicating a healthier diet. Researchers report that repeated assessments of diet quality during midlife didn’t show any significant association with subsequent risk for dementia. The study relied on self-reported food frequency questionnaires.

Authors: Tasnime N. Akbaraly, Ph.D., Université de Montpellier, Inserm, Montpellier, France, and coauthors.

(doi:10.1001/jama.2019.1432)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Disparities in Access to Trauma Centers

Posted March 5, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 8, 2019

Media advisory: To contact corresponding study author Elizabeth L. Tung, M.D., M.S., email Ashley Heher at Ashley.Heher@uchospitals.edu. The full study and invited commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0138?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=030819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: An analysis of census tract data for neighborhoods in America’s three largest cities suggests black-majority neighborhoods are associated with disparities in access to trauma centers. The study paired census tract data for New York City, Los Angeles and Chicago with coordinates for trauma centers within a five-mile buffer. Black-majority neighborhoods were more likely than white-majority neighborhoods to be located in so-called trauma deserts in Chicago and Los Angeles, although racial/ethnic disparities were only significant in New York after accounting for poverty and its interaction with race. This suggests that New York’s extensive trauma network may limit racial/ethnic disparities by ensuring access to low-income neighborhoods. New York is more densely populated than Los Angeles and Chicago. Hispanic/Latino neighborhoods were less likely to be in trauma deserts in New York and Los Angeles but slightly more likely in Chicago. A limitation of the study is that it only shows associations and causal inferences can’t be drawn. This study suggests trauma planning should address racial equity.

Authors: Elizabeth L. Tung, M.D., M.S., University of Chicago, Chicago, Illinois, and coauthors

(doi: 10.1001/jamanetworkopen.2019.0138)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Is Dry Eye Disease Associated With Migraine Headaches?

Posted March 5, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MARCH 7, 2019

Media advisory: To contact corresponding author Richard M. Davis, M.D., email Tom Hughes at tom.hughes@unchealth.unc.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2726703?guestAccessKey=e4206440-4b2d-4d42-a655-6afde03e06d4&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=030719

Bottom Line: Dry eye disease is when tears can’t adequately lubricate the eyes and patients may feel a stinging, burning or scratchy sensation. This study looked at whether there is association between dry eye disease and migraine headaches.

Author: Richard M. Davis, M.D., University of North Carolina, Chapel Hill, and coauthors

(doi:10.1001/jamaophthalmol.2019.0170)

Editor’s Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Is It Ever Too Late for Adults to Benefit from Physical Activity?

Posted March 5, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 8, 2019

Media advisory: To contact corresponding author Pedro F. Saint-Maurice, Ph.D., email the National Cancer Institute at ncipressofficers@mail.nih.gov. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0355?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=030819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: It may never be too late for adults to become physically active and enjoy some health benefits. This observational study looked at how patterns of leisure-time physical activity from adolescence (15 to 18) to later adulthood (40-61) were associated with risk of dying using data for 315,000 U.S. adults. The results suggest maintaining physical activity from adolescence into later adulthood was associated with lower risk of dying and so was increasing leisure-time physical activity in adulthood, including from age 41 to 60, for adults who had been less active. The study relied on self-reported hours per week of leisure-time physical activity, including historical questions about activity as a young person.

Authors: Pedro F. Saint-Maurice, Ph.D., National Cancer Institute, Bethesda, Maryland, and coauthors

(doi: 10.1001/jamanetworkopen.2019.0355)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

How Common is Persistent Opioid Use After Plastic, Reconstructive Surgery?

Posted March 5, 2019 by Jim Michalski

JAMA Facial Plastic Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MARCH 7, 2019

Media advisory: To contact corresponding author Sam P. Most, M.D., email Mandy Erickson at merickso@stanford.edu. The full study and podcast are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/2727142?guestAccessKey=516f577c-e682-4aee-b2d4-060fc38a5681&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=030719

Bottom Line: This study examined how common persistent opioid use was after plastic and reconstructive surgery procedures of the nose, eye, breast, abdomen and soft tissue. The study included about 467,000 patients, of whom about half filled prescriptions for postoperative pain relievers and nearly all those prescriptions filled were for opioids. Persistent opioid use (prescription filled 90 to 180 days after surgery) occurred in 30,865 (6.6 percent) patients and prolonged opioid use (opioid prescription filled 90-180 days after surgery and then again 181 to 365 days after surgery) occurred in 10,487 (2.3 percent) patients. Patients who filled prescriptions for opioids shortly before or after surgery were more likely to have persistent and prolonged use. A limitation of the study is that opioid prescription fills were used as a proxy for opioid consumption, which doesn’t account for patients who may fill but not use a postoperative opioid prescription or patients who may have obtained opioids by other means such as from friends, family or other nonmedical sources.

Author: Sam P. Most, M.D., Stanford Hospital and Clinics, Stanford, California, and coauthors

(doi:10.1001/jamafacial.2018.2035)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Is Infant Temperament Associated With Future Risk of Childhood Obesity?

Posted March 7, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MARCH 11, 2019

Media advisory: To contact corresponding authors Myles S. Faith, Ph.D., and Erica P. Gunderson, Ph.D., M.S., M.P.H., email Janet Byron at Janet.L.Byron@kp.org. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2726997?guestAccessKey=08e53fd7-2bff-4c9d-9672-82a256bdaf58&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031119

Bottom Line: This observational study looked at whether the temperament of infants born to mothers with gestational diabetes was associated with future risk of childhood obesity at ages 2 to 5 years. Children whose mothers develop diabetes during pregnancy are more likely to become obese but how infant temperament might influence the development of obesity in this population isn’t clear. In healthy populations, the evidence for the influence of infant temperament on child weight status has been mixed. Participants in this study included 382 mother-infant pairs who filled out a survey to assess infant temperament at ages 2 to 6 months. Findings suggest elevated soothability (children who are easily soothed have elevated soothability) was associated with increased likelihood of early childhood obesity. Infant temperaments of elevated soothability and activity also were associated with the early introduction of fruit juice and sugar-sweetened beverages before the age of 6 months and shorter breastfeeding duration. Explanations for why elevated soothability might contribute to obesity risk still need to be identified.

Authors: Myles S. Faith, Ph.D., of University at Buffalo, State University of New York, Buffalo, New York, and Erica P. Gunderson, Ph.D., M.S., M.P.H., R.D., of Kaiser Permanente Northern California Division of Research, Oakland, California, and coauthors

(doi:10.1001/jamapediatrics.2018.5199)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Do Weight-Loss Surgery Outcomes Differ Between Black and White Patients?

Posted March 4, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 6, 2019

Media advisory: To contact corresponding author Jonathan F. Finks, M.D., email Shantell Kirkendoll at SMkirk@umich.edu. The full study and commentary are linked to this news release.

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Bottom Line: Researchers examined the association of race on outcomes of weight-loss surgery for black and white patients in Michigan by analyzing data from a statewide clinical registry.

Authors: Jonathan F. Finks, M.D., University of Michigan Health Systems, Ann Arbor, and coauthors

(doi:10.1001/jamasurg.2019.0029)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Estimates of Older Patients With Fractures Associated with Walking Leashed Dogs

Posted March 4, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MARCH 6, 2019

Media advisory: To contact corresponding author Jaimo Ahn, M.D., Ph.D., email Frank Otto at francis.otto@uphs.upenn.edu. The full study is linked to this news release.

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Bottom Line: Dog walking is often suggested as something older adults can do to improve their health. But older adults are at increased risk of fractures. This observational study estimated the number of patients (65 or older) nationwide with fractures associated with walking leashed dogs. Researchers used an injury surveillance database for patients at about 100 U.S. emergency departments to make their annual nationwide estimates. The number of patients 65 years or older with fractures associated with walking leashed dogs increased from 1,671 in 2004 to 4,396 in 2017. Most fractures occurred in women and most patients had hip fractures, although the upper extremity from the shoulder to fingers was the most frequently fractured area overall. These findings likely underestimate the injuries associated with older Americans walking leashed dogs.

Authors: Jaimo Ahn, M.D., Ph.D., University of Pennsylvania, Philadelphia, and coauthors

(doi:10.1001/jamasurg.2019.0061)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract

Posted February 27, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MARCH 1, 2019

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Visual Abstract:

(doi:10.1001/jamanetworkopen.2019.0168)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Can Changes in Physical Activity, Sedentary Behavior in People With Type 2 Diabetes Last?

Posted February 28, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MARCH 5, 2019

Media advisory: To contact corresponding author Giuseppe Pugliese, M.D., Ph.D., email giuseppe.pugliese@uniroma1.it. The full study is linked to this news release.

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Bottom Line: The American Diabetes Association recommends people with type 2 diabetes regularly do physical activity that is moderate to vigorous in intensity and reduce their time being sedentary. This was a randomized clinical trial of 300 physically inactive and sedentary patients with type 2 diabetes at three outpatient diabetes clinics in Rome, Italy. Researchers examined whether a behavioral intervention that included counseling sessions with diabetes and exercise specialists was more effective than standard care with general physician recommendations in producing a sustained increase in physical activity and reducing sedentary behavior.

Authors: Giuseppe Pugliese, M.D., Ph.D., “La Sapienza” University, Rome, and coauthors

(doi:10.1001/jama.2019.0922)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Clinical Trial Examines Nutritional Strategies to Prevent Major Depressive Disorder Among Overweight, Obese Adults

Posted February 28, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MARCH 5, 2019

Media advisory: To contact corresponding author Marjolein Visser, Ph.D., email m.visser@vu.nl. The full study, related article and editorial area linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2726983?guestAccessKey=f2dcc0d4-c707-4bcf-b347-86a4d7ebf968&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=030519

Bottom Line: A randomized clinical trial examined the effects of two nutritional strategies (multinutrient supplementation and food-related behavioral activation therapy) and their combination on preventing new episodes of major depressive disorder in overweight and obese adults over one year. About 1,000 overweight and obese adults with elevated depressive symptoms from four European countries were included.

Authors: Marjolein Visser, Ph.D., Vrije Universiteit Amsterdam, and coauthors

(doi:10.1001/jama.2019.0556)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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How Common Are Mental Health Disorders After Diagnosis of Head and Neck Cancer?

Posted February 26, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 28, 2019

Media advisory: To contact corresponding author Neerav Goyal, M.D., M.P.H., email Joslyn Neiderer at jms1140@psu.edu. The full study is linked to this news release.

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Bottom Line: Treatment for head and neck cancer (HNC) might cure the disease but it also can result in adverse effects such as disfigurement and speech difficulties, which can affect quality of life for patients. Using information from a large insurance claims database, this study examined how common mental health disorders were in patients with HNC and how they were associated with diagnosis and treatment. The study included nearly 53,000 patients with HNC and researchers report the proportion of mental health disorders was 29.9 percent, an increase from 20.6 percent before the cancer diagnosis. Women and patients with a history of tobacco use and alcohol use were more likely to develop mental health disorders. The study may have underestimated how common mental health disorders were among the patients. Researchers suggest patients with HNC be monitored for mental health disorders.

Authors: Neerav Goyal, M.D., M.P.H., Pennsylvania State University, Hershey, and coauthors

(doi:10.1001/jamaoto.2018.4512)

Editor’s Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Family Opioid Use and Risk of Opioid Use Among Teens, Young Adults Following Surgical, Dental Procedures

Posted February 25, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 27, 2019

Media advisory: To contact corresponding author Jennifer F. Waljee, M.D., email Beata Mostafavi at bmostafa@umich.edu. The full study and commentary are linked to this news release.

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Bottom Line: This study looked at whether long-term opioid use by one or more family members was associated with long-term opioid use by adolescents and young adults prescribed opioids for the first time after common surgical or dental procedures. This observational study used data from a commercial insurance database for about 346,000 patients (ages 13 to 21) who underwent procedures including tooth extraction, appendectomy, hernia repair, and arthroscopic knee and shoulder surgery, and who were dependents on a family insurance plan. Among those patients, about 257,000 (74 percent) had their first opioid prescription filled. Of those patients with an initial opioid prescription filled, about 11,000 (4.3 percent) had a family member with long-term opioid use. Persistent opioid use (defined as one or more opioid prescription filled between 91 and 180 days after surgery among patients with an initial opioid prescription filled) occurred in 453 patients (4.1 percent) with a family member who was a long-term user of opioids compared with 5,940 patients (2.4 percent) without long-term opioid use by a family member. The findings suggest having a family member with long-term opioid use was associated with a higher likelihood of persistent opioid use by adolescents and young adults who are prescribed their first opioid. Physicians should screen young patients for long-term opioid use in their family. This study cannot explain the reasons for the association. And, the study included patients with private employer-based insurance so the findings may not be generalized to patients who are publicly insured or uninsured.

Authors: Jennifer F. Waljee, M.D., University of Michigan Medical School, Ann Arbor, and coauthors

(doi:10.1001/jamasurg.2018.5838)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

What Was Effect of Offering Breakfast in the Classroom on Obesity?

Posted February 21, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 25, 2019

Media advisory: To contact author Katherine W. Bauer, Ph.D., email kwbauer@umich.edu. The full study and editorial are linked to this news release.

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Bottom Line: Offering breakfast in the classroom at some Philadelphia public schools did not affect the proportion of students developing overweight and obesity, when examined as a combined measure, after 2 ½ years. However, offering breakfast in the classroom did increase the proportion of students with obesity, although precise reasons for the increase are unknown. This study reports on a randomized clinical trial among more than 1,300 students starting in the fourth through sixth grades at 16 public schools in Philadelphia. Half of the schools offered students a breakfast in the classroom initiative that included providing breakfast during the first period of the day with complimentary breakfast-specific nutrition education. The other half of schools continued offering students breakfast in the cafeteria before school, plus standard nutrition education. Researchers acknowledge the effect of the initiative could be unique to older elementary and middle school students, who may have more freedom to buy food outside school in the morning. More research is needed to understand whether offering breakfast in the classroom would have a similar effect on obesity among other populations of students, and whether alternative models of offering the School Breakfast Program could increase program participation without an unintended consequence of increasing children’s weight status.

Authors: Katherine W. Bauer, Ph.D., of the University of Michigan School of Public Health, Ann Arbor, and coauthors

(doi:10.1001/jamapediatrics.2018.5531)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

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Is Prenatal Vitamin Use by Moms Associated With Risk for Autism Spectrum Disorder Recurrence in Young Siblings

Posted February 25, 2019 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 27, 2019

Media advisory: To contact corresponding author Rebecca J. Schmidt, Ph.D., email Nadine A Yehya at nyehya@ucdavis.edu. The full study is linked to this news release.

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Bottom Line: This study examined whether prenatal vitamin use by mothers was associated with autism spectrum disorder (ASD) recurrence in high-risk families. The study included 241 children who were selected because a sibling was diagnosed with ASD. Mothers reported their use of prenatal vitamins during pregnancy. While most mothers reported taking prenatal vitamins while pregnant, only 87 (36 percent) mothers met the recommendations to take prenatal vitamins in the six months before pregnancy. Researchers report that children whose mothers had taken prenatal vitamins during the first month of pregnancy appeared less likely to be diagnosed with ASD when compared with children whose mothers hadn’t taken prenatal vitamins during that time. The proportion of children with ASD among mothers who took prenatal vitamins in the first month of pregnancy was 14.1 percent (18 children) compared with 32.7 percent (37 children) among those whose mothers didn’t take prenatal vitamins during that time. One limitation is that this study was observational, which means there may have been differences between the two groups that weren’t accounted for during the analysis, even though the investigators accounted for many factors. Another limitation is the study’s relatively small sample size. This study is important because there have been conflicting studies about whether maternal prenatal vitamin use is associated with a lower risk of ASD. More research is needed to confirm the associations observed in this study.

Authors: Rebecca J. Schmidt, Ph.D., of the University of California, Davis, and coauthors

(doi:10.1001/jamapsychiatry.2018.3901)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein in Children With Peanut Allergy

Posted February 20, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 22, 2019

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2019.1113

(10.1001/jama.2019.1113)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Radiation Contamination at a Crematorium

Posted February 21, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 26, 2019

Media advisory: To contact corresponding author Kevin L. Nelson, Ph.D., email Lynn Closway at Closway.Lynn@mayo.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2725673?guestAccessKey=d1c4b9d2-5808-487c-a3ca-a6dd4d530da9&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022619

Bottom Line: Radioactive compounds known as radiopharmaceuticals are used in nuclear medicine procedures to diagnose and treat disease. This research letter reports on radiation contamination at an Arizona crematorium where a man with a pancreatic tumor was cremated after treatment with an intravenous radioactive drug. A later examination of the crematorium found evidence of radiation contamination on equipment, including the oven, vacuum filter and bone crusher. A trace amount of a different type of radioactive compound not used in the man with the pancreatic tumor was also detected in the crematory operator’s urine, suggesting he may have been possibly exposed to that compound while cremating other human remains. Regulations for cremating patients treated with radiopharmaceuticals vary by state and internationally. More studies are needed to evaluate the extent of radiation contamination at crematoriums and the potential health effects of exposure for crematorium employees, especially with a cremation rate greater than 50 percent in the United States in 2017.

Authors: Nathan Y. Yu, M.D., Mayo Clinic, Phoenix, Arizona, and coauthors.

(doi:10.1001/jama.2018.21673)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Digital Breast Tomosynthesis vs Digital Mammography Screening Outcomes

Posted February 26, 2019 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 28, 2019

Media advisory: To contact corresponding author Emily F. Conant, M.D., email Greg Richter at gregory.richter@uphs.upenn.edu. The full study is linked to this news release.

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Bottom Line: This study compared data on 180,340 breast cancer screenings for about 96,000 women ages 40 to 74 who underwent screening with 3D digital breast tomosynthesis (DBT) and 2D digital mammography to see if the outcomes varied by patient age and breast density. The findings suggest DBT was associated with a better ability to correctly identify women without breast cancer and better detection of breast cancers across all age and breast density groups. DBT was associated with the detection of invasive cancers that were more likely to be smaller and more often node-negative, especially among women ages 40 to 49. Some limitations of this observational study to consider are that women weren’t randomly assigned to the type of screening and there may have been differences between study participants not accounted for during the analysis.

Authors: Emily F. Conant, M.D., of the University of Pennsylvania, and coauthors

(doi:10.1001/jamaoncol.2018.7078)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair

Posted February 19, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 22, 2019

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0111

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

(doi:10.1001/jamanetworkopen.2019.0111)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Geographic Distribution of Opioid-Related Deaths

Posted February 19, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 22, 2019

Media advisory: To contact corresponding study author Mathew V. Kiang, Sc.D., email Beth Duff-Brown at bethduff@stanford.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0040

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Identifying changes in the geographic distribution of opioid-related deaths is important, and this study analyzed data for more than 351,000 U.S. residents who died of opioid-related causes from 1999 to 2016. Researchers report increased rates of opioid-related deaths in the eastern United States, especially from synthetic opioids. In 2016, there were 42,249 opioid-related deaths (28,498 men and 13,751 women) in the United States for an opioid-related mortality rate of 13 per 100,000 people. Eight states (Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire and Ohio) had opioid-related mortality rates that were at least doubling every three years, and two states (Florida and Pennsylvania) and the District of Columbia had opioid-related mortality rates that were at least doubling every two years. A limitation of the study is the potential for misclassification of deaths, which could result in an underreporting of opioid-related deaths. The study findings suggest policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids.

Authors: Mathew V. Kiang, Sc.D., Stanford University School of Medicine, Palo Alto, California, and coauthors

(doi:10.1001/jamanetworkopen.2019.0040)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Could Whole Grains, Dietary Fiber Be Associated With Lower Risk of Liver Cancer?

Posted February 19, 2019 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 21, 2019

Media advisory: To contact corresponding author Xuehong Zhang, M.D., Sc.D., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study is linked to this news release.

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Bottom Line: This study used data for participants followed-up for 24 years as part of two well-known study groups to examine the association between whole grain and dietary fiber intake with the risk of hepatocellular carcinoma, a predominant form of liver cancer.

Authors: Xuehong Zhang, M.D., Sc.D., of Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, and coauthors

(doi:10.1001/jamaoncol.2018.7159)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Effect of a Nurse-Led Preventive Psychological Intervention on Post-ICU PTSD Symptoms

Posted February 14, 2019 by Jim Michalski

Comparing Financial Burdens of Head and Neck Cancer with Other Cancers

Posted February 19, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 21, 2019

Media advisory: To contact corresponding author Sean T. Massa, M.D., email Diane Duke Williams at williamsdia@wustl.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2725438?guestAccessKey=f7118a3f-8e5a-473c-b9b5-05e569e4df63&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022119

Bottom Line: Head and neck cancer is expensive to treat and the disease can create long-term health needs. Using national survey data over nearly two decades, this study assessed the financial burdens of head and neck cancers compared with other cancers among nearly 17,000 patients with cancer, of whom 489 reported head and neck cancer.

Authors: Sean T. Massa, M.D., Washington University in St. Louis, and coauthors

(doi:10.1001/jamaoto.2018.3982)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Effect of an Esophageal Pressure–Guided PEEP Titration Strategy vs an Empirical High PEEP-Fio2 Strategy in ARDS

Posted February 14, 2019 by Jim Michalski

Visual Abstract: Effect on Septic Shock Mortality of Resuscitation Targeting Peripheral Perfusion vs Serum Lactate Levels

Posted February 14, 2019 by Jim Michalski

Summary Video: Does IV Acetaminophen Reduce the Risk of Postoperative Delirium in Older Patients Undergoing Cardiac Surgery?

Posted February 14, 2019 by Jim Michalski

A summary video is available for the study, “Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery,” by Balachundhar Subramaniam, M.D., M.P.H., of Beth Israel Deaconess Medical Center, Boston, and coauthors. The video can be viewed on this page and embedded on your website by copying and pasting the HTML code below. To download the video, email mediarelations@jamanetwork.org for information.

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5995583802001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Do Improvements in Sexual Functioning After Weight-Loss Surgery Last?

Posted February 18, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 20, 2019

Media advisory: To contact corresponding author Kristine Steffen, Pharm.D., Ph.D., email Carol Renner at carol.renner@ndsu.edu. The full study, commentary and podcast are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/2724862?guestAccessKey=a305b0ac-2da1-4809-a46a-1197d63ac14d&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022019

Bottom Line: Short-term improvements in sexual functioning have been reported after weight-loss surgery but not much is known about whether these improvements last. This study included about 2,000 adults undergoing bariatric surgery who completed questionnaires about sexual functioning before and after surgery over five years of follow-up. Among those adults who reported some level of dissatisfaction with their sex life before surgery, researchers report about half of women and men experienced improvements in five years of follow-up. Fewer depressive symptoms before surgery and a decrease in depressive symptoms after surgery were associated with a better chance of improvement in sexual satisfaction for men and women, as well as in some other measures of sexual functioning. The study lacked a nonsurgical control group for comparison.

Authors: Kristine Steffen, Pharm.D., Ph.D., North Dakota State University, Fargo, and coauthors

(doi:10.1001/jamasurg.2018.1162)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Has Screen Time Increased for Young Children and on What Screen?

Posted February 14, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 18, 2019

Media advisory: To contact authors Weiwei Chen, Ph.D., or Jessica L. Adler, Ph.D., email Madeline Baró at mbaro@fiu.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2725040?guestAccessKey=b9e14c2f-7ee8-499a-8a3a-02502d420717&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21819

Bottom Line: Children younger than 6 spend most of their screen time watching TV. That’s the finding of a new study that assessed screen time in young children in 1997 and in 2014, before and after mobile devices were widely available. The study used time diary data from a representative group of American children younger than 6 who completed the time diary (1,327 children in 1997 and 443 children in 2014). In 1997, daily screen time averaged 1.3 hours for children up to age 2 and almost 2.5 hours for children 3 to 5, with the highest amount of screen time per day spent watching TV. By 2014, total screen time among children up to age 2 increased to about 3 hours per day and most of that time was spent watching TV; children 3 to 5 didn’t have a significant change in total screen time in 2014 but most of it was spent watching TV. Authors suggest future research look at the association between screen time and parenting style and sibling and peer influence.

Authors: Weiwei Chen, Ph.D., and Jessica L. Adler, Ph.D., of Florida International University, Miami, Florida

(doi:10.1001/jamapediatrics.2018.5546)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Primary Care Physician Supply and Life Expectancy

Posted February 14, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 18, 2019

Media advisory: To contact study corresponding study author Sanjay Basu, M.D., Ph.D., email Erin Digitale at digitale@stanford.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2724393?guestAccessKey=1af666c9-8ff4-4da1-bf84-98ddb3997000&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21819

Bottom Line: This study used U.S. population data to identify changes in the supply of primary care physicians across counties from 2005 to 2015 and the association with life expectancy and other outcomes. A greater supply of primary care physicians was associated with better life expectancy but the per capita supply of primary care physicians across counties decreased, mostly because of disproportionate losses in some counties and population increases in general. More specifically, the total number of primary care physicians in the United States increased (196,014 in 2005 to 204,419 in 2015) but distribution across counties changed with the average supply of primary care physicians decreasing from about 46 to 41 per 100,000 population, with greater declines in rural areas. However, every 10 additional primary care physicians per 100,000 population was associated with a 51-day increase in life expectancy, after accounting for health care, demographic, socioeconomic and behavioral factors. The authors suggest the decrease in primary care physician supply across counties could have important health implications, although conclusions about individual-level effects shouldn’t be drawn from population-level associations.

Authors: Sanjay Basu, M.D., Ph.D., Stanford University, California, and coauthors

(doi:10.1001/jamainternmed.2018.7624)

Editor’s Note: The article contains conflict of interest and funding support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations@jamanetwork.org.

Is Guideline-Recommended Therapy for Coronary Artery Disease More Likely in Medicare Advantage?

Posted February 18, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 20, 2019

Media advisory: To contact corresponding author Jose F. Figueroa, M.D., M.P.H., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/2724986?guestAccessKey=d4cd5655-6c85-4777-991b-e2683f75b108&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022019

Bottom Line: Medicare Advantage is Medicare’s managed-care alternative to traditional fee-for-service Medicare. Private insurance plans in Medicare Advantage have financial incentives to follow evidence-based guidelines but whether this results in better care for a long-term condition such as coronary artery disease isn’t clear. This observational study included about 36,000 patients enrolled in Medicare Advantage and 173,000 enrolled in traditional fee-for-service Medicare who were diagnosed with coronary artery disease. Medicare Advantage beneficiaries were more likely to receive guideline-recommended therapy for coronary artery disease than those in traditional Medicare but there were no significant differences in blood pressure and cholesterol control. The study is limited by several factors, including an inability to know how long patients were on prescribed therapies, which can affect outcomes.

Authors: Jose F. Figueroa, M.D., M.P.H., Harvard Medical School, Brigham and Women’s Hospital, Boston, and coauthors.

(doi:10.1001/jamacardio.2019.0007)

Editor’s Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Study Suggests Lazy Eye Associated With Children’s Sense of Self-Perception

Posted February 12, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 14, 2019

Media advisory: To contact corresponding author Eileen E. Birch. Ph.D., email ebirch@retinafoundation.org. The full study and an author interview are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2723995?guestAccessKey=52b3fd36-65cc-4921-a778-86e9590a7dc4&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21419

Bottom Line: This observational study looked at whether the condition known as “lazy eye” (amblyopia) was associated with an altered sense of self-perception in children (ages 3 to 7) and whether any differences in self-perception were associated with deficiencies in vision and fine motor skills like coordination. Researchers report that among 60 children with lazy eye, the condition was associated with lower measures of self-perception for peer acceptance and physical competence compared with 20 healthy children. The findings cannot be generalized to children with different types of lazy eye and researchers couldn’t assess the association of glasses with children’s self-perception because most children with lazy eye wore glasses.

Author: Eileen E. Birch. Ph.D., Retina Foundation of the Southwest, Dallas, and coauthors

(doi:10.1001/jamaophthalmol.2018.7075)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

How Common, Preventable Are Sepsis-Associated Deaths in Hospitals?

Posted February 12, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 15, 2019

Media advisory: To contact corresponding study author Chanu Rhee, M.D., M.P.H.,., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study and an invited commentary is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.7571

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: This study estimates how common sepsis-related deaths are in hospitals and how preventable those deaths might be. In a retrospective study using medical record reviews of 568 patients who died in six U.S. hospitals or who were discharged to hospice in 2014 or 2015, sepsis was present in more than half (300) of the hospitalizations and directly caused death in more than one-third (198) of cases. Most sepsis-associated deaths occurred in medically complex patients with severe coexisting conditions and most deaths were considered unlikely to have been prevented through better hospital care. These findings suggest that further innovations in the prevention and care of underlying conditions may be necessary before major reduction in sepsis deaths can be achieved. The study was conducted in only six hospitals and may not generalize to all hospitals.

Authors: Chanu Rhee, M.D., M.P.H., Harvard Medical School, Boston, Massachusetts, and coauthors

(doi:10.1001/jamanetworkopen.2018.8341)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Paracetamol and Ibuprofen and Morphine Use After Total Hip Replacement

Posted February 8, 2019 by Jim Michalski

Push-Up Exercise Capacity and Cardiovascular Disease Events in Male Firefighters

Posted February 12, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 15, 2019

Media advisory: To contact corresponding study author Stefanos N. Kales, M.D., M.P.H., email Chris Sweeney at csweeney@hsph.harvard.edu. The full study is linked to this news release and a visual abstract is below.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.8341

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: A study of male Indiana firefighters suggests that push-up capacity may be associated with lower risk of cardiovascular disease (CVD) events, including coronary artery disease, heart failure or sudden cardiac death. In this observational study of more than 1,100 firefighters, incidence of CVD was reduced for each increase in 10 push-ups. However the association between push-up capacity and reduced CVD remained only for the 21-to-30 push-up category after accounting for age and body mass index (BMI) and wasn’t evident after accounting for maximal oxygen consumption, a physiologic measure of fitness. The findings suggest that low push-up capacity is a risk factor for CVD, but not independent of age, BMI, and oxygen consumption. Researchers caution the results may not generalize to others, including women and people who are inactive, because the study group consisted of middle-aged men who were active on the job. Larger studies with more diverse groups of people are needed to understand if push-up capacity can be used as an objective clinical tool to help assess patients and if it can provide useful information beyond standard assessments of age and BMI.

Authors: Stefanos N. Kales, M.D., M.P.H., Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and coauthors

Visual Abstract:

(doi:10.1001/jamanetworkopen.2018.8341)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Is Using Marijuana in Adolescence Associated With Increased Risk of Depression, Anxiety or Suicidal Behavior Later in Life?

Posted February 11, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 13, 2019

Media advisory: To contact corresponding author Gabriella Gobbi, M.D., Ph.D., email Julie Robert at julie.robert@muhc.mcgill.ca. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2723657?guestAccessKey=ca2d5287-277b-497a-a025-3826723adac1&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21319

Bottom Line: Marijuana is commonly used by teenagers but not much is known about how that use might impact mood and risk of suicide later in life. This study analyzed the combined the results of 11 studies with about 23,300 people and found marijuana use during adolescence before age 18 was associated with increased risk of depression and suicidal thoughts or attempts during young adulthood between the ages of 18 and 32. There was no similar association with anxiety. The findings highlight the importance of efforts aimed at educating teenagers about the risks of using marijuana.

Authors: Gabriella Gobbi, M.D., Ph.D., McGill University, Montreal, Canada, and coauthors

(doi:10.1001/jamapsychiatry.2018.4500)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Randomized Clinical Trial for Suicide Prevention Intervention in Military Personnel

Posted February 11, 2019 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 13, 2019

Media advisory: To contact corresponding author Amanda H. Kerbrat, M.S.W., email Leila Gray at leilag@uw.edu. The full study, editorials and podcast are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2723658?guestAccessKey=45f04731-0ab6-43ed-9da4-3f08f2885651&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21319

Bottom Line: A randomized clinical trial of about 650 U.S. Army soldiers and Marines showed inconsistent results for a suicide prevention intervention that supplemented standard care with caring text messages to reduce suicidal thoughts and behaviors. Two accompanying editorials discuss the inexpensive intervention and potential reasons that could help to explain the uncertain results in a military population.

Authors: Amanda H. Kerbrat, M.S.W., University of Washington, Seattle, and coauthors

(doi:10.1001/ jamapsychiatry.2018.4530 )

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Livers From Older Donors Decrease Despite Improved Outcomes for Recipients

Posted February 11, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 13, 2019

Media advisory: To contact corresponding author Dorry L. Segev, M.D., Ph.D., email Raigan Wheeler at rwheel13@jhmi.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2723658?guestAccessKey=45f04731-0ab6-43ed-9da4-3f08f2885651&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=21319

Bottom Line: More than 10 percent of patients waiting for a liver transplant die each year. This observational study looked at trends in the transplantation of livers from older donors (70 and older) and outcomes in recipients of these older livers from 2003 to 2016. There was a decrease in the use of liver grafts from older donors despite improvements in liver graft loss and death among recipients of these older liver grafts. The study included 4,127 liver grafts from older donors and 3,350 liver-only recipients of these older liver grafts, and 78,990 liver grafts from younger donors (18 to 69) and 64,907 liver-only recipients of these younger liver grafts. A limitation of the study was the inability to determine whether the improvement in outcomes was associated with improved post-transplant care or improved older donor candidate selection. The findings suggest it may be reasonable to expand the donor pool with broader use of liver grafts from older donors.

Authors: Dorry L. Segev, M.D., Ph.D., Johns Hopkins University School of Medicine, Baltimore, and coauthors

(doi:10.1001/jamasurg.2018.5568)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

How Common Are Mental Health Disorders, Treatment in Children?

Posted February 7, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 11, 2019

Media advisory: To contact corresponding author Daniel G. Whitney, Ph.D., email Kara Gavin at kegavin@med.umich.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724377?guestAccessKey=f689aa19-31f1-481d-878a-6bf83844536a

Bottom Line: An estimated 7.7 million children in the United States (16.5 percent) have at least one mental health disorder and about half didn’t receive treatment from a mental health professional. National survey data were used to estimate how common mental health disorders were in children at the national and state levels, along with how common mental health care use was in children. An estimated 46.6 million children were included for analysis and prevalence estimates varied widely by state. For example, the prevalence of children with at least one mental health disorder ranged from 7.6 percent in Hawaii to 27.2 percent in Maine and the prevalence of children with a mental health disorder not treated or counseled by a mental health professional ranged from 29.5 percent in Washington, D.C., to 72.2 percent in North Carolina. Policy efforts to improve treatment across the states are needed.

Authors: Daniel G. Whitney, Ph.D., and Mark D. Peterson, Ph.D., of the University of Michigan, Ann Arbor

(doi:10.1001/jamapediatrics.2018.5399)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Increase in Conservative Management of Low-Risk Prostate Cancer

Posted February 7, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 5 P.M. (ET), MONDAY, FEBRUARY 11, 2019

Media advisory: To contact corresponding author Brandon A. Mahal, M.D., email Victoria Warren at victoria_warren@dfci.harvard.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.19941

Bottom Line: National guidelines in 2010 began advocating conservative management of low-risk prostate cancer with active surveillance or watchful waiting (AS/WW) as an alternative to radiation to the treat the prostate or surgery to remove the entire prostate. This study examined trends in the management of localized prostate cancer among 165,000 men from 2010 to 2015 using data from a national database of cancer statistics. Use of AS/WW for men with low-risk localized prostate cancer increased from 14.5 percent in 2010 to 42 percent in 2015, becoming the most common management approach. Use of AS/WW increased among men with intermediate-risk disease and remained stable among those with high-risk disease. Surgery to remove the entire prostate declined among men with low-risk disease but increased among patients with higher-risk disease. A limitation of the study is the lack of data on AS/WW compliance.

Authors: Brandon A. Mahal, M.D., Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, and coauthors.

(doi:10.1001/jama.2018.19941)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Teacher Ratings on Childhood Inattention, Prosocial Behavior Associated With Adult Earnings

Posted February 7, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 11, 2019

Media advisory: To contact corresponding author Sylvana M. Côté, Ph.D., email sylvana.cote.1@umontreal.ca. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724382?guestAccessKey=6c5b881d-e164-40ef-9784-7419ff54d8ba

Bottom Line: In a study of 920 boys from low-socioeconomic neighborhoods in Montreal, Canada, teacher ratings of inattention in kindergarten at ages 5 and 6 were associated with lower earnings as adults 30 years later, while increased ratings on prosocial behavior (such as helping, sharing and cooperating) were associated with higher earnings after accounting for child IQ and family adversity. Average personal earnings in adulthood were about $29,000 and an increase in inattention ratings as a child was associated with a decrease in earnings of about $1,300 and better ratings on prosocial behavior were associated with increased earnings of about $400. Teacher ratings on behaviors of hyperactivity, opposition and aggression weren’t associated with earnings in this observational study, which used earning data from government tax records. A limitation of the study is that it cannot explain causal reasons behind the observed associations.

Author: Sylvana M. Côté, Ph.D., of the Université de Montreal, Canada, and coauthors

(doi:10.1001/jamapediatrics.2018.5375)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

4 Opioid-Related Articles: Prescribing Trends, Overdose Deaths, Disparities in Prescriptions

Posted February 7, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 11, 2019

Media advisory: The full studies and commentary are linked to this news release.

Bottom Line: JAMA Internal Medicine is publishing four opioid-related articles (an original investigation, invited commentary and two research letters) that report on racial/ethnic and income disparities in the prescription of opioids and other other controlled medications in California, racial differences in opioid overdose deaths in New York, and county-level opioid prescribing in the United States.

Want to embed links to these articles in your story? These full-text links will be live at the embargo time:

Original Investigation: Assessment of Racial/Ethnic and Income Disparities in the Prescription of Opioids and Other Controlled Medications in California https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723625?guestAccessKey=7fe163de-0ce6-4464-bf27-3c0dfafbc437

Invited Commentary: Opioid Prescribing Trends and the Physician’s Role in Responding to the Public Health Crisis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723622?guestAccessKey=eaeac693-8773-4ecc-8353-6327c9902121

Research Letter: County-Level Opioid Prescribing in the United States, 2015 and 2017 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723623?guestAccessKey=fbc1862d-97ca-4f52-9905-1edcf73387a2

Research Letter: Racial Differences in Opioid Overdose Deaths in New York City, 2017 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723624?guestAccessKey=f9becdd5-b7cb-4264-a766-1cba0a5753c9

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial and conflict of interest disclosures, funding and support, etc.

# # #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations@jamanetwork.org.

USPSTF Recommendation Statement on Interventions to Prevent Depression During Pregnancy, After Childbirth

Posted February 7, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 12, 2019

Media advisory: To contact the U.S. Preventive Services Task Force, email the Media Coordinator at Newsroom@USPSTF.net or call 202-572-2044. The full report and related articles are linked to this news release.

Want to embed a link to this report in your story? This full-text link will be live at the embargo time and all links to all USPSTF articles remain free indefinitely: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2019.0007

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends clinicians provide counseling interventions to pregnant and postpartum women at increased risk of depression or refer patients to those services.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is a new recommendation on interventions to prevent perinatal depression, which is the development of a depressive disorder during pregnancy or after childbirth. Depression is one of the most common complications during pregnancy and after childbirth, and it can have adverse effects on both women and children.

The USPSTF Concludes:

(doi:10.1001/jama.2019.0007)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Note: More information about the U.S. Preventive Services Task Force, its process, and its recommendations can be found on the newsroom page of its website.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Case Study Documents Bone Cancer in 240-Million-Year-Old Stem-Turtle

Posted February 5, 2019 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 7, 2019

Media advisory: To contact corresponding author Yara Haridy, M.S., email yara.haridy@mfn-berlin.de. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamaoncology/fullarticle/2723578?guestAccessKey=36a3caee-1474-4c66-88e0-e38dc4e8304d

Bottom Line: This research letter documents bone cancer in a 240-million-year-old stem-turtle from the Triassic period, helping to provide more data about the history of cancer in tetrapod evolution. This is a case study about a highly malignant bone tumor on the femur of a shell-less stem-turtle. The appearance of the tumor in the fossilized specimen conforms with present-day periosteal osteosarcoma in humans.

Authors: Yara Haridy, M.S., of the Museum für Naturkunde, Berlin, Germany, and coauthors

Featured Image: The image shows the bone cancer (osteosarcoma) on the femur of the fossil stem-turtle. The circled area shows the extent of the mass.

(doi:10.1001/jamaoncol.2018.6766)

Editor’s Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Is Chronic Rhinosinusitis Associated With Increased Risk of Depression, Anxiety?

Posted February 5, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 7, 2019

Media advisory: To contact corresponding author Dong-Kyu Kim, M.D., Ph.D., email doctordk@naver.com. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2724230?guestAccessKey=9200fd5c-1371-46df-91ef-12048a2cf8a5

Bottom Line: Chronic rhinosinusitis is a common condition marked by sinus inflammation that can make breathing difficult and cause face pain or tenderness. The condition affects quality of life but whether it contributes to depression and anxiety in patients is unclear. This study of about 49,000 people in a South Korean insurance database examined the risk of depression and anxiety in chronic rhinosinusitis and depending on the type of chronic rhinosinusitis (with or without nasal polyps). Researchers report chronic rhinosinusitis was associated with an increased risk of depression and anxiety during 11 years of follow-up and that having nasal polyps was associated with a higher risk of depression and anxiety than chronic rhinosinusitis without nasal polyps. A limitation of the study is that it didn’t include information on smoking and alcohol use by participants and those factors could have influenced outcomes.

Authors: Dong-Kyu Kim, M.D., Ph.D., Hallym University College of Medicine, Chuncheon, Republic of Korea, and coauthors

(doi:10.1001/jamaoto.2018.4103)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Optimism Associated With Less Likelihood of New Pain Reported By Soldiers After Deployment

Posted February 5, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 8, 2019

Media advisory: To contact corresponding study author Afton L. Hassett, Psy.D., email Kelly Malcom at kmalcom@med.umich.edu. The full study is linked to this news release and a visual abstract is below.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723643?guestAccessKey=e0f7b001-bb32-4770-9b51-ebe3e787f9e6

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Many veterans experience chronic pain after deployment. This study of almost 21,000 U.S. Army soldiers who deployed to Afghanistan or Iraq examined the association between feelings of optimism (such as expecting the best and believing good things will happen) before deployment and new reports of pain after deployment, including new back pain, joint pain and frequent headaches. Higher levels of optimism before deployment were linked with a lower likelihood of reporting new pain after deployment, even after accounting for demographic, military and combat factors. The findings suggest soldiers with low levels of optimism before deployment may benefit from programs designed to enhance feelings of optimism. There are limitations to interpreting the study results because researchers didn’t account for psychiatric disorders and assessments of pain were limited.

Authors: Afton L. Hassett, Psy.D., University of Michigan, Ann Arbor, Michigan, and coauthors

Visual Abstract:

(doi:10.1001/jamanetworkopen.2018.8076)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Study Examines Association Between Birth Weight, Risk of Developing Psychiatric Disorders in Adulthood

Posted February 4, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 6, 2019

Media advisory: To contact corresponding author Erik Pettersson, Ph.D., email erik.pettersson@ki.se. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2722846?guestAccessKey=6ca738e0-dc1a-4d8a-a853-7f93e29c27d5

Bottom Line: It is unclear if the associations between fetal growth as indicated by birth weight and later mental health conditions remain after taking into account family-related factors that could affect these conditions. This study included more than 500,000 pairs of siblings who were part of a register in Sweden since birth and were followed up to an average age of 27 years. After controlling for family-related factors that could influence the outcomes, lower birth weight (adjusted for gestational age) was associated with a small but significant increased risk for several psychiatric disorders, including attention-deficit/hyperactivity disorder, autism, obsessive-compulsive disorder and depression. A potential limitation of the study is that the registers only included individuals with more severe forms of these conditions.

Authors: Erik Pettersson, Ph.D., Karolinska lnstitutet, Stockholm, Sweden, and coauthors

(doi:10.1001/jamapsychiatry.2018.4342)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Association Between EMS Response Time and Motor Vehicle Crash Mortality

Posted February 4, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 6, 2019

Media advisory: To contact corresponding author James P. Byrne, Ph.D., M.D., email Laura Bristow at Laura.Bristow@sunnybrook.ca. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/2723267?guestAccessKey=b77f7f26-9bd6-4815-8540-d9448184de88

Bottom Line: Motor vehicle crashes are a leading cause of death and injury in the United States. Emergency medical service (EMS) response time is a factor with the potential to influence survival. This study examined EMS response times to motor vehicle crashes in nearly 2,300 U.S. counties from 2013 to 2015. Longer EMS response times in counties were associated with higher rates of motor vehicle crash mortality, after accounting for other important regional differences in EMS time intervals, access to trauma resources, traffic safety laws and how rural a county is. A significant proportion of fatalities (almost 10 percent in rural/wilderness areas and 14 percent in urban/suburban areas) were associated with prolonged county response times as defined by the median time (10 minutes or greater in rural/wilderness areas and 7 minutes or greater in urban/suburban areas). The authors interpret their findings to suggest that regional differences in EMS response time capabilities should be evaluated in efforts to improve trauma systems to reduce motor vehicle crash deaths. An important limitation of the study was the inability to capture regional differences in crash characteristics, which could have influenced the outcomes.

Authors: James P. Byrne, Ph.D., M.D., Sunnybrook Health Sciences Center, Toronto, and coauthors

(doi:10.1001/jamasurg.2018.5097)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Is Type 1 Diabetes Associated With Poorer Performance in School by Children?

Posted January 31, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 5, 2019

Media advisory: To contact corresponding author Niels Skipper, Ph.D., email nskipper@econ.au.dk. The full study is linked to this news release.

Want to embed a link to this study in your story? This link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.21819

Bottom Line: This observational study compared standardized test scores in reading and math for more than 630,000 Danish public school children with and without type 1 diabetes. Researchers found no significant difference in reading and math scores between the groups of children who were attending second, third, fourth, sixth and eighth grades in Denmark. The findings may not apply to other countries.

Authors: Niels Skipper, Ph.D., Aarhus University, Aarhus, Denmark, and coauthors.

(doi:10.1001/jama.2018.21819)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Did Use of Long-Acting Reversible Contraceptives Increase After 2016 Election?

Posted January 31, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 4, 2019

Media advisory: To contact study author Lydia E. Pace, M.D., M.P.H., email Johanna Younghans at jyounghans@bwh.harvard.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2723071?guestAccessKey=0784ba9e-1dd9-46a3-92d7-9849b434a0e2

Bottom Line: Insertions of long-acting reversible contraceptive (LARC) methods increased in the 30 business days after the 2016 presidential election based on an analysis of data for a large group of commercially insured women. Industry and media reports after the 2016 election of Donald Trump described an increase in the utilization of LARC methods; one proposed reason was that women were concerned about access to contraceptives if the Patient Protection and Affordable Care Act (ACA) was repealed under the Trump administration. LARC methods (intrauterine devices and implants) can be effective for years at preventing pregnancy. This study of commercially insured women (more than 3.4 million in 2015 and more than 3.2 million in 2016) compared LARC utilization during the 30 days after the 2016 election with 30 days before the election and the same time period in 2015. In 2015, the average adjusted daily LARC insertion rate during the 30 business days before and including November 8 was 12.9 per 100,000 women compared with 13.7 per 100,000 women during the subsequent 30 days; the comparable averages before and after the 2016 election were 13.4 vs. 16.3 per 100,000 women. The authors acknowledge important limitations of their study including that they only studied women with commercial insurance.

Authors: Lydia E. Pace, M.D., M.P.H., of Brigham and Women’s Hospital, Boston, Massachusetts, and coauthors

(doi:10.1001/jamainternmed.2018.7111)

Editor’s Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Study Examines Women, Men and Brain Marker of Alzheimer Disease

Posted January 31, 2019 by Jim Michalski

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 4, 2019

Media Advisory: To contact corresponding author Reisa A. Sperling, M.D., email Terri Janos at tjanos@partners.org. The full study is linked to this news release.

To place an electronic embedded link in your story: This link will be live at the embargo time: https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.4693

Bottom Line: Growing evidence suggests women may be at increased risk of certain physiological changes associated with Alzheimer disease (AD). This study examined nearly 300 clinically normal adults (average age 74) for deposits in the brain of the protein tau, a marker of AD, as measured by positron emission tomography. Women showed more tau in a region of the brain than men, which was associated with individuals with greater amounts of plaque deposits of the β-amyloid peptide (Aβ), another marker of AD. These findings support other studies in identifying potential reasons for differences in risk for AD between men and women. The study population may limit the generalizability of these results.

Authors: Reisa A. Sperling, M.D., Massachusetts General Hospital, Harvard Medical School, Boston, and coauthors

(doi:10.1001/jamaneurol.2018.4693)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Is Coronary Artery Calcification in Highly Active People Like Marathon Runners Associated With Increased Risk of Death?

Posted January 28, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 30, 2019

Media advisory: To contact corresponding author Benjamin D. Levine, M.D., email Lori Soderbergh at Lori.Soderbergh@UTSouthwestern.edu. The full study, commentary and author interview are linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/2722746?guestAccessKey=3c09c9c9-2972-4158-a259-62acd9f7c23c

Bottom Line: Some studies have suggested that people with high levels of physical activity way beyond current physical activity guidelines, such as marathon runners, can have significant build-up of calcium in the arteries of their heart called coronary artery calcification (CAC). But data are limited about the risk of death in these highly active people with CAC. This study included nearly 22,000 men (average age almost 52) with varying levels of self-reported physical activity and who underwent CAC scanning. Elevated levels of CAC were more common among highly active men but after a decade of follow-up they didn’t have an increased risk of death compared with less-active men. Men with the highest levels of physical activity, regardless of CAC level, had a lower rate of death than those with the lowest activity levels. This study was observational and doesn’t allow for causal interpretations of the findings.

Authors: Benjamin D. Levine, M.D., University of Texas Southwestern Medical Center, Dallas, and coauthors.

(doi:10.1001/jamacardio.2018.4628)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Visual Abstract: Effect of Hydrocortisone Therapy on Outcomes of Very Preterm Infants Receiving Mechanical Ventilation

Posted January 24, 2019 by Jim Michalski

USPSTF Recommendation Statement on Prevention of Gonococcal Eye Infections in Newborns

Posted January 24, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 29, 2019

Media advisory: To contact the U.S. Preventive Services Task Force, email the Media Coordinator at Newsroom@USPSTF.net or call 202-572-2044. The full report and related articles are linked to this news release.

Want to embed a link to this report in your story? This full-text link will be live at the embargo time and all links to all USPSTF articles remain free indefinitely: https://jamanetwork.com/journals/jama/fullarticle/2722778?guestAccessKey=a2298e7c-7d40-4328-b37a-fcd57f3af914

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) reaffirms its recommendation for the use of an antibiotic ointment to prevent gonococcal eye infections in all newborns, a gonorrhea infection that is transmitted from the mother to the newborn during delivery.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is a reaffirmation of its 2011 recommendation on prevention of gonococcal ophthalmia neonatorum, a gonorrhea infection of the eye in newborns. This infection can spread to the cornea and cause blindness as early as 24 hours after birth. In the absence of prevention, transmission rates of gonococcal infection from mother to newborn are 30 percent to 50 percent.

The USPSTF Concludes:

(doi:10.1001/jama.2018.21367)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Note: More information about the U.S. Preventive Services Task Force, its process, and its recommendations can be found on the newsroom page of its website.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Quality, Experience of Outpatient Care in U.S. for Adults With or Without Primary Care

Posted January 24, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 28, 2019

Media advisory: To contact study author David M. Levine, M.D., M.P.H., M.A,. email Johanna Younghans at jyounghans@bwh.harvard.edu. The full study and commentary are linked to this news release.

Want to embed a full-text link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2721037?guestAccessKey=0983f57a-7a4e-480a-b0b4-7bbcc2c6649b

Bottom Line: Adults who have primary care receive similar amounts of care as adults who don’t, but they receive more high-value care, similar low-value care, and report better access and patient experiences. In this analysis, researchers used data from an annual nationally representative survey to compare 49,286 adults with primary care to 21,133 adults without primary care. Health care systems in many countries are organized around primary care, whereas health care in the U.S. is organized around hospitals and specialty care. These findings suggest increasing investment in primary care may improve value in the U.S. health care system. A limitation of the study was primary care may be defined differently in different contexts.

Authors: David M. Levine, M.D., M.P.H., M.A., of Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, and coauthors

(doi:10.1001/jamainternmed.2018.6716)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Association Between Economic Factors, Clinician Supply and Rate of Newborns Exposed to Opioids During Pregnancy

Posted January 24, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 29, 2019

Media advisory: To contact corresponding author Stephen W. Patrick, M.D., M.P.H., M.S., email Craig Boerner at craig.boerner@vumc.org. The full study and editorial are linked to this news release.

Want to embed a full-text link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2722771?guestAccessKey=2ea89e39-3977-4a39-9b38-9b96aef3d4d1

Bottom Line: Neonatal abstinence syndrome (NAS), which are symptoms that primarily occur in newborns exposed to opioids during pregnancy, has increased over the last two decades but there is limited information on its association with economic conditions or clinician supply. This study, which included 580 U.S. counties in eight states and 6.3 million births from 2009 to 2015, found higher rates of NAS at the county level to be associated with high rates of long-term unemployment and areas with a shortage of mental health clinicians. Neonatal abstinence syndrome rates were often highest in rural, remote counties. The design of the study does not allow for cause-and-effect interpretations of the findings.

Authors: Stephen W. Patrick, M.D., M.P.H., M.S., Vanderbilt University, Nashville, and coauthors.

(doi:10.1001/jama.2018.20851)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Does Intensive Blood Pressure Control Reduce the Risk of Dementia?

Posted January 24, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 28, 2019

Media advisory: To contact corresponding author Jeff D. Williamson, M.D., M.H.S., email Marguerite Beck at marbeck@wakehealth.edu. The full study and editorial are linked to this news release and the visual abstract is below.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/2723256?guestAccessKey=f288411d-ef32-4812-b5a6-7da27b17151f

Bottom Line: Alzheimer disease and related dementias are projected to affect 115 million people worldwide by 2050. There are currently no proven treatments to reduce the risk of dementia and mild cognitive impairment (MCI). High blood pressure (hypertension) has been identified as a potentially modifiable risk factor for dementia and MCI in observational studies. In this randomized clinical trial that included about 9,400 adults age 50 or older with hypertension, participants were treated to achieve a systolic blood pressure goal of either less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). The researchers found that intensive blood pressure control did not result in a significant reduction in the risk of probable dementia compared to those who received standard treatment. The study may have been underpowered for this outcome because of early termination of the study and fewer than expected cases of dementia.

Authors: Jeff D. Williamson, M.D., M.H.S., Wake Forest School of Medicine, Winston-Salem, North Carolina, and coauthors

Visual Abstract

(doi:10.1001/jama.2018.21442)

Editor’s Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

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Is Increased Screen Time Associated With Delayed Child Development?

Posted January 24, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 28, 2019

Media advisory: To contact corresponding author Sheri Madigan, Ph.D., email Heath McCoy at hjmccoy@ucalgary.ca. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2722666?guestAccessKey=879c6c87-141e-48f8-8c95-4d684600a644

Bottom Line: Many children spend more time on screens than is recommended. This study looked at whether more screen time was associated with lower scores in a measure of developmental milestones in children and it also looked at the opposite association of whether children with delays in development received more screen time to control challenging behavior. The study included about 2,400 typically developing children in Canada and found higher levels of screen time at ages 2 and 3 were associated with poorer performance on the developmental screening measure at ages 3 and 5. The opposite association wasn’t observed. A limitation of this observational study is that screen time behaviors in children may have changed since final data were collected in 2016. The authors recommend managing children’s screen time.

Author: Sheri Madigan, Ph.D., University of Calgary, Alberta, Canada and coauthors

(doi:10.1001/jamapediatrics.2018.5056)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Injuries Associated With Standing Electric Scooter Use

Posted January 22, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 25, 2019

Media advisory: To contact corresponding study author Tarak K. Trivedi, M.D., M.S., Enrique Rivero at erivero@mednet.ucla.edu. The full study and commentary are linked to this news release.

Want to embed a link to this study in your story?: This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2722574?guestAccessKey=c8d43986-1131-4af7-b3bc-a9f9415cd3b3

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Nearly 250 patients ended up at two Southern California emergency departments with injuries associated with standing electric scooter use and few riders were wearing helmets. This observational study used medical record review to examine injuries associated with standing electric scooter use over a one-year period; 228 patients were injured as riders and 21 as nonriders. Nearly 11 percent of riders were younger than 18 and only about 4 percent of riders were documented as wearing helmets. Fractures, head injuries and soft-tissue injuries were the most common. Nearly all patients were discharged from the emergency department but 15 were admitted, including two with severe heard injuries. The authors suggest their findings may help to inform public policy around standing electric scooter use, a growing and cheap mode of transportation.

authors: Tarak K. Trivedi, M.D., M.S., University of California, Los Angeles, Los Angeles, California, and coauthors

(doi:10.1001/jamanetworkopen.2018.7381)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Harsh Punishment, Maltreatment in Childhood Associated With Adult Antisocial Behavior

Posted January 22, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 25, 2019

Media advisory: To contact corresponding study author Tracie O. Afifi, Ph.D., email Chris Rutkowski at Chris.Rutkowski@umanitoba.ca. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2722572?guestAccessKey=3d62bf1f-9952-431a-b089-e74fbcf6929c

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Harsh physical punishment (pushing, grabbing, shoving, slapping and hitting), maltreatment (physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect and exposure to intimate partner violence) and a combination of the two during childhood were all associated with antisocial behaviors in adulthood among men and women. This observational study used data on about 36,000 adults in the general U.S. population. Authors suggest prevention efforts to eliminate harsh physical punishment and maltreatment in childhood should be a public health priority in an effort to reduce antisocial behavior among adults.

Authors: Tracie O. Afifi, Ph.D., University of Manitoba, Winnipeg, Canada, and coauthors

(doi:10.1001/jamanetworkopen.2018.7374)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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Examination of Outpatient Prescribing Patterns for Anxiety Drugs

Posted January 22, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 25, 2019

Media advisory: To contact corresponding author Sumit D. Agarwal, M.D., email Johanna Younghans at jyounghans@bwh.harvard.edu. The full study is linked to this news release and a visual abstract is below.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.7399

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Benzodiazepines (tranquilizers) are a large class of drugs with lots of potential uses from treating anxiety to other conditions including insomnia, seizures and neuropathic pain. This study used nationally representative data to examine patterns in outpatient prescribing of benzodiazepines and included more than 386,000 ambulatory care visits from 2003 through 2015. The rate of ambulatory care visits where benzodiazepines were recorded nearly doubled over the time period from 3.8 percent to 7.4 percent. Primary care physicians accounted for about half of all visits with benzodiazepines. Authors suggest addressing prescribing patterns could help curb growing use of benzodiazepines amid increased benzodiazepine-related overdose deaths.

Authors: Sumit D. Agarwal, M.D., Brigham and Women’s Hospital, Boston, and Bruce E. Landon, M.D., M.B.A., M.Sc., Harvard Medical School, Boston.

Visual Abstract:

(doi:10.1001/jamanetworkopen.2018.7399)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations@jamanetwork.org.

Birth Rates in Fukushima City Before, After Nuclear Disaster

Posted January 22, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 25, 2019

Media advisory: To contact corresponding author Noriaki Kurita, M.D., Ph.D., email kuritanoriaki@gmail.com. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.7455

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: An earthquake and subsequent tsunami led to the Fukushima Daiichi Nuclear Power Plant disaster in Japan in 2011. This observational study examined associations between the earthquake and power plant disaster with birth rates in Fukushima City, the capital of the prefecture. There was an estimated 10 percent reduction in monthly birth rates in the first two years after the disaster but after that the trend in birth rates was similar to before the disaster, a finding the authors suggest may be indicative of rebuilding efforts. The study acknowledges the potential for underestimation of birth rates several years after the disaster.

Author: Noriaki Kurita, M.D., Ph.D., Fukushima Medical University Hospital, Fukushima City, Japan

(doi:10.1001/jamanetworkopen.2018.7455)

Editor’s Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations@jamanetwork.org.

Study Examines Racial Differences in Time to Breast Cancer Surgery in Military Health System

Posted January 18, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 23, 2019

Media advisory: To contact corresponding author Kangmin Zhu, M.D., Ph.D., email Sarah Marshall at sarah.marshall@usuhs.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.5113

Bottom Line: Less access to care and lower insurance coverage are among the reasons for racial disparities in breast cancer survival in the United States. Eligible beneficiaries in the U.S. Military Health System have insurance and access to care. This study examined whether racial differences existed in time to surgery and whether any differences in that time might explain racial disparities in overall survival between nearly 1,000 black and 3,900 white women diagnosed with breast cancer in the Military Health System. Researchers report black women had greater estimated time to surgery than white women but that those delays don’t appear to explain racial disparities in overall survival. The clinical significance of differences in time to surgery in this study is unclear and more research is needed to understand racial disparities in breast cancer treatment and survival.

Authors: Kangmin Zhu, M.D., Ph.D., Uniformed Services University of the Health Sciences, Rockville, Maryland, and coauthors

(doi:10.1001/jamasurg.2018.5113)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Visual Abstract: Effect of a Low Free Sugar Diet vs Usual Diet on Nonalcoholic Fatty Liver Disease in Adolescent Boys

Posted January 17, 2019 by Jim Michalski

Association of Childhood Lead Exposure with Adult Personality Traits, Mental Health

Posted January 18, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 23, 2019

Media advisory: To contact corresponding author Aaron Reuben, M.E.M., email Karl Bates at karl.bates@duke.edu. The full study is linked to this news release.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.4192

Bottom Line: Millions of adults now entering middle age were exposed to high levels of lead as children, with childhood lead exposure linked to lower IQ, greater rates of child behavior problems, hyperactivity and antisocial behavior. This study included nearly 600 children in New Zealand who had their blood lead levels measured at age 11 and their mental health assessed periodically through age 38. Researchers found higher childhood blood lead levels were associated with more mental health problems throughout life and difficult adult personality traits such as being more neurotic, less agreeable and less conscientious. This was an observational study and it doesn’t allow for a cause-and-effect interpretation of the association between lead and the tested outcomes.

Authors: Aaron Reuben, M.E.M., Duke University, Durham, North Carolina, and coauthors

(doi:10.1001/ jamapsychiatry.2018.4192)

Editor’s Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Full-Text Link Available

Posted January 17, 2019 by Deanna Bellandi

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/2721243?guestAccessKey=9aa042b5-b0b9-4512-9924-a8e78140501e

Full-Text Link Available

Posted January 17, 2019 by Deanna Bellandi

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/2721244?guestAccessKey=bdb9b43c-20d9-4c06-8195-789469c50510