Could Locking All Household Guns Reduce Youth Suicides, Unintentional Firearm Deaths?

Posted May 9, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 13, 2019

Media advisory: To contact corresponding author Michael C. Monuteaux, Sc.D., email Erin Tornatore at erin.tornatore@childrens.harvard.edu. The full study is linked to this news release.

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Bottom Line: An increase in the number of firearm owners who live with children who lock up all their household guns could be associated with a reduction in youth firearm deaths by suicide and unintentional injury. This modeling study of a hypothetical intervention estimates that if 20% of households storing at least one gun unlocked changed in one year to locking all firearms then between 72 and 135 youth firearm fatalities and between 235 and 323 youth firearm shootings (nonfatal injuries and deaths combined) may be prevented. A gun in a home can increase risk of suicide and unintentional deaths, and safe gun storage practices have been associated with reduced risk of intentional self-inflicted and unintentional firearm injuries. Authors of this study acknowledge their analysis relied on a single study from more than 15 years ago because they says it’s the only published study that quantifies the relationship between gun storage practices among youth and the risk of firearm injuries. Nonetheless, researchers say their results underscore the need to develop approaches that will motivate adults to safely store guns.

Authors: Michael C. Monuteaux, Sc.D., of Boston Children’s Hospital, and coauthors

(doi:10.1001/jamapediatrics.2019.1078)

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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Cost-Effectiveness Analysis of 12 Cervical Cancer Screenings

Posted May 9, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 13, 2019

Media advisory: To contact corresponding author George F. Sawaya, M.D., email Elizabeth Fernandez at elizabeth.fernandez@ucsf.edu. The full study, commentary and author interview are linked to this news release.

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Bottom Line: This cost-effectiveness analysis incorporates women’s preferences and estimates quality of life and economic outcomes for 12 cervical cancer screening strategies.

Authors: George F. Sawaya, M.D., of the University of California, San Francisco, and coauthors

(doi:10.1001/jamainternmed.2019.0299)

Editor’s Note: The articles 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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Philadelphia Beverage Tax Associated With Higher Prices, Reduced Sales

Posted May 9, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 14, 2019

Media advisory: To contact corresponding author Christina A. Roberto, Ph.D., email Katie Delach at Katie.Delach@pennmedicine.upenn.edu. The full study and editorial are linked to this news release.

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Bottom Line: A few U.S. cities have instituted beverage taxes on sweetened drinks to generate revenue and to reduce consumption of these drinks because of their association with obesity and poor health. This study looked at changes in beverage prices and sales before and after Philadelphia implemented such a tax (1.5 cents per ounce) in 2017 compared with Baltimore, which had no such tax. In an analysis that included nearly 300 stores, study authors report Philadelphia’s tax was associated with increased beverage prices and large sales declines, which were partially offset by increased purchases in neighboring areas. This study relied on data for beverages sold only at chain retailers.

Authors: Christina A. Roberto, Ph.D., University of Pennsylvania Perelman School of Medicine, Philadelphia, and coauthors

(doi:10.1001/jama.2019.4249)

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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What is Association of Age With Risk of Death for ICU Patients?

Posted May 7, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 10, 2019

Media advisory: To contact corresponding author Matthieu Legrand, M.D., Ph.D., email Matthieu.Legrand@aphp.fr. 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: This study of nearly 134,000 patients admitted to intensive care units in France examined the association of age with risk of death in the hospital and then three months and three years after discharge.

Authors: Matthieu Legrand, M.D., Ph.D., L’Assistance Publique-Hopitaux de Paris, France, and coauthors

(doi:10.1001/jamanetworkopen.2019.3215)

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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Time of Day Associated With Physicians Ordering Cancer Screenings, Patients Completing Them

Posted May 7, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 10, 2019

Media advisory: To contact corresponding author Mitesh S. Patel, M.D., M.B.A., M.S., email Frank Otto at Frank.Otto@pennmedicine.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: The time of day of a primary care appointment was associated with the likelihood of a physician ordering cancer screenings and of patients completing those screenings in this study of 33 practices with patients eligible for breast or colorectal cancer screening. The likelihood of physicians ordering cancer screenings decreased as the clinic day progressed and so did the likelihood of patients completing those screenings within one year of the office visit. This observational study cannot explain the cause behind these associations but clinician and patient factors may explain it, such as shorter interactions with patients if physicians fall behind and cancer screenings not being discussed. Screening test order rates were highest at 8 a.m. and lowest at 5 p.m. The results of this study may not be generalizable because it was conducted at a single health system and variation in screening orders and patient completion may be related to factors unaccounted for in this study. Future interventions that aim to increase cancer screenings should consider how the timing of primary care visits might influence physician and patient behavior.

Authors: Mitesh S. Patel, M.D., M.B.A., M.S., University of Pennsylvania, Philadelphia, and coauthors

(doi:10.1001/jamanetworkopen.2019.3403)

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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Disparities Associated With Buprenorphine Prescriptions for Opioid Use Disorder

Posted May 6, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 8, 2019

Media advisory: To contact corresponding author Pooja A. Lagisetty, M.D., M.Sc., email Kara Gavin at kegavin@med.umich.edu. The full study is linked to this news release.

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Bottom Line: This study used national survey data to estimate buprenorphine prescription rates to treat opioid use disorder by race/ethnicity and by payment type for office visits, which is how most patients with buprenorphine prescriptions get care. Researchers report buprenorphine office visits increased from 0.04% to 0.36% of ambulatory visits from 2004-2015 and that represented about 13.4 million visits from 2012-2015. Buprenorphine prescriptions were received at more visits from 2012-2015 by white patients than patients of other races/ethnicities. Office visits were most commonly paid for by private insurance or were self-pay. Increasing rates of opioid overdoses mean it is important that policy and research efforts address racial/ethnic and payment differences in access to treatment for opioid use disorder.

Authors: Pooja A. Lagisetty, M.D., M.Sc., University of Michigan, School of Medicine, Ann Arbor, and coauthors

(doi:10.1001/jamapsychiatry.2019.0876)

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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How Common is Alcoholic Fatty Liver Disease?

Posted May 2, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 7, 2019

Media advisory: To contact corresponding author Robert J. Wong, M.D., M.S., email Terry Lightfoot at tlightfoot@alamedahealthsystem.org. The full study is linked to this news release.

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Bottom Line: This study used national survey data from 2001-2016 to examine how common alcoholic fatty liver disease is in the United States.

Authors: Robert J. Wong, M.D., M.S., Highland Hospital, Oakland, California, and coauthors

(doi:10.1001/jama.2019.2276)

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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Articles Focus on Psoriasis, Risk of Mental Health Disorders

Posted May 6, 2019 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 8, 2019

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

Bottom Line: Two related articles and an editorial focus on the chronic inflammatory skin disorder psoriasis and the risk of mental health disorders.

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Psoriasis and Risk of Mental Disorders in Denmark (Leisner):

https://jamanetwork.com/journals/jamadermatology/fullarticle/2732602?guestAccessKey=c9ff7dac-bc39-4a5a-87cb-c0dc9dba01a6&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050819

Association of Psoriasis With Mental Health Disorders in South Korea (Lee):

https://jamanetwork.com/journals/jamadermatology/fullarticle/2732603?guestAccessKey=701fc219-b454-4bd1-bb18-574749208547&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050819

Exploring Mental Disorders in Patients With Skin Diseases (Armstrong):

https://jamanetwork.com/journals/jamadermatology/fullarticle/2732599?guestAccessKey=13d616cd-7fa6-4137-ab9e-b318dbbd74e6&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050819

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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Association Between Weight Before Pregnancy, Weight Gain During Pregnancy and Adverse Outcomes for Mother, Infant

Posted May 2, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 7, 2019

Media advisory: To contact corresponding author Romy Gaillard, M.D., Ph.D., email r.gaillard@erasmusmc.nl. The full study and editor’s note are linked to this news release.

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Bottom Line: An analysis that combined the results of 25 studies including nearly 197,000 women suggests prepregnancy body mass index (BMI) of the mother was more strongly associated with risk of adverse maternal and infant outcomes than the amount of gestational weight gain.

Authors: Romy Gaillard, M.D., Ph.D., Erasmus MC, University Medical Center, Rotterdam, the Netherlands, and coauthors

(doi:10.1001/jama.2019.3820)

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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How Common is E-Cigarette Use Among Adults in Households With Kids?

Posted May 2, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 6, 2019

Media advisory: To contact corresponding author Jenny L. Carwile, Sc.D., M.P.H., email media@mmc.org. The full study is linked to this news release.

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Bottom Line: Nearly 5% of adults living in households with children use e-cigarettes based on analyses of national survey data from 2016-2017.

Authors: Jenny L. Carwile, Sc.D., M.P.H., of Maine Medical Center, Portland, Maine, and coauthors

(doi:10.1001/jamapediatrics.2019.1139)

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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Aspirin Before At-Home Colorectal Cancer Screening Test Didn’t Significantly Improve Ability to Detect Cancer Precursors

Posted May 2, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 7, 2019

Media advisory: To contact corresponding author Hermann Brenner, M.D., M.P.H., email h.brenner@dkfz-heidelberg.de. The full study is linked to this news release and a visual abstract is below.

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Bottom Line: Some observational studies have suggested that taking aspirin before undergoing colorectal cancer screening with a fecal immunochemical test for blood in stool might improve the ability of the test to detect cancer precursors. This randomized clinical trial included about 1,200 adults (between the ages of 40 and 80) who took a single dose of aspirin (300 mg) two days before collecting a stool sample for a fecal immunochemical test and about 1,200 adults who took a placebo. Researchers report a higher detection rate in the aspirin group but the difference between the two groups wasn’t statistically significant. A limitation of the study is that the results were based on relatively few individuals who had cancer precursors.

Authors: Hermann Brenner, M.D., M.P.H., German Cancer Research Center, Heidelberg, Germany, and coauthors

(doi:10.1001/jama.2019.4755)

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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Clinical Trial Looks at Absorption Levels of Sunscreen Active Ingredients into Bloodstream

Posted May 3, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 6, 2019

Media advisory: To contact corresponding author David G. Strauss, M.D., Ph.D., email Sandy Walsh at Sandy.Walsh@fda.hhs.gov. The full study and editorial are linked to this news release and a visual abstract is below.

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Bottom Line: The U.S. Food and Drug Administration recommends that active ingredients in sunscreen absorbed into the bloodstream above a certain level undergo toxicology testing. Researchers from the FDA conducted this small randomized clinical trial of 24 healthy volunteers to determine bloodstream concentrations of four active ingredients (avobenzone, oxybenzone, octocrylene and ecamsule) in four sunscreens applied four times per day for four days with blood samples collected from study participants over seven days. Researchers report that all four active ingredients were found in blood samples at levels exceeding the threshold recommended for toxicology testing. The effect of these concentrations is unknown and further studies are needed to determine the clinical significance of these findings. Some limitations of this clinical trial include that it was conducted under indoor conditions without exposure to heat, sunlight or humidity, which may affect the rate of sunscreen absorption, and the study wasn’t designed to look at differences in absorption by the type of sunscreen formulation, skin type or age of the user. Researchers emphasize that their results don’t suggest people refrain from using sunscreen, which prevents skin damage.

Authors: David G. Strauss, M.D., Ph.D., U.S. Food and Drug Administration, Silver Spring, Maryland, and coauthors

(doi:10.1001/jama.2019.5586)

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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Severe Tinnitus Associated with Suicide Attempts in Women

Posted April 30, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 2, 2019

Media advisory: To contact corresponding author Christopher R. Cederroth, Ph.D., email christopher.cederroth@ki.se. The full study is linked to this news release.

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Bottom Line: Previously, severe ringing in the ears (tinnitus) has been associated with depression and anxiety, and a 2016 study reported an association with increased risk of suicide attempts. This study used responses to a questionnaire from about 72,000 adults in Sweden to examine whether an association with increased risk of suicide attempts might be different between men and women. Of 874 women who reported severe tinnitus, 82 (9.4%) reported attempting suicide; of 1,121 men who reported severe tinnitus, 62 (5.5%) reported a suicide attempt. After analyses, an association between severe tinnitus and suicide attempt remained statistically significant only in women. Individuals who had a formal diagnosis of tinnitus weren’t at increased risk for a suicide attempt, suggesting medical attention may help to alleviate quality of life impairments. Cognitive behavioral therapy is an established approach. A limitation of the study is its reliance on self-reported tinnitus.

Authors: Christopher R. Cederroth, Ph.D., Karolinska lnstitutet, Stockholm, Sweden, and coauthors

(doi:10.1001/jamaoto.2019.0566)

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 Private Insurance Claims for Naloxone Prescriptions

Posted April 30, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 3, 2019

Media advisory: To contact corresponding study author Mai T. Pho, M.D., M.P.H., email Ashley Heher at Ashley.Heher@uchospitals.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.3209?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=050319

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 based on a national database of private insurance claims suggests few patients at high risk of opioid overdose receive prescriptions for naloxone, which can reverse an overdose, during encounters with the health care system from hospitalizations and emergency department visits to physician visits. Among 138,108 high-risk patients, only 2,135 (1.5%) were prescribed naloxone. A greater likelihood of receiving naloxone was associated with prior diagnoses of opioid misuse or dependence and overdose compared to those diagnoses without overdose. A prior diagnosis of opioid overdose alone was associated with decreased likelihood of receiving naloxone compared with a prior diagnosis of opioid misuse or dependence without overdose. Study authors acknowledge their results underestimate the distribution and use of naloxone because many patients get it through programs where insurance isn’t billed or patients may pay out of pocket. The study findings also may not be generalized to patients covered by Medicaid, some Medicare plans or those who are uninsured. Still, understanding barriers, such as a lack of awareness of local laws, to physician prescribing of naloxone to high-risk patients is important so that health care encounters aren’t missed opportunities to provide the medication.

Authors: Mai T. Pho, M.D., M.P.H., of the University of Chicago Medicine, and coauthors

(doi: 10.1001/jamanetworkopen.2019.3209)

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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Study Looks at Association of High Cholesterol Levels, Statin Use with Glaucoma Risk

Posted April 30, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 2, 2019

Media advisory: To contact corresponding author Jae H. Kang, Sc.D., email Mark Murphy at mmurphy90@bwh.harvard.edu. The full study and commentary are linked to this news release.

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Bottom Line: A study of adults 40 and older suggests high cholesterol levels are associated with increased risk for the most common form of glaucoma, while longer use of a cholesterol-lowering statin, compared with never using, was associated with lower risk. Data for this observational study came from more than 136,000 adults who participated in three national study groups and provided information on their statin use and cholesterol levels over 15 years. There were 886 new cases of primary open-angle glaucoma (POAG) identified among the adults. The association between longer statin use for five or more years and lower risk of POAG was stronger among those 65 and older. The study is limited by self-reported statin use and cholesterol levels, and the results also may not generalize to other groups because study participants were mostly white health care professionals. These results need to be confirmed in other studies but they are of interest given the widespread use of statins in older persons at risk for this type of glaucoma.

Authors: Jae H. Kang, Sc.D., Brigham and Women’s Hospital, Harvard Medical School, Boston, and coauthors

(doi:10.1001/jamaophthalmol.2019.0900)

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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Could Mouth Rinse to Detect HPV DNA Be Associated With Predicting Risk of Head/Neck Cancer Recurrence, Death?

Posted April 30, 2019 by Jim Michalski

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 2, 2019

Media advisory: To contact corresponding author Maura L. Gillison, M.D., Ph.D., email Scott Merville at SMerville@mdanderson.org. The full study is linked to this news release.

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Bottom Line: Researchers examined if a mouth rinse to detect human papillomavirus (HPV) DNA might be associated with helping to predict risk of recurrence of head and neck squamous cell cancer and death. This study included 396 adults with head and neck squamous cell cancer of the mouth or throat, of which 202 patients had HPV-positive cancers. The adults were tested for the presence of HPV DNA with an oral rinse at various times. After completing cancer treatment, the repeated detection of HPV DNA identical to their tumor type in oral rinses was associated with a higher risk of cancer recurrence and death. The typical follow-up time of about two years in this study may have underestimated the associations between the persistence of HPV and cancer recurrence. More research is needed but these findings suggest HPV DNA may be a promising biomarker to understand cancer treatment response and future risk of progression.

Authors: Maura L. Gillison, M.D., Ph.D., University of Texas MD Anderson Cancer Center, Houston, and coauthors

(doi:10.1001/jamaoncol.2019.0439)

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

Posted April 29, 2019 by Deanna Bellandi

JAMA

EMBARGOED FOR RELEASE: 10:30 P.M. (ET), MONDAY, APRIL 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/jama.2019.5790)

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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Describing Aspects of Melanoma Progression

Posted April 29, 2019 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 1, 2019

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

Bottom Line: Three related articles and an editorial focus on various aspects of melanoma progression.

Embed these links to provide your readers free access to the full-text articles: These links will be live at the embargo time.

Risk of Melanoma Recurrence After Diagnosis of a High-Risk Primary Tumor (von Schuckmann et al): https://jamanetwork.com/journals/jamadermatology/fullarticle/2731995?guestAccessKey=6363259c-9dfb-47d7-aa30-8291dc916eb1&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050119

Association of Time From Primary Diagnosis to First Distant Relapse of Metastatic Melanoma With Progression of Disease and Survival (Vallet et al): https://jamanetwork.com/journals/jamadermatology/fullarticle/2731994?guestAccessKey=fff14ad9-9a75-4594-8af1-ed639ece487c&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050119

Risk Factors for Lymphatic and Hematogenous Dissemination in Patients With Stages I to II Cutaneous Melanoma (Nagore et al): https://jamanetwork.com/journals/jamadermatology/fullarticle/2731993?guestAccessKey=dea8c2b1-744f-4acc-86b9-84c58be07c1c&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050119

The Changing Kinetics of Advanced Melanoma (Coit): https://jamanetwork.com/journals/jamadermatology/fullarticle/2731989?guestAccessKey=cfedae00-02f1-45e3-a830-dd4a06cf28f6&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050119

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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Estimates of Illness, Death Among Children, Adolescents Worldwide

Posted April 25, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 29, 2019

Media advisory: To contact corresponding author Nicholas J. Kassebaum, M.D., email Kelly Bienhoff at kbien@uw.edu. The full study is linked to this news release.

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Bottom Line: This study analyzed data from around the world to estimate illness and death in children and adolescents (birth up to age 20) in 195 countries and territories from 1990 to 2017. Mortality decreased over the 27-year period and that meant children and adolescents were more likely to reach their 20th birthdays. The fastest decline in deaths was among children 1 to 4 years old mostly due to global declines in deaths due to diarrhea, respiratory infection and other common infectious diseases. However, nonfatal health loss as measured by years lived with disability (YLDs) increased, with some of the leading causes of YLDs in 2017 including iron-deficient anemia, vitamin A deficiency, neonatal disorders, congenital disorders and mental health disorders. The Global Burden of Disease 2017 collaborators who authored the study note that these summary measures of population health are influenced by data availability and time lags in the reporting of certain health information may mean the estimates are based on data already out of date. Researchers urge that careful attention be paid to nonfatal illness and disability among children and adolescents around the globe.

Authors: Nicholas J. Kassebaum, M.D., Institute for Health Metrics & Evaluation, Seattle, and coauthors

(doi:10.1001/jamapediatrics.2019.0337)

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.

Study Examines Reliability of Early Diagnoses of ASD in Toddlers

Posted April 25, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 29, 2019

Media advisory: To contact corresponding author Karen Pierce, Ph.D., email Scott LaFee at slafee@ucsd.edu. The full study is linked to this news release.

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Bottom Line: Autism spectrum disorder (ASD) is common in children and is, on average, generally detected and treated by about age 4. This study examined whether earlier diagnoses of ASD would remain stable and persist, potentially allowing for earlier treatment. Included in this study were 1,269 toddlers from the general population with and without ASD who received their first diagnostic evaluation between the ages of 12 and 36 months and had at least one subsequent evaluation. Researchers report the stability of an ASD diagnosis was weakest in children ages 12 to 13 months but the analyses suggest ASD may be reliably diagnosed in children beginning as young as 14 months. Overall, of the 400 toddlers initially designated as having ASD, 336 (84%) retained that diagnosis at their final diagnostic visit. Research is needed to test the usefulness of ASD treatment at an early age.

Authors: Karen Pierce, Ph.D., University of California, San Diego, La Jolla, and coauthors

(doi:10.1001/jamapediatrics.2019.0624)

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.

Attitudes Toward Physician-Assisted Death Among Adults With Elevated Level of Biomarker Associated With Alzheimer Disease

Posted April 25, 2019 by Jim Michalski

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 29, 2019

Media Advisory: To contact corresponding author Emily A. Largent, J.D., Ph.D., R.N., email John Infanti at John.Infanti@pennmedicine.upenn.edu. The full study is linked to this news release.

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Bottom Line: Cognitively normal adults with elevated levels of the biomarker amyloid-β, which is associated with increased risk of developing Alzheimer disease, were interviewed as part of this study that examined attitudes toward physician-assisted death.

Authors: Emily A. Largent, J.D., Ph.D., R.N., University of Pennsylvania Perelman School of Medicine, Philadelphia, and coauthors

(doi:10.1001/jamaneurol.2019.0797)

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.

Use of Cigarettes, e-Cigarettes Among Women of Reproductive Age in U.S.

Posted April 25, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 29, 2019

Media advisory: To contact corresponding author Wei Bao, M.D., Ph.D., email Tom Snee at Tom-snee@uiowa.edu. The full study is linked to this news release.

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Bottom Line: Cigarette use was lower among pregnant women in the United States (8%) than among nonpregnant women (14.3%) but rates of e-cigarette use were almost identical (3.6% for pregnant women and 3.3% for nonpregnant women) in a study based on national health survey data. The study included data for 1,071 pregnant and 26,849 nonpregnant women (18 to 44 years old) from 2014 to 2017. E-cigarette use was more common among pregnant women who also smoke cigarettes (38.9%) than among nonpregnant women who use both kinds of cigarettes (13.5%). The small size of the group of pregnant women in the study means that the precision of the estimates about how common cigarettes and e-cigarettes are may be limited. Research starting in the preconception period is needed to understand changing patterns of cigarette and e-cigarette use among women.

Authors: Wei Bao, M.D., Ph.D., University of Iowa, Iowa City, and coauthors

(doi:10.1001/jamapediatrics.2019.0658)

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.

Podcast

Posted April 17, 2019 by Jim Michalski

Is State Medicaid Expansion Associated With Changes in Low Birth Weight, Preterm Births?

Posted April 18, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 23, 2019

Media advisory: To contact corresponding author J. Mick Tilford, Ph.D., email Leslie Taylor at Leslie@uams.edu. The full study and editor’s note is linked to this news release.

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Bottom Line: This observational study examined whether state Medicaid expansion under the Affordable Care Act was associated with changes in low birth weight and preterm birth both overall and by race/ethnicity. Using data on 15.6 million births from 2011-2016, researchers report state Medicaid expansion wasn’t associated with differences in rates of low birth weight or preterm birth overall but was associated with greater reductions in rates of low birth weight and preterm birth outcomes among black infants in expansion states compared to white infants but no change in disparities among Hispanic infants. Data came from 18 states that expanded Medicaid and 17 states that didn’t. The database used for this study may have missing data or lack information on maternal factors potentially related to birth outcomes. Also, it may take time for the benefits of health care coverage under the Medicaid expansion to improve maternal health and access to care.

Authors: J. Mick Tilford, Ph.D., University of Arkansas for Medical Sciences, Little Rock, and coauthors

(doi:10.1001/jama.2019.3678)

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.

Treatment, Spending on Outpatient Care for Depression in U.S.

Posted April 22, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, APRIL 24, 2019

Media advisory: To contact corresponding author Jason M. Hockenberry, Ph.D., email Holly Korschun at hkorsch@emory.edu. The full study is linked to this news release.

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Bottom Line: Researchers analyzed national survey data on the use of health services and spending to examine trends in the outpatient treatment of depression in the U.S. population from 1998 to 2015, a time when many policy changes have expanded insurance coverage for mental health conditions.

Authors: Jason M. Hockenberry, Ph.D., Emory University, Atlanta, and coauthors

(doi:10.1001/jamapsychiatry.2019.0633)

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.

Association of Quitting Smoking During Pregnancy, Risk of Preterm Birth

Posted April 16, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, APRIL 19, 2019

Media advisory: To contact corresponding study author Samir Soneji, Ph.D., email Derik Hertel at Derik.Hertel@dartmouth.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.2514?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=041919

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 of more than 25 million pregnant women reports on rates of smoking cessation at the start of and during pregnancy and also examines the association of quitting cigarette smoking and the risk of preterm birth.

Authors: Samir Soneji, Ph.D., Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, and Hiram Beltrán-Sánchez, Ph.D., of the University of California, Los Angeles

(doi: 10.1001/jamanetworkopen.2019.2514)

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.

Pharmacy Closures Associated With Declines in Cardiovascular Medication Adherence

Posted April 16, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, APRIL 19, 2019

Media advisory: To contact corresponding study author Dima M. Qato, Pharm.D., M.P.H., Ph.D., email Jacqueline Carey at jmcarey@uic.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.2606?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=041919

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: How pharmacy closures are associated with declines in cardiovascular medication adherence for statins, β-blockers and oral anticoagulants among adults 50 or older was the focus of this analysis of prescription claims.

Authors: Dima M. Qato, Pharm.D., M.P.H., Ph.D., University of Illinois at Chicago, and coauthors

(doi: 10.1001/jamanetworkopen.2019.2606)

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.

Study Examines Privacy Policies, Data Sharing of Popular Apps for Depression, Smoking Cessation

Posted April 16, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, APRIL 19, 2019

Media advisory: To contact corresponding study author Kit Huckvale, M.B.Ch.B., M.Sc., Ph.D., email c.huckvale@unsw.edu.au. 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 Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.2542?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=041919

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 looked at the privacy practices of popular apps for depression and smoking cessation. Researchers assessed the content of privacy policies and compared disclosures regarding data sharing with commercial third parties to actual behavior for 36 apps.

Authors: Kit Huckvale, M.B.Ch.B., M.Sc., Ph.D., UNSW (University of New South Wales) Sydney, Australia, and coauthors

(doi: 10.1001/jamanetworkopen.2019.2542)

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.

How Much Time Do Americans Spend Sitting?

Posted April 18, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 23, 2019

Media advisory: To contact corresponding author Yin Cao, M.P.H., Sc.D., email Diane Duke Williams at Williamsdia@wustl.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/2731178?guestAccessKey=7a264df9-860b-4443-b743-87fc1d7f6b2b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042319

Bottom Line: Americans spend more time sitting. Total time spent sitting increased about an hour per day to 8.2 hours for adolescents and 6.4 hours for adults in 2007-2016 in this analysis of nationally representative survey data. Data from nearly 52,000 children, adolescents and adults from 2001-2016 were used to examine trends over time in sedentary behaviors among the U.S. population. An estimated 62% of children, 59% of adolescents and 65% of adults sat watching television or videos at least 2 hours a day in 2015-2016, with generally stable trends since 2001. The estimated proportion of people who used computers an hour a day or more during leisure time increased across all age groups from 43% to 56% among children from 2001-2016; from 53% to 57% among adolescents from 2003-2016; and from 29% to 50% among adults from 2003-2016. It is possible the self-reported sedentary behaviors in this study may not reflect the true amount of sitting, however, trends over time will less likely to be affected by errors from self-reports.

Authors: Yin Cao, M.P.H., Sc.D., Washington University School of Medicine, St. Louis, and coauthors

(doi:10.1001/jama.2019.3636)

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.

Not Drinking Water Associated With Consuming More Calories from Sugary Drinks

Posted April 18, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 22, 2019

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

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/2731125?guestAccessKey=b031fa95-125f-4902-a45a-cf26169f5dd4&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042219

Bottom Line: This study examined how drinking water was associated with the amount of calories children, adolescents and young adults consume from sugar-sweetened beverages, including sodas, fruit drinks and sports drinks. Among 8,400 participants in a nationally representative survey (ages 2-5, 6-11 and 12-19 years), about one-fifth reported no water intake on a given day. Not drinking water was associated with consuming more calories from sugary beverages. After accounting for sociodemographic factors, no water intake was associated with intake of 93 calories and 4.5% more calories from sweetened drinks among participants ages 2 to 19. The magnitude of that caloric intake varied by age and racial/ethnic groups. For example, non-Hispanic white children who didn’t drink water consumed an extra 122 calories from sugary beverages while Hispanic children consumed an extra 61 calories from sweetened drinks. The study data doesn’t allow for inferences about causality but researchers report the findings demonstrate that children, adolescents and young adults should drink water every day to avoid consuming extra calories and sugar.

Authors: Asher Y. Rosinger, Ph.D., M.P.H., Pennsylvania State University, University Park, and coauthors

(doi:10.1001/jamapediatrics.2019.0693)

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.

Transgender Adults More Likely to Report Worse Health-Related Quality of Life

Posted April 18, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 22, 2019

Media advisory: To contact corresponding author Kellan E. Baker, M.P.H., M.A., email Barbara Benham at bbenham1@jhu.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2730765?guestAccessKey=8df94717-7900-4a4c-a238-361ec792d0ea&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042219

Bottom Line: Transgender adults were more likely to report worse health-related quality of life compared with cisgender adults. This study used data from a large national health survey with an optional sexual orientation and gender identity module, which 36 U.S. states and territories used at least once from 2014 through 2017. The pooled data compared 3,075 transgender adults with about 719,000 cisgender adults. Transgender adults reported being less likely to have health insurance coverage and were more likely to report worse quality of life as measured by a greater likelihood of fair or poor health or severe mental distress. In addition, they reported more recent days of combined poor physical and mental health and activity limitations. The generalizability of these findings is limited because not all states and territories have used the survey’s sexual orientation and gender identity module. The study suggests that all states and territories should use the module so that data from a truly nationwide sample of the transgender population can inform ongoing debates over public accommodations access, nondiscrimination protections and other issues that influence the health of transgender individuals.

Authors: Kellan E. Baker, M.P.H., M.A., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

(doi:10.1001/jamainternmed.2019.7931)

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 Exercise, Swimming Goggles Help Protect Astronauts Against Spaceflight-Associated Changes to Eye, Vision?

Posted April 16, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 18, 2019

Media advisory: To contact corresponding author Jessica M. Scott, Ph.D., email Nicole McNamara at mcnamarn@mskcc.org. The full study, commentary and podcast are linked to this news release.

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Bottom Line: Astronauts on long missions at the International Space Station can experience changes to their eyes and vision that can last for years. This study included 20 men who on three separate days at NASA’s Johnson Space Center in Houston completed exercises while on their back and tilted back head-first (to simulate the effect of exercise in space); 10 of the participants wore swimming goggles. Researchers found exercise was associated with decreases in pressure in the eye, while the addition of swimming goggles was associated with modestly increased pressure, which could reduce some of the adverse effects on the eye of long-duration spaceflights. These findings need to be replicated in spaceflight to determine whether increasing eye pressure with swim googles is safe and effective.

Authors: Jessica M. Scott, Ph.D., Universities Space Research Association, Houston, and Memorial Sloan Kettering Cancer Center, New York, and coauthors

(doi:10.1001/jamaophthalmol.2019.0459)

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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Low Use of Hearing Aids Among Older Hispanic/Latino Adults in U.S.

Posted April 16, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 18, 2019

Media advisory: To contact corresponding author Michelle L. Arnold, Au.D., Ph.D., email Rich Shopes at rshopes@sar.usf.edu. The full study and podcast are linked to this news release.

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Bottom Line: This study examined how common hearing aids were and the factors associated with their use among a group of nearly 1,900 adults (average age 60) of Hispanic/Latino backgrounds with hearing loss. The results reveal low use of hearing aids, with only 87 adults (4.6%) reporting use. Factors associated with adults being more likely to report using hearing aids were access to health insurance, poorer measured hearing, higher perceived need for hearing aids, and where they live. The majority of data for this study were collected prior to passage of the Affordable Care Act and subsequent Medicaid expansion, so hearing aid use may now be greater among adults enrolled in Medicaid. The data also can’t explain the cause of the low use of hearing aids. The results support increasing access to hearing care for older adults from Hispanic/Latino backgrounds with hearing loss.

Authors: Michelle L. Arnold, Au.D., Ph.D., University of South Florida Sarasota-Manatee, Sarasota, and coauthors.

(doi:10.1001/jamaoto.2019.0433)

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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Examination of Adolescent Homicides Committed by Intimate Partners

Posted April 11, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 15, 2019

Media advisory: To contact corresponding author Avanti Adhia, Sc.D., email Bobbi Nodell at bnodell@uw.edu. The full study and editorial are linked to this news release.

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Bottom Line: This study used data from a large national surveillance system from 2003 to 2016 to report on adolescent homicides committed by an intimate partner (current or former girlfriend or boyfriend or spouse) and to describe characteristics of the victims, perpetrators and incidents. Nearly 2,200 homicides of young people 11 to 18 were included and 150 (6.9%) were classified as perpetrated by an intimate partner. Nearly all the victims were female, killed by a firearm and the homicides usually involved a broken or desired relationship or jealousy. The study is limited by the data, which come from only 32 states, and a fixed period of time. The authors stress that understanding homicides in early adolescent dating relationships could help prevention and intervention efforts.

Authors: Avanti Adhia, Sc.D., University of Washington, Seattle, and coauthors

(doi:10.1001/jamapediatrics.2019.0621)

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.

What is Effect of Workplace Wellness Program on Employee Health, Job Performance, Economics?

Posted April 11, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 16, 2019

Media advisory: To contact corresponding author Zirui Song, M.D., Ph.D., email Terri Ogan Janos at tjanos@partners.org. The full study and editorial are linked to this news release.

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Bottom Line: Employees of a large multistate warehouse retail company working in locations with a workplace wellness program reported some better health behaviors after 18 months than coworkers in locations without wellness programming. However, there were no statistically significant differences in other measures. In this randomized clinical trial, which included about 33,000 employees, 20 work sites (about 4,000 employees) had wellness programming on nutrition, physical activity, stress reduction and other related topics, while 140 other work sites (nearly 29,000 employees) had no wellness programming and were used for comparison. Researchers compared employee-reported health and behaviors collected from surveys and clinical measures of health among 20 work sites with wellness programming and 20 others without it, while health care spending and use and employment outcomes were compared among 20 sites with wellness programming and 140 without. Work sites with wellness programming had higher rates of employees reporting more regular exercise and actively managing their weight, but after 18 months there were no significant differences in other health outcomes; clinical measures such as cholesterol, blood pressure and body mass index; health care spending and use; and employment outcomes such as absenteeism, job tenure and performance. These findings may not be generalizable to other workplaces or employee populations. Still, while workplace wellness programs are popular, the authors suggest these findings might temper employer expectations about their ability to lower health care costs and improve employee health and productivity in the short term.

Authors: Zirui Song, M.D., Ph.D., Harvard Medical School, Massachusetts General Hospital, Boston, and Katherine Baicker, Ph.D., University of Chicago Harris School of Public Policy, Chicago.

(doi:10.1001/jama.2019.3307)

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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USPSTF Recommendation Statement on Screening for Elevated Blood Lead Levels in Children, Pregnant Women

Posted April 11, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 16, 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.

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Bottom Line: This recommendation from the U.S. Preventive Services Task Force (USPSTF) updates its 2006 statement regarding screening for elevated blood lead levels in children and pregnant women. The USPSTF now finds inadequate evidence to recommend for or against screening for elevated blood lead levels in asymptomatic children 5 years or younger and in asymptomatic pregnant women.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. Elevated blood lead levels in children are associated with neurologic effects such as behavioral and learning problems, lower IQ, hyperactivity, hearing problems and impaired growth. In pregnant women, lead exposure can impair organ systems and increase the risk of preeclampsia and adverse outcomes for the infant.

The USPSTF Concludes:

(doi:10.1001/jama.2019.3326)

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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Lots of Patients With Cancer, Cancer Survivors Use But Don’t Report Complementary/Alternative Medicine Therapies

Posted April 9, 2019 by Deanna Bellandi

JAMA Oncology

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

Media advisory: To contact corresponding author Nina N. Sanford, M.D., email Patrick McGee at Patrick.McGee@UTSouthwestern.edu. The full study is linked to this news release.

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Bottom Line: This study used data from a nationwide survey to estimate how many patients with cancer and cancer survivors use complementary and alternative medicines (CAMS) in addition to or instead of conventional therapies, and how many don’t disclose that to their physicians. Among about 3,100 survey participants reporting a history of cancer, 33.3% used CAMs in the past 12 months and the most commonly used were herbal supplements (35.8%), followed by other modalities that include chiropractic or osteopathic manipulation (25.4%); massage (14.1%); yoga/tai chi/qigong (7.6%); mantra/mindfulness/spiritual meditation (6.9%); special diets (2.9%); and acupuncture (2.0%). Among the 1,023 participants who reported using CAM, 288 (29.3%) didn’t disclose that to their physicians. Many participants said they didn’t disclose their CAM use because physicians didn’t ask or they didn’t think their physicians needed to know. Considering the high proportion of patients with cancer and cancer survivors using CAM, there needs to be more study of its use on cancer outcomes.

Authors: Nina N. Sanford, M.D., of University of Texas Southwestern, Dallas, and coauthors

(doi:10.1001/jamaoncol.2019.0349)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. 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.

Association Between Household Workload, Career Dissatisfaction for Physician Moms

Posted April 8, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, APRIL 10, 2019

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

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Bottom Line: This study used data from an online survey of about 1,700 physician mothers to examine how responsibilities at home are associated with career dissatisfaction and whether that differs by specialty. Nearly all of the physician mothers were partnered or married and 27% were in procedural specialties (defined as all surgical specialties, anesthesiologists, gastroenterologists and obstetricians-gynecologists). Overall, physician mothers reported being responsible for most tasks at home compared with their spouses/partners, including child care, cooking, laundry and grocery shopping. Physician mothers in procedural specialties who reported being primarily responsible for five or more tasks at home more often reported career dissatisfaction as a desire to change careers than those with fewer than five household tasks. This association wasn’t observed among physician mothers in nonprocedural specialties. These data come from a voluntary membership group (the Physicians Mom Group on Facebook) and may not be representative of all physician mothers. Study authors suggest a more equitable distribution of household tasks among physician mothers and their spouses/partners or outsourcing these duties might help to sustain physician mothers in practice.

Author: Nelya Melnitchouk, M.D., M.Sc., Brigham and Women’s Hospital, Harvard Medical School, Boston, and coauthors

(doi:10.1001/jamasurg.2019.0529)

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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Summary Video Available

Posted April 4, 2019 by Jim Michalski

Video embed code:

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Study Reports on Bacterial STIs Among Men Using PrEP

Posted April 4, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 9, 2019

Media advisory: To contact corresponding author Michael W. Traeger, M.Sc., email michael.traeger@burnet.edu.au. The full study and editorial are linked to this news release.

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Bottom Line: This study, which included nearly 3,000 mostly gay and bisexual men in Australia who received daily HIV preexposure prophylaxis (PrEP), reports on the association of bacterial sexually transmitted infections (STIs) by describing diagnoses of chlamydia, gonorrhea or syphilis among the men and behavioral risk factors.

Authors: Michael W. Traeger, M.Sc., Burnet Institute, Melbourne, Australia, and coauthors

(doi:10.1001/jama.2019.2947)

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.

Difficulty in Middle Age Performing Activities of Daily Living Associated With Adverse Outcomes

Posted April 4, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 8, 2019

Media advisory: To contact corresponding author Rebecca T. Brown. M.D., M.P.H., email Karen Kreeger at Karen.Kreeger@pennmedicine.upenn.edu. The full study is linked to this news release.

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Bottom Line: Vital to quality of life and health for older adults is the ability to perform activities of daily living: bathing, dressing, eating, using the toilet, transferring locations to get in bed or sit in a chair, and walking across a room. This study looked at whether difficulty in performing ADLs (called functional impairment) in middle age was associated with increased risk of hospitalization, admission to a nursing home and death. Data for 5,540 adults were analyzed and those who developed functional impairment between the ages of 50 and 64 were at increased risk of hospitalization, nursing home admission and death compared with those without functional impairment, although the risk of death wasn’t statistically significant after adjusting for traditional risk factors including health status, health-related behaviors and sociodemographics. Middle-age adults with difficulty performing instrumental ADLs, such as managing money and medicine, shopping for groceries and preparing meals or making phone calls, had increased risk of hospitalization, nursing home admission and death in analyses adjusted, or not, for other risk factors. Limitations of this observational study include results not generalizable to people with longstanding disabilities because those with impairments at the study start were excluded. Study results suggest functional impairment has important clinical implications for even relatively young people in middle age.

Authors: Rebecca T. Brown, M.D., M.P.H., of the University of Pennsylvania, Philadelphia, and coauthors

(doi:10.1001/jamainternmed.2019.0008)

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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Estimates of Emergency Department Visits for Suicide Attempts, Thoughts Among Kids, Teens

Posted April 4, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 8, 2019

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

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Bottom Line: Many children with suicide attempts/suicidal thoughts present to emergency departments (EDs). An analysis of U.S. ED data from 2007 to 2015 estimates annual visits almost doubled from 580,000 to 1.12 million for suicide attempts/suicidal thoughts by children ages 5 to 18 years. As a proportion of all pediatric encounters in EDs, suicide attempts/suicidal thoughts increased from 2.17% in 2007 to 3.50% in 2015. Limitations of the study are that a cause cannot be inferred from the results and it’s possible that nonsuicidal self-harm was incorrectly coded by physicians as suicide attempts/suicidal thoughts. Study findings suggest a need to strengthen community mental health resources, increase ED physician preparedness for dealing with these cases, and develop initiatives to decrease suicide risk among children and teens.

Author: Brett Burstein, M.D.C.M., Ph.D., M.P.H., Montreal Children’s Hospital, Montreal, Canada, and coauthors

(doi:10.1001/jamapediatrics.2019.0464)

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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How Common is Sex for Boys Before Age 13?

Posted April 4, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 8, 2019

Media advisory: To contact corresponding author Laura D. Lindberg, Ph.D., email Media@guttmacher.org. The full study and editorial are linked to this news release.

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Bottom Line: Researchers combined data from two U.S. surveys to examine how common it is for boys to have sex before they turn 13. The study included data from nearly 20,000 male high school students and about 7,700 other males between the ages of 15 to 24. Overall, 7.6% of the male high school students and 3.6% of the other males reported having sexual intercourse before age 13. The proportion varied across metropolitan areas, from 5% in San Francisco to 25% in Memphis, with higher rates among non-Hispanic black and Hispanic males in most areas. The study notes limitations including that sexual intercourse is just one indicator of sexuality and that it’s important to consider behaviors other than vaginal-penile intercourse to understand sexual development. These findings may have implications for the timing of sex education and sexual and reproductive health care.

Author: Laura D. Lindberg, Ph.D., Guttmacher Institute, New York, and coauthors

(doi:10.1001/jamapediatrics.2019.0458)

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.

Vision Loss Associated with Longer Hospital Stays, More Readmissions, Greater Costs

Posted April 2, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 4, 2019

Media advisory: To contact corresponding author Alan R. Morse, J.D., Ph.D., email Bryan Dotson at bdotson@mannersdotson.com. The full study and commentary are linked to this news release.

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Bottom Line: Researchers analyzed health care claims data for older adults (12,330 Medicare beneficiaries and 11,858 with commercial health insurance) to see if vision loss was associated with longer stays and higher readmission rates and costs when patients were hospitalized with common illnesses. The study reports patients with vision loss used more health care resources and had higher costs than those without vision loss. Authors estimate vision loss among hospitalized patients contributed to excess health costs of more than $500 million annually. The study is limited by its reliance on claims data, which lacks important clinical information on types of vision loss. The findings suggest identifying vision loss during hospitalization or discharge planning could help to develop strategies for patients with vision loss and improve patient outcomes.

Authors: Alan R. Morse, J.D., Ph.D., Lighthouse Guild, New York, and coauthors

(doi:10.1001/jamaophthalmol.2019.0446)

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.

What Are the Costs of Continued Smoking Among Patients with Cancer?

Posted April 2, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, APRIL 5, 2019

Media advisory: To contact corresponding study author Graham W. Warren, M.D., Ph.D., email Heather Woolwine at woolwinh@musc.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: This study was an economic evaluation and it used a model to examine the costs of subsequent cancer treatment associated with continued smoking by patients after their initial cancer treatment failed. The model was developed to consider a host of factors, including expected initial treatment failure rates in nonsmoking patients, how common smoking was, and the cost of cancer treatment after initial treatment failed. The analysis conservatively suggests continued smoking by patients with cancer adds nearly $11,000 per smoking patient in treatment costs after the initial cancer treatment failed. The model has limitations and didn’t quantify the potential benefits of smoking cessation.

Authors: Graham W. Warren, M.D., Ph.D., Medical University of South Carolina, Charleston, South Carolina, and coauthors

(doi: 10.1001/jamanetworkopen.2019.1703)

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.

Changes in Gun Purchases After Mass Shootings

Posted April 2, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, APRIL 5, 2019

Media advisory: To contact corresponding study author Douglas J. Wiebe, Ph.D., email Gregory Richter at gregory.richter@pennmedicine.upenn.edu. The full study is linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.1736?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=040519

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: For this analysis, researchers examined monthly data on U.S. background checks for gun purchases and permits from November 1998 through April 2016, and they looked for purchasing trends after mass shootings during that time. A total of 124 major mass shootings (5 or more individuals injured or killed) and nearly 234 million background checks occurred. Researchers report 26 of the shootings (21%) were associated with increases in gun purchases and 22 of the shootings (17.7%) were associated with decreases in gun purchases. Shootings receiving extensive media coverage were associated with increases in handgun purchases, whereas high-fatality shootings were more likely to be associated with decreases in handgun purchases. It is important to study the reasons underlying these changes to better understand the connections between gun violence and public opinion. A primary limitation of the study is the inability to draw causal conclusions from the findings.

Authors: Douglas J. Wiebe, Ph.D., University of Pennsylvania, Philadelphia, Pennsylvania, and coauthors

(doi: 10.1001/jamanetworkopen.2019.1736)

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.

Study Examines Association of Individual Factors, Likelihood of Bullying

Posted April 1, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, APRIL 3, 2019

Media advisory: To contact corresponding author Jean-Baptiste Pingault, Ph.D., email j.pingault@ucl.ac.uk. The full study is linked to this news release.

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Bottom Line: Exposure to bullying is common. This study included about 5,000 children in the United Kingdom and it used genetic data, information on observable traits and exposure to bullying to identify individual risk factors associated with the likelihood of being bullied.

Authors: Jean-Baptiste Pingault, Ph.D., University College London, and coauthors

(doi:10.1001/jamapsychiatry.2019.0310)

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.

Racial Disparities, Access to Kidney Transplants After New Organ Allocation System

Posted April 1, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, APRIL 3, 2019

Media advisory: To contact corresponding author Sanjay Kulkarni, M.D., M.H.C.M., email Ziba Kashef at ziba.kashef@yale.edu. The full study and commentary are linked to this news release.

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/2729436?guestAccessKey=2ffacc2d-2317-4e2f-af17-82dd517c0c6a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=040319

Bottom Line: Among the priorities of a new Kidney Allocation System implemented in 2014 was to improve access to transplants to underserved populations. This study included nearly 43,000 patients on a kidney transplant wait-list after implementation of the new system. Researchers looked at whether changes in patient status on the list (active or inactive) differed based on race/ethnicity and sensitivity levels (which indicate an immune system more likely to reject transplantation), and if those differences were associated with the likelihood of transplantation after implementation of the new allocation system.

Authors: Sanjay Kulkarni, M.D., M.H.C.M., Yale School of Medicine, New Haven, Connecticut, and coauthors

(doi:10.1001/jamasurg.2019.0512)

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 Conception by IVF Associated With Childhood Cancer Risk?

Posted March 28, 2019 by Deanna Bellandi

JAMA Pediatrics

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

Media advisory: To contact corresponding author Logan G. Spector, Ph.D., email Chuck Tombarge at tombarge@umn.edu. The full study is linked to this news release.

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Bottom Line: This study compared the risk of childhood cancer diagnosed in the first decade of life among children conceived by in vitro fertilization with those children conceived naturally. Included in the study were almost 276,000 children conceived by IVF and more than 2.2 million other children; 321 cancers were detected among the children conceived by IVF and 2,042 cancers were detected among the children not conceived by IVF. The association of conception by IVF with risk of childhood cancer was small and limited to rare tumors. Limitations of this observational study include the inability to examine fertility treatments other than IVF and other unmeasured potential confounding factors.

Authors: Logan G. Spector, Ph.D., of the University of Minnesota, and coauthors

(doi:10.1001/jamapediatrics.2019.0392)

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 Estimates How Common Carriers of Polyglutamine Disease-Associated Gene Variants Are in General Population

Posted March 28, 2019 by Deanna Bellandi

JAMA Neurology

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

Media Advisory: To contact co-corresponding author Sarah L. Gardiner, M.D., email s.l.gardiner@lumc.nl and to contact N. Ahmad Aziz, M.D., email ahmad.aziz@dzne.de. The full study and editorial are linked to this news release.

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Bottom Line: Huntington disease is one of nine rare hereditary neurodegenerative diseases known as polyglutamine diseases. This observational study estimated how common carriers with intermediate and pathological ranges of polyglutamine disease-associated gene variants were among the general population using data from five European studies that included DNA samples for more than 14,000 participants without a known polyglutamine disease diagnosis.

Authors: Sarah L. Gardiner, M.D., of Leiden University Medical Center, Leiden, the Netherlands, and N. Ahmad Aziz, M.D., of the German Center for Neurodegenerative Diseases, Bonn, Germany, and coauthors

(doi:10.1001/jamaneurol.2019.0423)

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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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.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.1047?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=032919

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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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.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.1474?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=032919

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

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2728954?guestAccessKey=5b5a77c6-6b2c-4541-a94e-7dc0993468cb&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=032519

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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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.

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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 19, 2019 by Deanna Bellandi

Embed this link to provide your readers free access to the full-text article: This link will be live at the embargo time: http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0968?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=032219

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.

Want to embed a link to this study in your story? This full-text link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.1156?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=032219

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.

# # #

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.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamadermatology/fullarticle/2728818?guestAccessKey=c97000c6-a89c-47e9-af56-29ca0e59cd02&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=032019

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.

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/2728476?guestAccessKey=accdea9c-1b47-4553-a28e-3890d9c76990&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031519

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

Want to embed a link to this study in your story? This full-text link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.0554?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.

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.

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/2728487?guestAccessKey=8c4cf1ef-5c3d-4c32-b157-ba708f8c4b6f&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031519

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.

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/2727333?guestAccessKey=6ed8d2f3-0898-418f-b3f6-1cb128366506&utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=031519

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 http://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.

# # #

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.

# # #

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 http://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.

# # #

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.

# # #

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

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 http://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.

# # #

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.

# # #

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 http://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.

# # #

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.

# # #

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 http://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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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.

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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.

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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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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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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.

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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.

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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.

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/2726985?guestAccessKey=fa9f4042-ed37-414e-a564-ab00509c100c&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=030519

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.

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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.

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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.

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/2726600?guestAccessKey=e8a54b18-b2cb-4e43-817a-a97b55b8393b&utm_source=JAMA Network&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022719

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.

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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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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

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(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.

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