Is Exposure to Disinfectants, Cleaning Products at Work Associated With COPD Among Female Nurses?

Posted October 15, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 18, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13563?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: This observational study investigated an association between exposure to disinfectants and cleaning products at work and risk of new cases of chronic obstructive pulmonary disease (COPD) among a large group of female nurses.

Authors: Orianne Dumas, Ph.D., of INSERM U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches in Villejuif, France, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.13563)

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 media relations.

Exposure to Secondhand Smoke Associated With Eye Differences Among Children

Posted October 15, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 17, 2019

Media advisory: 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/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2019.4178?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101719

What The Study Did: About 1,400 young children in Hong Kong had eye exams to see if those exposed to secondhand smoke at home had differences in choroidal thickness, a layer of the eye that contains blood vessels and connective tissue, compared to children not exposed to smoke.

Authors: Jason C. Yam, F.R.C.S.Ed., of the Chinese University of Hong Kong, is the corresponding author.

(doi:10.1001/jamaophthalmol.2019.4178)

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 media relations.

Changes in Cardiovascular Risk Factors Among College Football Players

Posted October 14, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamacardiology/fullarticle/10.1001/jamacardio.2019.3909?guestAccessKey=a6e0736c-a9a1-408f-b0e9-c519343b71ba&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: Researchers recruited 126 college football players from two programs in Georgia and South Carolina to examine over three years how cardiovascular risk factors emerged and changed, including weight, blood pressure and heart structure and function.

Authors: Jonathan H. Kim, M.D., M.Sc., of the Emory Clinical Cardiovascular Research Institute in Atlanta, is the corresponding author.

(doi:10.1001/jamacardio.2019.3909)

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 media relations.

Do Surgeons Get Lower Patient Satisfaction Ratings When They Prescribe Fewer Opioids?

Posted October 14, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamasurgery/fullarticle/10.1001/jamasurg.2019.2875?guestAccessKey=aab5adb4-52a6-4470-bcec-426257e6a9d2&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: A survey study of nearly 1,000 patients who underwent common outpatient surgical procedures reports no significant change in ratings for how satisfied patients were with surgeons when surgeons prescribed fewer opioids.

Authors: Richard J. Barth Jr., M.D., of the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, is the corresponding author.

(doi:10.1001/jamasurg.2019.2875)

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 media relations.

Sociodemographic Factors Associated With Passing Surgery Board Exams

Posted October 14, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: The full study, commentary and podcast 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/10.1001/jamasurg.2019.4081?guestAccessKey=00a8ee32-a0f4-4591-a43f-3db5ffb18b9a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: Survey responses from general surgery trainees were used to examine the association between sociodemographic factors such as race/ethnicity, gender and family status with the likelihood of passing the American Board of Surgery board examinations.

Authors: Heather L. Yeo, M.D., M.H.S., M.B.A., M.S., of NewYork-Presbyterian/Weill Cornell Medicine in New York City, is the corresponding author.

(doi:10.1001/jamasurg.2019.4081)

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 media relations.

Examining Risk of Suicide and Use of ACE Inhibitors, ARBs

Posted October 14, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13304?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101619

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: Associations between risk of suicide and medications widely used in the management of high blood pressure, chronic kidney disease, heart failure and diabetes (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers) were examined in this observational study.

Authors: Tony Antoniou, Pharm.D., Ph.D., of St. Michael’s Hospital in Toronto, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.13304)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 14, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13298?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101619

Visual Abstract

Study Examines Breastfeeding and Risk of Maternal Diabetes, Hypertension

Posted October 14, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13401?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101619

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: To examine if breastfeeding is associated with a lower risk of maternal diabetes or hypertension, six studies with more than 200,000 participants were combined in this systematic review and meta-analysis.

Authors: Haitham M. Ahmed, M.D., M.P.H., of AdvantageCare Physicians in New York, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.13401)

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.

Psoriasis Appears Associated With Increased Risk of Developing, Dying of Cancer

Posted October 14, 2019 by Jim Michalski

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamadermatology/fullarticle/10.1001/jamadermatol.2019.3056?guestAccessKey=c91d53c0-6564-4c0f-9465-d941756c3bb3&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: The risk of developing and dying of cancer among people with psoriasis was examined in this study (called a systematic review and meta-analysis) that combined the results of 58 observational studies.

Authors: Alex M. Trafford, M.Sc., of the University of Manchester in the United Kingdom, is the corresponding author.

(doi:10.1001/jamadermatol.2019.3056)

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 media relations.

Are High School Personality Traits Associated With Later Dementia Diagnoses?

Posted October 14, 2019 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2914?guestAccessKey=0c3f389d-11cb-4b6a-9a2f-802e5672524e&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: A national sample of high school students in the United States in 1960 was used in this observational study to assess whether personality traits measured in high school were associated with dementia diagnoses more than 50 years later using Medicare records.

Authors: Benjamin P. Chapman, Ph.D., M.P.H., M.S., of the University of Rochester Medical Center in Rochester, New York, is the corresponding author.

(doi:10.1001/jamapsychiatry.2019.2914)

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 media relations.

Bulimia Nervosa and Long-Term Risk of Cardiovascular Disease, Death Among Women

Posted October 14, 2019 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: The full study and editorial 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2914?guestAccessKey=1e6086ce-a6d1-4632-95ca-39b649d31075&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: Bulimia nervosa (binge eating followed by purging) is a common psychiatric disease in women. This observational study examined the association between bulimia nervosa and the risk of long-term cardiovascular disease and death during 12 years of follow-up using hospitalization data for a large group of women in Canada.

Authors: Nathalie Auger, M.D., M.Sc., F.R.C.P.C., of the Institut National de Santé Publique du Québec in Canada, is the corresponding author.

(doi:10.1001/jamapsychiatry.2019.2914)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 10, 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/jama/fullarticle/10.1001/jama.2019.14630?guestAccessKey=28863035-c5ce-4c2d-8ec7-3a2e7121774c&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101519

Is Bipolar Disorder Associated With Increased Risk of Parkinson Disease?

Posted October 10, 2019 by Jim Michalski

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 14, 2019

Media Advisory: To contact corresponding author Joaquim J. Ferreira, M.D., Ph.D., email joaquimjferreira@gmail.com. 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/jamaneurology/fullarticle/10.1001/jamaneurol.2019.3446?guestAccessKey=2cb24d8a-f8cf-4e48-b523-7ac94ff8a6b9&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Bottom Line: This study, called a systematic review and meta-analysis, combined the results of seven studies with 4.3 million participants to examine a potential association between bipolar disorder with a later diagnosis of Parkinson disease of unknown cause. The findings suggest that a previous diagnosis of bipolar disorder was associated with increased likelihood of a subsequent Parkinson disease diagnosis but subgroup analyses suggest the possibility of an overestimation of the magnitude of the associations. The main limitation of the study is analysis that suggests a greater likelihood of a Parkinson disease diagnosis in shorter studies which raises concerns over misdiagnosis.

Authors: Joaquim J. Ferreira, M.D., Ph.D., Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal, and coauthors.

(doi:10.1001/jamaneurol.2019.3446)

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.

Premature Death From Cardiovascular Disease

Posted October 14, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 16, 2019

Media advisory: 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/jamacardiology/fullarticle/10.1001/jamacardio.2019.3891?guestAccessKey=66b100a3-51c2-4b85-b8e3-0040bfe64230&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101619

What The Study Did: National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.

Authors: Yingxi Chen, M.D., Ph.D., of the National Cancer Institute in Rockville, Maryland, is the corresponding author.

(doi:10.1001/jamacardio.2019.3891)

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 media relations.

Breastfeeding Disparities Among US Children by Race/Ethnicity

Posted October 10, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 14, 2019

Media advisory: To contact corresponding author Ruowei Li, M.D., Ph.D., email Anita Blankenship at aob4@cdc.gov. 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/10.1001/jamapediatrics.2019.3319?guestAccessKey=2eb9dc6c-20eb-4c3c-9e68-51b646d3ac48&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Bottom Line: Overall rates of breastfeeding increased from 2009 to 2015 but they varied by race/ethnicity in this observational study that used national survey data for nearly 168,000 infants in the United States. When breastfeeding rates took into account sociodemographic factors, such as participation in the Special Supplemental Nutrition Program for Women, Infants and Children, marital status, maternal education level and household income, the breastfeeding disparities were larger between black and white infants. For example, the difference for exclusive breastfeeding through six months increased from 0.5 to 4.5 percentage points. Breastfeeding differences between infants from all other nonwhite groups (Hispanic, Asian and American Indian or Alaskan Native) and white infants mostly got smaller or stayed the same, largely because of breastfeeding increases among white infants. All breastfeeding rates (ever, exclusive through six months, and continuation at 12 months) were lower for black infants than white infants in 2014-2015. Limitations of the study include the data from a national survey that excluded households without telephones. Efforts to improve breastfeeding rates among black infants are needed.

Authors: Ruowei Li, M.D., Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and coauthors

(doi:10.1001/jamapediatrics.2019.3319)

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

# # #

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

Visual abstract, link to provide your readers free access to the full-text article

Posted October 9, 2019 by Jim Michalski

JAMA Network Open

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

Want to embed a link to this study in your story? This full-text link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13054?utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=101119

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.2019.13054)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 10, 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/jamaneurology/fullarticle/10.1001/jamaneurol.2019.3403?guestAccessKey=b1769b38-7871-4767-86f9-8e6afa4ceef7&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Emerging Increase in Electronic Cigarette Use by Young Adults between 2017-2018

Posted October 10, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 14, 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.

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/10.1001/jamainternmed.2019.4957?guestAccessKey=5f47d068-7a56-422f-b0b6-1656d98ff144&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Bottom Line: This research letter uses updated national survey data for 2018 to estimate how common electronic cigarette use is among adults 18 and older in the United States. The analysis included about 153,000 survey participants, of whom 55% were women. The authors report that while current e-cigarette use decreased from 3.7% in 2014 to 2.8% in 2017, it increased again in 2018 to 3.2%. The biggest increase between 2017-2018 was among young adults aged 18 to 24 years (5.2% in 2017 vs. 7.6% in 2018), with no such increase among middle-age or older adults. Limitations of the study include self-reported e-cigarette use. The authors stress their findings are of public health concern and that interventions to decrease e-cigarette use among young adults are needed.

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

(doi:10.1001/jamainternmed.2019.4957)

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.

Association Between Weight-Loss Surgery in Women and Risk of Birth Defects in Infants

Posted October 10, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 15, 2019

Media advisory: To contact corresponding author Martin Neovius, Ph.D., email martin.neovius@ki.se. 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/10.1001/jama.2019.12925?guestAccessKey=27aad08c-4798-435b-a157-e1fe0db8b554&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Bottom Line: Researchers used national registry data in Sweden to examine the risk of major birth defects in infants born to women who had gastric bypass surgery compared with infants born to women who didn’t have the surgery but were similar based on other factors including maternal body mass index and diabetes. The analysis included 2,921 women who had Roux-en-Y gastric bypass surgery and 30,573 women who didn’t for comparison. Infants born to women who had gastric bypass surgery had lower risk of major birth defects. Study authors speculate that surgery-induced improvements in glucose control and other benefits associated with weight loss may contribute to reducing the risk of major birth defects. Limitations of the study include pregnancy termination data that was unavailable, not including stillbirths and individual birth defects couldn’t be analyzed.

Authors: Martin Neovius, Ph.D., Karolinska Institutet, Stockholm, Sweden, and coauthors.

(doi:10.1001/jama.2019.12925)

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 media relations.

Clinical Trial Tests Varenicline to Help Adolescents, Young Adults Quit Smoking

Posted October 10, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 14, 2019

Media advisory: To contact corresponding author Kevin M. Gray, M.D., email Montez Seabrook at seabromo@musc.edu. The full study and editorial 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/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.3553?guestAccessKey=9ac5aef0-6ea0-46d4-ad11-501bd8e908e4&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101419

Bottom Line: Many adult cigarette smokers start before they turn 21 and this randomized clinical trial of volunteer participants tested how effective the smoking-cessation medication varenicline was in helping adolescents and young adults to quit. The 157 volunteers seeking treatment to quit ranged in age from 14 to 21; 77 participants received a 12-week course of varenicline and 80 received placebo but both groups received weekly smoking cessation counseling. The authors report the medicine was well tolerated but abstinence rates at the end of treatment, which was the trial’s primary outcome, didn’t differ between the two groups. However, secondary findings suggest varenicline helped smokers achieve self-reported abstinence earlier and better self-reported overall abstinence during treatment and at posttreatment follow-up. A potential limitation of the study was that biomarkers used to verify smoking abstinence may have been affected by participants who used marijuana or electronic cigarettes.

Authors: Kevin M. Gray, M.D., Medical University of South Carolina, Charleston, and coauthors

(doi:10.1001/jamapediatrics.2019.3553)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 8, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13249?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101119

Here’s a link to provide your readers free access to the full-text article

Posted October 8, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.13123?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101119

Barriers to Access to Hearing Aids for Children

Posted October 8, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 10, 2019

Media advisory: 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/jamaotolaryngology/fullarticle/10.1001/jamaoto.2019.2877?guestAccessKey=c1a8b984-4097-4680-9c4c-0d582eb03643&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101019

What The Study Did: Researchers looked at demographic, socioeconomic and clinical factors that were associated with timely access to hearing aids for children.

Authors: Jonathan Walsh, M.D., of the Johns Hopkins University School of Medicine in Baltimore, is the corresponding author.

(doi:10.1001/jamaoto.2019.2877)

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 media relations.

Firearm-Related Eye Injuries to Patients Under 21

Posted October 8, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 10, 2019

Media advisory: To contact corresponding author Joyce N. Mbekeani, M.D., F.R.C.S., F.R.C.Ophth., email Rachael McCallen at RMCCALL@montefiore.org. 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/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2019.3562?guestAccessKey=6e4372e4-f2c7-4461-950c-17eac3009125&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101019

Bottom Line: Researchers used data from a national registry of hospitalized trauma cases in the United States to examine patterns of firearm-related eye injuries among patients under age 21 from 2008 through 2014. There were about 8,700 eye injuries from firearms in the U.S. during that time, of which nearly a quarter (1,972) were in patients under 21, mostly male adolescents ages 12 to 18. Black patients were most likely to be injured in assaults and white patients were most likely to have self-inflicted firearm-related eye injuries. Most firearm-related eye injuries were sight-threatening and associated with severe injury and traumatic brain injury. About 12% of patients died from their injuries in the hospital. Limitations of this observational study include the exclusion of patients who weren’t hospitalized because they died at the scene, which may underestimate the true implications of firearm-related eye trauma.

Authors: Joyce N. Mbekeani, M.D., F.R.C.S., F.R.C.Ophth., Montefiore Medical Center, Bronx, New York, and coauthors.

(doi:10.1001/jamaophthalmol.2019.3562)

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 media relations.

Study Assesses Cost of Overpayments for Topical Prescription Medications

Posted October 7, 2019 by Jim Michalski

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 9, 2019

Media advisory: 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/jamadermatology/fullarticle/10.1001/jamadermatol.2019.3078?guestAccessKey=c5c178d0-6aee-4ff5-9256-81da7592f27a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100919

What The Study Did: This study examined how common and at what cost is the practice of so-called “clawbacks” for topical prescription drugs when an insured patient’s copayment exceeds the insurer’s cost for the drug.

Authors: Joslyn Kirby, M.D., M.S., M.Ed., of the Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania, is the corresponding author.

(doi:10.1001/jamadermatol.2019.3078)

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 media relations.

Long-Term Outcomes for Transplant Patients Who Receive High-Risk Donor Lungs

Posted October 7, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 9, 2019

Media advisory: 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/10.1001/jamasurg.2019.4079?guestAccessKey=9110ee31-f9bc-4a68-8dca-356015ca3622&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=1000919

What The Study Did: Researchers compared long-term outcomes between transplant patients who received conventional donor lungs and those who received high-risk donor lungs that had been assessed and reconditioned outside the body through a technique known as ex vivo lung perfusion.

Authors: Jussi M. Tikkanen, M.D., of Toronto General Hospital in Toronto, is the corresponding author.

(doi:10.1001/jamasurg.2019.4079)

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 media relations.

Differences in Severity, Health Care Utilization for Firearm Injuries, Other Penetrating Trauma in Kids

Posted October 7, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 9, 2019

Media advisory: To contact corresponding author Ashley E. Wolf, M.D., email press@seattlechildrens.org. 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12850?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100919

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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: Pediatric firearm injuries were associated with greater severity and health care utilization than other penetrating trauma suffered by children caused by cutting or piercing, such as with a knife. This observational study used national trauma data in the United States from 2007 through 2016 to analyze 25,155 hospital encounters for firearm injury and 21,270 encounters for a cut or pierce injury in children 17 years old or younger. Firearm injuries were more likely to require admission to the intensive care unit (ICU) and have a higher degree of severity, as well as longer hospital and ICU stays, compared to cut or pierce injuries. Bullets have more force than many other weapons used to inflict a cut or pierce injury. Limitations of the study include that the data aren’t fully comprehensive. Study authors suggest pediatric firearm injuries can be reduced through legislative efforts, safe gun storage practices and community-based interventions.

Authors: Ashley E. Wolf, M.D., formerly of Seattle Children’s Hospital, University of Washington, Seattle, but now at Rush University Medical Center, Chicago, and coauthors

(doi:10.1001/jamanetworkopen.2019.12850)

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.

Here’s a link to provide your readers free access to the full-text article

Posted October 7, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12895?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100919

Elevated Risk of Blood Clot in Lungs After Surgery Lasts for How Long?

Posted October 7, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 9, 2019

Media advisory: 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/10.1001/jamasurg.2019.3742?guestAccessKey=03a95875-89ab-4962-88d0-2dc65e687255&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100919

What The Study Did: Researchers examined how long an increased risk of pulmonary embolism (lung artery blockage usually caused by a blood clot) persisted after six types of surgery (vascular, gynecological, gastrointestinal, hip or knee replacement, fractures and other orthopedic operations) among 60,000 cancer-free middle-age adults using data from a French national inpatient database.

Authors: Alexandre Caron, M.D., of the University Lille in France, is the corresponding author.

(doi:10.1001/jamasurg.2019.3742)

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 media relations.

Large Income Change Associated With Cardiovascular Disease Risk

Posted October 7, 2019 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 9, 2019

Media advisory: To contact corresponding author Scott D. Solomon, M.D., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study, commentary and podcast 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/jamacardiology/fullarticle/10.1001/jamacardio.2019.3788?guestAccessKey=934dce44-ce9b-4bfe-9e47-01415e543e3b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100919

Bottom Line: Whether a significant change in income is associated with risk of cardiovascular disease (CVD) was the focus of this observational study. Previous research has indicated that having a higher income is associated with lower risk of CVD; however, there is limited evidence on the association between changes in income and CVD. Using data from the ongoing Atherosclerosis Risk in Communities study, this analysis included nearly 9,000 participants from four areas of the United States (Jackson, Mississippi; Washington County, Maryland; suburbs of Minneapolis; and Forsyth County, North Carolina) who were categorized based on changes in their reported income. A drop in income of 50% or more was associated with higher risk of CVD (including heart attack, fatal coronary heart disease, heart failure or stroke) during an average follow-up of 17 years, while a 50% or more increase in income was associated with lower risk of CVD. A limitation of the study is the possibility that participants who developed health issues may have been more likely to experience a decrease in income.

Authors: Scott D. Solomon, M.D., Brigham and Women’s Hospital, Harvard Medical School, Boston, and coauthors.

(doi:10.1001/jamacardio.2019.3788)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 3, 2019 by Jim Michalski

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/10.1001/jama.2019.13051?guestAccessKey=b6f00aa9-8927-457e-9e19-d7bb983256ad&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=1008919

Retraction and Republication

Posted October 3, 2019 by Deanna Bellandi

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 8, 2019

Media advisory: The related articles are linked.

# # #

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

Here’s a link to provide your readers free access to the full-text article

Posted October 3, 2019 by Jim Michalski

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/10.1001/jama.2019.10943?guestAccessKey=0c8e7495-72ba-4c4a-bf11-2992d40affc1&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100819

# # #

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

Association of Family Relationships During Adolescence With Later Depression Risk

Posted October 3, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 7, 2019

Media advisory: To contact authors Ping Chen, Ph.D., and Kathleen Mullan Harris, Ph.D., email Melody Kramer at mjkramer@email.unc.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/10.1001/jamapediatrics.2019.3336?guestAccessKey=c370ed0c-0fdd-4dd2-ab08-984022018fa0&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100719

Bottom Line: Positive family relationships during adolescence appeared to be associated with lower levels of depressive symptoms from adolescence to midlife in this observational study of about 18,000 adolescents followed up until they were 32 to 42 years old. The study examined differences between males and females in depressive symptoms by levels of positive family relationships during adolescence as measured by family cohesion (adolescent reports about how much their family understood them, had fun, and paid attention to them) and the absence of parent-child conflict (adolescent reports of a serious argument in the past month over their behavior). Family cohesion and the absence of parent-child conflict were associated with a lower risk of depression from adolescence into midlife. The reduction in depressive symptoms associated with positive adolescent family relationships was greater for females than males during adolescence and into the early 20s but then leveled out to be equally beneficial for males and females throughout young adulthood into midlife. Limitations of the study include a self-reported measure of depressive symptoms and preadolescent family relationships weren’t examined.

Authors: Ping Chen, Ph.D., and Kathleen Mullan Harris, Ph.D., of the Carolina Population Center at the University of North Carolina at Chapel Hill

(doi:10.1001/jamapediatrics.2019.3336)

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.

How Common is High Blood Pressure Among Children Worldwide?

Posted October 3, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 7, 2019

Media advisory: To contact corresponding author Yajie Zhu, Ph.D., email yajie.zhu@georgeinstitute.ox.ac.uk. The full study and editorial 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/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.3310?guestAccessKey=74d63283-8af6-41a6-9444-7b314482badc&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100719

Bottom Line: This study, called a review and meta-analysis, combined the results of 47 articles published from 1994 to 2018 to estimate worldwide how common high blood pressure is among children and adolescents age 19 and younger. Authors report the overall proportion of childhood hypertension was 4%. Hypertension was more common among overweight or obese children and those undergoing puberty. How common hypertension was also varied when measured by different devices. A limitation of this analysis was variation in reported prevalence among included studies. The findings suggest childhood high blood pressure is a considerable public health challenge worldwide.

Authors: Yajie Zhu, Ph.D., University of Oxford, United Kingdom, and coauthors

(doi:10.1001/jamapediatrics.2019.3310)

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.

Did Providing Free Essential Medicines Increase Adherence?

Posted October 3, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 7, 2019

Media advisory: To contact corresponding author Navindra Persaud, M.D., M.Sc., C.C.F.P., email Michael Oliveira at Michael.Oliveira@unityhealth.to. 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/10.1001/jamainternmed.2019.4472?guestAccessKey=3a5a5e5e-1ccb-4562-b29c-ce6b1037ba3a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100719

Bottom Line:More patients who said they couldn’t afford their medications adhered to treatment when they received free essential medicines for one year in a randomized clinical trial, but not all measures of health outcomes improved. The trial enrolled 786 patients (764 completed it) at nine primary care sites in Ontario, Canada. Patients were randomly split into two groups: 395 received free essential medicines plus usual care and 391 had usual care and usual access to medicines. Medicines aren’t universally publicly funded in Canada like hospitalizations and physician care are. Free medicines included in the trial were treatments for chronic conditions, such as antipsychotics, antiretrovirals, glucose-lowering medicines and antihypertensives, and for acute conditions, such as antibiotics and analgesics. Researchers report more people who received free essential medicines were appropriately adherent (151 of 395 or 38.2%) compared with those in the group with usual access to medicine (104 of 391 or 26.6%). The free distribution of medicine reduced systolic blood pressure among those prescribed an antihypertensive but it didn’t significantly improve low-density lipoprotein cholesterol levels and there was a nonsignificant improvement in diabetes control (decrease in hemoglobin A1c ) in those prescribed treatment to control diabetes. The importance of these findings from one high-income country should be applied cautiously to other locales with different health care systems.

Authors: Navindra Persaud, M.D., M.Sc., C.C.F.P., of St. Michael’s Hospital, Toronto, and coauthors

(doi:10.1001/jamainternmed.2019.4472)

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.

Here’s a link to provide your readers free access to the full-text article

Posted October 1, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12443?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100419

25% of Total US Health Care Spending Estimated to be Waste

Posted October 3, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 7, 2019

Media advisory: To contact corresponding author William H. Shrank, M.D., M.S.H.S., email Alex Kepnes at akepnes@humana.com. The full study, editorials and podcast 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/jama/fullarticle/10.1001/jama.2019.13978?guestAccessKey=bf8f9802-be69-4224-a67f-42bf2c53e027&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100719

Bottom Line: A new study estimates about one-quarter of total health care spending in the United States is waste, with a price tag ranging from $760 billion to $935 billion. The United States spends more on health care than any other country. For this analysis, the authors identified government-based reports, articles and peer-reviewed publications from 2012 to 2019 that focused on estimates of costs or savings related to six areas of waste. There were 71 estimates from 54 publications and those estimates were combined into ranges or totaled. Study authors report total estimated annual cost of waste was $265.6 billion for administrative complexity (billing and coding waste, physician time spent reporting on quality measures); $230.7 billion to $240.5 billion for pricing failure (prices increase far from those expected in a well-functioning market); $102.4 billion to $165.7 billion for failure of care delivery (poor execution or lack of widespread adoption of best care processes); $75.7 billion to $101.2 billion for overtreatment or low-value care; $58.5 billion to $83.9 billion for fraud and abuse; and $27.2 billion to $78.2 billion for failure of care coordination (unnecessary admissions or avoidable complications and readmissions). The authors also searched the published literature to find estimates of the potential to reduce waste in each of the categories listed by scaling proven strategies. Projected potential savings from efforts to reduce waste ranged from $191 billion to $282 billion, a potential 25% reduction in the total cost of waste. The authors highlight the opportunity to reduce waste through insurer-clinician collaboration and data interoperability. This analysis has limitations, including that the studies used may not represent all costs and savings in each area of waste, and that data from some of the studies may not be generalizable to the U.S. population. Implementing effective measures to decrease waste is a chance to reduce continued increases in U.S. health care costs.

Authors: William H. Shrank, M.D., M.S.H.S., Humana Inc., Louisville, Kentucky, and coauthors

(doi:10.1001/jama.2019.13978)

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 media relations.

Here’s a link to provide your readers free access to the full-text article

Posted October 1, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12516?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100419

Evaluating Value of Senses

Posted October 1, 2019 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 3, 2019

Media advisory: 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/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2019.3537?guestAccessKey=1072c858-6c49-4033-875e-140f872c04d8&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100319

What The Study Did: What senses (sight, hearing, touch, smell, taste, balance, temperature and pain) are most valued by the general public? That’s the question this web-based survey in the U.K. answered.

Authors: David P. Crabb, Ph.D., of the University of London, is the corresponding author.

(doi:10.1001/jamaophthalmol.2019.3537)

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.

Cost-Effectiveness of Multigene Testing of All Patients With Breast Cancer

Posted October 1, 2019 by Jim Michalski

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 3, 2019

Media advisory: The full study and podcast 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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.3323?guestAccessKey=583f4614-cd6e-4be8-96a9-8db42b4763dd&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100319

What The Study Did: Researchers estimated the cost-effectiveness and health effects of multigene testing for all patients with breast cancer compared with selective testing based on family history or clinical criteria using data for nearly 12,000 women with breast cancer from the U.S., U.K. and Australia.

Authors: Ranjit Manchanda, M.D., Ph.D., of the Queen Mary University of London, is the corresponding author.

(doi:10.1001/jamaoncol.2019.3323)

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.

Changes Over Time in Cases of Head/Neck Melanoma Among Kids, Teens, Young People in US, Canada

Posted October 1, 2019 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 3, 2019

Media advisory: 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/jamaotolaryngology/fullarticle/10.1001/jamaoto.2019.2769?guestAccessKey=9bfdcb86-2790-47ba-b577-bdc9896ba33b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100319

What The Study Did: This observational study looked at changes in new cases of head and neck melanoma among children, adolescents and young adults in the U.S. and Canada over a 20-year period from 1995 to 2014.

Authors: Haley N. Bray, M.D., of the Saint Louis University School of Medicine in Missouri, is the corresponding author.

(doi:10.1001/jamaoto.2019.2769)

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

# # #

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

Here’s a link to provide your readers free access to the full-text article

Posted September 30, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12352?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100219

Here’s a link to provide your readers free access to the full-text article

Posted September 30, 2019 by Jim Michalski

Media advisory: This article is being released to coincide with presentation at the European Society of Intensive Care Medicine (ESICM) annual congress in Berlin.

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/10.1001/jama.2019.14608?guestAccessKey=97c21250-7922-4a3b-8086-1b4f0eee6ec8&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

Here’s a link to provide your readers free access to the full-text article

Posted September 30, 2019 by Jim Michalski

Media advisory: This article is being released to coincide with presentation at the European Society of Intensive Care Medicine (ESICM) annual congress in Berlin.

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/10.1001/jama.2019.14901?guestAccessKey=3a37cddc-c94a-4ce2-91c4-3043ae779131&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

Here’s a link to provide your readers free access to the full-text article

Posted September 30, 2019 by Jim Michalski

Media advisory: This article is being released to coincide with presentation at the European Society of Intensive Care Medicine (ESICM) annual congress in Berlin.

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/10.1001/jama.2019.14607?guestAccessKey=7c75fd20-5e1f-47d2-9bc7-ec47375fc7e1&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

Going to Sleep on Your Back in Late Pregnancy

Posted September 30, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12614?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100219

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: This study looked at whether going to sleep on your back in the third trimester of pregnancy was associated with average lower birth weights.

Authors: Lesley M.E. McCowan, M.D., of the University of Auckland in New Zealand, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.12614)

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.

Maternal Lead Exposure, Intergenerational Risk of Childhood Overweight/Obesity and Folate

Posted September 30, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12343?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100219

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: An observational study of 1,442 mother-child pairs examined associations between lead blood levels in mothers and intergenerational risk of their children being overweight or obese and whether adequate folate levels in mothers mitigated that risk.

Authors: Xiaobin Wang, M.D., M.P.H., Sc.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.12343)

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.

Grading Evidence in Studies About Antidepressant Use/Exposure and Adverse Health Outcomes

Posted September 30, 2019 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: The full study and editorial 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2859?guestAccessKey=5481e8d7-21f2-4ed3-8aad-9e3ab14a3225&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

What The Study Did: This study graded the evidence of 45 meta-analyses of observational studies on the association between antidepressant use or exposure and adverse health outcomes.

Authors: Elena Dragioti, Ph.D., of Linköping University in Linköping, Sweden, is the corresponding author.

(doi:10.1001/jamapsychiatry.2019.2859)

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@jamanetw

ADHD and Risk of Giving Birth as Teenagers

Posted September 30, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12463?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100219

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: Data were used from about 384,000 girls and women in Sweden (including 6,410 with attention-deficit/hyperactivity disorder) who gave birth for the first time between 2007-2014 to examine whether those with ADHD have an increased likelihood of giving birth as teenagers.

Authors: Charlotte Skoglund, Ph.D., of the Karolinska Institute in Stockholm, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.12463)

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.

Lifetime Indoor Tanning Associated With Squamous Cell Carcinoma Cancer

Posted September 30, 2019 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: The full study and editorial 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/jamadermatology/fullarticle/10.1001/jamadermatol.2019.2681?guestAccessKey=16542ca9-1c94-4522-86fa-3989d6b8061d&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=100219

What The Study Did: This observational study used data from nearly 160,000 women in Norway to examine lifetime indoor tanning and risk of squamous cell carcinoma, one of the most common types of cancer worldwide. The findings suggest the association between cumulative exposure to indoor tanning and risk of squamous cell carcinoma was the same regardless of how many years the women tanned and what age they were when they started.

Authors: Simon Lergenmuller, M.Sc., of the University of Oslo, Norway, is the corresponding author.

(doi:10.1001/jamadermatol.2019.2681)

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.

Earnings Disparities Between Female, Male Surgeons in Canada

Posted September 30, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: To contact corresponding author Nancy N. Baxter, M.D., Ph.D., email Jennifer Stranges at Jennifer.Stranges@unityhealth.to. 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/10.1001/jamasurg.2019.3769?guestAccessKey=ca5dfc05-a79c-4c66-8546-7512c3452071&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

Bottom Line: Female surgeons in Ontario, Canada, earned less per hour than their male counterparts within a fee-for-service system, and women were less likely to perform the most lucrative procedures. Fee-for-services systems of payment are often proposed as being unbiased. This analysis used administrative data from a single-payer health system to compare earnings per hour spent operating for 3,275 surgeons who performed 1.5 million surgical procedures between 2014 and 2016. Female surgeons had practiced fewer years than male surgeons and the largest proportion of female surgeons practiced gynecology. Researchers report female surgeons earned 24% less per hour than male surgeons, with the largest average earning differences in cardiothoracic surgery at nearly $60 (in US dollars) per hour and orthopedic surgery at $55 per hour. Limitations of the study include the small number of women in some specialties, limiting the ability to identify earnings differences. Earnings differences also may have been underestimated.

Authors: Nancy N. Baxter, M.D., Ph.D., University of Toronto, Ontario, Canada, and coauthors

(doi:10.1001/jamasurg.2019.3769)

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

Here’s a link to provide your readers free access to the full-text article

Posted September 26, 2019 by Deanna Bellandi

Media advisory: This article is being released to coincide with the opening of the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.

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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.2996?guestAccessKey=e077cbf5-5a57-4ace-b5cc-edff3cf74311&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092719

Here’s a link to provide your readers free access to the full-text article

Posted September 26, 2019 by Deanna Bellandi

Media advisory: This article is being released to coincide with presentation at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.

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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.4794?guestAccessKey=6bddf612-f517-465c-bbf3-5f5b5061f57b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=093019

Here’s a link to provide your readers free access to the full-text article

Posted September 26, 2019 by Deanna Bellandi

Media advisory: This article is being released to coincide with presentation at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.

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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.4782?guestAccessKey=570a7e0e-e643-4edf-99c0-37fa07fa32b9&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092919

How Were Oral Contraceptives, Concurrent Depressive Symptoms Associated Among Adolescents, Young Women?

Posted September 30, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 2, 2019

Media advisory: To contact corresponding author Anouk E. de Wit, B.Sc., email a.e.de.wit@umcg.nl. 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2838?guestAccessKey=653456f6-38a8-4a18-8150-dd9cbcf099a3&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100219

Bottom Line: This observational study examined associations between depressive symptoms and oral contraceptive use in adolescents and young women and how those associations might differ by age. Oral contraceptive use has been associated with increased risk for subsequent depression in adolescents. The study included about 1,000 girls and young women in the Netherlands who completed at least 1 of 4 assessments about their oral contraceptive use and depressive symptoms at ages 16, 19, 22 and 25. Authors report oral contraceptive use showed no association with depressive symptoms when all the age groups were combined. However, 16-year-old girls who used oral contraceptives reported higher depressive symptoms scores and were more likely to report crying, eating problems and excessive sleepiness than those who didn’t use oral contraceptives. Limitations of the study include causal inferences cannot be made, and the results may not be generalizable to other countries where access to contraception and the acceptability of its use are different.

Authors: Anouk E. de Wit, B.Sc., University of Groningen, the Netherlands, and coauthors.

(doi:10.1001/jamapsychiatry.2019.2838)

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.

How Common is Food Insecurity Among Medicare Enrollees?

Posted September 26, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 30, 2019

Media advisory: To contact corresponding author Jeanne M. Madden, Ph.D., email Shannon Nargi at s.nargi@northeastern.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/10.1001/jamainternmed.2019.3900?guestAccessKey=b80b24f0-2baf-413a-9b72-2e7a71ed2ab3&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=093019

Bottom Line: Nearly 1 in 10 Medicare enrollees age 65 and over and 4 in 10 enrollees younger than 65 with long-term disabilities experience food insecurity. This study provides national estimates of how common it is for Medicare enrollees to be unable to get the food they need because they lack money. Study authors used data from a 2016 survey of Medicare beneficiaries with six questions about food insecurity. The nearly 9,700 people interviewed represented 50.7 million Medicare enrollees living in community settings. Analysis of risk factors found that lower incomes, reporting four or more chronic condition diagnoses, and having symptoms of depression or anxiety were each independently associated with food insecurity in both age groups. A limitation of this observational study is that it cannot determine causality.

Authors: Jeanne M. Madden, Ph.D., of Northeastern University, Boston, and coauthors

(doi:10.1001/jamainternmed.2019.3900)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 26, 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/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.3480?guestAccessKey=082e517a-8472-4c89-bceb-d3c2f3b72352&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=093019

Rural, Urban Drive Times to Nearest Opioid Treatment Programs Differ

Posted September 26, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 1, 2019

Media advisory: To contact corresponding author Paul J. Joudrey, M.D., M.P.H., email Bill Hathaway at william.hathaway@yale.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/10.1001/jama.2019.12562?guestAccessKey=3b2b2fb6-9390-43c0-9437-86057c608fcd&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100119

Bottom Line: Comparing drive times to the nearest opioid treatment programs in urban and rural counties in five U.S. states with the highest county rates of opioid-related overdose deaths was the focus of this research letter. Methadone for treating opioid use can only be dispensed from certified treatment programs in the United States, of which there is a shortage in rural counties. This analysis included 489 counties in Indiana, Kentucky, Ohio, Virginia and West Virginia. Among all the counties, average drive time to the nearest opioid treatment programs was 37 minutes. Longer drive times were associated with rural counties compared with urban ones, with driving times ranging from 41 to 49 minutes in rural counties compared with eight to 35 minutes in urban counties. Longer drive times in the most rural counties could be reduced from 49 minutes to 17 minutes if methadone prescribing occurred at federally qualified health centers (federally supported primary care clinics). Limitations of the study include drive times were county-level population estimates, individual drive times within counties vary, and the geographic availability of methadone in urban areas was likely overestimated because of public transportation.

Authors: Paul J. Joudrey, M.D., M.P.H., Yale School of Medicine, New Haven, Connecticut, and coauthors

(doi:10.1001/jama.2019.12562)

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

Prior DUI Convictions Among Legal Handgun Purchasers Associated With Risk of Later Violent Crimes

Posted September 26, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 30, 2019

Media advisory: To contact corresponding author Rose M.C. Kagawa, Ph.D., M.P.H., email Carole Gan at cfgan@ucdavis.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/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2019.4491?guestAccessKey=2e65dc76-96cc-43c5-a5c7-33ddf3e34108&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=093019

Bottom Line: A study of legal handgun purchasers in California suggests convictions for driving under the influence (DUI) prior to a gun purchase may be associated with subsequent risk of arrest for violent crimes, including firearm-related ones. The observational study included about 79,000 gun purchasers followed-up from their first gun purchase in 2001 through 2013. Of the 1,495 purchasers with DUI convictions, 131 (8.8%) were subsequently arrested for violent crimes listed on the Crime Index (murder, rape, robbery and aggravated assault) published by the FBI. Among 65,700 purchasers with no prior criminal history, 1,188 (1.8%) were subsequently arrested for Crime Index-listed violent crimes. Compared with gun purchasers who had no prior criminal history, gun purchasers with prior DUI convictions and no other criminal history were at increased risk of arrest for a Crime Index-listed violent crime, a firearm-related violent crime and any violent crime. Limitations of the study include the exclusion of gun purchasers age 50 and older thus limiting the generalizability of the findings. The federal government and many states have restricted the purchase and possession of firearms by members of high-risk groups, such as people convicted of felonies, domestic violence and other violent misdemeanors, and study authors suggest that similar restrictions on people convicted of DUI may help to reduce violent criminal activity.

Authors: Rose M.C. Kagawa, Ph.D., M.P.H., of the University of California, Davis, in Sacramento, and coauthors

(doi:10.1001/jamainternmed.2019.4491)

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.

Did IV High-Dose Vitamin C Improve Outcomes for Patients With Sepsis and Severe Lung Condition?

Posted September 26, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 1, 2019

Media advisory: To contact corresponding author Alpha A. Fowler III, M.D., email Laura Rossacher at lrossacher@vcu.edu. The full study and editorial are linked to this news release. A visual abstract is below.

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/10.1001/jama.2019.11825?guestAccessKey=62db20f8-8ba0-4199-8a8c-de3b07be8551&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=100119

Bottom Line: This randomized clinical trial looked at whether high-dose vitamin C delivered intravenously could reduce organ failure, inflammation and vascular injury in patients with sepsis and acute respiratory distress syndrome (ARDS), a severe lung condition that is a common organ injury associated with sepsis. Previous research has suggested that intravenous vitamin C may lessen inflammation and vascular injury. In this trial, 167 patients with sepsis and ARDS at seven intensive care units in the United States received intravenous vitamin C or placebo every six hours for 96 hours. The authors report that compared with placebo, intravenous vitamin C didn’t result in improved measures of organ dysfunction or levels of biomarkers indicating inflammation (C-reactive protein) or vascular injury (the anticoagulant thrombomodulin) by seven days. Limitations of this preliminary study include that it may have been underpowered to detect differences in measures of organ failure and biomarker levels and the dosage of vitamin C may have been insufficient.

Authors: Alpha A. Fowler III, M.D., Virginia Commonwealth University, Richmond, and coauthors

Visual Abstract

(doi:10.1001/jama.2019.11825)

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

Here’s a link to provide your readers free access to the full-text article

Posted September 24, 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/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2019.3731?guestAccessKey=a193ec13-097b-4c55-9620-afed5b8edc82&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092619

Optimism Associated With Lower Risk of Heart Disease, Early Death

Posted September 24, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 27, 2019

Media advisory: To contact corresponding author Alan Rozanski, M.D., email Ilana Nikravesh at ilana.nikravesh@mountsinai.org. 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12200?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=092719

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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: Optimism was associated with lower risk of cardiovascular events and less risk of overall death in this observational study. The study, called a systematic review and meta-analysis, combined results from 15 studies (10 studies reported data on cardiovascular events and nine reported data on all-cause mortality) with nearly 230,000 participants and an average follow-up of nearly 14 years. Limitations of the study include wide variation in ages of the participants; the inability to account for individual mitigating factors such as smoking, diabetes and hypertension; and a study design that doesn’t permit causal inferences to be made. Future studies should examine what might explain this association, as well as investigate the potential benefits of interventions that could promote optimism and reduce pessimism.

Authors: Alan Rozanski, M.D., Mount Sinai St. Luke’s Hospital, New York, and coauthors

(doi:10.1001/jamanetworkopen.2019.12200)

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.

Smoking Cessation Program for Patients With, Without Cancer

Posted September 24, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 27, 2019

Media advisory: To contact corresponding author Paul Cinciripini, Ph.D., email Meagan Raeke at meraeke@mdanderson.org. 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12251?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=092719

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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 tobacco treatment program delivered at a cancer center had average seven-day smoking abstinence rates of about 45% at three- and six-month follow-ups and nearly 44% at the nine-month follow-up, and those rates didn’t differ between patients with and without cancer. This observational study included 3,245 participants in a model tobacco treatment program (2,343 with current cancer; 309 with a history of cancer; and 593 with no history of cancer) that consisted of an in-person medical consultation, in-person and telephone counseling sessions, and prescription drug therapy. Limitations of the study include that it wasn’t a randomized clinical trial. The findings suggest providing a comprehensive tobacco treatment program in an oncologic setting could foster smoking cessation, which can affect outcomes of patients with cancer who smoke.

Authors: Paul Cinciripini, Ph.D., the University of Texas MD Anderson Cancer Center, Houston, and coauthors

(doi:10.1001/jamanetworkopen.2019.12251)

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.

Potential Factors Associated With Severity of Diabetes Complications in Patients With Mental Health, Substance Use Disorders

Posted September 23, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 25, 2019

Media advisory: To contact corresponding author Eric M. Schmidt, Ph.D., email Kim Betton at Kim.Betton@va.gov. 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.12060?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=092519

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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: Among 123,000 patients in the U.S. Department of Veterans Affairs health system with newly diagnosed diabetes, 23% had mental health or substance use disorder diagnoses and that prior engagement with the health care system may be associated with a lower severity of complications for a few years after the onset of diabetes. More than 90% of patients with mental health or substance use disorders had primary care visits before diabetes was diagnosed compared with 58 percent of patients without those disorders. Patients with already diagnosed mental health and substance use disorders had lower overall, but more quickly progressing, complication severity scores through seven years after a diabetes diagnosis than those patients without, even after accounting for other mitigating factors such as coexisting illnesses. Study authors speculate patients with diagnosed mental health or substance use disorders likely were already being treated for other conditions, such as hypertension, when diabetes was diagnosed. Limitations of the study include missing data.

Authors: Eric Schmidt, Ph.D., Veterans Affairs Palo Alto Health Care System, Menlo Park, and Stanford University, Stanford, California, and coauthors

(doi:10.1001/jamanetworkopen.2019.112060)

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.

Association of Genetic Risk to Psychotic Experiences With Neuropsychiatric Disorders

Posted September 23, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 25, 2019

Media advisory: The full study and editorial 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2508?guestAccessKey=05958f32-6d33-4a01-8960-0ec0f4dba66b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092519

What The Study Did: Data from the UK Biobank were used to examine whether genetic risk to psychotic experiences is shared with neuropsychiatric disorders.

Authors: James T. R. Walters, M.R.C.Psych., Ph.D., and Stanley Zammit, M.R.C.Psych., Ph.D., of Cardiff University in Cardiff, United Kingdom, are the corresponding authors.

(doi:10.1001/jamapsychiatry.2019.2508)

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.

Use of Mental Health Services After Weight-Loss Surgery

Posted September 23, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 25, 2019

Media advisory: 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2741?guestAccessKey=13d2181c-aae0-4464-9062-d34c16e6be41&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092519

What The Study Did: With data from nearly 25,000 patients who underwent weight-loss surgery in Western Australia over 10 years, this study examined the association between bariatric surgery and the use of outpatient, emergency department and inpatient mental health services.

Authors: David J.R. Morgan, M.B.B.S., St. John of God Subiaco Hospital, Perth, Western Australia, is the corresponding author.

(doi:10.1001/jamapsychiatry.2019.2741)

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.

Changes in Internal Medicine Subspecialty Choices of Women, Men

Posted September 19, 2019 by Jim Michalski

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 23, 2019

Media advisory: 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/10.1001/jamainternmed.2019.3833?guestAccessKey=5eb41f98-9775-427e-ad39-586edac1e949&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

What The Study Did: This study used enrollment data to examine changes in the internal medicine subspecialty choices of women and men from 1991 to 2016. Data were examined for nine internal medicine subspecialties: cardiovascular disease, endocrinology, gastroenterology, geriatric medicine, hematology and oncology, infectious disease, nephrology, pulmonary disease and critical care, and rheumatology.

Authors: Mary Norine Walsh, M.D., M.A.C.C., of the St. Vincent Hospital and Heart Center in Indianapolis, is the corresponding author.

(doi:10.1001/jamainternmed.2019.3833)

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.

Use, Discontinuation of Insulin Treatment Among Older Adults

Posted September 19, 2019 by Jim Michalski

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 23, 2019

Media advisory: 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/10.1001/jamainternmed.2019.3759?guestAccessKey=e1982c2b-b1e4-48ef-b2ba-4b51e6e9b8f1&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

What The Study Did: Whether insulin treatment was used less frequently and discontinued more often among older adults (ages 75 to 79) in poor health compared with those in good health was the focus of this observational study that included more than 21,000 adults with type 2 diabetes.

Authors: Jonathan Z. Weiner, M.D., M.P.H., of Kaiser Permanente of Northern California in Oakland, is the corresponding author.

(doi:10.1001/jamainternmed.2019.3759)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 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:

https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2019.2995?guestAccessKey=8ff25d58-cf7b-429b-833e-a29f7673cd2a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

Loss of Automatic Reenrollment Option Associated With Enrollment Decrease in California Marketplace

Posted September 19, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 23, 2019

Media advisory: 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/10.1001/jamainternmed.2019.3717?guestAccessKey=70f9359d-b5ea-4de9-8ad0-17993200b8c2&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

What The Study Did: This research letter analyzed enrollment data from California’s health insurance marketplace, Covered California, and study authors report losing the option to automatically reenroll because some insurers exited the marketplace was associated with a decrease in enrollment.

Authors: Coleman Drake, Ph.D., of the University of Pittsburgh, and David M. Anderson, M.S., of the Duke Margolis Center for Health Policy, Durham, North Carolina, are the authors.

(doi:10.1001/jamainternmed.2019.3717)

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.

Does Being Younger Than Classmates Increase Likelihood of Childhood Depression, ADHD, Intellectual Disability?

Posted September 19, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 23, 2019

Media advisory: 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/10.1001/jamapediatrics.2019.3194?guestAccessKey=7ddeb72b-5a0a-4eae-a5b6-a2230b9e793e&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

What The Study Did: This observational study included 1 million children in the United Kingdom and looked at the association between children who are younger than their classmates and the likelihood of depression, attention-deficit/hyperactivity disorder and intellectual disability.

Authors: Jeremy P. Brown, M.Sc., of the London School of Hygiene and Tropical Medicine, is the corresponding author.

(doi:10.1001/jamapediatrics.2019.3194)

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.

Modest Improvements in Diets of U.S. Adults But Still Too Much Sugar, Saturated Fat

Posted September 19, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 24, 2019

Media advisory: To contact corresponding author Zhilei Shan, M.D., Ph.D., email Chris Sweeney at csweeney@hsph.harvard.edu. To contact corresponding author Fang Fang Zhang, M.D., Ph.D., email Siobhan Gallagher at Siobhan.Gallagher@tufts.edu. The full study and editorial 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/jama/fullarticle/10.1001/jama.2019.13771?guestAccessKey=143e6dff-5b1e-48eb-948b-a8a2e386627a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092419

Bottom Line: U.S. adults made modest improvements to their diets in recent years but still eat too much low-quality carbohydrates and saturated fat based on an analysis of nationally representative survey data. The study included data from nearly 44,000 adults who reported their dietary intake in a 24-hour period. Researchers report a decline in the consumption of low-quality carbohydrates (primarily added sugar) and increases in high-quality carbohydrates (primarily whole grains), plant protein (primarily whole grains and nuts) and polyunsaturated fatty acids from 1999 to 2016. However, intake of low-quality carbohydrates and saturated fat remained high. There was slight improvement in overall diet quality as assessed by a measure of adherence to key recommendations in dietary guidelines. A limitation of the study is its use of self-reported dietary data.

Authors: Zhilei Shan, M.D., Ph.D., Harvard T. H. Chan School of Public Health, Boston, Fang Fang Zhang, M.D., Ph.D., Tufts University, Boston, and coauthors

(doi:10.1001/jama.2019.13771)

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

Marijuana Use Among U.S. Adults With, Without Medical Conditions

Posted September 17, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 20, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11936?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=092019

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: National survey data was used in this study to examine how common marijuana use was among adults with and without medical conditions.

Authors: Hongying Dai, Ph.D., of the University of Nebraska Medical Center in Omaha, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.11936)

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.

USPSTF Recommendation on Screening for Asymptomatic Bacteriuria in Adults

Posted September 19, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 24, 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, related articles and a podcast 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 and all USPSTF articles remain free indefinitely https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2019.13069?guestAccessKey=61fd61b1-2e94-4933-b248-c8798f0774bc&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092419

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends screening people who are pregnant for asymptomatic bacteriuria (bacteria in the urine without signs or symptoms of a urinary tract infection) using urine culture and not screening other adults. The condition is present in an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, a kidney infection that is a common reason for hospitalization in pregnant women. The USPSTF routinely makes recommendations about the effectiveness of preventive care services and this statement updates its 2008 recommendation.

(doi:10.1001/jama.2019.13069)

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.

# # #

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

Is Overall Screen Time Associated With Academic Performance in Kids, Teens?

Posted September 19, 2019 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 23, 2019

Media advisory: To contact corresponding author Mireia Adelantado-Renau, M.Sc., email adelantm@uji.es. The full study and editorial 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/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.3176?guestAccessKey=f02523bb-1adb-4566-8f9f-02bab8189b69&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=092319

Bottom Line: Screen time overall wasn’t associated with the academic performance of children and adolescents in this observational study. Called a systematic review and meta-analysis, this research consisted of a review of 58 studies from 23 countries (involving 480,000 participants ages 4 to 18) and a meta-analysis that combined the results of 30 of those studies involving 106,000 participants. The studies examined time or frequency for computer, internet, mobile phone, television, video game and overall screen media use and academic performance including composite scores, language and mathematics. While authors report the amount of time spent overall on screens wasn’t associated with academic performance, the more time spent watching television and playing video games was associated with poorer academic performance. Previous research has produced conflicting findings about the association between screen media use and academic performance. A limitation of this research is that causal inferences can’t be made. The findings of this current report suggest education and public health professionals should consider supervision and reduced time spent on screens.

Authors: Mireia Adelantado-Renau, M.Sc., University Jaume I, Castellon, Spain, and coauthors

(doi:10.1001/jamapediatrics.2019.3176)

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.

Comparing Major Adverse Cardiovascular Events Among Patients With Diabetes, Reduced Kidney Function Treated With Metformin or Sulfonylurea

Posted September 17, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 7:15 A.M. (ET), THURSDAY, SEPTEMBER 19, 2019

Media advisory: The full study and editorial are linked to this news release. This study is being released to coincide with presentation at the European Association for the Study of Diabetes annual meeting.

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/10.1001/jama.2019.13206?guestAccessKey=cef46538-89de-4513-9868-f7178fab8a7a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

What The Study Did: This observational study compared major cardiovascular events (including hospitalization for heart attack, stroke, transient ischemic attack or cardiovascular death) among patients with diabetes and reduced kidney function treated with metformin or a sulfonylurea (a class of drugs to treat diabetes).

Authors: Christianne L. Roumie, M.D., M.P.H., of the Nashville VA Medical Center in Nashville, is the corresponding author.

(doi:10.1001/jama.2019.13206)

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

Comparison of Cardiovascular Outcomes for Medications to Treat Type 2 Diabetes

Posted September 17, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 7:15 A.M. (ET), THURSDAY, SEPTEMBER 19, 2019

Media advisory: The full study and editorial are linked to this news release. This study is being released to coincide with presentation at the European Association for the Study of Diabetes annual meeting.

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/10.1001/jama.2019.13772?guestAccessKey=e6057f58-b61e-4c46-8897-573917f3d6cb&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

What The Study Did: This randomized clinical trial compared the outcomes of heart attack, stroke or death from cardiovascular causes among 6,000 patients with type 2 diabetes who were treated with the glucose-lowering medications linagliptin or glimepiride.

Authors: Nikolaus Marx, M.D., of Aachen University in Aachen, Germany, is the corresponding author.

(doi:10.1001/jama.2019.13772)

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

Study Examines Association Between Prenatal Anemia, Neurodevelopmental Disorders in Children

Posted September 16, 2019 by Jim Michalski

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 18, 2019

Media advisory: 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/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2019.2309?guestAccessKey=c72368c6-2eee-4193-8734-9e51efc83604&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091819

What The Study Did: Data on 500,000 children born in Sweden were used to examine the association between mothers with anemia during pregnancy and the risk of children being diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder and intellectual disability.

Authors: Renee M. Gardner, Ph.D., of the Karolinska lnstitutet in Stockholm, Sweden, is the corresponding author.

(doi:10.1001/jamapsychiatry.2019.2309)

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

# # #

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

What is Association Between Pain, Patient Satisfaction After Rhinoplasty?

Posted September 16, 2019 by Deanna Bellandi

JAMA Facial Plastic Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 19, 2019

Media advisory: 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/jamafacialplasticsurgery/fullarticle/10.1001/jamafacial.2019.0808?guestAccessKey=1ea593fc-e1f2-458f-9cae-ec66059fe376&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

What The Study Did: This study surveyed 104 patients and looked at whether there was an association between patient-reported pain, opioid use and perceived surgical success after rhinoplasty for cosmetic improvement or for functional reasons to improve breathing.

Authors: Linda N. Lee, M.D., of Harvard Medical School in Boston, is the corresponding author.

(doi:10.1001/jamafacial.2019.0808)

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

How Often Do Hospitals, Physician Practices Screen Patients for Food, Housing, Other Social Needs?

Posted September 16, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 18, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11514?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: National survey data helped the authors of this study examine how common it is for U.S. hospitals and physician practices to screen patients for social needs such as food insecurity, housing instability, utility and transportation needs, and experience with interpersonal violence.

Authors: Taressa K. Fraze, Ph.D., of Dartmouth College in Lebanon, New Hampshire, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.11514)

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.

Opioid Prescriptions Filled After Eye Surgery With Incision

Posted September 17, 2019 by Deanna Bellandi

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 19, 2019

Media advisory: The full study and podcast 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/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2019.3694?guestAccessKey=81a2d7eb-3c85-4ad3-9e51-7612c1291525&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

What The Study Did: This study use data from a large insurer’s administrative medical claims database to examine the rate of opioid prescriptions filled around the time of eye surgery where an incision was made, and how that rate has changed over time.

Authors: Brian L. VanderBeek, M.D., M.P.H., of the University of Pennsylvania in Philadelphia, is the corresponding author.

(doi:10.1001/jamaophthalmol.2019.3694)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 17, 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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.3105?guestAccessKey=922a177f-fe24-45d9-a57e-b819b1b40f11&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

Inconsistencies Between Electronic Health Record, Physicians’ Observed Behaviors

Posted September 16, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 18, 2019

Media advisory: To contact corresponding author Carl T. Berdahl, M.D., M.S., email Enrique Rivero at erivero@mednet.ucla.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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11390?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091819

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

Bottom Line: A study of nine emergency department residents reports inconsistencies between the electronic medical record and physicians’ behaviors observed and recorded during patient encounters. Resident physicians were shadowed by trained observers for 20 encounters in this study conducted at emergency departments in two academic medical centers. The study quantified the review of systems (when patients are asked questions about different organs) and physical examinations documented by physicians and what observers confirmed. Physicians documented a median of 14 systems during the review of systems, while audio recordings confirmed a median of five. For physical examination, physicians documented a median of eight systems, while observers confirmed a median of 5.5. The study notes the electronic medical record could be prone to inaccuracy in those areas because of autopopulated information. Electronic medical records are used to generate bills. Limitations of the study include the small number of resident physicians and their behavior may not represent that of attending emergency physicians, also the observers may have missed things. Further research could help to determine if such inconsistencies are widespread.

Authors: Carl T. Berdahl, M.D., M.S., of the National Clinician Scholars Program, University of California, Los Angeles, and coauthors, including David L. Schriger, M.D., M.P.H., of the University of California, Los Angeles, who is an associate editor of JAMA.

(doi:10.1001/jamanetworkopen.2019.11390)

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.

Study Examines Associations Between Adverse Childhood Experiences, Caregiver Support, Brain Development

Posted September 16, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 18, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11426?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091819

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: This study examined the association of adverse childhood experiences and caregiver support with the development of regions of the brain in childhood and adolescence. The analysis included 211 children who had neuroimaging and behavioral assessments conducted during preschool and adolescence. Magnetic resonance imaging (MRI) measured changes in volume of specific regions of the brain. Preschool and school-age adverse childhood experiences and caregiver support were assessed.

(doi:10.1001/jamanetworkopen.2019.11426)

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.

Survival in Women, Men Diagnosed With Breast Cancer

Posted September 17, 2019 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 19, 2019

Media advisory: To contact corresponding author Xiao-Ou Shu, M.D., Ph.D., email Craig Boerner at craig.boerner@vumc.org. 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/jamaoncology/fullarticle/10.1001/jamaoncol.2019.2803?guestAccessKey=76c2bceb-e9f2-4b4d-811b-cd9918d08801&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091919

Bottom Line: An analysis of nearly 1.9 million patients diagnosed with breast cancer suggests overall survival is lower among men than women and that undertreatments and clinical characteristics account for much of the difference. The study included National Cancer Database data for 16,025 male and 1.8 million female patients diagnosed with breast cancer between 2004-2014. Men had higher mortality across all breast cancer stages. For men, the three-year survival rate was 86.4% and the five-year survival rate was 77.6%. For women, the three-year survival rate was 91.7% and the five-year survival rate was 86.4%. Limitations of the study include a lack of information on cancer recurrence and cause of death, as well as missing information on details of cancer pathology and treatment, patient compliance data, lifestyle factors and coexisting illnesses. Study authors suggest future research focus on why clinical characteristics and biological features may have different implications for survival in male and female patients with breast cancer.

Authors: Xiao-Ou Shu, M.D., Ph.D., the Vanderbilt University Medical Center, Nashville, and coauthors

(doi:10.1001/jamaoncol.2019.2803)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 12, 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/10.1001/jamainternmed.2019.3649?guestAccessKey=b7017dd3-0c75-423b-8d15-f127f21dacf5&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091619

Patterns of Long-Term Opioid Use Within VHA

Posted September 16, 2019 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 18, 2019

Media advisory: 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/jamasurgery/fullarticle/10.1001/jamasurg.2019.2895?guestAccessKey=712bf997-80ad-44cd-90c7-7c115a85f9a7&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091819

What The Study Did: This research letter examined postoperative long-term opioid use and quitting within the Veterans Health Administration between 2000 and 2016, and it also looked at the association of an opioid safety initiative with long-term opioid use in veterans undergoing total knee replacement surgery.

Authors: Karthik Raghunathan, M.B.B.S., M.P.H., of the Duke University Medical Center in Durham, North Carolina, is the correspdonding author.

(doi:10.1001/jamasurg.2019.2895)

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

Is Headache From Anesthesia After Childbirth Associated With Risk of Bleeding Around Brain?

Posted September 12, 2019 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 16, 2019

Media Advisory: 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/jamaneurology/fullarticle/10.1001/jamaneurol.2019.2995?guestAccessKey=68bf4ef9-fc57-4d0d-a140-1c00e11419eb&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091619

Bottom Line: This study examined whether postpartum women with headache from anesthesia after neuraxial anesthesia (such as epidural) during childbirth had increased risk of being diagnosed with bleeding around the brain (intracranial subdural hematoma).

Authors: Albert R. Moore, M.D., of the Royal Victoria Hospital, McGill University, in Montreal, Canada, is the corresponding author.

(doi:10.1001/jamaneurol.2019.2995)

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.

Comparing Effectiveness of 2 Surgical Methods for Uterine Prolapse

Posted September 12, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 17, 2019

Media advisory: To contact corresponding author Charles W. Nager, M.D., email Michelle Brubaker at mmbrubaker@ucsd.edu. The full study and editorial 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/jama/fullarticle/10.1001/jama.2019.12812?guestAccessKey=568a6a1e-ab3f-454a-ae88-a8b58392b0fe&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091719

Bottom Line: Uterine prolapse happens when weakened muscles and ligaments no longer provide enough support for the uterus, which then protrudes into or out of the vagina. This randomized clinical trial compared the effectiveness of two surgical methods to treat women: a vaginal hysterectomy to remove the uterus with ligament suspension to support remaining tissue or uterus-sparing suspension techniques, known as hysteropexy. A previous review of trials comparing these techniques didn’t find one superior to the other. This study included 175 postmenopausal women with uterine prolapse who had a mesh-augmented repair with the uterus remaining in place (transvaginal mesh hysteropexy) or vaginal hysterectomy (removal of the uterus) with ligament suspension. Researchers report that the vaginal mesh hysteropexy was 12 percentage points better than the hysterectomy procedure at three years for the composite outcome that combined retreatment of prolapse, prolapse beyond the hymen or prolapse symptoms, but this was not quite statistically significant. Further research (including continued follow-up in this trial) is needed to assess whether vaginal mesh hysteropexy is superior. A potential limitation of the study is the inclusion of only postmenopausal women because rates of pain or sexual pain could be different in younger patients.

Authors: Charles W. Nager, M.D., UC San Diego Health, San Diego, and coauthors

(doi:10.1001/jama.2019.12812)

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

Chronotype, Social Jet Lag Associated With Higher Waist Size, Fat Mass in Adolescent Girls

Posted September 12, 2019 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 16, 2019

Media advisory: To contact corresponding author Elizabeth M. Cespedes Feliciano, Sc.D., Sc.M., email Janet Byron at Janet.L.Byron@kp.org or Mckenzie Ridings at mridings@partners.org. The full study and editorial 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/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.3089?guestAccessKey=d73ab72d-c791-46ec-b95d-6db6e0064ed4&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091619

Bottom Line: For adolescent girls but not boys, bigger waistlines and greater fat mass were associated with being an evening chronotype who prefers going to bed and waking up later and greater social jet lag because of later sleep timing on weekends versus weekdays, independent of sleep duration and other lifestyle factors. This observational study of 804 adolescents (418 girls and 386 boys; average age 13) from eastern Massachusetts included data from wrist monitors, questionnaires and body measurements. Chronotype was measured based on a scale with higher scores indicating evening versus morning preferences for adolescents; social jet lag was the difference in sleep midpoint in hours from midnight on weekends (free days) versus weekdays (school days) with higher values meaning that sleep timing shifted later on free days. There were no associations with a cardiometabolic risk score. A limitation of the study is that causal inferences cannot be made about the associations. The findings suggest that obesity prevention efforts should consider regular patterns of sleep and wake times, in addition to more and better-quality sleep.

Author: Elizabeth M. Cespedes Feliciano, Sc.D., Sc.M., of Kaiser Permanente Northern California, Oakland, and coauthors

(doi:10.1001/jamapediatrics.2019.3089)

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.

Does Adding Therapy Before, After Surgery for Urinary Incontinence Help?

Posted September 12, 2019 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 17, 2019

Media advisory: To contact corresponding author Vivian W. Sung, M.D., M.P.H., email Kevin Stacey at kevin_stacey@brown.edu. The full study and editorial 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/jama/fullarticle/10.1001/jama.2019.12467?guestAccessKey=f9020ca2-0a3e-4b5c-b2cf-cc401fe54287&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091719

Bottom Line: Adding behavioral and physical therapy before and after surgery for women with stress and urgency urinary incontinence resulted in a small improvement in symptoms compared to women who just had surgery but that difference in symptoms may not be clinically important. There have been a lack of studies examining treatments for women with both stress and urgency urinary incontinence also called mixed urinary incontinence. This randomized clinical trial included 480 women with symptoms of mixed urinary incontinence and compared the effect among women of having sessions of behavioral and pelvic floor muscle therapy before and after midurethral sling surgery for incontinence or surgery alone. The authors report that after 12 months, compared to women who just had surgery, women in the combined therapy and surgery group had a small improvement in symptoms of mixed urinary incontinence but that difference didn’t meet the threshold set for clinical importance. A limitation of the study was a lack of well-established thresholds when this study was designed for determining minimal clinically important differences for women with mixed urinary incontinence.

Authors: Vivian W. Sung, M.D., M.P.H., Alpert Medical School of Brown University, Providence, Rhode Island, and coauthors

(doi:10.1001/jama.2019.12467)

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

How Common Are Forced 1st Sexual Intercourse Experiences Among U.S. Women?

Posted September 12, 2019 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 16, 2019

Media advisory: To contact corresponding author Laura Hawks, M.D., email David Cecere at dcecere@challiance.org. 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/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2019.3500?guestAccessKey=c65bdb04-8dfd-495f-b868-43e129b345ea&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=091619

Bottom Line: This study estimates 1 in 16 U.S. women had an unwanted first sexual intercourse experience that was physically forced or coerced. In an analysis of nationally representative survey data for 13,310 women, 6.5% of the respondents reported a forced first sexual intercourse encounter, which is equivalent to more than 3.3 million women between the ages of 18 and 44. The average age for women at the time of the forced encounter was 15 ½ compared with 17 ½ for those reporting a voluntary first sexual intercourse experience. The average age of the assailant at a first forced sexual intercourse was six years older (27 vs. 21) compared with the partner in a voluntary first sexual experience. Women with a forced first sexual intercourse experience were more likely to have an unwanted first pregnancy or abortion, as well as other gynecological and general health problems. Limitations of the study include its observational design so causal inferences are impossible and authors were unable to account for other potential influencing factors.

Authors: Laura Hawks, M.D., of Cambridge Health Alliance and Harvard Medical School, Boston, and coauthors

(doi:10.1001/jamainternmed.2019.3500)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 10, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11139?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091319

Here’s a link to provide your readers free access to the full-text article

Posted September 9, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11027?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091119

Are Differences in Working Memory Development Associated With Crashes Involving Young Drivers?

Posted September 10, 2019 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 13, 2019

Media advisory: 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11421?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091319

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.

What The Study Did: This study of 84 young drivers looked at the association between motor vehicle crashes and differences in the development of working memory, which is critical to awareness of hazards while driving.

Authors: Elizabeth A. Walshe, Ph.D., of the University of Pennsylvania in Philadelphia, is the corresponding author.

(doi:10.1001/jamanetworkopen.2019.11421)

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.

Here’s a link to provide your readers free access to the full-text article

Posted September 9, 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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11063?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091119

Study Examines Patterns of Violence Among Young Urban Males

Posted September 10, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 13, 2019

Media advisory: To contact corresponding author Alison J. Culyba, M.D., Ph.D., M.P.H., email Arvind Suresh at suresha2@upmc.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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11375?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091319

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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 observational study of adolescent men in urban neighborhoods examined associations between social support, patterns of violence, and violence-related risk behaviors or protective factors that might mitigate them. The analysis included data from a recently completed randomized clinical trial that included 866 male adolescents from lower-resource neighborhoods in Pittsburgh who were enrolled at community agencies. Participants were surveyed on issues including violence, bullying, sexual and dating violence, substance use and involvement in school. The authors report that a high level of social support was associated with fewer risk behaviors among young people, and high social support and mentoring were both associated with a lower likelihood of being involved in a gang. The results suggest understanding the associations between different types of violence and their related risk and protective factors may help in prevention efforts. A limitation of the study was that it was conducted in urban neighborhoods in a single city, which may limit its generalizability to other communities.

Authors: Alison J. Culyba, M.D., Ph.D., M.P.H., University of Pittsburgh School of Medicine, and coauthors

(doi:10.1001/jamanetworkopen.2019.11375)

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.

Accounting for Influencing Factors When Estimating Suicide Rates Among U.S. Youth

Posted September 10, 2019 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 13, 2019

Media advisory: To contact corresponding author Bin Yu, M.D., M.P.H., email Rossana Passaniti at PASSAR@shands.ufl.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/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.11383?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=091319

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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: Using unadjusted suicide rates to describe trends may be skewed because they are affected by differences in age and year of birth. This secondary analysis of data included total population and suicide deaths by single year of age from 10 to 19 and by sex from 1999 to 2017 and accounted for those factors. Unadjusted suicide rates for females were 1.6 per 100,000 in 1999 and 3.5 per 100,000 in 2017, while adjusted rates that accounted for differences in age and year of birth increased from 1.7 per 100,000 in 1999 to 4.2 per 100,000 in 2017. Unadjusted rates for males were 7.4 per 100,000 in 1999 and 10.7 per 100,000 in 2017, while adjusted rates were 4.9 per 100,000 in 1999 and 8.7 per 100,000 in 2017. A limitation of the study is the use of data and coding in which the misclassification of suicide death cannot be completely ruled out.

Authors: Bin Yu, M.D., M.P.H., University of Florida, Gainesville, and coauthors

(doi:10.1001/jamanetworkopen.2019.11383)

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.