To identify mental health concerns among soldiers returning from the Iraq war, the Department of Defense has initiated population-wide screening immediately upon return from deployment and a median of 6 months later. Milliken and colleagues report screening results from a cohort of 88 235 soldiers who completed the initial Post-Deployment Health Assessment and the Post-Deployment Health Re-Assessment. Among the authors' findings were that compared with the initial screening, soldiers reported more mental health concerns and were referred for mental health care at a higher rate on the reassessment.
Some data suggest a relationship between the number of lymph nodes examined and survival after colectomy for colon cancer. In a retrospective cohort study of Medicare patients having a colectomy for colon cancer, Wong and colleagues Article assessed whether hospitals that examine more lymph nodes have superior 5-year survival rates. The authors found no relationship between hospital lymph node examination rates and colon cancer survival rates. Hospitals with the highest proportions of patients with 12 or more sampled nodes—a recently endorsed measure of hospital quality—were found to treat lower-risk patients and to have higher procedure volumes. In an editorial, Simunovic and Baxter Article discuss the implications of the study findings for the development and application of valid quality indicators.
To aid understanding of the benefits of the national immunization program, Roush, writing for the Centers for Disease Control and Prevention Vaccine-Preventable Disease Table Working Group, reviewed morbidity and mortality data for the prevaccine eras and compared these with recent morbidity and mortality data for 13 vaccine-preventable diseases (VPDs). The authors found significant decreases in the number of cases, hospitalizations, and deaths for each of the VPDs examined.
Anecdotal reports and some objective evidence suggest that health research in the United States has been adversely affected by implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Ness Article, writing for the Joint Policy Committee, Societies of Epidemiology, reports results of a survey of epidemiologists regarding their experiences with subject recruitment, data access, and other aspects of research conduct since implementation of the Privacy Rule. Among the survey findings were that two-thirds of respondents thought the rule had a negative influence on the conduct of research and only one-quarter thought the rule had enhanced confidentiality and privacy for research participants. In an editorial, Fost and Levine Article discuss the increasing regulation of human subjects research.
From a systematic review of the literature and expert consultation, Bern and colleagues provide evidence-based recommendations for the evaluation, counseling, and treatment of patients with chronic Trypanosoma cruzi infection (Chagas disease) in the United States.
“More than anything, what my mother wanted from physicians was commitment and wonder.” From “The Last Gift.”
New studies examine the efficacy of the 7-valent pneumococcal conjugate vaccine in children and the human papillomavirus vaccine in women, as well as the impact of bacterial or viral strains not covered by these vaccines.
An article in the Archives of Pediatrics & Adolescent Medicine reports results of a randomized trial that compared sustained-release bupropion with placebo for adolescent smoking cessation. Colby and Gwaltney discuss the challenges of helping adolescents achieve long-term abstinence from smoking.
FDA Amendments Act
Hospital disaster preparedness
Shortage of general surgeons
How would you manage a 93-year-old man with advanced dementia and eating problems? Go to www.jama.com to read the case and submit your response. Your response may be selected for online publication. Submission deadline is November 28.
For your patients: Information about Chagas disease.
This Week in JAMA . JAMA. 2007;298(18):2107. doi:10.1001/jama.298.18.2107