This Viewpoint discusses the rationale and policy objectives of the Pennsylvania Rural Health Model, a program launched by CMS and the Commonwealth of Pennsylvania in 2017 to transition rural hospitals from fee-for-service reimbursement to a multipayer global budget payment method intended to improve population health outcomes and quality of care while lowering costs.
This Viewpoint summarizes findings from a population-based birth defect surveillance report from the Centers for Disease Control and Prevention estimating the prevalence of birth defects potentially related to Zika virus infection in US areas with documented local Zika virus transmission in 2016.
This Viewpoint argues that the therapeutic approach to bipolar disorder should mimic that for cancer, with immediate aggressive treatment and vigilant monitoring and follow-up to prevent long-term sequelae of disability, cognitive deficits, and suicide.
In this narrative essay, the author wonders what effect the #metoo phenomenon will have on mentoring between male mentors and junior female trainees and faculty and recalls male mentors who were supportive of her and other women colleagues’ professional development in a plea for diversity and inclusion among leaders in medicine that supports the entire academic medical community.
This study uses NHANES data to estimate the mean population sodium intake and describe urinary potassium excretion among US adults aged 20 to 69 years.
This network meta-analysis of randomized trials compares the efficacy and safety of indomethacin, ibuprofen, and acetaminophen for closure of clinically or echocardiographically diagnosed hemodynamically significant patent ductus arteriosus (PDA) in preterm infants.
This cohort study investigates the association between loss of hospital-based obstetric services between 2004 and 2014 and changes in location of childbirth and preterm births in rural counties in the United States.
This population epidemiology study estimates county-level patterns in mortality rates from infectious diseases in the United States between 1980 and 2014.
This narrative review summarizes evidence on the use of tenofovir disoproxil fumarate (TDF)/emtricitabine for HIV preexposure prophylaxis (PrEP) and calls for increased prescribing of PrEP and research on measures to identify individuals at high risk for HIV to ensure their access to PrEP and maximize medication adherence.
This JAMA Performance Improvement article uses the case of a patient with acute myocardial infarction and heart failure who developed cardiogenic shock after being given carvedilol as part of a standard STEMI admission order set to discuss the limits of orders sets and of guideline-based care and the need to optimize each for individual patient circumstances.
A 56-year-old woman with persistent GERD symptoms on 40 mg esomeprazole had a normal EGD and 24-hour ambulatory reflux monitoring results. What would you do next?
This study reports 3-year outcomes of a randomized trial that compared close contact casting vs the usual surgery for unstable ankle fractures in older adults and that found equivalent ankle function outcomes at 6 months.
This study analyzed patient safety reports in and near Pennsylvania from 2013 through 2016 to identify those that contained explicit language associating possible patient harm with an electronic health record usability issue.
This Medical News article examines why BMI-based definitions of overweight and obese might misclassify postmenopausal women as normal weight.
This JAMA Patient Page describes hypothermia, its prevention, and treatment strategies.