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Basic View | Expanded View
 Showing 1-20 of 68 Articles
Roy C. Ziegelstein, MD, MACP
This Viewpoint discusses the importance of teaching medical students and residents the skills involved in patient-centered care and communication and enhancing the behavioral and social science content of a medical school’s curriculum and that these skills are just as important as teaching the molecular and genetic basis of health and ...
Teachable Moment 
Bharat Kumar, MD; Melissa L. Swee, MD, MS
Original Investigation 
Susan L. Greenspan, MD; Subashan Perera, PhD; Mary Anne Ferchak, BSN; David A. Nace, MD; Neil M. Resnick, MD
Includes: Supplemental Content

Importance  Eighty-five percent of institutionalized elderly people have osteoporosis and bone fracture rates 8 to 9 times higher than rates observed among community-dwelling elderly people. Nevertheless, most of these persons are left untreated and are excluded from pivotal osteoporosis trials.

Objective  To determine the efficacy and ...

Invited Commentary: Osteoporosis Treatment and Fracture Outcomes; Robert Lindsay, MB, ChB, PhD
Original Investigation 
Timothy S. Walsh, MD; Lisa G. Salisbury, PhD; Judith L. Merriweather, PhD; Julia A. Boyd, PhD; David M. Griffith, MD; Guro Huby, PhD; Susanne Kean, PhD; Simon J. Mackenzie, MBChB; Ashma Krishan, MSc; Stephanie C. Lewis, PhD; Gordon D. Murray, PhD; John F. Forbes, PhD; Joel Smith, PhD; Janice E. Rattray, PhD; Alastair M. Hull, MD; Pamela Ramsay, PhD; for the RECOVER Investigators
Includes: Supplemental Content

Importance  Critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain.

Objective  To evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post–intensive care unit (ICU) acute hospital stay ...

Invited Commentary: Improving Functional Recovery After Critical Illness; Christopher E. Cox, MD, MPH; Catherine L. Hough, MD, MSc
Case Report/Case Series 
Luke Gilman, MD; Dori N. Cage, MD; Adam Horn, MD; Frank Bishop, MD; Warren P. Klam, MD; Andrew P. Doan, MD, PhD

Importance  Excessive use of smartphones has been associated with injuries.

Observations  A 29-year-old, right hand–dominant man presented with chronic left thumb pain and loss of active motion from playing a Match-3 puzzle video game on his smartphone all day for 6 to 8 weeks. On physical ...

Invited Commentary 
Robert Lindsay, MB, ChB, PhD
In this issue of JAMA Internal Medicine, Greenspan and colleagues1 present intriguing data on zoledronic acid, one of the most potent drugs in the bisphosphonate family—if not the most potent—approved for treatment of osteoporosis. In a study of frail elderly women living in nursing homes, the authors suggest that a ...
Invited Commentary 
Christopher E. Cox, MD, MPH; Catherine L. Hough, MD, MSc
Conducting clinical research among critically ill patients is a tough business. Few disciplines have experienced such difficulty aligning positive physiologic studies with survival and the other outcomes that matter most to families: functional independence and quality of life. This trend continues with the publication in this issue of JAMA Internal ...
Editor's Note 
Rita F. Redberg, MD, MSc
This Editorial Note discusses the effects of post–acute care on variation in Medicare.
Research Letter 
Peter S. Hussey, PhD; Peter Huckfeldt, PhD; Samuel Hirshman, BA; Ateev Mehrotra, MD, MPH
Health care spending varies widely between geographic regions, but there is disagreement regarding the appropriate policy response.1 Regional policies include reducing Medicare payment rates in high-spending regions,2 limiting the supply of health care facilities using certificate-of-need criteria, and implementing care-improvement collaboratives. The Institute of Medicine opposed regional policies in favor ...
Editor's Note: Post–Acute Care and Variation in Medicare; Rita F. Redberg, MD, MSc
Research Letter 
Jonathan C. Hsu, MD, MAS; Paul S. Chan, MD, MSc; Fengming Tang, MS; Thomas M. Maddox, MD, MSc; Gregory M. Marcus, MD, MAS
In patients with atrial fibrillation (AF) who are at risk for thromboembolism, anticoagulation therapy with warfarin or the newer novel anticoagulants reduces morbidity and mortality.1,2 Because oral anticoagulant use carries a risk of bleeding, the drugs are not recommended in patients with AF who are at a particularly low risk ...
Teachable Moment 
Amanda E. Goldberg, MD; Abi Vijenthira, MD; Brian M. Wong, MD
Teachable Moment 
Daniel Schneider, MD, PhD; Douglas Arenberg, MD
Editorial: Selecting the Best Candidates for Lung Cancer Screening; Tanner Caverly, MD, MPH
Tanner Caverly, MD, MPH
The Center for Medicare and Medicaid Services (CMS) recently decided to reimburse for annual lung cancer screening with low-dose computed tomography (LDCT) among persons who meet the inclusion criteria for the National Lung Cancer Screening Trial (NLST).1 Those who have smoked for more than 30 pack-years, continue to smoke, or ...
Original Investigation 
Elizabeth Dzeng, MD, MPH, MPhil, MS; Alessandra Colaianni, BA, MPhil; Martin Roland, BM BCh, DM; Geetanjali Chander, MD, MPH; Thomas J. Smith, MD; Michael P. Kelly, PhD; Stephen Barclay, BM BCh, MD; David Levine, MD, MHS, ScD
Includes: Supplemental Content

Importance  Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient’s best interest (beneficence).

Objective  To explore how physicians’ approaches to DNR decision making at the ...

Invited Commentary: Resuscitation Discussions; Lynnea Mills, MD; Wendy Anderson, MD, MS
Original Investigation  FREE
Lawrence Oresanya, MD; Shoujun Zhao, MD, PhD; Siqi Gan, MPH; Brant E. Fries, PhD; Philip P. Goodney, MD, MS; Kenneth E. Covinsky, MD, MPH; Michael S. Conte, MD; Emily Finlayson, MD, MS

Importance  Lower extremity revascularization often seeks to allow patients with peripheral arterial disease to maintain the ability to walk, a key aspect of functional independence. Surgical outcomes in patients with high levels of functional dependence are poorly understood.

Objective  To determine functional status trajectories, changes in ...

Invited Commentary: Revascularization in Nursing Home Residents; William J. Hall, MD, MACP
Original Investigation 
Hannah Arem, MHS, PhD; Steven C. Moore, PhD; Alpa Patel, PhD; Patricia Hartge, ScD; Amy Berrington de Gonzalez, DPhil; Kala Visvanathan, MBBS, MPH; Peter T. Campbell, PhD; Michal Freedman, JD, PhD; Elisabete Weiderpass, MD, MSc, PhD; Hans Olov Adami, MD, PhD; Martha S. Linet, MD; I.-Min Lee, MBBS, ScD; Charles E. Matthews, PhD
Includes: Supplemental Content

Importance  The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 vigorous-intensity or 150 moderate-intensity minutes per week (7.5 metabolic-equivalent hours per week) of aerobic activity for substantial health benefit and suggested additional benefits by doing more than double this amount. However, the upper limit ...

Invited Commentary: Achieving the Most Public Health Bang for the Buck; Todd M. Manini, PhD
Original Investigation 
Klaus Gebel, PhD; Ding Ding, PhD; Tien Chey, MAppStats; Emmanuel Stamatakis, PhD; Wendy J. Brown, PhD; Adrian E. Bauman, PhD

Importance  Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes.

Objective  To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount ...

Invited Commentary  FREE
William J. Hall, MD, MACP
The number of older adults residing in long-term care facilities in the United States is increasing at an unprecedented rate; at present, there are approximately 1.5 million nursing home residents, and this number will double to 3 million by 2030.1 More than half will be older than 85 years. Most ...
Invited Commentary 
Lynnea Mills, MD; Wendy Anderson, MD, MS
Prior work1 has indicated that institutional cultural, political, and policy-driven factors affect physicians’ decisions and recommendations surrounding end-of-life care. However, until now, to our knowledge, no published study has aimed to verify this effect specifically on discussions of resuscitation status and to understand cultural effects on trainees’ development of their ...
Invited Commentary 
Todd M. Manini, PhD
The overall health benefits of physical activity have been known for several decades. It is clear that consistent participation in physical activity leads to large physiologic adaptations that are closely connected to improved cardiorespiratory, vascular, musculoskeletal, mental, and metabolic health. These effects are pervasive across the lifespan. In fact, there ...

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