JAMA network open
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Hospital networks formed around top-ranked cancer hospitals represent an opportunity to optimize complex cancer care in the community. ⋯ These findings suggest that short- and long-term survival after complex cancer treatment were superior at top-ranked hospitals compared with affiliates of top-ranked hospitals. Further study of cancer care within top-ranked cancer networks could reveal collaborative opportunities to improve survival across a broad contingent of the US population.
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Iowa is 1 of 5 states in the US that have not issued a stay-at-home order during the coronavirus disease 2019 (COVID-19) pandemic. There is no empirical evidence on whether issuing a stay-at-home order in Iowa could have been associated with a reduced rate of COVID-19 infections in the state. ⋯ This cross-sectional study with a difference-in-differences design found an increase in estimated rates of COVID-19 cases per 10 000 residents in the border counties in Iowa compared with the border counties in Illinois following a stay-at-home order that was implemented in Illinois but not in Iowa.
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Urgent care (UC) centers are a growing option to address children's acute care needs, which may cause unanticipated changes in health care use. ⋯ High UC reliance occurred more often in healthy, nonminority, school-aged children and was associated with lower health care use across other outpatient settings. There may be an opportunity in certain populations to ensure that UC reliance does not disrupt the medical home model.
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Bone marrow transplant (BMT) is a potentially curative treatment for sickle cell disease (SCD). Patient and caregiver attitudes toward BMT for SCD and the willingness to accept risks of BMT vary, but these attitudes are not well understood. ⋯ This qualitative study found a continuum in attitudes toward BMT for SCD and highlights the complexity of decision-making in BMT for SCD. Patients and families with SCD expressed an interest in learning about BMT. Future prospective studies of patient decision-making regarding BMT, especially in the context of emerging curative and novel disease-modifying therapies for SCD, are warranted.
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Health care workers (HCWs) have high infection risk owing to treating patients with coronavirus disease 2019 (COVID-19). However, research on their infection risk and clinical characteristics is limited. ⋯ In this case series, most infections among HCWs occurred during the early stage of disease outbreak. That non-first-line HCWs had a higher infection rate than first-line HCWs differed from observation of previous viral disease epidemics. Rapid identification of staff with potential infection and routine screening among asymptomatic staff could help protect HCWs.