JAMA network open
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Pediatric firearm injuries are a serious and growing public health problem, constituting the second leading cause of death in children and adolescents in the United States. Firearm injuries have a high case fatality, but knowledge is limited to date regarding their injury severity and health care utilization burden compared with those of other penetrating injuries, especially among children with critical injury. ⋯ This study found that pediatric firearm injuries were associated with greater severity and health care utilization compared with penetrating trauma from other mechanisms, suggesting that the mechanism of injury is an important consideration in penetrating sharp force trauma in children and adolescents. Public health measures, legislative efforts, and safe storage practices are among the interventions needed to reduce pediatric firearm injuries.
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Opioid use disorder (OUD) is a public health crisis in the United States, but only 5% of US physicians have obtained a Drug Addiction Treatment Act (DATA) waiver to prescribe buprenorphine to treat OUD. Increasing the number of primary care physicians (PCPs) who have obtained the waiver and are able to treat patients with OUD is of utmost importance. ⋯ In this quality improvement study, an educational intervention was associated with an increase in the number of PCPs and clinics that could provide buprenorphine treatment for OUD and with an increase in the patients who were able to access care with medications for OUD.
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Out-of-hospital cardiac arrest is a common scenario facing prehospital emergency medical services (EMS) professionals and nearly always involves either manual or mechanical cardiopulmonary resuscitation (CPR). Mechanical CPR devices are expensive and prior clinical trials have not provided evidence of benefit for patients when compared with manual CPR. ⋯ Mechanical CPR device use increased more than 4-fold among patients with out-of-hospital cardiac arrest treated by EMS professionals. Given the high costs of mechanical CPR devices, better evidence is needed to determine whether these devices improve clinically meaningful outcomes for patients treated for out-of-hospital cardiac arrest by prehospital EMS professionals to justify the significant increase in their use.
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In peer-reviewed medical journals, authoring an invited commentary on an original article is a recognition of expertise. It has been documented that women author fewer invited publications than men do. However, it is unknown whether this disparity is due to gender differences in characteristics that are associated with invitations, such as field of expertise, seniority, and scientific output. ⋯ In this case-control study, women had lower odds of authoring invited commentaries than their male peers. This disparity was larger for senior researchers. Journal editors could use natural language processing of published research to widen and diversify the pool of experts considered for commentary invitations.
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With immune recovery following early initiation of antiretroviral therapy (ART), the risk of tuberculosis (TB) reactivation among individuals with HIV could be reduced. The current strategy of annual latent TB infection (LTBI) testing should be revisited to increase cost-effectiveness and reduce the intensity of testing for individuals. ⋯ Changing the current testing strategy to less intense testing strategies is likely to be cost-effective in the presence of an increased coverage of baseline LTBI testing and/or treatment.