JAMA internal medicine
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JAMA internal medicine · May 2015
Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life.
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). ⋯ Institutional cultures and policies might influence how physician trainees develop their professional attitudes toward autonomy and their willingness to make recommendations regarding the decision to implement a DNR order. A singular focus on autonomy might inadvertently undermine patient care by depriving patients and surrogates of the professional guidance needed to make critical end of life decisions.
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JAMA internal medicine · May 2015
ReviewEffect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data.
Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear. ⋯ Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.
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JAMA internal medicine · May 2015
Prospective evaluation of the association of nut/peanut consumption with total and cause-specific mortality.
High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status. ⋯ Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health.
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JAMA internal medicine · May 2015
Association between apple consumption and physician visits: appealing the conventional wisdom that an apple a day keeps the doctor away.
Fruit consumption is believed to have beneficial health effects, and some claim, "An apple a day keeps the doctor away." ⋯ Evidence does not support that an apple a day keeps the doctor away; however, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.