Kevin M. Harris, MD; Lawrence L. Creswell, MD; Tammy S. Haas, RN; Taylor Thomas, BS; Monica Tung, BA; Erin Isaacson, BS; Ross F. Garberich, MS; Barry J. Maron, MD
Reports of race-related triathlon fatalities have raised questions regarding athlete safety. This case series describes death and cardiac arrest among participants in U.S. triathlon races from 1985 to 2016.
Carolina Díez, BA; Rachel P. Kurland; Emily F. Rothman, ScD; Megan Bair-Merritt, MD, MSCE; Eric Fleegler, MD, MPH; Ziming Xuan, ScD, SM, MA; Sandro Galea, MD, DrPH, MPH; Craig S. Ross, PhD, MBA; Bindu Kalesan, PhD, MPH, MSc; Kristin A. Goss, PhD, MPP; Michael Siegel, MD, MPH
Some states have adopted laws to restrict possession of firearms by perpetrators of intimate partner violence (IPV). This study examined the relationship between state IPV-related firearm laws and intimate partner homicides in the United States between 1991 and 2015.
Lois Snyder Sulmasy, JD; Paul S. Mueller, MD, MPH; for the Ethics, Professionalism and Human Rights Committee of the American College of Physicians
How we die, live, and are cared for at the end of life is important, with implications for individuals, their families, and society. The emphasis by medicine and society on intervention and cure sometimes comes at the expense of good end-of-life care. Within this context, a few U.S. jurisdictions have legalized physician-assisted suicide. This paper presents the position of the American College of Physicians (ACP) on the topic. On the basis of substantive ethics, clinical practice, policy, and other concerns articulated in this paper, the ACP does not support legalization of physician-assisted suicide.
David A. Asch, MD, MBA; Kevin G. Volpp, MD, PhD
Investment in discovering transformative health care interventions favors future generations who might realize its large but distant benefits, but it shortchanges current generations who could immediately benefit from the “halfway technologies” that get us pretty far but not to the moon. Human behavior typically sits on the path between therapy and effect. In that sense, the real halfway approaches we have made are our half-hearted investments in understanding and overcoming the behaviors and system imperfections that keep health technologies from reaching their full potential.
I. Glenn Cohen, JD; Sharona Hoffman, JD, LLM, SJD; Eli Y. Adashi, MD, MS
Ransomware is a malicious software (malware) that denies users access to their data unless they pay a ransom. Typically, hackers encrypt data and promise a decryption key in exchange for ransom. Health care data are especially vulnerable given the imperative of acute care interventions. This commentary describes the threat to electronic health records and preventive measures that clinicians should be aware of.
Katrina Hedberg, MD, MPH; Craig New, PhD
Twenty years ago, Oregon voters approved the Death With Dignity Act, making Oregon the first state in the United States to allow physicians to prescribe medications to be self-administered by terminally ill patients to hasten their death. This report summarizes the experience in Oregon, including the numbers and types of patients and providers participating. These data should inform the ongoing policy debate as additional jurisdictions consider such legislation.
Joslyn Fisher, MD, MPH; Amy Bonomi, PhD, MPH
Díez and colleagues report a study that finds that states with firearm “relinquishment” laws were found to have intimate partner homicide rates that were significantly lower than in states without these laws. The editorialists discuss how these findings inform a simmering national debate about firearm-related policy and see them as a call to action for health care professionals.
Timothy E. Quill, MD; Robert M. Arnold, MD; Stuart J. Youngner, MD
The American College of Physicians (ACP) position paper on the legalization of physician-assisted suicide reaffirms the ACP's opposition to this practice, even though it is now legal in several countries and U.S. jurisdictions. Given the diversity of opinions and the legality of the procedure for so many people, the editorialists worry that the ACP's rigid opposition misses an opportunity to educate clinicians and learn about best practices.
Reginald T. Ho, MD; Karen Glanz, PhD, MPH
In their report for Annals, Harris and colleagues shed light on the causes of death in U.S. triathletes over a 30-year period. The editorialists discuss questions raised but not answered by the study. They call for prospective studies to strengthen the ability to reduce triathletes' low but real risk for sudden death.
William G. Kussmaul III, MD
The American College of Physicians (ACP) position paper on the legalization of physician-assisted suicide reaffirms the ACP's opposition to this practice, even though it is now legal in several countries and U.S. jurisdictions. The editorialist explains why the ACP's position deserves credit for its clarity and courage.
Jerry A. Molitor, MD, PhD
Jack Coulehan, MD, MPH
Lawrence J. Hergott, MD
Dennis G. Maki, MD, MACP
Lawrence E. Hart, MB BCh, MSc, FRCPC
Angela Lowenstern, MD; L. Kristin Newby, MD, MHS
Gregory Jacquin, MD, FRCPC; Alexandre Poppe, MD, CM, FRCPC
Terry Quinn, MD
Catherine M. Kress, MD; Ngozi U. Obi, MD; Allan V. Prochazka, MD, MSc
Henry S. Sacks, PhD, MD
Paul Kruger, MBBS; John Eikelboom, MBBS
Andrew Worster, MD, MSc; Peter Kavsak, PhD, FCACB, FACB, FCCS
Geno J. Merli, MD; Howard H. Weitz, MD
Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.
Darren B. Taichman, MD, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Jeanne M. Farnan, MD, MHPE; Vineet M. Arora, MD, MAPP
Years ago, when hospital medicine emerged as a subspecialty, it appeared to offer several attractive qualities for female physicians, including scheduling flexibility and a competitive salary. As a brand-new specialty, it held the promise of moving away from gender norms already firmly ensconced in existing subspecialties. But has this young field kept its promise of equal opportunity and advancement for women?
Nadine Abdullah, MD
Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.
Lisa Richardson, MD
Nilay Shah, MD
Kevin Venus, MD
Thomas Bodley, MD
Bikrampal Sidhu, MD
Natalie Wong, MD
Mena Gewarges, MD
Seema Marwaha, MD
Samir C. Grover, MD
Ariel Lefkowitz, MD
Arno Kumagai, MD
Shelly Dev, MD
Michael Schull, MD, MSc
Robert Sargeant, MD
Keith M. Diaz, PhD; Virginia J. Howard, PhD; Brent Hutto, MSPH; Natalie Colabianchi, PhD; John E. Vena, PhD; Monika M. Safford, MD; Steven N. Blair, PED; Steven P. Hooker, PhD
Although total sedentary time has been associated with increased mortality, most studies have relied on participant recall to report past activity. Whether longer or shorter bouts of inactivity are associated with different outcomes is not known. This large cohort study objectively measured physical activity to assess total as well as shorter and longer bouts of sedentary time.
James J. Chamberlain, MD; Rita Rastogi Kalyani, MD, MHS; Sandra Leal, PharmD, MPH; Andrew S. Rhinehart, MD; Jay H. Shubrook, DO; Neil Skolnik, MD; William H. Herman, MD, MPH
This synopsis focuses on the 2017 American Diabetes Association recommendations about monitoring and pharmacologic approaches to glycemic management for type 1 diabetes.
Arabella L. Simpkin, MD, MMSc; Jatin M. Vyas, MD, PhD; Katrina A. Armstrong, MD, MSCE
Diagnostic reasoning is one of the most important skills of internal medicine physicians. However, given the complexities of the current health care environment, training in the diagnostic process has received less emphasis during internal medicine residency. In this essay, the authors describe several initiatives at their institution to foster the development of diagnostic reasoning skills among internal medicine residents.
David A. Alter, MD, PhD
Diaz and colleagues' study tracked physical activity in adults aged 45 years or older and showed a strong relationship between daily volume of sedentary behavior and all-cause mortality, even after adjustment for episodes of moderate to vigorous physical activity. The editorialist discusses the findings and the strategies needed to reduce daily sedentary time and uninterrupted sedentary bout lengths.
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