Cover photograph by Ronan Allencherril
More information on Personae Photography
IN THIS ISSUE
Other Audio Options:
Download MP3 | Subscribe to Podcast
Exercise benefits people who are obese or have diabetes, but the separate effects of exercise duration and intensity are not well-understood. The authors studied the separate effects of exercise amount and intensity on abdominal obesity and glucose tolerance. Participants assigned to higher or lower intensities of the same total amount of exercise had similar reductions in waist circumference and weight, although higher-intensity exercise led to greater increases in cardiovascular fitness and improved 2-hour glucose tolerance.
Smoking is associated with increased illness and death in adults with HIV. The authors compared the prevalence of cigarette smoking and smoking cessation between adults with HIV receiving medical care and adults in the general population. They found that adults with HIV smoked more and were less likely to quit than adults in the general population. These findings emphasize the importance of tobacco screening and cessation strategies in routine HIV care.
In the United States, members of minority groups are at increased risk for incarceration and other involvement with the criminal justice system, and this may be a factor contributing to health disparities. This study found that less than 0.1% of National Institutes of Health grants and less than 1.5% of its total health disparities budget in 2012 focused on criminal justice health research. These findings suggest that this area is understudied given the prevalence of incarceration.
The Centers for Medicare & Medicaid Services measures the quality of care provided by the private, managed care plans in its Medicare Advantage program. This observational analysis investigated the association of Medicare Advantage contract characteristics with quality of care and found that nonprofit contracts received higher ratings than for-profit contracts.
In this guideline on risk assessment and prevention of pressure ulcers, the American College of Physicians (ACP) recommends that clinicians perform a risk assessment to identify patients who are at risk for pressure ulcers and that clinicians use advanced static mattresses or advanced static overlays in such patients. The ACP recommends against using alternating-air mattresses or alternating-air overlays in patients who are at increased risk for pressure ulcers.
In this guideline on treatment of pressure ulcers, the American College of Physicians (ACP) recommends that clinicians use protein or amino acid supplementation and hydrocolloid or foam dressings in patients with pressure ulcers to reduce wound size. The ACP also recommends the use of electrical stimulation as adjunctive therapy in patients with pressure ulcers to accelerate wound healing.
This article applies major economic concepts, such as supply, demand, monopoly, monopsony, adverse selection, and moral hazard, to central features of U.S. health care. These illustrations help explain some of the principal problems of health policy—high cost and the uninsured—and why solutions are difficult to obtain.
The ethical and personal challenges in caring for patients during geopolitical conflict are the topics of this issue's look back into the Annals archives.
In this issue, Ross and colleagues report on the separate effects of exercise intensity and amount on glucose tolerance and abdominal obesity. The editorialists discuss the study's findings and the implications for the advice about physical activity that we provide patients.
This issue features 2 evidence-based guidelines from the American College of Physicians on risk assessment, prevention, and treatment of pressure ulcers. The editorialist emphasizes the importance of clinical judgment in the assessment and treatment of pressure ulcers and highlights areas in which more research is needed.
The politics are complex, but my colleagues are not political people. They are doctors caring for patients, regardless of ethnicity, origin, religion, or any socially constructed barrier.