0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
This Week in JAMA | June 12, 2013|

This Week in JAMA FREE

JAMA. 2013;309(22):2295. doi:10.1001/jama.2013.5825.
Text Size: A A A
Published online

MUSIC THERAPY, ANXIETY, AND SEDATIVE USE

Patients receiving mechanical ventilation experience significant levels of anxiety. In a multicenter randomized trial that enrolled 373 patients receiving mechanical ventilatory support, Chlan and colleagues assessed the effects of listening to music that was self-initiated and patient-directed on anxiety and the intensity and frequency of sedative exposure. The authors found that patient-directed music resulted in greater reductions in anxiety and sedation intensity than usual care but not compared with noise-cancelling headphones and greater reduction in sedation frequency than either usual care or noise-cancelling headphones. In an editorial, Azoulay and colleagues discuss the potential of music therapy to reduce anxiety in critically ill, mechanically ventilated patients.

See Article and Editorial

ANTIMICROBIAL STEWARDSHIP FOR PEDIATRIC OUTPATIENTS

In a cluster randomized trial involving 18 pediatric primary care practices and 162 clinicians, Gerber and colleagues examined the effect of an antimicrobial stewardship intervention—composed of clinician education, audit, and feedback—on rates of broad-spectrum (off-guideline) antibiotic prescribing for bacterial acute respiratory tract infections (ARTIs) and viral ARTIs. The authors report that compared with usual practice, the intervention improved adherence to prescribing guidelines for bacterial ARTIs but did not affect antibiotic prescribing for viral infections. In an editorial, Finkelstein discusses interventions to promote judicious antibiotic prescribing.

See Article, Editorial, and

INFLAMMATORY BIOMARKERS AND EXACERBATIONS OF COPD

Some patients with stable chronic obstructive pulmonary disease (COPD) have elevated levels of inflammatory biomarkers. In a prospective cohort of 6574 patients with COPD, Thomsen and colleagues found that simultaneously elevated levels of C-reactive protein (≥3 mg/L) and fibrinogen (≥14 μmol/L) and an elevated leukocyte count (≥9 × 109/L) were associated with an increased risk of a COPD exacerbation. In an editorial, Mador and Sethi discuss the identification of patients at high risk of COPD exacerbations.

See Article and Editorial

MATERNAL OBESITY AND RISK OF PRETERM DELIVERY

In an analysis of 1992-2010 data from nearly 1.6 million singleton pregnancies in Sweden, Cnattingius and colleagues found that maternal overweight and obesity during early pregnancy were associated with increased risks of preterm delivery, particularly extreme preterm deliveries at 22 to 27 weeks' gestation.

See Article

HEALTH OUTCOMES IN ADULT CHILDHOOD CANCER SURVIVORS

Adult survivors of childhood cancer are at risk of treatment-related adverse health outcomes. Hudson and colleagues assessed the general health status and age-specific cumulative prevalence of adverse outcomes by organ system in a cohort of 1713 long-term survivors of childhood cancer. The authors found that the percentage of survivors with 1 or more chronic health conditions was very high, reaching 95% at age 45 years.

See Article

CLINICIAN'S CORNER

JAMA Clinical Challenge

A previously healthy 63-year-old man is seen in the emergency department with ptosis, limited ocular motility, and rapidly decreasing vision. Serum glucose is 690 mg/dL. Maxillofacial computed tomography imaging reveals sinusitis and orbital stranding. What would you do next?

See Article

MEDICAL NEWS & PERSPECTIVES

Researchers are trying to tease out risk factors for homelessness among veterans to allow better targeting of preventive services.

See Article

VIEWPOINTS

Encouraging patients to ask questions

See Article

Patient-centered communication and the electronic health record

See Article

Encouraging smokers to ask for help in quitting

See Article

Patients' responsibility to participate in decision making and research

See Article

EDITORIAL

Talking to patients in the 21st century

See Article

A PIECE OF MY MIND

“High-functioning teams create structures—like daily huddles—that ensure that all relevant patient information is incorporated into the treatment plan and shared with all team members who ‘touch’ the patient.” From “The Columbo Phenomenon.”

See Article

EDITOR'S AUDIO SUMMARY

Dr Bauchner summarizes and comments on this week's issue, including Viewpoints, Editorials, Original Contributions, and clinical content. Go to www.jama.com

JAMA PATIENT PAGE

For your patients: Information about head lice.

See Article

First Page Preview

View Large
First page PDF preview

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.