JAMA Network Open最新文献

{"title":"Alcohol Use Disorder Treatment Availability at Mental Health Treatment Facilities.","authors":"Susan H Busch, David A Fiellin, Kaede Iida, Kim Gannon, Melissa B Weimer, Jason Hockenberry","doi":"10.1001/jamanetworkopen.2025.20409","DOIUrl":"10.1001/jamanetworkopen.2025.20409","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2520409"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nirsevimab Uptake in a Pediatric Primary Care Network During the 2023-2024 RSV Season.","authors":"Sarah Schaffer DeRoo, Tamima Hossain, Thevaa Chandereng, Jessica Lazerov","doi":"10.1001/jamanetworkopen.2025.20440","DOIUrl":"10.1001/jamanetworkopen.2025.20440","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2520440"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Equation.","authors":"","doi":"10.1001/jamanetworkopen.2025.25545","DOIUrl":"10.1001/jamanetworkopen.2025.25545","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2525545"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to Gender-Affirming Care and Alternatives to That Care Among Transgender Adults.","authors":"Teresa A Graziano","doi":"10.1001/jamanetworkopen.2025.20808","DOIUrl":"10.1001/jamanetworkopen.2025.20808","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2520808"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Risk Concerns and Communication Gaps Regarding GLP-1 Medications.","authors":"Roxanna Attar-Olyaee, Ramez Kouzy, Michael K Rooney, Zakaria El-Kouzi, Karen E Hoffman, Sherif M Gadoue, Comron J Hassanzadeh, Junyi Jessy Li, Osama Mohamad","doi":"10.1001/jamanetworkopen.2025.21878","DOIUrl":"10.1001/jamanetworkopen.2025.21878","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2521878"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 RA Use and Survival Among Older Adults With Cancer and Type 2 Diabetes.","authors":"Rotana M Radwan, Ying Lu, Hao Dai, Thomas J George, Yi Guo, Jingchuan Guo, Jiang Bian","doi":"10.1001/jamanetworkopen.2025.21887","DOIUrl":"10.1001/jamanetworkopen.2025.21887","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2521887"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Mental Health Problems in US Public Schools.","authors":"Jonathan Cantor, Ryan K McBain, Jacquelin Rankine, Aaron Kofner, Fang Zhang, Alyssa Burnett, Joshua Breslau, Ateev Mehrotra, Bradley D Stein, Hao Yu","doi":"10.1001/jamanetworkopen.2025.21896","DOIUrl":"10.1001/jamanetworkopen.2025.21896","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2521896"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Cardiac Rehabilitation and Heart Failure Recovery-Early to Rehabilitation, Early to Thrive.","authors":"Bharathi Upadhya, R Brandon Stacey","doi":"10.1001/jamanetworkopen.2025.24151","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.24151","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2524151"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant Chemotherapy, Case Volume, and Mortality in Advanced Ovarian Cancer.","authors":"Mary Kathryn Abel, Varvara Mazina, Amy J Bregar, Allison A Gockley, Marcela G Del Carmen, Eric L Eisenhauer, Roni Nitecki Wilke, J Alejandro Rauh-Hain, Joseph A Dottino, Alexander Melamed","doi":"10.1001/jamanetworkopen.2025.23434","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.23434","url":null,"abstract":"<p><strong>Importance: </strong>Death after cytoreductive surgery for advanced-stage ovarian cancer is more frequent in low-volume hospitals. Neoadjuvant chemotherapy (NACT) has been shown to reduce surgical complexity, complications, and surgical mortality without compromising oncologic outcomes.</p><p><strong>Objective: </strong>To measure whether more frequent NACT utilization is associated with postoperative mortality and overall survival after cytoreductive surgery, especially in low-volume hospitals.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study included patients treated for newly diagnosed stage III or IV epithelial ovarian cancer at Commission on Cancer-accredited cancer programs in the United States between January 2010 and December 2019. Data were analyzed from August 2023 to April 2025.</p><p><strong>Exposures: </strong>The main exposures of interest were cancer program-level rates of NACT and tertile of program mean annual volume of cytoreductive surgery (<12.0, 12.0-23.9, or ≥24.0 cases/y).</p><p><strong>Main outcomes and measures: </strong>Standardized rates and odds ratios (ORs) for 90-day perioperative morality and differences in 60-month life expectancy (restricted mean survival time).</p><p><strong>Results: </strong>A total of 70 707 patients (mean [SD] age, 63.1 [12.1] years; 5807 [8.2%] Black, 4745 [6.7%] Hispanic, and 56 336 [79.7%] White) treated in 1333 programs were identified. After adjusting for observed demographic and clinical covariates, 90-day surgical mortality was lower in centers with higher NACT rates, and the magnitude of this association differed by hospital volume (P for interaction < .001). High utilization of NACT (59%) compared with low utilization (22%) was associated with a larger decrease in 90-day mortality in high-volume centers (OR, 0.26; 95% CI, 0.17-0.41; rates, 10.0% vs 2.9%) compared with average-volume centers (OR, 0.49; 95% CI, 0.33-0.72; rates, 7.3% vs 3.7%) or low-volume centers (OR, 0.48; 95% CI, 0.39-0.60; rates, 9.5% vs 4.8%). Among high-volume centers, high utilization was associated with a 4.0 month (95% CI, 1.6-6.5 month)-improvement in 60-month life expectancy compared with low NACT utilization (42.2 vs 38.1 months).</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study, treatment in high-volume centers with high NACT utilization was associated with the lowest 90-day surgical mortality and longest 60-month survival for patients with advanced stage ovarian cancer.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2523434"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout Among Primary Care Practitioners and Staff in VA Clinics Using Virtual Contingency Staffing.","authors":"Eric A Apaydin, Caroline K Yoo, Nicholas J Jackson, Susan E Stockdale, Danielle E Rose","doi":"10.1001/jamanetworkopen.2025.18977","DOIUrl":"10.1001/jamanetworkopen.2025.18977","url":null,"abstract":"<p><strong>Importance: </strong>Primary care practitioners (PCPs) and staff in Veterans Health Administration (VHA) clinics with staffing shortages have reported higher rates of burnout that may be associated with higher workloads. Introducing PCPs through the Clinical Research Hub (CRH) virtual contingency staffing program into these clinics may help reduce burnout but may also disrupt workflows and increase burnout.</p><p><strong>Objective: </strong>To understand how rates of burnout among VHA PCPs and staff vary by staffing level and CRH program use.</p><p><strong>Design, setting, and participants: </strong>This survey study used annual, repeated, cross-sectional VHA employee survey data from fiscal years 2018 to 2022 to examine associations between staffing and burnout before and after implementation of the CRH program.</p><p><strong>Exposure: </strong>Clinical Research Hub virtual contingency PCP visits.</p><p><strong>Main outcome and measures: </strong>The main outcome was burnout as measured using multilevel, mixed-effects logistic regression to estimate the association between health care system-level PCP staffing and individual-level PCP and staff burnout before and after implementation of the CRH program. An interaction term was used to test the association between program use and burnout in health care systems with full and less-than-full PCP staffing, controlling for PCP, staff, and health care system characteristics. Estimated marginal means of burnout were calculated from model results.</p><p><strong>Results: </strong>Survey responses from 134 640 PCPs and staff (53% younger than 49 years; 70% female) in 139 VHA health care systems were analyzed. From fiscal years 2018 to 2022, 38% of PCPs and staff experienced burnout, and CRH visits ranged from a median of 0 to 127.6 (IQR, 76.7-237.4) visits per 1000 patients at the health care system level. In estimations derived from the full model, the probability of burnout was higher in clinics without full PCP staffing before program implementation (34.3% [95% CI, 33.4%-35.2%] without full staffing vs 36.5% [95% CI, 35.3%-37.8%] with full staffing) and in the lowest tertile of CRH visits (37.4% [95% CI, 36.4%-38.4%] without full staffing vs 40.2% [95% CI, 38.3%-42.1%] with full staffing). However, burnout did not differ by staffing at higher levels of CRH visits.</p><p><strong>Conclusions and relevance: </strong>In this survey study of VHA PCPs and staff, the association between low staffing and burnout was mitigated at higher levels of CRH program use, suggesting that contingency PCPs may alleviate high workload in short-staffed clinics.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2518977"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}