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This Week in JAMA
JAMA. 1998;279:1849.
Undertreated Pain a Persistent Problem
Untreated and undertreated pain is a persistent clinical problem. In this study, Dr Bernabei and colleagues (SEE ARTICLE) assessed a cohort of nursing home patients with cancer and found that up to 38% had daily pain, but 26% of these patients received no analgesics. Older patients and those of non-white race were more likely to have untreated pain. In an accompanying editorial, Dr Cleeland (SEE ARTICLE) explores reasons for undertreating pain and ways to improve pain treatment.
Physicians Disciplined for Sexual Misconduct
Sexual misconduct by physicians is an uncommon but troubling event. Ms Dehlendorf and Dr Wolfe (SEE ARTICLE) found that from 1989 to 1996, the number of physicians disciplined per year for sex-related offenses nationwide increased from 42 to 147, and the proportion of all disciplinary orders that were related to sexual offenses increased from 2.1% to 4.4%. Nearly 75% of disciplinary orders for sex-related offenses involved sexual contact with patients, and nearly 40% of physicians disciplined for sex-related offenses prior to 1994 were licensed to practice in 1997.
related editorial (SEE ARTICLE)
Medical Board Sanctions Against Physicians
Dr Morrison and Mr Wickersham (SEE ARTICLE) examined disciplinary orders reported by the Medical Board of California for 375 physicians disciplined for 465 offenses during an 18-month period. The most common causes for discipline were negligence or incompetence (34%), substance abuse (14%), inappropriate prescribing practices (11%), and inappropriate contact with patients (10%); 34% of disciplinary actions resulted in revocation or suspension of the physician's license.
related editorial (SEE ARTICLE)
HIV Infection in Young Adults
Young adults may not have received as much attention previously as some other groups with regard to risk for HIV infection. Dr Rosenberg and colleagues present evidence suggesting that HIV incidence in this population due to homosexual contact may be declining even as heterosexual contact is becoming a more important mode of transmission.
(SEE ARTICLE)
Hold the Garlic: No Effect on Serum Lipoproteins
In a randomized controlled trial, Dr Bethold and colleagues evaluated the effect of a garlic oil preparation on serum lipoproteins. The preparation had no effect on serum lipoprotein levels, cholesterol absorption, or cholesterol synthesis.
(SEE ARTICLE)
Asleep at the Wheel
Motor vehicle crashes are a leading cause of death and injury. This report from the AMA Council on Scientific Affairs indicates that driver sleepiness is a contributing factor in 1% to 3% of all US motor vehicle crashes, and that 96% of sleep-related crashes involve drivers of passenger vehicles. The council report reviews risk factors for sleep-related crashes, advises physicians to counsel patients about the risks of driving while sleepy, and recommends additional research on ways to counter the problem.
(SEE ARTICLE)
The Cover
"The artist, as king, represents the soul of man and rules over the subordinate world of matter." Max Beckmann, The King, 1933, German.
(SEE ARTICLE)
A Piece of My Mind
"Your heart, your mind, and your hands have in some way become my own." From "Tribute."
(SEE ARTICLE)
Medical News & Perspectives
Recent student shootings in school have physicians considering courses of action to confront this public health issue.
(SEE ARTICLE)
Policy Perspectives
The past and future of Blue Cross and Blue Shield.
(SEE ARTICLE)
JAMA Patient Page
For your patients: the problem of drivers falling asleep at the wheel.
(SEE ARTICLE)
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