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Presents an editorial calling for research papers on the causes, consequences and prevention of interpersonal violence as well as the prevention and management of the health effects of violence among survivors of armed conflict, war, mass displacement, torture and other human rights abuses. Call for controlled studies of interventions for the prevention and treatment of intimate partner violence, child abuse, youth violence, effects of terrorism, sexual assault and more.

Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost.Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity.Evidence Review: Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings.Findings: The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress.Conclusions and Relevance: The action priorities and essential infrastructure needs represent major opportunities to improve health outcomes and increase efficiency and value in the health system. As the new US administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress. [ABSTRACT FROM AUTHOR]

The article presents a call for papers to be published in a special October, 2008 issue devoted to the health of the U.S. Preference will be given to papers describing original research that presents new scientific understanding backed by solid data. Any topic related to the nation's health is eligible, including national health status, the composition of the health care work force, econometric analysis of health care reform, and comparative analyses with health care systems in other countries.

Presents a letter to the editor in response to an editorial on computer technology and clinical trial work in the March 9, 2005 edition of the "Journal of the American Medical Association."

The article discusses the responsibility of investigators to meet the needs of study participants for ancillary care. The authors argue that investigators is responsible for providing care for a range of health needs, including those medical conditions that are not related to the goals and procedures of the study. One of such responsibilities is providing diagnostic or prognostic information. Investigators argue that their responsibility to provide ancillary care is limited to conditions relevant to the study. The fundamental issues associated in providing ancillary care are explored. A clinical case demonstrating the roles of investigators in providing clinical care for conditions discovered during the course of the study is also presented.

The article discusses the management of thyroid cancers. The author cites that many thyroid nodules are asymptomatic and impalpable but that the increase in incidence may be because of the ability of ultrasound-guided fine needle aspiration biopsy to detect smaller tumors. The article includes information taken from different medical studies that sought to research the prevalence of thyroid cancers. The author describes the American Thyroid Association's management guidelines for patients with thyroid nodule and thyroid cancers.

The article presents a medical study to review the accuracy and precision of bedside clinical maneuvers for diagnosing hearing impairment. Hearing impairment is often underdiagnosed among older patients. Older patients who acknowledge they have hearing impairment require audiometry. Patients who say they do not have hearing impairment should be screened with the whispered-voice test. Those unable to detect the whispered voice require audiometry. This study suggests that the Weber and Rinne tests should not be used for general medical screening.

Context: Intimate partner violence is prevalent and is associated with significant impairment, yet it remains unclear which interventions, if any, reduce rates of abuse and reabuse. Objective: To systematically review, from the perspective of primary health care, the available evidence on interventions aimed at preventing abuse or reabuse of women. Data Sources: MEDLINE, PsycINFO, CINAHL, HealthStar, and Sociological Abstracts were searched from the database start dates to March 2001 using database-specific key words such as domestic violence, spouse abuse, partner abuse, shelters, and battered women. References of key articles were hand searched. The search was updated in December 2002. Study Selection: Both authors reviewed all titles and abstracts using established inclusion/exclusion criteria. Twenty-two articles met the inclusion criteria for critical appraisal. Data Extraction: Following the evidence-based methods of the Canadian Task Force on Preventive Health Care, both authors independently reviewed the 22 included studies using an established hierarchy of study designs and criteria for rating internal validity. Quality ratings of individual studies—good, fair, or poor—were determined based on a set of operational parameters specific to each design category developed with the US Preventive Services Task Force. Data Synthesis: Screening instruments exist that can identify women who are experiencing intimate partner violence. No study has examined, in a comparative design, the effectiveness of screening when the end point is improved outcomes for women (as opposed to identification of abuse). No high-quality evidence exists to evaluate the effectiveness of shelter stays to reduce violence. Among women who have spent at least 1 night in a shelter, there is fair evidence that those who received a specific program of advocacy and counseling services reported a decreased rate of reabuse and an improved quality of life. The benefits of several... INSET: Box. Canadian Task Force of Preventive Health Care Levels. [ABSTRACT FROM AUTHOR]

The article focuses on an article in the Journal of the American Medical Association, "Sirolimus- vs paclitaxel-eluting stents in de novo coronary artery lesions: the REALITY trial: a randomized controlled trial" by M-C Morice. Some of the difficulties of performing the study are discussed, such as the non-linear progress of stent patients. Cardiologists want to find out whether there are marked advantages of using one kind of stent for diabetes or patients with long or bifurcating lesions. While the data is useful in finding lessened occurrence of in-lesion restenosis using Sirolimus-eluting stents, specific subgroups of the study were difficult to collect beneficial data from.

Presents an editorial about concerns related to conflicts of interest in medical research. Review of policies for authors reporting conflicts of interest and disclosing financial support for their work; Requirements for reporting of industry-sponsored studies.