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Frontline Clinic Administrator Perspectives on Extreme Weather Events, Clinic Operations, and Climate Resilience.

J Ambul Care Manage

January 2025

Author Affiliations: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Drs Wiskel and Dresser); Harvard T.H. Chan School of Public Health Center for Climate, Health, and the Global Environment, Boston, Massachusetts (Drs Wiskel and Dresser); Americares, Stamford, Connecticut (Mr Matthews-Trigg, Ms Stevens, and Dr Miles); and Harvard Medical School, Boston, Massachusetts (Drs Wiskel, Dresser, and Bernstein).

Climate-sensitive extreme weather events are increasingly impacting frontline clinic operations. We conducted a national, cross-sectional survey of 284 self-identified administrators and other staff at frontline clinics determining their attitudes toward climate change and the impacts, resilience, and preparedness of clinics for extreme weather events. Most respondents (80.

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Factors Associated With Semaglutide Initiation Among Adults With Obesity.

JAMA Netw Open

January 2025

Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts.

Importance: Semaglutide, a novel glucagon-like peptide-1 (GLP-1) receptor agonist medication, was approved for weight management in individuals with obesity in June 2021. There is limited evidence on factors associated with uptake among individuals in this subgroup without diabetes.

Objective: To explore factors associated with semaglutide initiation among a population of commercially insured individuals with obesity but no diagnosed diabetes.

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Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.

Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.

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External Validation of a 5-Factor Risk Model for Breast Cancer-Related Lymphedema.

JAMA Netw Open

January 2025

Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Importance: Secondary lymphedema is a common, harmful side effect of breast cancer treatment. Robust risk models that are externally validated are needed to facilitate clinical translation. A published risk model used 5 accessible clinical factors to predict the development of breast cancer-related lymphedema; this model included a patient's mammographic breast density as a novel predictive factor.

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Importance: Spontaneous reports have indicated that montelukast increases the risk of neuropsychiatric adverse events, and the US Food and Drug Administration added a boxed warning about these risks in 2020. However, the potential mechanism is not well understood, and the observational evidence is scarce, particularly in children.

Objective: To assess the potential association between the use of montelukast and the risk of neuropsychiatric adverse events in children and adolescents.

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