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ImportanceBreast density is an independent risk factor for breast cancer. Despite the proliferation of mandated written notifications about breast density following mammography, there is little understanding of how women perceive the relative breast cancer risk associated with breast density.ObjectiveTo assess women’s perception of breast density compared with other breast cancer risks and explore their understanding of risk reduction.Design, Setting, and ParticipantsThis mixed-methods qualitative study used telephone surveys and semistructured interviews to investigate perceptions about breast cancer risk among a nationally representative, population-based sample of women. Eligible study participants were aged 40 to 76 years, reported having recently undergone mammography, had no history of prior breast cancer, and had heard of breast density. Survey participants who had been informed of their personal breast density were invited for a qualitative interview. Survey administration spanned July 1, 2019, to April 30, 2020, with 2306 women completing the survey. Qualitative interviews were conducted from February 1 to May 30, 2020.Main Outcomes and MeasuresRespondents compared the breast cancer risk associated with breast density with 5 other risk factors. Participants qualitatively described what they thought contributed to breast cancer risk and ways to reduce risk.ResultsOf the 2306 women who completed the survey, 1858 (166 [9%] Asian, 503 [27%] Black, 268 [14%] Hispanic, 792 [43%] White, and 128 [7%] other race or ethnicity; 358 [19%] aged 40-49 years, 906 [49%] aged 50-64 years, and 594 [32%] aged ≥65 years) completed the revised risk perception questions and were included in the analysis. Half of respondents thought breast density to be a greater risk than not having children (957 [52%]), having more than 1 alcoholic drink per day (975 [53%]), or having a prior breast biopsy (867 [48%]). Most respondents felt breast density was a lesser risk than having a first-degree relative with breast cancer (1706 [93%]) or being overweight or obese (1188 [65%]). Of the 61 women who were interviewed, 6 (10%) described breast density as contributing to breast cancer risk, and 43 (70%) emphasized family history as a breast cancer risk factor. Of the interviewed women, 17 (28%) stated they did not know whether it was possible to reduce their breast cancer risk.Conclusions and RelevanceIn this qualitative study of women of breast cancer screening age, family history was perceived as the primary breast cancer risk factor. Most interviewees did not identify breast density as a risk factor and did not feel confident about actions to mitigate breast cancer risk. Comprehensive education about breast cancer risks and prevention strategies is needed.

Objective.— To deal with public and professional concern regarding possible overprescription of attention-deficit/hyperactivity disorder (ADHD) medications, particularly methylphenidate, by reviewing issues related to the diagnosis, optimal treatment, and actual care of ADHD patients and of evidence of patient misuse of ADHD medications. Data Sources.— Literature review using a National Library of Medicine database search for 1975 through March 1997 on the termsattention deficit disorder with hyperactivity, methylphenidate, stimulants, and stimulant abuse and dependence. Relevant documents from the Drug Enforcement Administration were also reviewed. Study Selection.— All English-language studies dealing with children of elementary school through high school age were included. Data Extraction.— All searched articles were selected and were made available to coauthors for review. Additional articles known to coauthors were added to the initial list, and a consensus was developed among the coauthors regarding the articles most pertinent to the issues requested in the resolution calling for this report. Relevant information from these articles was included in the report. Data Synthesis.— Diagnostic criteria for ADHD are based on extensive empirical research and, if applied appropriately, lead to the diagnosis of a syndrome with high interrater reliability, good face validity, and high predictability of course and medication responsiveness. The criteria of what constitutes ADHD in children have broadened, and there is a growing appreciation of the persistence of ADHD into adolescence and adulthood. As a result, more children (especially girls), adolescents, and adults are being diagnosed and treated with stimulant medication, and children are being treated for longer periods of time. Epidemiologic studies using standardized diagnostic criteria suggest that 3% to 6% of the school-aged population (elementary through high school) may suffer from ADHD, although the percentage of US youth being treated for ADHD is at most at the lower end of this prevalence range. Pharmacotherapy, particularly use of stimulants, has been extensively studied and generally provides significant short-term symptomatic and academic improvement. There is little evidence that stimulant abuse or diversion is currently a major problem, particularly among those with ADHD, although recent trends suggest that this could increase with the expanding production and use of stimulants. Conclusions.— Although some children are being diagnosed as having ADHD with insufficient evaluation and in some cases stimulant medication is prescribed when treatment alternatives exist, there is little evidence of widespread overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of methylphenidate by physicians. JAMA. 1998;279:1100-1107

IN 1981 the House of Delegates of the American Medical Association (AMA) adopted a report from the Council on Scientific Affairs entitled Health Care Needs of the Homosexual Population . A substantial number of studies involving gay men and lesbians have subsequently appeared in the medical literature that provide a better understanding of health issues related to sexual orientation and behavior. For this reason, the original recommendations were reviewed, including that of reversal of sexual orientation in selected cases. 1 DEFINITION AND DEMOGRAPHICS In this report, sexual orientation refers to an individual's self-perception as gay, lesbian, bisexual, or heterosexual. Sexual behavior may or may not correlate with sexual orientation. Furthermore, an individual's sexual behavior and orientation may vary over time. The scientific literature indicates that homosexual feelings are more frequent than homosexual behavior and that same-sex behavior is more frequent than lasting homosexual identification. 2-11 According to researchers from RAND, 10(p145)

SUFFERING patients are now requesting physician assistance to end their lives. Physicians who serve the sick are now called on to discern whether that service should include helping to speed the death of the sufferer. The discourse has centered on cases, arguing whether there is or should be a right to stop particular examples of severe suffering, and often relying on reflections about American culture and history. The debate must include review of how the health care system actually serves persons who are dying. What is known about these matters is the subject of this review, which is the third in a series of reports on physician-assisted suicide requested by the American Medical Association (AMA) Board of Trustees in response to Resolution 3 at the 1993 House of Delegates Annual Meeting. The first two reports were presented at the 1993 Interim Meeting: Council on Ethical and Judicial Affairs Report 8

Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia. ( JAMA . 1995;274:1714-1716)