In this issue: access to care, spirituality, and relevant research.

The study by Rittenhouse and colleagues examines the association between attending a medical school funded by the US government’s Title VII primary care training grant program and 2 markers of practicing in a setting dedicated to caring for patients and populations that would otherwise be underserved.1 The fi nding that Title VII supports the training of physicians who are more likely to staff Community Health Centers and participate in the National Health Service Corps could be in part due to selection factors of who attends these medical schools, but it also implies a possible effect of Title VII in increasing access to care for vulnerable populations. China, facing growing disparities in health and health care, is embarking on a major reemphasis on primary care. The study by Yang et al provides a snapshot of the staffi ng and service delivery of community health services as China embarks upon this transition.2 The study by Farley et al examines the feasibility of increasing access to diabetic retinopathy screening by training community health center primary care physicians to read retinal photographs taken in the clinics.3 This is an excellent example of a practice network implementing a new program, rigorously evaluating it, and then sharing the fi ndings in a way that advances transportable knowledge and points the way for others. An analysis of data from the COMBINE trial of naltrexone and acamprosate with medical management for alcohol dependence examines patient and clinician factors associated with treatment outcomes.4 Although the identifi ed patient and clinician factors may have implications for increasing access to care for intensive alcohol dependence treatment, the conduct of the study at sites associated with alcohol treatment centers raises caution in transporting these fi ndings to other settings where motivation, available expertise, and resources may be lower. A methodology study compares the HearingDependent Daily Activities Scale with a standardized audiogram.5 By helping to identify the impact of hearing loss on the daily life of elderly patients, this instrument may be useful in tailoring access to audiology services. The article featured in this issue’s Annals Journal Club shows how access to home blood pressure monitoring can provide better patient stratifi cation for mortality risk than just using offi ce blood pressures.6 These fi ndings may be useful in tailoring the aggressiveness of therapy and call for trials of stepped approaches to hypertension management that include home blood pressure monitoring.7