tbuckley/cabot-search huggingface dataset:
Cabinet Office approval should be required for severance payments that involve whistleblowers, MPs say
Authors: C. Dyer
Journal: BMJ (2014)

“Gagging” clauses in settlement agreements with whistleblowers who leave NHS jobs have been used to stop them speaking out on patient care and child safety, say MPs.

The House of Commons Public Accounts Committee heard “shocking examples of using taxpayers’ money to ‘pay off’ individuals who have flagged up concerns about patient or child safety,” said the committee’s chairwoman, Margaret Hodge. “We are deeply concerned about the use of compromise agreements and special severance payments to terminate employment in the public sector.”

She added, “It is clear that confidentiality clauses may have been used in compromise agreements to cover up failure—and this is simply outrageous. It is vital that people feel free to speak out …
Long-term follow-up of the residents of the Three Mile Island accident area: 1979-1998.
Authors: Evelyn O Talbott, Ada O Youk, Kathleen P McHugh-Pemu, Jeanne V Zborowski
Journal: Environmental Health Perspectives (2002)

The Three Mile Island (TMI) nuclear power plant accident (1979) prompted the Pennsylvania Department of Health to initiate a cohort mortality study in the TMI accident area. This study is significant because of the long follow-up (1979-1998), large cohort size (32,135), and evidence from earlier reports indicating increased cancer risks. Standardized mortality ratios (SMRs) were calculated to assess the mortality experience of the cohort compared with a local population. Relative risk (RR) regression modeling was performed to assess cause-specific mortality associated with radiation-related exposure variables after adjustment for individual smoking and lifestyle factors. Overall cancer mortality in this cohort was similar to the local population [SMRs = 103.7 (male); 99.8 (female)]. RR modeling showed neither maximum gamma nor likely gamma exposure was a significant predictor of all malignant neoplasms; bronchus, trachea, and lung; or heart disease mortality after adjusting for known confounders. The RR estimates for maximum gamma exposure (less than or equal to 8, 8-19, 20-34, greater than or equal to 35 mrem) in relation to all lymphatic and hematopoietic tissue (LHT) are significantly elevated (RRs = 1.00, 1.16, 2.54, 2.45, respectively) for males and are suggestive of a potential dose-response relationship, although the test for trend was not significant. An upward trend of RRs and SMRs for levels of maximum gamma exposure in relation to breast cancer in females (RRs = 1.00, 1.08, 1.13, 1.31; SMRs = 104.2, 113.2, 117.9) was also noted. Although the surveillance within the TMI cohort provides no consistent evidence that radioactivity released during the nuclear accident has had a significant impact on the overall mortality experience of these residents, several elevations persist, and certain potential dose-response relationships cannot be definitively excluded.
Delayed‐type hypersensitivity to a nonionic, radiopaque contrast medium
Authors: S. Courvoisier, A. J. Bircher
Journal: Allergy (1998)

Background True allergic reactions to iodinated radiocontrast media are rare, and only a few well‐documented cases of delayed‐type hypersensitivity reactions caused by contrast media have been described. Methods We report a 61‐year‐old patient in whom percutaneous transluminal coronary angioplasty (PTCA) was performed with iopamidol, a nonionic contrast medium. Seven days later, the patient developed generalized maculopapular exanthema. Repeated patch tests with several iodinated agents were performed. Results A first patch test with iopamidol was positive. Repetition of the patch tests showed positive results to iopamidol as well as to iohexol and ioversol. two other nonionic contrast media, but not to other iodinated substances. Three months later, PTCA was repeated, and iopamidol was used again. Despite premedication. pruritic macular exanthema developed 1 day later. Whether iopamidol or trometamol ‐ an additive substance in the contrast medium ‐ was causative could not be determined, since a third set of patch tests was negative. Conclusions Delayed‐type hypersensitivity reactions to iodinated contrast media are rare. We recommend that patients with delayed exanthematous reactions undergo patch or intradermal tests with different contrast media and their additives, and that readings be performed immediately and later at days 2 and 3.
Detection and Diagnosis of Hemorrhagic States
Authors: Armand J. Quick
Journal: JAMA (1966)

Bleeding conditions are common but are often missed or ignored because serious hemorrhage occurs only occasionally and usually can be managed and controlled by transfusion of blood or plasma. There has been, nevertheless, a growing demand to detect bleeders, and attempts have been made to devise a screening test for this purpose. Because hemostasis is a complex physiological process, the prospect of finding one single test to establish defective hemostasis is remote. Fortunately, it is possible to achieve this goal fairly satisfactorily by a combination of four simple tests: bleeding, clotting, prothrombin, and prothrombin consumption times. Even mild bleeding states can be detected and usually definitively diagnosed. Each of the tests requires a minimum of skill and no special equipment, thereby making this battery of procedures available to hospitals with limited laboratory facilities. It is the purpose of this presentation to point out the clinical application and interpretation of the
Care for the Homebound Aged
Authors: JOSEPH I. BERMAN
Journal: Annals of Internal Medicine (1975)

Article1 May 1975Care for the Homebound AgedJOSEPH I. BERMAN, M.D., M.P.H., MORRIS OSTROFF, M.D., M.P.H.JOSEPH I. BERMAN, M.D., M.P.H.Search for more papers by this author, MORRIS OSTROFF, M.D., M.P.H.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-5-717 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. Brickner and colleagues deserve great credit for the work they have done in providing for the needs of homebound elderly in New York City (1). Although the services are provided through a hospital-based program, that program is apparently not part of a home health agency, certified by the Social Security Administration. This would account for the inability of the hospital to bill for some of the services being provided to the aged. This point is of particular interest to us. Certified agencies, following Medicare regulations for reimbursement, cannot meet the total needs of the aged.The...Reference1. BRICKNERDUQUEKAUFMAN PTA: The homebound aged. A medically unreached group. Ann Intern Med 82:1-6, 1975 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Community Medicine Sinai Hospital of Baltimore, Inc. Baltimore, Maryland 21215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1975Volume 82, Issue 5Page: 717-717KeywordsElderlyMedicare Issue Published: 1 May 1975 PDF DownloadLoading ...
High-fat feeding promotes obesity via insulin receptor/PI3K-dependent inhibition of SF-1 VMH neurons
Authors: Tim Klöckener, Simon Hess, Bengt F Belgardt, Lars Paeger, Linda A W Verhagen, Andreas Husch, Jong-Woo Sohn, Brigitte Hampel, Harveen Dhillon, Jeffrey M Zigman, Bradford B Lowell, Kevin W Williams, Joel K Elmquist, Tamas L Horvath, Peter Kloppenburg, Jens C Brüning
Journal: Nature Neuroscience (2011)
Teaching terminal care at Queen's University of Belfast. I--Course, sessional educational objectives, and content.
Authors: W G Irwin
Journal: BMJ (1984)

Discuss death before it happens with both patient and family.* Relieve the patient as far as possible of guilt and irrational fears.* Be accessible to the patient and relatives.* Anticipate and explain the process of bereavement.* Communicate effectively with other health and social workers and with specialist hospital colleagues.* Be as optimistic as the situation permits to avoid hopelessness
Global Gene Repression by the Steroid Receptor Coactivator SRC-1 Promotes Oncogenesis
Authors: Claire A. Walsh, Jarlath C. Bolger, Christopher Byrne, Sinead Cocchiglia, Yuan Hao, Ailis Fagan, Li Qin, Aoife Cahalin, Damian McCartan, Marie McIlroy, Peadar O'Gaora, Jianming Xu, Arnold D. Hill, Leonie S. Young
Journal: Cancer Research (2014)

Transcriptional control is the major determinant of cell fate. The steroid receptor coactivator (SRC)-1 enhances the activity of the estrogen receptor in breast cancer cells, where it confers cell survival benefits. Here, we report that a global analysis of SRC-1 target genes suggested that SRC-1 also mediates transcriptional repression in breast cancer cells. Combined SRC-1 and HOXC11 ChIPseq analysis identified the differentiation marker, CD24, and the apoptotic protein, PAWR, as direct SRC-1/HOXC11 suppression targets. Reduced expression of both CD24 and PAWR was associated with disease progression in patients with breast cancer, and their expression was suppressed in metastatic tissues. Investigations in endocrine-resistant breast cancer cell lines and SRC-1(-/-)/PyMT mice confirmed a role for SRC-1 and HOXC11 in downregulation of CD24 and PAWR. Through bioinformatic analysis and liquid chromatography/mass spectrometry, we identified AP1 proteins and Jumonji domain containing 2C (JMD2C/KDM4C), respectively, as members of the SRC-1 interactome responsible for transcriptional repression. Our findings deepen the understanding of how SRC-1 controls transcription in breast cancers.
ONE POINT OF VIEW
Authors: K. Calvin Nicholas
Journal: JAMA (1960)

<h3>To the Editor:—</h3> InThe Journal, April 23, page 1972, appeared a letter from Dr. Sedgwick Mead. It seems to me that he has stumbled on something when he contends that it is not the responsibility of the doctors to provide the nation with an adequate supply of physicians. Neither is it the responsibility of a "sovereign state to see that its people have an adequate supply." The shortage of physicians is due to the lack of inclination on the parts of students and parents to pave the way for themselves by raising an adequate supply of physicians. One does not see the clergy forcing people to become clergymen; this has to come from the parents and their offspring. To point out that other fields are becoming more attractive than medicine is merely to beg the question rather than to explain why there is shortage of physicians. If there is
Hepatic Ischemia in Dogs
Authors: William M. Backlund
Journal: JAMA (1965)

Hepatic ischemia produces many physiological: alterations, and death occurs if occlusion of the vascular inflow is prolonged. The period of occlusion which may be tolerated in dogs is increased by decompression of the portal venous system to prevent venous congestion of the intestinal tract. Jolly and Foster<sup>1</sup>reported uniform survival when occlusion was maintained for less than 49 minutes if portal venous decompression was accomplished, while Raffucci and Wangensteen<sup>2</sup>obtained uniform survival without portal decompression only if occlusion was less than 20 minutes. One of the problems which has been the subject of study is the development of shock at the time of release of clamps occluding the vessels. In fact, it has been ascertained that animals survive longer when complete occlusion of the hepatic vascular inflow is maintained than when a period of occlusion is followed by release of the clamps. The shock which develops may be
The Hospital: A Social and Architectural History
Authors: Russell Hollander
Journal: JAMA (1976)

This book traces the development of hospital ward design from the 11th century to the present, in western Europe and the United States. The authors focus on the changing nature of architectural design, from reliance on forms adopted from nonmedical purposes to the emergence of forms specifically designed to meet hospital needs. A mini-sociopolitical history is woven into the architectural narrative. The book successfully combines a well-written text with a generous supply of ward designs, prints, and photographs. Two main derived architectural forms are discussed. The first developed out of the early connection between the hospital and the Church. Here, the hospital had to fit its needs around the architectural and spiritual demands of monastic life. The second derived form started in the Renaissance and reflects the palatial quality of the homes of the donors. In both cases, stylistic demands dominate over practical needs. The book takes us through the
The Alcoholism of Eugene O'Neill
Authors: Donald W. Goodwin
Journal: JAMA (1971)

Two psychiatrists have won the Nobel Prize for medicine—Julius Wagner-Jauregg for the malarial treatment of neurosyphilis, and Antonio Moniz for promoting lobotomy. More deserving than either, perhaps, was Gilbert V. Hamilton. As a young New York psychoanalyst in the mid 1920s, Hamilton converted America's greatest playwright from a ferocious alcoholic into a dedicated teetotaler, and did it all in six weeks. In the process he may also have transformed his patient, Eugene O'Neill, from a spectacularly productive playwright into a recluse who went 12 years without having a play on Broadway, but this cannot be proven. His cure of O'Neill's drinking problem, on the other hand, surely must represent one of the outstanding medical triumphs of the century. It all happened in a most peculiar manner. Hamilton had received a grant to survey the sexual practices of married people. His subjects included Mr. and Mrs. Eugene O'Neill. Hamilton later received
Acanthosis Nigricans With Lupoid Hepatitis
Authors: Denny L. Tuffanelli
Journal: JAMA (1964)

ACANTHOSIS NIGRICANS was first described by Pollitzer in 1891 as a symmetrical eruption usually involving the axillae, neck, and knuckles and characterized by hyperpigmented, soft, verrucous folds of skin. Winkelmann<sup>1</sup>stated that acanthosis nigricans occurs in patients with endocrine diseases in whom obesity is not a constant factor. To the knowledge of the present author, the association of acanthosis with lupoid hepatitis has not been reported. This papers reports the apparent combination of these diseases. <h3>Report of a Case</h3> A 17-year-old female Mexican student was first seen at the Los Angeles County Hospital in January, 1963. She had entered the United States six months previously and since that time had developed jaundice, malaise, and oligomenorrhea. She also had frontal headaches associated with dizziness. One year earlier she had an episode of arthritis of the right knee. There was no history of fever, polyarthritis, alopecia, Raynaud's phenomenon, or pleurisy. Upon
Onwards and upwards, maybe
Authors: C. Douglas
Journal: BMJ (1996)

The embarrassing hiatus between the Dreich and Auchendreich by-election and the equally important general election is perhaps not the ideal time for major decisions on public spending, but nevertheless decisions have to be made. Here in Auchendreich we are of course nomeetingt exempt from these difficulties, and they were focused on sharply at an important last week when the three rival consortia bidding for the long awaited private finance initiative replacement for Auchendreich General presented their ideas.

No one was surprised that MalibuCorp, a Californian conglomerate with wide experience in health maintenance organisations and private correctional facilities, came up with the most innovative proposals. Beautifully tailored …
The Cardiovascular Disease Researcher
Authors: J. Michael Gaziano, Eric Peterson
Journal: JAMA (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Is sexual contact a major mode of hepatitis C virus transmission?
Authors: Rania A. Tohme, Scott D. Holmberg
Journal: Hepatology (2010)

Medical opinion varies considerably regarding the transmission of hepatitis C virus (HCV) through sexual contact. Based on the study design, representativeness of the study population, and the methods used for case ascertainment, we analyzed 80 qualifying reports regarding the evidence for or against sexual transmission. Regarding heterosexual transmission, the weight of evidence is that there is no increased risk of sexual transmission of HCV among heterosexual couples in regular relationships. This risk increases among persons with multiple sexual partners (adjusted odds ratio [aOR] 2.2-2.9), but this association may be confounded by increased likelihood of injection drug use with increased number of partners. There appears to be a real increased risk for women coinfected with human immunodeficiency virus (HIV) or other sexually transmitted infections (aOR 3.3-3.9) and especially for HIV-infected gay men who are having sex with one another compared with HIV-uninfected men (aOR 4.1-5.7). HIV-infected gay men increase their risk of such transmission in association with practices that lead to mucosal trauma (multiple sexual partners, fisting, use of sex toys) and the presence of genital ulcerative disease. Conclusion: This review should inform, and not distract from, recommendations to reduce the risk of HCV transmission. Health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals. Hepatology 2010
Stretch-dependent slow force response in isolated rabbit myocardium is Na dependent
Authors: D VONLEWINSKI, B STUMME, L MAIER, C LUERS, D BERS, B PIESKE
Journal: Cardiovascular Research (2003)

Objective: Stretch induces functional and trophic effects in mammalian myocardium via various signal transduction pathways. We tested stretch signal transduction on immediate and slow force response (SFR) in rabbit myocardium. Methods: Experiments were performed in isolated right ventricular muscles from adult rabbit hearts (37 °C, 1 Hz stimulation rate, bicarbonate-buffer). Muscles were rapidly stretched from 88% of optimal length (L88) to near optimal length (L98) for functional analysis. The resulting immediate and slow increases in twitch force (first phase and SFR, respectively) were assessed at reduced [Na+]o or without and with blockade of stretch activated ion channels (SACs), angiotensin-II (AT1) receptors, endothelin-A (ETA) receptors, Na+/H+-exchange (NHE1), reverse mode Na+/Ca2+-exchange (NCX), or Na+/K+-ATPase. The effects of stretch on sarcoplasmic reticulum Ca2+-load were characterized using rapid cooling contractures (RCCs). Intracellular pH was measured in BCECF-AM loaded muscles, and action potential duration (APD) was assessed using floating electrodes. Results: On average, force increased to 216±8% of the pre-stretch value during the immediate phase, followed by a further increase to 273±10% during the SFR (n=81). RCCs significantly increased during SFR, whereas pH and APD did not change. Neither inhibition of SACs, AT1, or ETA receptors affected the stretch-dependent immediate phase nor SFR. In contrast, SFR was reduced by NHE inhibition and almost completely abolished by reduced [Na+]o or inhibition of reverse-mode NCX, whereas increased SFR was seen after raising [Na+]i by Na+/K+-ATPase inhibition. Conclusions: The data demonstrate the existence of a delayed, Na+- and Ca2+-dependent but pH and APD independent SFR to stretch in rabbit myocardium. This inotropic response appears to be independent of autocrine/paracrine AT1 or ETA receptor activation, but mediated through stretch-induced activation of NHE and reverse mode NCX.
Effect of codeine phosphate, Lomotil, and Isogel on ileostomy function
Authors: C. R. Newton
Journal: Gut (1978)

The effect on ileostomy function of codeine phosphate, Lomotil, or Isogel was tested in 20 subjects at home living a normal life, studied over two three-day periods on and off treatment. Codeine phosphate 60 mg three times daily was associated with a reduction in the mean total weight of ileostomy output and the ileostomy outputs of water, sodium, and potassium (p < 0.05). The proportion of faecal solids increased on codeine and the effluent appeared thicker but the output of faecal solids remained unchanged. Mean faecal fat increased on codeine. The transit rate from mouth to stoma was slower in four of the five subjects on codeine and a further two subjects withdrew from the trial with temporary intestinal obstruction while on the drug. Lomotil two tablets three times daily was associated with a small and statistically not quite significant fall in the mean total weight of ileostomy output and the ileostomy output of water. Sodium and potassium outputs in the effluent fell on Lomotil (p < 0.05) but the other parameters remained unchanged. Isogel 15 ml three times daily was associated with an increase in the mean total weight of ileostomy output and the ileostomy outputs of water, sodium, potassium, and faecal solids (p < 0.01). Although the effluent looked more viscid on Isogel, the proportion of faecal solids was unchanged. These results suggest that codeine phosphate has a beneficial effect on ileostomy function, reducing the loss of water and electrolytes, while Lomotil has a similar but less effective action in the dosage tested. By contrast, Isogel increases the ileostomy loss of water and electrolytes and will aggravate their depletion in patients with excessive fluid effluents. The increase in faecal fat associated with taking codeine phosphate suggests that it should be stopped before collecting specimens for faecal fat estimations.
Response to Comment on Khunti et al. Clinical Inertia in People With Type 2 Diabetes: A Retrospective Cohort Study of More Than 80,000 People. Diabetes Care 2013;36:3411–3417
Authors: Kamlesh Khunti, Michael L. Wolden, Brian L. Thorsted, Marc Andersen, Melanie J. Davies
Journal: Diabetes Care (2014)

We would like to thank Esposito et al. (1) for their interest in and comment on our article (2), in particular their recognition of the importance of the study and the significance of our results. Regarding their concern surrounding the definition of clinical inertia, there are several points that we would like to expand upon. First, we acknowledge that individualizing HbA1c targets may be needed for certain patients (e.g., the elderly) for whom balancing good glycemic control against the risk of hypoglycemia is even more important (3). HbA1c targets in treatment guidelines are only a recommendation. However, these clinical guidelines are used by physicians in practice, and as the …