tbuckley/cabot-search huggingface dataset:
NHS reorganisations: who's kicking whom, who's protesting?: NHS is not short for National Health Service
Authors: Daniel J Albert
Journal: BMJ (2006)

EDITOR—Hawkes' description of English healthcare is uncannily accurate: painfully so for those of us that have given much of our time (the best years of our lives?) to supporting the “New NHS”; for which, now read the “Old NHS.”1 He is right to identify the kicking hierarchy as being important.



I have often wondered how it is that we are all so …
Administering, analysing, and reporting your questionnaire
Authors: Petra M Boynton
Journal: BMJ (2004)

Understanding your study group is key to getting a good response to a questionnaire; dealing with the resulting mass of data is another challenge The first step in producing good questionnaire research is getting the right questionnaire. 1 However, even the best questionnaire will not get adequate results if it is not used properly.This article outlines how to pilot your questionnaire, distribute and administer it; and get it returned, analysed, and written up for publication.It is intended to supplement published guidance on questionnaire research, three quarters of which focuses on content and design.
Stopping smoking--carpe diem?
Authors: J. Harris
Journal: BMJ (2012)

I am a midwife, a health psychologist, and a smoker. In December 2011, I decided that I wanted to quit, and asked my general practitioner for a varenicline prescription. I was told that the practice “do not deal with that,” and a referral to the local health trainers was made to assess my needs. I was told to call if no contact was made by the end of January. 

By mid-January, with no contact and my new year resolve waning, I tried to …
Psychological factors in prurigo nodularis in comparison with psoriasis vulgaris: results of a case-control study
Authors: G. Schneider, J. Hockmann, S. Ständer, T.A. Luger, G. Heuft
Journal: British Journal of Dermatology (2005)

Journal Article Psychological factors in prurigo nodularis in comparison with psoriasis vulgaris: results of a case–control study Get access G. Schneider, G. Schneider Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, 48149 Münster, Germany *Bahnhofstr. 15, D‐59302 Oelde, Germany †Department of Dermatology and Venerology, University of Münster, Von‐Esmarch‐Str. 56, D‐48149 Münster, Germany Gudrun Schneider. E‐mail: schneig@mednet.uni‐muenster.de Search for other works by this author on: Oxford Academic Google Scholar J. Hockmann, J. Hockmann Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, 48149 Münster, Germany *Bahnhofstr. 15, D‐59302 Oelde, Germany †Department of Dermatology and Venerology, University of Münster, Von‐Esmarch‐Str. 56, D‐48149 Münster, Germany Search for other works by this author on: Oxford Academic Google Scholar S. Ständer, S. Ständer Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, 48149 Münster, Germany *Bahnhofstr. 15, D‐59302 Oelde, Germany †Department of Dermatology and Venerology, University of Münster, Von‐Esmarch‐Str. 56, D‐48149 Münster, Germany Search for other works by this author on: Oxford Academic Google Scholar T.A. Luger, T.A. Luger Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, 48149 Münster, Germany *Bahnhofstr. 15, D‐59302 Oelde, Germany †Department of Dermatology and Venerology, University of Münster, Von‐Esmarch‐Str. 56, D‐48149 Münster, Germany Search for other works by this author on: Oxford Academic Google Scholar G. Heuft G. Heuft Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, 48149 Münster, Germany *Bahnhofstr. 15, D‐59302 Oelde, Germany †Department of Dermatology and Venerology, University of Münster, Von‐Esmarch‐Str. 56, D‐48149 Münster, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 154, Issue 1, 1 January 2006, Pages 61–66, https://doi.org/10.1111/j.1365-2133.2005.06852.x Published: 01 January 2006 Article history Accepted: 13 May 2005 Published: 01 January 2006
Vitamin B12 Status in Pregnancy among Immigrants to Britain
Authors: P. D. Roberts, H. James, A. Petrie, J. O. Morgan, A. V. Hoffbrand
Journal: BMJ (1973)

Haemoglobin, serum vitamin B(12), and serum and red cell folate levels have been measured in 322 pregnant immigrant women in London at their first booking and in a proportion at 34 weeks of gestation and postnatally. The Indian, East-African Indian, and Pakistani and Bangladeshi patients showed significantly lower initial mean serum vitamin B(12) levels than the European group, the levels being lower in Hindu and Sikh patients than in Moslems. The patients of West Indian, Indian, and East-African Indian origin showed significantly lower initial mean haemoglobin levels than the immigrants from European countries. Though there was no overall correlation between haemoglobin and serum vitamin B(12) level the incidence of hypersegmented polymorphs and macrocytosis in the peripheral blood was highest in the Indian and East-African Indian patients, and both these features were particularly frequent in patients with subnormal serum vitamin B(12) levels. Only one patient, however, had overt megaloblastic anaemia due to vitamin B(12) deficiency. The Indian patients whose red cell folate levels were less than 200 ng/ml also had a lower mean serum vitamin B(12) level than those with red cell folate levels greater than 200 ng/ml. The Indian patients had smaller babies than the Europeans but this was not related to the differences in vitamin B(12) status between the two groups. However, out of 39 babies of the Indian group 5 (13%) showed subnormal serum vitamin B(12) levels in the first 10 days of life, the lowest level being 120 pg/ml.Though there was an overall statistically significant fall in serum vitamin B(12) between first booking and 34 weeks of pregnancy there was no significant fall in serum vitamin B(12) in those who initially had subnormal levels. Thus many Indian women are vitamin B(12) deficient in pregnancy, and this is associated with morphological blood abnormalities in many cases, but megaloblastic anaemia due to this deficiency is relatively infrequent.
PUBLIC HEALTH EDUCATION
Authors: G. F. REINHARDT
Journal: JAMA (1913)

It is the purpose of this paper to indicate briefly some of the requirements of an efficient public health officer, and to point out the work that is being done for the instruction of the public, and the opportunities for the professional training of a public health administrator and the places where they may be found. To educate the average citizen or the special officer in the business of public health is not so easy as it sounds, for it includes the difficult task of educating the educated as well as the ignorant; it demands great unselfishness of the practicing physician; it imposes radical readjustment on our educational system, and it robs the average citizen of many dear beliefs, while urging on him new and unaccustomed actions. Among physicians it is no longer disputed that work in public health cannot be relegated to a political sideline. The day has passed
Targeted Therapies in Rheumatology
Authors: Barry Bresnihan
Journal: Annals of Internal Medicine (2004)

Medical Writings: Book Notes20 January 2004Targeted Therapies in RheumatologyBarry Bresnihan, MDBarry Bresnihan, MDFrom St. Vincent's University Hospital, Dublin, Ireland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-2-200401200-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Smolen JS, Lipsky PE. 768 pages. London: Martin Dunitz; 2003. $130.00. ISBN 1841841579. Order phone 215-625-8900.Field of medicine: Rheumatology.Format: Hardcover book.Audience: Rheumatologists, pediatric rheumatologists, allergy and immunology physicians, and policymakers. Specific chapters will appeal to gastroenterologists, dermatologists, and neurologists.Purpose: To provide relevant information on advances in understanding the pathophysiologic pathways, which have led to the development of innovative treatments for inflammatory musculoskeletal disease and other diseases. In addition, information is provided on approved targeted therapies that inhibit pro-inflammatory cytokines and on potential therapies targeting other molecules that have pivotal mechanistic roles.Content: Detailed background information is ... Author, Article, and Disclosure InformationAffiliations: From St. Vincent's University Hospital, Dublin, Ireland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 January 2004Volume 140, Issue 2Page: 152KeywordsLupus erythematosusMuscular dystrophiesMyositisPopulation statisticsQuality of lifeRheumatologySclerodermaSoftware toolsTranscription factorsVasculitis ePublished: 20 January 2004 Issue Published: 20 January 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A stable model of left ventricular dysfunction in an intact animal assessed with high fidelity pressure and cinemagnetic resonance imaging
Authors: L. J Dell'Italia, G. G Blackwell, F. Urthaler, D. J Pearce, G. M Pohost
Journal: Cardiovascular Research (1993)

Objective: Numerous models of acute and chronic left ventricular dysfunction have been used over the years. However, few can produce a rapid onset of global systolic and diastolic dysfunction that is stable and potentially reversible. The aim of this study was to develop such a model. Methods: A model of left ventricular dysfunction was produced in six intact dogs using 1% halothane anaesthesia and pharmacological autonomic blockade with atropine (0.1 mg·kg−1) and propranolol (2 mg·kg−1). Left ventricular function was assessed by combined high fidelity pressure and cinemagnetic resonance imaging (cine-MR) during increases in afterload using infusions of angiotensin. Results: Left ventricular systolic dysfunction was characterised by a diminished resting ejection fraction of 45(SD 4)% and a depressed +dP/dtmax of 1537(100) mm Hg·s−1. Diastolic dysfunction was manifested by an increased left ventricular end diastolic pressure of 16(2) mm Hg, a decreased −dP/dtmax of −1705(369) mm Hg·s−1, and a prolonged time constant of left ventricular relaxation of 42(9) ms. As left ventricular systolic pressure steadily rose with angiotensin infusion from 87(7) to 124(13) to 152(10) mm Hg (p<0.001), left ventricular ejection fraction decreased markedly from 45(4) to 35(4) to 27(4)% (p<0.001). Left ventricular +dP/dtmax did not change [1537(100) to 1500(110) to 1498(84) mm Hg·s−1] in spite of a significant increase in left ventricular end diastolic pressure from 16(2) to 21(5) to 29(7) mm Hg (p<0.001) and left ventricular end diastolic volume from 59(12) to 71(14) to 78(17) ml (p<0.001). Individual slopes of the end systolic pressure- volume relationship were also low, ranging between 2.1 and 4.4 mm Hg·s−1 (r=0.99 to 1.00), typical of impaired contractility. Conclusions: Halothane anaesthesia in dogs pretreated with large amounts of propranolol and appropriate muscarinic cholinergic blockade produces a moderate decrease in baseline systolic and diastolic function in our intact dog model. However, left ventricular systolic function showed limited contractile reserve when challenged by physiological increases in systemic arterial pressure. Impaired systolic and diastolic function may, at least in part, be related to diminished activator calcium produced by halothane in addition to the well known negative inotropic action of β adrenergic blockade. Cardiovascular Research 1993;27:974-979
Email consultations in health care: Patients need to be given a choice
Authors: John Charnock
Journal: BMJ (2004)

General practitioners say that evidence based information is changing practiceEditor-As the publishers of the BMJ's Clinical Evidence we have more than a passing interest in the extent to which the provision of evidenced based information changes clinical practice.In this context, the results of an evaluation of Clinical Evidence commissioned by us assumed some importance.A total of 5960 general practitioners in England were contacted by Stingray Research, an independent market research company, and asked to provide some broad perceptions about the role of evidence in their day to day practice and to pass judgment on Clinical Evidence.The response rate was 838/5960 (14.1%).Some findings were not surprising.Seventy five per cent of general practitioner respondents reported that their patients were likely to show interest in the latest research findings.Ninety seven per cent of the general practitioners had used an information resource to find the latest evidence, and 45% expected to do so at least once every fortnight.Subject matter ranged across the broad spectrum of disease.Clinical Evidence was used mainly around clinical consultations-before, during, and after.However, other uses, such as education and teaching, and assisting the development of practice guidelines, were also reported by 77% and 52% of respondents, respectively.The most crucial findings related to the proportion of doctors, 75%, who reported that they had changed their practice as a result of using Clinical Evidence.Two thirds of these had done so in the previous six months.Change of practice in response to Clinical Evidence was most likely in younger doctors, but was also reported by 56% of respondents aged over 55.Quotes from respondents underlined the message; that provision of evidence from an independent, trusted source supported them in developing their practice and improved the quality of their consultations.There are limitations to this evaluation.We don't know what the non-respondents thought, for example.However, the evidence seems to imply that there is a substantial body of clinicians of all ages-in this case English general practitioners, but we know that similar results have been found among Italian 1 and US doctors-who are motivated to use evidence based sources to improve their care for patients.
Health Effects of Airborne Exposures from Concentrated Animal Feeding Operations
Authors: Dick Heederik, Torben Sigsgaard, Peter S. Thorne, Joel N. Kline, Rachel Avery, Jakob H. Bønløkke, Elizabeth A. Chrischilles, James A. Dosman, Caroline Duchaine, Steven R. Kirkhorn, Katarina Kulhankova, James A. Merchant
Journal: Environmental Health Perspectives (2006)

Toxic gases, vapors, and particles are emitted from concentrated animal feeding operations (CAFOs) into the general environment. These include ammonia, hydrogen sulfide, carbon dioxide, malodorous vapors, and particles contaminated with a wide range of microorganisms. Little is known about the health risks of exposure to these agents for people living in the surrounding areas. Malodor is one of the predominant concerns, and there is evidence that psychophysiologic changes may occur as a result of exposure to malodorous compounds. There is a paucity of data regarding community adverse health effects related to low-level gas and particulate emissions. Most information comes from studies among workers in CAFO installations. Research over the last decades has shown that microbial exposures, especially endotoxin exposure, are related to deleterious respiratory health effects, of which cross-shift lung function decline and accelerated decline over time are the most pronounced effects. Studies in naïve subjects and workers have shown respiratory inflammatory responses related to the microbial load. This working group, which was part of the Conference on Environmental Health Impacts of Concentrated Animal Feeding Operations: Anticipating Hazards-Searching for Solutions, concluded that there is a great need to evaluate health effects from exposures to the toxic gases, vapors, and particles emitted into the general environment by CAFOs. Research should focus not only on nuisance and odors but also on potential health effects from microbial exposures, concentrating on susceptible subgroups, especially asthmatic children and the elderly, since these exposures have been shown to be related to respiratory health effects among workers in CAFOs.
HPV vaccination does not lead to risky sexual behaviour in adolescent girls, study finds
Authors: M. McCarthy
Journal: BMJ (2014)

Despite concerns that vaccination against the human papillomavirus (HPV) may promote promiscuity, receiving the vaccine does not seem to lead adolescent girls to engage in risky sexual behaviour, a large Canadian study has found.

The study was published online in the Canadian Medical Association Journal on 8 December. Leah M Smith of McGill University in Montreal, Quebec, was the paper’s lead author.1

The quadrivalent HPV vaccine is designed to protect against four types of the virus (6, 11, 16, 18) that cause 70% …
"RELATIVE POSITION OF REST OF THE EYES AND THE PROLONGED OCCLUSION TEST"
Authors: F. W. Marlow
Journal: JAMA (1924)

<h3>To the Editor:</h3> —In the review of my monograph on "The Relative Position of Rest of the Eyes and the Prolonged Occlusion Test" (The Journal, July 26), your reviewer states that the "prolonged occlusion test" is used to relax spasm of the extrinsic ocular muscles<i>exactly</i>as atropin relaxes a spasm of the ciliary muscle. (The italics are mine throughout.) No such claim is made in the book itself. On page 2, while the effect of the "prolonged occlusion test" is compared with that of a cycloplegic, the<i>difference</i>between them is specifically stated. Again, he states that no matter what the patient's muscle balance, refraction, or age, "<i>if asthenopic symptoms were present, a patch was placed over one eye</i>," etc., from which any ordinary reader would infer that all patients presenting symptoms of asthenopia were subjected to the test. This is contrary to what is stated in the book.
A Randomized, Double-Blind Trial of Nystatin Therapy for the Candidiasis Hypersensitivity Syndrome
Authors: William E. Dismukes, J. Scott Wade, Jeannette Y. Lee, Bonita K. Dockery, Jack D. Hain
Journal: New England Journal of Medicine (1990)

Candida albicans infection has been proposed to cause a chronic hypersensitivity syndrome characterized by fatigue, premenstrual tension, gastrointestinal symptoms, and depression. long-term antifungal therapy has been advocated as treatment for the syndrome, which is most often diagnosed in women with persistent or recurrent candida vaginitis.
Endothelium-dependent vascular relaxation is abnormal in the coronary microcirculation of atherosclerotic primates.
Authors: F W Sellke, M L Armstrong, D G Harrison
Journal: Circulation (1990)

Atherosclerosis impairs endothelium-dependent relaxation of large conduit arteries. Because coronary resistance vessels are spared from the development of overt atherosclerosis, endothelium-dependent responses were examined in these vascular segments. Malaysian cynomolgus monkeys (n = 6) were made atherosclerotic by being fed a 0.7% cholesterol diet for 18 months. Control monkeys (n = 6) were fed a standard diet. Coronary microvessels (122-220 microns) were studied in a pressurized (20 mm Hg), no-flow state using a video-imaging apparatus. Relaxations of microvessels, preconstricted with the thromboxane analogue U46619, were determined in response to acetylcholine, bradykinin, the calcium ionophore A23187, adenosine, and sodium nitroprusside. Microvascular relaxations to bradykinin and A23187 were reduced in atherosclerotic monkeys compared with controls, whereas acetylcholine produced additional contraction in atherosclerotic monkeys. Responses of preconstricted microvessels to adenosine and sodium nitroprusside were identical in atherosclerotic and control animals. Indomethacin did not alter responses in control or atherosclerotic animals. Histologic examination revealed neither intimal thickening nor plaque formation in microvessels of this size class despite marked changes in conduit arteries. Electron microscopy showed minor alterations of endothelial cell morphology in microvessels of atherosclerotic animals. In conclusion, long-term hypercholesterolemia markedly impairs endothelium-dependent vascular relaxation in the coronary microcirculation where overt atherosclerosis does not develop. These changes in endothelial cell function may significantly alter regulation of myocardial perfusion by neurohumoral stimuli.
Adult Immunization
Authors: James A. McComb, Leo Levine
Journal: New England Journal of Medicine (1961)

THE incidence of allergic reactions to diphtheria toxoid was reduced in adult immunization by a combination of toxoid purification and drastic dose reduction.1 , 2 A previous study2 described such a low-dose diphtheria prophylactic combined with a conventional dose of tetanus toxoid. In the course of extensive clinical trials, evidence emerged that reactions encountered were attributable to the tetanus-toxoid component. This was somewhat unanticipated because natural immunity to tetanus cannot occur in any manner analogous with that of diphtheria. In a study of this phenomenon2 it was concluded that these reactions occurred in previously immunized persons and that they were age dependent, . . .
GEOGRAPHIC MISS WITH AORTO–OSTIAL CORONARY STENT IMPLANTATION: INSIGHTS FROM CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY
Authors: Ronen Rubinshtein, Nissan Ben–Dov, David Halon, Idit Lavi, Ariel Finkelstein, Basil Lewis, Ronen Jaffe
Journal: Journal of the American College of Cardiology (2013)
Where Is the Health in Health System Reform?
Authors: Jonathan Fielding
Journal: JAMA (1994)

THE HEALTH system reform debate is over how to organize, deliver, and finance personal health care services. At $1 trillion, the enormity of the health care sector warrants a healthy debate about its structure and the respective roles of the public and private sectors. Erosion of middle-class health insurance coverage and an insecure economic and employment future have mobilized a broad constituency for insurance market reforms.<sup>1,2</sup>Distributive justice issues raise concern for the 40 million Americans without health benefits. Lost, however, among discussions of health security, universal coverage, and competitive markets is the unstated principal mission that any health system must serve to<i>improve</i>the health of the entire population. Legislators know that increasing public interest in health reform is attributable to the emergence of health insurance coverage as a middle-class issue.<sup>2,3</sup>An increasing proportion of the voting public has become part See also pp 1276 and 1297.
Laser Disintegration of Cyanoacrylate Clot with Successful Endoscopic Removal of Sclerotherapy Needle from Gastric Varix
Authors: A. Lorenz, N. Städtler, H.-J. Schulz
Journal: Endoscopy (2002)

Intravariceal cyanoacrylate injection is a highly effective and safe procedure for the treatment of bleeding gastric varices. Reports of large series mostly describe the minor complications already recognized with endoscopic injection therapy with sclerosing agents, including dysphagia, chest pain, fever, and local ulcerations. Nevertheless, some cases of severe cyanoacrylate-specific complications due to embolization have been described [1] [2] [3]. Technical difficulties, including the risk of sclerotherapy needle clogging, and cyanoacrylate sticking to the tip and the accessory channel of the endoscope, have been mentioned in other reports [4] [5].
Reprise: Gemtuzumab Ozogamicin for Older Patients With Acute Myeloid Leukemia
Authors: Donna S. Neuberg
Journal: Journal of Clinical Oncology (2012)

regimen for this patient population.The results of Burnett et al, supported by those recently published by Castaigne et al, 5 merit reconsideration of the availability of GO as a component of therapy for older patients newly diagnosed with AML.