tbuckley/cabot-search huggingface dataset:
Preventing 30-Day Hospital Readmissions
Authors: Aaron L. Leppin, Michael R. Gionfriddo, Maya Kessler, Juan Pablo Brito, Frances S. Mair, Katie Gallacher, Zhen Wang, Patricia J. Erwin, Tanya Sylvester, Kasey Boehmer, Henry H. Ting, M. Hassan Murad, Nathan D. Shippee, Victor M. Montori
Journal: JAMA Internal Medicine (2014)

<h3>Importance</h3> Reducing early (&lt;30 days) hospital readmissions is a policy priority aimed at improving health care quality. The cumulative complexity model conceptualizes patient context. It predicts that highly supportive discharge interventions will enhance patient capacity to enact burdensome self-care and avoid readmissions. <h3>Objective</h3> To synthesize the evidence of the efficacy of interventions to reduce early hospital readmissions and identify intervention features—including their impact on treatment burden and on patients' capacity to enact postdischarge self-care—that might explain their varying effects. <h3>Data Sources</h3> We searched PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and Scopus (1990 until April 1, 2013), contacted experts, and reviewed bibliographies. <h3>Study Selection</h3> Randomized trials that assessed the effect of interventions on all-cause or unplanned readmissions within 30 days of discharge in adult patients hospitalized for a medical or surgical cause for more than 24 hours and discharged to home. <h3>Data Extraction and Synthesis</h3> Reviewer pairs extracted trial characteristics and used an activity-based coding strategy to characterize the interventions; fidelity was confirmed with authors. Blinded to trial outcomes, reviewers noted the extent to which interventions placed additional work on patients after discharge or supported their capacity for self-care in accordance with the cumulative complexity model. <h3>Main Outcomes and Measures</h3> Relative risk of all-cause or unplanned readmission with or without out-of-hospital deaths at 30 days postdischarge. <h3>Results</h3> In 42 trials, the tested interventions prevented early readmissions (pooled random-effects relative risk, 0.82 [95% CI, 0.73-0.91];<i>P</i> &lt; .001;<i>I</i><sup>2</sup> = 31%), a finding that was consistent across patient subgroups. Trials published before 2002 reported interventions that were 1.6 times more effective than those tested later (interaction<i>P</i> = .01). In exploratory subgroup analyses, interventions with many components (interaction<i>P</i> = .001), involving more individuals in care delivery (interaction<i>P</i> = .05), and supporting patient capacity for self-care (interaction<i>P</i> = .04) were 1.4, 1.3, and 1.3 times more effective than other interventions, respectively. A post hoc regression model showed incremental value in providing comprehensive, postdischarge support to patients and caregivers. <h3>Conclusions and Relevance</h3> Tested interventions are effective at reducing readmissions, but more effective interventions are complex and support patient capacity for self-care. Interventions tested more recently are less effective.
Which clinical studies provide the best evidence?
Authors: S. Barton
Journal: BMJ (2000)

A common question in clinical consultations is: “For this person, what are the likely effects of one treatment compared with another?” The central tenet of evidence based medicine is that this task is achieved by using the best evidence combined with consideration of that person's individual needs.1 A further question then arises: “What is the best evidence?” Two recent studies in the New England Journal of Medicine have caused uproar in the research community by finding no difference in estimates of treatment effects between randomised controlled trials and non-randomised trials.

The randomised controlled trial and, especially, systematic reviews of several of these trials are traditionally the gold standards for judging the benefits of treatments, mainly because it is conceptually easier to attribute any observed effect to the treatments being compared. The role of non-randomised (observational) studies in evaluating treatments is contentious: deliberate choice of the treatment for each person implies that observed outcomes may be caused by differences among people being given the two treatments, rather than the treatments alone. Unrecognised confounding factors can always interfere with attempts to correct for identified differences between groups.

These considerations have supported a hierarchy of evidence, with randomised controlled trials and derivatives at the top, controlled …
Ruptured Arteriosclerotic Aneurysms of the Abdominal Aorta
Authors: Leslie W. Ottinger
Journal: JAMA (1975)

Mortality in 100 patients undergoing resection of ruptured atherosclerotic aneurysms of the abdominal aorta was 58%. In addition to advanced age and concurrent cardiac disease, lethal factors included preoperative hypotension, cardiac arrest, anuria, and free intra-abdominal rupture. Failure to establish the correct diagnosis until the onset of these four signs contributed to the high mortality. (<i>JAMA</i>233:147-150, 1975)
A hospital-based case-control study of quality of life in older asthmatics
Authors: CA Dyer, AJ Sinclair
Journal: European Respiratory Journal (1997)

Asthma is a common but neglected problem in older people, the impact of which is relatively unstudied. The aim of this study was to objectively assess quality of life and depression in older asthmatics. The subjects studied were 50 hospitalized known asthmatics, over 55 yrs of age (mean age 72 yrs). Of these, 40 had objective evidence of asthma, and were compared to 40 age- and sex-matched controls. Using a structured questionnaire, the Geriatric Depression Score, subjective health status (short form (SF)-36), and other comparative disability data were recorded. Spirometric results were also recorded. Depressive symptoms were common in both groups but were not significantly different. Mean SF-36 scores were significantly worse in the asthmatics, especially for components of physical function (p = 0.04), physical role limitation (p = 0.01), energy (p = 0.01), health change (p = 0.01), and general health perception (p = 0.01). However mental, mental role and social scores were similar in both groups. We conclude that quality of life is impaired in hospitalized asthmatics compared to controls. Physical components appear to be most adversely affected. Depressive symptoms are common but no overall difference was found for psychological disability. Older asthmatics appear to adapt well to adverse situations.
Memory CD8+ T cells vary in differentiation phenotype in different persistent virus infections
Authors: Victor Appay, P. Rod Dunbar, Margaret Callan, Paul Klenerman, Geraldine M.A. Gillespie, Laura Papagno, Graham S. Ogg, Abigail King, Franziska Lechner, Celsa A. Spina, Susan Little, Diane V. Havlir, Douglas D. Richman, Norbert Gruener, Gerd Pape, Anele Waters, Philippa Easterbrook, Mariolina Salio, Vincenzo Cerundolo, Andrew J. McMichael, Sarah L. Rowland-Jones
Journal: Nature Medicine (2002)
EDITORIALS
Authors: Charles Eil
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article EDITORIALS: Parathyroid Hormone–Related Protein: A Paraneoplastic Factor in Search of Another Name Get access Charles Eil Charles Eil Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 1, 3 January 1990, Pages 2–3, https://doi.org/10.1093/jnci/82.1.2 Published: 03 January 1990 Article history Received: 16 November 1989 Accepted: 17 November 1989 Published: 03 January 1990
Decade May Be More Than Half Over Before Acellular Pertussis Vaccines Arrive on Scene
Authors: Charles Marwick
Journal: JAMA (1990)

IN SPITE of evidence that they are less reactogenic and confer long-standing immunity, the acellular pertussis vaccines are still a long way from reaching the American pediatrician. At least one speaker from the Sixth International Symposium on Pertussis (held at the National Institutes of Health [NIH], Bethesda, Md), Roger Bernier, MD, of the Centers for Disease Control, Atlanta, Ga, says it is unlikely that an acellular vaccine will be available before the mid-1990s. Bernier's point is that there has been no direct comparison between the acellular and whole-cell vaccines. Hence, he says, another trial is needed to ascertain the relative efficacy and safety of the acellular vaccines. This prediction was not seriously challenged. "I think it's going to be 4 or 5 years before we get there, although I hope it's sooner," comments John R. LaMontagne, MD, of the National Institute of Allergy and Infectious Diseases, part of the NIH.
COMPARISON OF SPORT COMPETITIVE ANXIETY LEVELS OF SAUDI ARABIAN NATIONAL TEAM ATHLETES WITH AND WITHOUT DISABILITIES IN COMPETITIONS
Authors: H Halawani
Journal: British Journal of Sports Medicine (2014)

Objective The purpose of the present study is to compare the individual differences in the levels of somatic anxiety, worry, and concentration disruption of Saudi Arabian national team with and without disabilities in competitions. The purpose of this study was to compare whether significant differences existed in the levels of somatic anxiety, worry, and concentration disruption between individuals of the Saudi Arabian national team with and without disabilities in competitions. Design Cross-sectional. Setting Survey, where differences in somatic anxiety, worry, and concentration disruption were examined between athletes in an individual or team sport. The Sport Anxiety Sale was employed to measure the subscales. Participants Participants were 120 Saudi Arabian national team athletes with and without disabilities who participated in competitions during the 2010 competitive season. Sixty Saudi Arabian national team athletes with disabilities from four different sports (track and field, table tennis, wheelchair basketball and volleyball) were surveyed. Another 60 Saudi Arabian national team athletes without disabilities who competed in the same four sports were also surveyed. Athletes' ages ranged from 18-35 years. Furthermore, athletes varied in their level of competitive experience. Results Results of the multivariate analysis indicated that there were no statistically significant differences between athletes with and without disabilities or between individual and team sport participants in their levels of somatic anxiety, worry, and concentration disruption. It was found that Saudi Arabian national team athletes with and without disabilities both have relatively the same levels of somatic anxiety, worry, and concentration disruption. Conclusion At this point and especially in Saudi Arabia, individuals with disabilities who participate in sports are considered athletes. They could definitely use their practices and mental skills training to improve performances and promote their enjoyable sporting experience. Therefore, in terms of the anxiety performance relationship, the psychological profile of athletes with and without disabilities seems similar.
Medical students with science A levels less likely to drop out
Authors: Roger Dobson
Journal: BMJ (2004)

Medical students who have a parent who is a doctor, who live on rather than off campus, or who did well in science subjects at A level were less likely to drop out during their first year at university, a new study shows.

The study's authors, from the University of Warwick, looked at data on 51 810 first year students at 21 medical schools between 1980 and 1992 ( Medical Education 2004;38:492-503).

Students who scored high grades in biology, chemistry, or physics were …
Street Youth Mortality
Authors: Sue Ellen Abdalian
Journal: JAMA (2004)

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
Politicians, AIDS Experts Wage Budget Debate
Authors: Rebecca Voelker
Journal: JAMA (1996)

A NEW REPORT that recommends restructuring federal AIDS research has reignited a tug-of-war over who should control the purse strings for such research. During a news conference last month in Chicago, Ill, a trio of AIDS experts called on a small group in Congress to restore full spending authority to the Office of AIDS Research (OAR) of the National Institutes of Health (NIH). "The promise of AIDS research is very much at risk because of these debates," said Mathilde Krim, PhD, chair of the American Foundation for AIDS Research (AmFAR). Krim was joined by Mark Harrington, policy director of the New York, NY—based Treatment Action Group, and Steven Wolinsky, MD, associate professor of medicine at the Northwestern University Medical School in Chicago. Harrington and Wolinsky were among the 114 scientists, academics, drug company representatives, and community advocates who conducted a sweeping review of the $1.4 billion NIH AIDS research effort.
Inhibition of polymorphonuclear leukocyte chemiluminescence for detection of immune complexes in human sera.
Authors: N J Doll, M R Wilson, J E Salvaggio
Journal: Journal of Clinical Investigation (1980)

An assay for the detection and quantitation of immune complexes is described. Experimental immune complexes or aggregated human gamma globulin (AHG) were incubated with polymorphonuclear leukocytes (PMN). After challenge of the PMN with opsonized zymosan, chemiluminescence was recorded in a scintillation spectrometer. A quantitative inhibition of chemiluminescence could be demonstrated by the interaction of PMN with immune complexes or AHG. Experimental immune complexes of bovine serum albumin-anti-bovine serum albumin were formed and tested by this assay, and immune complexes formed near antigen excess were best described by this technique. The technique was used to demonstrate immune complexes in the sera from patients with systemic lupus erythematosus, rheumatoid arthritis, and vasculitis. Immune complexes were quantitated by reference to a standard curve using AHG. By this technique, normal human sera had < 10 micrograms of AHG per milliliter of serum. Immune complexes at levels above this were detected in 9/15 patients with systemic lupus erythematosus, 18/30 patients with rheumatoid arthritis, and 2/5 patients with vasculitis. Therefore, this assay is a sensitive, simple method for measurement of circulating immune complexes in the sera of patients with certain connective tissue diseases.
The 6-min walk test in patients with COPD: walk this way!
Authors: Sally J Singh, Martijn A Spruit, Thierry Troosters, Anne E Holland
Journal: Thorax (2014)

The 6-min walk test in patients with COPD: walk this way!As the co-chairs of the joint American Thoracic Society/European Thoracic Society (ATS/ERS) task force on field exercise testing we noted with interest the work by Beekman et al, 1 who describe reference values for a 6-min walk test (6MWT) performed around a 10 m course.These authors have previously shown that walk distances on this track provoke a significantly shorter distance than on the course consistently recommended in guidelines in patients with COPD. 2 This protocol deviation does not represent a conventional 6MWT, 3 and we suggest should be renamed to avoid confusion.Importantly, it remains unclear whether other important 'benchmark values' such as the minimal important difference (MID) and the distance below which survival is affected can simply be transposed to the 10 m-6MW.][9][10] It is currently unclear what this variant adds to this existing repertoire of field based exercise tests.While we appreciate the test is conducted within 6 min, it does not accurately reflect current guidance on standard performance of the 6MWT in terms of track length.We would encourage researchers and clinicians to conduct the 6MWT as indicated in international guidelines. 3For clarity, we would propose to label this test as 10 m-6MW or comparable alternative.In addition we want to alert readers to the fact that for this version of the test little is known about the validity, reliability, responsiveness and its place in an endpoint model of outcomes.
College of General Practice
Authors: D. C. L. Fitzwilliams
Journal: BMJ (1951)

A study was undertaken to investigate the management of ophthalmic conditions in general practice in order to identify areas requiring education and training input. Management of patients with eye disease presenting to 17 Nottingham general practitioners was examined over a 12-month period. Of all patients registered with the participating doctors, 4% presented with eye problems, accounting for 1.5% of all general practice consultations. Children under five years of age had the highest consultation rates, female patients having higher consultation rates than male patients in all age groups. Infective conjunctivitis was responsible for 41% of consultations about eye problems and allergic conjunctivitis for a further 13%; 70% of consultations resulted in a prescription. Corticosteroids were prescribed in 3% of consultations for eye problems; this was considered inappropriate by the study ophthalmologist in over a third of these cases. Patients were referred for further management following 16% of consultations. Thirty nine per cent of referrals to the hospital ophthalmic service were either to an eye casualty department or requested an urgent clinic appointment. While most eye problems are managed solely by general practitioners there is clearly a need for ophthalmic services that can rapidly provide a specialist opinion. However, most eye disease seen in general practice involves the external eye or anterior segment, and the diagnosis may be confidently made using basic ophthalmic history taking and examination skills with non-specialist equipment. The acquisition of these skills should be emphasized at undergraduate level and built upon in later years in postgraduate training.
Influence of Diets Containing Eicosapentaenoic or Docosahexaenoic Acid on Growth and Metastasis of Breast Cancer Cells in Nude Mice
Authors: D. P. Rose, J. M. Connolly, J. Rayburn, M. Coleman
Journal: JNCI Journal of the National Cancer Institute (1995)

Journal Article Influence of Diets Containing Eicosapentaenoic or Docosahexaenoic Acid on Growth and Metastasis of Breast Cancer Cells in Nude Mice Get access David P. Rose, David P. Rose Correspondence to: David P. Rose, M.D., Ph.D., Division of Nutrition and Endocrinology, American Health Foundation, Valhalla, NY 10595. Search for other works by this author on: Oxford Academic PubMed Google Scholar Jeanne M. Connolly, Jeanne M. Connolly Search for other works by this author on: Oxford Academic PubMed Google Scholar Jodie Rayburn, Jodie Rayburn Search for other works by this author on: Oxford Academic PubMed Google Scholar Melissa Coleman Melissa Coleman *Division of Nutrition and Endocrinology, American Health FoundationValhalla, N.Y. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 87, Issue 8, 19 April 1995, Pages 587–592, https://doi.org/10.1093/jnci/87.8.587 Published: 19 April 1995
International effort to find AIDS vaccine for India
Authors: G. Mudur
Journal: BMJ (2001)

India's health ministry and the International AIDS Vaccine Initiative have signed an agreement to accelerate efforts to develop and test an AIDS vaccine against HIV subtype C, the predominant strain in India.

Under the agreement, the initiative—which was set up in 1996 with money from UNAIDS (the joint United Nations programme on HIV and AIDS), individual governments, and private foundations—will invest several million dollars in the development of an AIDS vaccine in India. It will be similar to the modified vaccinia Ankara vaccine against HIV designed by researchers at …
Human cord blood cells induce angiogenesis following myocardial infarction in NOD/-mice
Authors: N MA, C STAMM, A KAMINSKI, W LI, H KLEINE, B MULLERHILKE, L ZHANG, Y LADILOV, D EGGER, G STEINHOFF
Journal: Cardiovascular Research (2005)

Objective: We tested the hypothesis that intravenously administered human umbilical cord blood (hUCB) cells contribute to repair processes following myocardial infarction.
State Parity Laws and Access to Treatment for Substance Use Disorder in the United States
Authors: Hefei Wen, Janet R. Cummings, Jason M. Hockenberry, Laura M. Gaydos, Benjamin G. Druss
Journal: JAMA Psychiatry (2013)

The passage of the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act incorporated parity for substance use disorder (SUD) treatment into federal legislation. However, prior research provides us with scant evidence as to whether federal parity legislation will hold the potential for improving access to SUD treatment.To examine the effect of state-level SUD parity laws on state-aggregate SUD treatment rates and to shed light on the impact of the recent federal SUD parity legislation.We conducted a quasi-experimental study using a 2-way (state and year) fixed-effect method. We included all known specialty SUD treatment facilities in the United States and examined treatment rates from October 1, 2000, through March 31, 2008. Our main source of data was the National Survey of Substance Abuse Treatment Services, which provides facility-level information on specialty SUD treatment.State-level SUD parity laws during the study period.State-aggregate SUD treatment rates in (1) all specialty SUD treatment facilities and (2) specialty SUD treatment facilities accepting private insurance.The implementation of any SUD parity law increased the treatment rate by 9% (P < .001) in all specialty SUD treatment facilities and by 15% (P = .02) in facilities accepting private insurance. Full parity and parity only if SUD coverage is offered increased the SUD treatment rate by 13% (P = .02) and 8% (P = .04), respectively, in all facilities and by 21% (P = .03) and 10% (P = .04), respectively, in facilities accepting private insurance.We found a positive effect of the implementation of state SUD parity legislation on access to specialty SUD treatment. Furthermore, the positive association is more pronounced in states with more comprehensive parity laws. Our findings suggest that federal parity legislation holds the potential to improve access to SUD treatment.