tbuckley/cabot-search huggingface dataset:
Administrative Costs in U.S. Hospitals
Authors: Steffie Woolhandler, David U. Himmelstein, James P. Lewontin
Journal: New England Journal of Medicine (1993)

Previous estimates of administrative costs in U.S. hospitals have been based on figures for California, and nationwide extrapolation has been controversial. If the costs of bureaucracy are high, major policy reforms may yield substantial savings.We obtained detailed data on hospital expenses for fiscal year 1990 from reports submitted to Medicare by 6400 hospitals. We calculated each hospital's administrative costs by summing expenses in the following Medicare cost-accounting categories: administrative and general, nursing administration, central services and supply (excluding the purchase cost of supplies), medical records and library, utilization review, and the salary costs of the employee benefits department. We classified costs in most other categories as clinical. Some small categories of expenses (e.g., gift shop) were excluded from both our clinical and administrative groupings, and for others (e.g., plant operations), a proportional share was allocated between the two groupings.Nationwide, administration accounted for an average of 24.8 percent of each hospital's spending in fiscal 1990. Average hospital administrative costs ranged from 20.5 percent in Minnesota to 30.6 percent in Hawaii. Administrative salaries accounted for 22.4 percent of the average hospital's salary costs. Administrative costs were similar in states with high and low rates of enrollment in health maintenance organizations (HMOs).Hospital administrative costs in the United States are higher than previous estimates and more than twice as high as those in Canada. Greater enrollment in HMOs, with more competitive bidding by hospitals for managed-care contracts, an important element of proposed managed-competition health care reforms, does not seem to lower hospital administrative costs.
Child soldiers: understanding the context
Authors: D. Somasundaram
Journal: BMJ (2002)

Concern is growing about the increasing use of child soldiers in armed conflicts around the world.1 However, it may not be enough to just condemn or prohibit the recruitment of children. We need to ask why children join armies. If we are to prevent children fighting we need to understand the conditions under which children become soldiers and work to improve these conditions. One such context, that of Sri Lanka, may shed some light on the issues.

The reasons why children become fighters can be categorised into push and pull factors. The use of push-pull categorisation has been used recently in relation to child labour by the International Labour Organization (see www.ilo.org/public/english/standards/ipec/child/2tour.htm) and more specifically child soldiers (see http://www.child-soldiers.org/conferences/confreport_asiawgc.html).2

#### Summary points

The recruitment and use of children as soldiers should be condemned and prohibited

Understanding why children choose to fight is important for preventing it

Factors that prompt children to join armed groups include witnessing the death of relatives; destruction of homes; displacement; economic difficulties; political oppression, and harassment

Children may be enticed by beliefs in the cause, threat to group identity, propaganda, thrill of adventure, and entrapment

Responsibility lies not only with those recruiting children but also with the civil society, state, and international community

### Traumatisation

In the civil war that has been in progress in north east Sri Lanka for almost two decades children have been traumatised by common experiences such as shelling, helicopter strafing, round ups, cordon and search operations, deaths, injury, destruction, mass arrests, detention, shootings, grenade explosions, and landmines. Studies focusing on children in war situations—for example, in Mozambique3 and the Philippines4—report considerable psychological sequelae. A detailed Canadian study of children in the Eastern Province of Sri Lanka found considerably more exposure to war trauma and psychological sequelae in ethnic minority Tamil …
PTH-121 The Burden Of Poor Nutrition In Chronic Pancreatitis: What Are The Impact Of Behavioural And Socioeconomic Factors?
Authors: B Paranandi, PS Patel, GH El-Sayed, D Joshi, A Ghai, K Koshy, MH Chapman, SP Pereira, GJ Webster, GJ Johnson
Journal: Gut (2014)

Introduction Nutrition centred research in pancreatitis has largely focused on acute pancreatitis. There is limited nutritional data in patients with Chronic Pancreatitis (CP), a condition that predisposes to endocrine and exocrine failure, fat-soluble vitamin deficiency and osteoporosis, which may worsen a patient’s quality of life and long-term outcome. We aim to determine the prevalence of malnutrition (using the Malnutrition Universal Screening Tool -MUST), active alcohol consumption and cigarette smoking in patients with CP. Methods Prospective study of consecutive patients with CP attending a tertiary clinic between October and December 2013. They were invited to participate in a face-to-face questionnaire study. Behavioural and socioeconomic data were collated. Results A cohort of 86 patients identified were predominantly male (67%), White British (62%), median age 58 years (range 18–90), of socio-economic class (SEC) 8 (21% never worked/long-term unemployed) with educational level (EL) 1 (29% degree or equivalent). Aetiologies included alcohol (29%), idiopathic (25%), autoimmune (22%) and gallstones (11%). The aetiology in 6% was actively under investigation. Median follow up was 27.5 months (range 0 – 151) from index appointment. Active alcohol exposure was noted in 33% (28/86) with excessive amounts (m >21 u, f >14 u/week) in 8% (7/86). The majority of patients (> 70%) with ongoing exposure to alcohol had primary aetiologies other than alcohol. Active cigarette smoking was noted in 34%. MUST scores ≥ 1 were noted in 38% (33/86) conferring “medium to high risk of malnutrition”. Multiple linear regression analysis of age, gender, ethnicity, SEC, EL, aetiology, alcohol exposure and smoking did not show any statistically significant variables that predicted MUST score. 27% (9/33) patients “at risk of malnutrition” had been referred to or had been seen by a dietitian within the previous 12 months. The remaining 73% (24/33) “at risk” patients all claimed to have received nil or suboptimal nutritional advice with regards to CP within the previous 24 months. Conclusion Patients with CP attending our tertiary clinic are at significant risk of malnutrition, which may be under-recognised. Behavioural and socioeconomic factors do not allow reliable prediction of risk of malnutrition to be made, in this cohort. This data emphasises the need for an algorithmic approach to improve recognition of malnutrition in CP and for implementation of specialist dietetic, alcohol liaison and smoking cessation services within the outpatient environment. Disclosure of Interest None Declared.
Changing Incidence Trends of Cutaneous T-Cell Lymphoma
Authors: Kaveri Korgavkar, Michael Xiong, Martin Weinstock
Journal: JAMA Dermatology (2013)

<h3>Importance</h3> Cutaneous T-cell lymphoma (CTCL) incidence and survival have been increasing steadily for over 25 years. <h3>Objective</h3> We sought to measure changes in CTCL incidence trends and survival rates. <h3>Design, Setting, and Participants</h3> Population-based study. The CTCL incidence and survival data were obtained from the 9 original registries (1973-2009) and the 4 additional registries (1992-2009) of the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (NCI). Trend analysis was performed using the Joinpoint Regression Program provided by the NCI. Survival analysis was performed using the SeerSTAT statistical software of the NCI. The total number of cases of CTCL from 1973 to 2009 was 6230. <h3>Main Outcomes and Measures</h3> Diagnoses of CTCL. <h3>Results</h3> Overall CTCL incidence has stabilized since 1998 (95% CI, 1994-2002), with an annual percent change (APC) of 5.7% from 1973 to 1998 (95% CI, 4.9%-6.5%) and an APC of 0.1% from 1998 to 2009 (95% CI, −1.4% to 1.5%). Similar incidence stabilization patterns were found in subgroup analyses of race, sex, age, diagnosis, and registry. Five-year CTCL survival rates increased until 2004. <h3>Conclusions and Relevance</h3> The incidence of CTCL is no longer increasing. Causes for this trend change may include real incidence stabilization, stabilization of physician detection, or artifact.
Response to Letters Regarding Article, “Stroke or Transient Ischemic Attack in Patients With Transvenous Pacemaker or Defibrillator and Echocardiographically Detected Patent Foramen Ovale”
Authors: Christopher V. DeSimone, Paul A. Friedman, Amit Noheria, Michael J. Ackerman, Samuel J. Asirvatham, Daniel C. DeSimone, Christopher A. Aakre, Vaibhav R. Vaidya, Amit Noheria, Nikhil A. Patel, Sami Bdeir, Joshua P. Slusser, David O. Hodge, Alejandro A. Rabinstein
Journal: Circulation (2014)
Effective prescribing at practice level should be identified and rewarded
Authors: T. Greenhalgh
Journal: BMJ (1998)

Controversies in primary care Setting prescribing budgets in general practiceGeneral practice prescribing costs have risen rapidly in recent years, and there are wide variations between practices in rates and costs of prescribing.Setting general practice prescribing budgets with a capitation based formula seems to offer a solution to these problems.However, capitation based formulas may unfairly penalise legitimate variations and increases in prescribing costs.We therefore asked Azeem Majeed and Trisha Greenhalgh to give their views on the subject.
Dysfibrinogenemia Associated with Liver Disease
Authors: Joseph E. Palascak, Jose Martinez
Journal: Journal of Clinical Investigation (1977)

To test the possibility that a functionally abnormal fibrinogen may exist in some patients with liver disease, we studied the plasma and purified fibrinogens of five patients whose plasma thrombin times were prolonged at least 40% over normal controls. In no patient was there evidence of disseminated intravascular coagulation and/or fibrinolysis. No abnormalities were detected by immunoelectrophoresis of plasmas or purified fibrinogens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of reduced patient fibrinogens showed normal mobility and amount of Aα, Bβ, and γ chains. Alkaline polyacrylamide gel electrophoresis and gradient elution, DEAE-cellulose chromatography of admixtures of radio-iodinated patient 125I-fibrinogen and normal 131I-fibrinogen showed identical mobility in the gel and simultaneous elution from the column, respectively. Thrombin and Reptilase (Abbott Scientific Products Div., Abbott Laboratories, South Pasadena, Calif.) times of purified patient fibrinogens were prolonged, and calcium ions improved but did not completely correct these defects. Increasing amounts of thrombin progressively shortened the clotting times of patient fibrinogens but not to the level of normal. Addition of equal amounts of patient fibrinogen to normal fibrinogen resulted in a prolongation of the thrombin time of the normal protein. Thrombin-induced fibrinopeptide release was normal. Fibrin monomers prepared from patient plasmas and purified fibrinogens demonstrated impaired aggregation at low (0.12) and high (0.24) ionic strength. These studies demonstrate that some patients with liver disease and prolonged plasma thrombin times have a dysfibrinogenemia functionally characterized by an abnormality of fibrin monomer polymerization.
The Care of the Patient
Authors: Francis W. Peabody
Journal: JAMA (2015)

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 Journals 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 2024 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
Noninvasive evaluation of pulmonary capillary wedge pressure in patients with acute myocardial infarction by deceleration time of pulmonary venous flow velocity in diastole
Authors: Atsushi Yamamuro, Kiyoshi Yoshida, Takeshi Hozumi, Takashi Akasaka, Tsutomu Takagi, Shuichirou Kaji, Takahiro Kawamoto, Junichi Yoshikawa
Journal: Journal of the American College of Cardiology (1999)
The Disorders of Cardiac Rhythm
Authors: Harry B. Greenberg
Journal: JAMA (1972)

For the resident and intern, and for their older colleagues who must interpret the electrocardiographic data that pours from intensive care, coronary care, and other special monitoring units,<i>The Disorders of Cardiac Rhythm</i>may prove a godsend. Schamroth shows how to distinguish one arrythmia from another, a distinction that, when quickly made, sometimes influences a patient's treatment and prognosis. Of course, studying Schamroth's book will not turn a novice into an electrocardiographer, but it will help. Schamroth's text is detailed and remarkably thorough. In the first half of his book, four-, five-, and six-page chapters relate disturbances of impulse formation and conduction and refer to the illustrative electrocardiograms that make up the second half. Consequently, the reader frequently must leaf pages from front to back as he refers to one illustration after another. On the other hand, a special index makes it easy to retrieve typical electrocardiograms for comparison with
TOTAL NONDIALYZABLE SOLIDS (TNDS) IN HUMAN URINE V. SUBFRACTIONATION OF THE ULTRAFILTRATE (UF-O) FRACTION *
Authors: J. Stanton King, William H. Boyce
Journal: Journal of Clinical Investigation (1959)

A procedure has been reported (1) for the re-producible separation of the total nondialyzable solids (TNDS) of normal human urine into three primary fractions. The most abundant of the -three fractions, designated UF-O, was separated from the other two by virtue of its passage through a collodion ultrafilter membrane. The overall chemical composition of fraction UF-O was described, but no further information was then available. Accordinigly, we have devised a procedure for the separation of this material into subfractions. While these subfractions appear to be cleanly separated, they are all probably mixtures of various chemical compounds. The method yields consistent results and therefore seems to be a useful tool for the study of possible changes in physiological and pathological conditions, and as an intermediate step in the ultimate separation of the components of UF-O. This report describes the procedure for the subfractionation of the UF-O and the results obtained with it, including the range of normal daily variation in the excretion of the subfractions and their overall chemical composition. Some perti
Modulation of cisplatin sensitivity and growth rate of an ovarian carcinoma cell line by bombesin and tumor necrosis factor-alpha.
Authors: S Isonishi, A P Jekunen, D K Hom, A Eastman, P S Edelstein, F B Thiebaut, R D Christen, S B Howell
Journal: Journal of Clinical Investigation (1992)

A twofold change in the cisplatin (DDP) sensitivity of 2008 human ovarian carcinoma cells is sufficient to reduce tumor response in vivo. The DDP sensitivity of these cells can be enhanced by activation of the epidermal growth factor and protein kinase C signal transduction pathways. We report here that two endogenous growth factors, bombesin and tumor necrosis factor alpha (TNF alpha), enhanced DDP sensitivity by factors of 1.7 +/- 0.1 (SD)-fold and 1.8 +/- 0.1 (SD)-fold, respectively. Both agents also produced sensitization in an 11-fold DDP-resistant 2008 subline. Neither bombesin nor TNF alpha changed the accumulation of DDP, glutathione content, or glutathione-S-transferase activity in 2008 cells. However, a 2-h exposure to both bombesin and TNF alpha was sufficient to increase 2008 cloning efficiency by up to 2.6 +/- 0.1 (SD)-fold and 2.2 +/- 0.1 (SD)-fold, and it increased average colony size by 1.35 +/- 0.1 (SD)-fold and 1.55 +/- 0.1 (SD)-fold, respectively. Bombesin increased intracellular free calcium, and this was blocked by the bombesin receptor-specific antagonist SC196, demonstrating that 2008 cells have functional bombesin receptors. These results indicate that bombesin and TNF alpha can enhance sensitivity to DDP in both DDP sensitive and resistant variants of a human ovarian carcinoma and that both agents serve as growth factors for this tumor.
Vesiculo-bullous Darier's disease
Authors: N.R. TELFER, S.M. BURGE, T.J. RYAN
Journal: British Journal of Dermatology (1990)

Journal Article Vesiculo‐bullous Darier's disease Get access N.R. TELFER, N.R. TELFER Department of Dermatology, The Slade Hospital, Oxford Search for other works by this author on: Oxford Academic Google Scholar S.M. BURGE, S.M. BURGE Department of Dermatology, The Slade Hospital, Oxford Dr S.M. Burge, Department of Dermatology, The Slade Hospital, Oxford OX3 7JH, U.K. Search for other works by this author on: Oxford Academic Google Scholar T.J. RYAN T.J. RYAN Department of Dermatology, The Slade Hospital, Oxford Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 122, Issue 6, 1 June 1990, Pages 831–834, https://doi.org/10.1111/j.1365-2133.1990.tb06273.x Published: 01 June 1990
CÆSAREAN SECTION TWICE IN ONE PERSON.
Authors: J. W. COAKLEY
Journal: JAMA (1896)

August 3, 1893, I was called to see Mrs. P., aged 30 years, in her fourth pregnancy, there having been previously one abortion. I had performed craniotomy in two preceding labors on account of so great contraction of the pelvis that it was impossible for the child to be delivered, as the conjugate diameter was less than two and one-half inches. It was difficult to assume the responsibility of the operation owing to opposition to it by elder members of the profession, as indeed it has been one of the most hazardous operations known until within the light of aseptic surgery. Dr. Harris collected with great industry 153 operations performed by the older methods in the United States, 56 of which, or 37.5 per cent. ended in recovery; under this showing it will be seen that more than one-half of the cases proved fatal. Baudon, writing in 1873, said, in
Mapping and Ablation of Left Atrial Flutters
Authors: Pierre Jaïs, Dipen C. Shah, Michel Haïssaguerre, Mélèze Hocini, Jing Tian Peng, Atsushi Takahashi, Stéphane Garrigue, Philippe Le Métayer, Jacques Clémenty
Journal: Circulation (2000)

Typical right atrial isthmus-dependent flutters have been described in detail, but very little is known about left atrial (LA) flutters.We performed conventional and 3D mapping of the LA for 22 patients with atypical flutters. Complete maps in 17 patients demonstrated macroreentrant circuits (n=15) with 1 to 3 loops rotating around the mitral annulus, the pulmonary veins, and a zone of block or a silent area. In 2 patients, a small reentry circuit with a zone of markedly slow conduction was identified. Linear ablation performed across the most accessible part of the circuit cured 16 patients (73%) with a follow-up of 15+/-7 months.LA reentrant tachycardias are related to individually varying circuits and are amenable to mapping guided radiofrequency ablation.
Acute sensory responses of nonsmokers at very low environmental tobacco smoke concentrations in controlled laboratory settings.
Authors: M H Junker, B Danuser, C Monn, T Koller
Journal: Environmental Health Perspectives (2001)

The objective of this study was to provide a basis for effectively protecting nonsmokers from acute sensory impacts and for preventing deterioration of indoor air quality caused by environmental tobacco smoke (ETS) emissions. With an olfactory experiment we determined odor detection thresholds (OT) of sidestream ETS (sETS), and with a full-body exposure experiment we investigated sensory symptoms at very low sETS exposure concentrations. OT concentrations for sETS are three and more orders of magnitude lower than ETS concentrations measured in field settings and correspond to a fresh air dilution volume of > 19,000 m(3) per cigarette, over 100 times more than had previously been suggested for acceptable indoor air conditions. Eye and nasal irritations were observed at one order of magnitude lower sETS concentrations than previously reported, corresponding to a fresh air dilution volume of > 3,000 m(3) per cigarette. These findings have great practical implications for defining indoor air quality standards in indoor compartments where ETS emissions occur. Our study strongly supports the implementation and control of smoking policies such as segregating smoking areas from areas where smoking is not permitted or instituting smoking bans in public buildings.
Assisted Ventilation Does Not Improve Outcome in a Porcine Model of Single-Rescuer Bystander Cardiopulmonary Resuscitation
Authors: Robert A. Berg, Karl B. Kern, Ronald W. Hilwig, Marc D. Berg, Arthur B. Sanders, Charles W. Otto, Gordon A. Ewy
Journal: Circulation (1997)

Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swine model of prehospital cardiac arrest.Five minutes after ventricular fibrillation, swine were randomly assigned to 8 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC + V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of intensive care support and were observed for 24 hours. All 10 CC animals, 9 of the 10 CC + V animals, and 4 of the 6 control animals attained return of spontaneous circulation. Five of the 10 CC animals, 6 of the 10 CC + V animals, and none of the 6 control animals survived for 24 hours (CC versus controls, P = .058; CC + V versus controls, P < .03). All 24-hour survivors were normal or nearly normal neurologically.In this model of prehospital single-rescuer bystander CPR, successful initial resuscitation, 24-hour survival, and neurological outcome were similar after chest compressions only or chest compressions plus assisted ventilation. Both techniques tended to improve outcome compared with no bystander CPR.