Publications

mycoplasma, chlamydia, epstein-barr, herpes i and ii, and aids infections among 100 consecutive infertile female patients and husbands: diagnosis, treatment, and results.	one hundred consecutive infertile patients were studied to determine the incidence of sexually transmitted diseases (stds) among middle and upper income patients, most of whom were referred as longstanding failures by other physicians. there were no cases of syphilis, gonorrhea, or aids found among these patients. one patient was pregnant when first seen, and was eliminated. genital mycoplasmas were cultured from 64 wives. antibodies for past or recent infection with chlamydia were present in on ...	1986	2898437
association of human t lymphotropic virus type iii antibodies with sexual and other behaviors in a cohort of homosexual men from boston with and without generalized lymphadenopathy.	forty asymptomatic homosexually active men seen at a boston community health center and 39 men with generalized lymphadenopathy were interviewed and filled out detailed epidemiologic questionnaires. twenty percent of the asymptomatic men and 92 percent of those with lymphadenopathy had antibodies to human t lymphotropic virus type iii (htlv-iii). none of the men have subsequently had the acquired immune deficiency syndrome (aids). seropositivity was associated with receptive anal intercourse and ...	1986	3006486
a 12-year audit of irb decisions.	institutional review boards (irbs) are inter-disciplinary committees mandated by the federal government to review all research protocols that involve human subjects developed in institutions receiving federal funds. the purpose of the irb is to protect those subjects from unnecessary risk or from risks that outweigh potential benefits. at boston city hospital, a study was conducted of the decision-making process of the hospital's irb over a 12-year period (from 1973-1984) to determine empiricall ...	1986	3085041
density-dependent migration and human population structure in historical massachusetts.	studies of population structure often focus on the effects of population size and migration rates on genetic variation. few studies, however, have investigated the relationship between these two factors. the purpose of this paper is to determine the extent to which migration (and gene flow) is density-dependent (that is, affected by population size) for populations in historical massachusetts. data from 4,859 marriage records were analyzed from four populations in north-central massachusetts dur ...	1986	3518482
putnam, merritt, and the discovery of dilantin.	in the first part of this essay, the "common wisdom" about putnam and merritt's contributions to the treatment of epilepsy was summarized (rowland, 1982). based on the history that has been presented here, how true are these "wisdoms"? putnam and merritt did devise "a simple and reliable method to test drugs of anticonvulsant effect" and they did show "that anticonvulsant effects in cats accurately predicted effects in humans," but others before them had done these same things. dilantin, contrar ...	1986	3527690
[the man behind the syndrome: joe vincent meigs. history-making in the gynecology of the 20th century].		1986	3543566
comparative prevalence of babesia microti and borrelia burgdorferi in four populations of ixodes dammini in eastern massachusetts.	we determined the prevalence of babesia microti and borrelia burgdorferi in four populations of ixodes dammini in eastern massachusetts. the feulgen's reaction was more sensitive than the giemsa method for detecting salivarian babesia. a combination of darkfield and direct-fluorescent-antibody examination proved more sensitive than either method alone for detecting spirochetal infection. the prevalence of spirochetes was greater than the prevalence of babesia in each of the tick populations stud ...	1986	2430433
judicial recognition of feticide: usurping the power of the legislature?		1986	11649213
court says feeding may stop for man in a vegetative state.		1986	11646483
understanding abortion via different scholarly methodologies: book review essay.	erde review three works that in his opinion have made important contributions to the abortion debate: abortion policy: an evaluation of the consequences for maternal and infant health, by jerome s. legge, jr. (albany: state university of new york press; 1985); abortion and the politics of motherhood, by kristen luker (berkeley: university of california press; 1984); and abortion: moral and legal perspective, edited by j.l. garfield and p. hennessey (amherst: university of massachusetts press; ...	1986	11655806
the dissenting opinions: biting the hands that won't feed.	the three dissenting opinions in brophy focus on concerns about the majority's decision to allow the withdrawal of food and water from a comatose patient. according to justice joseph nolan, who disagrees that food and liquids should be considered medical treatment, the decision "affronts logic, ethics, and the dignity of the human person." justice neil lynch, basing his argument on the state's interest in preserving life, says that the decision flouts the common law prohibition of suicide. justi ...	1986	10311790
design of a new medical record department: a case study.		1985	10274703
a sound way to curtail abortion.		1985	11647360
the spatial variation in unemployment and labour force participation rates of male and female workers.	this paper uses 1980 us census tract data from boston, denver, pittsburgh, seattle, and st. louis to examine spatial variation between male and female unemployment and labor force participation. research shows that families and individuals with characteristics making them more prone to unemployment tend to live in central cities. suburban workers living far from the city's center may also have higher unemployment rates due to higher job search and commuting costs. female workers differ from m ...	1985	12340358
risk of nosocomial infection with human t-cell lymphotropic virus iii (htlv-iii).	infection with human t-cell lymphotropic virus iii (htlv-iii) is closely linked to the acquired immunodeficiency syndrome (aids). we evaluated the risk of nosocomial infection with htlv-iii by testing for antibodies to htlv-iii among hospital employees, including victims of needle-stick exposure, endoscopists, pathologists, and laboratory workers. assays for antibody against the virus were performed by enzyme-linked immunosorbent assay and electrophoretic (western blot) techniques. although all ...	1985	2981106
seroepidemiology of human t-lymphotropic virus type iii among homosexual men with the acquired immunodeficiency syndrome or generalized lymphadenopathy and among asymptomatic controls in boston.	we studied a cohort of 45 homosexual men with the acquired immunodeficiency syndrome, 78 with persistent unexplained generalized lymphadenopathy, and 160 asymptomatic homosexual controls for serologic evidence of infection with human t-lymphotropic virus type iii (htlv-iii). study participants were recruited from a community-based health center and a university hospital practice. ninety-eight percent of men with the syndrome and greater than 90% of men with generalized lymphadenopathy had antibo ...	1985	2982305
absence of antibodies to htlv-iii in health workers after hepatitis b vaccination.	a proportion of the plasma for the triply inactivated, plasma-derived hepatitis b vaccine produced in the united states is obtained from homosexual men. because homosexual men are a high-risk group for the acquired immunodeficiency syndrome (aids), concern has emerged that the vaccine could harbor the aids agent. to evaluate this risk, we tested 15-month postvaccination serum samples for antibodies to human t-cell lymphotropic virus type iii in 100 health care workers who had received inactivate ...	1985	2991619
the development of benign prostatic hyperplasia among volunteers in the normative aging study.	this study describes the development of benign prostatic hyperplasia among 2,036 volunteers in the veterans administration normative aging study, a longitudinal study of human aging situated in boston. men were followed from enrollment in the study (between 1961 and 1970) until their last examination prior to may 15, 1982. two indications of benign prostatic hyperplasia were considered: 1) a clinical diagnosis made at a uniform physical examination, and 2) surgical treatment. incidence rates for ...	1985	3964994
fetal research: the question in the states.	baron, a law professor, traces the history of state and federal regulation of fetal research from 1973 to 1983. he explores the dilemmas raised by research on fetuses, particularly aborted fetuses, and the aspects of fetal research that the federal regulations and state laws were enacted to control. while criticizing many of the states' actions for lack of uniformity and blanket prohibitions based on the status of the fetus or abortus, baron acknowledges that less-than-perfect legislation is t ...	1985	4008234
cardiac surgery for adults with mental retardation. dilemmas in management.	in summary, cardiac surgery for adults with mental retardation raises a series of controversial legal, economic, ethical, medical, and nursing dilemmas. during the past 20 years, many improvements have taken place in the care of these patients. however, in the future, judicial and statutory mandates requiring high-quality medical care for persons with mental retardation may conflict increasingly with hospital cost-control legislation and thereby affect clinical decisions. for example, it is conc ...	1985	4050829
humanities in medical education: rationale and resources for the dissection laboratory.	dissection of a human body during an anatomy course raises for first-year medical students questions about invasion of privacy, cadaver sources, dying and death. emotions evoked are often heightened by the fear and uneasiness each student experiences when dissecting the body of a human being. providing curricular resources for identification and discussion of reactions to death and dissection early in the first year can demonstrate to students the humanity of having such reactions, and that thes ...	1985	4058336
measles infection and parkinson's disease.	a case-control analysis of parkinson's disease and infections in childhood was conducted in a cohort of 50,002 men who attended harvard college (cambridge, ma) or the university of pennsylvania (philadelphia, pa) between 1916 and 1950 and who were followed in adulthood for morbidity and mortality data. cases of parkinson's disease were identified from responses to mailed questionnaires and death certificates through 1978. four controls from the same population were selected for each case. a redu ...	1985	4061437
the people vote on abortion funding: colorado and washington.	on election day 1984, colorado voters narrowly approved an amendment to the state constitution cutting off all public funds for abortion. that same election day saw an effort to end abortion funding in the state of washington fail decisively. in both states, the effort to terminate funding was led by antiabortion activists who sought to characterize the issue as an economic one. failure of the colorado taxpayers for choice to emphasize the economic impact of the amendment appears to have been ...	1985	3842805
pasteurized milk as a vehicle of infection in an outbreak of listeriosis.	between june 30th and august 30th, 1983, 49 patients in massachusetts acquired listeriosis. seven cases occurred in fetuses or infants and 42 in immunosuppressed adults; 14 patients (29 per cent) died. of 40 listeria monocytogenes isolates available for testing, 32 were serotype 4b. two case-control studies, one matching for neighborhood of residence and the other for underlying disease, revealed that the illness was strongly associated with drinking a specific brand of pasteurized whole or 2 pe ...	1985	3918263
mhc determinants of response to rh immunization.	the demonstration of immune response genes in man has been difficult, although there is evidence for genes linked to the mhc in mouse and guinea pig that control both the specificity and magnitude of immune responses. a number of features of the antibody response to the rh d antigen, such as the failure of some individuals at risk to respond, the restricted immunoglobulin class, subclass, and light chain type of the antibody produced, and the presumed minor structural difference between rh d ant ...	1984	6197442
a simultaneous outbreak of respiratory syncytial virus and parainfluenza virus type 3 in a newborn nursery.	over a 3-week period, 20 of 34 (59%) infants in a newborn nursery developed nosocomial viral respiratory tract disease. either respiratory syncytial virus (seven infants) or parainfluenza virus type 3 (five) or both (two) were demonstrated in respiratory secretions from 14 of the 20 symptomatic patients. symptoms in the 20 infants included rhinitis (15 infants), cough (14), apnea (eight), pulmonary infiltrates (seven), and fever (six). there were no differences in symptoms between children infec ...	1984	6325655
legislation raising the legal drinking age in massachusetts from 18 to 20: effect on 16 and 17 year-olds.	the 1979 massachusetts law raising the legal drinking age from 18 to 20 is examined--the effects on the drinking, drinking and driving, and nonfatal and fatal crash involvement of 16-17 yr-olds, teenagers immediately younger than those targeted by the law. data from massachusetts are compared with those from new york state, where the drinking age remained at 18. a total of 3 yr of survey data from the two states and 6 yr of data from the department of transportation's fatal accident reporting sy ...	1984	6521479
epidemiology of coronary heart disease: the framingham study.	coronary heart disease continues to be the number one cause of death in most northern european, north american and other industrialized caucasian societies. by the age of 60, every fifth man and one in 17 women have some form of this disease. one in 15 men and women will eventually have a stroke. other cardiovascular diseases related to atherosclerosis are also important. epidemiologic (prospective) studies enable one to predict most of the potential victims of cardiovascular disease, years befo ...	1984	6702862
commonwealth v. cass.	the massachusetts supreme judicial court decided the question of whether a viable fetus is a "person" for purposes of the vehicular homicide statute in massachusetts. although the common law rule in every american jurisdiction that has considered the question, including massachusetts, has been that the destruction of the fetus in utero is not homicide, the supreme judicial court ruled to the contrary. confident in the ability of medical science to provide competent proof as to whether the cond ...	1984	12041184
recognizing the human potential.		1984	10265322
hospital payment coalition formed.		1984	10299721
social justice programs target discrimination, employment.		1983	10258663
nuclear weapons: us research put to vote.	a statute banning nuclear weapons research in cambridge, massachusetts, is scheduled for a referendum vote in november 1983. if passed, the act would require the city to fine or imprison violators after the ban takes effect in october 1985, and could have an impact on work done at harvard university and the massachusetts institute of technology, as well as at the charles stark draper laboratory. lawyers for draper and the local anti-nuclear group that drafted the statute, mobilization for surv ...	1983	11653480
the law of patient care in massachusetts.		1983	11658444
a theoretical model of the physiological dynamics of circulatory disease in human populations.		1983	6873927
ann hargreaves returns from fact-finding in el salvador.		1983	6551626
a population study of herpesvirus infections and hla antigens.	in a population-based study of herpesvirus infection and human leukocyte antigen (hla) phenotype, conducted during the period 1977-1979 in the framingham study cohort, hla-bw16 was found less often and hla-cw2 more often in individuals with histories of herpes labialis than in other individuals. similarly, both geometric mean antibody titer to herpes simplex type 1 and proportion of individuals with detectable antibody were higher in those without bw16 and in those with cw2. no strong associatio ...	1982	6280494
nutrition classics. transactions of the association of american physicians, volume 75, 1962, pages 307-320. experimental nutritional folate deficiency in man. by victor herbert.		1982	6752773
choline content of mothers' milk in ecuador and boston.		1982	7054668
abortion legislation. implications for medicine.	the legal ramifications of proposed legislation to prohibit abortion and to confer personhood on fetuses are examined in terms of their effect on the rights and liability of physicians and pregnant women in decisions involving maternal versus fetal health and life. other possible consequences include the prohibition of certain contraceptive methods, effect on property and inheritance rights of fetuses, and restriction of important fetal research. the negative impact of a massachusetts law limi ...	1982	7097944
harvard accused of impropriety.		1982	7133127
learning from anesthesia mishaps: analysis of critical incidents in anesthesia helps reduce patient risk.	human error and mechanical failure in anesthesia frequently cause incidents which, if not detected and corrected in time, could lead to increased patient morbidity or mortality. a study was conducted to analyze the human and technical factors that contribute to such incidents. the data thus obtained proved useful in reducing preventable anesthesia mishaps in specific institutions and generated recommendations for improving anesthesia practice in general.	1981	6787496
reservoir hosts of human babesiosis on nantucket island.	the host range of babesia microti was studied on nantucket island in order to identify the enzootic reservoir of this human pathogen. white-footed mice (peromyscus leucopus) were more frequently parasitized than were other indigenous animals. infection was ubiquitous in locations where deer were abundant. mice were most frequently parasitemic during spring and summer and adults more frequently than juveniles. parasitemia, which was rarely intense, was sustained for as long as 4 months. mice live ...	1981	7020449
recovery of parasitic nematodes from fish by digestion or elution.	two methods, digestion and elution, were used to recover parasitic nematodes from 470 flatfish belonging to species in the family pleuronectidae. samples of similar fish were collected from market lots; half of each sample was subjected to digestion, and half was subjected to elution (sedimentation). the edible (flesh) and the inedible (viscera) portions of each fish were analyzed separately. the total number of nematodes recovered by digestion was 1,110, which was not significantly greater than ...	1981	7235710
perinatal echovirus infection: risk of transmission during a community outbreak.	during a community outbreak of enterovirus infection, seven of 194 pregnant women (3.6 per cent) were found to be excreting a prime strain of echovirus 11 at term. each of the seven women possessed serum neutralizing echovirus 11 antibody in titers ranging from 1:20 to 1:320, and the cord serum of their seven infants had antibody in titers of 1:10 to 1:640. none of these seven infants became ill, but four were shedding virus from the respiratory or gastrointestinal tract by three days of age. in ...	1981	7254269
issues encountered in an attempt to implement a second-generation management information system.	human service organization are beset by internal and external requests for information. as the scale and complexity of such delivery systems has increased, the use of computer-based information systems has become a necessity. the evolution of a client information system in a large, decentralized mental health center is reviewed in this paper to illustrate several critical issues that can be encountered in the application of computer-based technology to human services. an analysis of the center's ...	1981	7255661
epidemiology of human babesiosis on nantucket island.	between 1969 and 1977, 14 persons with parasitologically confirmed babesia microti infections and seven persons with antibody titers to b. microti greater than or equal to 1:1,024 were identified on nantucket island, massachusetts. nineteen of these 21 persons were interviewed. about half were permanent residents of nantucket; the others spent most of their summers on the island. there were 12 women and seven men. patients ranged in age from 23 to 86 years; all of those with parasitologically co ...	1981	7283012
nitrite stability and nitrosation potential in human gastric juice.	human gastric juice samples were investigated from high- and low-risk areas (colombia and boston) for factors which influence the stability of nitrite and its potential for nitrosamine formation. the samples from individuals with chronic atrophic gastritis and intestinal metaplasia were not reactive to nitrite and supported a rate of nitrosation largely compatible with the nitrite and thiocyanate concentration. the samples from other individuals contained factors which destroyed nitrite and inhi ...	1981	7317877
nursing's fifth column.		1981	6910952
franz j. ingelfinger: the man.		1981	7009314
shields warren: the legend and the man.		1980	7018223
on epidemics, metaphors and madness.		1980	6991954
spotted fever group rickettsiae in dermacentor variabilis from cape cod, massachusetts.	spotted fever group (sfg) rickettsiae were identified by indirect immunofluorescent antibody tests in 1.1% of 6,956 specimens of dermacentor variabilis collected on cape cod, massachusetts. forty-one of 45 rickettsial isolates were serotyped as rickettsia montana, one as rickettsia rickettsii, and three were unidentified. studies of canines and humans with clinical evidence of spotted fever, and of healthy dogs with antibody to sfg rickettsiae, indicated that exposure of the canine population to ...	1980	6773430
adolescents' knowledge of consent laws in a massachusetts community.		1980	6899032
evidence of rickettsia prowazekii infections in the united states.	from january 1976 through january 1979 serum specimens from 1,575 individuals were received at the center for disease control and tested for antibodies to rickettsiae. of these, sera from eight persons gave serological results indicative of recent infections with epidemic typhus rickettsiae (rickettsia prowazekii). five of the persons were from georgia, and one each was from tennessee, pennsylvania and massachusetts. the illnesses occurred during the winter, chiefly in persons living in a rural ...	1980	6154428
potential use of shared antigens for immunization against gram-negative bacillary infections.	the demonstration of common antigens shared by all enterobacteriaceae has led to evaluation of the effects of immunization of animals and man with these antigens in protecting against bacterial infections and challenge with lps. both active and passive immunization with the re mutant of s. minnesota and the j5 mutant of e. coli afforded significant protection to mice and rabbits against lethal challenge with viable bacteria and heterologous lps. kdo appears to be the antigenic determinant respon ...	1980	6163155
special educational ideology and political-economic conservatism.	in the united states, the educational and human service systems, in addition to the attitudes and behaviors of the professionals associated with these systems, are being shaped to a lesser or greater extent by the scandinavian ideology termed normalization. this paper examines such a belief system through a special education ideology scale developed by the author and administered to school committee members and superintendents in 16 communities in the commonwealth of massachusetts. the scale dis ...	1980	6450176
a cluster of infants born with trisomy 18.		1980	7350419
consultation to a puerto rican drug abuse program.	the increasing number of hispanics residing within the united states requires the development of human service programs which are culturally and linguistically relevant to this population. the area of drug abuse is no exception to this need. however, the limited amount of resources targeted to serve drug-addicted hispanics has required the development of innovative strategies to maximize existing resources. the development of collaborative programs for reaching hispanic addicts and their familie ...	1980	7435484
human babesiosis on nantucket island: prevalence of babesia microti in ticks.	in order to derive direct evidence implicating ixodes dammini as a vector of human babesiosis, we determined the prevalence of babesia microti infection in nymphal i. dammini collected on nantucket island. in experiments in the laboratory we found that nymphs remained attached to hamsters for about 3 days. babesial infection was transmitted more often during 54 hours of attachment then during 36 or 48 hours. since parasites were demonstrable in salivary glands solely after 48 hours, we derived a ...	1980	7435782
medical decisions for incompetent adults: the spring case i.		1980	7449376
human babesiosis in north america.		1980	7189910
babesiosis in post-splenectomy hosts.	two persons who had been splenectomized later contracted babesiosis, one on cape cod and one near islip, long island, areas where human cases of babesiosis had not been previously identified. one of the patients received pentamidine, but parasitemia persisted after therapy. no deaths have been recorded for persons who had had splenectomies and were later infected with babesia microti. until more effective therapy is available, such patients should be treated conservatively.	1980	7192058
psychological impact of medical equipment on patients.	this study involves the analysis of interviews with patients who are using complex medical machines. in particular, personal interviews were conducted with twenty-six patients who have undergone cardiac catheterization, ten patients utilizing a cardiac monitor, and ten people currently receiving renal dialysis treatments. the variables selected for this study fit into five general categories: 1) environment; 2) patient's personal anxiety; 3) staff interaction; 4) approach to machine; and 5) mach ...	1980	10248692
community health centers after fifteen years.		1980	10249733
the new professional--the human services worker--a survey of training needs.		1980	10250866
breastfeeding: volunteer counselors enter an age-old scenario.		1979	10240736
boston md leads drive to help jewish physicians leave russia.		1979	10240768
natural infection of dogs on cape cod with rickettsia rickettsii.	four isolates of rickettsiae from sick dogs on cape cod, mass., were serologically identical to isolates of rickettsia rickettsii from human patients with rocky mountain spotted fever. the antigenic analysis used the indirect fluorescent-antibody test and antisera prepared in mice to each of the isolates and to reference strains of r. rickettsii and rickettsia montana. serological responses of infected dogs were specific for r. rickettsii, although antibodies to r. montana were also detected in ...	1979	114534
viral exposure and autism.		1979	222139
a regional cardiac care program: planning & development.	five hospitals in northeastern massachusetts joined together to provide a cardiac care nursing educational program for staff nurses. their mutual effort reduced costs for each hospital and maximized the use of human and material resources. the endeavor has been successful, based upon a number of evaluation factors.	1979	253743
creutzfeldt-jakob disease: patterns of worldwide occurrence and the significance of familial and sporadic clustering.	the worldwide epidemiology of creutzfeldt-jakob disease (cjd) is presented from an analysis of 1,435 patients. in the united states, the average annual mortality rate is at least 0.26 deaths per million. temporal-spatial clustering of cases was not found in the united states, but reports from other countries indicate that such clustering does occur. fifteen percent of the cases were of the familial type, suggesting a genetic susceptibility to infection. iatrogenic transmission by corneal transpl ...	1979	371520
babesia infections in man.	only recently has it been recognized that hemotropic animal parasites of the genus babesia are also human pathogens. similar to malaria in both symptoms and laboratory findings, acute babesiosis generally results in self-limited illness, but it can be fatal in the asplenic patient. the widely disseminated vector tick, ixodes dammini, can transmit infection at each stage of its development, larva and nymph as well as adult.	1979	376427
the osler medal essay: height, weight, and health: anthropometric study of human growth in nineteenth-century american medicine.		1979	389320
pandemic influenza 1918.		1979	394807
human babesiosis on nantucket island, usa: description of the vector, ixodes (ixodes) dammini, n. sp. (acarina: ixodidae).		1979	439119
age as a function in the development of sodium-related hypertension.	the populations of the developed nations of the world exhibit an increase in blood pressure with age, while in primitive societies blood pressure remains relatively constant throughout adult life. hypertension may be a complex of diseases all having the same clinical manifestations but not being caused necessarily by the same factors. a possible common denominator in the development of any chronic elevation of blood pressure is the need for the kidney to increase urine volume to promote sodium e ...	1979	510240
enhanced anticaries action from drinking water containing 5 ppm fluoride.	dental examinations were conducted on 1,878 adolescent schoolchildren native to seven us cities in five states, where the water was fluoride-deficient, fluoridated, or contained approximately 5 ppm of naturally occurring fluoride. dental caries experience was considerably lower in all the communities with fluoridated water than in boston, which had water deficient in fluoride, and ranged from 38% to 83% fewer mean dmf for the children in the regions with fluoridated water than for the children i ...	1979	282343
[the lesson of the practolol drama; can adverse effects of drugs be recognized as such sooner?].		1978	360080
castle: right man, time, and place.		1978	363006
the incompetent's right to die: the case of joseph saikewicz.		1978	624618
what's happening to federally aided health programs under state departments of human resources.		1978	652943
managing public health risks: the swine flu immunization program revisited.	in this comment, the massachusetts commissioner of public health views the federal government's 1976-77 swine flu immunization program, which was sharply criticized by dr. cyril wecht in a recent article in this journal, as a classic example of a public policy decision made under conditions of stress and uncertainty. once the responsible government officials had made a public commitment to immunize the entire populace of the united states, he contends, they found it very difficult to reformulate ...	1978	685984
federal preclusion of state certificate-of-need exemptions for research and education expenditures.	the national health planning and resources development act of 1974 requires each state to enact a certificate-of-need program in compliance with federal standards in order to remain eligible for continued receipt of federal funds for health resource development after 1980. this note contends that the act and related hew regulations preclude states from exempting health care facilities' research expenditures and education expenditures from the scope of the states' certificate-of-need programs. th ...	1978	685985
teaching occupational health to physicians.	a comprehensive training program for physicians interested in occupational health is presented. the objectives are to prepare students to identify and prevent occupational disease, with an emphasis on the development of a public health perspective. seven content areas are described: epidemiology and biostatistics, toxicology, industrial hygiene, safety and ergonomics, policy issues, administration, and clinical aspects. these are organized in a matrix to provide appropriate levels of training fo ...	1978	691028
program evaluation as health services research.	evaluation of health program is necessary for more rational allocation of scarce resources. steps in evaluation include: 1)specification of the program goals, 2) description of the program, 3) definition and measurement of outcome, 4) assessment of intervening variables, 5) analysis of data, and 6) implementation of findings. examples from impirical evaluation studies are presented to illustrate one practical application of these steps. while the random controlled trial is a most powerful tool, ...	1978	281768
eastern equine encephalitis in massachusetts, 1957-1976. a prospective study centered upon analyses of mosquitoes.	reappearance of eastern equine encephalitis (eee) in massachusetts residents in the 1970's provided an opportunity to assess the predictive value of data on rainfall, eee in horses, and carriage of eee virus (eeev) by mosquitoes, factors which had been studied annually since the last eee outbreak in 1955-1956. the cycle of multiple cases during 1973-1975 started in a second consecutive year of rainfall that exceeded the annual mean by more than 20 cm, conditions recapitulating the 1955-1956 expe ...	1978	23676
mortality from leukaemia and cancer in shipyard nuclear workers.	a review of death certificates in new hampshire, maine, and massachusetts for 1959-77 yielded a total of 1722 deaths among former workers at the portsmouth naval shipyard where nuclear submarines are repaired and refuelled. next of kin were contacted for 592. all deaths under age 80 were classified as being in former nuclear or non-nuclear workers depending on information supplied by next of kin. with u.s. age-specific proportional cancer mortality for white males as a standard, the observed/exp ...	1978	76937
phenotypic and epidemiologic correlates of auxotype in neisseria gonorrhoeae.	previous studies from seattle, wash., suggested that strains of neisseria gonorrhoeae which require arginine, hypoxanthine, and uracil (arg-hyx-ura- auxotype) are unifomly highly susceptible to penicillin g, are relatively resistant to complement-dependent killing by heated, pooled human serum, and are associated with disseminated gonococcal infection. for further study of the epidemiology of these strains and for analysis of the susceptibility to penicillin, serum sensitivity, and the nutrition ...	1978	98600
u and the 4 r's: uniform reporting, rate review and regulation.		1978	10243290
judges at the bedside: the case of joseph saikewicz.		1978	10289106
a child's fight for life: parents vs. doctors.		1978	10289142
student research in service agencies.		1978	11661773
dr. edelin cleared by appeals court.		1977	11663717
epidemiologic transition in the united states: the health factor in population change.	the general theory of epidemiologic transition is explained. the theory hypothesizes that long-term changes in health and disease patterns in any society are related to the demographic and social conditions in that country. mortality is considered to be the major factor in population change. the theory is illustrated by a detailed consideration of birth and death trends in the u.s. mortality decline began in the u.s. in the middle of the nineteenth century. associated with this decline was ...	1977	12335110
tumor-associated antigen levels (carcinoembryonic antigen, human chorionic gonadotropin, and alpha-fetoprotein) antedating the diagnosis of cancer in the framingham study.	determinations of carcinoembryonic antigen (cea), human chorionic gonadotropin (hcg), and alpha-fetoprotein (afp) were done by use of frozen serum samples antedating the diagnosis of cancer for 9 pancreatic and 8 gastric carcinoma patients from the framingham heart study. the longest intervals for elevated antigens before cancer diagnosis were 10 months for cea and 26 months for hcg. (the single elevated afp was found in a sample 10 days before clinical diagnosis.) samples from 31 controls match ...	1977	68118
clinical spectrum of gonococcal infection in women.	the medical records of 278 women infected with neisseria gonorrhoeae during a 6-month period were reviewed. these represented 75% of the infections in women at boston city hospital during this time. women who presented to the venereal-disease clinic because they had had contact with an infected man and women who were found to be infected during routine examinations in the obstetrics-and-gynaecology clinic were usually free of symptoms or had non-specific symptoms such as vaginal discharge. howev ...	1977	68279
human babesiosis on nantucket island. clinical features.	between 20 july and 15 octoboer 1975, five cases of human infection with babesia microti were diagnosed on nantucket island, massachusetts. the illness was characterized by fever, drenching sweats, shaking chills, myalgia, arthralgia, extreme fatigue, and a mild-to-moderate hemolytic anemia. none of the patients had a history of splenetomy. although all patients responded symptomatically to treatment with oral chloroquine phosphate, parasitemia and fatigue frequently persisted for several weeks ...	1977	556920
human babesiosis on nantucket island. evidence for self-limited and subclinical infections.		1977	561308
leptospirosis in new england.	although rarely reported in humans in new england, leptospirosis is enzootic in western and central massachusetts. recently there were three cases of leptospira interrogans, serotype var pomona, in easthampton, mass. our study and others indicate a potential for waterborne epidemics in humans.	1977	578899