Tammy Chung’s new research will further examine the effects of medical marijuana.
Keep ReadingRutgers Center for State Health Policy celebrates 25 years of informing sound state health policy.
Keep ReadingIFH’s Min Hee Kim publishes research on the impact of educational attainment on cognitive outcomes.
Keep ReadingIFH’s Howard Leventhal Scholarship supporting doctoral candidates is accepting applications!
Keep ReadingResearchers led by Daniel Horton and Priyanka Yalamanchili analyze trends in therapies for juvenile idiopathic arthritis.
Keep ReadingIFH researcher Soko Setoguchi named to prestigious NIH Climate and Health Scholar Program.
Keep ReadingReminder: Internet access will be down at IFH office on 11/13, 11/20, 11/21.
Keep ReadingResearchers led by Stephen Crystal aim to find ways to improve outcomes for released prisoners with opioid use disorder.
Keep ReadingIFH’s Elizabeth Stone publishes research on support for medical cannabis policies.
Keep ReadingCheck out the latest news from the Institute for Health!
Keep ReadingIFH welcomes new faculty member, Dr. Erica Eliason!
Keep ReadingIFH faculty Kathleen Pottick receives one of the highest honors in the field of social work.
Keep ReadingIFH’s Benjamin Bates leads research on the impact of weather events on cancer treatment.
Keep ReadingCheck out new research opportunities at IFH’s Center for Health Services Research!
Keep ReadingIFH welcomes its newest faculty member, Mara Getz Sheftel!
Keep ReadingIFH interns complete summer research.
Keep ReadingRutgers ethicists provide advice to nonprofit.
Keep ReadingWork-in-Progress series aims to be a sounding board for Alzheimer’s researchers at Rutgers.
Keep ReadingDr. Elizabeth Luth leads new research on the disparities in hospice discharges and what might combat the risks.
Keep ReadingResearchers led by Dr. William Hu and the Center for Healthy Aging Research conduct one of the most detailed investigations into long COVID and brain fog.
Keep ReadingCongratulations to Nir Eyal, director of IFH’s Center for Population-Level Bioethics, on his new appointment!
Keep ReadingView letter from IFH researchers to CMS in response to their proposed data policy changes.
Keep ReadingLearn more about IFH’s summer research internship program and apply by April 26.
Keep ReadingRutgers doctoral students Naomi Cruz and Alexis Richeson named 2024 IFH Howard Leventhal Scholars.
Keep ReadingFaculty from across IFH collaborated on Mutual Mentoring Grants to promote collaboration and mentorship.
Keep ReadingIFH faculty Dr. Michal Schnaider Beeri publishes new research on the association between fat in abdominal organs and brain cognition in middle-aged males with high Alzheimer’s risk.
Keep ReadingIFH researcher, Dr. Olga Jarrín, publishes new research on connection between home health care and hospice care utilization.
Keep ReadingRutgers-NYU center hosts retreat at IFH focused on asian health and community research.
Keep ReadingThe Resource Center for Alzheimer’s and Dementia Research in Asian and Pacific Americans (RCASIA) awarded four pilot grants to researchers to study the health of Asian older adults.
Keep ReadingIFH core faculty member Dr. Michal Beeri Schnaider is collaborating with Israeli universities to to organize the US-Israel Alzheimer’s Disease Conference.
Keep ReadingIFH’s Zeeshan Ahmed develops software to analyze data, discover biomarkers and predict diseases.
Keep ReadingLearn about the recent retreat focused on Alzheimer’s and dementia research in Asian and Pacific Americans.
Keep ReadingIFH core faculty member Dr. Elizabeth Stone publishes new research on people with cognitive abilities and their experience with the health care system.
Keep ReadingIFH core faculty member Dr. Margaret Marsh and her husband are making a $500,000 gift to establish the Gerald Grob Endowed Legacy Professorship.
Keep ReadingIFH’s Hillary Samples publishes new research on the association of medical cannabis and the frequency of nonmedical prescription opioid use.
Keep ReadingIFH faculty Dr. Michal Schnaider Beeri publishes new research on link between ADHD and dementia.
Keep ReadingResearchers from the Center for Asian Health Promotion and Equity attend health equity conference.
Keep ReadingDr. William Hu will lead new NIA-funded resource center focused on Alzheimer’s and dementia in Asian and Pacific Americans.
Keep ReadingCongratulations to all the RBHS Chancellor Award winners!
Keep Reading11 exceptional students complete IFH’s Summer Research Internship Program.
Keep ReadingThe Rutgers Health Service Corps launched its inaugural high school summer program, PHOENIX, hosted at IFH.
Keep ReadingIFH’s Dr. Marie Sizemore presented research AIDSImpact and IPPA World Congress.
Keep ReadingDrs. Tammy Chung and Michelle Chen present research at INS Meeting.
Keep ReadingDarina Petrovsky selected for newest cohort of NIA IMPACT Scholars.
Keep ReadingPETS postdoc Mackenzie Henderson publishes research on MS treatment trends.
Keep ReadingPETS’ Dr. Soko Setoguchi publishes new research on the relationship between body mass index and mortality.
Keep ReadingCPLB’s Dr. Mark Budolfson publishes new research on animal welfare in Science.
Keep ReadingDrs. Stephen Crystal and Greta Bushnell observe decline in antipsychotic medication use in children.
Keep ReadingDr. Darina Petrovsky has been selected for the Dementia Palliative Care Clinical Trials Program.
Keep ReadingRWJF program calls for proposals to access data from variety of data sets including IFH’s iPHD Project.
Keep ReadingRutgers-NYU Center for Asian Health Promotion calls for pilot proposals applications.
Keep ReadingDr. Michelle Chen has been selected for Neuropsychology’s Early Career Editorial Fellowship program.
Keep ReadingThe Rutgers-NYU Center for Asian Health Promotion and Equity hosted a panel on AAPI health and climate change.
Keep ReadingIFH researchers led by Peter Treitler analyzed risk of overdose and death after a mass prison release in 2020.
Keep ReadingIFH researcher, Dr. Ashley Grosso, receives $3 million grant to study barriers to HIV research in Africa.
Keep ReadingRutgers names Dr. Tobias Gerhard new director of IFH.
Keep ReadingCSHP’s Ann Nguyen publishes research on impact of temporary licenses for mental health providers during pandemic.
Keep ReadingStudent researchers present research and are recognized at undergraduate symposium.
Keep ReadingIFH’s Dr. Edward Selby developed a mental health app to help users deal with stressful situations.
Keep ReadingDr. Darina Petrovsky and Dr. Ann Nguyen along with their teams receive Mutual Mentoring Grants for peer mentoring programs.
Keep ReadingIFH’s Stephen Crystal and James Lloyd featured in FORE’s Issue Brief on OUD Treatment.
Keep ReadingIFH and PETS’ Dr. Dan Horton publishes new research on drop in childhood asthma.
Keep ReadingIFH awards Molly Nowels and James Terhune the 2023 Howard Leventhal Scholarship for Trainees.
Keep ReadingLearn more about IFH’s summer research internship program and apply by April 21.
Keep ReadingIFH’s Tammy Chung discusses challenges of accurately diagnosing cannabis use disorder in a Q&A.
Keep ReadingIFH’s Tammy Chung and Carolyn Sartor to lead workshop at the annual Research Society on Alcohol meeting this summer.
Keep ReadingIFH core member Yanping Jiang selected for two scholar programs.
Keep ReadingIFH core member Dr. Zeeshan Ahmed publishes research on artificial intelligence and cardiovascular disease.
Keep ReadingIFH core member Dr. Chintan Dave receives grant to study impact of medications.
Keep ReadingIFH researchers publish new research on the impact of NJ’s opioid prescribing regulations.
Keep ReadingCheck out featured events in New Brunswick this Spring!
Keep ReadingInstitute for Health members were part of the coalition that helped the MAT Act get signed into law.
Keep ReadingIFH core member Michelle Chen selected for Alzheimer’s health equity scholars program.
Keep ReadingIFH associate member Amesika Nyaku named to state advisory council to combat opioid epidemic.
Keep ReadingDr. Yanping Jiang publishes new research findings on the importance of connection to neighbors for older Chinese adults.
Keep ReadingFaculty members from the Rutgers Center for Pharmacoepidemiology and Treatment Science (PETS) at the Institute for Health, Health Care Policy and Aging Research …
Keep ReadingFaculty and staff from the Center for Pharmacoepidemiology and Treatment Science attended the International Society of Pharmacoepidemiology’s annual conference…
Keep ReadingIFH’s Greta Bushnell analyzes which treatments for sleep disorders are associated with higher risk of overdose.
Keep ReadingThe deadline to apply for the scholarship award is January 13, 2023.
Keep ReadingDr. Stephen Crystal and IFH researchers examine importance of outpatient visits for patients in treatment for opioid use.
Keep ReadingIFH’s Tammy Chung, Carolyn Sartor, Ashley Grosso + Yanping Jiang found a connection between young women who binge drink and their risk of COVID-19 infection.
Keep ReadingIFH Interim Director, Tobias Gerhard, was installed as ISPE President at ISPE’s annual conference in August.
Keep ReadingThe Rutgers Asian Resource Center for Minority Aging Research (RCMAR) appoints new leadership.
Keep ReadingDr. Zeeshan Ahmed leads one of the first studies examining artificial intelligence and precision medicine.
Keep ReadingDr. Chintan Dave will lead researchers in conducting the largest study of children at risk of developing a life-threatening complication of Type 1 diabetes.
Keep ReadingDr. Ann Nguyen of Rutgers Center for State Health Policy publishes new research in Health Affairs on NJ’s temporary licensure program.
Keep ReadingMultiple IFH researchers presented research findings at NJ ACTS’s Community Engaged Scholarship Symposium in June.
Keep ReadingIFH’s Interim Director, Tobias Gerhard, was elected new member of AES – an honorary society with a mission to provide a scientific forum for senior epidemiologists.
Keep ReadingRutgers Center for State Health Policy launched the New Jersey Integrated Population Health Data (iPHD) Project to address some of the state’s most pressing health care issues
Keep ReadingIFH’s Stephen Crystal coauthors study on how use of buprenorphine prior to entering opioid disorder treatment can prepare patients to stay in care.
Keep ReadingRemembering Shirley Smoyak, Distinguished Professor and member of the Institute for Health, Health Care Policy and Aging Research
Keep ReadingIFH’s Nir Eyal and Tobias Gerhard and RBHS Chancellor Brian Strom present reasons to assess the effectiveness and safety of vaccines with both conventional and challenge trials .
Keep ReadingRutgers Center for State Health Policy led an independent evaluation of Rutgers tele-mentoring program for primary care providers.
Keep ReadingIFH’s Dr. Greta Bushnell led research on youth with overdoses for certain drugs who have prescriptions for those medications.
Keep ReadingIFH’s Dr. Michelle Chen leads research on telehealth services for people with MS during the COVID-19 pandemic.
Keep ReadingRutgers IFH is now accepting applications for the 2022 summer internship program.
Keep ReadingIFH’s Ann Nguyen and Nathan Stewart describe the need to support our API health care workers.
Keep ReadingIFH Core Member Margaret Marsh named AAAS fellow, recognized for contributions to social sciences and history of medicine.
Keep ReadingAnnual report highlighting impact of Rutgers IFH community outreach and engagement efforts.
Keep ReadingCheck out the November-December 2021 edition of IFH’s Community Newsletter!
Keep ReadingThe redistribution of revenues from a carbon tax can promote equity and protect vulnerable populations, according to study published in Nature Climate Change by IFH associate member, Mark Budolfson.
Keep ReadingRead the September-October 2021 edition of IFH’s Community Newsletter!
Keep ReadingNew center will work to advance research on cardiometabolic disease and mental health of Asian adults
Keep ReadingRutgers-led study looks at medically treated opioid overdoses in New Jersey during the rapid spread of fentanyl.
Keep ReadingNew article suggests areas of research to better understand risk factors of and protection against elder mistreatment.
Keep ReadingThe Rutgers Institute for Health, Health Care Policy, and Aging Research eagerly shares the July/August 2021 edition of the Community Newsletter.
Keep ReadingEsta serie cubrirá temas relacionados con el mantenimiento de una buena salud mental mientras mantenemos las regulaciones que la CDC a creado para el distanciamiento social
Keep ReadingNew 5-week series will cover topics related to maintaining good mental health while adhering to CDC guidelines and social distancing.
Keep ReadingThe latest news and happenings from the Rutgers Institute for Health community to yours!
Keep ReadingIFH Director XinQi Dong issued a statement in response to anti-Asian racism and violence against Asians across the country.
Keep ReadingPlease join us June 3 and 4, 2021 to mark the launch of a new initiative to increase the presence of New Jersey clinical practices in academic research.
Keep ReadingXinQi Dong, committee member, adds to recommendations on how to improve dementia caregiving, reduce disparities and expand future research
Keep ReadingLearn more about our legacy, our mission, and our vision for the future of population health research in a new video.
Keep ReadingWatch the celebration and panel discussion on Feb. 17, 2021.
Keep ReadingThe latest news and happenings from the Rutgers Institute for Health community to yours!
Keep ReadingThe latest news and happenings from the Rutgers Institute for Health community to yours!
Keep Reading“Elder fraud and abuse, those aren’t new problems, but unfortunately the coronavirus pandemic and economic crisis have made it even more prevalent.”
Keep ReadingResearchers will enroll up to 10,000 participants throughout New Jersey, with a focus on minority and low-income individuals and diverse immigrant groups, as well as factors related to the COVID-19 pandemic.
Keep ReadingThe virtual event will take place on Thursday, Dec. 3, 2020.
Keep ReadingThe deadline to apply for an award of up to $5,000 is Monday, Nov. 30, 2020.
Keep ReadingThe deadline to apply for the grant writing workshop series is Oct. 25, 2020.
Keep ReadingCheck out community events and happenings at Rutgers Institute for Health!
Keep ReadingThe new Ahmed Lab at Rutgers Institute for Health is charting the course with advanced data and technology.
Keep ReadingThis series is designed to help people use evidence and research to make informed decisions for health and well-being as they age.
Keep ReadingResearchers today are trying to determine what is causing the disparities in hospitalizations and deaths of Black Americans during COVID-19.
Keep ReadingCheck out community events and happenings at Rutgers Institute for Health!
Keep ReadingRutgers study finds gaps in filial expectations affect longevity of older Chinese Americans
Keep ReadingFoundation for Opioid Response Efforts (FORE) Announces Grants to Urgently Increase Access to Recovery Support Services for Opioid Use Disorder During COVID-19
Keep ReadingFindings may help health care and social service providers develop interventions for cognitive function
Keep ReadingAt Institute for Health, Health Care Policy and Aging Research, Dinesh Mendhe, Stephanie Bergren, and XinQi Dong build a novel survey platform to increase accuracy in multilingual data collection and reduce selection bias.
Keep ReadingDirector XinQi Dong says we need further research into neurological effects of COVID-19 and atypical symptoms in some patients, including older adults
Keep ReadingThis series is designed to help people use evidence and research to make informed decisions for health and well-being as they age.
Keep ReadingIFH Director Dr. XinQi Dong talks about the common myths of aging.
Keep ReadingIn the midst of COVID-19, as thousands of people are passing away in hospitals without loved-ones, two Rutgers Institute for Health experts, discuss death, dying and end-of-life care during the global pandemic.
Keep ReadingIntroducing the new Rutgers IFH Community Outreach Newsletter!
Keep ReadingStudy adds to the understanding of self-neglect and the role of cultural factors.
Keep ReadingWe’ve launched a social media campaign to connect New Jersey’s minority and immigrant communities with COVID-19 information and resources in their own languages.
Keep ReadingThe Rutgers Institute for Health, Health Care Policy and Aging Research launches a new series exploring ‘modern myths of aging.’
Keep ReadingNew Jerseyans in unstable situations much more likely to face housing quality issues that could affect their health, researchers at the Center for State Health Policy find.
Keep ReadingThe new reports detail analyses conducted over the last 18 months as part of a project to evaluate a sweeping 2017 law in response to the state’s opioid crisis.
Keep ReadingNir Eyal, director of the Rutgers Center for Population-Level Bioethics, and his coauthors argue a human challenge trial could dramatically accelerate development of a COVID-19 vaccine.
Keep ReadingThe project is one of 19 nationwide to receive inaugural grants from the Foundation for Opioid Response Efforts (FORE).
Keep ReadingDirector Dr. XinQi Dong says Asian Americans and older adults face additional risks from discrimination and isolation related to COVID-19.
Keep Reading항상 많은 연구들이 진행되고 있습니다. 본인께서 연구에 참여하실 자격이 될 수도 있으니 살펴보시고
건강문제들을 예방하고 더 나은 방법을 발견하는 데 도움을 주시길 바랍니다…
Constantemente se realizan muchos estudios de investigación en la universidad de Rutgers. Usted podría participar en ellos y ayudar a encontrar mejores formas de prevenir o tratar los problemas de salud que le rodean…
Keep ReadingThere are many research studies happening at Rutgers all the time. You could be eligible to participate in them and help find better ways to prevent or treat health concerns surrounding you…
Keep ReadingAdditional findings could improve treatment for at-risk older adults and help prevent self-neglect.
Keep ReadingChicago resident Kathy Lovitt has been caring for her mom, 97-year-old Katherine Lovitt, for the last 15 years.
Keep ReadingThe Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, is rightly proud of its storied legacy. Founded by eminent medical sociologist David Mechanic PhD in 1985.
Keep ReadingFindings will have statewide and national importance toward promoting a culture of health.
Keep ReadingRutgers Center for State Health Policy has three recent reports highlighting the potential role of Medicaid for people experiencing homelessness.
Keep ReadingStudy findings are important to improving culturally patient-centered care, Rutgers IFH researchers say.
Keep ReadingThe American Academy of Social Work and Social Welfare will recognize new fellows at an induction ceremony in January.
Keep ReadingWe’re looking forward to our Strategic Planning Retreat on Oct. 24 and 25 at the Ocean Place Resort in Long Branch. The retreat will feature two days of discussions surrounding future visions as a institution.
Keep ReadingInformation may help providers improve services, treatment for older immigrants.
Keep ReadingFindings underscore need for culturally targeted interventions to prevent and reduce tobacco use, manage chronic disease and screen for lung cancer.
Keep ReadingCollaborative will bring together researchers and community leaders to increase engagement of black, Hispanic, and Asian older adults in New Jersey.
Keep ReadingRutgers studies find older Chinese Immigrants are healthier and happier and their children less burdened by caregiving when cultural family values are maintained
Keep ReadingAn elderly Chinese American man lives by himself in subsidized housing for seniors in Boston. He struggles with dementia, so he sticks to familiar places, otherwise he gets lost. And it’s hard for him to get help, because he doesn’t speak English.
Keep ReadingWeb-based data collection and management system addresses linguistic and cultural barriers for researching minority populations.
Keep ReadingTwo Rutgers studies examine the role of psychosocial factors in oral health among older Chinese Americans
Keep ReadingStudies suggest the need for culturally relevant depression screenings to prevent the onset of disability and improve the management of chronic medical conditions of older minorities
Keep ReadingRutgers releases first of their kind studies revealing the impact of immigration, gender, psychological distress, education, social engagement, and oral health on Chinese Americans’ cognitive function…
Keep ReadingNot enough is being done to prevent elder abuse in the Chinese American community, according to four new Rutgers studies published in the current edition of the Journal of the American Geriatrics Society…
Keep ReadingNewswise — Since 2011, the Population Study of Chinese Elderly in Chicago (PINE), the most extensive epidemiological cohort study of Chinese older adults in the United States …
Keep ReadingRutgers study finds increase in antihistamine use for colds, following the 2008 FDA advisory to decrease use of cough and cold medicines, despite risks…
Keep ReadingHealthcare experts explore the changing world of healthcare by examining issues of affordability, accessibility, and new technology. Guests: Shereef Elnahal, MD, MBA, Commissioner, NJ Dept. of Health Amy Perry, CEO, Hospital Division, Atlantic Health System Stephen Crystal, Ph.D., Rutgers University
Keep ReadingReproductive Technology from Test-Tube Babies to Uterus Transplants. Since the 1978 birth of the first IVF baby, Louise Brown, in England, more than eight million children have been born with the help of assisted reproductive technologies.
Keep ReadingThis past year, the Robert Wood Johnson Foundation, Rutgers Center for State Health Policy, and the John J. Heldrich Center for Workforce Development collaborated to identify policy and practice changes to help ensure that everyone in New Jersey has the opportunity for better health, no matter who they are or where they live.
Keep ReadingThe Institute for Health, Health Care Policy, and Aging Research (IFH) Summer Research Internship Program is to identify undergraduate/graduate students interested in biomedical or social science research.
Keep ReadingDr. Peter J. Guarnaccia is Professor in the Department of Human Ecology and Investigator at the Institute for Health at Rutgers University.
Keep ReadingIn January, Joel Cantor, distinguished professor and director of the Center for State Health Policy at IFH was elected to the National Academy of Social Insurance.
Keep ReadingMarie A. Bernard, MD serves as Deputy Director of the National Institute on Aging (NIA) at the National Institutes of Health. As NIA’s senior geriatrician, she serves as the principal advisor to the NIA director. She co-chairs two new Department of Health and …
Keep ReadingThis award is presented by the Asian and Pacific Islander Caucus for Public Health, which recognizes individuals who have made outstanding contributions toward achieving health equity.
Keep ReadingThis supplement will involve collaborating with Mark Gluck of Newark’s African American Brain Health Initiative to collect data on older African Americans’ childhood circumstances, examining their implications for healthy brain aging.
Keep ReadingDirector of the Institute for Health, Health Care Policy and Aging Research Dr. XinQi Dong was featured in the latest episode of SmartLinx podcast. Please see the link below to listen or read this interview. Click Here for Full Article
Keep ReadingOlder Asian-American immigrants are healthier and happier if they are socially active, connected to their families and communities and are able to maintain their cultural values while adapting to western culture, according to a new Rutgers study.
Keep ReadingRutgers Professor Stephen Crystal, who co-authored a pioneering study showing that U.S. survivors of opioid overdoses are highly likely to die within a year from drug use–related causes, suicide and wide-ranging diseases, is available for interviews.
Keep Reading7th Jan 2025 12:00 pm
Wellness Workshop: Maternity Planning for Faculty in Academia
at Room No. 112
16th Jan 2025 12:00 pm
Seminar with Dr. Temidayo Fadelu on Breast Cancer Care
at Zoom
African Americans experience relatively low rates of mental disorder despite being disproportionately exposed to psychosocial stressors…
Keep ReadingObjective: This study examined trends and geographic variability in dispensing of prescription psychotropic medications to U.S. youths before and after the start of the COVID-19 pandemic…
Keep ReadingPurpose: Given limited information available on real-world data (RWD) sources with pediatric populations, this study describes features of globally available RWD sources for pediatric pharmacoepidemiologic research…
Keep ReadingBackground: Vaping is an increasingly common mode of cannabis use among young adults. Despite potential to inform targeted prevention, settings and social contexts where young adults vape and/or smoke cannabis have rarely been investigated. We addressed this question in a diverse young adult sample…
Keep ReadingAbstract: The theory of shattered assumptions proposes that experiencing traumatic events can change how people view themselves and the world. Most adults experience a traumatic event during their lifetime, and some subsequently develop post-traumatic stress disorder (PTSD). However, the current conceptualization of trauma (i.e., Criterion A PTSD) may be too narrow to adequately capture the range of potentially traumatizing events that People of Color experience, including racial discrimination and neighborhood disadvantage. This study investigated the association of racial discrimination and neighborhood disadvantage with core beliefs about the world being safe and predictable (i.e., world assumptions) among a sample of Black, Latine, and Asian young adults. Multi-step analyses of covariance tested associations between racial discrimination and neighborhood disadvantage with world assumptions and whether these held in the context of other traumatic exposures. Results indicated that racial discrimination negatively impacted world assumptions among Asian young adults only and this effect remained in the context of trauma. In addition, low neighborhood support negatively impacted world assumptions across all racial groups and neighborhood violence negatively impacted world assumptions among Latine young adults only; however, this effect did not remain in the context of trauma. This study indicates it is worthwhile to consider other adverse events in the conceptualization of trauma, such as racial discrimination and neighborhood disadvantage, that may impact world assumptions and contribute to subsequent post-trauma psychopathology…
Keep ReadingBackground: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18–20. Profile indicators included: women’s and partner’s alcohol and cannabis use, women’s sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors. Results: Two of the five identified profiles had low STI likelihood: “Low Use” of alcohol and cannabis (25.5%; overrepresented by Black women), and “Alcohol Only” (19.1%; overrepresented by White women)…
Keep ReadingCharacterizing variations in the timing of alcohol, cigarette, and cannabis use onset both among and between Black and White youth can inform targeted prevention. The current study aimed to capture cross-substance initiation patterns in Black and White girls and characterize these patterns with respect to substance use related socioeconomic, neighborhood, family, community, and individual level factors. Data were drawn from interviews conducted at ages 8 through 17 in an urban sample of girls (n = 2172; 56.86% Black, 43.14% White). Discrete-time multiple event process survival mixture modeling was used to identify patterns (i.e., classes) representing timing of alcohol, cigarette, and cannabis use initiation, separately by race. Class characteristics were compared using multinomial logistic regression …
Keep ReadingAbstract: A randomized controlled trial evaluated the preliminary efficacy of a dyadically-delivered motivational interviewing (MI) intervention to reduce drug use and sexual risk in a sample of 50 sexual minority (cis)male (SMM) couples. In each couple, at least one partner was aged 18–29; reported drug use and sexual HIV transmission risk; and was HIV-negative. Couples were randomized to either the three-session MI intervention or an attention-matched control, with follow-up surveys completed at 3- and 6-months post-baseline. Between-group differences for all outcomes were non-significant in the overall sample. Subsequent moderation analyses indicated the intervention significantly reduced illicit drug use (excluding marijuana) at 3-month follow-up when either respondents (B = − 1.96; interval rate ratio—IRR 0.02–1.22; p = .001), their partners (B = − 2.60; IRR 0.01–0.64; p = .004), or both (B = − 2.38; IRR 0.01–0.80; p = .001) reported high levels of baseline use. The intervention also reduced condomless anal sex (CAS) with casual partners when both partners reported high frequency baseline CAS (B = − 2.54; IRR 0.01–0.83; p = .047). Findings provide initial evidence of the potential for MI to address drug use and sexual risk-taking among SMM couples at highest risk.
Keep ReadingThis study evaluated the effectiveness of Project PLUS, a 6-session Motivational Interviewing and Cognitive Behavioral intervention to reduce substance use and improve antiretroviral therapy (ART) adherence among PLWH. In a quasi-experimental design, 84 participants from a network of three comprehensive care clinics in New York City received the intervention immediately post-baseline (the Immediate condition) and 90 were assigned to a Waitlist control. Viral load and CD4 data were extracted from electronic medical records (EMR) for a No-Intervention comparison cohort (n = 120). Latent growth curve analyses did not show a consistent pattern of significant between-group differences post-intervention or across time in ART adherence or substance use severity between Immediate and Waitlist participants. Additionally, Immediate intervention participants did not differ significantly from the Waitlist or No-Treatment groups on viral load or CD4 post-intervention or across time. The potential to detect intervention effects may have been limited by the use of a quasi-experimental design, the high quality of standard care at these clinics, or inadequate intervention dose…
Keep ReadingABSTRACT: Despite the prominence of self-efficacy as a predictor of antiretroviral therapy (ART) adherence, relatively little work has examined domain-specific associations with steps in the care continuum or the possibility that substance use may have domain-specific associations with self-efficacy. This study analyzed data from a sample of 174 people living with HIV recruited through three clinics in the New York City metro area. Consistent with hypotheses, path analysis showed that appointments kept and viral load were each predicted only by their respective domain-specific self-efficacy components (i.e., self-efficacy for keeping appointments, B = 0.01, p = .04; and self-efficacy for taking ART medications, B = −0.02, p < .01). Path models also indicated domain-specific associations with substance use. Self-efficacy for keeping appointments was negatively associated with severity of drug use (B = −1.81, p < .01); meanwhile, self-efficacy for taking ART medications was negatively associated with severity of alcohol use (B = −0.52, p < .01). Accordingly, studies assessing barriers to retention in the HIV care continuum should conduct multi-domain assessments of self-efficacy for differential associations with specific behaviors. Furthermore, HIV care providers might consider screening for domain-specific self-efficacy to identify patients at risk of drop-out and tailoring interventions to various care continuum domains.
Keep ReadingABSTRACT: Although transgender women (TGW), and especially TGW of color, are disproportionately exposed to discrimination and violence, many of them experience stress-related growth. However, little is known about the experience of stress-related growth and its correlates among TGW. Using data from a racially-diverse sample of 210 TGW, the short version of the Stress-Related Growth Scale was modified to assess growth as a result of coming to terms with one’s transgender identity among TGW. The psychometric properties of the modified scale were examined, along with its associations with various cognitive, emotional, and social factors. A confirmatory factor analysis revealed a unidimensional factor, along with excellent reliability. A stepwise regression revealed that positive reappraisal, internal locus of control, social support, and emotional expression were associated with greater stress-related growth. Findings suggest that cognitive, emotional, and social resources are related to stress-related growth in TGW. Interventions to foster stress-related growth among TGW are discussed…
Keep ReadingBackground: Many individuals with depression are not being linked to treatment by their primary care providers. Electronic health records (EHRs) are common in medicine, but their impact on depression treatment is mixed. Because EHRs are diverse, differences may be attributable to differences in functionality. This study examines the relationship between EHR functions, and patterns of depression treatment in primary care.
Keep ReadingElisabeth Kübler-Ross’ pioneering work focused on dying, yet some clinicians persist in prescribing it as a path through grief. We surveyed 964 mental health clinicians who completed a five-section mixed methods survey: two sections assessed knowledge with multiple choice questions and a case study to assess clinicians’ knowledge-base and approach to grief/loss in practice. Analysis of four items related to Kübler-Ross’ model and 66/962 case studies indicates ongoing use of “stages” and Kübler-Ross’ model. Only 330 (34.2%) of the clinicians were deemed knowledgeable; 462 (47.9%) were questionable; and 172 (17.9%) were misinformed, continuing to use Kübler-Ross’ stage theory for grief…
Keep ReadingBackground: Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life. Physician psychological propensities are an important potential determinant of this variability, but the pertinent literature has yet to be synthesized…
Keep ReadingBACKGROUND: The mortality, morbidity, health care utilization, and cost attributable to vaccine-preventable diseases are substantial for those aged 50 years and older. Although vaccination is the most cost-effective strategy to prevent common infectious diseases in older adults, vaccination rates remain below US Centers for Disease Control and Prevention benchmarks, especially among racial minorities. Historical mistrust, structural racism within the US medical system, and misinformation contributed to lower immunization rates among minorities, especially Black Americans. To address the critical need to increase knowledge and trust in vaccination, 2 community-based educational interventions were tested: a pharmacist-led didactic session (PHARM) and a peer-led educational workshop (PEER).
Keep ReadingIntroduction: More than 35% of hospice care recipients 65 and older have a dementia diagnosis. Yet family care partners of persons living with dementia report feeling unprepared to address their hospice recipient’s changing needs nearing end of life. Hospice clinicians may have unique insight into the knowledge needs of family care partners and strategies for end-of-life dementia caregiving.
Keep ReadingBackground: Social support is a protective factor against cognitive decline in the general population. However, the relationship between social support and cognitive functioning among persons with multiple sclerosis (MS) is not well understood…
Keep ReadingAbstract: Little epidemiologic research has focused on pollution-related risks in medically vulnerable or marginalized groups. Using a nationwide 50% random sample of 2008–2016 Medicare Part D–eligible fee-for-service participants in the United States, we identified a cohort with high-risk conditions for cardiovascular and thromboembolic events (CTEs) and linked individuals with seasonal average zip-code–level concentrations of fine particulate matter (particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5)).
Keep ReadingAbstract: We examine how out-of-pocket health care spending by single-mother families responds to income losses. We use eleven two-year panels of the Medical Expenditure Panel Survey for the period 2004–2015 and apply the correlated random effects estimation approach. We categorize income in relation to the federal poverty line (FPL): poor or near-poor (less than 125% of the FPL); low income (125 to 199% of the FPL); middle income (200 to 399% of the FPL); and high income (400% of the FPL or more). Income losses among high-income single-mother families lead a decline in out-of-pocket spending toward office-based care and emergency room care of $119–$138 and $30–$60, respectively. Among middle-income single-mother families, income losses lead to a $30 decline in out-of-pocket spending toward family emergency room care and a $45–$91 decline in mother’s out-of-pocket spending toward prescription medications. Further research should examine whether these declines compromise health status of single-mother family members…
Keep ReadingAbstract: Violent crime remains a prevalent threat to population health within the United States. States offer varying policy approaches to prevent violent crime and support behavioral health, such as community-based programs that include substance use disorder prevention and treatment. Using state mental health agency data, we construct a panel of U.S. states over nine years and apply an instrumental variables empirical model with state and time fixed effects to adjust for policy endogeneity, omitted variable bias, and time trends. We find that a 10% increase in community-directed state mental health agency expenditures yielded nearly a 4% reduction in violent crime rates. Larger magnitude reductions in violent crime rates were associated with the presence of gun control regulations and increases in the proportion of the population completing secondary education. Policymakers should consider the added benefit of violent crime reduction when considering budgetary allocations of community-directed state mental health agency expenditures…
Keep ReadingAbstract: The growth in US income inequality since the late 1970s has directed much public policy attention to the macroeconomic and political factors contributing to such growth. In this review, I focus on the microeconomic implications of income inequality for household wellbeing, specifically, on whether income inequality per se has an impact on the health of household members. In doing so I review work that has posited the social and biological pathways through which inequality may affect health, and the empirical approaches and challenges to identifying such causality. I find that despite both theoretical and conceptual arguments that income inequality may affect the health of family members through the family’s relative position in the income distribution, the weight of the empirical evidence does not support such a causal relationship. I conclude with a discussion differentiating the importance of income support for those in the lower percentiles of the income distribution, and efforts to improve the relative economic status of others.
Keep ReadingBackground: Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic…
Keep ReadingAbstract: We recently nominated cytokine signaling through the Janus-kinase–signal transducer and activator of transcription (JAK/STAT) pathway as a potential AD drug target. As hydroxychloroquine (HCQ) has recently been shown to inactivate STAT3, we hypothesized that it may impact AD pathogenesis and risk. Among 109,124 rheumatoid arthritis patients from routine clinical care, HCQ initiation was associated with a lower risk of incident AD compared to methotrexate initiation across 4 alternative analyses schemes addressing specific types of biases including informative censoring, reverse causality, and outcome misclassification (hazard ratio [95% confidence interval] of 0.92 [0.83–1.00], 0.87 [0.81–0.93], 0.84 [0.76–0.93], and 0.87 [0.75–1.01]). We additionally show that HCQ exerts dose-dependent effects on late long-term potentiation (LTP) and rescues impaired hippocampal synaptic plasticity prior to significant accumulation of amyloid plaques and neurodegeneration in APP/PS1 mice. Additionally, HCQ treatment enhances microglial clearance of Aβ1-42, lowers neuroinflammation, and reduces tau phosphorylation in cell culture-based phenotypic assays. Finally, we show that HCQ inactivates STAT3 in microglia, neurons, and astrocytes suggesting a plausible mechanism associated with its observed effects on AD pathogenesis…
Keep ReadingAbstract: Population-level statistics on pandemic-related change in substance use can obscure patterns of use (e.g., polysubstance use) within individuals. This longitudinal study used a person-centered approach to identify subgroups with respect to patterns of substance use prior to and during the COVID-19 pandemic, and to examine profile correlates (e.g., socio-demographic characteristics), which can inform tailored intervention…
Keep ReadingAbstract: Evidence suggests that healthy behaviors initiated during childhood may continue over time. The objective of this study was to determine whether active commuting to/from school (ACS) at baseline predicted continued ACS at follow-up two to five years later.
Two cohorts of households with 3–15 year-olds in four low-income New Jersey cities were randomly sampled and followed for two to five year periods between 2009 and 2017. Children who walked, bicycled, or skateboarded to/from school at least one day/week were classified as active commuters. Children with complete data at both time points were included in this analysis (n = 383). Multivariate logistic regression was used to examine the association between ACS at T1 and T2. Models adjusted for child age, sex, and race/ethnicity; parent’s education and nativity status (native-born vs foreign-born); household poverty level; car availability; neighborhood level characteristics; and distance from home to school.
Keep ReadingBackground: Healthcare reform in the United States has focused on improving the value of health care, but there are some concerns about the inequitable delivery of value-based care…
Keep ReadingABSTRACT: The COVID-19 public health emergency required US states to respond rapidly on regulatory issues, including the process for licensing healthcare practitioners. At least 45 states enacted some form of a licensure waiver, enabling practitioners to temporarily work across state lines. We conducted 22 interviews with national and local (New Jersey) licensure stakeholders in September and October 2021 to capture perceptions of how emergency licensure impacted access to care…
Keep ReadingBackground: Guidelines for managing and preventing chronic disease tend to be well-known. Yet, translation of this evidence into practice is inconsistent. We identify a combination of factors that are connected to guideline concordant delivery of evidence-informed chronic disease care in primary care…
Keep ReadingNew Jersey’s COVID-19 Temporary Emergency Reciprocity Licensure program provided temporary licenses to more than 31,000 out-of-state health care practitioners. As one of the first COVID-19 hot spots in the US, New Jersey is uniquely positioned to provide insights on enabling an out-of-state health care workforce through temporary licensure to address critical, ongoing concerns about health care workforce supply. In January 2021 we surveyed New Jersey temporary licensees…
Keep ReadingAtrial fibrillation (AF) and heart failure (HF) contribute to about 45% of all cardiovascular disease (CVD) deaths in the USA and around the globe. Due to the complex nature, progression, inherent genetic makeup, and heterogeneity of CVDs, personalized treatments are believed to be critical. To improve the deciphering of CVD mechanisms, we need to deeply investigate well-known and identify novel genes that are responsible for CVD development. With the advancements in sequencing technologies, genomic data have been generated at an unprecedented pace to foster translational research. Correct application of bioinformatics using genomic data holds the potential to reveal the genetic underpinnings of various health conditions…
Keep ReadingPrecision medicine is driven by the paradigm shift of empowering clinicians to predict the most appropriate course of action for patients with complex diseases and to improve routine medical and public health practice. Understanding patients’ multi-omics make-up in conjunction with the clinical data will lead to determining predisposition, diagnostic, prognostic and predictive biomarkers and to optimal paths providing personalized care for diverse and targeted chronic, acute, and infectious diseases…
Keep ReadingPrecision medicine is driven by the paradigm shift of empowering clinicians to predict the most appropriate course of action for patients with complex diseases and improve routine medical and public health practice. It promotes integrating collective and individualized clinical data with patient specific multi-omics data to develop therapeutic strategies, and knowledgebase for predictive and personalized medicine in diverse populations…
Keep ReadingA human immunogenetics variation study was conducted in samples collected from diverse COVID-19 populations. Materials & methods: Whole-genome and whole-exome sequencing (WGS/WES), data processing, analysis and visualization pipeline were applied to identify variants associated with genes of interest. Results: A total of 2886 mutations were found across the entire set of 13 genomes. Functional annotation of the gene variants revealed mutation type and protein change. Many variants were found to be biologically implicated in COVID-19…
Keep ReadingNaloxone distribution is central to ongoing efforts to address the opioid overdose crisis. Some critics contend that naloxone expansion may inadvertently promote high-risk substance use behaviors among adolescents, but this question has not been directly investigated…
Keep ReadingPrecision medicine has greatly aided in improving health outcomes using earlier diagnosis and better prognosis for chronic diseases. It makes use of clinical data associated with the patient as well as their multi-omics/genomic data to reach a conclusion regarding how a physician should proceed with a specific treatment. Compared to the symptom-driven approach in medicine, precision medicine considers the critical fact that all patients do not react to the same treatment or medication in the same way. When considering the intersection of traditionally distinct arenas of medicine, that is, artificial intelligence, healthcare, clinical genomics, and pharmacogenomics—what ties them together is their impact on the development of precision medicine as a field and how they each contribute to patient-specific, rather than symptom-specific patient outcomes. This study discusses the impact and integration of these different fields in the scope of precision medicine and how they can be used in preventing and predicting acute or chronic diseases. Additionally, this study also discusses the advantages as well as the current challenges associated with artificial intelligence, healthcare, clinical genomics, and pharmacogenomics…
Keep ReadingAbstract: Importance COVID-19 disrupted delivery of buprenorphine and naltrexone treatment for opioid use disorder (OUD), and during the pandemic, members of racial and ethnic minority groups experienced increased COVID-19 and opioid overdose risks compared with White individuals. However, whether filled buprenorphine and naltrexone prescriptions varied across racial and ethnic groups during the COVID-19 pandemic remains unknown…
Keep ReadingBackground: Patients with medically-treated opioid overdose are at high risk for subsequent adverse outcomes, including repeat overdose. Understanding factors associated with repeat overdose can aid in optimizing post-overdose interventions…
Keep ReadingBackground: States have enacted multiple types of laws, with a variety of constituent provisions, in response to the opioid epidemic, often simultaneously. This temporal proximity and variation in state-to-state operationalization has resulted in significant challenges for empirical research on their effects. Thus, expert consensus can be helpful to classify laws and their provisions by their degree of helpfulness and impact…
Keep ReadingThe Global Health Security Index, published in October 2019 by public health experts (1), rated nations by their readiness to respond to infectious disease outbreaks. The United States ranked first, whereas New Zealand trailed in 35th place. Yet when the coronavirus disease 2019 (COVID-19) pandemic struck months later, these rankings turned out to be unreliable (2): The United States has to date reported the most deaths, whereas New Zealand fares considerably better. These results point to a fundamental challenge more than to the failings of a particular assessment approach. They may demonstrate that, for all our careful testing of pharmaceuticals, researchers lack a solid evidence base regarding the effectiveness of health policies—against pandemics, and more widely…
Keep ReadingAbstract: Many studies that seek to cure HIV must ask participants to interrupt their antiretroviral treatment. In such circumstances, is it permissible to include a placebo group in the study? We explain why doing so is a scientific and an ethical necessity, and more benign than imagined…
Keep ReadingAbstract: In high-income countries that were first to roll out coronavirus disease 2019 (COVID-19) vaccines, older adults have thus far usually been prioritized for these vaccines over younger adults. Age-based priority primarily resulted from interpreting evidence available at the time, which indicated that vaccinating the elderly first would minimize COVID-19 deaths and hospitalizations…
Keep ReadingOn 31 March 2022, Killingley et al. published the results from the world’s first COVID-19 human challenge trial, in which 36 healthy volunteers between the ages of 18 and 30 years were intranasally exposed to a low dose of wild type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1.]. Around half (53%) of the volunteers became infected with COVID-19, with researchers finding that the viral load peaked 5 days after inoculation. SARS-CoV-2 was first detectable in the throat, before rising higher in the respiratory tract, where its presence in the nose continued for 10 days. The team found that symptoms develop rapidly, starting on average just 2 days after infection. They also found that lateral flow tests were a reliable indicator of whether or not volunteers were infectious. Six volunteers were given remdesivir after testing positive. No volunteers reported any major negative health outcomes after 180 days, though some reported partial smell disturbance…
Keep ReadingAbstract: Notwithstanding the success of conventional field trials for vaccines against COVID-19, human challenge trials (HCTs) that could obtain more information about these and about other vaccines and further strategies against it are about to start in the UK. One critique of COVID-19 HCTs is their distinct paucity of information on crucial population groups. For safety reasons, these HCTs will exclude candidate participants of advanced age or with comorbidities that worsen COVID-19, yet a vaccine should (perhaps especially) protect such populations. We turn this cliché on its head. The truth is that either an HCT or a field trial has intrinsic generalisability limitations, that an HCT can expedite protection of high-risk participants even without challenging them with the virus, and that an important route to obtaining results generalisable to high-risk groups under either strategy is facilitated by HCTs…
Keep ReadingAbstract: Despite their clearly demonstrated safety and effectiveness, approved vaccines against COVID-19 are commonly mistrusted. Nations should find and implement effective ways to boost vaccine confidence. But the implications for ethical vaccine development are less straightforward than some have assumed. Opponents of COVID-19 vaccine challenge trials, in particular, made speculative or empirically implausible warnings on this matter, some of which, if applied consistently, would have ruled out most COVID-19 vaccine trials and many non-pharmaceutical responses…
Keep ReadingObjective: This study aimed to examine the impact of COVID-19 on hospice Interdisciplinary team (IDT) members’ self-reported stress and identify possible sources of moral distress…
Keep ReadingBackground: Neurocognitive testing may advance the goal of predicting near-term suicide risk. The current study examined whether performance on a Go/No-go (GNG) task, and computational modeling to extract latent cognitive variables, could enhance prediction of suicide attempts within next 90 days, among individuals at high-risk for suicide…
Keep ReadingOBJECTIVE: To evaluate trends in antidiabetic medication initiation patterns among patients with type 2 diabetes mellitus (T2DM) with and without chronic kidney disease (CKD)…
Keep ReadingIntroduction: Individuals with mental health and substance use problems have higher rates of smoking and tobacco-related morbidity and mortality than the general population. These increased rates can be explained, in part, by lower cessation rates compared with overall declines in tobacco use in recent years. The purpose of this study was to examine tobacco screening and cessation counseling in healthcare settings to compare rates for adults with mental health and substance use problems with those without such problems…
Keep ReadingIntroduction: Recent U.S. trends demonstrate sharp rises in adverse opioid-related health outcomes, including opioid use disorder (OUD), overdose, and death. Yet few affected people receive treatment for OUD and a minority of those who receive treatment are effectively retained in care. The purpose of this study was to examine duration of buprenorphine treatment for OUD following treatment initiation to identify risk factors for early discontinuation…
Keep ReadingObjective: The Mental Health Parity and Addiction Equity Act (MHPAEA) was intended to eliminate differences in insurance coverage for mental health and substance use disorder services and medical-surgical care. No studies have examined mental health service use after federal parity implementation among individuals with diagnoses of eating disorders, for whom financial access to care has often been limited. This study examined whether MHPAEA implementation was associated with changes in use of mental health services and spending in this population…
Keep ReadingBackground: Most individuals with alcohol use disorder do not receive treatment and little national-level United States (U.S.) data exist on the association between screening and intervention with receipt of treatment. Methods: The sample includes adults 18 years and older reporting prior year symptoms of alcohol use disorder from 2013 and 2014 National Survey on Drug Use and Health…
Keep ReadingPrior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known. We assessed associations of opioid use and misuse with suicidal ideation, suicide plans, and suicide attempts among adults aged 18-64 years (n = 86,186) using nationally representative cross-sectional data from the 2015 and 2016 administrations of the National Survey on Drug Use and Health…
Keep ReadingBackground: Primary care providers encounter a large proportion of the population with depression. Yet, many primary care patients with depression remain undiagnosed and untreated. Objective: This study aims to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting. Design: This is a cross-sectional analysis of nationally representative survey data of visits to outpatient physician offices from the 2005 to 2015 National Ambulatory Medical Care Surveys…
Keep ReadingAbstract: The optimal, or even minimum, duration of medication treatment for opioid use disorder (OUD) needed to improve long-term outcomes has not been established empirically. As a result, health plans set potentially restrictive treatment standards to guide benefits and payment. To address this gap, we used a National Quality Forum measure for OUD medication treatment duration (180 days) to examine the impact of longer treatment on health care outcomes within a key population of Medicaid enrollees…
Keep ReadingBackground:Drug treatment utilization is low despite a high public health burden of drug use disorders (DUDs). Engaging people at risk for DUDs across a broader range of health care settings may improve uptake of drug treatment.Objectives:To estimate the prevalence of drug use screening/discussions between health care providers and individuals with past-year drug use, and to assess the associations between drug use screening/discussions and perceived need and use of drug treatment…
Keep ReadingImportance: Medication for opioid use disorder (MOUD) is the criterion standard treatment for opioid use disorder (OUD), but nationally representative studies of MOUD use in the US are lacking. Objective: To estimate MOUD use rates and identify associations between MOUD and individual characteristics among people who may have needed treatment for OUD…
Keep ReadingObjective: Successful retention on buprenorphine improves outcomes for opioid use disorder (OUD); however, we know little about associations between use of non–prescribed buprenorphine (NPB) preceding treatment intake and clinical outcomes. Methods: The study conducted observational retrospective analysis of abstracted electronic health record (EHR) data from a multi-state nationwide office-based opioid treatment program…
Keep ReadingThe overdose epidemic remains an urgent public health concern, with recent estimates indicating that deaths in the United States have surged to over 100 000 per year, predominantly attributed to opioids. Responses to growth in opioid-involved mortality over time have emphasized opioid prescribing regulations or restrictions, including a proliferation of state laws aimed at reducing harm by limiting exposure to opioids…
Keep ReadingIn 2019, 4777 youth died of a drug overdose in the United States. Seven-hundred and twenty-seven youth died of overdoses involving benzodiazepines (BZDs) and 902 from overdoses involving psychostimulants. Opioid-related overdose deaths frequently involve other substances, and in youth, stimulants and BZDs are the most commonly involved substances. Overdoses can involve prescription drugs accessed through medical prescriptions or through illicit means. Among persons aged 18 to 25 years, 5.8% report past-year prescription stimulant misuse and 3.8% prescription BZD misuse…
Keep ReadingThe New Jersey Individual Health Coverage Program (IHCP) was implemented in 1993; key provisions included pure community rating and guaranteed issue/renewal of coverage. Despite positive early evaluations, the IHCP appears to be heading for collapse. Using unique administrative and survey data, we examined trends in IHCP enrollment and premiums. We found the stability of the IHCP to be fragile in light of improving opportunities for job-related health insurance…
Keep ReadingAbstract: The Patient Protection and Affordable Care Act (ACA) requires that adults up to age twenty-six be permitted to enroll as dependents on their parents’ health plans. This article examines the experiences of states that enacted dependent expansion laws. Drawing on public information from thirty-one enacting states and case studies of four diverse reform states, it derives lessons that are pertinent to the implementation of this ACA provision. Dependent coverage laws vary across the states, but most impose residency, marital status, and other restrictions…
Keep ReadingRelative to non-Latino Whites, Latinos in the United States with major depressive disorder (MDD) show low engagement in antidepressant therapy, whether engagement is defined as pharmacotherapy access, medication initiation, pill-taking, or treatment retention. One potential reason for this disparity in depression care is the low cultural congruence of pharmacotherapy for this population…
Keep ReadingOlder men are less likely than older women to receive depression treatment. Latino older men in particular have been found to have significantly lower rates of depression treatment than their white-non-Mexican (WNM) counterparts. Prior research has shown that men are less likely than women to express overt affect and/or report depression symptoms that may prompt primary care physicians’ inquiry about depression. Previous studies have overlooked the idioms of distress common among older men…
Keep ReadingAbstract: Cultural competence training is mandatory in the United States of America to alleviate minority health disparities though few studies have examined perceptions across stakeholders. We conducted separate focus groups with patients, clinicians, and administrators from the psychiatry department at one community hospital and compared responses to hospital policies. Stakeholders defined cultural competence through group-based or person-centered traits despite policies recommended person-centered approaches…
Keep ReadingAbstract: Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in studying how cultural processes influence health and health behaviors…
Keep ReadingObjective: To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment. Methods: Authors conducted electronic searches of published and grey literature databases from inception to November 2014, forward citation analyses, and backward bibliographic sampling of included articles. Included studies reported original data on clinician communication strategies to improve minority treatment engagement, defined as initiating, participating, and continuing services. Results: Twenty-three studies met inclusion criteria…
Keep ReadingResearch collaboration in “real world” practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies. This study describes an initiative to integrate research into a hospital-based outpatient psychiatric clinic within an academic medical center, focusing on collaborative processes across three research projects…
Keep ReadingImmigration, Diversity and Student Journeys to Higher Education presents an in-depth understanding of how immigrant students at a major public research university balanced keeping their family cultures alive and learning U.S. culture to get to college. A revitalized anthropological understanding of acculturation provides the theoretical framework for the book. The text builds its analysis using extensive quotes from the 160 immigrant students who participated in the 21 focus groups that form the core of this study…
Keep ReadingObjectives: this case-control study compared levels of stress and allostatic load (AL) among Mexican women in the US (n =19) and Mexico (n = 40). Method: measures of stress included the Perceived Stress Scale (PSS) and the Hispanic Women’s Social Stressor Scale (HWSSS). A composite measure of 8 indicators of AL (systolic and diastolic blood pressure, body mass index (BMI), waist-to-hip ratio, total cholesterol, glycated hemoglobin (hemoglobin A1C), triglycerides and C-reactive protein) was calculated…
Keep ReadingMany autoimmune diseases confer a higher risk of cancer on patients compared to the general population. A controversial factor tying autoimmune diseases to malignancy is harm from immunosuppressive treatment. Nonetheless, multiple sclerosis is different from other autoimmune diseases, and findings from other disease populations may not apply…
Keep ReadingObjective: Improved treatments for juvenile idiopathic arthritis (JIA) have increased remission rates. We conducted this study to investigate how patients and caregivers make decisions about stopping medications when JIA is inactive. Methods: We performed a mixed-methods study of caregivers and patients affected by JIA, recruited through social media and flyers, and selected by purposive sampling. Participants discussed their experiences with JIA, medications, and decision-making through recorded telephone interviews…
Keep ReadingMonitoring the burden and spread of infection with the new coronavirus SARS-CoV-2, whether within small communities or in large geographical settings, is of paramount importance for public health purposes. Serology, which detects the host antibody response to the infection, is the most appropriate tool for this task, since virus-derived markers are most reliably detected during the acute phase of infection…
Keep ReadingBackground: We studied risk factors, antibodies, and symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a diverse, ambulatory population. Methods: A prospective cohort (n = 831) previously undiagnosed with SARS-CoV-2 infection underwent serial testing (SARS-CoV-2 polymerase chain reaction, immunoglobulin G [IgG]) for 6 months…
Keep ReadingObjective: Biologic medications have significantly improved disease control and outcomes of patients with juvenile idiopathic arthritis (JIA). Current treatment recommendations suggest escalating therapy, including changing biologics if needed, when inactive or low disease activity is not attained. The patterns and reasons for switching biologics in clinical practice in North America are not well described…
Keep ReadingWe report a case of COVID-19 in a pediatric patient with systemic lupus erythematosus (SLE), who presented with respiratory distress marked by increased work of breathing and low oxygen saturation. Lab tests confirmed COVID-19, and showed lymphocytopenia and elevated markers of inflammation and coagulopathy. Chest X-ray showed bilateral mid-lung opacities, and the patient required intubation early in his disease course…
Keep ReadingImportance: Cytokine signaling, including tumor necrosis factor (TNF) and interleukin (IL)-6, through the Janus-kinase (JAK)-signal transducer and activator of transcription pathway, was hypothesized to attenuate the risk of Alzheimer disease and related dementia (ADRD) in the Drug Repurposing for Effective Alzheimer Medicines (DREAM) initiative based on multiomics phenotyping. Objective: To evaluate the association between treatment with tofacitinib, tocilizumab, or TNF inhibitors compared with abatacept and risk of incident ADRD…
Keep ReadingIn this issue of Clinical and Translational Science, Yun-Han Wang and colleagues report on a potential link between treatment with proton pump inhibitors (PPIs) and incident depression and anxiety disorders in children. The proposed mechanism between PPI use and anxiety and depression is related to the “microbiota-gut-brain axis.”…
Keep ReadingObjective: To provide recommendations for the management of juvenile idiopathic arthritis (JIA) with a focus on nonpharmacologic therapies, medication monitoring, immunizations, and imaging, irrespective of JIA phenotype…
Keep ReadingObjective: To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided…
Keep ReadingBackground: The rate of AD for African Americans (AAs) is 64% higher than for non-Hispanic White Americans (Whites). It is hypothesized that poor peripheral vascular function, in combination with genetics, stress, and inflammation may directly contribute to the accumulation of AD pathologic biomarkers. These risk factors may disproportionately affect AAs.
Keep ReadingAbstract : Among patients with coronavirus disease (COVID-19), IgM levels increased early after symptom onset for those with mild and severe disease, but IgG levels increased early only in those with severe disease. A similar pattern was observed in a separate serosurveillance cohort. Mild COVID-19 should be investigated separately from severe COVID-19…
Keep Readingackground: Currently, there is no objective, clinically available tool for the accurate diagnosis of Alzheimer’s disease (AD). There is a pressing need for a novel, minimally invasive, cost friendly, and easily accessible tool to diagnose AD, assess disease severity, and prognosticate course. Metabolomics is a promising tool for discovery of new, biologically, and clinically relevant biomarkers for AD detection and classification…
Keep ReadingAbstract: Biomarkers to discriminate the main pathologies underlying frontotemporal lobar degeneration (FTLD-Tau, FTLD-TDP) are lacking. Our previous FTLD cerebrospinal fluid (CSF) proteome study revealed that sex hormone-binding globulin (SHBG) was specifically increased in FTLD-Tau patients. Here we investigated the potential of CSF SHBG as a novel biomarker discriminating the main FTLD pathological subtypes…
Keep ReadingOBJECTIVE: To assess whether primary lateral sclerosis (PLS), classified as pure when the EMG is normal, converts to amyotrophic lateral sclerosis (ALS) after longitudinal follow-up. METHODS: Retrospective chart review was performed of patients with pure PLS at Mayo Clinic in Rochester, MN (1990-2016). Inclusion criteria required a normal EMG during the first 4 years of symptoms…
Keep ReadingAbstract: Neuroinflammation is associated with Alzheimer’s disease, but the application of cerebrospinal fluid measures of inflammatory proteins may be limited by overlapping pathways and relationships between them. In this work, we measure 15 cerebrospinal proteins related to microglial and T-cell functions, and show them to reproducibly form functionally-related groups within and across diagnostic categories in 382 participants from the Alzheimer’s Disease Neuro-imaging Initiative as well participants from two independent cohorts…
Keep ReadingAbstract: We explore the association between three Alzheimer’s disease-related and ten inflammation-related CSF markers and freezing of gait (FOG) in patients with Parkinson’s disease (PD). The study population includes PD patients with FOG (PD-FOG, N = 12), without FOG (PD-NoFOG, N = 19), and healthy controls (HC, N = 12). Age and PD duration are not significantly different between groups…
Keep ReadingAlzheimer’s disease (AD) is a devastating, progressive neurodegenerative disease resulting in memory loss and a severe reduction in the ability to perform activities of daily living. Ethnicity-related genetic factors promoting the development of dementias among African Americans (AA) and increased risk among women for developing AD indicates that AA women with a parental history of AD are at great risk for developing AD…
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Keep ReadingObjective: We assessed whether a cohort of patients with primary lateral sclerosis (PLS) and limited electromyography (EMG) motor unit denervation changes evolve into amyotrophic lateral sclerosis (ALS) with prolonged follow-up. Methods: We initially ascertained all PLS patients diagnosed at Mayo Clinic-Rochester (1990–2016). Of 64 total cases, 43 had normal EMGs (“pure” PLS) during the first 4 years after symptom onset and were the focus of a prior publication, documenting absence of evolution to ALS…
Keep ReadingBackground:Rigorous measurement of organizational performance requires large, unbiased samples to allow inferences to the population. Studies of organizations, including hospitals, often rely on voluntary surveys subject to nonresponse bias. For example, hospital administrators with concerns about performance are more likely to opt-out of surveys about organizational quality and safety, which is problematic for generating inferences.Objective:The objective of this study was to describe a novel approach to obtaining a representative sample of organizations using individuals nested within organizations, and demonstrate how resurveying nonrespondents can allay concerns about bias from low response rates at the individual-level…
Keep ReadingBackground:Misclassification of Medicare beneficiaries’ race/ethnicity in administrative data sources is frequently overlooked and a limitation in health disparities research.Objective:To compare the validity of 2 race/ethnicity variables found in Medicare administrative data [enrollment database (EDB) and Research Triangle Institute (RTI) race] against a gold-standard source also available in the Medicare data warehouse: the self-reported race/ethnicity variable on the home health Outcome and Assessment Information Set (OASIS)…
Keep ReadingAbstract: Patients living with end stage renal disease (ESRD) who are undergoing hemodialysis experience frequent hospitalizations associated with complications of care and exacerbations of illness. Efforts to reduce hospitalizations have had limited success. The purpose of this study was to explore why hospitalizations occur from the perspectives of patients undergoing hemodialysis treatment, their caregivers, and health care providers. Semi-structured interviews and focus groups were conducted with 21 patients living with ESRD, 10 caregivers, and three focus groups with health care professionals…
Keep ReadingAbstract: Background and Objectives: Antipsychotic medications have been widely used in nursing homes to manage behavioral and psychological symptoms of dementia, despite significantly increased mortality risk. Use grew rapidly during the 2000s, reaching 23.9% of residents by 2011. A national campaign for safer dementia care in U.S. nursing homes was launched in 2012, with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. By the second quarter of 2019, use had declined by 40.1% to 14.3%. We assessed the impact of state and facility initiatives during the Campaign aimed at encouraging more-judicious prescribing of antipsychotic medications…
Keep ReadingAbstract: Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015…
Keep ReadingAbstract: Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and outcomes including disabling and life-threatening complications among patients with diabetes. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordination, and psychosocial support for patients and their caregivers…
Keep ReadingAbstract: The Centers for Medicare and Medicaid Services administrative data contains two variables that are used for research and evaluation of health disparities: the enrollment database (EDB) beneficiary race code and the Research Triangle Institute (RTI) race code. The objective of this article is to examine state-level variation in racial/ethnic misclassification of EDB and RTI race codes compared with self-reported data collected during home health care…
Keep ReadingAbstract: In spring, summer and autumn 2020, one abiding argument against controlled human infection (CHI) studies of SARS-CoV-2 vaccines has been their impact on local communities. Leading scientists and bioethicists expressed concern about undue usage of local residents’ direly needed scarce resources at a time of great need and even about their unintended infection. They recommended either avoiding CHI trials or engaging local communities before conducting any CHIs…
Keep ReadingAbstract: A vaccine for COVID-19 is urgently needed. Several vaccine trial designs may significantly accelerate vaccine testing and approval, but also increase risks to human subjects. Concerns about whether the public would see such designs as ethical represent an important roadblock to their implementation; accordingly, both the World Health Organization and numerous scholars have called for consulting the public regarding them…
Keep ReadingAbstract: Background Participation in longitudinal research studies in resource-limited settings often involves frequent interactions with study staff and other participants, as well as receipt of incentives and transportation reimbursements. Social support—receipt of material and emotional resources from one’s social network—has been linked to antiretroviral adherence in sub-Saharan Africa. The extent to which social support arises from study participation, its range and depth, and its implications for observational study conduct, have not been extensively described. Methods We conducted individual open-ended and semi-structured interviews with participants in a longitudinal, observational antiretroviral therapy adherence monitoring study in Mbarara, Uganda.
Keep ReadingAbstract: The world’s first coronavirus disease 2019 human challenge trial using the D614G strain of severe acute respiratory syndrome 2 (SARS-CoV-2) is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta and Delta variant for a follow-up human challenge trial, and researchers at hVIVO are considering conducting these trials. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. We explore 2 specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical…
Keep ReadingSARS-CoV-2’s B.1.351 (“South African”) variant “is markedly more resistant to neutralization by convalescent plasma (9.4 fold) and vaccinee sera (10.3–12.4 fold),”1,2 raising the specter that that variant could resist the leading authorized spike-based vaccines.2 Indeed, in earlier lab exams, Moderna’s vaccine showed “A six-fold reduction in neutralizing titers … with the B.1.351 variant relative to prior variants.”3 Pfizer-BioNTech’s “neutralization of the B.1.351-spike virus was weaker by approximately two thirds.”4 When tested in human volunteers, AstraZeneca’s vaccine provided only 10% protection from mild to moderate disease caused by that variant, and its distribution in South Africa was suspended.5 Janssen’s vaccine also did less well in South Africa than elsewhere, presumably due to lower neutralization of infecting viruses…
Keep ReadingAbstract: Individual informed consent is a central requirement for clinical research on human subjects, yet whether and how consent requirements should apply to health policy experiments (HPEs) remains unclear. HPEs test and evaluate public health policies prior to implementation. We interviewed 58 health experts in Tanzania, Bangladesh and Germany on informed consent requirements for HPEs…
Keep ReadingBackground: Although prior literature suggests that metoprolol may worsen glucose control compared to carvedilol, whether this has clinical relevance among older adults with diabetes and heart failure (HF) remains an open question…
Keep ReadingConsiderations when assessing the effect of nightshifts on hypertension prevalence …
Keep ReadingBackground and Aim: The prevalence of ulcerative colitis (UC) is increasing in Japan. Validated claims-based definitions are required to investigate the epidemiology of UC and its treatment and disease course in clinical practice. This study aimed to develop a claims-based algorithm for UC in Japan…
Keep ReadingBackground: Heart failure is an epidemic in the United States, and transplantation remains the most definitive therapy. We describe multidecade trends in posttransplant graft survival, adjusted for concurrent changes in the population, over the 30 years antecedent to the most recent heart allocation policy change…
Keep ReadingBACKGROUND: The risks for anaphylaxis among intravenous (IV) iron products currently in use have not been assessed. OBJECTIVE: To compare risks for anaphylaxis among 5 IV iron products that are used frequently. DESIGN: Retrospective cohort study using a target trial emulation framework. SETTING: Medicare fee-for-service data with Part D coverage between July 2013 and December 2018…
Keep ReadingAbstract: There has been a growing number of oncology drug approvals. Non-interventional postauthorization safety/effectives studies (PASSs/PAESs) aim to provide real-world evidence on the safety/effectiveness of oncology drugs postapproval. To understand the current landscape, a comprehensive search as of March 1, 2021, was conducted in major register/databases…
Keep ReadingMany of us who have served in health care long enough witnessed a transition from cloth gowns, sheets, and reusable surgical trays to disposal plastic replacements decades ago. However, we have rarely connected a pair of gloves and equipment that were discarded after each use to melting ice caps and dying polar bears…
Keep ReadingIntroduction: Limited evidence for incident frailty risks associated with prescription analgesics and sedatives in older (≥ 65 years) community-living adults prompted a more comprehensive investigation…
Keep ReadingCharacterizing variations in the timing of alcohol, cigarette, and cannabis use onset both among and between Black and White youth can inform targeted prevention. The current study aimed to capture cross-substance initiation patterns in Black and White girls and characterize these patterns with respect to substance use related socioeconomic, neighborhood, family, community, and individual level factors. Data were drawn from interviews conducted at ages 8 through 17 in an urban sample of girls (n = 2172; 56.86% Black, 43.14% White). Discrete-time multiple event process survival mixture modeling was used to identify patterns (i.e., classes) representing timing of alcohol, cigarette, and cannabis use initiation, separately by race. Class characteristics were compared using multinomial logistic regression. Among both Black and White girls, four classes, including abstainer and cross-substance early onset classes, emerged. Two classes characterized by mid-adolescence onset (Black girls) and variation in onset by substance (White girls) were also observed. Class differences centered around cannabis for Black girls (e.g., preceding or following cigarette use) and alcohol for White girls (e.g., (in)consistency over time in greater likelihood of initiation relative to cigarette and cannabis use). Several factors distinguishing the classes were common across race (e.g., externalizing behaviors, friends’ cannabis use); some were specific to Black girls (e.g., intentions to smoke cigarettes) or White girls (e.g., primary caregiver problem drinking). Findings underscore the need to recognize a more complex picture than a high-risk/low-risk dichotomy for substance use initiation and to attend to nuanced differences in markers of risky onset pathways between Black and White girls…
Keep ReadingObjective This study investigated binge drinking in college students with and without disabilities and sexual violence (SV). Participants: This analysis includes 2,113 college students recruited from campus health or counseling centers between 2015 and 2017, aged 18-24. Method: Multinomial logistic regression procedures were used to estimate adjusted odds ratios (AOR) for past month binge drinking days (BDD). Results: Among students with disabilities, 68% endorsed SV, compared with 53% of those without disability. Disability was not significantly associated with BDD; SV was significantly associated with BDD (p <.0001). Students with SV, regardless of disability status, had 1.7- to 2.1-fold greater odds of having 4+ past month BDD. Conclusions: While disability alone is not a risk factor for binge drinking, novel findings include that students with disabilities binge drink at similarly high rates to their nondisabled peers, and are at elevated risk for SV, which is closely associated with binge drinking...
Keep ReadingBackground: Given possible impairment in psychomotor functioning related to acute cannabis intoxication, we explored whether smartphone-based sensors (e.g., accelerometer) can detect self-reported episodes of acute cannabis intoxication (subjective “high” state) in the natural environment. Methods: Young adults (ages 18–25) in Pittsburgh, PA, who reported cannabis use at least twice per week, completed up to 30 days of daily data collection: phone surveys (3 times/day), self-initiated reports of cannabis use (start/stop time, subjective cannabis intoxication rating: 0–10, 10 = very high), and continuous phone sensor data. We tested multiple models with Light Gradient Boosting Machine (LGBM) in distinguishing “not intoxicated” (rating = 0) vs subjective cannabis “low-intoxication” (rating = 1–3) vs “moderate-intensive intoxication” (rating = 4–10). We tested the importance of time features (i.e., day of the week, time of day) relative to smartphone sensor data only on model performance, since time features alone might predict “routines” in cannabis intoxication…
Keep ReadingObjective: This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information on “for whom” a specific treatment may work best. Method: We used Google Scholar, PubMed, PsycInfo, and manual search of relevant reference lists to identify eligible peer-reviewed publications from January 2005 to December 2019. Results: We summarize 21 published studies (including meta-analyses, randomized clinical trials, and correlational work) testing moderators and/or predictors of adolescent SUD treatment outcomes…
Keep ReadingBackground: Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Methods: Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11–20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12–19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy…
Keep ReadingAbstract: Previous research indicates that risk for substance use is associated with poor inhibitory control. However, it remains unclear whether at-risk youth follow divergent patterns of inhibitory control development. As part of the longitudinal National Consortium on Adolescent Neurodevelopment and Alcohol study, participants (N = 113, baseline age: 12–21) completed a rewarded antisaccade task during fMRI, with up to three time points…
Keep ReadingBorderline personality disorder (BPD) and alcohol use disorder often cooccur, yet we know little about risk processes underlying this association. We tested two mechanistic pathways linking BPD symptoms and alcoholrelated problems. In the “affective pathway,” we hypothesized that BPD symptoms would be associated with alcohol-related problems through affective instability and drinking to cope. In the “sensation-seeking pathway,” we proposed that BPD symptoms would be related to alcoholrelated problems through sensation seeking and drinking to enhance positive experiences…
Keep ReadingBackground: Moderate to heavy alcohol use during pregnancy (≥3 drinks/occasion) is linked to a range of adverse offspring outcomes. Prior studies suggest that adolescent and young adult mothers may be particularly vulnerable to these risky drinking behaviors during and after pregnancy. This study used latent class growth analysis (LCGA) to examine changes in risky drinking from prepregnancy to postpregnancy and identified prepregnancy predictors representing cognitive and social factors to inform prevention. Methods: Participants included 432 adolescent and young adult mothers (aged 13 to 24; 78% Black) assessed annually since childhood in the Pittsburgh Girls Study. Participants prospectively reported frequency of risky drinking (≥3 drinks/occasion) in the year of pregnancy and 2 years before and after pregnancy, as well as social–cognitive risk factors for drinking (alcohol expectancies, drinking motives, caregiver, and peer alcohol use)…
Keep ReadingAlcohol-specific attentional biases (AttB) and approach biases (AppB) are postulated to play a role in alcohol use disorders but their association with drinking in young adults remains unknown. A subsample of young adults with risky alcohol use (N = 296) enrolled in a randomized trial, testing different text message interventions completed weekly tasks via a mobile app for up to 14 weeks: Alcohol Stroop was used to measure AttB and Approach-Avoidance Task was used to measure AppB…
Keep ReadingAs the number of adolescents seeking treatment for marijuana use increases, it is important to identify factors that mediate marijuana treatment outcomes. Alcohol consumption is highly prevalent in clinical samples of adolescents but has been neglected as a potential mediator of marijuana use treatment outcomes. In this study, we sought to examine alcohol consumption as a mediator of both marijuana use frequency (number of use days) and negative consequences related to marijuana use in a longitudinal study of 159 adolescents (Mage = 16.69 years; 35% female; 87% White; 70% marijuana as a preferred drug) enrolled in intensive outpatient substance use disorder (SUD) treatment…
Keep ReadingObjective: To examine the prevalence and characteristics of precollege sexual victimization (SV) experiences and associations with revictimization and recent substance use behaviors among a sample of college students who reported precollege SV. Participants: A sub-sample of 931 college students who reported precollege SV at baseline data collection for an ongoing multi-site clinical trial. Methods: Data were collected via electronic surveys between September 2015 and March 2017. Measures included precollege and during college SV, recent substance use, and alcohol-related harm reduction behaviors…
Keep ReadingBackground and aims: Nearly all the research conducted on high-intensity drinking has focused on college and school-based samples, with recent calls for research to understand this risky drinking pattern in non-school-based samples and across time. This study aimed to characterize predictors and consequences of non-binge drinking, age- and gender-adjusted binge drinking (level I) and drinking at levels representing two or more times (level II) and three or more times the level I binge threshold (level III) in a clinical sample of adolescents followed into young adulthood…
Keep ReadingPurpose: Social distancing strategies such as “stay-at-home” (SAH) orders can slow the transmission of contagious viruses like the SARS-CoV-2 virus, but require population adherence to be effective. This study explored adherence to SAH orders by young adults with hazardous drinking, and the role of alcohol consumption with in-person contacts on adherence…
Keep ReadingBackground: Mobile assessment of the effects of acute marijuana on cognitive functioning in the natural environment would provide an ecologically valid measure of the impacts of marijuana use on daily functioning. Objective: This study aimed to examine the association of reported acute subjective marijuana high (rated 0-10) with performance on 3 mobile cognitive tasks measuring visuospatial working memory (Flowers task), attentional bias to marijuana-related cues (marijuana Stroop), and information processing and psychomotor speed (digit symbol substitution task [DSST])…
Keep ReadingPurpose: This longitudinal study aimed to identify variation by race in the associations between religious involvement and initiation of alcohol, cigarette, and marijuana use, including distinctions by substance or type of religious involvement, in Black and White adolescent girls. Methods: Data were drawn from interviews conducted at ages 11 through 17 with 2172 Pittsburgh Girls Study participants (56.8% Black; 43.2% White)…
Keep ReadingBackground: Peer victimization is consistently linked to adolescents’ alcohol use. However, the relative influence of relational and physical peer victimization on alcohol use, and timing of drinking initiation, is not well understood. In this study, we evaluate the impact of both relational and physical peer victimization on adolescent girls’ alcohol use initiation, and the extent to which depression severity moderates these associations…
Keep ReadingAbstract: Text messaging (SMS) interventions incorporating a combination of behavior change techniques can assist reductions in alcohol consumption among young adult hazardous drinkers, but mechanisms of action remain unknown. In this secondary analysis, we test the hypothesis that desire to get drunk (DD) recorded prior to drinking episodes would mediate SMS intervention effects on the likelihood of event-level heavy drinking (4+/5+ drinks for women/men)…
Keep ReadingObjective: Low parental involvement and monitoring are risk factors for adolescent cigarette use. Assessments of parental involvement and monitoring by youth and parents may capture an additional source of risk: Differences in perceptions of these parenting behaviors. This study tested for unique contributions of youth-reported parental involvement and monitoring and youth–parent discrepancies in reporting to first cigarette use in girls. Method: Data were drawn from interviews at ages 8–17 with 1,869 girls (57.3% Black, 42.7% White) and their primary caregivers (94% mothers) in the Pittsburgh Girls Study…
Keep ReadingGarcia and colleagues1 delve into an understudied but vitally important physician workforce concern: professional burnout. Their work draws on a national survey of physicians with a sample large enough to examine differences in important metrics by race/ethnicity. Given the long-standing struggle to improve the diversity of the medical profession, examining the extent of burnout among physicians of minority racial/ethnic groups is imperative…
Keep ReadingAbstract: Government sponsored pay-for-performance systems (P4P) have emerged in many contexts, including those featuring third-party federalism such as Medicaid. In this vein, voluntary networks called Medicaid accountable care organizations (ACOs) seek to achieve health care savings while boosting the quality of care. Drawing on evidence from four states, this study probes how collaborative governance strategies that downplay formal democratic controls and enhance administrative flexibility shaped the response to two implementation problems. We find that administrative flexibility, combined with signals of support from political principals, helped galvanize ACO formation but undermined efforts to tailor performance metrics to the needs of Medicaid enrollees…
Keep ReadingAbstract: Policy Points Large numbers of homeless adults gained Medicaid coverage under the Affordable Care Act, increasing policymaker interest in strategies to improve care and reduce avoidable hospital costs for homeless populations. Compared with nonhomeless adult Medicaid beneficiaries, homeless adult beneficiaries have higher levels of health care needs, due in part to mental health issues and substance use disorders. Homeless adults are also more likely to visit the emergency department or require inpatient admissions…
Keep ReadingPURPOSE Racial and ethnic disparities in cancer care near the end of life (EOL) have been recognized, but EOL care experienced by Medicaid beneficiaries is not well understood. We assessed the prevalence of aggressive EOL care and hospice enrollment for Medicaid beneficiaries and determined whether racial and ethnic disparities exist. PATIENTS AND METHODS We identified Medicaid beneficiaries (age 21-64 years) who were diagnosed from 2011 to 2015 with stage IV breast and colorectal cancer and who died by January 2016 through a New Jersey State Cancer Registry–Medicaid claims linked data set…
Keep ReadingUnderstanding the impact of health insurance coverage on access to and quality of cancer care, as well as the implications for cancer outcomes, is critically important for informing practice and policy within the complex and changing health-care context. In this issue of the Journal, Yabroff et al. (1) conducted a systematic review of 29 studies, published between 1980 and 2019, evaluating health insurance coverage disruptions and cancer care and outcomes in the United States…
Keep ReadingAbstract: Video-electroencephalogram (EEG) monitoring in the epilepsy monitoring unit (EMU) is essential for managing epilepsy and seizure mimics. Evaluation of care in the EMU would benefit from a validated code set capable of identifying EMU admissions from administrative databases comprised of large, diverse cohorts. We assessed the ability of code-based queries to parse EMU admissions from administrative billing records in a large academic medical center over a four-year period, 2016–2019. We applied prespecified queries for admissions coded as follows: 1) elective, 2) receiving video-EEG monitoring, and 3) including diagnoses typically required by major US healthcare payers for EMU admission…
Keep ReadingAbstract: The timeline followback (TLFB) takes more resources to collect than the Alcohol Use Disorder Identification Test (AUDIT-C). We assessed agreement of TLFB and AUDIT-C with the biomarker phosphatidylethanol (PEth) and compared changes in TLFB and PEth among persons with HIV (PWH) using secondary data from randomized trials. We calculated operating characteristics and agreement between TLFB (> 1 and > 2 average drinks/day), AUDIT-C ≥ 4 and PEth ≥ 20 among 275 men with HIV…
Keep ReadingBackground: Heavy episodic drinking (HED) is a risk factor for opioid-related overdose and negatively impacts HIV disease progression. Among a national cohort of patients with HIV (PWH), we examined sociodemographic and clinical correlates of concomitant HED and self-reported opioid use. Methods: We used data collected from 2002 through 2018 from the Veterans Aging Cohort Study, a prospective cohort including PWH in care at eight US Veterans Health Administration sites. HED was defined as consuming six or more drinks at least once in the year prior to survey collection. We examined the relationship between HED and self-reported opioid use and created a 4-level composite variable of HED and opioid use…
Keep ReadingObjective: Successful retention on buprenorphine improves outcomes for opioid use disorder (OUD); however, we know little about associations between use of non–prescribed buprenorphine (NPB) preceding treatment intake and clinical outcomes. Methods: The study conducted observational retrospective analysis of abstracted electronic health record (EHR) data from a multi-state nationwide office-based opioid treatment program. The study observed a random sample of 1000 newly admitted patients with OUD for buprenorphine maintenance (2015–2018) for up to 12 months following intake. We measured use of NPB by mandatory intake drug testing and manual EHR coding…
Keep ReadingBackground: Patients with medically-treated opioid overdose are at high risk for subsequent adverse outcomes, including repeat overdose. Understanding factors associated with repeat overdose can aid in optimizing post-overdose interventions. Methods: We conducted a longitudinal, retrospective cohort study using NJ Medicaid data from 2014 to 2019. Medicaid beneficiaries aged 12–64 with an index opioid overdose from 2015 to 2018 were followed for one year for subsequent overdose. Exposures included patient demographics; co-occurring medical, mental health, and substance use disorders; service and medication use in the 180 days preceding the index overdose; and MOUD following index overdose. Results: Of 4898 individuals meeting inclusion criteria, 19.6% had repeat opioid overdoses within one year…
Keep ReadingObjective: The COVID-19 pandemic led to unprecedented temporary federal and state regulatory flexibilities that rapidly transformed medication for opioid use disorder (MOUD) treatment delivery. This study aimed to understand changes in treatment providers’ care during COVID-19, provider experiences with the adaptations, and perceptions of which changes should be sustained long-term. Methods: We conducted in-depth, semi-structured interviews with 20 New Jersey MOUD providers, purposively sampled to reflect diversity in provider setting, specialty, and other characteristics. Using a rapid analysis approach, we summarized content within interview domains and analyzed domains across participants for recurring concepts and themes…
Keep ReadingIntroduction: Current evidence indicates that buprenorphine is a highly effective treatment for opioid use disorder (OUD), though premature medication discontinuation is common. Research on concurrent psychosocial and behavioral therapy services and related outcomes is limited. The goal of this study was to define patterns of OUD-related psychosocial and behavioral therapy services received in the first 6 months after buprenorphine initiation, identify patients’ characteristics associated with service patterns, and examine the course of buprenorphine treatment, including the association of therapy with medication treatment duration…
Keep ReadingAbstract: Although opioid agonist therapy (OAT) is associated with positive health outcomes, including improved HIV management, long-term retention in OAT remains low among patients with opioid use disorder (OUD). Using data from the Veterans Aging Cohort Study (VACS), we identify variables independently associated with OAT retention overall and by HIV status…
Keep ReadingAbstract: Antipsychotic medication use for nursing home residents with dementia poses major patient safety challenges. This article investigates health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes (National Partnership) and its companion state coalitions. These programs were introduced in 2012 to encourage reductions in antipsychotic use and increased use of nonpharmacological treatments for dementia…
Keep ReadingAbstract: We assessed whether tobacco screening provides clinically meaningful information about other substance use, including alcohol and other drug use, potentially facilitating targeting of screening for substance use. Using data from the Veterans Aging Cohort Study survey sample (VACS; N = 7510), we calculated test performance characteristics of tobacco use screening results for identification of other substance use including sensitivity, specificity, positive-likelihood-ratio (+LR = [sensitivity/(1-specificity)]: increase in odds of substance use informed by a positive tobacco screen), and negative-likelihood-ratio (-LR: [(1-sensitivity)/specificity]: reduction in odds of substance use informed by a negative tobacco screen). The sample was 95% male, 75% minority, and 43% were current and 33% were former smokers. Never smoking, versus any history, indicated an approximate four-fold decrease in the odds of injection drug use (-LR = 0.26), an approximate 2.5-fold decrease in crack/cocaine (-LR = 0.35) and unhealthy alcohol use (-LR = 0.40), an approximate two-fold decrease in marijuana (-LR = 0.51) and illicit opioid use (-LR = 0.48), and an approximate 30% decrease in non-crack/cocaine stimulant use (-LR = 0.75)…
Keep ReadingBACKGROUND: HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. METHODS AND RESULTS: We analyzed data on 106 333 (33 528 HIV-positive; 72 805 HIV-negative) people who were free of baseline cardiovascular disease from an observational cohort of HIV-positive people and matched uninfected veterans in care from April 1, 2003 through December 31, 2014. International Classification of Diseases, Ninth Revision (ICD-9) codes from medical records were used to determine baseline depression and incident stroke…
Keep ReadingOBJECTIVE: The objective of this study was to determine the availability and national distribution of HIV testing and counseling at substance use treatment facilities in the United States. METHODS: Analyses of data from the 2018 National Survey of Substance Abuse Treatment Services assessed HIV testing and counseling availability in U.S. substance use treatment facilities (excluding those in U.S. territories). Facilities were subcategorized by availability of mental health services and medication for opioid use disorders and compared by using logistic models. Descriptive statistics were calculated to characterize the availability of HIV testing and counseling by state, state HIV incidence, and facility characteristics…
Keep ReadingObjective: Medically treated opioid overdoses identify a population at high risk of subsequent mortality and need for treatment. This study reports on medically treated opioid overdose trends in a state with rapid fentanyl spread. Methods: We conducted stratified trend analysis of medically treated overdose due to heroin, synthetic opioids, methadone, or other natural opioids among New Jersey Medicaid beneficiaries aged 12–64 years (2014–2019); evaluated associations with demographics and co-occurring conditions; and examined trends in fentanyl penetration in suspected heroin seizures from New Jersey State Police data. Results: Overdose risk more than tripled from 2014 to 2019, from 120.5 to 426.8 per 100,000 person-years, respectively…
Keep ReadingBackground: Hundreds of laws aimed at reducing inappropriate prescription opioid dispensing have been implemented in the United States, yet heterogeneity in provisions and their simultaneous implementation have complicated evaluation of impacts. We apply a hypothesis-generating, multistage, machine-learning approach to identify salient law provisions and combinations associated with dispensing rates to test in future research…
Keep ReadingAbstract: Pain management clinic (PMC) laws were enacted by 12 states to promote appropriate opioid prescribing, but their impact is inadequately understood. We analyzed county-level opioid overdose deaths (National Vital Statistics System) and patients filling long-duration (≥30 day) or high-dose (≥90 morphine milligram equivalents per day) opioid prescriptions (IQVIA, Inc.) in the United States in 2010-2018…
Keep ReadingAbstract: Early into COVID, human challenge trials were considered, but usually as alternatives to conventional randomized controlled trials. Instead, assessment of authorized COVID vaccines, of further COVID vaccines, and of vaccines …
Keep ReadingAbstract: Knowledge of how to effectively prevent suicide attempt (SA) in high suicide–risk patients who also misuse opioids is limited. In a subset of data from 36 participants with baseline opioid misuse in a randomized clinical trial testing adjunctive mindfulness-based cognitive therapy to prevent suicide among high suicide–risk veterans (n = 18 per treatment condition), MBCT-S reduced the likelihood of SA and acute psychiatric hospitalization over 12-month follow-up…
Keep ReadingPharmacoepidemiology, the study of use and effects of medications, devices, diagnostics, and other medical interventions in large populations, is a science under constant development. New study designs are added to the armamentarium, new data sources are being leveraged, and new approaches are developed. All are changing the conduct of pharmacoepidemiological studies…
Keep ReadingBackground: Longitudinal studies of many health behaviors often rely on infrequent self-report assessments.
Keep ReadingBinge drinking and age at first full drink (AFD) of alcohol prior to 21 years (AFD < 21) have been linked to neuroanatomical differences in cortical and subcortical grey matter (GM) volume, cortical thickness, and surface area.
Keep ReadingCOVID-19 presents significant social, economic, and medical challenges.
Keep ReadingExamining predictors of alcohol use among adolescent girls is increasingly important to enhance prevention efforts, given that the gender gap in alcohol use is steadily closing.
Keep ReadingBackground: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors.
Keep ReadingThe novel coronavirus pandemic that emerged in late 2019 (COVID-19) has created challenges not previously experienced in human research.
Keep ReadingSexual-minority women (SMW) report higher rates of substance use and disorder across the life span and greater levels of minority stress in adolescence and young adulthood.
Keep ReadingSolitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant.
Keep ReadingBackground: Substance use is linked to increases in young women’s risk for intimate partner violence (IPV).
Keep ReadingImportance: People with schizophrenia are at high risk of receiving a diagnosis of dementia.
Keep ReadingObjectives: To evaluate the real-world effectiveness of ADHD medications on adverse driving outcomes in teenage drivers with ADHD.
Keep ReadingBackground: Adults with mood and anxiety disorders have an increased likelihood of being prescribed opioids.
Keep ReadingThe advent of the genomic age has created a rapid increase in complexity for the development and selection of drug treatments.
Keep ReadingBackground: Black women are more likely to have comorbidity at breast cancer diagnosis compared with White women, which may account for half of the Black-White survivor disparity.
Keep ReadingBACKGROUND: Permanent supportive housing (PSH) programs have the potential to improve health and reduce Medicaid expenditures for beneficiaries experiencing homelessness.
Keep ReadingPURPOSE: Black women are disproportionately burdened by comorbidities and breast cancer.
Keep ReadingResearch Objective: Initiatives to address social determinants of health (SDOH) and measure health-related social needs (HRSN) within clinic settings are increasing.
Keep ReadingPolicy Points Medicaid policymakers have a growing interest in addressing homelessness as a social determinant of health and driver of the potentially avoidable use of expensive medical services.
Keep ReadingPurpose: Diabetes and hypertension are two common comorbidities that affect breast cancer patients, particularly Black women.
Keep ReadingObjective: To estimate trends of annual antipsychotic medication use by privately insured young children (aged 2–7 years) in the United States, and to describe the clinical and treatment characteristics of these children.
Keep ReadingObjective: This article employs a best-worst scaling (BWS) experiment to identify the claims-based outcomes that matter most to patients and other relevant parties when evaluating pediatric antipsychotic monitoring programs in the United States.
Keep ReadingAlcohol use increases non-adherence to antiretroviral therapy (ART) among persons living with HIV (PLWH).
Keep ReadingThe disproportionate prescribing of high-risk antipsychotic medication for youth in foster care is a significant social problem across the U.S.
Keep ReadingGabapentin is commonly prescribed for chronic pain, including to patients with HIV (PWH). There is growing concern regarding gabapentin’s potential for harm, particularly in combination with opioids.
Keep ReadingImportance: Although adults with schizophrenia have an increased risk of suicide, sample size limitations of previous research have hindered characterizations of suicide risk across the life span.
Keep ReadingObjectives: Elder mistreatment (EM) is associated with worse physical health and psychological well-being, but little is known regarding its cognitive consequences.
Keep ReadingObjective: To develop a predictive index that estimates the individual risk of incident self-neglect onset among the US Chinese older adults.
Keep ReadingEngaging in leisure activities that are cognitively simulating and enjoyable may be protective against cognitive decline in older adults; yet, few studies have examined this topic.
Keep ReadingObjective Given a large number of community-based older adults with mild cognitive impairment, it is essential to better understand the relationship between unmet palliative care (PC) needs and mild cognitive impairment in community-based samples.
Keep ReadingObjectives: This study addressed two questions: (1) Is age at migration associated with cognitive function among Chinese older immigrants? and (2) what personal and environmental factors confound the above relationship?
Keep ReadingObjectives: To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits.
Keep ReadingA broad literature has explored racial disparities in cognitive aging. Research incorporating sociocultural factors would provide a more comprehensive understanding of minority aging.
Keep ReadingDespite significant scientific and medical discoveries, the genetics of novel infectious diseases like COVID-19 remains far from understanding.
Keep ReadingIntroduction: Guided by the intergenerational solidarity theory, this study examined how different dimension of intergenerational solidarity of adult children associated with their choice of being a primary caregiver for aging parents in the Chinese American families.
Keep ReadingObjectives: Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants.
Keep ReadingBACKGROUND/OBJECTIVES: To better understand the role of sensory loss as a potentially modifiable risk factor for cognitive decline, this study examined cognitive decline in relation to single modality hearing or vision loss and dual sensory loss.
Keep ReadingBackground and objectives: Focusing on a less studied aspect of friendship and an overlooked type of loss, this study examined associations between loss of friends and psychological well-being among older Chinese immigrants and whether such associations are moderated by age, gender, marital status, and social connection.
Keep ReadingIntroduction and hypothesis: The aim was to examine the prevalence of and risk factors for lower urinary tract symptoms (LUTS) in a community-dwelling cohort of older Chinese American women.
Keep ReadingIn the present study, we examined self-rated health as a mediator between physical health conditions (chronic diseases and functional disability) and depressive symptoms in older Chinese and Korean Americans.
Keep ReadingStudies of family relations have not kept pace with the acceleration of international migration.
Keep ReadingThis study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults.
Keep ReadingThis study investigated sociodemographic factors for immunization care use and the relationship between trust in physician (TIP) and immunization service use in older Chinese Americans.
Keep ReadingLarge-Scale New Jersey Prison Releases During COVID-19: Experiences of Released Prisoners with Substance Use Disorders
Keep ReadingBackground: Relatively little is known about the use patterns of potential pharmacologic treatments of COVID-19 in the United States. Objective: To use the National COVID Cohort Collaborative (N3C), a large, multicenter, longitudinal cohort, to characterize the use of hydroxychloroquine, remdesivir, and dexamethasone, overall as well as across individuals, health systems, and time…
Keep ReadingBackground: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18–20. Profile indicators included: women’s and partner’s alcohol and cannabis use, women’s sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors…
Keep ReadingPurpose: Real-world data from large administrative claims databases in Japan have recently become available, but limited evidence exists to support their validity. VALIDATE-J validated claims-based algorithms for selected cancers in Japan. Methods: VALIDATE-J was a multicenter, cross-sectional, retrospective study. Disease-identifying algorithms were used to identify cancers diagnosed between January or March 2012 and December 2016 using claims data from two hospitals in Japan…
Keep ReadingAbstract: A well-articulated research question will clearly define the hypothesis, the research rationale, and core elements of the study: the population, the intervention, the comparator, the outcome, the timing or duration of study, the setting, and the effect to be estimated. Clear definition of these elements will facilitate a research design that answers the intended clinical question…
Keep ReadingAbstract: The authors regret that they did not acknowledge Dr. Kleinman’s funding source. Dr. Kleinman was supported by grant U3DMC32755-02 from the Health Resources & Services Administration. The authors would like to apologize for any inconvenience caused…
Keep ReadingGrowth in the US population of older adults places an increasing number of people at risk of developing dementia. Most, but not all, studies report an increase in dementia incidence with each successive age group. Results have also been inconsistent regarding whether incidence of dementia varies between men and women of the same age. Although the incidence of dementia is higher for similarly aged black than white adults, whether age-adjusted incidence differs between other racial/ethnic groups remains unclear …
Keep ReadingFactors affecting independence in basic and instrumental activities of daily living have been established in older adults, but not centenarians. The purpose of this study …
Keep ReadingThis study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults …
Keep ReadingPrecision medicine is one of the recent and powerful developments in medical care, which has the potential to improve the traditional symptom-driven practice of medicine …
Keep ReadingElder abuse is a pervasive public health issue. The relationship between personality traits and elder abuse remains unclear. This study aims to examine the associations between neuroticism …
Keep ReadingObjective: Given a large number of community-based older adults with mild cognitive impairment, it is essential to better understand the relationship between unmet palliative …
Keep ReadingBACKGROUND: The only way to systematically screen for self-neglect among older adults is through in-home observations, which are often difficult and unfeasible …
Keep ReadingObjective: To develop a predictive index that estimates the individual risk of incident self-neglect onset among the US Chinese older adults …
Keep ReadingElder mistreatment, a pervasive public health issue, is of growing concern. Interpersonal relationships are culturally constructed, and attempts to understand elder mistreatment …
Keep ReadingObjective: This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults …
Keep ReadingFace-saving represents a unique culturally salient construct among Chinese. However, our understanding regarding its relationship with psychological distress …
Keep ReadingA broad literature has explored racial disparities in cognitive aging. Research incorporating sociocultural factors would provide a more comprehensive understanding …
Keep ReadingObjectives: Adult children play a significant role in ageing parents’ health and well-being. However, the evidence is mixed regarding whether the parent-child relations will affect older adults’ …
Keep ReadingRelying on two unique data-sets on Chinese older immigrants (N = 3,157) and younger immigrants with ageing parents (N = 469) in Chicago, this study compared the level of filial expectation …
Keep ReadingIn this study, we aimed to examine the relationship of social support with hospitalizations and emergency department (ED) visits among older Chinese adults in the United States …
Keep ReadingThis study investigates the differential associations of activity engagement and perceived neighborhood characteristics (i.e., cohesion, disorder, sense of community) with cognitive measures …
Keep ReadingThis study examined the relationship of kinship bereavement with the psychological well-being of Chinese American older women and men. Data from the Population Study of ChInese …
Keep ReadingBackground and Objectives: Despite an increasing, yet still limited amount of research on social determinants of oral health, the influences of neighborhood characteristics…
Keep ReadingObjectives: This study aims to identify (a) different types of parent-child relations among Chinese older immigrants, (b) predictors of each relation type, and (c) the most “optimal” …
Keep ReadingBackground: Given the importance of ethnic culture in family caregiving and recent Chinese immigrant population growth, this study explored effects of multiple filial …
Keep ReadingIn reply to Dr. Yoshikawa’s comments, we acknowledge that the PINE/PIETY studies have limited generalizability that may not apply to other ethnic …
Keep ReadingBackground and Objectives: The family fundamentally underpins the immigration and acculturation processes. But most existing research on acculturation …
Keep ReadingMinority populations are increasing rapidly in the United States, with the Asians the fastest growing population. Preliminary research showed marked disparities in relationship …
Keep ReadingThis study aims to examine the association between neighborhood cohesion and cancer screening utilization in a community-dwelling Chinese American older population …
Keep ReadingImportance: People who have experienced abuse as a child or violence with an intimate partner might have higher odds of being abused again, but this has been insufficiently investigated …
Keep ReadingObjectives: To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits …
Keep ReadingOBJECTIVES: The prevalence and health consequences of comorbid depressive symptoms (DSs) and chronic medical conditions (CMCs) among older ethnic minority populations ..
Keep ReadingOlder adults visit emergency departments (EDs) at a disproportionally higher rate than other age groups. Prior studies examining racial disparities in ED utilization focus on African Americans and Hispanics …
Keep ReadingOBJECTIVES: This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults …
Keep ReadingOBJECTIVES: To investigate the relationship between different definitions and subtypes of elder mistreatment (EM) and yearly mortality …
Keep ReadingOBJECTIVES: To examine whether and how early-life experiences such as years of schooling affect late-life cognitive function through a pathway of activity engagement …
Keep ReadingCultural values are believed to influence perceptions of and solutions to elder mistreatment (EM) perpetrated by family members. This study aimed to understand the influence of family …
Keep ReadingBACKGROUND/ OBJECTIVES: Prior research has shown that social engagement is beneficial to older adults’ health and well-being. This study examined the association between environmental …
Keep ReadingBACKGROUND/OBJECTIVES: Somatization of depressive symptoms among Chinese American older adults remains understudied. This study aimed to identify whether the relationship between …
Keep ReadingThe family is the key for survival and success of the 4.6 million older immigrants in the United States. It is also an overlooked context to understand older immigrants …
Keep ReadingBackground and Objectives The migrating age of an individual has far-reaching implications for their acculturation experience, social integration, and well-being …
Keep ReadingSurvey research is an essential component of epidemiological research to understand the health of older adults. However, there are several limitations to conventional data …
Keep ReadingOBJECTIVES: To examine the associations between violence experiences including phenotypes (psychological, physical/sexual abuse, financial exploitation, caregiver neglect) …
Keep ReadingBackground and objectives: Focusing on a less studied aspect of friendship and an overlooked type of loss, this study examined associations between loss of friends and psychological …
Keep ReadingObjective: The aim of this study is to explore the association between mental work demands (MWDs) and late-life cognition among Chinese older adults …
Keep ReadingObjectives: The projected increase in the population of older adults in the United States entails a pressing need to examine risk and protective factors associated with cognitive function …
Keep ReadingBACKGROUND/OBJECTIVES: Limited research is available on the relationship between oral health symptoms and cognitive function among community-dwelling US Chinese older adults …
Keep ReadingOBJECTIVES: To examine whether higher levels of perceived stress are associated with lower levels of cognitive function and faster cognitive decline in older Chinese-American adults …
Keep ReadingBACKGROUND/OBJECTIVES: Focusing on Chinese immigrants, this study examined (1) whether filial obligation, the core social norm in the Chinese culture, is related to caregiving burdens …
Keep ReadingOBJECTIVES: We aimed to examine the associations between immigration-related factors and prevalent and incident cognitive impairment (CI) and whether the associations varied by sex among …
Keep ReadingOBJECTIVES: Research has examined the relationships between positive social support (PSS) and elder mistreatment (EM) but less is known regarding the negative aspect of social …
Keep ReadingTo examine associations between social support and negative social interaction with past suicidal ideation (SI) at multiple time intervals …
Keep ReadingBackground: As health care reform continues within the United States, navigators may play increasingly diverse and vital roles across the health care continuum …
Keep ReadingBACKGROUND/OBJECTIVE: Depression impacts quality of life at all life stages, but the epidemiology of depression in the last year of life is unknown. This study’s objectives were to document …
Keep ReadingBACKGROUND/OBJECTIVES: Among older adults, intergenerational support can help to improve well-being. This study examines the correlation between intergenerational relationships and the subjective …
Keep ReadingOBJECTIVE: To examine the influence of smoking status on the health profiles of community-dwelling older Chinese American men in the greater Chicago, IL, area.
DESIGN: This study utilized a cross-sectional study design to analyze data obtained from the larger Population Study of Chinese Elderly in Chicago (PINE).
The time has never been more critical for drug discovery data and innovative solutions development based on artificial intelligence …
Keep ReadingAbstract: Neurological and psychiatric (mental health) disorders have a large impact on health burden globally. Cognitive disorders (including dementia) and stroke are leading causes of disability. Mental health disorders, including depression, contribute up to one-third of total years lived with disability. The Neurological and mental health Global Epidemiology Network (NeuroGEN) is an international multi-database network that harnesses administrative and electronic medical records from Australia, Asia, Europe and North America.
Keep ReadingIntroduction: Over the centuries, quests for answers have led us to take giant leaps. It was only in the last century that the discovery of antibiotics freed us from many of the dreaded diseases of the past …
Keep ReadingIntroduction: Since the beginning of scientific discoveries, it has been critically central to understand the cause of disease, pain, and senescence.1 Over the centuries, quests for the answers have led us to take giant leaps. It was only in the last century that the discovery of …
Keep ReadingObjectives: this case-control study compared levels of stress and allostatic load (AL) among Mexican women in the US (n =19) and Mexico (n = 40).
Keep ReadingPurpose: Exposures to favorable environments in childhood, including those in schools, are associated with healthy habits among children. In this study, we developed a series of indices aimed at measuring students’ exposure to different dimensions of the school food and physical activity (PA) environment. We implemented these indices to investigate how different aspects of the school food and PA environment changed over time and examined their correspondence with known changes in relevant policies and programs.
Keep ReadingBackground: The United States Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is the country’s largest nutrition assistance program for low-income populations. Although SNAP has been shown to reduce food insecurity, research findings on the diet quality of program participants are inconsistent.
Keep ReadingNew Jersey has a lot to be proud of when it comes to health, including comparatively low rates of smoking, teen births, infant deaths, and premature deaths, and high rates of preschool enrollment and high school graduation.
Keep ReadingCancer outcomes for Medicaid enrollees may be affected by patients’ primary care (PC) utilization and complex Medicaid enrollment dynamics, which have recently changed for many states under the Affordable Care Act.
Keep ReadingBACKGROUND AND OBJECTIVES: Depressive symptomatology is a significant predictor of increased health services utilization and health care cost in the general older adult population. However, there is scant information on the relationship between depressive symptoms and health service utilization among U.S. Chinese older adults. The objective of this study was to examine the relationship between depressive symptoms and physician visits, emergency department (ED) visits, and hospitalization.
Keep ReadingBackground: Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. Objective: This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults.
Keep ReadingBackground: Given the importance of ethnic culture in family caregiving and recent Chinese immigrant population growth, this study explored effects of multiple filial piety traits—filial expectation, self-rated filial performance, and filial discrepancy—on psychological well-being of Chinese immigrants who care for older parents (adult-child caregivers) in the United States.
Keep ReadingObjective: The aim of this study is to explore the association between mental work demands (MWDs) and late-life cognition among Chinese older adults. Method: Data were drawn from the baseline of the Shanghai Aging Study.
Keep ReadingThe family is the key for survival and success of the 4.6 million older immigrants in the United States. It is also an overlooked context to understand older immigrants’ health service utilisation. Most prior studies on this topic either focus on individual or institutional factors that affect how older immigrants use formal health services.
Keep ReadingCultural values are believed to influence perceptions of and solutions to elder mistreatment (EM) perpetrated by family members. This study aimed to understand the influence of family cohesion on EM reported by community-dwelling older Chinese Americans.
Keep ReadingImportance: People who have experienced abuse as a child or violence with an intimate partner might have higher odds of being abused again, but this has been insufficiently investigated regarding elder abuse. More conclusive evidence might be critical to assessment and prevention strategies.
Keep ReadingBackground: Opioid use disorder (OUD) is prevalent among people with HIV (PWH). Opioid agonist therapy (OAT) is the most effective treatment for OUD and is associated with improved health outcomes, but is often not initiated.
Keep ReadingBackground: HIV, hepatitis C virus (HCV), and alcohol-related diagnoses (ARD) independently contribute increased risk of all-cause hospitalization. We sought to determine annual medical intensive care unit (MICU) admission rates and relative risk of MICU admission between 1997 and 2014 among people with and without HIV, HCV, and ARD, using data from the largest HIV and HCV care provider in the United States.
Keep ReadingObjectives: The contribution of depression to mortality in adults with and without HIV infection is unclear. We hypothesized that depression increases mortality risk and that this association is stronger among those with HIV infection. Methods: Veterans Aging Cohort Study (VACS) data were analysed from the first clinic visit on or after 1 April 2003 (baseline) to 30 September 2015.
Keep ReadingBackground: Despite growing demand for home care nursing, there is a growing home care workforce shortage, due in part to hospital-centric nursing curricula that lead students to undervalue of home care and community practice setting (Van Iersel et al., 2018a, 2018b).
Keep ReadingImportance: People with schizophrenia are commonly treated with psychotropic medications in addition to antipsychotics, but there is little evidence about the comparative effectiveness of these adjunctive treatment strategies. Objective: To study the comparative real-world effectiveness of adjunctive psychotropic treatments for patients with schizophrenia.
Keep ReadingPurpose: To describe published validation studies of administrative health care claims data in the Asia-Pacific region. Methods: A comprehensive literature search was conducted in PubMed for English language articles published through 31-Oct-2017 in humans from 10 Asian-Pacific countries or regions (Japan, Australia, New Zealand, China, Hong Kong, India, Singapore, South Korea, Taiwan, and Thailand) that validated claims-based diagnoses with a gold standard data source. Search terms included the: validation, validity, accuracy, sensitivity, agreement, specificity, positive predictive value, kappa, kappa coefficient, and Cohen’s kappa. Results: Forty-three studies across six countries were identified: Australia (21); Japan (6); South Korea (6); Taiwan (7); Singapore (2); and New Zealand (1).
Keep ReadingObjective: To examine the patient perspective on the risks and benefits of linking existing data sources for research. Materials and methods: Between December 2015 and February 2016, we fielded a questionnaire in PatientsLikeMe, an online patient community representing over 2500 health conditions. The questionnaire was developed using subject matter expertise and patient feedback from a concept elicitation phase (N = 57 patients).
Keep ReadingMedicaid expansion under the Affordable Care Act (ACA) has raised questions about whether and how the program will be able to meet the rising demand for demand for services from new enrollees. The supply of primary care services is of particular concern. Numerous reports have warned about national shortages in the supply of primary care physicians overall and many practicing physicians do not participate in Medicaid.
Keep ReadingThere is substantial evidence that social factors influence health, health services use, and health care spending. Among these “social determinants of health”, housing is key (Doran, Misa, and Shah 2013).
Keep ReadingRilpivirine (RPV) and Etravirine (ETR) are approved second-generation non-nucleoside reverse transcriptase inhibitors (NNRTIs) for HIV treatment. There is a cross-resistance HIV mutation profile between first-and second-generation NNRTI drugs. We determined the prevalence of HIV-1 drug resistance mutations (DRMs) to RPV and ETR in Botswana.
Keep ReadingThe World Health Organization plans to eliminate hepatitis B and C Infections by 2030. Therefore, there is a need to study and understand hepatitis B virus (HBV) epidemiology and viral evolution further, including evaluating occult (HBsAg-negative) HBV infection (OBI), given that such infections are frequently undiagnosed and rarely treated.
Keep ReadingOccult hepatitis B infections (OBI) represent a reservoir of undiagnosed and untreated hepatitis B virus (HBV), hence the need to identify mutations that lead to this phenotype. Functionally characterizing these mutations by in vitro studies is time-consuming and expensive.
Keep ReadingBackground There is a high burden of tuberculosis (TB) in HIV antiretroviral programmes in Africa. However, few studies have looked at predictors of incident TB while on Truvada-based combination antiretroviral therapy (cART) regimens. Methods We estimated TB incidence among individuals enrolled into an observational cohort evaluating the efficacy and tolerability of Truvada-based cART in Gaborone, Botswana between 2008 and 2011.
Keep ReadingPurpose: To develop a valid and feasible short-form corner store audit tool (SCAT) that could be used in-store or over the phone to capture the healthfulness of corner stores. Design: Nonexperimental.
Keep ReadingObjectives. To determine the proportion of restaurants that will be required to post calorie information under the Food and Drug Administration’s menu-labeling regulations in 4 New Jersey cities.
Keep ReadingRelationships between food and physical activity (PA) environments and children’s related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections.
Keep ReadingObjectives; To evaluate National School Lunch Program (NSLP) and School Breakfast Program (SBP) participation over a 7-year period before and after the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA), which required healthier school lunch options beginning in school year (SY) 2012-2013 and healthier school breakfast options beginning in SY2013-2014.
Keep ReadingBackground: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery.
Keep ReadingBackground: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence.
Keep ReadingOBJECTIVES: Among adolescents and young adults with nonfatal self-harm, our objective is to identify risk factors for repeated nonfatal self-harm and suicide death over the following year. METHODS: A national cohort of patients in the Medicaid program, aged 12 to 24 years (n = 32 395), was followed for up to 1 year after self-harm. Cause of death information was obtained from the National Death Index.
Keep ReadingObjective: This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. Methods: The authors identified opioid-related decedents, age #64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life.
Keep ReadingBackground: Little is known about risk factors for repeated opioid overdose and fatal opioid overdose in the first year following nonfatal opioid overdose. Methods: We identified a national retrospective longitudinal cohort of patients aged 18–64 years in the Medicaid program who received a clinical diagnosis of nonfatal opioid overdose. Repeated overdoses and fatal opioid overdoses were measured with the Medicaid record and the National Death Index. Rates of repeat overdose per 1000 person-years and fatal overdose per 100,000 person-years were determined. Hazard ratios of repeated opioid overdose and fatal opioid overdose were estimated by Cox proportional hazards.
Keep ReadingIntroduction: Recent U.S. trends demonstrate sharp rises in adverse opioid-related health outcomes, including opioid use disorder (OUD), overdose, and death. Yet few affected people receive treatment for OUD and a minority of those who receive treatment are effectively retained in care. The purpose of this study was to examine duration of buprenorphine treatment for OUD following treatment initiation to identify risk factors for early discontinuation.
Keep ReadingObjective: The authors examined the use of different classes of psychotropic medication in outpatient treatment of schizophrenia and schizoaffective disorder. Methods: Data from the United States Medicaid program were used to examine psychotropic medication use in a cohort of patients who had a diagnosis of schizophrenia or schizoaffective disorder in the calendar year 2010.
Keep ReadingThe present study examined the influence of acculturation level and family relationships (i.e., positive family support and negative family strain) on quality of life (QOL), using the data from the Population Study of ChINese Elderly (PINE) in Chicago (N = 3159). Controlling for sociodemographic variables and health status, it was found that individuals’ acculturation level and positive family support were positively related to QOL, whereas negative family strain was negatively associated with QOL. More importantly, higher acculturation levels were associated with increased protective effects of positive family support and reduced risk effects of negative family strain on QOL among U.S. Chinese older adults.
Keep ReadingObjectives: This study examined the potential influence of coping resources at individual (sense of mastery), family (spousal and family support, children’s filial piety), and community levels (community cohesion) on the mental health (depression, anxiety) of U.S. Chinese older adults.
Keep ReadingObjectives: The projected increase in the population of older adults in the United States entails a pressing need to examine risk and protective factors associated with cognitive function. This study aims to examine the association between neighborhood social cohesion and cognitive function among older Chinese adults in the United States.
Keep ReadingIn this study, we aimed to examine the relationship of social support with hospitalizations and emergency department (ED) visits among older Chinese adults in the United States and its possible mechanism.
Keep ReadingOlder adults visit emergency departments (EDs) at a disproportionally higher rate than other age groups. Prior studies examining racial disparities in ED utilization focus on African Americans and Hispanics. There is a dearth of information on ED utilization patterns among older Asian Americans despite the evidence that ED expenditures in Asian Americans are comparable to that of Caucasians.
Keep ReadingObjective This study examines racial discrimination as a potential novel risk factor for suicide ideation among older Chinese Americans. Design In a cross-sectional analysis, this study drew on data collected in the Population-based Study of Chinese Elderly in Chicago on Chinese older adults age 60 + in the Greater Chicago area (N = 3,157). Thirty-day suicide ideation was a dichotomous variable, derived from items of the Physical Health Questionnaire and the Geriatric Mental State Examination-Version A. Self-reported discrimination was dichotomously coded, based on the Experiences of Discrimination instrument, which asks respondents whether they have ever experienced discrimination in nine situations because of their race/ethnicity/color.
Keep ReadingThis study aims to examine the association between neighborhood cohesion and cancer screening utilization in a community-dwelling Chinese American older population. Data were drawn from the Population Study of Chinese Elderly including 3159 Chinese American older adults aged 60 and above in the greater Chicago area. Cancer screening utilization was assessed by asking whether participants had undergone colon, breast, cervical, or prostate cancer screening.
Keep ReadingBACKGROUND: Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use
Keep ReadingObjective to determine whether tumour necrosis factor inhibitor (tnFi) use is associated with an increased rate of incident malignancy compared with no tnFi use in the treatment of juvenile idiopathic arthritis (JIA), paediatric inflammatory bowel disease (pIBd) and paediatric plaque psoriasis (ppso).
Keep ReadingThe Institute of Medicine concluded in To Err Is Human in 1999 that transformation of nurse work environments was needed to reduce patient harm. We studied 535 hospitals in four large states at two points in time between 2005 and 2016 to determine the extent to which their work environments improved, and whether positive changes were associated with greater progress in patient safety.
Keep ReadingDespite a growing body of evidence that adaptations of evidence-based interventions (EBI) are ubiquitous, few studies have examined the nature and rationale for modifications to the components of these interventions.
Keep ReadingPurpose: The objective of the study was to determine the risk of sudden sensorineural hearing loss (SNHL) associated with use of phosphodiesterase type 5 (PDE5) inhibitors. Methods: We conducted a retrospective cohort study in the MarketScan Commercial Claims and Encounters Database including adult men who initiated a PDE5 inhibitor (n = 377,722) and 1,957,233 nonusers between 1998 and 2007.
Keep ReadingObjective: To characterize the role of antipsychotic medications in the community treatment of adult depression. Methods: We identified adults (aged 18-64 years) with new episodes of depression treatment (ICD-9-CM 296.2, 296.3, 300.4, or 311) in US national Medicaid data (2001-2010). Patients with alternative ICD-9-CM antipsychotic indications, such as schizophrenia or bipolar disorder, were excluded.
Keep ReadingPurpose: The safety of nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used in Asia-Pacific countries has had limited study. We assessed the risk of hospitalization for gastrointestinal events with loxoprofen and mefenamic acid compared with other NSAIDs in Asia-Pacific populations. Methods: We conducted a cohort study using a distributed network with a common data model in Australia, Hong Kong, Japan, Korea, and Taiwan. We included patients who initiated diclofenac, loxoprofen, mefenamic acid, or celecoxib and followed them until their first gastrointestinal hospitalization, switch or discontinuation of medication, disenrollment, or end of database coverage. We used Cox proportional hazards models to assess hospitalization risk.
Keep ReadingObjective: The goal of the Asian Pharmacoepidemiology Network is to study the effectiveness and safety of medications commonly used in Asia using databases from individual Asian countries. An efficient infrastructure to support multinational pharmacoepidemiologic studies is critical to this effort.
Keep ReadingIntroduction: Advanced imaging can inform prognosis and may be a mechanism to de-escalate unnecessary end-of-life care in patients with cancer. Associations between greater use of advanced imaging and less-aggressive end-of-life care in real-world practice has not been examined.
Keep ReadingThe New Jersey Medicaid Accountable Care Organization (ACO) Demonstration was implemented over a three-year period beginning on July 1, 2015 and recently, a one-year extension of the Demonstration was recently authorized. Previously published reports provided quantitative and qualitative information about activities leading up to and in the first year of the Demonstration. This report provides a detailed assessment of ACO activities in Demonstration year 2.
Keep ReadingThis report provides a first assessment of spending and utilization indicators related to the New Jersey Medicaid Accountable Care Organization (ACO) Demonstration Project (NJ P.L. 2011, c.114).
Keep ReadingBuilding a Culture of Health will give all members of our society the opportunity to lead healthier lives. To achieve this aim, more stakeholders in the community-residents, elected officials, community-based nonprofits, law enforcement, and schools-need to be engaged in addressing the health challenges in our communities. Moreover, all community stakeholders have to think and act “upstream” by addressing the social determinants of health in their communities. Discussed in this article are some of the lessons that are being learned from the “upstream” actions of school nurses in New Jersey about building a Culture of Health.
Keep ReadingMichael Grossman’s seminal work on the demand for health extended the concept of a household production function to the commodity “good health.”……
Keep ReadingObjectives: Depression is associated with high healthcare expenditures, and depression treatment may reduce healthcare expenditures. However, to date, there have not been any studies on the effect of depression treatment on healthcare expenditures among cancer survivors. Therefore, this study examined the association between depression treatment and healthcare expenditures among elderly with depression and incident cancer.
Keep ReadingBackground: We aimed to investigate the relationship of engagement in social and cognitive activities and social support with the sense of community (SOC) and its components among older Chinese Americans.
Keep ReadingBackground: Physical function decline is a major public health concern and can predict later mortality. This study aims to examine the sociodemographic factors associated with physical function decline among U.S. Chinese older adults through a longitudinal population-based study.
Keep ReadingIn this issue of the Hastings Center Report, Govind Persad and Ezekiel Emanuel argue that “[t]he provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.”
Keep ReadingCross-sectional estimation of HIV incidence could misclassify some established or chronic HIV infections as recent. Usually long-term nonprogressors, elite and viremic controllers, and individuals on ART contribute to misclassification.
Keep ReadingThe advent of antiretroviral therapy has significantly improved AIDS-related morbidity and mortality. Yet, among people living with HIV, deaths due to non-AIDS-defining illnesses have been on the rise.
Keep ReadingSub-Saharan Africans infected with HIV-1C make up the largest AIDS patient population in the world and exhibit large heterogeneity in disease progression before initiating antiretroviral therapy.
Keep ReadingResearch collaboration in “real world” practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies.
Keep ReadingBackground Understanding determinants of high consumption of sugar-sweetened beverages (SSBs), a highly prevalent obesogenic behavior, will help build effective customized public health interventions.
Keep ReadingBlack and Hispanic (minority) MSM have a higher incidence of HIV than white MSM. Multiple sexual partners, being under the influence of drugs and/or alcohol during sex, having a detectable HIV-1 RNA, and non-condom use are factors associated with HIV transmission. Using data from the Veterans Aging Cohort Study, we consider minority status and sexual orientation jointly to characterize and compare these factors.
Keep ReadingPurpose of the Study Earlier studies have identified a pattern of cumulative advantage leading to increased within-cohort economic inequality over the life course, but there is a need to better understand how levels of inequality by age have changed in the evolving economic environment of recent decades. We utilized Survey of Income and Program Participation (SIPP) data to compare economic inequality across age groups for 2010 versus 1983-1984. Design and Methods We examined changing age profiles of inequality using a summary measure of economic resources taking into account income, annuitized value of wealth, and household size.
Keep ReadingObjective: The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. Method: A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 personyears and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models.
Keep ReadingPurpose: Newly approved novel drugs in Europe receive a black triangle label to promote pharmacovigilance. With growing momentum for earlier drug approvals and reliance on real-world evidence, we studied if the black triangle label promotes more judicious prescribing. Methods: We examined whether general practitioners prescribed escitalopram, tadalafil, and vardenafil with a black triangle more cautiously than the same or similar drugs without a black triangle in The Health Improvement Network (UK). We performed interrupted time-series analyses to estimate changes in new prescription rates and nested case-control studies to compare characteristics of new users before and after removal of a black triangle.
Keep ReadingObjective: To meta-analytically examine the trends and correlates of antipsychotic use in youth with mood disorders. Methods: Systematic literature search without language restriction in PubMed/ MEDLINE/PsycINFO from database inception through March 2015 using the following search terms: (antipsychotic∗OR neuroleptic∗OR “dopamine blocker∗” OR antidopaminergic) AND (child∗OR adolescen∗OR pediatric OR youth) AND (prescription∗OR prescrib∗OR use OR utilization OR database OR pharmacoepidemiolog∗OR frequency OR rate OR rates).
Keep ReadingObjective: To characterize treatment trajectories in children newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). Methods: We utilized billing records of children aged 3 to 18 years in 28 US states’f Medicaid programs between 1999 and 2006. Children entered the cohort at the first ADHD diagnosis (ICD-9-CM: 314.00) preceded by. 6 months with no psychotropic medication use and no psychiatric diagnoses. We followed children for 5 years to assess use of (1) psychotropic polypharmacy (the use of. 3 psychotropic medication classes), (2) antipsychotics, and (3) anticonvulsants. We used mixedeffects logistic regression to model the probability of each utilization outcome as a function of age at ADHD diagnosis and follow-up year, adjusted for sociodemographic factors.
Keep ReadingNon-adherence to medications is a major challenge in diabetes care. The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. We used a data source that linked electronic prescriptions with insurance claims to assess whether new electronic prescriptions for diabetes medications were followed by dispensing claims consistent with that prescription.
Keep ReadingBackground: Depression is a major public health concern among older adults and health care professionals play a vital role in screening and treatment. However, this process may be impeded by issues like lack of trust in physician (TIP). This study aims to examine the cross-sectional and longitudinal relationships between TIP and depressive symptoms among Chinese older adults in the Chicago area.
Keep ReadingBackground: This study aims to assess cognitive change in a 2-year period among U.S. Chinese older adults and examine sociodemographic characteristics associated with the change.
Methods: Data were from the Population Study of Chinese Elderly (PINE) in which 2,713 participants (aged 60 and older) received in-home interviews at both the baseline and 2-year follow-up. A battery of cognitive tests that assessed episodic memory, working memory, perceptual speed, and overall cognitive status were administered in both times. A composite global cognition was constructed using all tests. Mixed-effect regression was conducted.
Keep ReadingBackground Unlike the Magnet Recognition Program, the newer Pathway to Excellence Program designed to improve work environments in a broader range of organizations has not yet been the focus of substantial research.
Keep ReadingBackground: Granular clinical and laboratory data available in electronic health record (EHR) databases provide researchers the opportunity to conduct investigations that would not be possible in insurance claims databases; however, for pharmacoepidemiology studies, accurate classification of medication exposure is critical. Objective: The aim of this study was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data.
Keep ReadingElder self-neglect is a global public health and human rights issue that threatens older people’s health and safety. It commonly refers to refusal or failure to provide oneself with care and protection in areas of food, water, clothing, hygiene, medication, living environments, and safety precautions. While prevalent, the status of self-neglecting individuals remains largely unclear, in particular within community-dwelling populations. By reviewing the epidemiology of elder self-neglect (definition, prevalence, risk factors, and consequences) to date, the present paper identifies key research gaps such as methodological inconsistency in case identification and measurement, and study designs that are inadequate to determine risk factors of self-neglect. More importantly, in light of the rapidly growing older population, relevant stakeholders (researchers, healthcare providers, social service providers, legal professionals, community organizations, and policymakers) must be prepared for an expected increasing number of self-neglect cases and enlarging scope of the problem. Hence, in this article, I present an overview regarding the management issues of elderly self-neglect related to the detection, assessment, reporting and referral, and decision-making capacity. Based on the current literature, the paper is aimed to explore the present knowledge and challenges, and how they can pave the way for solutions to self-neglect research, practice, and policy.
Keep ReadingObjective. The current Juvenile Idiopathic Arthritis (JIA) Core Set was developed in 1997 to identify the outcome measures to be used in JIA clinical trials using statistical and consensus-based techniques, but without patient involvement.
Keep ReadingObjective. To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA). Methods.
Keep ReadingPurpose/Objectives: To determine predictors of unplanned hospitalizations in patients with lung cancer to receive chemotherapy in the outpatient setting and examine the potential financial burden of these events.
Keep ReadingBackground: Though ample research on grandparent caregiving and psychological well-being outcomes exist in Western literature, little attention has been focused on Chinese American grandparents. Based on role enhancement and role strain theories, this study examined grandparent caregiving and psychological well-being among Chinese American older adults and tested whether caregiving burden or pressure from adult children moderated such association.
Keep ReadingBackground: Given the growth in the number of older Chinese immigrants in the United States and the importance of family support in Chinese culture, this study examines how supportive and negative relationships with family members (children and spouse) influence depressive symptom severity among this population.
Keep ReadingBackground: Conflict in the family is a major risk factor for the well-being of older immigrants, whose lives are centered around their families. This study examined the potential linkage between personal coping resources and family and marital conflict among U.S. Chinese older adults.
Keep ReadingBackground: Social support is a key indicator of utilization of preventive health care among older adults, but we have limited knowledge on these associations in U.S. Chinese older adults. This study aims to examine the association between sources of social support and cancer screening behaviors among Chinese older adults in the greater Chicago area.
Keep ReadingBackground: Chicago’s Chinatown is home to a sizeable community of first-generation Chinese American immigrants. This qualitative study seeks to describe the attitudes toward, and barriers and facilitators of, breast cancer screening among Chinese women in Chicago’s Chinatown to inform strategies for future interventions.
Keep ReadingObjectives We studied oral glucocorticoids and osteonecrosis, a rare but serious bone disease, in individuals with various chronic inflammatory diseases. We hypothesised that we would find stronger associations in adults versus children and in people with autoimmune diseases.
Keep ReadingUsing the 1999–2011 waves of the Panel Study of Income Dynamics, we examine how actual unemployment …
Keep ReadingUsing a between-subject 3 × 3 design of an experimentally manipulated realistic case vignette of Black…….
Keep ReadingDespite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families…….
Keep ReadingObjectives: Despite high prevalence rates of depression in primary care ,depressive symptoms are often undetected by physicians……..
Keep ReadingObjective: Depression treatment can improve the health outcomes of elderly cancer survivors. There is a paucity of studies on the extent to which depression is treated among elderly cancer survivors. Therefore, this study estimated the rates of depression treatment among elderly cancer survivors and identified the factors affecting depression treatment.
Keep ReadingBackground: Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes.
Keep ReadingBackground: Elderly individuals (age >65 years) with cancer are at high risk for newly diagnosed depression after a cancer diagnosis. It is not known whether the risk of newly diagnosed depression varies by cancer type.
Keep ReadingBackground: Low-dose computed tomography lung cancer (LDCT) screening is an effective way to decrease lung cancer mortality. Both Medicare and private insurers offer coverage of LDCT screening to beneficiaries who are at high risk of developing lung cancer. In this study, we examined rates and predictors of chronic smoking behavior and eligibility for coverage of LDCT screening among older Chinese men living in the greater Chicago area
Keep ReadingThis book provides a global comprehensive and systematic state-of-the review of this field that fills the gaps between research, practice, and policy. The book addresses the epidemiology of the issue and the global prevalence of elder abuse in both developed and developing countries, which synthesizes the most up-to-date data about risk factors and protective factors associated with elder abuse and consequences of elder abuse; clinical assessment and management of elder abuse, including screening, detection, management of elder abuse, and the role of decision making capacity and forensic approaches;
Keep ReadingOur primary objective was to gather pilot data from caregivers and stakeholders to guide the development of a training program to assist informal caregivers in re-entering the job market. The goal of the program would be to help caregivers rebound from their incurred economic burden by transitioning into a paid caregiving or other health-service role.
Keep ReadingABSTRACT: Although community-based participatory research (CBPR) has been recognized as a useful approach for eliminating health disparities, less attention is given to how CBPR projects may address gender inequalities in health for immigrant older women. The goal of this article is to share culturally sensitive strategies and lessons learned from the PINE study—a population-based study of U.S. Chinese older adults that was strictly guided by the CBPR approach.
Keep ReadingThis study aimed to examine the socio-demographic and socioeconomic characteristics associated with prevalence and severity of elder self-neglect in an U.S. Chinese older population. The PINE study is a population-based epidemiological study in the greater Chicago area.
Keep ReadingThe rapid increase in grandparents caring for grandchildren has received growing attention, but little research has focused on Chinese-American grandparents and their caregiving experiences.
Keep ReadingAim: The present study examined the cognitive, physical and psychological characteristics associated with elder self-neglect in a USA Chinese older population.
Keep ReadingThe objective of this study was gather pilot data from informal caregivers regarding the potential for a training program to assist current or past caregivers in reentering the job market, and thus offering a pathway to economic resilience.
Keep ReadingThis study explored the prevalence and correlates of elder mistreatment among community-dwelling Chinese women in the U.S. Data were from the Population Study of Chinese Elderly in Chicago (PINE), a population-based study of U.S. Chinese older adults aged 60 years and above.
Keep ReadingThis article aims to advance the global issue of elder abuse through exploring how the current body of elder abuse literature can collectively pave the way for present and future directions for research, practice, and policy.
Keep ReadingBackground: In Côte d’Ivoire, tuberculosis (TB) is a common cause of death among HIV-infected antiretroviral therapy (ART) enrollees. Ivorian guidelines recommend screening for TB and initiation of TB treatment before ART initiation. Compliance with these guidelines can help reduce TB-related mortality during ART and possibly nosocomial TB transmission.
Keep ReadingObjective: To evaluate the variation in all-cause attrition [mortality and loss to follow-up (LTFU)] among HIV-infected individuals in Botswana by health district during the rapid and massive scale-up of the National Treatment Program.
Keep ReadingObjectives: To determine the incidence and risk factors of mortality for all HIV-infected patients receiving antiretroviral treatment at public and private healthcare facilities in the Botswana National HIV/AIDS Treatment Programme. Design: We studied routinely collected data from 226 030 patients enrolled in the Botswana National HIV/AIDS Treatment Programme from 2002 to 2013.
Keep ReadingHepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection has emerged as an important cause of morbidity and mortality. We determined the response to Truvada-based first-line combination antiretroviral therapy (cART) in HIV/HBV-coinfected verus HIV-monoinfected patients in Botswana.
Keep ReadingHIV infects cells of the immune system causing immune activation and proliferation of immune cells, leading to alteration of production and activity of a number of cytokines. These changes in cytokine levels can affect the immune function, and have the potential to directly impact the course of HIV disease.
Keep ReadingThe social construction of womanhood in Africa can be said to have two central defining elements: being a wife and being a mother. The interplay between HIV and these elements is not well understood outside of prevention efforts.
Keep ReadingObjective To measure the association between the number of doctors, nurses and hospital beds per 10,000 people and individual HIV-infected patient outcomes in Botswana.
Keep ReadingBackground: Understanding the motivations and perspectives of providers in following guidance and evidence-based policies can contribute to the evidence on how to better implement and deliver care, particularly in resource-constrained settings. This study explored how providers’ attitudes and behaviors influenced the implementation of an intervention, provider-initiated HIV testing and counseling, in primary health care settings in Botswana.
Keep ReadingAn obesity paradox has been proposed in many conditions including HIV. Studies conducted to investigate obesity and its effect on HIV disease progression have been inconclusive and are lacking for African settings.
Keep ReadingCultural competence training is mandatory in the United States of America to alleviate minority health disparities though few studies have examined perceptions across stakeholders.
Keep ReadingCulture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research.
Keep ReadingObjective: To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment.
Keep ReadingIn response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP).
Keep ReadingObservational comparative effectiveness and safety studies are often subject to immortal person-time, a period of follow-up during which outcomes cannot occur because of the treatment definition. Common approaches, like excluding immortal time from the analysis or naïvely including immortal time in the analysis, are known to result in biased estimates of treatment effect.
Keep ReadingBackground: Multivariable confounder adjustment in comparative studies of newly marketed drugs can be limited by small numbers of exposed patients and even fewer outcomes. Disease risk scores (DRSs) developed in historical comparator drug users before the new drug entered the market may improve adjustment. However, in a high dimensional data setting, empirical selection of hundreds of potential confounders and modeling of DRS even in the historical cohort can lead to over-fitting and reduced predictive performance in the study cohort.
Keep ReadingObjective To compare confounding adjustment by high-dimensional propensity scores (hdPSs) and historically developed high-dimensional disease risk scores (hdDRSs) in three comparative study examples of newly marketed medications: (1) dabigatran vs. warfarin on major hemorrhage; (2) on death; and (3) cyclooxygenase-2 inhibitors vs. nonselective nonsteroidal anti-inflammatory drugs on gastrointestinal bleeds. Study Design and Setting In each example, we constructed a concurrent cohort of new and old drug initiators using US claims databases.
Keep ReadingPurpose: Record linkage can enhance data quality of observational database studies. Probabilistic linkage, a method that allows partial match of linkage variables, overcomes disagreements arising from errors and omissions in data entry but also results in false-positive links. The study aimed to assess the validity of probabilistic linkage in the absence of unique personal identifiers (UPI) and the methods of cutoff weight selection.
Keep ReadingPurpose: The study aimed to evaluate the comparative risk of oral ulcerations among antipsychotic medications. Methods: We analyzed the National Health Insurance Research Database of Taiwan and included patients newly initiated with a single antipsychotic agent including haloperidol, sulpiride, olanzapine, quetiapine, risperidone, or amisulpride during 2002 to 2010. The outcome of interest was oral ulceration, defined by the presence diagnoses of stomatitis and mucositis, aphthous-like ulceration and oral burns, or dispensing of stomatological corticosteroids included triamcinolone, dexamethasone, hydrocortisone, and prednisolone.
Keep ReadingWe compared persistence of antiepileptic drugs (AEDs) including carbamazepine, oxcarbazepine, gabapentin, lamotrigine, topiramate, valproic acid, and phenytoin in an Asian population with epilepsy. A retrospective cohort study was conducted by analyzing Taiwan’s National Health Insurance Research Database (NHIRD). Adult epilepsy patients newly prescribed with AEDs between 2005 and 2009 were included.
Keep ReadingHarms of opioid analgesics, especially high-dose therapy among individuals with comorbidities and older age, are increasingly recognized. However, trends in opioid receipt among HIV-infected patients are not well characterized. We examined trends, from 1999 to 2010, in any and high-dose (≥120 mg/day) opioid receipt among patients with and without HIV, by age strata, controlling for demographic and clinical correlates. Of 127,216 patients, 64 % received at least one opioid prescription.
Keep ReadingObjective: The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector. Methods: Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484).
Keep ReadingObjective: Patients with substance use disorders (SUDs) prescribed long-term opioid therapy (LtOT) are at risk for overdose and mortality. Prior research has shown that receipt of LtOT in accordance with clinical practice guidelines has the potential to mitigate these outcomes. Our objective was to determine whether the presence of a SUD modifies the association between guideline-concordant care and 1-year all-cause mortality among patients receiving LtOT for pain.
Keep ReadingPurpose: For patients receiving long-term opioid therapy (LtOT), the impact of guideline-concordant care on important clinical outcomes—notably mortality—is largely unknown, even among patients with a high comorbidity and mortality burden (e.g., HIV-infected patients). Our objective was to determine the association between receipt of guideline-concordant LtOT and 1-year all-cause mortality.
Keep ReadingClosing the gap between evidence-based clinical practice standards and their inclusion in routine practice continues to be a major goal of health policy reforms. This gap is especially large for the care of children with psychiatric disorders-especially those from low-income families, many of whom are insured through Medicaid.
Keep ReadingObjective: To determine the association between HIV infection and other risk factors for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Design: Longitudinal, national Veterans Aging Cohort Study including 43 618 HIV-infected and 86 492 uninfected veterans. Methods: AECOPD was defined as an inpatient or outpatient COPD ICD-9 diagnosis accompanied by steroid and/or antibiotic prescription within 5 days.
Keep ReadingThe rapid growth of antipsychotic medication use among publicly insured children in the early and mid-2000s spurred new state efforts to monitor and improve prescription behavior. A starting point for many oversight initiatives was the foster care system, where most of the children are insured publicly through Medicaid.
Keep ReadingBackground. The Patient Protection and Affordable Care Act encourages healthcare systems to track quality-of-care measures; little is known about their impact on mortality rates. The objective of this study was to assess associations between HIV quality of care and mortality rates.
Keep ReadingAIMS: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care.
DESIGN: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use.
Keep ReadingIntroduction Individuals with HIV and hepatitis C (HCV) infection, alcohol use disorder, or who are prescribed potentially hepatotoxic medications may be at increased risk for buprenorphine (BUP) associated hepatotoxicity. Materials and methods We examined a cohort of HIV-infected and uninfected patients receiving an initial BUP prescription between 2003 and 2012. We compared changes in alanine and aspartate aminotransferases (ALT and AST) and total bilirubin (TB) stratified by HIV status.
Keep ReadingBackground Using electronic medical record (EMR) data for clinical decisions, quality improvement, and research is common. While unhealthy alcohol use is particularly risky among HIV infected individuals (HIV+), the validity of EMR data for identifying unhealthy alcohol use among HIV+ is unclear. Among HIV+ and uninfected, we: (1) assess agreement of EMR and research AUDIT-C at validated cutoffs for unhealthy alcohol use; (2) explore EMR cutoffs that maximize agreement; and (3) assess subpopulation variation in agreement.
Keep ReadingObjective: Chronic obstructive pulmonary disease (COPD) prevalence is increasing among aging HIV-infected individuals. We determined the association between COPD and self-reported measures of frailty [adapted frailty-related phenotype (aFRP)] and physical limitation, and a clinical biomarker of physiologic frailty [Veterans Aging Cohort Study (VACS) Index] in HIV-infected compared with uninfected individuals. Design: Cross-sectional study of VACS participants between 2002 and 2012.
Keep ReadingIndividuals with HIV infection are living substantially longer on antiretroviral therapy, but hospitalization rates continue to be relatively high. We do not know how overall or diagnosis-specific hospitalization rates compare between HIV-infected and uninfected individuals or what conditions may drive hospitalization trends. Hospitalization rates among United States Veterans were calculated and stratified by HIV serostatus and principal diagnosis disease category.
Keep ReadingObjective To examine rates and predictors of receiving a psychosocial service before initiating antipsychotic treatment among young people in the Medicaid program. Method A retrospective new-user cohort study of 8 state Medicaid programs focused on children and adolescents 0 to 20 years, initiating antipsychotic treatment (N = 24,372).
Keep ReadingIMPORTANCE Antipsychotics are used increasingly in youth for nonpsychotic and off-label indications, but cardiometabolic adverse effects and (especially) type 2 diabetes mellitus (T2DM) risk have raised additional concern. OBJECTIVE To assess T2DM risk associated with antipsychotic treatment in youth. DATA SOURCES Systematic literature search of PubMed and PsycINFO without language restrictions from database inception until May 4, 2015. Data analyses were performed in July 2015, and additional analyses were added in November 2015.
Keep ReadingIMPORTANCE Although psychiatric inpatients are recognized to be at increased risk for suicide immediately after hospital discharge, little is known about the extent to which their short-Term suicide risk varies across groups with major psychiatric disorders. OBJECTIVE To describe the risk for suicide during the 90 days after hospital discharge for adults with first-listed diagnoses of depressive disorder, bipolar disorder, schizophrenia, substance use disorder, and other mental disorders in relation to inpatients with diagnoses of nonmental disorders and the general population.
Keep ReadingBACKGROUND: Antidepressant effects on increased suicidality in children have raised public concern in recent years. Approved in 2002 for attention-deficit/hyperactivity disorder treatment, the selective noradrenalin-reuptake-inhibitor atomoxetine was initially investigated for the treatment of depression. In post-hoc analyses of clinical trial data, atomoxetine has been associated with an increased risk of suicidal ideation in children and adolescents. We analyzed whether the observed increased risk of suicidal ideation in clinical trials translates into an increased risk of suicidal events in pediatric patients treated with atomoxetine compared with stimulants in 26 Medicaid programs.
Keep ReadingObjective: The authors compared the effectiveness of initiating treatment with either clozapine or a standard antipsychotic among adults with evidence of treatment-resistant schizophrenia in routine clinical practice. Method: U.S. national Medicaid data from 2001 to 2009 were used to examine treatment out comes in a cohort of patients with schizophrenia and evidence of treatment resistance that initiated clozapine (N=3,123) and in a propensity score-matched cohort that initiated a standard antipsychotic (N=3,123).
Keep ReadingObjective Although irritability and aggression are relevant treatment targets in autism spectrum disorders (ASDs) and intellectual disability (ID) that may prompt antipsychotic use, antipsychotic prescribing patterns in such youth have not been systematically reviewed. Method We systematically searched PubMed/MEDLINE/PsycInfo until March 2015 for studies reporting data on the frequency of youth diagnosed with ASDs and/or ID among antipsychotic-treated youth, as well as antipsychotic use in youth with ASD/ID, conducting a meta-analysis and meta-regression analysis of potential moderators, including publication year, study time point, country, setting, sample size, age, sex, and race/ethnicity.
Keep ReadingVoltage-gated sodium channel Nav1.7 is a central player in human pain. Mutations in Nav1.7 produce several pain syndromes, including inherited erythromelalgia (IEM), a disorder in which gain-of-function mutations render dorsal root ganglia (DRG) neurons hyperexcitable. Although patients with IEM suffer from episodes of intense burning pain triggered by warmth, the effects of increased temperature on DRG neurons expressing mutant Nav1.7 channels have not been well documented.
Keep ReadingThe Affordable Care Act (ACA) has many potential implications for the hospital industry. One of the most closely followed issues is the expansion of Medicaid, which became a state option as a result of the Supreme Court decision of 2012.1 As of this writing, 31 states and Washington, D.C., have elected to expand Medicaid, and […]
Keep ReadingIntroduction: Family time caring for children with diabetes is an overlooked component of the overall burden of the condition. We document and analyze risk factors for time family members spend providing health care at home and arranging/coordinating health care for children with diabetes. Methods: Data for 755 diabetic children and 16,161 non-diabetic children whose chronic conditions required only prescription (Rx) medication were from the 2009–2010 United States National Survey of Children with Special Health Care Needs (NS-CSHCN). We used generalized ordered logistic regressions to estimate adjusted odds ratios (AORs) of time burden by diabetes, insulin use, and stability of the child’s health care needs, controlling for health and socioeconomic status.
Keep ReadingBackground: Chemotherapy administration and supportive management for solid tumors is intended to take place in the ambulatory setting, but little is known about why some patients experience treatment-related adverse events so severe as to require acute inpatient care.
Keep ReadingImportance: The incidence of Clostridium difficile infection has increased among children. The epidemiology of pediatric C difficile infection-associated reactive arthritis is poorly understood.
Keep ReadingBackground & Aims Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years.
Keep ReadingAlthough HIV-1 RNA levels are measured at the time of initial diagnosis, the results are not used for the clinical follow-up of the patients. This study evaluates the prognostic value of the baseline HIV-1 RNA levels (above or below 10,000 copies/ml) on rate of disease progression, among antiretroviral therapy (ART)-naive patients in Botswana.
Keep ReadingIMPORTANCE Antibiotics disrupt human microbiota and have been associated with several pediatric autoimmune diseases. Psoriasis activity has been linked to group A streptococcal and viral infections.
Keep ReadingBACKGROUND AND OBJECTIVE: Recent evidence has linked childhood antibiotic use and microbiome abstract disturbance to autoimmune conditions. This study tested the hypothesis that antibiotic exposure was associated with newly diagnosed juvenile idiopathic arthritis (JIA).
Keep ReadingChinese people have practiced traditional Chinese medicine (TCM) for thousands of years, but there is a paucity of research regarding TCM use in Chinese older adult immigrants in the United States. This study aims to provide an overall estimate of TCM use for Chinese older adults in the United States and to examine associations between sociodemographic characteristics, health measures, and TCM use.
Keep ReadingDespite increasing need to boost the recruitment of underrepresented populations into cancer trials and biobanking research, few tools exist for facilitating dialogue between researchers and potential research participants during the recruitment process.
Keep ReadingAs one of the leading causes of death around the world, suicide is a global public health threat. In the Chinese population, suicides constitute one-fifth of all recorded suicides in the world.
Keep ReadingBackground: Religiosity influences health and well-being. We assessed religiosity among U.S. Chinese older adults. Methods: Data were drawn from the PINE study based on 3,159 community-dwelling U.S. Chinese older adults aged 60+ in the greater Chicago area. Two items retrieved from Duke University Religion Index (DUREL) were used to assess the frequency of participating in religious activities, and a separate item was used to assess the importance of religion.
Keep ReadingThe DuPage Patient Navigation Collaborative (DPNC) adapted and scaled the Patient Navigation Research Program’s intervention model to navigate uninsured suburban DuPage County women with an abnormal breast or cervical cancer screening result.
Keep ReadingObjectives To characterize the relationship between perceived stress and Adult Protective Services (APS) elder abuse cases in a population-based sample.
Keep ReadingAcculturation is a difficult process for minority older adults for a variety of reasons, including access and exposure to mainstream culture, competing ethnic identities, and linguistic ability and preference. There is a paucity of research regarding overall level of acculturation for Chinese older adults in the United States.
Keep ReadingObjectives: The DuPage Patient Navigation Collaborative evaluated the Patient Navigation Research Program (PNRP) model for uninsured women receiving free breast or cervical cancer screening through the Illinois Breast and Cervical Cancer Program in DuPage County, Illinois.
Keep ReadingThis review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse.
Keep ReadingThis article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations.
Keep ReadingIntroduction: Narrowing the racial/ethnic and socioeconomic disparities in breast and cervical cancer requires an in-depth understanding of motivation for adherence to cancer screening and follow-up care. To inform patient-centered interventions, this study aimed to identify reasons why low-income women adhered to or delayed breast or cervical cancer screening, follow-up and treatment despite access to cancer care-related services.
Keep ReadingElder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation.
Keep ReadingBackground: Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes.
Keep ReadingObjective: Depression is conceptualized as both a risk factor for and a consequence of elder abuse; however, current research is equivocal. This study examined associations between elder abuse and dimensions of depressive symptoms in older adults.
Keep ReadingBackground: Hepatitis B virus (HBV) is a major global health problem especially in sub-Saharan Africa and in East Asia. Ten hepatitis B virus genotypes have been described that differ by geographic distribution, disease progression, and response to treatment.
Keep ReadingRelative to non-Latino Whites, Latinos in the United States with major depressive disorder (MDD) show low engagement in antidepressant therapy, whether engagement is defined as pharmacotherapy access, medication initiation, pill-taking, or treatment retention.
Keep ReadingOlder men are less likely than older women to receive depression treatment. Latino older men in particular have been found to have significantly lower rates of depression treatment than their white-non-Mexican (WNM) counterparts.
Keep ReadingObjective: The Social Ecological Model (SEM) has been used to describe the aetiology of childhood obesity and to develop a framework for prevention. The current paper applies the SEM to data collected at multiple levels, representing different layers of the SEM, and examines the unique and relative contribution of each layer to children’s weight status.
Keep ReadingLittle evidence exists examining if parental nativity, neighborhood disadvantage and built environment features are associated with physical activity behaviors in Latino youth.
Keep ReadingThe current and projected nurse faculty shortage threatens the capacity to educate sufficient numbers of nurses for meeting demand. As part of an initiative to foster strategies for expanding educational capacity, a survey of a nationally representative sample of 3,120 full-time nurse faculty members in 269 schools and programs that offered at least one prelicensure degree program was conducted.
Keep ReadingIntroduction: When unique identifiers are unavailable, successful record linkage depends greatly on data quality and types of variables available. While probabilistic linkage theoretically captures more true matches than deterministic linkage by allowing imperfection in identifiers, studies have shown inconclusive results likely due to variations in data quality, implementation of linkage methodology and validation method. The simulation study aimed to understand data characteristics that affect the performance of probabilistic vs. deterministic linkage.
Keep ReadingBackground and Purpose – After the 2005 National Coverage Determination to reimburse carotid artery stenting (CAS) for Medicare beneficiaries, the number of CAS procedures increased and carotid endarterectomy (CEA) decreased. We evaluated trends in surgeons’ past-year CEA case-volume and 30-day mortality after CEA, and their association before and after the National Coverage Determination.
Keep ReadingObjectives To compare the risk of pneumonia in older adults receiving donepezil, galantamine, or rivastigmine for dementia. Design Retrospective cohort study. Setting Nationally representative 5% sample of Medicare databases. Participants Medicare beneficiaries aged 65 and older who newly initiated cholinesterase inhibitor therapy between 2006 and 2009.
Keep ReadingBackground – Clinical trials demonstrated the efficacy of carotid artery stenting (CAS) relative to carotid endarterectomy when performed by physicians with demonstrated proficiency. It is unclear how CAS performance may be influenced by the diversity in CAS and non-CAS provider volumes in routine clinical practice.
Keep ReadingOBJECTIVE: To examine the effectiveness of primary implantable cardioverter defibrillators (ICDs) in elderly patients receiving the device during a hospital admission for exacerbation of heart failure or other acute co-morbidities, with an emphasis on adjustment for early mortality and other factors reflecting healthy candidate bias rather than the effect of the ICD.
Keep ReadingIMPORTANCE: Despite increased carotid artery stenting (CAS) dissemination following the 2005 National Coverage Determination, to our knowledge, periprocedural and long-term outcomes have not been described among Medicare beneficiaries. OBJECTIVE: To describe the incidence of outcomes during and after the periprocedural period among Medicare beneficiaries undergoing CAS.
Keep ReadingBackground: This study describes the availability and characteristics of databases in Asian-Pacific countries and assesses the feasibility of a distributed network approach in the region. Methods: A web-based survey was conducted among investigators using healthcare databases in the Asia-Pacific countries. Potential survey participants were identified through the Asian Pharmacoepidemiology Network.
Keep ReadingWe aim to (1) compare compliance of anastrozole, letrozole, exemestane, and tamoxifen in women and (2) identify clinical factors associated with medication non-adherence and non-persistence. Female Medicare beneficiaries who were new users of anastrozole, letrozole, exemestane, or tamoxifen between 2007 and 2010 were analyzed.
Keep ReadingIMPORTANCE: Antiretroviral therapy (ART) has converted human immunodeficiency virus (HIV) infection into a chronic condition, and patients now undergo a variety of surgical procedures, but current surgical outcomes are inadequately characterized. OBJECTIVE: To compare 30-day postoperative mortality in patients with HIV infection receiving ART with the rates in uninfected individuals. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of nationwide electronic medical record data from the US Veterans Health Administration Healthcare System, October 1, 1996, to September 30, 2010.
Keep ReadingBackground: Increased long-term prescription of opioids and/or benzodiazepines necessitates evaluating risks associated with their receipt. We sought to evaluate the association between long-term opioids and/or benzodiazepines and mortality in HIV-infected patients receiving antiretroviral therapy and uninfected patients.
Keep ReadingIMPORTANCE Although adults with schizophrenia have a significantly increased risk of premature mortality, sample size limitations of previous research have hindered the identification of the underlying causes. OBJECTIVE To describe overall and cause-specific mortality rates and standardized mortality ratios (SMRs) for adults with schizophrenia compared with the US general population.
Keep ReadingBackground: Lithium inhibits glycogen synthase kinase-3, an enzyme implicated in the pathogenesis of dementia. Aims: To examine the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder. Method: The cohort included individuals ≥50 years diagnosed with bipolar disorder who did not receive dementia-related services during the prior year. Each follow-up day was classified by past-year cumulative duration of lithium use (0, 1-60, 61-300 and 301-365 days).
Keep ReadingObjectives To determine whether adjustment for prognostic indices specifically developed for nursing home (NH) populations affect the magnitude of previously observed associations between mortality and conventional and atypical antipsychotics. Design Cohort study. Setting A merged data set of Medicaid, Medicare, Minimum Data Set (MDS), Online Survey Certification and Reporting system, and National Death Index for 2001 to 2005. Participants Dual-eligible individuals aged 65 and older who initiated antipsychotic treatment in a NH (N = 75,445).
Keep ReadingClinical trials supporting the use of therapeutic hypothermia (TH) in the treatment of out-of-hospital cardiac arrest (OHCA) are based on small patient samples and do not reflect the wide variation in patient selection, cooling methods, and other elements of post-arrest care that are used in everyday practice. This study provides a real world evaluation of the effectiveness of post-arrest care in TH centers during a time of growing TH dissemination in the state of New Jersey (NJ).
Keep ReadingWe identify need, enabling, and predisposing factors for high family time burdens associated with the health care of chronically-ill children, using data from the U.S. 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 children with special health care needs (CSHCN).
Keep ReadingStrategic planning for research priorities in schools of nursing requires consensus building and engagement of key stakeholders. However, traditional approaches to strategic planning using work groups and committees sometimes result in low rates of faculty participation and fail to engage other important stakeholders.
Keep ReadingObjectives To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home.
Keep ReadingObjective: This study aimed to examine the prevalence and correlates of elder mistreatment among U.S. Chinese older adults. Method: Data were drawn from the Population-Based Study of ChINese Elderly (PINE) study, a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area.
Keep ReadingBackground. This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function.
Keep ReadingPurpose – The purpose of this paper is to explore US Chinese older adults’ views regarding elder abuse interventions in order to understand barriers and facilitators of help-seeking behaviors.
Keep ReadingPatient navigation emerged as a strategy to reduce cancer disparities among low-income and minority patients and has demonstrated efficacy in improving clinical outcomes.
Keep ReadingBackground. Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults.
Keep ReadingThe participation of racial and ethnicminorities and underserved populations in clinical trials is a critical link between scientific innovation and improvements in health care delivery and health outcomes.
Keep ReadingBackground. Experiences of discrimination are detrimental to health and well-being. This study aimed to examine experiences of discrimination and responses to unfair treatment among community-dwelling U.S. Chinese older adults.
Keep ReadingBackground/Aim: Elder self-neglect is associated with increased morbidity and mortality. The objective of this study is to examine the prospective relationship between reported elder self-neglect and the rate of 30-day hospital readmission in a community population.
Keep ReadingOlder adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia.
Keep ReadingElder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation.
Keep ReadingBackground: Elder mistreatment (EM) is a pervasive public health issue and is associated with morbidity and premature mortality. This study aimed to examine how the prevalence of EM and its subtypes vary using different definitions among U.S. Chinese older adults.
Keep ReadingObjective: We aimed to assess the representativeness of the demographic characteristics of the PINE study to the Chinese aging population in the Greater Chicago area.
Keep ReadingObjective: This study aimed to examine the longitudinal association between decline in cognitive function and elder mistreatment (EM). Methods: Chicago Health and Aging Project (CHAP) is an epidemiologic study conducted in a geographically defined community (N = 6,159).
Keep ReadingBackground: Using community-based participatory research (CBPR), the DuPage County Patient Navigation Collaborative (DPNC) developed an academic campus-community research partnership aimed at increasing access to care for underserved breast and cervical cancer patients within DuPage County, a collar county of Chicago. Given rapidly shifting demographics, targeting CBPR initiatives among underserved suburban communities is essential.
Keep ReadingElder mistreatment (EM) is associated with increased morbidity and mortality. The objective of this study is to examine the association between depressive symptoms and EM in a U.S. Chinese population.
Keep ReadingObjective: This report aims to establish the reliability and validity of five psychological and social well-being indictors in their applications to a U.S. Chinese aging population.
Keep ReadingWe examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse.
Keep ReadingBackground. This study aimed to explore the prevalence and correlates of anxiety disorders and any anxiety symptoms among community-dwelling U.S. Chinese older adults.
Keep ReadingThe PINE Study-the Population Study of Chinese Elderly in Chicago, sōng nián yán jiū) is a population-based epidemiological study of U.S. Chinese older adults in the greater Chicago area with primary aims to examine their health status and well-being.
Keep ReadingBackground. Existing methodological challenges in aging research has dampened our assessment of cognitive function among minority older adults. We aim to report the composite scores of five cognitive function tests among U.S. Chinese older adults, and examine the association between cognitive function and key sociodemographic characteristics.
Keep ReadingSETTING: In Côte d’Ivoire, more than 2000 human immunodeficiency virus (HIV) infected children aged <15 years were started on antiretroviral therapy (ART) during 2004-2008.
Keep ReadingBackground: In Côte d’Ivoire during 2004-2007, numbers of ART enrollees increased from <5,000 to 36,943. Trends in nationally representative ART program outcomes have not yet been reported.
Keep ReadingBackground: During 2004-2008, >2000 children (<15 years old) initiated antiretroviral therapy (ART) in Côte d'Ivoire. Nationally representative outcomes, temporal trends in outcomes during 2004-2008 and site-level outcome determinants have not been investigated.
Keep ReadingUnderstanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART).
Keep ReadingObjective: To evaluate the safety of combination antiretroviral therapy (ART) in conception and pregnancy in different health systems. Design: A pilot ART registry to measure the prevalence of birth defects and adverse pregnancy outcomes in South Africa and Zambia.
Keep ReadingBackground: Short-term mortality rates among patients with HIV receiving antiretroviral therapy (ART) in sub-Saharan Africa are higher than those recorded in high-income countries, but systematic long-term comparisons have not been made because of the scarcity of available data. We analysed the effect of the implementation of Botswana’s national ART programme, known as Masa, from 2002 to 2010.
Keep ReadingLaboratory cross-sectional assays are useful for the estimation of HIV incidence, but are known to misclassify individuals with long-standing infection as recently infected.
Keep ReadingPeople living with serious mental illness (SMI) have shorter life expectancies than the general population. We examined how contextual factors influence the physical health of this population. We conducted interviews, focus groups, and participant observations with stakeholders from six behavioral health organizations.
Keep ReadingA small but growing number of states are turning to accountable care concepts to improve their Medicaid programs. In 2011 New Jersey enacted the Medicaid Accountable Care Organization (ACO) Demonstration Project to offer local provider coalitions the opportunity to share any savings they generate.
Keep ReadingBackground: Obesity rates among school-age children remain high. Access to energy-dense foods at home, in schools, in stores, and restaurants around homes and schools is of concern. Research on the relationship between food environment around schools and students’ weight status is inconclusive. This study examines the association between weight status of middle and high school students and proximity to a comprehensive set of food outlets around schools.
Keep ReadingBackground-Linking patient registries with administrative databases can enhance the utility of the databases for epidemiological and comparative effectiveness research. However, registries often lack direct personal identifiers, and the validity of record linkage using multiple indirect personal identifiers is not well understood.
Keep ReadingBackground-The accuracy of stroke diagnosis in administrative claims for a contemporary population of Medicare enrollees has not been studied. We assessed the validity of diagnostic coding algorithms for identifying stroke in the Medicare population by linking data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study to Medicare claims.
Keep ReadingObjectives To describe new users of antihypertensive medications and identify predictors of combination therapy initiation in older Americans. Design Retrospective observational cohort study. Setting Population-based study using U.S. Medicare fee-for-service healthcare claims (2007-2010). Participants Medicare beneficiaries aged 65 and older with no recent diagnoses, procedures, or medications for cardiovascular disease who newly initiated an antihypertensive therapy (n = 275,493; 210,605 initiated monotherapy, 64,888 initiated combination therapy).
Keep ReadingMedical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices.
Keep ReadingObjective. Linkages between registries and administrative data may provide a valuable resource for comparative effectiveness research. However, personal identifiers that uniquely identify individuals are not always available. Here we describe methods to link a de-identified arthritis registry and US Medicare data. The linked data set was also used to evaluate the generalizability of the registry to the US Medicare population.
Keep ReadingMethods: We included 9285 participants from the Finnish Public Sector Study who began statin therapy after completing the survey. We linked their survey data with data in national health registers. We used prescription dispensing data to determine participants’ nonadherence to statin therapy during the first year of treatment (defined as < 80% of days covered by filled prescriptions). We used logistic regression to estimate the association of several lifestyle factors with nonadherence, after adjusting for sex, age and year of statin initiation.
Keep ReadingObjective: To assess the potential contribution of unmeasured general health status to patient selection in assessments of the clinical effectiveness of implantable cardioverter-defibrillator (ICD) therapy. Design: Retrospective cohort study. Setting: Linked data from an ICD registry, heart failure registry, and Medicare claims data for ICDs implanted in 2005 through 2009.
Keep ReadingOBJECTIVE:: Isotonic saline is the most commonly used crystalloid in the ICU, but recent evidence suggests that balanced fluids like Lactated Ringer’s solution may be preferable. We examined the association between choice of crystalloids and in-hospital mortality during the resuscitation of critically ill adults with sepsis.
Keep ReadingBACKGROUND: Whether the use of selective serotonin-reuptake inhibitors (SSRIs) and other antidepressants during pregnancy is associated with an increased risk of congenital cardiac defects is uncertain. In particular, there are concerns about a possible association between paroxetine use and right ventricular outflow tract obstruction and between sertraline use and ventricular septal defects.
Keep ReadingBackground All antipsychotic medications carry warnings of increased mortality for older adults, but little is known about comparative mortality risks between individual agents. Aims To estimate the comparative mortality risks of commonly prescribed antipsychotic agents in older people living in the community.
Keep ReadingBackground: Frailty is a geriatric syndrome of decreased physiologic reserve and a risk factor for hospitalization and mortality. We hypothesized that an adapted survey-based frailtyrelated phenotype (aFRP) predicts hospitalization and mortality among HIV-infected and uninfected individuals in adjusted models but is uncommon among those achieving undetectable HIV-1 RNA.
Keep ReadingObjective: The potential misuse of antipsychotic medications (APMs) is an ongoing quality concern in nursing homes (NHs), especially given recent black box warnings and other evidence regarding the risk of APMs when used in NH populations. One mechanism regulators could use is public reporting of APM use by NHs; however, there is currently no agreed-upon measure of guideline-inconsistent APM use. In this paper, we describe a proposed measure of quality of APM use that is based on Centers for Medicare and Medicaid Services (CMS) Interpretive Guidelines, Food and Drug Administration (FDA) indications for APMs, and severity of behavioral symptoms.
Keep ReadingOBJECTIVES: In 2003, the US Food and Drug Administration issued warnings about hyperglycemia and diabetes with second-generation antipsychotics (SGAs); guidelines have recommended metabolic screening since 2004. However, little is known of contemporary practices of glucose screening among youth initiating SGAs. Our objective was to evaluate baseline glucose assessment among youth in the Mini-Sentinel Distributed Database starting an SGA. METHODS: The cohort included youth ages 2 through 18 newly initiating SGAs January 1, 2006, through December 31, 2011, across 10 sites. Baseline glucose was defined as fasting/random glucose or hemoglobin A1c (GLU) measurement occurring relative to first SGA dispensing. Differences in GLU assessment were evaluated with χ2 tests and logistic regression.
Keep ReadingBackground: An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs.
Keep ReadingFrontloading of skilled nursing visits is one way home health providers have attempted to reduce hospital readmissions among skilled home health patients. Upon review of the frontloading evidence, visit intensity emerged as being closely related. This state of the science presents a critique and synthesis of the published empirical evidence related to frontloading and visit intensity. OVID/Medline, PubMed, and Scopus were searched. Seven studies were eligible for inclusion. Further research is required to define frontloading and visit intensity, identify patients most likely to benefit, and to provide a better understanding of how home health agencies can best implement these strategies.
Keep ReadingBy 1999, 64% of all public schools had students participating in service activities, and then between 1984 and 1999 the number of high schools offering community service opportunities rose from 27% to over 80% (National Center for Education Statistics, n.d.). More recently, in a 2007-2008 survey of 1,190 colleges, it was found that nearly one-third of students participated in service (Campus Compact, 2009).
Keep ReadingThe implications of civic engagement for child and adolescent well-being are explored conceptually and empirically. To establish a foundation for this chapter, the meaning of well-being for individuals and societies is first considered. Flourishingis distinguished from pleasure and conventional success, and we argue that flourishing is (1) the essence of well-being, and (2) requires civic participation for its attainment. The evidence for dynamic relations among civic engagement in childhood and adolescence and individual and societal flourishing is reviewed and evaluated. We conclude that research to date supports the conclusion that fostering civic engagement among children and adolescents can promote well-being.
Keep ReadingThe lack of evidence on the effectiveness and safety of interventions in chronic dialysis patients has been a subject of continuing criticism. Newtechnologies are often introduced into themarketwithout having specifically studied or even included patients with advanced kidney disease.
Keep ReadingThere has been a general recognition of a syndemic that includes HIV/AIDS and serve mental illnesses including schizophrenia, major depression, bipolar disorder, post-traumatic stress disorder, and others.
Keep ReadingBackground: Unicompartmental knee arthroplasty is a less-invasive alternative to total knee arthroplasty for patients with arthritis affecting only the medial or lateral compartment. However, little is known about recent trends in the use of these procedures and the associated outcomes among older patients.
Keep ReadingThe proven effectiveness of biologics and other immunomodulatory products in inflammatory rheumatic diseases has resulted in their widespread use as well as reports of potential short- And longterm complications such as infection and malignancy.
Keep ReadingObjective: To determine whether use of serotonin or non-serotonin reuptake inhibitors near to delivery is associated with postpartum hemorrhage. Design: Cohort study. Setting: 2000-07 nationwide Medicaid data (Medicaid Analytic eXtract). Population 106 000 pregnant women aged 12-55 with a diagnosis of mood or anxiety disorder.
Keep ReadingOpioid use has been reported to be associated with increased fracture risks. In a nested case-control study using the United Kingdom-based General Practice Research Database, we tested the hypotheses that fracture risk was associated with 1) an elevated risk of falls caused by the acute central nervous system effects of opioids including sedation and dizziness, and 2) osteoporosis caused by chronic opioid-induced hypogonadism.
Keep ReadingObjectives: To assess the extent of immortal time bias in estimating the clinical effectiveness of implantable cardioverter-defibrillators (ICDs) and the impact of methods of handling immortal time bias.
Keep ReadingFamilismo (familism) has been introduced in various ways in Latino mental health. For people with mental illnesses such as depression, familism can create pressures that are treatment discouraging.
Keep ReadingBackground: Few children accumulate the recommended ≥60 minutes of physical activity each day. Active travel to and from school (ATS) is a potential source of increased activity for children, accounting for 22% of total trips and time spent traveling by school-aged children.
Keep ReadingObjectives: Conflicting findings on associations between food and physical activity (PA) environments and children’s weight status demand attention in order to inform effective interventions. We assess relationships between the food and PA environments in inner-city neighborhoods and children’s weight status and address sources of conflicting results of prior research.
Keep ReadingBACKGROUND: Prior studies suggest that women who use antidepressants during pregnancy have an increased risk for preeclampsia, yet the comparative safety of specific antidepressants remains unclear. US nationwide Medicaid Analytic eXtract (MAX) data have not been used to study medication safety during pregnancy.
Keep ReadingPurpose: The role of administrative databases for research on drug safety during pregnancy can be limited by their inaccurate assessment of the timing of exposure, as the gestational age at birth is typically unavailable. Therefore, we sought to develop and validate algorithms to estimate the gestational age at birth using information available in these databases.
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