Substance Abuse and Hospitalization for Mood Disorder among Medicaid Beneficiaries
Objectives. We compared the influence of substance abuse with that of other comorbidities (e.g., anxiety, HIV) among people with mood disorder (N=129524) to explore risk factors for psychiatric hospitalization and early readmission within 3 months of discharge.
Lay and expert interpretations of cancer cluster evidence
Conflict frequently occurs between community members and environmental/public health officials when an unusual number of cancer cases is reported.
Family cohesion and its relationship to psychological distress among Latino groups
This article presents analyses of a representative sample of U.S. Latinos (N = 2,540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress.
Testing language effects in psychiatric epidemiology surveys with randomized experiments: Results from the national Latino and Asian American study
To evaluate the prevalence of mental disorders for persons of non-English-language origin, it is essential to use translated diagnostic interviews. The equivalence of translated surveys is rarely tested formally.
Holes in the safety net: A case study of access to prescription drugs and specialty care
The health care safety net in the United States is intended to fill gaps in health care services for uninsured and other vulnerable populations. This paper presents a case study of New Brunswick, NJ, a small city rich in safety net resources, to examine the adequacy of the American model of safety net care.
Medicare inpatient treatment for elderly non-dementia psychiatric illnesses 1992-2002; length of stay and expenditures by facility type
We summarize Medicare utilization and payment for inpatient treatment of non-dementia psychiatric illnesses (NDPI) among the elderly during 1992 and 2002. From 1992 to 2002, overall mean Medicare expenditures per elderly NDPI inpatient stay declined by $2,254 (in 2002 dollars) and covered days by 2.8.
Antidepressant treatment and adherence to combination antiretroviral therapy among patients with AIDS and diagnosed depression
Background: The prevalence of depression is elevated among HIV-infected individuals and there is evidence that depression exerts a negative impact on HIV medication adherence.
Hospitalization for psychiatric illness among community-dwelling elderly persons in 1992 and 2002
Objective: The authors evaluated the evolution of inpatient care for psychiatric illness in 1992 and 2002 for senior community-dwelling Medicare beneficiaries. Methods: National Medicare Provider Analysis and Review files for 1992 and 2002 were analyzed.
Self-medication practices of Spanish-speaking older adults in Hartford, Connecticut
The self-medication practices of Spanish-speaking older adults in Hartford, Connecticut, are documented. A previously validated English self-medication practices survey was systematically translated into Spanish, pilot tested, and verbally administered via face-to-face interviews to 100 Spanish-speaking participants. Participants were recruited from five senior congregate housing sites. Eligibility criteria were age 60 and over, diagnosis of hypertension and/or diabetes, and independent physical and cognitive functioning.
The impact of implementing a chronic care residency training initiative on asthma outcomes
PURPOSE: To examine the impact of a chronic care residency training intervention on continuity clinic patients’ asthma-related emergency department use and primary care residents’ application of key elements of the Chronic Care Model (CCM).
Transforming Doctor-Patient Relationships to Promote Patient-Centered Care: Lessons from Palliative Care
Palliative care was studied for its potential to yield lessons for transforming doctor-patient relationships to promote patient-centered care. Examination of patient and provider experiences of the transition from curative to palliative care promises valuable insights about establishing and maintaining trust as the goals of care shift and about addressing a broad spectrum of patient needs.
Results from the Nurse Manifest 2003 Study: Nurses’ perspectives on nursing
The purpose of this article is to raise awareness, inspire action, and open dialogue about professional values and workplace conditions. Results of the Nurse Manifest 2003 Study are presented through meta-synthesis of group summaries answering the questions: What is it like to practice nursing? and, What changes do nurses desire to support practice? The results illuminate the underlying framework of professional values that splits our profession, nursing units, and educational institutions. An analysis of the similarities and differences within and between groups reflect values which are rooted in the history of our profession and affected by present working conditions.
A survey of psychiatric residency directors on current priorities and preparation for public-sector care
Objective: This study assessed how resident psychiatrists are being prepared to deliver effective public-sector care. Methods: Ten leaders in psychiatric education and practice were interviewed about which tasks they consider to be essential for effective public-sector care. The leaders identified 16 tasks. Directors of all general psychiatry residency programs in the United States were then surveyed to determine how they rate the importance of these tasks for delivery of care and how their training program prepares residents to perform each task.
Provider behaviors contributing to patient self-management of chronic illness among underserved populations
Effective treatment of chronic illness requires active engagement of patients in managing their own conditions. This research explores the influence of provider support for self-management on patients’ performance of self-care activities, a widely presumed but under-studied relationship, particularly among underserved populations.
Community rating and sustainable individual health insurance markets in New Jersey
The 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…
Assessing Residents’ Competency in Care Management: Report of a Consensus Conference
Background: Residency programs must prepare physicians to practice in the current health care environment. This mandate is reflected in 3 of the 6 competency domains now required by the Accreditation Council for Graduate Medical Education: systems-based practice, interpersonal skills and communication, and practice-based learning and improvement.
Effect of Communications Training on Medical Student Performance
Context: Although physicians’ communication skills have been found to be related to clinical outcomes and patient satisfaction, teaching of communication skills has not been fully integrated into many medical school curricula or adequately evaluated with large-scale controlled trials.
Realizing the promise of breast cancer screening: Clinical follow-up after abnormal screening among Black women
Background. Delayed or incomplete follow-up after abnormal screening results may compromise the effectiveness of breast cancer screening programs, particularly in medically underserved and minority populations. This study examined the role of socioeconomic status, breast cancer risk factors, health care system barriers, and patient cognitive-attitudinal factors in the timing of diagnostic resolution after abnormal breast cancer screening exams among Black women receiving breast cancer screening at three New York city clinics.
Oxidized low-density lipoprotein augments and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors limit CD40 and CD40L expression in human vascular cells
Background – Although CD40 signaling participates in atherosclerosis, links between lipid risk factors and this inflammatory pathway remain obscure. Cardiovascular risk reduction by 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may involve actions beyond lipid lowering, including reduced inflammation. Therefore, this study analyzed whether oxidized low-density lipoprotein (oxLDL) induces CD40/CD40L expression on cells implicated in atherogenesis and whether statins affect their expression in vitro as well as the expression of soluble CD40L (sCD40L) in vivo.
Expression of neutrophil collagenase (matrix metalloproteinase-8) in human atheroma: A novel collagenolytic pathway suggested by transcriptional profiling
Background – Loss of interstitial collagen, particularly type I collagen, the major load-bearing molecule of atherosclerotic plaques, renders atheroma prone to rupture. Initiation of collagen breakdown requires interstitial collagenases, a matrix metalloproteinase (MMP) subfamily consisting of MMP-1, MMP-8, and MMP-13. Previous work demonstrated the overexpression of MMP-1 and MMP-13 in human atheroma. However, no study has yet evaluated the expression of MMP-8, known as “neutrophil collagenase,” the enzyme that preferentially degrades type I collagen, because granulocytes do not localize in plaques.