72 results match your criteria: "Cambridge Health Alliance and Harvard Medical School[Affiliation]"

Background: Exposure to second-generation antipsychotics (SGAs) carries a risk of type 2 diabetes, but questions remain about the diabetogenic effects of SGAs.

Aims: To assess the diabetes risk associated with two frequently used SGAs.

Method: This was a retrospective cohort study of adults with schizophrenia, bipolar I disorder or severe major depressive disorder (MDD) exposed during 2008-2013 to continuous monotherapy with aripiprazole or olanzapine for up to 24 months, with no pre-period exposure to other antipsychotics.

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The dietary inflammatory index and cardiometabolic parameters in US firefighters.

Front Nutr

June 2024

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.

Introduction: Dietary choices play a crucial role in influencing systemic inflammation and the eventual development of cardiovascular diseases (CVD). The Dietary Inflammatory Index (DII®) is a novel tool designed to assess the inflammatory potential of one's diet. Firefighting, which is characterized by high-stress environments and elevated CVD risk, represents an interesting context for exploring the dietary inflammatory-CVD connection.

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Racial-Ethnic Disparities in Quality of Care Among Medicaid Beneficiaries With Schizophrenia.

Psychiatr Serv

October 2024

Department of Health Care Policy, Harvard Medical School, Boston (Normand, Zelevinsky, Abing); Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston (Normand); Office of Mental Health, New York State Department of Health, Albany (Finnerty, Leckman-Westin, Chen, Jeong); Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York (Leckman-Westin); RAND, Santa Monica, California (Tsuei), and Boston (Horvitz-Lennon); Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon).

Objective: The authors sought to update and expand the evidence on the quality of health care and disparities in care among Medicaid beneficiaries with schizophrenia.

Methods: Adult beneficiaries of New York State Medicaid with schizophrenia receiving care during 2016-2019 were identified. Composite quality scores were derived from item response theory models by using evidence-based indicators of the quality of mental and general medical health care.

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Financing the "Village": Establishing a Sustainable Financial System for Child Behavioral Health.

Child Adolesc Psychiatr Clin N Am

July 2024

RAND Corporation, 20 Park Plaza, Suite 910, Boston, MA 02116, USA; Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA, USA.

An increased need for child and adolescent behavioral health services compounded by a long-standing professional workforce shortage frames our discussion on how behavioral health services can be sustainably delivered and financed. This article provides an overview of different payment models, such as traditional fee-for-service and alternatives like provider salary, global payments, and pay for performance models. It discusses the advantages and drawbacks of each model, emphasizing the need to transition toward value-based care to improve health care quality and control costs.

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The schizophrenia syndrome, circa 2024: What we know and how that informs its nature.

Schizophr Res

February 2024

Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America.

With new data about different aspects of schizophrenia being continually generated, it becomes necessary to periodically revisit exactly what we know. Along with a need to review what we currently know about schizophrenia, there is an equal imperative to evaluate the construct itself. With these objectives, we undertook an iterative, multi-phase process involving fifty international experts in the field, with each step building on learnings from the prior one.

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Background: Individuals with schizophrenia exposed to second-generation antipsychotics (SGA) have an increased risk for diabetes, with aripiprazole purportedly a safer drug. Less is known about the drugs' mortality risk or whether serious mental illness (SMI) diagnosis or race/ethnicity modify these effects.

Methods: Authors created a retrospective cohort of non-elderly adults with SMI initiating monotherapy with an SGA (olanzapine, quetiapine, risperidone, and ziprasidone, aripiprazole) or haloperidol during 2008-2013.

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In this article, the authors provide their response to the Association for Behavior Analysis International (2022) position statement on the use of contingent electric skin shock (CESS). In this response, we address concerns raised by the task force regarding limitations of the Zarcone et al. (2020) review article in which both methodological and ethical concerns were raised about the quality of research in the use of CESS with people with disabilities in the treatment of challenging behavior.

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COVID-19 has had a disproportionate impact on the most disadvantaged members of society, including minorities and those with disabling chronic illnesses such as schizophrenia. We examined the pandemic's impacts among New York State's Medicaid beneficiaries with schizophrenia in the immediate post-pandemic surge period, with a focus on equity of access to critical healthcare. We compared changes in utilization of key behavioral health outpatient services and inpatient services for life-threatening conditions between the pre-pandemic and surge periods for White and non-White beneficiaries.

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WITHDRAWN: Non-Anti-TNF Biologics as Salvage Therapy for Refractory Acute Severe Ulcerative Colitis, A Systematic Review.

Curr Rev Clin Exp Pharmacol

February 2023

Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Unlabelled: Since the authors are not responding to the editor’s requests to fulfill the editorial requirement, therefore, the article has been withdrawn. Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused. The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.

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Research on schizophrenia has been pursued for over a century. While the ability to view the brain and also the entire human genome advanced dramatically during this time and particularly in recent years, it is still unclear whether these advances helped to understand the nature of schizophrenia. What appears, however, to be the case is that early detection and treatment of people who are at high risk for developing schizophrenia due to various clinical signs, lead to better outcomes and recovery in many cases.

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Article Synopsis
  • This systematic review and meta-analysis assessed the effectiveness and safety of biologic therapies for patients with steroid-refractory microscopic colitis (MC).
  • A total of 376 studies were screened, resulting in 13 articles focused on 78 patients, showing remission rates of approximately 66% at 3-6 weeks and 54% at 12-16 weeks, with a 100% clinical response rate initially but a drop to around 67% later on.
  • The study found a significant incidence of medication discontinuation (16.1%) as the most common adverse event, and concluded that while there is low-quality evidence supporting the short-term use of biologics, more rigorous research is needed to clarify their long-term efficacy
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Objective: Ulcerative mucositis (UM) is a devastating complication of most cancer therapies with less recognized risk factors. Whilst risk predictions are most vital in adverse events, we utilized Machine learning (ML) approaches for predicting chemotherapy-induced UM.

Methods: We utilized 2017 National Inpatient Sample database to identify discharges with antineoplastic chemotherapy-induced UM among those received chemotherapy as part of their cancer treatment.

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Background: Physicians often receive lower payments for dual-eligible Medicare-Medicaid beneficiaries versus nondual Medicare beneficiaries because of state reimbursement caps. The Affordable Care Act (ACA) primary care fee bump temporarily eliminated this differential in 2013-2014.

Objective: To examine how dual payment policy impacts primary care physicians' (PCP) acceptance of duals.

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Background: Age greater than 65 years is a well-defined risk factor for increased mortality in patients with non-variceal upper gastrointestinal bleeding (NVGIB). Endoscopy is indicated in most patients at any age but presents unique risks in the elderly cohort, and ideal timing is unclear. This study examined the association between outcomes and early (within 24 h) esophagogastroduodenoscopy (EGD) among elderly patients with NVGIB.

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Background: Obesity is the fifth leading risk factor for mortality in the world and it has increased among patients with ulcerative colitis in recent years. We examined the impact of obesity on the hospitalized patients admitted primarily with a diagnosis of ulcerative colitis.

Methods: We used the National Inpatient Sample data for the year 2016 to identify patients with ulcerative colitis and compared obese and non-obese patients in terms of length of hospital stay, total charges, and mortality.

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Importance: Medicare has historically imposed higher beneficiary coinsurance for behavioral health services than for medical and surgical care but gradually introduced parity between 2009 and 2014. Although Medicare insures many people with serious mental illness (SMI), there is limited information on the impact of coinsurance parity in this population.

Objective: To examine the association between coinsurance parity and outpatient behavioral health care use among low-income beneficiaries with SMI.

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During the COVID-19 pandemic, rural Appalachia is at great risk of unforeseen side effects including increased mortality from substance use disorders (SUDs). People living with SUDs are at increased risk for both exposure to and poor outcomes from COVID infection. The economic impacts of COVID-19 must also be considered.

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Mental Health Policy in the Era of COVID-19.

Psychiatr Serv

November 2020

Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon).

The response to the global COVID-19 pandemic has important ramifications for mental health systems and the patients they serve. This article describes significant changes in mental health policy prompted by the COVID-19 crisis across five major areas: legislation, regulation, financing, accountability, and workforce development. Special considerations for mental health policy are discussed, including social determinants of health, innovative technologies, and research and evaluation.

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