402 results match your criteria: "The Harvard Medical School[Affiliation]"
Med Care
November 2014
*Cambridge Health Alliance and the Harvard Medical School Center for Primary Care, Somerville, MA †Portneuf Health Care Foundation, Pocatello, ID.
Background: The transition of a primary care practice to a patient-centered medical home can be arduous. It requires time and resources from staff and leaders. Evidence to date suggests that not all medical homes are equally successful and that there is a substantial difference between the achievement of medical home recognition and meaningful transformation.
View Article and Find Full Text PDFAm J Public Health
October 2014
Mark McClelland is with the Office of Nursing Research and Innovation, Cleveland Clinic Health System, Cleveland, OH. Brent Asplin is with Catholic Health Partners, Cincinnati, OH. Stephen K. Epstein is with the Harvard Medical School Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Keith Eric Kocher is with the University of Michigan Department Of Emergency Medicine, Ann Arbor. Randy Pilgrim is with the Schumacher Group, Lafayette, LA. Jesse Pines is with the Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC. Elaine Rabin is with the Department of Emergency, Medicine Icahn School of Medicine at Mount Sinai, New York, NY. Niels Kumar Rathlev is with Tufts University School of Medicine, Baystate Medical Center, Boston.
The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage.
View Article and Find Full Text PDFHealth Aff (Millwood)
August 2014
Benjamin Lê Cook is a senior scientist and assistant professor of psychiatry at the Cambridge Health Alliance, in Somerville, and the Harvard Medical School, in Boston, both in Massachusetts.
The Affordable Care Act (ACA) required that insurers allow people ages 19-25 to remain as dependents on their parents' health insurance beginning in 2010. Using data from the 2008-12 National Survey of Drug Use and Health, we examined the impact of the ACA dependent coverage provision on people ages 18-25 with possible mental health or substance use disorders. We found that after implementation of the ACA provision, among people ages 18-25 with possible mental health disorders, mental health treatment increased by 5.
View Article and Find Full Text PDFSurgery
September 2014
Department of HPB & Transplant Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
Background: The lymph node (Ln) status of patients with resectable pancreatic ductal adenocarcinoma is an important predictor of survival. The survival benefit of extended lymphadenectomy during pancreatectomy is, however, disputed, and there is no true definition of the optimal extent of the lymphadenectomy. The aim of this study was to formulate a definition for standard lymphadenectomy during pancreatectomy.
View Article and Find Full Text PDFJ Biol Chem
August 2014
From the Whitehead Institute for Biomedical Research and Massachusetts Institute of Technology, Cambridge, Massachusetts 02142,
A number of toxins, including exotoxin A (PE) of Pseudomonas aeruginosa, kill cells by inhibiting protein synthesis. PE kills by ADP-ribosylation of the translation elongation factor 2, but many of the host factors required for entry, membrane translocation, and intracellular transport remain to be elucidated. A genome-wide genetic screen in human KBM7 cells was performed to uncover host factors used by PE, several of which were confirmed by CRISPR/Cas9-gene editing in a different cell type.
View Article and Find Full Text PDFJ Clin Psychopharmacol
October 2014
From the *Harvard Medical School, and †Harvard School of Public Health, Massachusetts General Hospital, Boston, MA.
Objective: Premature birth is associated with infant morbidity and mortality. Women with psychiatric disorders represent an at-risk population for premature delivery and other obstetrical complications. The primary aim of this study was to assess the association between omega-3 fatty acid use and length of gestation.
View Article and Find Full Text PDFThyroid
September 2014
1 Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and the Harvard Medical School, Boston, Massachusetts.
Background: There remain a small number of patients with papillary thyroid cancer (PTC) who suffer recurrence, metastases, or death. While mutation of the BRAF gene, corresponding to the constitutively active BRAF(V600E) protein, has been associated with worse clinical outcomes in thyroid cancer, the reasons underlying this observation are presently unknown. Disruption of endogenous host immune surveillance and promotion of tumor immune escape is one mechanism by which BRAF(V600E) tumors may achieve more aggressive behavior.
View Article and Find Full Text PDFJ Biol Chem
August 2014
From the Harvard Medical School, the Division of Hematology/Oncology, Boston Children's Hospital, the Department of Pediatric Oncology, Dana-Farber Cancer Institute, the Howard Hughes Medical Institute, Boston, Massachusetts 02115
The clustered regularly interspaced short [corrected] palindromic repeats (CRISPR)/CRISPR-associated (Cas) 9 nuclease system has provided a powerful tool for genome engineering. Double strand breaks may trigger nonhomologous end joining repair, leading to frameshift mutations, or homology-directed repair using an extrachromosomal template. Alternatively, genomic deletions may be produced by a pair of double strand breaks.
View Article and Find Full Text PDFAm Soc Clin Oncol Educ Book
November 2015
From the Harvard Medical School, Massachusetts General Hospital, Boston, MA.
The premise that all tumors are targetable has been met with some controversy in the approach to epithelial ovarian cancer (EOC). Genomic analysis shows that these tumors (specifically, high-grade serous carcinomas) are genomically unstable and lack actionable driver mutations, much like HER2 in breast and gastric cancers. In this paper, Michael Birrer, MD, PhD, Massachusetts General Hospital, argues that the interpretation of genomic data in ovarian cancer requires a more thoughtful approach that necessitates a closer inspection of the data beyond the mere presence or absence of mutations.
View Article and Find Full Text PDFAm J Public Health
July 2014
Idia B. Thurston is with the Department of Psychology, University of Memphis, Memphis, TN. Janan Dietrich, Kennedy N. Otwombe, Busiswe Nkala, and Glenda E. Gray are with the Perinatal HIV Research Unit, University of the Witwatersrand, Chris Hani Baragwanath Hospital, Johannesburg, South Africa. Laura M. Bogart is with Boston Children's Hospital and the Harvard Medical School, Boston, MA. Kathleen J. Sikkema is with the Department of Psychology and Neuroscience, Duke University, Durham, NC.
We explored psychosocial correlates of sexual risk among heterosexual and sexual minority youths (SMYs) in Johannesburg, South Africa. Young people 16 to 18 years old (n = 822) were administered surveys assessing demographic characteristics, sexual behaviors, mental health, and parent-child communication. Adjusted multivariate regressions examining correlates of sexual risk revealed that SMYs had more sexual partners than heterosexual youths (B = 3.
View Article and Find Full Text PDFTransplantation
November 2014
1 Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, MA. 2 Amgen, Inc., Thousand Oaks, CA. 3 Department of Medicine, University of California at Los Angeles, Los Angeles, CA. 4 Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH. 5 Address correspondence to: James R. Rodrigue, Ph.D., The Transplant Institute, Beth Israel Deaconess Medical Center, 110 Francis St., 7th Floor, Boston, MA 02215.
Background: Blacks receive live donor kidney transplant (LDKT) less often than patients of all other races. We evaluated the effectiveness of educational interventions in removing barriers to LDKT for blacks.
Methods: Patients were randomized to three interventions in which health educator(s) delivered an intervention to (a) the patient and his/her guests in the patient's home (house calls [HC], n=54), (b) clusters of patients and their guests in the transplant center (group based [GB], n=49), and (c) the individual patient alone in the transplant center (individual counseling [IC], n=49).
Obstet Gynecol
June 2014
Dr. Goldberg is from the Department of Obstetrics, Gynecology, and Reproductive Biology at the Harvard Medical School, the Division of Family Planning at Brigham and Women's Hospital, and Clinical Research and Training at the Planned Parenthood League of Massachusetts, Boston, Massachusetts; e-mail:
J Clin Lipidol
December 2014
University of Glasgow, Glasgow, UK.
Statin therapy reduces the risk of myocardial infarction, stroke, and cardiovascular death by 25% to 30% in primary as well as secondary prevention patients. Thus, statins are the pharmacologic therapy of choice for the management of high blood cholesterol levels. Prompted by examination of clinical trial data suggesting a modest, but statistically significant, increase in the incidence of new-onset type 2 diabetes mellitus with statin use, the US Food and Drug Administration in 2012 added a statement to the labels of statin medications indicating that increases in glycated hemoglobin (HbA1C) and fasting glucose levels have been reported with statin use.
View Article and Find Full Text PDFJ Adolesc Health
September 2014
Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; The Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Objective: Cancer risk behaviors often begin in adolescence and persist through adulthood. Tobacco use, indoor tanning, and physical inactivity are highly prevalent, socially patterned cancer risk behaviors, and their prevalence differs strongly by sex. It is therefore possible that these behaviors also differ by gender expression within the sexes due to social patterning.
View Article and Find Full Text PDFMethods Rep RTI Press
March 2013
Assistant professor in the Harvard Medical School Division of Sleep Medicine, an associate neuroscientist at Brigham and Women's Hospital (BWH), and director of the WFHN biomarker and actigraphy data coordinating center at BWH.
Recognizing a need for rigorous, experimental research to support the efforts of workplaces and policymakers in improving the health and wellbeing of employees and their families, the National Institutes of Health and the Centers for Disease Control and Prevention formed the Work, Family & Health Network (WFHN). The WFHN is implementing an innovative multisite study with a rigorous experimental design (adaptive randomization, control groups), comprehensive multilevel measures, a novel and theoretically based intervention targeting the psychosocial work environment, and translational activities. This paper describes challenges and benefits of designing a multilevel and transdisciplinary research network that includes an effectiveness study to assess intervention effects on employees, families, and managers; a daily diary study to examine effects on family functioning and daily stress; a process study to understand intervention implementation; and translational research to understand and inform diffusion of innovation.
View Article and Find Full Text PDFJ Vasc Surg
April 2014
Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital and the Harvard Medical School, Boston, Mass. Electronic address:
Virtual Mentor
December 2013
Chair of the Department of Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute and Brigham and Women's Hospital, co-director of the Harvard Medical School Center for Palliative Care, a professor of psychiatry and medicine at Harvard Medical School, and director of the End of Life Program at Harvard School of Public Health's Ariadne Labs in Boston.
Prog Transplant
December 2013
Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, Massachusetts.
Context: Knowing the prevalence and risk factors of immunosuppression nonadherence after liver transplant may help guide intervention development.
Objective: To examine whether sociodemographic and psychosocial variables before liver transplant are predictive of nonadherence after liver transplant.
Design: Structured telephone interviews were used to collect self-report immunosuppression adherence and health status information.
Context: Alcohol relapse after liver transplant heightens concern about recurrent disease, nonadherence to the immunosuppression regimen, and death.
Objectives: To develop a scoring system to stratify risk of alcohol relapse after liver transplant.
Design: Retrospective medical record review.
BJU Int
December 2014
Department of Medicine, Division of Hematology-Oncology, Massachusetts General Hospital and the Harvard Medical School, Boston, MA, USA.
Objective: To investigate the association of radiographic progression defined by Prostate Cancer Working Group (PCWG)-2 guidelines and overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC).
Patients And Methods: Two trials that used PCWG-2 guidelines to define progression were analysed: a randomized phase II trial (n = 221) comparing first-line docetaxel-prednisone plus AT-101 or placebo, and a phase III trial (n = 873) comparing prednisone plus sunitinib or placebo after docetaxel-based chemotherapy. Cox proportional hazards regression models were used to estimate the association of radiographic progression with OS.
Am Soc Clin Oncol Educ Book
November 2015
From the Harvard Medical School and Avon Breast Cancer Center of Excellence, Massachusetts General Hospital Cancer Center, Boston, MA; Center for Oncology, Hematology and Palliative Care, Vienna, Austria.
In recent years a growing amount of data on prognostic features of breast cancer has allowed for identification of tumors with a very low risk of recurrence. Markers used to predict the risk of distant spread include classic clinicopathologic features as well as newer tumor gene signatures, which have been validated and are being used in cohorts of patients with breast cancer patients who have low-risk disease. However, the definition of "low-risk" breast cancer requires consideration of patient-related factors such as comorbidities and age in addition to tumor characteristics, as high competing risks for mortality might be more important than cancer recurrence from a patient's point of view.
View Article and Find Full Text PDFTransplantation
March 2013
Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, MA, USA.
We show that HIV-infected waitlisted patients (n=33) had significantly lower knowledge (P<0.001), more concerns (P=0.01), and lower willingness to pursue live-donor kidney transplantation (LDKT; P=0.
View Article and Find Full Text PDFAnn Plast Surg
March 2014
From the *Harvard Medical School; †Department of Plastic and Oral Surgery, Children's Hospital Boston, Boston, MA; ‡Keck School of Medicine of the University of Southern California and Los Angeles County + University of Southern California Medical Center, Department of Surgery, Los Angeles, CA; and §Harvard School of Dental Medicine, Boston, MA.
"Value" has become a buzzword in current health-care discussions. This study demonstrates a provider-led strategy to measuring costs, an understudied component of the value equation, for a complex diagnosis for the purposes of improvement. A retrospective, microcosting methodology was used to measure costs for all hospital and physician services and costs to the patient over 18 months of multidisciplinary care for patients with cleft lip and palate.
View Article and Find Full Text PDFAnn Emerg Med
July 2012
Department of Emergency Medicine, Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, MA, USA.
The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to take specific and concrete actions to make this happen.
View Article and Find Full Text PDFN Engl J Med
January 2012
Department of Pediatrics, Children's Hospital, and the Harvard Medical School, Boston, USA.