Behavioral Health Service Use and Expenditures in Massachusetts Medicare and Medicaid Members Aged 55 and Over, 2005

Summary: This report describes behavioral health service use and expenditures for Massachusetts Medicare and Medicaid (MassHealth) members aged 55 and over with behavioral health disorders (BHDs) in calendar year 2005. With an expected increase in the number of elders with BHDs, a better and more comprehensive understanding of behavioral health service delivery is essential in order to identify opportunities for systematic changes that can improve behavioral health services for elders. However, older adults have not been the main focus of previous studies on behavioral health services and expenditures. Furthermore, although existing studies have examined behavioral health services and expenditures in broad geographic areas and at the national level, few studies have taken into account variations among health insurance coverage, particularly Medicare and Medicaid which are important resources for elders and for people with disabilities

Twelve-Month Diagnosed Prevalence of Mental Illness, Substance Use Disorders, and Medical Comorbidity in Massachusetts Medicare and Medicaid Members Aged 55 and Over, 2005

This report describes the 12-month diagnosed prevalence of behavioral health disorders (BHDs) among Massachusetts Medicare and Medicaid (MassHealth) members 55 years of age and older during calendar year 2005. Although population-based estimates of prevalence of BHDs among the elderly are available in only a few selected studies, none of them describe Massachusetts. With an expected rise in the number of elderly people with psychiatric disorders, a better understanding of the prevalence of mental illness and addictions in this population is needed to plan for services and supports

On Campus Video, featuring Kimberlin Pate and Ian O\u27Connell, two members of Up With People.

A videorecording of an interview with Kimberlin Pate and Ian O\u27Connell, two members of Up With People, conducted by Dr. Gary McCaleb of Abilene Christian University

Ohio Federal Military Jobs Commission Report

APRI staff provided research support to the Ohio Federal Military Jobs Commission as they met and developed their final report on strengthening the state\u27s federal military jobs sector. APRI primarily provided research and authorship for Chapter 3 of the report, titled Expand Small Business Federal Contracting. Chapter 3 discusses the strategy to enhance communication and collaboration among State entities in order to create statewide response to the federal initiatives that make contracts available to small business and veteran-owned businesses. Placing Small Business Development Centers and Procurement Technical Assistance Centers on a common information technology netowrk and educating small businesses on how to do work for the federal government can help accomplish the Commission\u27s strategy. Chapter 3 also includes a recommendation for a state-level matching opportunity for Small Business Innovation Research.https://corescholar.libraries.wright.edu/apri_defpol/1004/thumbnail.jp

Critical Analysis of a Doxycycline Treatment Trial of Rhesus Macaques Infected with Borrelia burgdorferi

A critical analysis was conducted of a doxycycline treatment trial of Indian rhesus macaques. In this treatment trial, the investigators attempted to infect the primates with Borrelia burgdorferi sensu stricto by at least 10 tick bites from artificially infected ticks. None of the primates became ill; nevertheless, 5 primates were treated with a 28-day course of oral doxycycline. In contrast to the conclusions of the authors, the data did not convincingly document the existence of viable B. burgdorferi in antibiotic-treated primates. The investigators were unable to cultivate the spirochete from any animal after treatment using highly sensitive in vitro methods. Like many prior animal studies, the current study also did not document that the doxycycline exposure in these animals was similar to that expected in humans. Numerous additional methodologic problems are discussed

Life-long dietary restrictions have negligible or damaging effects on late-life cognitive performance: A key role for genetics in outcomes.

Several studies report that caloric restriction (CR) or intermittent fasting (IF) can improve cognition, while others report limited or no cognitive benefits. Here, we compare the effects of 20% CR, 40% CR, 1-day IF, and 2-day IF feeding paradigms to ad libitum controls on Y-maze working memory (WM) and contextual fear memory (CFM) in a large population of Diversity Outbred mice that model the genetic diversity of humans. While CR and IF interventions improve lifespan, we observed no enhancement of working memory or CFM in mice on these feeding paradigms, and report 40% CR to be damaging to recall of CFM. Using Quantitative Trait Loci mapping, we identified the gene Slc16a7 to be associated with CFM outcomes in aged mice on lifespan promoting feeding paradigms. Limited utility of dieting and fasting on memory in mice that recapitulate genetic diversity in the human population highlights the need for anti-aging therapeutics that promote cognitive function, with the neuronal monocarboxylate transporter MCT2 encoded by Slc16a7 highlighted as novel target

Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia

OBJECTIVE: To evaluate the efficacy of triple-lumen central venous catheters coated with a combination product of chlorhexidine and silver sulfadiazine (CSS) in reducing the incidence of local catheter infection and catheter-related bacteremia. DESIGN: Randomized, controlled trial. SETTING: The surgical intensive care units in a university hospital. PATIENTS: All patients who needed central venous catheterization were randomized to receive either an uncoated triple-lumen catheter (n = 157) or a catheter coated with CSS (n = 151). MAIN OUTCOME MEASURE: Catheters were removed when no longer needed or suspected as a cause of infection. The tip and a 5-cm segment of the intradermal portion of the catheter were cultured semiquantitatively. Blood cultures were obtained when clinically indicated. The remaining segment of catheters coated with CSS were cut and incubated on an agar plate with strains of Staphylococcus aureus and Enterococcus. Zone of inhibition was determined 24 hours later. Data were analyzed by survival and logistic multivariate regression methods. RESULTS: Catheters coated with CSS were effective in reducing the rate of significant bacterial growth on either the tip or intradermal segment (40%) compared with control catheters (52%; P = .04). However, there was no difference in the incidence of catheter-related bacteremia (3.8% [uncoated] vs 3.3% [coated]; P = .81). In vitro activity of catheters with CSS against S aureus was evident up to 25 days but activity against Enterococcus dissipated more quickly over time and was absent by day 4. The most common colonizing organisms were coagulase-negative staphylococcus and enterococcus. Variables that were associated with a significant amount of growth on the tip or intradermal segment were a duration of catheterization of longer than 7 days, jugular insertion site, and the absence of a CSS coating. The use of a guidewire when the catheter was removed was associated with a lower risk of significant bacterial growth. CONCLUSIONS: The use of CSS reduces the incidence of significant bacterial growth on either the tip or intradermal segments of coated triple-lumen catheters but has no effect on the incidence of catheter-related bacteremia. In this patient population, catheters coated with CSS provide no additional benefit over uncoated catheters

Splenic Dysfunction From Celiac Disease Resulting in Severe Babesiosis

We describe a 79-year-old Irish man who, because he had hyposplenism and splenic atrophy due to adult celiac disease, became critically ill from a severe Babesia divergens infection. Greater awareness of the possible consequences of splenic dysfunction from adult celiac disease, such as serious pneumococcal infections and babesiosis, is warranted

Enhanced fracture repair by leukotriene antagonism is characterized by increased chondrocyte proliferation and early bone formation: a novel role of the cysteinyl LT-1 receptor

Inflammatory mediators and drugs which affect inflammation can influence the healing of injured tissues. Leukotrienes are potent inflammatory mediators, and similar to prostaglandins, are metabolites of arachidonic acid which can have positive or negative effects on bone and cartilage tissues. Here we tested the hypothesis that blocking the negative regulation of leukotrienes, would lead to enhanced endochondral bone formation during fracture repair. A closed femoral fracture was created in mice. Animals were divided into three groups for treatment with either montelukast sodium, a cysteinyl leukotriene type 1 receptor antagonist (trade name Singulair), zileuton, a 5-lipoxygenase enzyme inhibitor (trade name Zyflo), or carrier alone. The fractures were analyzed using radiographs, quantitative gene expression, histology and histomorphometry, and immunohistochemistry. Both the montelukast sodium group and the zileuton group exhibited enhanced fracture repair when compared with controls. Both treatment groups exhibited increased callous size and earlier bone formation when compared to controls as early as day 7. Gene expression analysis of treatment groups showed increased markers of chondrocyte proliferation and differentiation, and increased early bone formation markers when compared with controls. Treatment with montelukast sodium directly targeted the cysteinyl leukotriene type 1 receptor, leading to increased chondrocyte proliferation at early time points. These novel findings suggests a potential mechanism by which the cysteinyl leukotriene type 1 receptor acts as a negative regulator of chondrocyte proliferation, with important and previously unrecognized implications for both fracture repair, and in a broader context, systemic chondrocyte growth and differentiation

New Challenges in Psycho-Oncology Research III: A systematic review of psychological interventions for prostate cancer survivors and their partners: clinical and research implications

[Extract] The medical and social context of prostate cancer (PCa) has changed dramatically since the introduction of PSA testing for early detection in the late 1980s,¹ leading to a peak in incidence in the developed world in the 1990s and again a decade later.² Since that time, novel PCa treatments have rapidly emerged in the radiation and medical oncology field, as well as surgical advances.³ The recent emergence of active surveillance for low-risk disease has further expanded possible treatment approaches.⁴ Market forces from consumers, clinicians, and the therapeutic industry have driven changes in clinical and surgical management and treatment; however, psycho-oncological research and survivorship care arguably has lagged behind. Specifically, although men are surviving longer, they may not be surviving well. In 2012, there were over 1.1 million incident cases of PCa diagnosed and more than 300 000 deaths worldwide.⁵ Five-year prevalence estimates suggest that there are over 3.8 million PCa survivors globally⁶ with this expected to increase rapidly in future.⁷ The challenges we face in meeting the needs of these men and their families into the future are vast