The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection

Introduction: Dosing recommendations for paliperidone long-acting injectable antipsychotic (LAIA) do not include oral antipsychotic (OAP) overlap; however, OAPs are often given concurrently despite limited evidence describing both the risks and benefits of this practice. Methods: A retrospective chart review was conducted in patients initiated on paliperidone palmitate (PP) during a psychiatric hospitalization to compare patients who received OAP overlap versus those who did not. The primary outcome is the proportion of patients who receive prescription claims for benztropine, a medication commonly prescribed for extrapyramidal symptoms, at the time of LAIA discontinuation and 6 months postdischarge. Secondary outcomes include prescription claims for beta blockers and diphenhydramine, number of psychiatric emergency visits and hospitalizations, length of stay of the index hospitalization, frequency of LAIA discontinuation and the time to LAIA discontinuation. Results: There is a significant difference in the proportion of benztropine prescription claims in the OAP overlap group versus the no-overlap group at the time of LAIA discontinuation (30% vs 0%, P =.046) but not at 6 months postdischarge. There are also significant differences in the number of psychiatric emergency visits (0.7 vs 0.1, P =.02) and psychiatric hospitalizations (0.6 vs 0.1, P =.029) at the time of LAIA discontinuation. No other differences are observed in defined secondary outcomes. Discussion: Patients who receive OAP overlap while receiving PP receive more benztropine and have more psychiatric emergency visits and hospitalizations than those treated without OAP. Larger studies with better control for confounding variables are needed to confirm these results

The (Dis)similarity of a Minority Religion to Its Broader Religious Context: The Case of American Jews

While much research shows the relationship between individual-level variables, such as Jewish background, education, age, and income and an individual’s Jewish identity, very little research has systematically addressed the question of community context, either general or Jewish, as a factor influencing Jewish religious or ethnic identity. This lack of research has been partially a result of the lack of an adequate data set to facilitate such analysis. Using the newly-aggregated Decade 2000 data set, with its 19,800 cases spread across 22 Jewish communities, we find that despite the anecdotal evidence and the logic that suggests that environment impacts behavior, the environmental impact on Jewish identity is clearly weak. Individual characteristics are much stronger than community context in explaining variations in the strength of Jewish identity

The Relationship of Jewish Community Contexts and Jewish Identity: A 22-Community Study

This paper explores the manner in which Jewish community contexts relate to Jewish identity. We employ the Decade 2000 Data Set that contains almost 20,000 randomly selected Jewish households from 22 American Jewish communities interviewed from 2000 to 2010. Because of the large sample size, and its incorporation of community infrastructure data, this research also is able to examine various influences on Jewish identity that have not been definitively addressed in previous research, including the manner in which characteristics of Jewish community infrastructure are related to individuals’ Jewish identity. The Decade 2000 Data Set used for the analysis is described and some of the methodological considerations involved in its use are presented. Jewish identity is conceptualized as multidimensional, and a factor analysis results in four Jewish identity factors: a communal religious factor, a private religious factor, a broader ethnic factor, and a local ethnic factor. Multiple regressions for each of the Jewish identity factors are related to Jewish community characteristics; more commonly researched individual-level variables (Jewish background and connections, family status, socioeconomic status, demographic/geographic characteristics); and survey-level variables (such as size of sample and year of study) are also controlled. Surprisingly, except for the local ethnic factor, Jewish community characteristics have little relationship to individual Jewish identity. The contributions to a “sociology of Jewish place” and suggestions for further research are also discussed