Medicine and Health Sciences Commons^™

Drug Firms, The Codification Of Diagnostic Categories, And Bias In Clinical Guidelines, Lisa Cosgrove, Emily E. Wheeler

Counseling and School Psychology Faculty Publication Series

The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-of-interest model, we use the conceptual and normative framework of institutional corruption to examine how organized psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of …

Conflicts Of Interest And The Quality Of Recommendations In Clinical Guidelines, Lisa Cosgrove, Allen F. Shaughnessy, Deborah R. Erlich, Emily E. Wheeler, Harold J. Bursztajn

Counseling and School Psychology Faculty Publication Series

Background: There is increasing concern that conflicts of interest affect the development process of clinical practice guidelines. We evaluated The American Psychiatric Association's Practice Guideline for the Treatment of Patients with Major Depressive Disorder to determine the existence of financial and intellectual conflicts of interest and examine their possible effects. We selected this guideline because of its influence on clinical practice and because this guideline recommends pharmacotherapy for all levels of depression, despite controversies over the evidence base.

Methods and Findings: We determined the number and type of financial conflicts of interest for members of the guideline development group as …

Service Provider Promising Practice: New England Business Associates (Massachusetts) - Everyone Is Job-Ready, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

New England Business Associates (NEBA), a community rehabilitation provider in Springfield, Massachusetts, provides individualized employment services to local youth and adults with intellectual and developmental disabilities. This organization sets itself apart from other employment providers in many ways, from its appearance, to the attitudes of its staff, to the manner in which it provides services.

Service Provider Promising Practice: Kfi In Maine - Making Mission-Driven Choices About Funding And Service Innovation, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Katahdin Friends, Inc. (KFI), headquartered in the small rural community of Millinocket, Maine, has been a service provider in this community and surrounding regions for the last 54 years. After providing segregated services for its first 20 years, KFI became an early adopter of supported employment. In the 1980s, staff members started attending conferences to learn about better, cheaper ways to serve their customers. They were profoundly influenced by the integration approach to community and employment support espoused by other innovative service providers across the country

Finding Solutions To Institutional Corruption: Lessons From Cognitive Dissonance Theory, Lisa Cosgrove, Robert Whitaker

Counseling and School Psychology Faculty Publication Series

The American Psychiatric Association and academic psychiatry in the United States have two conflicts of interest that may affect their assessment of psychiatric drugs and their development of diagnostic and clinical care guidelines: payments from pharmaceutical companies and guild interests. Until recently, the proposed solution to industry-academic relationships has been transparency. However, cognitive dissonance research reveals that disclosure is not a solution because cognitive biases are commonplace and difficult to eradicate. Indeed, bias is most often manifest in subtle ways unbeknownst to the researcher or clinician, and thus is usually implicit and unintentional. Also, recent studies suggest that disclosure of …

Tamziq, Scattered And Connected: A Conversation In Art By Middle Eastern And American Artists, Paul Atwood, William Joiner Center For The Study Of War And Social Consequences, University Of Massachusetts Boston

Office of Community Partnerships Posters

The number of Iraqi refugees resettled in the United States has grown from only 202 in 2006 to approximately 17,000 in 2009. Since 2007, 58,810 Iraqi refugees have arrived in the United States. This group now forms the largest refugee population in the state of Massachusetts. At the same time, a large number of veterans are returning from Iraq and Afghanistan.

This project recognizes the increasing need for dialogue and exchange with and within these communities and a further need to broaden understanding of the cultural influences on our changing communities.

Planning For The Growing Older Population: Conducting Community Needs Assessments, Caitlin Coyle, Hayley Gravette, Jan Mutchler, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

Goals and Objectives: To describe the aging population of each community; To investigate the needs, interests and opinions of mature residents relating to their aging needs for age-related services in their respective communities; To provide recommendations to community partners and their stakeholders about how to create strong communities for older adults, based on needs assessment results; Generate reports and other documents to be used by the Department of Elder Services, other town offices, organizations that provide services, advocates, and community members.

Gokids Boston Youth Fitness, Training, And Research Center, Gokids Boston, University Of Massachusetts Boston

Office of Community Partnerships Posters

GoKids Boston embodies innovation and leadership in youth health through life-changing programs, groundbreaking research, exceptional training opportunities, and dedication to the community with a focus on eliminating health disparities.

Healthy Aging In Massachusetts: Reporting Indicators, Identifying Resources & Activating Allies, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Chae Man Lee, Kristina Turk

Office of Community Partnerships Posters

In Massachusetts, a Healthy Aging Collaborative comprised of a diverse group of stakeholders has been formed for multiple purposes: information sharing around healthy aging, idea generation, partnership building and activity mapping.

Cruza: The Alliance For Latino Health Through Faith And Action, A Umass Boston - Dana-Farber/Harvard Cancer Center Partnership For Community-Based Research, Gaston Institute, University Of Massachusetts Boston, Dana-Farber/Harvard Cancer Center

Office of Community Partnerships Posters

CRUZA is a community-based participatory research partnership aimed at shifting the focus from intervention delivery on an individual level to a focus on enhancing the capacity of community organizations. CRUZA intends to activate collective resources to translate scientific evidence into strategies that increase cancer screening among Latinos in Massachusetts.

The Gastón Institute’S Partnership With The Puerto Rican Cultural Center In Springfield, Ma, Gaston Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

No abstract provided.

Community Research Advisory Board Incorporated: Where The Community And Researchers Meet, Horizon Center, University Of Massachusetts Boston

Office of Community Partnerships Posters

CRAB is an incorporated Community Research Advisory Board that serves as a bridge to connect Roxbury residents and other inner Boston neighborhoods to research institutions in a mutually beneficial effort. These efforts increase knowledge and promote understanding about how community-based participatory research (CBPR) can help eliminate disparities in health and health care, thereby improving the health and well-being of people of color. CBPR is a collaborative approach to research, in which the research topic is a priority identified by the community. All partners and stakeholders contribute unique strengths and knowledge, and are involved equitably throughout the process.

Mirebalais, Haiti Planning Initiative, Jack Wiggin, Urban Harbors Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

The Mirebalais Planning Initiative (MPI), a joint project of the Urban Harbors Institute at UMass Boston, Boston University, and the University of the West Indies, is funded by the W.K. Kellogg Foundation. The initiative is a community-based participatory planning process designed to expand community leadership and decision-making capacity among community members in Mirebalais, Haiti.

Mobilizing Undergraduates To Address The Social Determinants Of Health In The Community: Year 1 Of Health Leads At Umass Boston, Luciano Ramos, Sherrod Williams, Adrienne Wald, Mark Marino

Office of Community Partnerships Posters

Health Leads, a national non-profit organization, currently operates in six cities. Following successful partnerships with Harvard University and Boston University, Health Leads Boston initiated a partnership with UMass Boston in the Fall of 2012 to mobilize undergraduate students in addressing the social determinants of health for patients at Codman Square Health Center (CSHC). 16 undergraduates at UMass Boston were selected into the Health Leads program at CSHC, joining 17 students from Harvard and 4 students from BU. In 6 months, Health Leads at CSHC served 337 families, with students reporting positive experiences. Further expansion of Health Leads at UMB is …

Lift Up Your Voice! Health Care Advocacy Training Program: Empowering Older Adults, Nina M. Silverstein, Alison Gottlieb, Kelli Barton, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

Lift Up Your Voice! (LUYV) is a health care advocacy training program developed by Community Catalyst and funded through Atlantic Philanthropies. LUYV directly engages older adults with chronic disease in state-based Campaign for Better Care initiatives to achieve changes in the health care delivery system.

Leadership Education In Neurodevelopmental Disabilities (Lend) - Partnership With Community-Based Organizations (Cbos), Institute For Community Inclusion, University Of Massachusetts Boston

Office of Community Partnerships Posters

Interdisciplinary Leadership Education in Neurodevelopmental Disabilities (LEND), a Maternal and Child Bureau (MCHB)-funded program providing long-term, graduate level training to health professionals and family members.

Awareness, Treatment And Control Of Hypertension In Kenya, Jacob Kariuki, Eileen M. Stuart-Shor, Samuel Kimani, James Muchira, Jessica Demita, Heather Milton, Mercy Kamau, Vincent Mutuma, Darren Golden, Peris Kariuki

Office of Community Partnerships Posters

The emerging epidemic of hypertension (HTN) in sub-Saharan Africa is predicted to worsen. Uncontrolled HTN is associated with CVD, high morbidity and premature mortality; hence early detection, treatment and control of HTN is critical to reduction of the associated sequelae. The study was guided by the Social Ecological Model and principles of Community Based Participatory Research.

Global Risk Assessment Of Cardiovascular Disease In Resource Constrained Settings, Jacob Kariuki, Eileen M. Stuart-Shor, Libin Zhang, Annya Volkova, Jaime Halliday, Shannon Sayer, Jessica Demita, Darren Golden, James Muchira, Samuel Kimani, Faith Maina

Office of Community Partnerships Posters

Cardiovascular disease (CVD) is an emerging problem in Sub-Saharan Africa. Many current guidelines recommend using global risk assessment (GRA) to quantify the risk for developing CVD and to guide treatment and policy. Most GRA tools require lipid measures which are not readily available in resource-constrained settings. Of the 3 most published non-laboratory based tools: Gaziano and Framingham substitute BMI for cholesterol; WHO does not include BMI or cholesterol.

Community Built Environment And Multilevel Social Determinants Of Obesity: Evidence From China Health And Nutrition Survey, Libin Zhang, Tim F. Liao, Laura L. Hayman

Office of Community Partnerships Posters

The prevalence of overweight and obesity is highest in wealthy countries like the United States, but is rapidly increasing in less developed countries. From 1992 to 2002, China had an increase from 14.6% to 21.8% in overweight and obesity. Social determinants of obesity in developing countries remain poorly understood. Further, these associations may vary by community built environment (BE) of developing countries.

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi A. Wright, Heather Stieglitz, Yankel M. Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid T. Katz, Francisco Munoz, Rachel B. Jimenez, Jan Mutchler, Lorna Rivera, Anthony L. Back, Holly G. Prigerson

Women’s and Gender Studies Faculty Publication Series

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

Warum Gesunde Menchen Immer Häufiger Fur Psychisch Krank Erklärt Werden, Lisa Cosgrove

Counseling and School Psychology Faculty Publication Series

zuerst einmal nicht schaden": Das ist der wohl wichtigste Grundsatz der Medizin. Aber diese Mission droht durch den Einfluss großer Pharmafirmen unterhöhlt zu werden. Der Vorwurf einer Verstrickung von Ärzten und Arzneimittelherstellern ist schon in fast allen medizinischen Fachrichtungen aufgekommen. Vor allem aber die Psychiatrie steckt in einer Glaubwürdigkeitskrise. Das zeigt sich in der aktuellen Debatte um die neue Auflage des "Diagnostischen und Statistischen Manual Psychischer Störungen" (DSM).

Dieses von der US-Psychiater-Vereinigung APA herausgegebene Handbuch definiert, was eine psychische Erkrankung ist. Die Bedeutung dieser Wertung geht weit über die USA hinaus - das Handbuch nimmt oft Definitionen der Weltgesundheitsorganisation vorweg. …

Industry’S Colonization Of Psychiatry: Ethical And Practical Implications Of Financial Conflicts Of Interest In The Dsm-5, Lisa Cosgrove, Emily E. Wheeler

Counseling and School Psychology Faculty Publication Series

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and …

A Healthier Bottom Line: Distilling Best Practices In Corporate Wellness, Mark Auriemma, Cfa, Angela Cassidy, Kelly Dougherty, Despina Garalis, Pharmd, Rph, Judith Pelletier, Jennifer Springer

Emerging Leaders Program Team Projects

The Massachusetts Business Roundtable (MBR) collaborated with a team from the Emerging Leaders Program (ELP) from the University of Massachusetts Boston to explore ways to control health care costs. One strategy being implemented by employers to control health care costs is through “wellness programs,” employer-sponsored efforts to improve the health of employees. Members of the Massachusetts Business Roundtable (MBR) and other large employers have had success in reducing their health care costs through the implementation of corporate wellness initiatives. The purpose of this paper is to define what is working in private sector wellness programs to determine whether there is …

The American Public’S Perception Of Illegal Steroid Use: A National Survey, 2013, Gary Siperstein, Neil Romano, Gizem Iskenderoglu, Anthony Roman, Floyd J. Fowler Jr., Max Drascher

Center for Social Development and Education Publications

Through the surge of news about doping scandals in the media, it is expected that the public is aware of the magnitude of the problem among professional athletes; however, it is uncertain whether the public is aware that the problem often starts when athletes are younger. To this end, the National Baseball Hall of Fame and Museum, the Taylor Hooton Foundation, and the Professional Baseball Athletic Trainers Society partnered with the Center for Social Development and Education and the Center for Survey Research at the University of Massachusetts Boston to conduct the most comprehensive national opinion survey to date to …

Predictors Of Accessing Substance Abuse Services Among Individuals With Mental Disorders Released From Correctional Custody, Stephanie Hartwell, Xiaogang Deng, William Fisher, Julianne Siegfriedt, Kristen Roy-Bujnowski, Craig Johnson, Carl Fulwiler

Sociology Faculty Publication Series

Objective

In the context of an increasing correctional population and corresponding rates of mental illness and substance abuse among this population, this study focuses on describing the predictors of substance abuse service utilization for ex-inmates with dual disorders. Our aim is to assess the likelihood and characteristics of ex-inmates with mental disorders who access substance abuse treatment services within two years of correctional release.

Methods

Using merged administrative data on all ex-inmates with open mental health cases released from Massachusetts Department of Corrections and two County Houses of Corrections from 2007 to 2009 (N=2,280) and substance abuse treatment outcome data …

Cultural Competency In Health Care: Framework, Training And Evaluation - A Review Of The Literature, Diana Salas Coronado

Center for Social Policy Publications

Healthcare professionals are now more aware of the challenges they face when providing healthcare services to a culturally and racially diverse population. Cultural competency has emerged as a framework for understanding health disparities among racial and ethnic groups in particular, but also for women, the elderly, sexual orientation and gender identity, people with disabilities, and religious minorities. Although there are several definitions of cultural competency, each emphasizes the need for healthcare systems and providers to be aware of and responsive to patients’ cultural perspectives and backgrounds. One example defines cultural competency as “a set of congruent behaviors, attitudes, and policies …

Data Note: People Served In Community Mental Health Programs And Employment, Stephanie Wallace, Frank A. Smith

Data Note Series, Institute for Community Inclusion

State mental health agencies provide a wide range of supports, including rehabilitation services and vocational and pre-vocational training, as well as supported and competitive employment supports. This Data Note explores how states vary in number and percentage of individuals who are employed among those served in Community Mental Health Programs (CMHPs), i.e., programs with all services provided in the community, rather than in an inpatient setting. It also explores national trends that occurred from 2002 to 2011.

Data Note: State Trends In The Vocational Rehabilitation Engagement Of Young Adults With Intellectual Disabilities: 2002-2011, Alberto Migliore, Jean E. Winsor

Data Note Series, Institute for Community Inclusion

Experiencing paid employment during and immediately after high school is a critical step on the path toward economic self-sufficiency in adulthood. Young adults with disabilities interested in gaining employment experiences may seek support from vocational rehabilitation (VR) programs. In this Data Note, we examine the extent to which young adults with intellectual disabilities engage with their state VR programs.

One way for assessing young adult engagement is to look at the number of them who exit the program, which implies that they either applied or were referred to the program. Specifically, we examined the average number of young adults 16 …

Data Note: Shifts In Vr Outcome Trends For Vr Customers With And Without Intellectual Disabilities, Frank A. Smith

Data Note Series, Institute for Community Inclusion

People with intellectual disabilities (ID) aspire to gainful employment1. To assist them with this goal, state vocational rehabilitation (VR) agencies offer employment services based upon Individualized Plans for Employment (IPEs). A commonly used measure of outcomes is the rehabilitation rate, defined as the percentage of individuals exiting the program who have achieved an employment outcome after receiving services with an IPE. This indicator does not consider that not all eligible consumers progress to receive services after an IPE is developed. This occurs for a variety of individual, service, and systems reasons. Reviewing data for eligible consumers who do not receive …