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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Boston Globe Health and Science staff:
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Monday, November 5, 2007

Screening shows 1 in 7 teens might have substance abuse problem

About 1 in 7 teenagers in Massachusetts and Vermont might have a substance abuse problem, according to screening questionnaires filled out during routine doctors’ visits, a study has found. The adolescents' answers were more likely to indicate a problem during an appointment when they were sick or injured than when they were having a checkup.

“Substance abuse screening should occur whenever the opportunity arises, not at well-child care visits only,” wrote Dr. John R. Knight of Children’s Hospital Boston, lead author of the study in this month’s Archives of Pediatrics & Adolescent Medicine.

Researchers from Children’s, Tufts-New England Medical Center, Cambridge Health Alliance, the University of Vermont and Fallon Clinic in Worcester asked more than 2,000 12- to 18-year-old patients to answer six questions: five about using alcohol or other drugs and one about engaging in risky behaviors, such as riding in a car with someone who was impaired. Two 'yes' answers meant the teen screened positive for substance abuse.

Overall, 14.8 percent of patients said yes to at least two of the six questions. The most positive responses to the questions came in school-based health centers, at just under 30 percent of patients, followed by rural family practices, at about 25 percent. At sick visits, 23.2 percent of the screenings were positive, compared with 11.4 percent of well visits.

Positive screenings do not establish a diagnosis, the authors write, but they do require follow-up. Noting that sick visits are generally allotted less time than well visits, they suggest healthcare providers be trained in how to help patients who test positive by either offering brief advice or referring them for counseling or treatment.

Posted by Elizabeth Cooney at 05:41 PM

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Tuesday, October 30, 2007

One in eight veterans under 65 is uninsured, study finds

By Elizabeth Cooney, Globe Correspondent

Most Americans might think that veterans automatically have healthcare from the government, but one in eight working-age veterans is uninsured, a study from Cambridge Health Alliance reports.

Healthcare at Veterans Health Administration hospitals and clinics is limited to veterans who have service-related conditions or who have incomes of less than about $30,000 a year, depending on where they live. That leaves many middle-income veterans under 65 without coverage of any kind, mirroring the situation of other uninsured groups, Dr. Steffie Woolhandler, author of the study in the American Journal of Public Health, said in an interview.

“I and I think a majority of Americans had assumed that all veterans were automatically eligible for healthcare, and this in fact was true in the late 1990s,” she said. Now “the majority of middle-income veterans are excluded.”

A 1996 law opened VA care to all veterans, with a $50 co-pay for those were not classified as poor. But in 2002, regional directors were told not to market enrollment to new veterans because demand was exceeding resources, according to a department memo quoted in the journal article. Then in 2003, enrollment was halted for most veterans without qualifying medical conditions or incomes.

Using government data, Woolhandler and her co-authors found 1.8 million veterans who were uninsured and not receiving VA care in 2004, the most recent year available. That represented an increase of 290,000 since 2000. They also identified 3.8 million family members of those veterans who also had no health insurance. Together they account for 12.2 percent of the 47 million uninsured people in the United States.

“This really epitomizes the uninsured in the United States. They are working-age families earning too little to be able to afford to buy health insurance but too much to qualify for Medicaid,” she said.

The typical uninsured veteran is a 45-year-old man who has worked in the past year and is earning from $30,000 to $40,000 a year, Woolhandler said.

“Our soldiers serve so we don’t have to. They’re serving and protecting us,” she said. “They’re holding up their part of the bargain and when they come home, we’re really saying we as a society don’t have any obligation to serve and protect them by providing healthcare.”

Posted by Elizabeth Cooney at 05:13 PM

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Wednesday, October 24, 2007

Boston group to share genetic data on autism

A Boston group is sharing genetic information from families affected by autism with other researchers to promote understanding of the developmental disorder.

The Autism Consortium, whose members include hospitals, medical schools and universities in the Boston area, will transfer profiles of 500,000 genetic variations found across the genomes of 700 families with two or more children who have autism. The data will be held by the Autism Genetic Resource Exchange, a program of the advocacy organization Autism Speaks. Scientists can apply to the exchange, which gathered DNA from the families. The samples have been scanned for sequences where there are deletions or extra copies of DNA segments. The consortium is sharing the genetic variations it found.

"We returned all of the raw data to AGRE so they can distribute it to any other investigtors who want to begin exploring what may be the genetic underpinnings of autism," Mark Daly, a consortium member from Massachusetts General Hospital and the Broad Institute of MIT and Harvard, said in an interview. "Understanding the genetics underlying a complex disease is not an easy problem to solve. So there's no excuse for hoarding your data when much more can be learned by sharing."

Only a small percentage of autism arises from a recognizable genetic cause, such as Fragile X syndrome, Daly said. Recent research suggests that some families with autism might have higher rates of genomic abnormalities, but very few of these abnormalities have been conclusively identified.

"There's very strong heritability to autism but very little of the heritability has been explained by specific mutations of specific genes," he said. "What we hope is that this data is a starting point. We need to perform collaborative research in the spirit of the Human Genome Project to deliver on the trust the public has placed in us."

Members of the Autism Consortium are Beth Israel Deaconess Medical Center, Boston Medical Center, Boston University, Boston University School of Medicine, the Broad Institute of MIT and Harvard, Cambridge Health Alliance, Children’s Hospital Boston, Harvard University, Harvard Medical School, Massachusetts General Hospital, Massachusetts Institute of Technology, McLean Hospital and Tufts-New England Medical Center.

Posted by Elizabeth Cooney at 11:37 AM

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Thursday, June 28, 2007

Notables

Cambridge Health Alliance will accept an award today from the National Association of Public Hospitals and Health Systems for its role in medical school curriculum change.

CHA developed a program for third-year Harvard Medical School students to follow patients for a year at one hospital instead of traditional rotations in different settings. The hospital was chosen for the 2007 Chair Award from 64 submissions, NAPH said in a statement.

Dr. Samantha L. Rosman, a third-year resident in pediatrics in Boston, has been re-elected to the American Medical Association's board of trustees. She is a 2004 graduate of Columbia University College of Physicians and Surgeons. After completing her residency, she will begin a fellowship in pediatric emergency medicine at Boston Medical Center.

Shedlack100.bmpDr. Karen Shedlack (left), medical adviser for the mental retardation division of Vinfen, has won a 2007 Distinguished Fellowship from the American Psychiatric Association.

Before joining Vinfen, a private, nonprofit human services organization based in Cambridge, Shedlack was medical director for the adult developmental disabilities program at McLean Hospital and worked in the department of psychology and brain science at the Massachusetts Institute of Technology.

Virgin Life Care has named three Boston academics to its science advisory board.

A subsidiary of the Virgin group headed by Sir Richard Branson, the Boston company develops activity-based health rewards programs.

The board members are Dr. I-Min Lee of Harvard Medical School and the Harvard School of Public Health, Kyle McInnis of UMass-Boston and Jessica Whitely of UMass-Boston and Brown Medical School.


Children's Hospital Boston has honored five doctors with Community Physician Awards for the care they give in pediatric practices and community health centers.

They are Dr. Anthony Compagnone of Hyde Park Pediatrics, Dr. Debra Ann Gfeller of Holliston Pediatrics, Dr. David Holder of the Martha Eliot Health Center, Dr. Richard Marshall of Harvard Vanguard Associates at Copley and Dr. Robert Michaels of Longwood Pediatrics.

Posted by Elizabeth Cooney at 11:05 AM

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Thursday, June 14, 2007

Hospital Association chairman takes gavel

Robert G. Norton, president and CEO of North Shore Medical Center in Salem, became chairman of the Massachusetts Hospital Association's board of trustees today, the group said.

Norton came to the Partners HealthCare hospital from Shands Jacksonville Medical Center in Florida after being executive vice president at Beth Israel Deaconess Medical Center.

Other MHA officers are Winchester Hospital president and CEO Dale M. Lodge, chairman elect; Tufts-New England Medical Center president and CEO Ellen M. Zane, treasurer; and Cambridge Health Alliance president and CEO Dennis Keefe, secretary.

Posted by Elizabeth Cooney at 04:07 PM

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Friday, May 25, 2007

Notables

Louis Kunkel, director of the program in genomics at Children's Hospital Boston, has won a one-year $100,000 distinguished investigator award from the Mental Health Research Association to study gene expression in autistic children.

Dr. Mary Jane England, president of Regis College, has been honored as this year's outstanding psychiatrist for lifetime achievement by the Massachusetts Psychiatric Society.

Dr. Suzanne A. Bird, medical director of Cambridge Health Alliance's psychiatric emergency service, has received the annual Irma Bland Award for Excellence in Teaching Residents from the American Psychiatric Association.

Maureen Walsh, a nurse and health teacher at St. Francis Xavier School in South Weymouth, was one of 13 people to receive national recognition from the Food Allergy & Anaphylaxis Network for service to children with food allergies.

US Representative Patrick Kennedy of Rhode Island will be honored with fellow Congressman Jim Ramstad of Minnesota for their Campaign to Insure Mental Health and Addiction Equity at Mental Health America's annual meeting June 6 through 9 in Washington.

Posted by Elizabeth Cooney at 11:34 AM

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Wednesday, April 18, 2007

Cambridge names new chief public health officer

jacob 100.bmpCambridge has named Claude-Alix Jacob (left) chief public health officer for the city and director of the Cambridge Public Health Department.

Jacob had been deputy director of the Office of Health Promotion at the Illinois Department of Public Health and before that he was chief of the Bureau of Disease Prevention and Control at the Baltimore City Health Department. He earned a master’s degree in public health from the University of Illinois at Chicago.

Jacob will take over from interim health director Dr. Karen Hacker, who was appointed in July after Harold D. Cox stepped down to become associate dean for public health practice at Boston University's School of Public Health.

The Cambridge Public Health Department is a municipal health agency operated by Cambridge Health Alliance through a contract with the City of Cambridge.

Posted by Elizabeth Cooney at 11:03 AM

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Monday, April 16, 2007

Three Mass. hospitals make integrated network top 100

Three Massachusetts hospitals have been named among the country's top 100 integrated health networks -- hospital systems that operate as a unified group.

Baystate Health System in Springfield was ranked 31st, Cambridge Health Alliance came in 49th and Lahey Clinic in Burlington finished 85th in the ratings released by Verispan. There were 587 hospital networks considered.

The healthcare information company said it surveyed health systems about patient access, clinical quality, physicians and the use of technology.

Posted by Elizabeth Cooney at 03:58 PM

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Wednesday, March 28, 2007

Treatment in doctors' offices works for opioid addiction, CHA study finds

People addicted to opioids such as methadone or oxycodone can be treated in their primary care doctor's office as safely and effectively as at specialized clinics, authors from Cambridge Health Alliance and Harvard Medical School report in the Annals of Family Medicine.

Dr. Ira L. Mintzer and his colleagues studied 99 patients who received the drug buprenorphine-naloxone to treat their opioid dependence at two urban primary care practices: one in a hospital clinic and the other in a neighborhood health center. After six months 54 percent of patients were sober.

Where the patients received their treatment made no significant difference in sobriety, the authors said.

"We hope that our findings will encourage other primary care physicians to consider providing this efficacious form of care," they wrote.

Posted by Elizabeth Cooney at 02:43 PM

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Wednesday, March 21, 2007

Firefighters' heart attack risk rises sharply on calls

By Elizabeth Cooney, Globe Correspondent

Heart disease has long been known to be the leading cause of death among firefighters, but a new study in tomorrow's New England Journal of Medicine reports that putting out fires raises a firefighter's risk of having a heart attack up to 100 times more than doing other, non-emergency duties.

Dr. Stefanos N. Kales of Cambridge Health Alliance and Harvard School of Public Healthled the study that looked at the types of tasks firefighters did -- responding to a fire, putting it out, returning from a call, training, etc. -- to see how these tasks were associated with death. They reviewed data on deaths from 1994 through 2004, excluding the 344 firefighters who died from the Sept. 11 terrorist attacks.

"This provides the strongest evidence to date that specific firefighting duties can precipitate coronary events," Kales said.

Firefighters don't have a higher risk of heart disease compared to the general population, but the sudden exertion of their work can trigger a heart attack in the same way shoveling snow can lead to a heart attack in someone else.

Firefighters may begin their careers in better shape than others, but as they grow older they may acquire risk factors, such as high blood pressure and cholesterol as well as weight gain.

"The implications of this study are clear," Dr. Linda Rosenstock and Dr. Jorn Olsen of UCLA write in an editorial. "Modifiable risk factors, whether or not they are related to occupation, should be aggressively addressed."

About 70 percent of fire departments don't have programs to promote fitness, according to the National Fire Protection Association.

"One of the issues for fire services is coming up with the funding to have medical evaluations" and fitness programs, said Rita Fahy, manager of fire databases and systems for the NFPA.

"It's the job, but the job's interaction with a person's underlying status," Kales said. "We have to make sure we are doing everything we can so risk factors are addressed sooner. Because the job is so dangerous, it needs to be career-long."

Posted by Elizabeth Cooney at 05:00 PM

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Thursday, March 15, 2007

Emergency medicine chief named at Cambridge Hospital

Dr. Luis F. Lobón has been named chief of emergency medicine at The Cambridge Hospital campus of Cambridge Health Alliance. Lobón comes to CHA from Caritas Carney Hospital in Dorchester, where he was chief of emergency medicine.

Lobón received his MD from the University of Cantabria Faculty of Medicine in Spain and performed his internship and residencies in emergency medicine in New York City at Albert Einstein College of Medicine, Mount Sinai Medical Center, Beth Israel Medical Center and Elmhurst Hospital Center. He received a master’s degree in health management and finance from New York University’s Robert F. Wagner Graduate School of Public Service.

Posted by Elizabeth Cooney at 03:24 PM

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Thursday, March 8, 2007

CHA gets grant to study depression treatment for minority patients

Cambridge Health Alliance has received a two-year, $599,999 grant from the Robert Wood Johnson Foundation to study the quality of depression treatment for ethnic and racial minorities, the hospital said today.

Margarita Alegría, director of the Center for Multicultural Mental Health Research at CHA and a professor of psychiatry at Harvard Medical School, will lead the study.

Posted by Elizabeth Cooney at 09:41 AM

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Thursday, March 1, 2007

CHA starts electronic reporting of diseases to DPH

Cambridge Health Alliance is the first hospital system to report communicable disease information electronically to the Massachusetts Department of Public Health, CHA said today.

Data from Cambridge Hospital, Somerville Hospital and Whidden Memorial Hospital will be sent to the DPH's secure server, giving state epidemiologists information about patient demographics, test type, specimen source, results and antibiotic susceptibilities the same day they become available.

Results now come to DPH by phone, fax or email, spokeswoman Donna E. Rheaume said in an e-mail.

Posted by Elizabeth Cooney at 03:50 PM

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Friday, February 23, 2007

Three CHA physicians promoted at Harvard

Three Cambridge Health Alliance physicians have earned academic promotions from Harvard Medical School.

Dr. Jean A. Frazier, director of the Child and Adolescent Neuropsychiatric Research Program at CHA and co-director of CHA’s Center for Child and Adolescent Development, has been named associate professor of psychiatry at the medical school.

Dr. Elizabeth H. Gaufberg, an internist and a psychiatrist at CHA, has been named assistant professor of medicine and assistant professor of psychiatry.

Dr. Cynthia J. Telingator, training director of CHA’s Division of Child and Adolescent Psychiatry, has been named assistant professor of psychiatry.

Posted by Elizabeth Cooney at 09:13 AM

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Wednesday, February 21, 2007

New way of training med students touted in NEJM

By Liz Kowalczyk, Globe staff

Doctors from Cambridge Health Alliance, which includes Cambridge Hospital, and Harvard Medical School tout a new way of training medical students in tomorrow's New England Journal of Medicine.

Third-year medical students who spend the entire year following the same patients as they are treated by various doctors throughout the health care system see patients more frequently and are supervised more often by experienced faculty, than students trained the traditional way, write Dr. David Hirsh and Dr. Barbara Ogur, both physicians at the hospital; and HMS professors Dr. George Thibault, an executive with Partners HealthCare, and Dr. Malcolm Cox of the federal Veteran's Health Administration. Students normally go from hospital to hospital for one- to three-month stints in specific specialties.

Students in the Cambridge pilot program, which began in July 2004, also score as well or better on tests of clinical skill and knowledge than their peers, the authors report, although results are preliminary.

Cox, who helped Hirsh and Ogur develop the program, gets revenge of sorts in the article. Many doctors at Harvard's other teaching hospitals considered the Cambridge approach too radical, and felt Cox was not building a consensus as leader of a curriculum reform initiative at Harvard Medical School. He resigned after 18 months, saying in an interview with the Globe last year that he had "deep philosophical differences" with many Harvard faculty who believed that students learn better the traditional way.

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Tuesday, February 20, 2007

Cambridge Health, Tufts seek to improve family medicine training

The Tufts University Family Medicine Residency Program at Cambridge Health Alliance is one of 14 programs in the country to be chosen for an initiative to improve how doctors are trained to practice family medicine.

The Preparing the Personal Physician for Practice program is a $1.75 million, five-year project funded by the Association of Family Medicine Residency Directors and the American Board of Family Physicians.

"The goal here is to create graduates of family medicine residency programs who are expert clinical decision makers, who use the best technology available and who are able to apply this in a very individualized process to provide personalized care," said Dr. Randy Wertheimer, chief of family medicine at CHA.

The 24 residents in the Tufts-CHA program will be based in a new CHA-Malden Family Medicine Center, reflecting the emphasis on outpatient care, said Dr. Lyle Bohlmann, associate director of the Family Medicine Residency Program.

Posted by Elizabeth Cooney at 10:12 AM

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Thursday, February 15, 2007

Cambridge nurse honored

Registered nurse Louise Yvette Charles of Cambridge Health Alliance has won the 2007 Excellence in Nursing Award from the New England Regional Black Nurses Association Inc.

new Charles.jpg
Louise Yvette Charles

Charles, a native of Haiti, graduated from nursing school in Port-au-Prince in 1977, immigrated to the United States in 1989, and earned her bachelor of science degree at Emmanuel College in 2004. She joined CHA in 1997 at the Zinberg Clinic, a multidisciplinary AIDS center at the Cambridge Hospital campus. Charles is currently a public health nurse with the Cambridge Public Health Department.

Posted by Elizabeth Cooney at 03:12 PM
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