MedicalResearch.com Interview with: Denise Bonds, MD, MPH
National Heart, Lung, and Blood Institute (NHLBI)MedicalResearch.com:What are the main findings of the study?Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin.
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MedicalResearch.com Interview with: Cristen J. Willer, PhD
Assistant Professor
Division of Cardiovascular Medicine, Dept of Internal Medicine
Dept of Human GeneticsDept of Computational Medicine and Bioinformatics
University of Michigan Ann Arbor, MI 48109-5618
MedicalResearch.com: What are the main findings of the study?Dr. Willer: We wanted to find new genes related to heart disease, so we examined the DNA of approximately 10,000 Norwegian individuals and found 10 genes that are important regulators of blood cholesterol levels. Nine of these were well known to be related to lipids, but one gene was new. It turned out to be in a region we'd previously noticed to be related to cholesterol, but it was a big region and we hadn't been able to pinpoint the gene yet. Using this new approach, focusing on DNA differences that result in slightly different proteins in people, we zeroed in on the gene. We then altered this gene in mice, and saw the predicted changes in cholesterol levels in mice.
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MedicalResearch.com Interview with:Yanzhuang Wang, PhD
Associate professor
Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan
Ann Arbor, MI 48109-1048
MedicalResearch.com: What are the main findings of the study?Dr. Wang: We learned how to repair a cellular structure called the Golgi apparatus that is broken in Alzheimer’s disease. This helps us understand how to reduce the formation of the toxic plaques that kill cells in the brain of Alzheimer's patients. The formation of amyloid plaques is a hallmark of Alzheimer’s disease; but exactly how much the plaques contribute to the disease is still not known. Our study found that the broken Golgi in the disease may be a major source of the toxicity of amyloid plaques. We showed in this study that repairing the Golgi can reduce the formation of the toxic plaques and thus may delay the disease development.
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MedicalResearch.com Interview with:Prof. Lu Qi,
Assistant Professor, Department of Nutrition
Harvard School of Public Health and Channing Division of Network Medicine
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Lu Qi: In this study, we for the first time provide reproducible evidence from three large cohort studies to show that the association between regular consumption of fried foods and higher BMI was particularly pronounced among people with a greater genetic predisposition to obesity. On the other hand, the adverse genetic effects on BMI were also amplified by consuming more fried foods, the effects among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week.
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MedicalResearch.com Interview with: Michelle M. Mielke, Ph.D.
Associate Professor
Department of Health Sciences Research, Division of Epidemiology
Department of Neurology
Mayo Clinic Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study?Dr. Mielke: Using a population-based sample of cognitively normal individuals, aged 70-89 at baseline, we found that a medical-record confirmed diagnosis of COPD was associated with an increased risk of mild cognitive impairment, specifically non-amnestic mild cognitive impairment. The risk of mild cognitive impairment increased with a longer duration of COPD such that individuals who had COPD for more than 5 years had a 2.5-fold increased risk of developing non-amnestic mild cognitive impairment.
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MedicalResearch.com Interview Invitation with: Dr. Eliana M. Perrin, MD, MPH
Associate Vice Chancellor for Research, and Director, Office of Research Development
University of North Carolina at Chapel Hill and
Associate Professor
Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine University of North Carolina at Chapel Hill, School of Medicine
Chapel Hill, NC 27599-7225
MedicalResearch.com: What are the main findings of the study?Dr. Perrin: The study included a large, diverse sample of 863 low-income parents of two-month-olds participating in Greenlight, an obesity prevention trial taking place at four medical centers: UNC, New York University, Vanderbilt University and the University of Miami. Among all of the parents, behaviors that are thought to be related to later obesity were highly prevalent. Exclusive formula feeding was more than twice as common (45 percent) as exclusive breastfeeding (19 percent). Twelve percent had already introduced solid food, 43 percent put infants to bed with bottles, 23 percent propped bottles instead of holding the bottle by hand (which can result in overfeeding), 20 percent always fed when the infant cried, and 38 percent always tried to get their children to finish their milk. In addition, 90 percent of the infants were exposed to television and 50 percent actively watched TV (meaning parents put their children in front of the television in order to watch). There were differences in these behaviors by race and ethnicity, and study results show that culturally-tailored counseling should be offered to parents of different backgrounds who may feed and play with their children differently.
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MedicalResearch.com Interview with:Dr. Atul Shinagare MD
Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
MedicalResearch.com: What are the main findings of the study?Answer: We evaluated 100 randomly selected patients from a cohort of 1771 patients evaluated for asymptomatic hematuria in 2004 at our institution in order to assess physician adherence to the 2001 American Urological Association (AUA) guidelines for evaluating patients and its impact on the diagnosis of urologic cancer. We found that most (64%) patients were not evaluated according to the guidelines, that there was substantial variation in the evaluation, and that the evaluation depended largely on the type of hematuria and physician specialty. Only 5% of patients were found to have urologic cancer, and all of them were evaluated according to the guidelines. No additional urologic cancers were diagnosed in patients in whom guidelines were not followed; however, since not all patients were tested thoroughly, occult malignancies may have been present.
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MedicalResearch.com Interview Invitation with:Dr. Brian C. Callaghan MD
Department of Neurology
University of Michigan Health System, Ann Arbor
MedicalResearch.com: What are the main findings of the study?Dr. Callaghan: The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time.
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MedicalResearch.com Interview with: Peter F. Schnatz, D.O.
Associate Chair & Residency Program Director
The Reading Hospital
Department of OB/GYN
Reading, PA 19612-6052
MedicalResearch.com: What are the main findings of the study?Dr. Schnatz: In a subsample of 576 women from the parent WHI CaD (calcium plus vitamin D supplementation) trial* , there was a significant (38%) increase in mean serum 25OHD3 concentrations after two years (95% CI 1.29-1.47, p< 0.001) for women randomized to CaD (24.3ng/mL vs. 18.2 ng/mL).
Women randomized to CaD had a 4.5 mg/dL mean decrease in LDL-C which was statistically significant. After accounting for serum 25OHD3 concentration, the effect of CaD was attenuated, suggesting that higher concentrations of 25OHD3, in response to CaD supplementation, are associated with improved LDL-C.
In observational analyses, higher concentrations of 25OHD3 were associated with significantly higher HDL-C along with significantly lower LDL-C and TG concentrations.
* 1,000 mg of elemental calcium plus 400 IU of vitamin D3 daily
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MedicalResearch.com Interview with:
Chandra Y. Osborn, PhD, MPH
Assistant Professor of Medicine & Biomedical Informatics
Division of General Internal Medicine & Public Health
Center for Health Services Research
Vanderbilt University Medical Center
Nashville, TN 37232-8300
MedicalResearch.com: What are the main findings of your study?Dr. Osborn: We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control.
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MedicalResearch.com Interview with:Dr Tobias Teichert
Assistant Professor of Psychiatry
University of Pittsburgh
Pittsburgh, PA 15261
MedicalResearch.com: What are the main findings of the study?Dr. Teichert: "Our study provided three main findings:First, we measured how long it takes subjects to allocate attention to a relevant target and how effectively they can block out the distractors. We found that after 120 msec selective attention is fully engaged and completely blocks out the distractor. Based on this finding, we predicted that subjects should be able to improve decision accuracy by delaying decision onset, and that this should be more effective than simply prolonging the whole decision process.
Most importantly, we found that subjects indeed use this more effective way of improving decision onset: On average, subjects delayed decision onset by about 50 msec when we asked them be as accurate as possible. The good news is that people seem to use this more optimal mechanism automatically, without being told to do so and without being aware of what they do. The bad news is that we don’t seem to be using this skill quite as effectively as we could. In our case, subjects could have improved accuracy even further by delaying decision onset by an additional 50 ms. However, taken together, our findings show that decision onset is to some degree under cognitive control, and that we might be able to devise training strategies to harness its full potential”
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MedicalResearch.com Interview with: Lynda D. Lisabeth, PhD
Interim Chair and Associate Professor
Department of Epidemiology
University of Michigan
Ann Arbor, Michigan
MedicalResearch.com: What are the main findings of the study?Dr. Lisabeth: The main findings were that Mexican Americans scored worse than non-Hispanic whites on all outcomes measured at 90 days following stroke, including neurologic, functional and cognitive outcomes, after adjustment for confounding factors. Further, we found that one-third of Mexican American stroke survivors have post-stroke dementia. Mexican Americans experienced more aphasia than non-Hispanic whites. Levels of functional impairment were substantial, with Mexican Americans on average experiencing moderate functional disability. Mexican Americans reported significantly greater difficulty than non-Hispanic whites with all activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that were studied.
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MedicalResearch.com Interview with:Glenn Yiu, MD, PhD
Duke Ophthalmology
Duke University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Yiu:This paper reported a child who suffered injury to both eyes from a powerful blue laser pointer purchased via the internet from overseas. Our report reviews the scientific basis for laser injuries in eyes and the factors that may affect outcomes, such as power, wavelength, duration, and distance of exposure. Newer green and blue lasers, especially high-powered ones, may be more prone to inducing eye injuries. We summarized the clinical features of ocular laser injuries, methods of prevention, and discussed how consumer availability of high powered lasers may require careful federal regulations.
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MedicalResearch.com Interview with: Martin Holzmann, MD, PhD
Department of Emergency Medicine,
Karolinska University Hospital
Stockholm Sweden.
MedicalResearch.com: What are the main findings of the study?Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes.
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MedicalResearch.com Interview with: Prof. Dr. Sven Cichon, PhD
Director, Division of Medical Genetics
University Hospital Basel
Human Genomics Research Group
Department of Biomedicine
University of Basel Basel, Switzerland
MedicalResearch.com: What were the main findings of the study?
Answer: We have identified two new gene regions that represent pieces of the jigsaw puzzle of genetic and non-genetic factors that lead to the development of bipolar disorder. One is the gene ADCY2 (Adenylate Cyclase 2) which is involved in signal transmission within nerve cells. The other region comprises two genes, both presumably playing a role in neurodevelopmental processes (MIR2113 and POU3F2). Importantly, these results come out of the largest of these kinds of studies so far, involving altogether more than 24,000 people.
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MedicalResearch.com Interview with:Lauren Dutra, ScD
Postdoctoral Scholar, UCSF School of Medicine
Cardiovascular Research Institute
San Francisco, CA 94143
MedicalResearch.com: What are the main findings of the study?Answer:Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers.
Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid.
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MedicalResearch.com Interview with:Surya P Bhatt MD
Assistant Professor
Division of Pulmonary and Critical Care Medicine
University of Alabama at Birmingham
MedicalResearch.com: What are the main findings of the study?Dr. Bhatt: The forced vital capacity (FVC) maneuver is a difficult maneuver for many patients and the forced expiratory volume in the first 6 seconds (FEV6) has been shown to be a reliable substitute. We used imaging findings on computed tomography, COPD questionnaires and tests of exercise capacity to compare these two spirometric measures (FEV1/FVC and FEV/FEV6) in the diagnosis of airflow obstruction, and showed that FEV6 can be reliably substituted for FVC. Our findings suggest that using FEV6 may in fact identify more patients with disease than by using FVC.
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MedicalResearch.com Interview with:William G Ward, Sr. MD
Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic
Sayre, Pennsylvania 18840
(Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery)
MedicalResearch.com: What are the main findings of this study?Dr. Ward:The main findings of the study include:
The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns. (more…)
MedicalResearch.com Interview with:Brendan Keating D.Phil
Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania
Lead Clinical Data Analyst, Center for Applied Genomics
Children's Hospital of Philadelphia
Michael V. Holmes, MD, PhD, MSc, BSc, MRCP
Transplant SurgeryDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
MedicalResearch.com: What are the main findings of the study?Answer:We found that individuals with a genetically-elevated BMI had higher
blood pressure, inflammatory markers, metabolic markers and a higher
risk of type 2 diabetes, although there was little correlation with
coronary heart disease in this study population of over 34,500
European-descent individuals of whom over 6,000 had coronary heart
disease.
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MedicalResearch.com Interview with: Juan Jesus CarreroPhD (Pharm and Med)
Associate Professor in Renal Medicine
Karolinska Institutet, Sweden.
MedicalResearch.com: Why did you choose to study this particular question?Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation.
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MedicalResearch.com Interview with: Mary-Ann Fitzcharles, MB, ChB, MRCP(UK), FRCP(C)
McGill University Health Centre
Division of Rheumatology and Alan Edwards Pain Management Unit
MedicalResearch.com: What are the highlights of your review?Dr. Fitzcharles: Thank you for your interest in the review article which will shortly be published in Arthritis Care & Research. This was not a research study but rather a review focused towards the use of herbal cannabis for patients with rheumatic diseases.
The essence of our message after a thorough review of the literature is that there is not a single study published regarding efficacy or side effects of herbal cannabis in the rheumatic diseases. It is notable that almost 2 thirds of persons using herbal cannabis for therapeutic reasons report use for musculoskeletal complaints. In the 21st century, we cannot rely upon heresay or anecdote to justify use of a treatment intervention. It is unacceptable to recommend use of a substance without knowledge of concentration of molecules in the product, any knowledge of blood concentrations that might have a positive or negative effect, and formal study in defined patient populations with acceptable endpoint criteria and evidence for short and long term risks.
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MedicalResearch.com Interview with:Sameer Saini MD
Veterans Affairs Center for Clinical Management Research,
VA Ann Arbor Healthcare System
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
MedicalResearch.com: What are the main findings of the study?Dr. Saini: The way that quality measures are defined can have important implications for how care is actually delivered. Current colorectal cancer screening quality measures use age to identify screen-eligible patients, encouraging screening in patients between 50 and 75 years of age. But they do not explicitly incorporate health status. In this context, our study had two main findings.
First, by focusing on age alone, we are not screening everyone who is likely to benefit. Specifically, many healthy people over 75 years of age (who are outside the target age range of the quality measure) may benefit from screening, but the current measure does not encourage screening in this population, leading to low screening use.
Second, some people who are NOT likely to benefit are being screened unnecessarily, like those with serious health problems. For example, people between ages 70-75 with serious health problems (who have limited life expectancy) are unlikely to benefit from screening, and may even be harmed by it. But the current quality measure encourages screening in such individuals due to their age, yielding relatively high screening rates. If the system focused on age and health status (rather than age alone), screening use would be more aligned with screening benefit, and we would have better health outcomes.
MedicalResearch.com Interview with:Professor Linda H Aiken PhD, FAAN, FRCN, RN
Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology
Director of the Center for Health Outcomes and Policy Research
Center for Health Outcomes and Policy Research
University of Pennsylvania School of Nursing
MedicalResearch.com:Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?
Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery.
A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009. Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions. Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce. (more…)
MedicalResearch.com Interview with:
Jonathan M. Spergel, M.D., Ph.D.
The Children's Hospital of Philadelphia
Chief, Allergy Section
Associate Professor of Pediatrics
Perelman School of Medicine at...
MedicalResearch.com Interview with:Dr. Kendra J. Grim
Department of Anesthesiology
Mayo Clinic, Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study? Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent. Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “
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MedicalResearch.com Interview with:Samuel R. Friedman PhD
Institute of Infectious Disease Research
National Development and Research Institutes, Inc. Ny, NY
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD
MedicalResearch.com: What are the main findings of the study?Dr. Friedman:The main finding is that programs that helped protect people who inject drugs from HIV and those that helped them to get medical care seem to be associated with less HIV disease and less death related to HIV disease among the heterosexual population of large United States metropolitan areas.
This is important. Drug users in the US are widely despised, and their has been a lot of political opposition to programs like syringe exchange and drug abuse treatment. Our findings show that these programs are associated with better health and less death in the broader population. It makes more sense to help people--even those you despise--stay uninfected, and to get medical care, than to restrict or attack programs for them.
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MedicalResearch.com Interview with:Dhruv S. Kazi, MD, MSc, MS
Assistant Adjunct Professor
Division of Cardiology San Francisco General Hospital
Department of Medicine, and
Department of Epidemiology and Biostatistics
University of California San Francisco
MedicalResearch.com: What is the background of your study?
Dr. Kazi: When we first asked the research question -what is the role of genotyping among patients receiving a stent for ACS, we quickly realized that there were no RCTs that had directly compared ticagrelor with prasugrel. But in our opinion, that was precisely the reason to build a model and systematically synthesize the available literature. There are nearly half a million PCIs for ACS in the US each year, and each time, the physician and patients have to examine the trade-offs between the various alternatives. What our model does is that it explicates the trade-offs - makes them transparent, and quantifies them. So patients and physicians can make an informed decision on what is the optimal therapy for them.
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MedicalResearch.com: Interview with:Dr Heike Daldrup-Link
Associate Professor of Radiology
Stanford University School of Medicine, Palo AltoMedicalResearch.com: What are the main findings of the study?Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT): We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans.
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MedicalResearch.com Interview with:Dr. David Hanauer, MD
Associate Professor, University of Michigan Medical School
1500 East Medical Center Drive
Ann Arbor, MI 48109-5940
MedicalResearch.com: What are the main findings of the studyDr. Hanauer: From my perspective, the primary findings were that 65% of the general public is now aware of physician rating web sites and among those who are aware, about 36% had used them in the prior year. Awareness and usage seems to be rapidly increasing compared to what has been reported in prior studies from just a few years ago. We also found that patients consider word of mouth recommendations (from family/friends) to be almost twice as important as ratings sites are.
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MedicalResearch.com Interview with: Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College
MedicalResearch.com: What are the main findings of this study?Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.
(more…)
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