Arthur Blank | Albert Einstein College of Medicine - Yeshiva University (original) (raw)

Papers by Arthur Blank

Journal of Palliative Medicine, 2005

This report describes the multiple complementary analytic methods used to create a composite eval... more This report describes the multiple complementary analytic methods used to create a composite evaluation of the benefits of a hospital-based inpatient palliative care consultation service at Montefiore Medical Center in its preliminary phase. We evaluated data regarding 592 consecutive patients consulted by the palliative care service between November 2000, through March 2002. Standardized medical record reviews indicated that over 90% of interventions recommended by the palliative care team were accepted and acted on by the primary team; audit of the medical records of 368 patients confirmed that pain and other symptoms improved in 87% of patients after palliative care intervention. Ninety-five percent of respondents to a telephone survey of family caregivers described themselves as likely to recommend the service to others. High levels of referring provider satisfaction were evidenced by a Likert-scale provider satisfaction survey and an increase in the rate of referral for palliative care consultation from 2% to 21% of all patients dying at our medical center during the study period. There were also significant reductions in charges for ancillary tests and ventilator charges after palliative care consultation. A matched case control study of mechanically ventilated patients demonstrated significant savings in hospital charges (n ϭ 160 pairs). Length of stay was significantly reduced for patients referred for hospice (n ϭ 112). This type of multifaceted approach is necessary for the evaluation of a service with multiple components that would be difficult to capture with a single analytic approach. This report suggests efficacy of our palliative care service in terms of patient outcomes, provider satisfaction, caregiver satisfaction, and cost savings.

Family Practice News, 2009

Journal of palliative medicine, 2017

Palliative care consultation improves quality of care through symptom management, communication, ... more Palliative care consultation improves quality of care through symptom management, communication, care coordination, and earlier hospice referral, and it may decrease burdensome hospital readmissions at the end of life. To compare 30-day readmission rates for patients admitted with exacerbation of congestive heart failure (CHF) receiving palliative care consultation services compared with controls. Retrospective cohort study using propensity score matching. A secondary, subgroup analysis compared patients with palliative care consults and patients with an incomplete consult order. Settings/Subjects: Single-center study in an academic acute inpatient setting. Of a pool of 8215 admissions from January 1, 2011 to April 6, 2014, 356 included a palliative care consultation, and 356 matched controls were found. The 30-day readmission rate was 50.8% for admissions including a palliative care consult and 36.0% for controls (OR 1.8, 95% CI 1.4-2.5). Those with a completed consult had fewer re...

The Psychiatric Clinics of North America, Jun 1, 1994

This article has reviewed the detection, diagnosis, and differential diagnosis of PTSD. Recogniti... more This article has reviewed the detection, diagnosis, and differential diagnosis of PTSD. Recognition of particular effects of traumatic stress on patients' communications and adjustments in interviewing technique facilitate the expression and detection of PTSD when it is present. The phenomenologic boundaries between PTSD and a number of clinical syndromes and disorders are explored in detail. Delineation of PTSD from other disorders even when they co-occur with PTSD is almost always possible with effective rapport and knowledge from clinical research. An understanding of the role of traumatic stress in the origin of several disorders aside from PTSD assists in differential diagnosis, particularly when PTSD is present along with another trauma disorder. To avoid an undue, misleading proliferation of diagnoses (illusory comorbidity), the clinician should move beyond simply a cross-sectional enumeration of symptoms, to conduct a careful exploration of the patient's longitudinal history and thus understand fully which features are secondary to traumatic stress.

Research has found that approximately 80 percent of the care received by elderly people living at... more Research has found that approximately 80 percent of the care received by elderly people living at home is provided by family members. Although assistance provided by informal supports can be important in sustaining the functionally disabled elderly at home, caregiving can have important negative effects on the informal providers. To examine the relationship between informal caregiving and burden in a service-rich environment, the experiences of 1,068 functionally disabled older persons in New York City were studied for one year. Information was obtained on their living arrangements, on the nature and extent of their functional disabilities, and on the sources and extent of help they received. Data were collected from 422 informal ..aregivers on both caregiving eff^rt and burden. Throve aspects of burden were measured: employment, finances, and restrictions on personal life. Results showed major differences between caregivers l'ving with the disabled older person and those living elswhere, both in intensity of reported help and burden. Caregivers living apart from the disabled older person offered about the same amount of help as those living with the disabled person. Increased help was associated with burden only for caregivers living with the impaired person. These results suggest a need for stronger service supports for informal caregivers living with those whom they help. (KGB)

American Journal of Psychiatry, Oct 7, 2014

Objective: The goal of this study was to assess and describe the long-term impact of traumatic pr... more Objective: The goal of this study was to assess and describe the long-term impact of traumatic prisoner of war (POW) experiences within the context of posttraumatic psychopathology. Specifically, the authors attempted to investigate the relative degree of normative response represented by posttraumatic stress disorder (PTSD) in comparison to other DSM axis I disorders often found to be present, either alone or concomitant with other disorders, in survivors of trauma. Method: A community group of 262 U.S. World War II and Korean War former POWs was recruited. These men had been exposed to the multiple traumas of combat, capture, and imprisonment, yet few had ever sought mental health treatment. They were assessed for psychopathology with diagnostic interviews and psychodiagnostic testing. Regression analyses were used to assess the contributions of age at capture, war trauma, and postwar social support to PTSD and the other diagnosed disorders. Results: More than half of the men (53%) met criteria for lifetime PTSD, and 29% met criteria for current PTSD. The most severely traumatized group (POWs held by the Japanese) had PTSD lifetime rates of 84% and current rates of 59%. Fifty-five percent of those with current PTSD were free from the other current axis I disorders (uncomplicated PTSD). In addition, 34% of those with lifetime PTSD had PTSD as their only lifetime axis I diagnosis. Regression analyses indicated that age at capture, severity of exposure to trauma, and postmilitary social support were moderately predictive of PTSD and only weakly predictive of other disorders. Conclusions: These findings indicate that PTSD is a persistent, normative, and primary consequence of exposure to severe trauma. (Am J Psychiatry 1997; 154:1576-1581

American Journal of Psychiatry, 1997

The American journal of psychiatry, 1998

The authors assessed DSM-III-R disorders among American former prisoners of war. Comorbidity, tim... more The authors assessed DSM-III-R disorders among American former prisoners of war. Comorbidity, time of onset, and the relationship of trauma severity to complicated versus uncomplicated posttraumatic stress disorder (PTSD) were examined. A community sample (N=262) of men exposed to combat and imprisonment was assessed by clinicians using the Structured Clinical Interview for DSM-III-R. The rates of comorbidity among the men with PTSD were lower than rates from community samples assessed by lay interviewers. Over one-third of the cases of lifetime PTSD were uncomplicated by another axis I disorder; over one-half of the cases of current PTSD were uncomplicated. PTSD almost always emerged soon after exposure to trauma. Lifetime PTSD was associated with increased risk of lifetime panic disorder, major depression, alcohol abuse/dependence, and social phobia. Current PTSD was associated with increased risk of current panic disorder, dysthymia, social phobia, major depression, and generaliz...

American Journal of Orthopsychiatry, 1995

Home Health Care Services Quarterly, Sep 11, 2009

Http Dx Doi Org 10 1300 J027v09n02_07, Sep 11, 2009

Http Dx Doi Org 10 1300 J027v09n02_09, Sep 11, 2009

Agency and altruism theory are combined to develop a framework for explaining expected returns on... more Agency and altruism theory are combined to develop a framework for explaining expected returns on informal investments in 35 countries that participated in the Global Entrepreneurship Monitor (GEM) in 2004 and 2005. 1 The principal finding is that altruism affects expected returns. Expected returns increase as the relationship distance between the investor and the entrepreneur increases; men expect higher returns

Clinical and Translational Science, 2015

The National Institutes of Health (NIH) Roadmap for Medical Research initiative, funded by the NI... more The National Institutes of Health (NIH) Roadmap for Medical Research initiative, funded by the NIH Common Fund and offered through the Clinical and Translational Science Award (CTSA) program, developed more than 60 unique models for achieving the NIH goal of accelerating discoveries toward better public health. The variety of these models enabled participating academic centers to experiment with different approaches to fit their research environment. A central challenge related to the diversity of approaches is the ability to determine the success and contribution of each model. This paper describes the effort by the Evaluation Key Function Committee to develop and test a methodology for identifying a set of common metrics to assess the efficiency of clinical research processes and for pilot testing these processes for collecting and analyzing metrics. The project involved more than one-fourth of all CTSAs and resulted in useful information regarding the challenges in developing common metrics, the complexity and costs of acquiring data for the metrics, and limitations on the utility of the metrics in assessing clinical research performance. The results of this process led to the identification of lessons learned and recommendations for development and use of common metrics to evaluate the CTSA effort. Clin Trans Sci 2015; Volume #: 1-9.