T. Boaz - Academia.edu (original) (raw)

Papers by T. Boaz

Research paper thumbnail of Event-related potentials: a critical review of methods for single-trial detection

Critical reviews in biomedical engineering, 1987

The analysis of ERP data has followed several lines over the last 20 years. The most prevalent me... more The analysis of ERP data has followed several lines over the last 20 years. The most prevalent method is simply to average ERPs for a given class of stimuli. The ERPs are compared for differences across classes of stimuli. Little other special data processing is used. The ERP comparisons are usually performed using visual examination of the wave-shapes. Sometimes statistics are calculated such as means, variances, and confidence limits. Linear filtering is used to reduce interference. Another approach is to model or analyze the ERP as a sequence of vectors or frames of data samples. These samples may be of the ERP time waveform or they may be of the frequency transform of the ERP waveform. The frames of data vary in length from the entire ERP waveform (500 to 1000 msec) to frames as short as ten sample points (100 msec). Recognition of an event in the ERP is achieved by computing a distance measure between parameter vectors for one class of stimuli and corresponding parameter vector...

Research paper thumbnail of Assisted living facility training manual. A curriculum written to address legislated changes in Florida's assisted living facility administrative code

Research paper thumbnail of Predictors of preventable nursing home hospitalizations: the role of mental disorders and dementia

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2010

Nursing home (NH) hospitalizations place an enormous economic burden on an already overtaxed Amer... more Nursing home (NH) hospitalizations place an enormous economic burden on an already overtaxed American healthcare system. Hospitalizations for "ambulatory care-sensitive" (ACS) conditions are considered preventable, as these are physical health conditions that can potentially be treated safely in a NH. The authors examined risk factors, including mental disorders and dementia, for hospitalization of Medicaid-enrolled NH residents with ACS conditions during fiscal year 2003-2006. The authors merged Medicaid claims and enrollment data and Online Survey Certification and Reporting information for 72,251 Medicaid-enrolled NH residents in 647 NHs in Florida. The authors identified at least one ACS hospitalization in 8,382 residents for a total of 10,091 hospital admissions (18.5% of all hospitalizations). The authors used Cox proportional hazard regression to assess time to the first ACS hospitalization. In a fully adjusted model, younger age, non-white race, dementia, and serio...

Research paper thumbnail of Association between SMI and/or dementia and type of ACS condition resulting in preventable hospitalization among nursing home residents

Research paper thumbnail of Correlates and predictors of behavioral health hospitalization in nursing home residents

Research paper thumbnail of Predictors of Involuntary Psychiatric Examination of Nursing Home Residents

Research paper thumbnail of Preventable Hospitalizations Among Assisted Living and Nursing Home Residents

Research paper thumbnail of The Role of Age and Mental Illness in Risk of Preventable Hospitalization Among Assisted Living Residents

Research paper thumbnail of The Role of Older Age in Receipt of Evidence Based Treatment for Major Depressive Disorder (MDD)

Research paper thumbnail of Early Rehospitalization of Older Adults Enrolled in Florida's Medicaid Program

Research paper thumbnail of Factors Affecting Hospitalization of Nursing Home Residents with Ambulatory Sensitive Conditions

Research paper thumbnail of PMH45 Discontinuation of Different Antipsychotic Medications After Discharge from Acute Care for Persons with Schizophrenia

Value in Health, 2010

of their relatives with schizophrenia were c292 (424), which corresponds to approximately 14% of ... more of their relatives with schizophrenia were c292 (424), which corresponds to approximately 14% of the mean gross income of caregivers. Large expenditure items were groceries, clothes, rent and travel. CONCLUSIONS: The objective burden adds halftime to an ordinary fulltime job (time spent on care) and additionally reduces gross incomes with approximately 14% (money spent on care) for informal caregivers to patients with schizophrenia spectrum disorders.

Research paper thumbnail of Characteristics and Experiences of Adults With a Serious Mental Illness Who Were Involved in the Criminal Justice System

Psychiatric Services, 2010

This study identified characteristics and experiences of arrestees and jail inmates with a seriou... more This study identified characteristics and experiences of arrestees and jail inmates with a serious mental illness that were associated with misdemeanor and felony arrests and additional days in jail. County and statewide criminal justice records and health and social service archival data sets were used to identify inmates with serious mental illness who were in the Pinellas County, Florida, jail between July 1, 2003, and June 30, 2004, and their health and social service contacts from July 1, 2002, to June 10, 2006. Criminal justice and mental health services were recorded longitudinally across 16 quarters, or 90-day periods. Generalized estimating equations for count data were used to describe the associations between individual characteristics and experiences and the risks of misdemeanor and felony arrests and additional days in jail. A total of 3,769 jail inmates (10.1% of all jail inmates) were diagnosed as having a serious mental illness. Participants experienced a mean+/-SD of .90+/-.60 arrest for every three quarters and 10.9+/-23.6 days in jail per quarter that they resided in the county. Being male, being homeless, not having outpatient mental health treatment, and having an involuntary psychiatric evaluation in the previous quarter were independently associated with significantly increased odds of misdemeanor arrests and additional days in jail. On the other hand, being black, being younger than 21 years, having a nonpsychotic diagnosis, and a co-occurring substance use disorder diagnosis were all independently associated with significantly increased odds of felony arrests, and with the exception of having a nonpsychotic diagnosis, they were also significantly associated with additional days in jail. Findings suggest that there are subgroups of individuals with a serious mental illness in the criminal justice system that may require different policy and programmatic responses.

Research paper thumbnail of Short-Term Impact of Preferred Drug List Changes on Health Care Use and Medicaid Costs: Injectable Risperidone

Psychiatric Services, 2010

This study assessed short-term effects of the removal of injectable risperidone long-acting thera... more This study assessed short-term effects of the removal of injectable risperidone long-acting therapy from the Florida Medicaid preferred drug list (PDL) in April 2006. A difference-in-difference approach was used to contrast changes (60 days pre and post) in health care utilization and costs of Medicaid recipients who were receiving risperidone long-acting therapy when the policy was changed (N=247) and of a matched sample who received risperidone long-acting therapy in April 2005 (non-PDL, N=247). The policy change was associated with increased acute care events. Whereas acute care events declined for the non-PDL group, involuntary commitments and total acute care events increased for the PDL group, as did expenditures for crisis-related events. Medicaid pharmacy costs fell for both groups, but total expenditures did not decline significantly for the PDL group. The PDL restriction was associated with increased acute care events and did not reduce short-term Medicaid program expenditures.

Research paper thumbnail of Involuntary Psychiatric Examination and Psychiatric Hospitalization of Medicaid Enrolled Nursing Home Residents

Research paper thumbnail of Predictors of Avoidable Hospitalizations Among Assisted Living Residents

Journal of the American Medical Directors Association, 2012

Research paper thumbnail of Reliability and validity of the Florida Sexual History Questionnaire

Journal of Clinical Psychology, 1991

The Florida Sexual History Questionnaire (FSHQ) is a brief 20-item questionnaire designed to asse... more The Florida Sexual History Questionnaire (FSHQ) is a brief 20-item questionnaire designed to assess male sexual dysfunction. The validity and reliability of the scale were examined in 33 diabetic impotent males and 58 nondiabetic, age-equivalent nonimpotent males. The FSHQ was found to have high internal consistency and split-half reliability and significantly discriminated between nonimpotent and impotent subjects. Among diabetic impotent subjects, some of the test items were correlated significantly with physiological measures of sexual functioning. However, the FSHQ failed to discriminate between diabetics diagnosed as having organic or psychogenic impotence. This latter finding is discussed within the context of recent suggestions that it may not be possible to draw a clear dichotomy between organic and psychogenic impotence.

Research paper thumbnail of Risperidone Long-Acting Therapy Prescribing Patterns and Their Impact on Early Discontinuation of Treatment in a Large Medicaid Population

The Journal of Clinical Psychiatry, 2011

Medicaid claims were examined to determine whether utilization of risperidone long-acting therapy... more Medicaid claims were examined to determine whether utilization of risperidone long-acting therapy (LAT) was consistent with manufacturer's prescribing information recommendations and what factors were associated with early discontinuation. Florida Medicaid claims between July 1, 2003, and June 30, 2007, were used. Recipient demographics and diagnoses, provision of oral antipsychotic supplementation during the first 21 days, number of injections received, medication possession ratio, and augmentation/polypharmacy after the first 21 days were assessed. Logistic regression was used to identify factors associated with early discontinuation of risperidone LAT. There were 3,364 individuals who received 4,546 episodes of risperidone LAT. Most recipients were between 18 and 64 years and had schizophrenia or schizoaffective disorder. Median episode length was 106 days. Median number of injections was 5. Supplementation with oral antipsychotic during the first 21 days was provided in 48% of episodes. Mean dosages were 25 mg or less for 28% of episodes and greater than 75 mg for 7% of episodes. Augmentation/polypharmacy after the first 21 days occurred in 43% of episodes. Early risperidone LAT discontinuation was associated with absence of oral supplementation during the first 21 days (P < .001), low (P = .045) or high (P < .001) initial doses of risperidone LAT, prior inpatient treatment (P < .001), having a substance use disorder (P = .001), and being male (P = .036). Prescribing practices for risperidone LAT were compared with the recommended protocol. Risperidone LAT was typically used with recommended age and diagnostic groups. However, important discrepancies were identified that could have reduced perceived effectiveness and tolerability of risperidone LAT. Early discontinuation was less likely when the recommendations in the manufacturer's prescribing information regarding dosage and supplementation with oral antipsychotics were followed.

Research paper thumbnail of Gender Differences and Risk of Arrest Among Offenders with Serious Mental Illness

The Journal of Behavioral Health Services & Research, 2011

Despite the increasing number of men and women with serious mental illness (SMI) incarcerated in ... more Despite the increasing number of men and women with serious mental illness (SMI) incarcerated in America's jails, little research exists on the role gender may play in arrest among persons with SMI. This study examined correlates of arrests among offenders with SMI, specifically the role of gender. County criminal justice records, as well as county and statewide social service archival databases, were used to identify jail inmates with SMI in a large urban county in Florida. Of the 3,769 inmates identified, 41% were female. This study identified three distinct classes of male and female offenders within which persons had similar trajectories of arrests over the 4-year study period representing those with minimal, low, and high arrest rates. Findings suggest some important differences between women and men in risk factors for re-arrests. Attention to these factors may improve the ability to prevent future recidivism among men and women with SMI. The increasing number of persons with serious mental illness (SMI) incarcerated in America's jails is a growing public health concern 1-3. Dramatic reductions in psychiatric inpatient treatment, erosion of public services for homeless persons and persons with mental illness, passage of strict civil commitment laws, and continuing increases in arrest rates for drug offenses have all

Research paper thumbnail of The association of individual and facility characteristics with psychiatric hospitalization among nursing home residents

International Journal of Geriatric Psychiatry, 2009

Objective To examine resident and facility characteristics associated with psychiatric hospitaliz... more Objective To examine resident and facility characteristics associated with psychiatric hospitalizations (PH) for Medicaid enrolled nursing home (NH) residents. Methods Participants were all Medicaid enrolled NH residents (n ¼ 32,604) from all Medicaid certified nursing homes in Florida (n ¼ 584) with complete data. We used individual demographic and diagnostic characteristics, as well as facility characteristics, to explore risk of psychiatric hospitalization in this dataset. Results Using generalized estimating equations, we found that younger age, male gender, poor physical health, serious mental illness, dementia, and drug use disorder were associated with risk of psychiatric hospitalization. Most notably, residents under 65 were more than three times more likely to undergo psychiatric hospitalization and dementia was associated with a threefold increase in the risk of psychiatric hospitalization. Predictors of PH differed somewhat for younger and older residents. Among facility characteristics, greater facility size, low proportion of those paying via Medicare and high proportion of residents with serious mental illness were associated with increased risk of psychiatric hospitalization, whereas, low proportion of residents paying via Medicaid, high proportion of residents paying via Medicare, and low proportion of resident with serious mental illness were associated with reduced risk. Conclusions Both resident and facility characteristics impact risk for psychiatric hospitalization. Attention to identified predictors may reduce risk and improve outcomes for nursing home residents.

Research paper thumbnail of Event-related potentials: a critical review of methods for single-trial detection

Critical reviews in biomedical engineering, 1987

The analysis of ERP data has followed several lines over the last 20 years. The most prevalent me... more The analysis of ERP data has followed several lines over the last 20 years. The most prevalent method is simply to average ERPs for a given class of stimuli. The ERPs are compared for differences across classes of stimuli. Little other special data processing is used. The ERP comparisons are usually performed using visual examination of the wave-shapes. Sometimes statistics are calculated such as means, variances, and confidence limits. Linear filtering is used to reduce interference. Another approach is to model or analyze the ERP as a sequence of vectors or frames of data samples. These samples may be of the ERP time waveform or they may be of the frequency transform of the ERP waveform. The frames of data vary in length from the entire ERP waveform (500 to 1000 msec) to frames as short as ten sample points (100 msec). Recognition of an event in the ERP is achieved by computing a distance measure between parameter vectors for one class of stimuli and corresponding parameter vector...

Research paper thumbnail of Assisted living facility training manual. A curriculum written to address legislated changes in Florida's assisted living facility administrative code

Research paper thumbnail of Predictors of preventable nursing home hospitalizations: the role of mental disorders and dementia

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2010

Nursing home (NH) hospitalizations place an enormous economic burden on an already overtaxed Amer... more Nursing home (NH) hospitalizations place an enormous economic burden on an already overtaxed American healthcare system. Hospitalizations for "ambulatory care-sensitive" (ACS) conditions are considered preventable, as these are physical health conditions that can potentially be treated safely in a NH. The authors examined risk factors, including mental disorders and dementia, for hospitalization of Medicaid-enrolled NH residents with ACS conditions during fiscal year 2003-2006. The authors merged Medicaid claims and enrollment data and Online Survey Certification and Reporting information for 72,251 Medicaid-enrolled NH residents in 647 NHs in Florida. The authors identified at least one ACS hospitalization in 8,382 residents for a total of 10,091 hospital admissions (18.5% of all hospitalizations). The authors used Cox proportional hazard regression to assess time to the first ACS hospitalization. In a fully adjusted model, younger age, non-white race, dementia, and serio...

Research paper thumbnail of Association between SMI and/or dementia and type of ACS condition resulting in preventable hospitalization among nursing home residents

Research paper thumbnail of Correlates and predictors of behavioral health hospitalization in nursing home residents

Research paper thumbnail of Predictors of Involuntary Psychiatric Examination of Nursing Home Residents

Research paper thumbnail of Preventable Hospitalizations Among Assisted Living and Nursing Home Residents

Research paper thumbnail of The Role of Age and Mental Illness in Risk of Preventable Hospitalization Among Assisted Living Residents

Research paper thumbnail of The Role of Older Age in Receipt of Evidence Based Treatment for Major Depressive Disorder (MDD)

Research paper thumbnail of Early Rehospitalization of Older Adults Enrolled in Florida's Medicaid Program

Research paper thumbnail of Factors Affecting Hospitalization of Nursing Home Residents with Ambulatory Sensitive Conditions

Research paper thumbnail of PMH45 Discontinuation of Different Antipsychotic Medications After Discharge from Acute Care for Persons with Schizophrenia

Value in Health, 2010

of their relatives with schizophrenia were c292 (424), which corresponds to approximately 14% of ... more of their relatives with schizophrenia were c292 (424), which corresponds to approximately 14% of the mean gross income of caregivers. Large expenditure items were groceries, clothes, rent and travel. CONCLUSIONS: The objective burden adds halftime to an ordinary fulltime job (time spent on care) and additionally reduces gross incomes with approximately 14% (money spent on care) for informal caregivers to patients with schizophrenia spectrum disorders.

Research paper thumbnail of Characteristics and Experiences of Adults With a Serious Mental Illness Who Were Involved in the Criminal Justice System

Psychiatric Services, 2010

This study identified characteristics and experiences of arrestees and jail inmates with a seriou... more This study identified characteristics and experiences of arrestees and jail inmates with a serious mental illness that were associated with misdemeanor and felony arrests and additional days in jail. County and statewide criminal justice records and health and social service archival data sets were used to identify inmates with serious mental illness who were in the Pinellas County, Florida, jail between July 1, 2003, and June 30, 2004, and their health and social service contacts from July 1, 2002, to June 10, 2006. Criminal justice and mental health services were recorded longitudinally across 16 quarters, or 90-day periods. Generalized estimating equations for count data were used to describe the associations between individual characteristics and experiences and the risks of misdemeanor and felony arrests and additional days in jail. A total of 3,769 jail inmates (10.1% of all jail inmates) were diagnosed as having a serious mental illness. Participants experienced a mean+/-SD of .90+/-.60 arrest for every three quarters and 10.9+/-23.6 days in jail per quarter that they resided in the county. Being male, being homeless, not having outpatient mental health treatment, and having an involuntary psychiatric evaluation in the previous quarter were independently associated with significantly increased odds of misdemeanor arrests and additional days in jail. On the other hand, being black, being younger than 21 years, having a nonpsychotic diagnosis, and a co-occurring substance use disorder diagnosis were all independently associated with significantly increased odds of felony arrests, and with the exception of having a nonpsychotic diagnosis, they were also significantly associated with additional days in jail. Findings suggest that there are subgroups of individuals with a serious mental illness in the criminal justice system that may require different policy and programmatic responses.

Research paper thumbnail of Short-Term Impact of Preferred Drug List Changes on Health Care Use and Medicaid Costs: Injectable Risperidone

Psychiatric Services, 2010

This study assessed short-term effects of the removal of injectable risperidone long-acting thera... more This study assessed short-term effects of the removal of injectable risperidone long-acting therapy from the Florida Medicaid preferred drug list (PDL) in April 2006. A difference-in-difference approach was used to contrast changes (60 days pre and post) in health care utilization and costs of Medicaid recipients who were receiving risperidone long-acting therapy when the policy was changed (N=247) and of a matched sample who received risperidone long-acting therapy in April 2005 (non-PDL, N=247). The policy change was associated with increased acute care events. Whereas acute care events declined for the non-PDL group, involuntary commitments and total acute care events increased for the PDL group, as did expenditures for crisis-related events. Medicaid pharmacy costs fell for both groups, but total expenditures did not decline significantly for the PDL group. The PDL restriction was associated with increased acute care events and did not reduce short-term Medicaid program expenditures.

Research paper thumbnail of Involuntary Psychiatric Examination and Psychiatric Hospitalization of Medicaid Enrolled Nursing Home Residents

Research paper thumbnail of Predictors of Avoidable Hospitalizations Among Assisted Living Residents

Journal of the American Medical Directors Association, 2012

Research paper thumbnail of Reliability and validity of the Florida Sexual History Questionnaire

Journal of Clinical Psychology, 1991

The Florida Sexual History Questionnaire (FSHQ) is a brief 20-item questionnaire designed to asse... more The Florida Sexual History Questionnaire (FSHQ) is a brief 20-item questionnaire designed to assess male sexual dysfunction. The validity and reliability of the scale were examined in 33 diabetic impotent males and 58 nondiabetic, age-equivalent nonimpotent males. The FSHQ was found to have high internal consistency and split-half reliability and significantly discriminated between nonimpotent and impotent subjects. Among diabetic impotent subjects, some of the test items were correlated significantly with physiological measures of sexual functioning. However, the FSHQ failed to discriminate between diabetics diagnosed as having organic or psychogenic impotence. This latter finding is discussed within the context of recent suggestions that it may not be possible to draw a clear dichotomy between organic and psychogenic impotence.

Research paper thumbnail of Risperidone Long-Acting Therapy Prescribing Patterns and Their Impact on Early Discontinuation of Treatment in a Large Medicaid Population

The Journal of Clinical Psychiatry, 2011

Medicaid claims were examined to determine whether utilization of risperidone long-acting therapy... more Medicaid claims were examined to determine whether utilization of risperidone long-acting therapy (LAT) was consistent with manufacturer's prescribing information recommendations and what factors were associated with early discontinuation. Florida Medicaid claims between July 1, 2003, and June 30, 2007, were used. Recipient demographics and diagnoses, provision of oral antipsychotic supplementation during the first 21 days, number of injections received, medication possession ratio, and augmentation/polypharmacy after the first 21 days were assessed. Logistic regression was used to identify factors associated with early discontinuation of risperidone LAT. There were 3,364 individuals who received 4,546 episodes of risperidone LAT. Most recipients were between 18 and 64 years and had schizophrenia or schizoaffective disorder. Median episode length was 106 days. Median number of injections was 5. Supplementation with oral antipsychotic during the first 21 days was provided in 48% of episodes. Mean dosages were 25 mg or less for 28% of episodes and greater than 75 mg for 7% of episodes. Augmentation/polypharmacy after the first 21 days occurred in 43% of episodes. Early risperidone LAT discontinuation was associated with absence of oral supplementation during the first 21 days (P < .001), low (P = .045) or high (P < .001) initial doses of risperidone LAT, prior inpatient treatment (P < .001), having a substance use disorder (P = .001), and being male (P = .036). Prescribing practices for risperidone LAT were compared with the recommended protocol. Risperidone LAT was typically used with recommended age and diagnostic groups. However, important discrepancies were identified that could have reduced perceived effectiveness and tolerability of risperidone LAT. Early discontinuation was less likely when the recommendations in the manufacturer's prescribing information regarding dosage and supplementation with oral antipsychotics were followed.

Research paper thumbnail of Gender Differences and Risk of Arrest Among Offenders with Serious Mental Illness

The Journal of Behavioral Health Services & Research, 2011

Despite the increasing number of men and women with serious mental illness (SMI) incarcerated in ... more Despite the increasing number of men and women with serious mental illness (SMI) incarcerated in America's jails, little research exists on the role gender may play in arrest among persons with SMI. This study examined correlates of arrests among offenders with SMI, specifically the role of gender. County criminal justice records, as well as county and statewide social service archival databases, were used to identify jail inmates with SMI in a large urban county in Florida. Of the 3,769 inmates identified, 41% were female. This study identified three distinct classes of male and female offenders within which persons had similar trajectories of arrests over the 4-year study period representing those with minimal, low, and high arrest rates. Findings suggest some important differences between women and men in risk factors for re-arrests. Attention to these factors may improve the ability to prevent future recidivism among men and women with SMI. The increasing number of persons with serious mental illness (SMI) incarcerated in America's jails is a growing public health concern 1-3. Dramatic reductions in psychiatric inpatient treatment, erosion of public services for homeless persons and persons with mental illness, passage of strict civil commitment laws, and continuing increases in arrest rates for drug offenses have all

Research paper thumbnail of The association of individual and facility characteristics with psychiatric hospitalization among nursing home residents

International Journal of Geriatric Psychiatry, 2009

Objective To examine resident and facility characteristics associated with psychiatric hospitaliz... more Objective To examine resident and facility characteristics associated with psychiatric hospitalizations (PH) for Medicaid enrolled nursing home (NH) residents. Methods Participants were all Medicaid enrolled NH residents (n ¼ 32,604) from all Medicaid certified nursing homes in Florida (n ¼ 584) with complete data. We used individual demographic and diagnostic characteristics, as well as facility characteristics, to explore risk of psychiatric hospitalization in this dataset. Results Using generalized estimating equations, we found that younger age, male gender, poor physical health, serious mental illness, dementia, and drug use disorder were associated with risk of psychiatric hospitalization. Most notably, residents under 65 were more than three times more likely to undergo psychiatric hospitalization and dementia was associated with a threefold increase in the risk of psychiatric hospitalization. Predictors of PH differed somewhat for younger and older residents. Among facility characteristics, greater facility size, low proportion of those paying via Medicare and high proportion of residents with serious mental illness were associated with increased risk of psychiatric hospitalization, whereas, low proportion of residents paying via Medicaid, high proportion of residents paying via Medicare, and low proportion of resident with serious mental illness were associated with reduced risk. Conclusions Both resident and facility characteristics impact risk for psychiatric hospitalization. Attention to identified predictors may reduce risk and improve outcomes for nursing home residents.