Beverly Cove, MA, United States
Beverly Cove, MA, United States

Endicott College is a private coeducational college located in Beverly, Massachusetts. Wikipedia.

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Sommers T.,Beth Israel Deaconess Medical Center | Corban C.,Beth Israel Deaconess Medical Center | Sengupta N.,Beth Israel Deaconess Medical Center | Jones M.,Macquarie University | And 5 more authors.
American Journal of Gastroenterology | Year: 2015

Objectives:Although constipation is typically managed in an outpatient setting, there is an increasing trend in the frequency of constipation-related hospital visits. The aim of this study was to analyze trends related to chronic constipation (CC) in the United States with respect to emergency department (ED) visits, patient and hospital characteristics, and associated costs.Methods:Data from 2006 to 2011, in which constipation (The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes 564.00-564.09) was the primary discharge diagnosis, were obtained from the National Emergency Department Sample (NEDS).Results:Between 2006 and 2011, the frequency of constipation-related ED visits increased by 41.5%, from 497,034 visits to 703,391 visits, whereas the mean cost per patient rose by 56.4%, from $1,474 in 2006 to $2,306 in 2011. The aggregate national cost of constipation-related ED visits increased by 121.4%, from $732,886,977 in 2006 to $1,622,624,341 in 2011. All cost data were adjusted for inflation and reported in 2014 dollars. Infants (<1 year old) had the highest rate of constipation-related ED visits in both 2006 and 2011. The late elders (85+ years) had the second highest constipation-related ED visit rate in 2006; however, the 1- to 17-year-old age group experienced a 50.7% increase in constipation-related ED visit rate from 2006 to 2011 and had the second highest constipation-related ED visit rate in 2011.Conclusions:The frequency of and the associated costs of ED visits for constipation are significant and have increased notably from 2006 to 2011. © 2015 by the American College of Gastroenterology.

Kelley J.M.,Endicott College | Kelley J.M.,Harvard University | Kaptchuk T.J.,Beth Israel Deaconess Medical Center
Contemporary Clinical Trials | Year: 2010

The randomized controlled trial (RCT) is the gold standard for assessing the efficacy of medical treatments. Over the past 50. years, RCT methodology has proven to be quite successful in identifying effective treatments and weeding out ineffective ones, thus transforming medicine from an intuitive art into an empirical science. However, the enormous success of the RCT has inadvertently contributed to a common inferential error that is insufficiently appreciated by some clinicians and researchers. Although RCTs can effectively distinguish between placebo and active treatment effects at the level of the group, contrary to intuition, this same disentanglement is much more difficult to achieve at the level of the individual. For individual patients it is surprisingly difficult to determine who is a treatment responder and who is not. Using data from a recent RCT, we illustrate the problem and detail its negative effects for research and clinical practice. Finally, we suggest strategies for minimizing these negative effects. © 2010 Elsevier Inc.

Wechsler M.E.,Harvard University | Kelley J.M.,Harvard University | Kelley J.M.,Endicott College | Boyd I.O.E.,Harvard University | And 6 more authors.
New England Journal of Medicine | Year: 2011

BACKGROUND: In prospective experimental studies in patients with asthma, it is difficult to determine whether responses to placebo differ from the natural course of physiological changes that occur without any intervention. We compared the effects of a bronchodilator, two placebo interventions, and no intervention on outcomes in patients with asthma. METHODS: In a double-blind, crossover pilot study, we randomly assigned 46 patients with asthma to active treatment with an albuterol inhaler, a placebo inhaler, sham acupuncture, or no intervention. Using a block design, we administered one each of these four interventions in random order during four sequential visits (3 to 7 days apart); this procedure was repeated in two more blocks of visits (for a total of 12 visits by each patient). At each visit, spirometry was performed repeatedly over a period of 2 hours. Maximum forced expiratory volume in 1 second (FEV 1) was measured, and patients' self-reported improvement ratings were recorded. RESULTS: Among the 39 patients who completed the study, albuterol resulted in a 20% increase in FEV1, as compared with approximately 7% with each of the other three interventions (P<0.001). However, patients' reports of improvement after the intervention did not differ significantly for the albuterol inhaler (50% improvement), placebo inhaler (45%), or sham acupuncture (46%), but the subjective improvement with all three of these interventions was significantly greater than that with the no-intervention control (21%) (P<0.001). CONCLUSIONS: Although albuterol, but not the two placebo interventions, improved FEV1 in these patients with asthma, albuterol provided no incremental benefit with respect to the self-reported outcomes. Placebo effects can be clinically meaningful and can rival the effects of active medication in patients with asthma. However, from a clinical-management and research-design perspective, patient self-reports can be unreliable. An assessment of untreated responses in asthma may be essential in evaluating patient-reported outcomes. (Funded by the National Center for Complementary and Alternative Medicine.) Copyright © 2011 Massachusetts Medical Society.

Kam-Hansen S.,Beth Israel Deaconess Medical Center | Jakubowski M.,Beth Israel Deaconess Medical Center | Kelley J.M.,Endicott College | Kelley J.M.,Harvard University | And 5 more authors.
Science Translational Medicine | Year: 2014

Information provided to patients is thought to influence placebo and drug effects. In a prospective, withinsubjects, repeated-measures study of 66 subjects with episodic migraine, we investigated how variations in medication labeling modified placebo and drug effects. An initial attack with no treatment served as a control. In six subsequent migraine attacks, each participant received either placebo or Maxalt (10-mg rizatriptan) administered under three information conditions ranging from negative to neutral to positive (told placebo, told Maxalt or placebo, told Maxalt) (N = 459 documented attacks). Treatment order was randomized. Maxalt was superior to placebo for pain relief. When participants were given placebo labeled as (i) placebo, (ii) Maxalt or placebo, and (iii) Maxalt, the placebo effect increased progressively. Maxalt had a similar progressive boost when labeled with these three labels. The efficacies of Maxalt labeled as placebo and placebo labeled as Maxalt were similar. The efficacy of open-label placebo was superior to that of no treatment. Relative to no treatment, the placebo, under each information condition, accounted for more than 50% of the drug effect. Increasing "positive" information incrementally boosted the efficacy of both placebo and medication during migraine attacks. The benefits of placebo persisted even if placebo was honestly described. Whether treatment involves medication or placebo, the information provided to patients and the ritual of pill taking are important components of care.

Kelley J.M.,Harvard University | Kelley J.M.,Endicott College | Kraft-Todd G.,Harvard University | Schapira L.,Harvard University | And 5 more authors.
PLoS ONE | Year: 2014

Objective: To determine whether the patient-clinician relationship has a beneficial effect on either objective or validated subjective healthcare outcomes. Design: Systematic review and meta-analysis. Data Sources: Electronic databases EMBASE and MEDLINE and the reference sections of previous reviews. Eligibility Criteria for Selecting Studies: Included studies were randomized controlled trials (RCTs) in adult patients in which the patient-clinician relationship was systematically manipulated and healthcare outcomes were either objective (e.g., blood pressure) or validated subjective measures (e.g., pain scores). Studies were excluded if the encounter was a routine physical, or a mental health or substance abuse visit; if the outcome was an intermediate outcome such as patient satisfaction or adherence to treatment; if the patient-clinician relationship was manipulated solely by intervening with patients; or if the duration of the clinical encounter was unequal across conditions. Results: Thirteen RCTs met eligibility criteria. Observed effect sizes for the individual studies ranged from d = -.23 to .66. Using a random-effects model, the estimate of the overall effect size was small (d = .11), but statistically significant (p = .02). Conclusions: This systematic review and meta-analysis of RCTs suggests that the patient-clinician relationship has a small, but statistically significant effect on healthcare outcomes. Given that relatively few RCTs met our eligibility criteria, and that the majority of these trials were not specifically designed to test the effect of the patient-clinician relationship on healthcare outcomes, we conclude with a call for more research on this important topic. © 2014 Kelley et al.

Malone L.A.,Lakeshore Foundation | Barfield J.P.,Endicott College | Brasher J.D.,Lakeshore Foundation
Disability and Health Journal | Year: 2012

Background: Information regarding factors that affect the initial step to exercise behavior change among persons with physical disabilities or chronic health conditions is available in the literature but much less is known regarding perceived benefits and barriers to exercise among those who are regularly active. Objective: The purpose of this study was to examine the perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise. Methods: Participants (n = 152) completed the Exercise Benefits and Barriers Scale (EBBS). For data analyses, disabilities and health conditions were grouped as neuromuscular, orthopedic, cardiovascular/pulmonary, or multiple conditions. Multivariate analysis of variance (MANOVA) was conducted to determine if mean differences on EBBS benefits and barriers scores existed among disability types, between sexes, among age groups, and between physical activity levels. Sum scores were computed to determine the strongest benefit and barrier responses. Results: No significant mean differences in EBBS scores were found between disability types, sexes, age groups, or physical activity levels (p > 0.05). Strongest benefit responses varied by group. Strongest barrier responses were the same for all demographic groups: "Exercise tires me," "Exercise is hard work for me," and "I am fatigued by exercise." Conclusions: EBBS scores were similar across disability/health condition, sex, age, and physical activity level. Primary benefits reported were in the areas of improved physical performance and psychological outlook whereas the primary barriers were in the area of physical exertion. © 2012 Elsevier Inc.

Livingstone R.M.,Endicott College
First Monday | Year: 2016

Software robots ("bots") play a major role across the Internet today, including on Wikipedia, the world's largest online encyclopedia. Bots complete over 20 percent of all edits to the project, yet often their work goes unnoticed by other users. Their initial integration onto Wikipedia was not uncontested and highlighted the opposing philosophies of "inclusionists" and "deletionists" who influenced the early years of the project. This paper presents an in-depth interview with Wikipedia user Ram-Man, an early bot operator on the site and creator or the rambot, the first mass-editing bot. Topics discussed include the social and technical climate of early Wikipedia, the creation of bot policies and bureaucracy, and the legacy of rambot and Ram-Man's work. © First Monday, 1995-2016.

Livingstone R.M.,Endicott College
Social Science Computer Review | Year: 2016

Through examining established and evolving conceptions of intelligence across natural and social science and applying them to Wikipedia, this article argues that the world’s largest encyclopedia and broadest implementation of the wiki is an online instance of collective intelligence (CI), as it fits key models for this concept. Further, by relying on sociotechnical ensembles of human intelligence, programmed bots, social bureaucracy, and software protocols, a more humanistic CI, as proposed by Lévy, is realized in a virtual knowledge space that embodies information as both product and process while empowering its community to explore the cultural possibilities of its collectivism. © 2015, © The Author(s) 2015.

Sniezyk C.J.,Crossroads Center for Children | Zane T.L.,Endicott College
Focus on Autism and Other Developmental Disabilities | Year: 2015

Sensory Integration Therapy (SIT) is a popular treatment for Pervasive Developmental Disorders that involves therapists using various strategies and manipulanda to provide sensory stimulation to improve behavioral dysfunctions. Although SIT is popular, the research literature demonstrates little experimental proof of effectiveness. Many published studies find little to no causal relationship between SIT and improvements in target behaviors. There are numerous internal and external validity threats that preclude confidence in a functional relationship for those studies that report positive changes. The current study attempted to evaluate the impact of different SIT techniques on the behavioral excesses of children diagnosed with autism, while using research designs that adhered to commonly accepted standards for internal and external validity controls. The results showed that there was no causal relationship between the sensory procedures and improvements in the targeted dependent variables. Thus, SIT remains an unproven treatment for autism. © Hammill Institute on Disabilities 2014.

McDaniel C.,Endicott College
Discrete and Computational Geometry | Year: 2013

Guillemin and Zara (Duke Math J 107(2):283-349, 2001) described an analogue of Morse theory on a certain class of 1-skeleta including all those coming from simple polytopes. In this paper we extend the methods of Guillemin and Zara to a larger class of 1-skeleta including all those coming from simple polytopes and their 1-skeleton projections. As an application of these methods we prove a lifting result which yields an intrinsic characterization of 1-skeleton projections of simple polytopes. © 2013 Springer Science+Business Media New York.

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