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Summary:ney transplantation between genetically or emotionally related persons, and bone marrow transplantation between relatives and between unrelated strangers has become As living organ, tissue, and bone marrow donation become increasingly prevalent treatments for a variety almost routine. [1][2][3][4] Furthermore, improvements in medical capabilities and immunosuppressive drugs have now made of diseases, better understanding of living donors' experiences, especially when the recipient does not sureven complex operations such as lung and liver lobe transplantation possible between relatives. 5,6 As ever growing vive after the transplant, also becomes more critical. Although some psychological outcome data exist connumbers of living donors provide relatives and strangers with opportunities to achieve longer, more fulfilling lives cerning living donation, there have been no systematic prospective investigations, to date, of the psychological at considerable sacrifice to themselves, it becomes increasingly critical to understand how such donors experience the impact of bereavement among sibling bone marrow donors. Studies of bereavement effects in other donation donation process, especially in cases where the recipient does not survive after the transplant. settings such as unrelated bone marrow donation and related kidney donation, suggest that bereavement mayTo date, studies that have examined psychological issues among bone marrow donors (for example see Refs 7-11) have a significant impact on donors' reactions. The present investigation studied a panel of sibling bone have focused primarily on unrelated donation -which involves little or no contact between donor and recipientmarrow donors at three key points in the donation process in order to (1) examine donor psychological welland thus have not been able to fully examine the additional effects of bereavement on donors' psychological wellbeing across time, and (2) investigate the effect of the sibling recipient's death on donor well-being. We surbeing. The failure of prior research to adequately address donor psychological issues including bereavement within veyed sibling donors by mail 1-2 weeks prior to donation, 1-2 weeks following donation, and again 1 the framework of related bone marrow donation led us in the current study to investigate such donation experiences year after their donation. In general, all donors reported high levels of predonation self-esteem, masin siblings. We were specifically interested in determining whether the death of a sibling bone marrow recipient affectery, happiness and life satisfaction. As might be expected, bereaved donors felt less as if their donation ted donor psychological well-being and adjustment assessed prospectively from predonation to 1 year posthad really helped their sibling as time passed. However, despite such donation-specific perceptions, bereaved donation. Although all living donations involve distinct sets of donors experienced global psychological gains following bereavement including enhanced self-es...

Low-income, uninsured immigrants are burdened by poverty and a high prevalence of trauma exposure, and thus are vulnerable to mental health problems. Disparities in access to mental health services highlight the importance of adapting evidence-based interventions in primary care settings that serve this population. In 2005, The Montgomery Cares Behavioral Health Program (MCBHP) began adapting and implementing a collaborative care model for the treatment of depression and anxiety disorders in a network of primary care clinics that serve low-income, uninsured residents of Montgomery County, Maryland, the majority of whom are immigrants. In its 6th year now, the program has generated much needed knowledge about the adaptation of this evidence-based model. The current article describes the adaptations to the traditional collaborative care model that were necessitated by patient characteristics and the clinic environment.

These associations indicate that more effective Medicaid prescription drug management and financing practices are needed to promote medication continuity and improve treatment outcomes.

The findings indicate consequential medication access problems for psychiatric patients during the implementation of Medicare Part D. Although Centers for Medicare and Medicaid Services policies were enacted to ensure access to protected classes of psychopharmacologic medications, the high rates of medication access problems observed indicate further refinement of these policies is needed.

Background: There is strong evidence supporting implementation of the Collaborative Care Model within primary care. Fee-for-service payment codes, published by Current Procedural Terminology in 2018, have made collaborative care separately reimbursable for the first time. These codes (ie, 99492–99494) reimburse for time spent per month by any member of the care team engaged in Collaborative Care, including behavioral care managers, primary care providers, and consulting psychiatrists. Time-based billing for these codes presents challenges for providers delivering Collaborative Care services. Objectives: Based on experience from multiple health care organizations, we reflect on these challenges and provide suggestions for implementation and future refinement of the codes. Conclusions: Further refinements to the codes are encouraged, including moving from a calendar month to a 30-day reimbursement cycle. In addition, we recommend payers adopt the new code proposed by the Centers for Medicare and Medicaid Services to account for smaller increments of time.

These associations indicate that more effective Medicaid prescription drug management and financing practices are needed to promote medication continuity and improve treatment outcomes.