Person: Borus, Jonathan
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Borus
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Borus, Jonathan
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Publication Nonspecific Medication Side Effects and the Nocebo Phenomenon(American Medical Association (AMA), 2002-02-06) Barsky, Arthur; Saintfort, Ralph; Rogers, Malcolm P.; Borus, JonathanPatients taking active medications frequently experience adverse, nonspe- cific side effects that are not a direct result of the specific pharmacological action of the drug. Although this phenomenon is common, distressing, and costly, it is rarely studied and poorly understood. The nocebo phenomenon, in which placebos produce adverse side effects, offers some insight into non- specific side effect reporting. We performed a focused review of the litera- ture, which identified several factors that appear to be associated with the nocebo phenomenon and/or reporting of nonspecific side effects while tak- ing active medication: the patient’s expectations of adverse effects at the outset of treatment; a process of conditioning in which the patient learns from prior experiences to associate medication-taking with somatic symp- toms; certain psychological characteristics such as anxiety, depression, and the tendency to somatize; and situational and contextual factors. Physi- cians and other health care personnel can attempt to ameliorate nonspecific side effects to active medications by identifying in advance those patients most at risk for developing them and by using a collaborative relationship with the patient to explain and help the patient to understand and tolerate these bothersome but nonharmful symptoms.Publication Nonspecific Medication Side Effects and the Nocebo Phenomenon(American Medical Association (AMA), 2002-02-06) Barsky, Arthur; Saintfort, Ralph; Rogers, Malcolm P.; Borus, JonathanPatients taking active medications frequently experience adverse, nonspecific side effects that are not a direct result of the specific pharmacological action of the drug. Although this phenomenon is common, distressing, and costly, it is rarely studied and poorly understood. The nocebo phenomenon, in which placebos produce adverse side effects, offers some insight into nonspecific side effect reporting. We performed a focused review of the literature, which identified several factors that appear to be associated with the nocebo phenomenon and/or reporting of nonspecific side effects while taking active medication: the patient's expectations of adverse effects at the outset of treatment; a process of conditioning in which the patient learns from prior experiences to associate medication-taking with somatic symptoms; certain psychological characteristics such as anxiety, depression, and the tendency to somatize; and situational and contextual factors. Physicians and other health care personnel can attempt to ameliorate nonspecific side effects to active medications by identifying in advance those patients most at risk for developing them and by using a collaborative relationship with the patient to explain and help the patient to understand and tolerate these bothersome but nonharmful symptoms.Publication Outbreak of Illness in a School Chorus: Toxic Poisoning or Mass Hysteria?(Massachusetts Medical Society, 1983-03-17) Small, Gary W.; Borus, JonathanPublication Deinstitutionalization of the Chronically Mentally Ill(Massachusetts Medical Society, 1981-08-06) Borus, JonathanDeinstitutionalization of the mentally ill has become the predominant public mental-health policy in most states. This policy has been supported by a curious political marriage of liberals, who decry the custodial-level care in state mental hospitals, and conservatives, who see the closing of expensive public institutions as an easy way to save tax dollars. Deinstitutionalization has been effected by discharging long-term inpatients from state hospitals and making it increasingly difficult to admit new patients. Over the past decade, it has resulted in the shift of the primary locus of clinical care in the public sector from traditional inpatient settings to . . .Publication Neighborhood Health Centers as Providers of Primary Mental-Health Care(Massachusetts Medical Society, 1976-07-15) Borus, JonathanThe 19 Boston neighborhood health centers with mental-health programs were studied to investigate the delivery of mental-health services as part of a primary health-care system. Staff-time utilization data show these programs focus on the provision of primary mental-health services to neighborhood residents and indirect consultative and collaborative services to general health staff to co-ordinate health care. Forty-eight per cent of referrals for mental-health services were patients first identified and referred by general health staff. Children constituted a disproportionately high percentage of the patients served (43 per cent), and 22 per cent of the services were outreach visits, primarily in patients' homes. Quantitative studies are necessary to confirm my qualititative findings that the conjoint health and mental-health delivery site at the neighborhood level increases the accessibility and psychologic acceptability of mental-health services and enhances case finding, successful referral, and co-ordination of primary health care.Publication Publish or perish: tools for survival(Southwest Journal of Pulmonary and Critical Care, 2017) Quan, Stuart; Borus, JonathanSuccess in one’s chosen profession is often predicated upon meeting a profession-wide standard of excellence or productivity. In the corporate world, the metric might be sales volume and in clinical medicine it may be patient satisfaction and/or number of patients seen. In academic medicine, including the fields of Pulmonary and Critical Care Medicine, the “coin of the realm” is demonstrable written scholarship. In large part, this is determined by the number and quality of publications in scientific journals. Unfortunately, the skills required to navigate the complexities of how to publish in the scientific literature rarely are taught in either medical school or postgraduate training. To assist the inexperienced academic physician or scientist, the Writing for Scholarship Interest Group of the Harvard Medical School Academy recently published “A Writer’s Toolkit”. This comprehensive monograph provides valuable information on all phases of the writing process ranging from conceptualization of a manuscript to understanding of the publication process itself. In today’s society, however, there are alternative methods of disseminating knowledge that may be better received by some learners than traditional prose. Examples include videos, podcasts and online interactive courses.Publication Scientific Authors in a Changing World of Scholarly Communication: What Does the Future Hold?(Elsevier BV, 2020-01) Baffy, Gyorgy; Burns, Michele; Hoffmann, Beatrice; Ramani, Subha; Sabharwal, Sunil; Borus, Jonathan; Pories, Susan; Quan, Stuart; Ingelfinger, JulieScholarly communication in science, technology and medicine has been organized around journal-based scientific publishing for the past 350 years. Scientific publishing has unique business models and includes stakeholders with conflicting interests – publishers, funders, libraries, and scholars who create, curate, and consume the literature. Massive growth and change in scholarly communication, coinciding with digitalization, have amplified stresses inherent in traditional scientific publishing as evidenced by overwhelmed editors and reviewers, increased retraction rates, emergence of pseudo-journals, strained library budgets, and debates about the metrics of academic recognition for scholarly achievements. Simultaneously, several open access models are gaining traction and online technologies offer opportunities to augment traditional tasks of scientific publishing, develop integrated discovery services, and establish global and equitable scholarly communication through crowdsourcing, software development, big data management and machine learning. These rapidly evolving developments raise financial, legal and ethical dilemmas that require solutions while successful strategies are difficult to predict. Key challenges and trends are reviewed from the authors’ perspective about how to engage the scholarly community in this multifaceted process.