Bei-Hung Chang

• ScD
• Professor (Associate) at University of Massachusetts Chan Medical School

Recovery has emerged as a focus of mental health rehabilitation in the past decade. Many have suggested that various domains of recovery-orientated services are integrated to an efficacious mental health care system. In this study we examined the association of domains of recovery-oriented services with recovery outcomes among inpatients in a state...

Recovery has emerged as a focus of mental health rehabilitation in the past decade. Many have suggested that various domains of recovery-orientated services are integrated to an efficacious mental health care system. In this study we examined the association of domains of recovery-oriented services with recovery outcomes among inpatients in a state...

Background: Within the field of behavioral health research, one of the most understudied populations is the U.S. Deaf and hard-of-hearing (D/HH) population - a diverse group of individuals with hearing loss that have varied language and communication preferences, community affiliations, and sociocultural norms. Recent research identified concernin...

[This corrects the article DOI: 10.1371/journal.pone.0062817.].

Background: Many systematic reviews of randomized clinical trials lead to meta-analyses of odds ratios (ORs). The customary methods of estimating an overall OR involve weighted averages of the individual trials' estimates of the logarithm of the OR. That approach, however, has several shortcomings, arising from assumptions and approximations, that...

Objective: The main aim of this study was to examine the differences between triple therapy (T: SSZ and HCQ added to MTX) and etanercept (E) added to MTX with regard to the infectious and gastrointestinal (GI) adverse events (AEs) reported in The Rheumatoid Arthritis Comparison of Active Therapies Trial. Methods: The patients were 353 RA MTX inc...

Background: In late 2012, the Worcester Recovery Center and Hospital opened, replacing the long standing Worcester State Hospital, in Worcester Massachusetts. The Recovery Center is a public psychiatric facility that represents a total systems and treatment shift from “care as usual” in a traditional hospital setting to an inpatient, recovery-focus...

Objective: This study evaluated three domains of job burnout (emotional exhaustion, depersonalization, and personal accomplishment) and factors associated with burnout in a national sample of peer specialists (PSs) employed at 138 Veterans Health Administration (VHA) health care systems in 49 states. Methods: Data were drawn from an observationa...

Objectives: Department of Veterans Affairs (VA) peer specialists and vocational rehabilitation specialists are Veterans employed in mental health services to help other Veterans with similar histories and experiences. Study objectives were to (a) examine job satisfaction among these employees, (b) compare them to other VA mental health workers, an...

Objective: The study compared employment experiences, mental health recovery, and quality of life among peer specialists and vocational rehabilitation (VR) specialists hired by the U.S. Department of Veterans Affairs (VA), the VR specialists under the Homeless Veterans Supported Employment Program. Employment characteristics associated with mental...

Objective: Although combat experiences can have a profound impact on individuals' spirituality, there is a dearth of research in this area. Our recent study indicates that one unique spiritual need of veterans who are at the end of life is to resolve distress caused by combat-related events that conflict with their personal beliefs. This study soug...

Objectives: Combat experience can impact individuals physically, psychologically, and spiritually. Physical and psychological traumas are well studied, yet spiritual trauma is often overlooked, possibly because it manifests as psychological symptoms such as post-traumatic stress disorder. Our recent study indicates that veterans who are at end of l...

Background and Objectives Substance use disorder (SUD) is a major health issue, especially among military veterans. We previously reported the effects of auricular acupuncture and the relaxation response (RR) on reducing craving and anxiety following 10-week interventions among veterans who were in recovery from SUDs. Our current analysis examines...

The relaxation response (RR) is the counterpart of the stress response. Millennia-old practices evoking the RR include meditation, yoga and repetitive prayer. Although RR elicitation is an effective therapeutic intervention that counteracts the adverse clinical effects of stress in disorders including hypertension, anxiety, insomnia and aging, the...

Temporal genomic expression patterns during one session of RR elicitation. Genes that were differentially expressed either across or within groups comparisons at different time point were used as seed sets of genes for Self-Organizing Map (SOM) analysis. These differentially expressed genes were partitioned to 18 separate maps according to Pearson...

Interactive network and focus hubs of genes depicting Longterm Upregulation patterns. A) Interactive network, B) Top 20 focus genes. The interactive network and focus hub identification analysis was performed on genes from 14 Long-term Upregulated pathways linked to DNA stability, recombination and repair. In the network each node represents a gene...

Gene—ontology enrichment analysis of progressive and long—term expression patterns. (PDF)

Schematic view of temporal relaxation response study design and analysis plans. The transcriptome profiling was performed on peripheral blood mononuclear cells (PBMCs) collected immediately prior to (T0), immediately after (T1) and 15 minutes after (T2) listening to a 20-minute Education CD by the Novices (N1) or a 20-minute RR CD by the Short term...

Interactive Network of progressively (Progressive II) upregulated genes. The network was generated from genes of 27 progressively upregulated pathways (Progressive I) related to energy production, metabolism, growth factors and glucose regulation. The interaction information about the genes was obtained from public interaction databases or the comm...

Correlation analysis of NO levels and Selected 10 pathways affected progressively or only in long term manner by RR (Bold). The correlation analysis was performed both by comparing FeNO and gene expression levels at particular time point (e.g. T0, T1, T2) as well as changes in gene expression and FeNO levels within a group. The significance of the...

Supporting Information (PDF)

Interactive network and focus hubs of genes depicting acute Progressive (Progressive II) Downregulation patterns. The interactive network and focus hub identification analysis was performed on genes from 15 Progressively Downregulated (Progressive I) pathways linked to mRNA processing and immune response. The focus gene hubs were identified using t...

Top focus gene hubs identified from Interactive networks of significantly affected Long-term Downregulated pathways. The figure represents the top 20 focus genes identified from complex interactive networks generated from pathways with Long-term Downregulated patterns. The focus gene hubs were identified and ranked using the bottleneck algorithm fo...

FeNO levels during one session of RR elicitation. (PDF)

Purpose: Spirituality plays an important role for many people. In particular, its crucial role among people at the end-of-life (EoL) has been recognized. Currently one out of 4 deaths in the US is a veteran. The study of spirituality among veterans who are at the EoL is therefore urgently needed. The objectives of this study are to understand the s...

Objective: Spiritual care is an essential component of quality palliative care. Recognizing the importance, the Department of Veterans Affairs (VA) mandates the inclusion of chaplains in a palliative care consult team (PCCT). The purpose of this study is to explain the process and content of spiritual care provided in a VA Medical Center from chap...

Spiritual care is an important domain of palliative care programs across the country and in the Veterans Affairs (VA) Healthcare System specifically. This qualitative study assessed the spiritual needs, spiritual care received, and satisfaction with spiritual care of both Veterans at the end of life and their families. Seventeen Veterans and 9 fami...

The relaxation response (RR) is a physiological state that is the counterpart to the stress response. We investigate the psychological and biological effects, as well as the correlation between these two effects that are associated with short-term vs. long-term practice of techniques that elicit the RR ("RR practice"). The study comprised both a cr...

To examine the effect of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) symptoms in HIV patients who are using highly active antiretroviral therapy (HAART). The authors conducted a 4-arm 2×2 double-blind randomised controlled trial in an acupuncture clinic in the USA. Sham acupuncture and health education were used...

Background & Aims: Substance abuse is a major health problem in the US population, particularly among veterans. Current treatments for substance abuse in the form of pharmacologic, behavioural, or psychosocial therapy can be effective in limited instances. We investigated the effect of using two complementary and alternative approaches, acupuncture...

Objectives: We examined the dose response of the combination of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) side effects, such as nausea, vomiting, and bowel upsets related to use of antiretroviral therapies (ART). Methods: We conducted a randomized controlled trial on HIV/AIDS patients who were on ART and had GI...

PURPOSE: Although cardiac rehabilitation programs have been shown to decrease cardiovascular risk, morbidity, and mortality, few programs have integrated a balanced mind/body approach in which patients are taught the relaxation response and utilize cognitive behavior skills for stress management, along with diet and exercise. We examined the medica...

Although cardiac rehabilitation programs have been shown to decrease cardiovascular risk, morbidity, and mortality, few programs have integrated a balanced mind/body approach in which patients are taught the relaxation response and utilize cognitive behavior skills for stress management, along with diet and exercise. We examined the medical and psy...

Objectives: Relaxation response (RR) practice has been found to improve spiritual quality of life in various patient populations including cardiac patients. In this study, we examined the relationship among RR, spirituality, weight loss, and medical and psychological outcomes of patients with coronary artery disease who participated in a mind-bod...

Objectives: We examined the dose response of acupuncture and the relaxation response (RR) for treating substance abuse using data collected from a randomized trial. Methods: Participants were recruited from residents of a homeless veteran rehabilitation program. Enrolled participants were randomly assigned to one of the three study groups: acupun...

Isolated systolic hypertension is common in the elderly, but decreasing systolic blood pressure (SBP) without lowering diastolic blood pressure (DBP) remains a therapeutic challenge. Although stress management training, in particular eliciting the relaxation response, reduces essential hypertension its efficacy in treating isolated systolic hyperte...

Objectives: To review the feasibility and preliminary data of a trial of acupuncture and the relaxation response (RR) for reducing substance craving among veterans. Methods: Study participants were recruited from a Veterans Administration residential, homeless rehabilitation program. Enrolled participants were randomly assigned into one of the th...

Treatment advances have transformed human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) into a chronic manageable disease; quality of life (QoL) has become an important health outcome. Some studies have shown the individual effects of acupuncture and the relaxation response (RR) in improving QoL of patients with HIV/AIDS. In...

The study of complementary and alternative medicine (CAM) using a randomized, controlled trial (RCT) design poses challenges, such as treatment standardization and blinding. We designed an RCT, which avoided these two common challenges, to evaluate the effect of adding the relaxation response (RR) to usual acupuncture treatment. In this paper, we r...

Mind/body practices that elicit the relaxation response (RR) are currently practiced by over 30% of American adults. RR elicitation reduces volumetric oxygen consumption (VO(2)) from rest and counteracts the effects of stress, although the mechanisms mediating the RR remain unknown. This study was designed to investigate whether RR elicitation is m...

To identify the extent of inappropriate prescribing using criteria for proper use developed by the Agency for Healthcare Research and Quality (AHRQ) and dose-limitation criteria defined by Beers, as well as to describe duration of use and patient characteristics associated with inappropriate prescribing for older people. Retrospective national Vete...

Patients with various medical conditions benefit from eliciting the relaxation response (RR), using a variety of techniques, but few studies have focused on chronic heart failure (CHF). We evaluated the efficacy of an RR intervention program on the quality of life (QOL) and exercise capacity of CHF patients by conducting a single-blind, 3-arm, rand...

We examined racial differences in cardiac catheterization rates and reviewed whether patients' beliefs or other variables were associated with observed disparities. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible...

Patient recruitment is one of the most difficult aspects of clinical trials, especially for research involving elderly subjects. In this paper, we describe our experience with patient recruitment for the behavioral intervention randomized trial, "The relaxation response intervention for chronic heart failure (RRCHF)." Particularly, we identify fact...

Fifty-seven veterans with congestive heart failure were interviewed about their experiences and changes after participating in a three-armed randomized trial: relaxation response (RR) training, cardiac education, and usual care. The interviews were tape-recorded, transcribed, and analyzed. Half of the 20 RR group interviewees reported physical impr...

We examined agreement of administrative data with self-reported race/ethnicity and identified correlates of agreement. We used Veterans Affairs administrative data and VA 1999 Large Health survey race/ethnicity data. Relatively low rates of agreement (approximately 60%) between data sources were largely the result of administrative data from patien...

We examine the association between sexual assault, religion and mental health among male veterans. We used longitudinal data collected from 2,427 male veterans who received VA outpatient care. Sexual assault was self-reported in the questionnaire. Two dimensions of religiosity were used: organizational (frequency of religious service attendance) an...

Objective:This study examined the relationship between language acculturation of disabled Puerto Rican elderly and their caregivers, their length of residence in mainland United States, and the utilization of formal services. Methods:Language acculturation was measured by language use, understanding, and preferences. The sample of this study consis...

To deternine whether there are racial differences in patients' health-related attitudes, beliefs, and experiences regarding invasive cardiac procedures, and to develop psychometrically and conceptually valid scales and single items to assess these dimensions. A survey was designed and administered to 854 white and black patients with ischemic heart...

We applied a mixed effects model to investigate between- and within-study variation in improvement rates of 180 schizophrenia outcome studies. The between-study variation was explained by the fixed study characteristics and an additional random study effect. Both rate difference and logit models were used. For a binary proportion outcome p(i) with...

An empirically derived risk adjustment model is useful in distinguishing among facilities in their quality of care. We used Veterans Affairs (VA) administrative databases to develop and validate a risk adjustment model to predict decline in functional status, an important outcome measure in long-term care, among patients residing in VA long-term ca...

Objective Religion has been shown to have a positive impact on well-being and to play an important role in coping with stressful life events. However, the buffering effect of religiosity on mental health, after a particularly stressful life event such as sexual assault, has not been studied. In this study we examined the buffering effect of religio...

Religion has been shown to have a positive impact on well-being and to play an important role in coping with stressful life events. However, the buffering effect of religiosity on mental health, after a particularly stressful life event such as sexual assault, has not been studied. In this study we examined the buffering effect of religion on menta...

This article demonstrates the use of two approaches to analyzing the relationship of multiple covariates to an outcome which has a high proportion of zero values. One approach is to categorize the continuous outcome (including the zero category) and then fit a proportional odds model. Another approach is to use logistic regression to model the prob...

This article demonstrates the use of two approaches to analyzing the relationship of multiple covariates to an outcome which has a high proportion of zero values. One approach is to categorize the continuous outcome (including the zero category) and then fit a proportional odds model. Another approach is to use logistic regression to model the prob...

BACKGROUND: Compared with the acute-care setting, use of risk-adjusted outcomes in long-term care is relatively new. With the recent development of administrative databases in long-term care, such uses are likely to increase. OBJECTIVES: The objective of this study was to determine the contribution of ICD-9-CM diagnosis codes from administrative da...

To demonstrate the potential of the Health Plan Employer Data and Information Set (HEDIS) for the calculation of a performance measure for eye exams in the diabetic population using Veterans Health Administration (VA) administrative data. We calculated a 1-year HEDIS-defined patient denominator and three alternative denominators that considered cod...

We derived two methods to estimate the logistic regression coefficients in a meta-analysis when only the 'aggregate' data (mean values) from each study are available. The estimators we proposed are the discriminant function estimator and the reverse Taylor series approximation. These two methods of estimation gave similar estimators using an exampl...

This article explores the relationships between caregiving stressors and caregiver well-being in a representative community sample of disabled elders and their informal caregivers. The direct and indirect effects of stressors and potential mediators on the outcome of caregiver psychological well-being, as measured by depression, were examined using...

Data from an observational study of a population-based sample of Puerto Rican, African-American, and non-Latino White persons age 60+ were used to investigate ethnic differences in the patterns and sources of care provided to functionally disabled elders. In general, ethnicity was not associated with either the types of care or source of care (info...

This study examined how religious/spiritual coping was related to specific conditions of caregiving and psychological distress among 127 informal caregivers to community-residing disabled elders. Support was found for the hypothesis that religious/spiritual coping influences caregiver distress indirectly through the quality of the relationship betw...

The purpose of this study was to compare attitudes toward violence and weapon-carrying among seventh-grade students in three dissimilar U.S. communities. A second focus was to determine students' understanding of their parents' violence-related guidance and behavior. Five hundred sixty-seven seventh-grade students (48% male, 46% white, 35% African-...

To determine the characteristics of recent fights among seventh-grade students at public middle schools in three dissimilar U.S. communities. The study sample was composed of 289 seventh-grade students at public middle schools in three U.S. communities who participated in fights during the previous 6 months. Students at each site completed a self-a...

Data from a comparative study of 1975 African American, Puerto Rican, and non-Hispanic White persons age 60 and older in a large Northeastern city were used to investigate the relative contribution of ethnicity and socioeconomic status (SES) to explaining differences in the need for and receipt of informal care. It was hypothesized that differences...

The associations among timing of maternal-fetal human immunodeficiency virus (HIV) transmission, infant age at first positive HIV culture, and CD8+ lymphocyte activation were examined for 74 perinatally infected infants. Nineteen of the infected infants had positive HIV cultures at < or =7 days of life, and 55 had negative HIV cultures at < or =7 d...

The associations among timing of maternal-fetal human immunodeficiency virus (HIV) transmission, infant age at first positive HIV culture, and CD8+ lymphocyte activation were examined for 74 perinatally infected infants. Nineteen of the infected infants had positive HIV cultures at ≤7 days of life, and 55 had negative HIV cultures at ≤7 days but we...

The associations among timing of maternal-fetal human immunodeficiency virus (HIV) transmission, infant age at first positive HIV culture, and CD8+ lymphocyte activation were examined for 74 perinatally infected infants. Nineteen of the infected infants had positive HIV cultures at ≤7 days of life, and 55 had negative HIV cultures at ≤7 days but we...

We evaluated the relationship between immunologic status and vaginal colonization or infection with Candida albicans for 605 women enrolled in a multicenter, prospective cohort study of mother-to-infant transmission of human immunodeficiency virus type 1 (HIV-1). A low CD4+ lymphocyte level (< 14% vs. > or = 14%, which corresponds to an absolute co...

To evaluate the use of dried blood spot (DBS) specimens and the early diagnostic value of the polymerase chain reaction (PCR) for detection of the human immunodeficiency virus (HIV) in DBS specimens collected at predefined age intervals from a large cohort of U.S. infants at risk of congenital or perinatal HIV infection. We assayed available DBS sp...

OBJECTIVE: To evaluate the use of dried blood spot (DBS) specimens and the early diagnostic value of the polymerase chain reaction (PCR) for detection of the human immunodeficiency virus (HIV) in DBS specimens collected at predefined age intervals from a large cohort of U.S. infants at risk of congenital or perinatal HIV infection. DESIGN: We assay...

To evaluate the relationship of drug use with maternal HIV culture positivity at delivery and perinatal HIV transmission. Multicenter prospective cohort study. Obstetric and pediatric clinics in five cities in the United States. Five hundred and thirty HIV-infected pregnant women and their infants. Multivariate logistic regression was used to evalu...

Highway fatality rates vary significantly among jurisdictions. Before attributing these variations to policy differences, it is important to account for exogenous factors (e.g. weather) that are beyond the control of policy makers. A new method is developed to identify states that are doing better or worse than expected. The method is applied to th...

To examine the relationship between economic well being and health status, two economic concepts were explored: the permanent-income hypothesis and the transitory-income hypothesis. A regression analysis of time-series mortality data for the period of 1950-1988 was conducted. The regression results indicated that the total mortality rate is negativ...

To estimate the mean cost of initial medical treatment for a variety of injury types and injury causes and project the national cost of initial medical care for injuries to children. We combined injury incidence data from the Massachusetts Statewide Childhood Injury Prevention Project (SCIPP) with a claims data set (1987 charges) from the Health Da...

We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachu...

As part of the California Mobile Home Study, over 250 mobile homes from throughout the State were monitored for nitrogen dioxide (N02) concentrations. Week-long average measurements were taken with Palmes tubes in the kitchen and bedroom of each mobile home during the summer of 1984 and the winter of 1985. The study was conducted entirely by mail w...

Indoor and outdoor aerosol sampling of two homes with wood-burning stoves was conducted at Waterbury, Vermont during February and March 1982. Altogether 201 indoor and 232 outdoor aerosol samples were collected using the continuous time sequence streaker filter samplers. The aerosol samples were analyzed by proton induced X-ray emission for the fol...

This article introduces item response theory as a method to test and improve the cross-cultural scalar equivalence of a psychological measurement instrument. A comparison of American Hispanics and Mainstream Americans on the dimension of modernity is also reported. The 25-item Overall Modernity Scale (Inkeles & Smith, 1974) was administered to 432...

U.S. Navy recruits (Hispanics and Anglos) provided autostereotypes and heterostereotypes of blacks, whites, and several Hispanic ethnic groups, by judging on a ten-point scale how likely it was for each of fifteen traits to be a characteristic of a given stimulus group. All autostereotypes were favorable. The Anglos had a more uniform, though not e...

The dimensions of Hispanic and Mainstream familism, that is emphasis on family relationships and family interdependence, were explored with a sample of Hispanic and Mainstream Navy recruits. Hispanic and Mainstream recruits were equally willing to sacrifice (take a loan, sell own TV, borrow) to be present at a family crisis (e.g. brother died) but...

Navy recruits (81 Hispanic and 79 Mainstream) responded to 132 Likert format items measuring work values. The items were based on Buchholz's five work ethics (Protestant work ethic, leisure ethic, organizational belief system, humanism, and Marxist-related belief system) as modified by Ross and Hulin. Cluster analyses revealed some similarities in...