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The 21st Century Medical School and the “Flipped” Classroom

Sep 30, 2014, 9:30 AM, Posted by Susan Dentzer

Flip the classroom video still

Pity the poor medical student...or at least many students now slogging away in medical schools across the nation.  

Most spend the first two years of medical school cramming their heads with facts about the functions of cells, organ systems, and other aspects of the human body. Having contact with real patients—the reason most students went to medical school in the first place—is quite limited until the third year, when clinical clerkships begin.

Meanwhile, medical knowledge is exploding, doubling every five years, and taxing the human brain’s capacity for processing and recall. Today’s medical students know that one day, they’ll be most likely to practice medicine with the aid of “cognitive computing” systems like IBM’s Watson, which has already “learned” as much as a second-year med student, and is helping clinicians at the Mayo Clinic, Memorial Sloan-Kettering Cancer Center, and other institutions process reams of medical information to make clinical decisions. 

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Healthy Communities: The Building Blocks of a Culture of Health

Aug 25, 2014, 9:15 AM, Posted by Jamie Bussel

Baldwin Park California

What do Corvallis, Ore.; Baldwin Park, Calif.; and Buffalo, N.Y. have in common? It certainly isn’t their weather.

Hint—the commonality is something much more relevant to RWJF’s newly refined mission. These three cities are building a Culture of Health for all their citizens. They are tapping into the skills and resources of a diverse group of partners to ensure everyone has access to healthy choices. It’s their collective efforts, along with dozens of other communities supported by the Foundation’s Healthy Kids, Healthy Communities (HKHC) program, that make me so optimistic about our organizational goal.

My strong belief that environments—physical, social and educational—play a prominent role in our individual health and well-being is what initially drew me to RWJF. So, in 2008, I excitedly embraced the opportunity to be the national program officer for HKHC, which addressed the root causes of childhood obesity by transforming the physical activity and food environments in which children and their families live, learn and play.

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Are E-Cigs a Gateway to Smoking for Teens?

Aug 21, 2014, 3:44 PM, Posted by Sheree Crute

Vaping Electronic Cigarette

As you step through the door of Beyond Vape, you are enveloped in the warm scent of vanilla, tinged with butterscotch. The sleek glass counters and display cases are reminiscent of a high-end cigar shop, but there are no tobacco leaves on hand here. This popular, high-end “vaping” parlor, on one of Williamsburg Brooklyn’s more popular streets, is one of seven the company owns on the East and West Coasts.

Vaping—or inhaling richly flavored, heated vapor through a slender, battery-powered tube—is the latest trend in “smoking,” without actually lighting a traditional cigarette. Cindy Hsu, the store’s manager, explains that some of her customers “vape" without even adding liquid nicotine to the tube’s cylinder. “They prefer to just enjoy the extensive menu of flavors such as mocha mint, kiwi strawberry and pineapple.”

Tasty flavors are one thing, but there’s another popular incentive to vape: the claim that vaping can help you stop smoking. Another neighborhood shop, Brooklyn Vaper, advertises its wares with a video explaining that vaping is a “greener, cheaper alternative to help you quit smoking effortlessly... while vaping in 40 flavors.”

Is that true? Can vaping or pre-packaged e-cigarettes help smokers quit?

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Building the Information-Rich Culture of Health

Aug 20, 2014, 10:36 AM, Posted by Michael Painter, Susan Dentzer

Reform by the Numbers Visual

What if your mother wanted to take some ibuprofen for her arthritis, but didn’t know if it would interact adversely with her other medications?

No problem, right?

She could whip out her smartphone and launch an app that connected to her local health information exchange. Within fractions of a second, the exchange would verify her identity, locate the computer storing her electronic health record (EHR), and shoot an answer back to her.

This scenario is just one example of the many ways that having timely access to health information could contribute to health. It could, that is, if the nation had an agreed-upon way to organize data about health and health care in ways that made it easily accessible and usable while still secure and protected.

But for now, we don’t.

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Preventing Suicide: If You See Something, Say Something

Aug 13, 2014, 9:16 AM, Posted by Brent Thompson

Dave and Brent Dave and Brent

The second week of August is one of the worst weeks of the year for me. At least it has been since 2008.

Six years ago this week, my friend Dave decided he had enough of the daily struggles of this world and took his own life on a trailhead in the desert near Tucson, Ariz.

He was 31 years old and left behind a fiancé, family, and scores of friends who loved him deeply.

Dave was one of the most incredible people I’ve ever known: a generous soul, full of humor, creativity, compassion, and love. He had more friends than anyone I know. Dave elevated everyone who knew him, inspiring them to find joy, open their minds, chase dreams, and see beauty in the world. It is impossible to count the lives Dave changed for the better, including my own.

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To Build a Culture of Health, There Is No Place Like Home

Aug 11, 2014, 3:36 PM, Posted by Kristin Schubert

mother with child speaking with a care coordinator

A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete.

The case for bringing health care back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns.

Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.

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An Ounce of Prevention, Even for Serious Mental Illness

Aug 7, 2014, 1:30 AM, Posted by Jane Isaacs Lowe

An educator works with a student on a hard problem

As we work to build a Culture of Health for all Americans, it is time to end the stigmatizing distinctions between mental and physical health. After all, the brain and the body are in constant contact, and affect the well-being of each other in too many ways to count. A true Culture of Health recognizes the interdependence of mental and physical health, and places a premium on prevention and early detection of illness, regardless of type.

We commonly provide preemptive treatment or suggest early lifestyle changes for people at risk for diabetes before the condition evolves into full-blown disease. Yet, we typically don’t approach care for serious mental illness in the same way. It’s time for that to change.

The results from a recently released national study of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP), a project RWJF funded between 2006 and 2013, demonstrate that early intervention to prevent the onset or progression of psychosis in teenagers and young adults improves health and well-being. By helping family members, pediatricians, teachers, young people, and other community members identify young people experiencing early symptoms of serious mental health problems, EDIPPP was able to engage and treat these young people early. That early intervention in turn helped them stay in school, remain employed, and maintain vital connections to family and friends. These benefits mitigated the effects of mental illness, and allowed these teens and young adults to lead healthier and more productive lives.

This study should shift our thinking about how we best treat young people at high risk of serious mental illness. It should also remind us to look at good health and good health practices through a much broader lens, because building a Culture of Health means finding and sharing solutions, and celebrating signs of progress.

Read a Washington Post article on the program

Read a first-person post about depression and the best way to support those who are suffering with it

Read a post by Brent Thompson on bipolar disorder and the death of a friend

If It’s Broken, They Fix It

Jul 30, 2014, 3:25 PM, Posted by Risa Lavizzo-Mourey

 A nurse fills a syringe, while another nurse watches

By “broken,” we mean medical equipment or processes that could use a little improvement—and sometimes a lot of improvement. And by “they,” we mean nurses who harness the power of their own creativity, often using whatever material they have on hand—and sometimes taking inventiveness to a whole new level.

They call them MakerNurses, eager participants in the emerging “maker” movement. One MakerNurse, Roxana Reyna, RN, of Corpus Christi, was honored at the recent White House Maker Faire for her innovative wound-care techniques in caring for infants born with their organs outside of their bellies, sparing them immediate surgery.

RWJF supports such nurse-inventors through the Little Devices @ MIT initiative’s MakerNurse program, because they hold the potential to make health care more effective and affordable.

It’s a sound investment with even larger possibilities, said RWJF President and CEO Risa Lavizzo-Mourey, MD, writing in the professional social networking site LinkedIn.

“The “maker” movement has the potential to empower all kinds of people to devise the solutions that make possible a Culture of Health—not just nurses, but caregivers, patients, and family members, all creating and sharing devices and ideas that improve health.”

Read Lavizzo-Mourey’s blog post on LinkedIn

Advanced Practice Nursing: Providing Care and Promoting Health

Jul 29, 2014, 10:50 AM, Posted by Susan Dentzer

Check out an August 1 Google+ Hangout with the Campaign for Action and RWJF.

The U.S. population is growing, getting older and suffering from more chronic disease. Thanks to the Affordable Care Act (ACA), more people are gaining health coverage and the means to obtain care. And there’s a widespread view that the country faces a drastic shortage of doctors—and primary care providers in particular.

So why are so many states seemingly determined not to let advanced practice registered nurses deliver the primary care they specifically trained to provide—and help millions of patients in the process?

Across the country, 31 states impose varying limits on the ability of nurse practitioners (one of the four types of advanced practice registered nurses) to evaluate patients; diagnose, order and interpret diagnostic tests; and to initiate and manage many treatments, including prescribing medications.

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Putting a Female Face on the Need for a Culture of Health

Jul 25, 2014, 11:29 AM, Posted by Susan Dentzer

A doctor examines a patient.  An image appears on a computer monitor.

Statistics are “human beings with the tears washed away,” an old saying goes. Sadly, the tears behind one set of statistics, showing that women’s life expectancy has been falling in just under half of U.S. counties, have rarely garnered much notice.

How to put a face on this story, to help mobilize corrective action?

Progress toward that end was made last week, when the Robert Wood Johnson Foundation teamed up with Women’s Policy, Inc, a nonprofit, nonpartisan organization that seeks to inform policy-making on women’s issues, to sponsor a briefing on that subject on Capitol Hill. About 75 people, including several female members of Congress, gathered in the Rayburn House Office Building to learn what is driving the widespread trend of poorer female health. (Watch the webcast by clicking here).

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