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Media Exposure and Acute Stress Following the Boston Marathon Bombings

Apr 15, 2014, 9:00 AM, Posted by Alison Holman

E. Alison Holman, PhD, FNP, is an associate professor in nursing science at the University of California, Irvine and a Robert Wood Johnson Foundation Nurse Faculty Scholar.

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A year ago today, on April 15, 2013, in the first major terror attack on U.S. soil since September 11, 2001, Dzhokhar and Tamerlan Tsarnaev planted two pressure cooker bombs near the finish line of the Boston Marathon. Three people died and more than 260 were injured. For a week authorities searched for the perpetrators, shootouts occurred, and Boston was locked down. As reporters and spectators filmed the mayhem, graphic images were shown repeatedly in both traditional and social media around the world. Like the September 11, 2001 (9/11) terrorist attacks, the population of the United States was the terrorists’ intended psychological target. Yet most research on reactions to such events focuses on individuals directly affected, leaving the public health consequences for populations living outside the immediate community largely unexplored.

Tens of thousands of individuals directly witnessed 9/11, but millions more viewed the attacks and their aftermath via the media. In our three-year study following 9/11, my colleagues and I found that people who watched more than one hour of daily 9/11-related TV in the week following the attacks experienced increases in post-traumatic stress (PTS) symptoms (e.g., flashbacks, feeling on edge and hyper vigilant, and avoidance of trauma reminders) and physical ailments over the next three years (Silver, Holman et al., 2013).

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Why Empathy is Essential to a Culture of Health

Apr 11, 2014, 11:34 AM, Posted by Tara Oakman

Peace activist Zak Ebrahim speaks at TED 2014

Everyone knows it is hard to get 2-year-olds to do anything on a schedule. They want to do everything their way, on their own time. As you can imagine, trying to get my twins out the door each morning—let alone take a bath or eat a meal, can be quite a challenge. After trying a number of different parenting methods, I have discovered that the one way I can usually motivate them is to talk about feelings, and get them to recognize how their actions affect their sibling. Just yesterday, the only way I could get my son out of the bath was by telling him that his sister was sad and lonely waiting for him. And then, and only then, did he move.

Building empathy has been a critical strategy in my household of late—not only because it helps motivate them, but also because it is an important part of their social development. Lately I have been thinking about empathy on a larger scale, beyond my household, and how critical it is to building a Culture of Health.

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In the Media: Mental Health Nurse Rocks Literary World

Apr 7, 2014, 1:00 PM

This is part of the April 2014 issue of Sharing Nursing’s Knowledge.

A nurse author is making a grand entrance on the literary scene.

British nurse Nathan Filer, 33, won a prestigious literary prize last month for his debut novel about mourning and mental illness. The book won the United Kingdom’s 2013 Costa Book of the Year award, which carries a prize of nearly $50,000.

Called Where the Moon Isn’t (and The Shock of the Fall in the U.K.), the novel tells the tale of a young schizophrenic who witnessed the death of his younger brother and winds up in a mental health institution.

It draws on Filer’s professional experience as a mental health nurse; he has worked in psychiatric wards for more than a decade.

“For a first novel it is astonishingly sure-footed. ... I think there is genuine excitement about this winner,” chief judge Rose Tremai said, according to a blog post on National Public Radio. “It is not just about schizophrenia—it is about grief.” 

Filer has said that he intends to remain active in nursing despite his newfound literary success.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

Breaking Down Barriers to Access in Social Media

Mar 31, 2014, 1:32 PM

The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) and the National Council on Disability (NCD) have established a virtual town hall conversation to examine the accessibility barriers of social media for individuals with disabilities. The town hall, which will continue through Friday, April 4, is the first in a series of three online events on the topic of social media accessibility that will take place over the next three months.

Social media is a critical tool for engaging customers, employees, jobseekers and stakeholders. When it is inaccessible to people with disabilities, a large portion of the population is excluded from important conversations. Advancing Accessibility and Inclusion in Social Media—The User Experience aims to identify the barriers to social media use and develop solutions to help ensure that all people can reap the benefits of social media and digital services.

Town hall participants are able to discuss personal social media experiences; submit comments and ideas; and vote on suggested solutions to accessibility barriers. Participants have shared feedback regarding a variety of social media platforms: Calling for captioning on government-produced Vine videos, seeking recommendations for using social media to find employment and suggesting increased accessibility training for social media developers. ODEP and NCD will use insights gleaned from the town halls to work with the social media industry to improve experiences for Americans with disabilities.

"We anticipate that this online discussion will present new and exciting opportunities for Americans with disabilities and people around the world,” said Janni Lehrer-Stein, chairperson of access and integration for NCD. “Social media opens up a new marketplace of ideas and access for everyone, including people with disabilities, adding value and providing new opportunities through inclusive engagement in the virtual world."

To participate, register at ODEP’s ePolicyWorks town hall and submit your feedback.

This commentary originally appeared on the RWJF New Public Health blog.

Head Start Program Uses Brain Science to Help Kids Heal

Mar 20, 2014, 3:40 PM, Posted by Jane Isaacs Lowe

In the late 1990s, a major study of adverse childhood experiences by Kaiser Permanente in California found that people who had been exposed to traumatic events such as violence or abuse during childhood were much more likely to have serious health problems as adults. Over the next decade, advances in neuroscience explained how childhood trauma can harm brain development and change the way kids feel and act in response to even normal events in their lives.

So, what to do? How do you protect or heal vulnerable children? An article on an innovative pre-school program in the Fixes column of yesterday's New York Times is an example of some solutions that are starting to emerge.

In 2010, the Robert Wood Johnson Foundation (RWJF) partnered with local funders and Crittenton Children's Center in Kansas City, Mo. to pilot a new kind of Head Start program that would provide caring support to pre-schoolers exposed to traumatic events—homelessness, abuse, the loss of a parent, for example. The idea was to create a web of support among all of the adults who would interact with kids throughout their day, including parents, teachers, administrators, even the school bus driver. The school would also give kids specific tools to help them deal with their emotions in a healthy way and build resilience.

Head Start Trauma Smart wanted to ensure that the children would master the skills they need by the time they start kindergarten, because kids who are already falling behind in kindergarten have a much harder time succeeding in school and living a healthy life. The results of the pilot were so promising that in 2013 RWJF gave Crittenton Children's Center a $2.3 million grant to expand the Head Start Trauma Smart model throughout the state of Missouri. 

Watch a new video documenting how Head Start Trauma Smart works. Hear some of the stories of kids who have been exposed to traumatic events that are almost unimaginable and of the caring adults who are helping them heal. 

The parents and school staff are trailblazers, doing inspired and inspiring work to help bring out the best in each and every child. And while there is nothing that they are doing in Missouri’s Head Start programs that couldn’t be done in every community, it’s not easy to get systems of care to adopt this kind of change.

New York Times columnist David Bornstein explains why this program is so significant. “Trauma interventions can be highly effective but the challenge today is extending them from therapeutic settings—which are limited and expensive—into the broad systems that serve larger numbers of children.”

Here at RWJF we think a lot about what it takes to build a culture of health in America. There are few better examples than the Head Start Trauma Smart pre-school, where every child has the chance to thrive, and every adult who crosses their path has an opportunity to be a positive influence. And where great ideas that improve health spread to more communities where they can help more families in need.

Adverse Working Conditions and Depression: A Strong Link

Feb 12, 2014, 9:00 AM

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Human Capital Blog: How does your study differ from previous research exploring the link between adverse working conditions and depression?

Sarah Burgard: The main contribution of this study was in the way we measured working conditions. Most studies that have looked at adverse working conditions and depression, or other measures of health, have looked at one adverse working condition at a time, such as job strain, job insecurity, or job dissatisfaction. But every job comes with a whole package of working conditions. We felt that capturing multiple indicators at the same time might give us a truer sense of the size, the magnitude, and the power of the association between work and depression.

Also, while some previous studies relied on longitudinal data that included multiple interviews with workers over time, they often excluded workers who did not participate in every interview because those workers didn’t have a measure of the focal working condition at every possible interview. That’s a problem because people who have worse jobs are probably more likely to drop out of longitudinal studies or leave work. Our approach was different; we analyzed data from everyone who participated in at least one interview, using all possible working conditions measure collected at each wave. We created an “overall working conditions score” at each wave using item response theory models. As a result, were able to get a more representative picture.

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Beyond Harassment: The Psychological Distress from Being Stalked

Dec 20, 2013, 8:00 AM, Posted by Darrick Hamilton

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In our recent study, we estimate that female victims of stalking have a two to three times greater risk of developing psychological distress than women who are not the victims of stalking.

Though stalking is generally viewed as a less serious issue than sexual assault, public health officials estimate that approximately one in 20 Americans will be stalked at some point in their lives.  One third of those stalkers will become violent, and there is a strong link between stalking and domestic violence.  Our study examined the mental distress associated with stalking, and thus provides a conservative estimate of the true effects, which would include the risk of sexual and other physical violence associated with stalking as well.

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APA ‘A Healthy Minds Minute’ Video Series: Reversing the Stigma Against Mental Illness

Sep 5, 2013, 3:13 PM

It’s been more than forty years since a U.S. vice presidential candidate, Senator Thomas Eagleton, was forced to withdraw his name from the ticket after it was revealed he’d been treated for depression. Medical science and understanding have come a long way since then. Still, for many there is still a stigma surrounding mental illness—a stigma that can leave people, already hurting, feeling even more alone.

This is a clear and major public health issue which dramatically reduces the likelihood that someone with a mental health condition will seek out and have access to effective health care and social services. In fact, only 38 percent of U.S. adults with diagnosable mental illnesses receive the treatment they need. The numbers are even worse for children and adolescents, with less than 20 percent getting treatment.

September is Suicide Prevention Month and Sept. 10 is the 11th-annual World Suicide Prevention Day. This year’s theme is “Stigma: A Major Barrier for Suicide Prevention.” Suicide is one of the top ten leading causes of death in the United States—with more than 38,000 deaths each year—and many of those people suffered in silence rather than reaching out to loved ones and available avenues of help.

As part of the collective effort to combat this barrier to full and compassionate care, the American Psychiatric Association (APA) is working to raise awareness so that people with mental illnesses and substance use disorders can feel more confident in seeking treatment, just as anyone with most any other medical concern would be.

APA’s new Public Service Advertisements (PSAs) series, called “A Healthy Minds Minute,” features a number of celebrities and prominent figures calling for equal access to quality care and insurance coverage for people with mental illness and substance use disorders. Below is a video with Former Congressman Patrick Kennedy.

This commentary originally appeared on the RWJF New Public Health blog.

Alzheimer's: Let's Search for Better Care Models as Well as a Cure

Jul 9, 2013, 2:00 PM, Posted by Catherine Arnst

An elderly disabled man walks with a stick on a path in a garden.

The New Yorker recently ran an excellent article by Jerome Groopman MD, Before Night Falls, about efforts to find a drug that can delay or even stop the onset of Alzheimer’s. What struck me most about this thorough piece of reporting, however, is that it covers much the same ground as a feature I wrote for Businessweek—in 2007. Despite the huge amount of money and other resources devoted to Alzheimer’s research, the quest for an effective treatment has moved forward by mere fractions in the past six years.

Almost every drug I wrote about in 2007 has since failed, which means it will be at least a decade, and probably far longer, before an effective treatment wins regulatory approval. Meanwhile, the Alzheimer’s Association recently reported that one in three seniors will die with Alzheimer’s or another form of dementia in the U.S. this year, and 5.2 million people are currently living with Alzheimer’s. By 2025, the number of people living with the disease will likely reach 7.1 million. So while we’re waiting for a cure, the medical community should also be developing better methods for caring for the millions of patients who are suffering right now.

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Building a More Resilient New York City

Jul 1, 2013, 12:41 PM

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In several recent and upcoming posts, NewPublicHealth is connecting with communities that have faced severe weather disasters in the last year. New York City, for example, is continuing to regroup and rebuild after Hurricane Sandy struck the region eight months ago. The city, and its health department, recently announced several initiatives aimed at “building back better” while supporting residents still facing housing as well as mental health problems since the storm last October. Some examples are detailed below.

  • The New York City Building Resiliency Task Force, an expert panel convened after Hurricane Sandy to help strengthen buildings and building standards, recently issued a report with recommendations for buildings and homes of all sizes in the city. The report recommends establishing backup power in the event that primary networks fail; protecting water supplies and stabilizing interior temperatures if residents need to shelter in place. ”Making our city’s buildings more resilient to coastal flooding and other climate hazards is a challenge that requires collaboration among government, designers, engineers, and building owners, among others,” said City Planning Commissioner Amanda M. Burden. “The Task Force's work exemplifies the kind of innovation and cooperation necessary to prepare our city for a changing climate.”  To create the report, the Task Force convened over 200 volunteer experts in architecture, engineering, construction, building codes and real estate.

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