Category Archives: HC Website Feature

Oct 23 2014
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RWJF Scholars in the News: CPR for Ebola patients, freezing women’s eggs, the inevitability of failure, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

The New York Times reports on remarks by medical ethicist Joseph J. Fins, MD, in which he calls for clearer guidance on whether clinicians should administer cardiopulmonary resuscitation (CPR) to Ebola patients whose hearts stop beating. In a commentary published on the Hastings Center Report website, and cited by the Times, Fins argues against administering CPR because of the danger of transmission of the virus to clinicians, the slim likelihood that Ebola patients will recover, and other clinical factors. Fins, an RWJF  Investigator Award in Health Policy Research recipient, urges a dialogue on the question leading to clear guidelines from hospitals and government officials.

In an article for CNN, Rene Almeling, PhD, and co-authors say that while Apple and Facebook made headlines last week for offering to cover costs for their female employees to freeze their eggs, people should be suspicious of egg-freezing as a “solution.” The technology carries risk and has high rates of failure, they write. “But even if the technology were perfect, the proposal to help women put motherhood on ice so they can focus on their jobs is shortsighted,” they add. “[R]ather than making fundamental changes to the structure of work in our society to accommodate women’s reproductive years, technological optimists reach for an engineering solution. ... Instead, the goal should be to build systems of production that allow us to live our lives without constantly watching the clock.” Almeling is an RWJF Scholars in Health Policy Research alumna.

The consumption of sugar-sweetened soda might be promoting disease independent of its role in obesity, according to a study co-authored by RWJF Health & Society Scholars program alumni Belinda Needham, PhD, MA, and David Rehkopf, ScD, MPH. The study shows that telomeres—the protective units of DNA that cap the ends of chromosomes in cells—were shorter in the white blood cells of survey participants who reported drinking more soda, Science Blog reports. Shorter telomeres have been linked to a number of chronic diseases, including heart disease, diabetes and some types of cancer.

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Oct 16 2014
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RWJF Scholars in the News: Ebola safeguards, pay-for-performance, brain development and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

PBS NewsHour interviews Howard Markel, MD, PhD, FAAP, on whether hospitals, doctors and nurses are sufficiently prepared to handle Ebola cases in the United States, and what measures should be taken to increase safety. “As someone who studies epidemics, there’s always lots of fear, scapegoating and blame,” Markel, an RWJF Investigator Award in Health Policy Research recipient, said. “American tolerance for anything less than perfection has only shortened. The incredible thing to focus on is that so little has happened, so few cases have spread here.” The video is available here and an accompanying article is available here. Markel is also quoted in an Ebola story in the New Republic and wrote a blog for the Huffington Post.

In an article for Forbes magazine, RWJF Investigator Award in Health Policy Research recipient Peter Ubel, MD, discusses whether pay-for-performance health care models can lead to overdiagnosis and overuse of antibiotics. He cites recent journal articles suggesting that sepsis may be over diagnosed in hospitals because the institutions receive higher reimbursements for sepsis patients than for those with milder infections. “In other words, it pays not to miss sepsis diagnoses,” Ubel writes. “Because of the inherent subjectivity of medical diagnoses, those groups that assess health care quality need to remain on the alert for the unintended consequences of their measures. And those insurers and regulators eager to establish clinical care mandates? They need to slow down and make sure their administrative fixes do not create undue side effects.” Ubel also wrote a separate Forbes article on health insurance turnover.

Recent research on children who began life in overcrowded Romanian orphanages shows that early childhood neglect is associated with changes in brain structure, Science Times reports. A study co-authored by RWJF Health & Society Scholars program alumna Margaret Sheridan, PhD, finds that children who spent their early years in Romanian orphanages have thinner brain tissue in cortical areas that correspond to impulse control and attention, providing support for a link between the early environment and Attention Deficit Hyperactivity Disorder (ADHD). Researchers compared brain scans from 58 children who spent at least some time in institutions with scans of 22 non-institutionalized children from nearby communities, all between the ages of 8 and 10. The article notes that the study is among the first to document how social deprivation in early life affects the thickness of the cortex.

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Oct 9 2014
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RWJF Scholars in the News: The nurse faculty shortage, teaching empathy, a link between overtime and diabetes, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

ABC News explores the nation’s nursing workforce shortage, focusing specifically on the faculty shortage at nursing schools. “Suddenly, we turned around and realized we’re not attracting enough nurses to go into teaching,” said Kimberly Glassman, PhD, RN, chief nursing officer at NYU Langone Medical Center. “The fear is we will have to shrink the number of nurses we can prepare for the future at a time when we need to prepare more.” Glassman is an RWJF Executive Nurse Fellow. The article was republished by Yahoo News and ABC News Radio.

RWJF Health & Society Scholars program alumnus Allison Aiello, PhD, MS, is interviewed for an NBC News story on Enterovirus D-68. She recommends that parents consider getting flu shots for their children, noting that preventing children from getting the flu should help make Enterovirus less complicated to diagnose and treat. The video is available here.

RWJF Harold Amos Medical Faculty Development Program scholar Paloma Toledo, MD, co-authors a Huffington Post blog entry on the need for medical schools to teach students to be empathetic. Over the course of their training, they become less empathetic, as opposed to more empathetic, and the reasons for this are unclear,” Toledo writes, recommending lectures on active listening and communication skills, among other measures. 

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Oct 2 2014
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RWJF Scholars in the News: Autism and birth order, nurse staffing and underweight infants, long-term care insurance, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

There is an increased risk of Autism Spectrum Disorders (ASD) among children born less than one year or more than five years after the birth of their next oldest sibling, Forbes reports. The study, led by RWJF Health & Society Scholars program alumna Keely Cheslack-Postava, PhD, MSPH, analyzed the records of 7,371 children born between 1987 and 2005, using data from the Finnish Prenatal Study of Autism. About a third of the children had been diagnosed with ASD by 2007. Researchers found that the risk of ASD for children born less than 12 months after their prior sibling was 50 percent higher than it was for children born two to five years after their prior sibling. “The theory is that the timing between pregnancies changes the prenatal environment for the developing fetus,” Cheslack-Postava said. 

The health outcomes and quality of care for underweight black infants could greatly improve with more nurses on staff at hospitals with higher concentrations of black patients, according to a study funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative (INQRI). The study, led by Eileen Lake, PhD, RN, FAAN, found that nurse understaffing and practice environments were worse at hospitals with higher concentrations of black patients, contributing to adverse outcomes for very low birthweight babies born in those facilities, reports Health Canal. More information is available on the INQRI Blog. The study was covered by Advance Healthcare Network for Nurses, among other outlets.

Because of a “medical-industrial complex” that provides financial incentives to overuse and fragment health care, patients nearing the end of their lives need an advocate to fight for their interests, Joan Teno, MD, MS, writes in an opinion piece for the New York Times. Teno encourages readers to “find a family member or friend who can advocate for the health care that you want and need. Find someone to ask the hard questions: What is your prognosis? What are the benefits and risks of treatments? Find someone not afraid of white coats.” Teno is an RWJF Investigator Award in Health Policy Research recipient. 

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Sep 25 2014
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RWJF Scholars in the News: Unintended consequences of shorter ER wait times, Ebola response, vaccinations and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Policies aimed at shortening emergency departments waiting times may have unintended consequences, including unnecessary admission of patients who might be better off being discharged, RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, tells Health Day. Hsia published two research letters in JAMA Internal Medicine on emergency wait times at urban and rural hospitals. RWJF Clinical Scholar alumnus Jeremiah Schuur, MD, MHS, author of an accompanying editorial, seconds Hsia’s concerns. “Medicare started advertising waiting times at ERs about a year ago. And that will be a strong incentive for hospitals to work on and improve their waiting times...[h]owever, some of the hospitals with longer waiting times, like teaching hospitals, care for the most complex patients who often don’t have access to regular care. And these places are, by nature and necessity, going to have longer waiting times,” he warned. The article was republished by U.S. News & World Report and Health.com, among other outlets.

CBS Detroit interviews Howard Markel, MD, PhD, FAAP, recipient of an RWJF Investigator Award in Health Policy Research, for a story on President Obama’s decision to send American troops and medical and logistical support to Africa to stop Ebola from spreading. “It is a humanitarian gesture,” Markel said. “I applaud the president for doing it. Do I wish as a physician and an epidemiologist it was done earlier? Yes, of course.” Markel says he does not expect the virus to spread to the United States. He is also quoted in the New Republic and Politico.

In an op-ed for the New York Times, Jason Karlawish, MD, explores the balance between risk-avoidance and enjoying life as we age. Noting that 3.6 percent of the population is 80 or older, he writes that as Americans age, “life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take.” Aging in the 21st century is all about risk reduction, but “[w]e desire not simply to pursue life, but happiness” and “medicine is important, but it’s not the only means to this happiness,” Karlawish writes. National investment in communities and services that improve the quality of our aging may be one answer, he adds. Karlawish is a recipient of an RWJF Investigator Award in Health Policy Research.

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Sep 18 2014
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RWJF Scholars in the News: Antibiotic overuse, sexual assault nurse examiners, diaper banks, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

RWJF Investigator Award in Health Policy Research recipient Anthony So, MD, MPA, co-authors a piece in the News & Observer (Raleigh, North Carolina) about the need to reduce the overuse of antibiotics, in both humans and animals. Overuse accelerates the development of antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that half of human antibiotic use and much animal antibiotic use is unnecessary, the article says. So calls for public policies that create incentives for farmers to decrease use of antibiotics and that limit antibiotic use in animals to disease treatment, rather than growth-promotion or as a substitute for hygiene and infection-control.

In Chicago, most children with asthma or food allergies do not have a health management form on file at school, leaving their schools without information they might need in emergencies, according to a study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH that was covered by Reuters Health. Researchers analyzed 2012-13 school year data on more than 400,000 Chicago schoolchildren, including 18,287 with asthma and 4,250 with a food allergy. Only a quarter of the asthmatic students and half of those with a food allergy had a health management plan on file. The study was also covered by The Chicago Tribune, Fox News, The Baltimore Sun, and Red Orbit, among other outlets.

RWJF Nurse Faculty Scholars alumna Angela Frederick Amar, PhD, RN, FAAN, publishes an op-ed on Talking Points Memo about the report from the White House Task Force to Protect Students from Sexual Assault, Not Alone. Amar notes that effective response to campus sexual assault should include medical care for survivors, and that Sexual Assault Nurse Examiners (SANEs) are trained to tend to the medical and emotional needs of survivors and collect forensic evidence. In other institutions with high rates of sexual violence, such as the military, SANEs are considered an essential part of treatment for victims of sexual violence, Amar writes.

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Sep 4 2014
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RWJF Scholars in the News: The nursing shortage, ADHD, meaningful online communications and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

NBC 2 (Buffalo, New York) interviewed Carol S. Brewer, PhD, RN, FAAN, co-director of RWJF’s RN Work Project, for a story about the nursing shortage and job prospects for nurses early in their careers. “We are not seeing as much demand for brand new graduates,” Brewer said. However, the anticipated retirement of many older nurses and the increasing demand for health care as a result of the Affordable Care Act could combine to create a 19-percent increase in demand for nurses in the near future, Brewer said. In the meantime, she suggests that new nurses be willing to relocate and look for nursing jobs in rural communities, where demand is greater.

It is important to keep media and public focus on the Affordable Care Act, Jake Haselswerdt, PhD, an RWJF Scholar in Health Policy Research, tells the Independent Voters Network website, because some states are still blocking full implementation of the law. “In order for the more stubborn states to move forward with implementation and expanding care, there may need to be some continued pressure,” he said. “That’s going to require the media to pay attention to the big disparities that are emerging between states that tried to implement the law and those that resisted.”

Tina Bloom, PhD, RN, an RWJF Nurse Faculty Scholar, led training for nurses in Columbia, Missouri, aimed at helping them identify the risk factors and symptoms of domestic violence, and then to support victims, ABC17 News reports. The training is consistent with preventive care provisions in the Affordable Care Act, the article says. Among other things, Bloom teaches nurses to look for certain types of injuries and for issues in patients’ medical histories that do not make sense.

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Aug 28 2014
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RWJF Scholars in the News: Medical marijuana’s unanticipated benefits, infant sleep pods, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

States that have legalized medical marijuana have seen nearly 25 percent fewer deaths from overdoses involving prescription painkillers than states that have not, according to a study led by Marcus Bachhuber, MD. ABC News reports on it, noting that 23 states and the District of Columbia have such laws. Researchers found that while opioid overdose rates continued to climb, the increase was much slower in states with medical marijuana laws, resulting in 25 percent fewer deaths from opioid overdose. “This study raises the possibility that there is an unintended public health benefit of medical marijuana laws, but we still need to collect more information to confirm or refute what we’ve found,” says Bachhuber, an RWJF/Veterans Administration Clinical Scholar at the Philadelphia Veterans Affairs Medical Center. Outlets covering Bachhuber’s study include CNN, Washington Post, Business Insider, Health Day and Vox.

An infant “sleep pod” designed by Jennifer Doering, PhD, RN, is one of 11 projects funded through new grants from the University of Wisconsin Extension and the Wisconsin Economic Development Corporation, the Milwaukee Journal Sentinel reports. The $25,000 Ideadvance grants are intended to move good ideas more quickly to the marketplace. Doering’s I-SleepPod, developed as a result of her work in the RWJF Nurse Faculty Scholars program, would allow an infant to sleep next to an adult while remaining safe, thanks in part to an alarm that wakes the adult in the event of an unsafe sleeping position. “We designed the sleep pod to minimize hazards because, if we don’t move in that direction of reducing sleep-related infant deaths, then [society] is essentially saying it’s acceptable to have 600 babies die every year that way,” Doering said.

Nutrition rating systems in supermarkets may encourage shoppers to purchase less junk food, according to a study led by John Cawley, PhD, an RWJF Scholars in Health Policy Research alumnus and Investigator Award in Health Policy Research recipient. The study coupled sales data from Hannaford Supermarkets in the northeastern United States from January 2005 to December 2007 with the Guiding Stars nutritional rating system. The ratings system assigns zero to three stars to food items, based on their nutritional value. Researchers found that sales of less healthy foods—such as highly processed snack foods—fell by 8.31 percent when branded with a low nutrition rating, while healthy food purchases rose by 1.39 percent, Medical Xpress reports.

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Aug 21 2014
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RWJF Scholars in the News: Costs for blood tests, dentists testing for hypertension and HIV, fudging medical history, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

A new study uncovers vast variation in pricing for common blood tests by California hospitals, reports the Washington Post. Renee Hsia, MD, MSc, an RWJF Physician Faculty Scholars program alumna, says she was “very surprised” to see such variation among more than 160 hospitals studied. Hsia’s research found that during 2011, some hospitals charged as little as $10 and others as much as $10,169 for a basic cholesterol test. The study found no clear explanation for the price differences for what Hsia categorized as ten “simple and standard” tests in which blood samples are inserted into a machine that performs the analysis. Time magazine, the Boston Globe and Kaiser Health News also cover Hsia’s research.

Dentists could offer a variety of medical tests in the future, including diagnostic tests for health problems such as diabetes, hypertension and HIV, Harold Pollack, PhD, tells Ozy.com. The mouth, Pollack says, “is the gateway to the human body.” He is an RWJF Investigator Award in Health Policy Research recipient.  

“There’s an overabundance of evidence that shows hospitals that have better staffing have better outcomes when we look at things like mortality,” Matthew McHugh, PhD, JD, MPH, FAAN, tells the Santa Fe New Mexican. In an article about nurse staffing ratios, McHugh, an RWJF Nurse Faculty Scholars program alumnus, says hospital readmissions, failure to rescue patients in distress, and patient satisfaction also correlate with increased staffing. “If you compare any two hospitals—one that’s good at staffing and one that has not as good staffing, but are similar in other factors—the hospital with better staffing is much less likely to be penalized” for bad patient outcomes by Medicare and Medicaid, McHugh notes. 

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Aug 14 2014
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RWJF Scholars in the News: Ebola fears, ER closures and mortality, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Bringing two American medical volunteers infected with the Ebola virus back to the United States for treatment triggered some criticism, particularly on social media. But Susan Mitchell Grant, MS, RN, CNAA-BC, who is treating the two patients at Emory Healthcare in Atlanta, writes that the criticism is “unfounded and reflect[s] a lack of knowledge about Ebola and our ability to safely manage and contain it.... We are caring for these patients because it is the right thing to do,” she says in a Washington Post op-ed. “Ebola won’t become a threat to the general public from their presence in our facility.” Grant, an RWJF Executive Nurse Fellows alumna, goes on to explain that “the insight we gain by caring for them will prepare us to better treat emergent diseases that may confront the United States in the future.”

Some hospice providers may not be serving patients in the way the end-of-life care should, according to research covered by the Washington Post. Joan Teno, MD, MS, recipient of an RWJF Investigator Award in Health Policy Research, is lead author of a study that analyzed more than 1 million records of Medicare patients across the country. Her research team found that some hospices, particularly those that are new and for-profit, have discharge rates of 30 percent or higher. That is double the standard discharge rate. Historically, some patients are discharged from hospice because their health unexpectedly improves. But Teno and colleagues say the higher discharge rates suggest two types of improper hospice practices: admitting patients who are not dying; and releasing patients when their care becomes expensive. She suggests that both practices may be driven more by “profit margins than compassionate care.”   

Chronic stress during adolescence can lead to adverse health outcomes later in life, says Keely Muscatell, PhD, an RWJF Health & Society Scholar, in an interview with NPR member station KALW (San Francisco). Based on her study, “How Stress Makes Us Sick,” Muscatell suggests that ongoing psychological stress during childhood triggers physiological inflammation throughout the body and could be a primary link to such conditions as major depression, cardiovascular disease, and rheumatoid arthritis. Muscatell explains that chronic stress can even change patterns of gene expression that lead to poor health later in life.

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