Voters across the country were presented Tuesday with more than 170 ballot initiatives, many on health-related issues. Among them, according to the Initiative & Referendum Institute at the University of Southern California:

- Assisted Suicide: Voters in Massachusetts narrowly defeated a “Death with Dignity” bill.

- Health Exchanges: Missouri voters passed a measure that prohibits the state from establishing a health care exchange without legislative or voter approval.

- Home Health Care: Michigan voters struck down a proposal that would have required additional training for home health care workers and created a registry of those providers.

- Individual Mandate: Floridians defeated a measure to reject the health reform law’s requirement that individuals obtain health insurance. Voters in Alabama, Montana and Wyoming passed similar measures, which are symbolic because states cannot override federal law.

- Medical Marijuana: Measures to allow for medical use of marijuana were passed in Massachusetts and upheld in Montana, which will make them the 18th and 19th states to adopt such laws. A similar measure was rejected by voters in Arkansas.

- Medicaid Trust Fund: Voters in Louisiana approved an initiative that ensures the state Medicaid trust fund will not be used to make up for budget shortfalls.

- Reproductive Health: Florida voters defeated two ballot measures on abortion and contraceptive services: one that would have restricted the use of public funds for abortions; and one that could have been interpreted to deny women contraceptive care paid for or provided by religious individuals and organizations. Montanans approved an initiative that requires abortion providers to notify parents if a minor under age 16 seeks an abortion, with notification to take place 48 hours before the procedure.

- Tobacco: North Dakota voters approved a smoking ban in public and work places. Missouri voters rejected a tobacco tax increase that would have directed some of the revenue to health education.

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

Following the announcement of the 2012 RWJF Community Health Leaders, many media outlets have covered the awardees. Among them: Kay Branch, MA, in the Anchorage Daily News, Ifeanyi Anne Nwabukwu, RN, BSN, in the Washington Informer, and Fred Brason in the Winston-Salem Journal.

A 2004 Community Health Leader also was in the news: Rabbi Elimelech Goldberg was named one of People Magazine’s “Heroes Among Us” for his work with Kids Kicking Cancer, a nonprofit that uses martial arts therapy to empower young cancer patients and help them manage pain.

RWJF Physician Faculty Scholar Deverick J. Anderson, MD, MPH, and colleagues conducted a single-center pilot study that finds ultraviolet light kills more than 90 percent of pathogens, when hospital rooms are flooded with the light from a robotic device. "We are now performing a study to determine if use of the device can actually prevent patients from acquiring these infections in the hospital," Anderson told MedPage Today. The findings were presented at the IDWeek 2012 conference.

Ruchi S. Gupta, MD, MPH, also a Physician Faculty Scholar, did a Q&A with the Chicago Tribune offering guidance for parents of children with food allergies, especially on Halloween. Read a post Gupta wrote for the RWJF Human Capital Blog about her professional—and personal—experience with child food allergies.

By Sally Welsh, MSN, RN, NEA-BC, Chief Executive Officer, The Alliance for Excellence in Hospice and Palliative Nursing

On July 15, 2012, the Palliative Nursing Leadership Institute became a reality.

The institute was a joint project supported by the Hospice and Palliative Nursing Association (HPNA) and the Hospice and Palliative Nursing Foundation (HPNF). Leadership development is a cornerstone of HPNA’s mission statement, which is: “Leading the way to promote excellence in the provision of palliative nursing care through leadership development, education, and the support of research in the field.”

The guiding vision for the Palliative Nursing Leadership Institute is “a national health care system in which every patient has access to quality palliative nursing care.” The mission of the institute is to “develop leaders who will embrace, utilize, and integrate palliative nursing concepts into professional nursing practices throughout the health care system, as achieved through a model of education and mentoring.”

Sarah Burgard, PhD, MS, MA, is an alumna of the RWJF Health & Society Scholars program, and an associate professor of sociology and epidemiology and research associate professor at the Population Studies Center at the University of Michigan. Burgard recently co-authored a study that finds perceived job insecurity is linked with significantly higher odds of fair or poor self-reported health, symptoms of depression, and anxiety attacks.

Human Capital Blog: What got you interested in researching the working lives and health outcomes of adults? Was there anything in particular that sparked your curiosity about job insecurity?

Sarah Burgard: I was interested in the excellent research being done by health disparities researchers that focused on socioeconomic position and its strong and persistent relationship with health. My dissertation looked at race and socioeconomic position and how they shaped children's health in different societies. When I started looking at the lives of adults in wealthy economies and focusing on health disparities in these groups, it struck me that most scholars were focused on education and income as stratifying factors, but not looking deeply at what connected them: paid employment.

Careers characterized by stimulating and satisfying work versus dangerous, monotonous or insecure work are of considerable interest in their own right to sociologists of stratification, but they could also be important for understanding divergence in health, as considerable research in occupational psychology and epidemiology has suggested. Many of the projects I've done have been aimed at bringing together the strong work in each of these fields to build even stronger explanations of the way work (or lack of work) influence health. I've been interested in less explored aspects of work, such as perceptions of job insecurity among those still employed, and in taking better account of the multitude of psychosocial aspects of work that affect individuals at a given point in time and the ways these could change over the career.

The Health Resources and Services Administration (HRSA) last week announced that the University of Minnesota Academic Health Center will lead its new Coordinating Center for Interprofessional Education and Collaborative Practice. The Center will have a mission to accelerate teamwork and collaboration among nurses, doctors and other health professionals, with a particular focus on medically underserved areas.

“Health care delivered by well-functioning coordinated teams leads to better patient and family outcomes, more efficient health care services, and higher levels of satisfaction among health care providers,” said HRSA Administrator Mary K. Wakefield, PhD, RN, in a news release issued Friday.  “We all share the vision of a U.S. health care system that engages patients, families, and communities in collaborative, team-based care.  This coordinating center will help us move forward to achieve that goal.”

The Robert Wood Johnson Foundation (RWJF) and three other leading foundations this summer announced their support for the Center and committed up to $8.6 million over five years. RWJF, the Josiah Macy Jr. Foundation, the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation aim to help make the Center the “go to” coordinating and connecting body for efforts to promote interprofessional education and collaborative practice, as well as a place to convene key stakeholders, develop interprofessional education programs, and identify and disseminate best practices and lessons learned.

“Interest in interprofessional education and team-based care has increased in recent years but we need to move faster,” Maryjoan Ladden, PhD, RN, FAAN, senior program officer at RWJF, said in announcing support from the four foundations. “We hope this Center will foster collaborations between educators and practice organizations to advance the field and improve how care is delivered to patients and families.”

Read the news release from the four foundations.
Read the news release from HRSA.

The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is asking diverse experts: What is and isn’t working in health professions education today, and what changes are needed to prepare a high-functioning health and health care workforce that can meet the country’s current and emerging needs? This post is by RWJF Investigator Award in Health Policy Research recipients Robert L. Wears, MD, PhD, a professor in the Department of Emergency Medicine at the University of Florida, and Kathleen M. Sutcliffe, PhD, The Gilbert and Ruth Whitaker Professor of Business Administration at the University of Michigan’s Ross School of Business.

There are many aspects to the problem of what is or is not working in health professionals’ education today, and the changes needed to address them.  From our view as researchers studying issues of safety, resilience, and managing for the unexpected, some of the more important are that health professionals’ education is seriously deficient in the social sciences; is limited almost exclusively to largely positivist ideas about what counts as scientific activity; and is almost totally devoid of the humanities. 

None of these deficiencies are new, and that is what concerns us.  The lack of engagement with the sciences of safety, and of human and organizational performance, has implications for practice, for safety, and for understanding and creating actionable knowledge.

With respect to practice, for example, without sufficient exposure to humanities and social sciences we risk socializing people to become authoritative but inhuman techno-nerds, even if they didn’t start out that way.  

With respect to safety, we risk training people in positivistic methods and research approaches that oversimplify and even miss local contextual specifics that create real threats to safety. 

With respect to understanding and knowledge creation, we risk training people to revere scientific and technical rationality and ‘objectivity’ at the expense or even denial of any sort of constructivist or interpretive understanding.

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

RWJF/ U.S. Department of Veterans Affairs Clinical Scholar Charles D. Scales, Jr., MD, spoke to NPR about a kidney stone “epidemic.” Scales led a study that finds the prevalence of kidney stones has nearly doubled since the mid-1990s, likely due to dietary and lifestyle changes that have led to increasing rates of obesity, diabetes, and gout. Read more about his research.

RWJF Investigator Award in Health Policy Research recipient Matthew C. Nisbet, PhD, MS, also spoke to NPR about his research on how to frame the climate change debate to best persuade and move people to action. Nisbet conducted the research with fellow Investigator Edward W. Maibach, PhD, MPH. Read more about their research, and read a Q&A with Nisbet about framing public health issues.

Separately, the Christian Science Monitor spoke to Maibach, director of the Center for Climate Change Communication at George Mason University, about a poll the Center conducted last spring on global warming and how much of a priority the issue should be for the President and Congress.

 “After 9/11, America’s about 10 million Arab and Muslim Americans, who were too often the victims of association with the perpetrators of the attacks, were—and continue to be—subjects of suspicion, discrimination, and abuse,” Clinical Scholars alumnus Aasim Padela, MD, MSc, writes on CNN’s Global Public Square blog. “As researchers who study the health of Arab and Muslim Americans, we regularly see the toll this climate of discrimination takes upon these communities… Healing our country after 9/11 must mean healing all Americans affected by that day, and the memory of 9/11 should not be used to discriminate against or marginalize any American. Ensuring that this is the case is the only way this country can continue to work to heal the gaping wound those attacks left on the social fabric of our entire country.” Read a post Padela wrote for the RWJF Human Capital Blog.

Raina Merchant, MD, MSHP, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholars program alumna and an assistant professor at the University of Pennsylvania Department of Emergency Medicine. She recently led the MyHeartMap Challenge, a community improvement initiative and research project to identify and map automated external defibrillators (AEDs) in Philadelphia. Read a post she wrote for the RWJF Human Capital Blog about the Challenge.

Human Capital Blog: Why was it important to collect information about the location of AEDs?

Raina Merchant: Currently there is no comprehensive map or database of where all the AEDs are located—in Philadelphia or really anywhere. So when someone collapses, we have to rely on people remembering where they last saw an AED. In fact, most 911 centers don’t have databases of where AEDs are located. So, the likelihood of being able to find one in an emergency is pretty low, and as a result we have these lifesaving devices that are rarely used. We used the MyHeartMap Challenge, an innovation tournament to have the public find AEDs in Philadelphia, take a photo using a smartphone app, and tag their location so we can make this information available to anyone who needs it.

HCB: How many people or teams participated in the Challenge? How many AEDs were identified?

Merchant: We were really excited about the results. We had more than 330 participants (individuals and teams) who contributed data to the Challenge. They reported more than 1,500 locations of AEDs in the city of Philadelphia. We’re still trying to sort out who exactly participated, but we had representation from schools and health organizations, as well as a lot of individuals who recruited their friends, neighbors and colleagues.  We were worried that people would make up devices, submit false locations or send low-quality pictures, but we were really impressed with the quality of data we received. Every one took this challenge very seriously. The challenge had two winners who were each awarded $9,000 for reporting more than 430 AEDs each. Both winners were also over the age of 40.

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

Zachary Goldberger, MD, an RWJF Clinical Scholar, spoke to the New York Times about a study he led that examined the ideal amount of time to continue cardiopulmonary resuscitation (CPR) on patients in cardiac arrest. “The study found that patients have a better chance of surviving in hospitals that persist with CPR for just nine minutes longer, on average, than hospitals where efforts are halted earlier,” the story reports.  First published in The Lancet, the study is one of the first to link the duration of CPR efforts with survival rates.  It is expected to prompt hospitals to reconsider their protocols.

RWJF Health & Society Scholar Jason Houle, PhD, continues to receive media coverage for his study that finds students from middle-income families leave school with an average of $6,000 more in student loan debt than their lower-income peers. The students were also more likely to have more student loan debt than their higher-income peers. Among the outlets to report on the findings: United Press International, Bloomberg Business Week, the Atlanta Journal-Constitution, and the Wisconsin State Journal.

A study supported by the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) finds that “when nurses take steps to intervene in the medication process, they are more likely to catch would-be errors before they reach the patient,” Fierce Healthcare reports. The findings also indicate that a supportive practice environment is associated with a higher quality of nursing care. Read more about the study.

Joanne Goldblum is a Robert Wood Johnson Foundation Community Health Leader, and the founder and executive director of the National Diaper Bank Network. The following post originally appeared on the Huffington Post.

This year, the National Diaper Bank Network is recognizing the week of September 10-17 as National Diaper Need Awareness Week, and local diaper banks across the country have asked their state and local officials to do the same. But more than merely declaring a week, we are acknowledging that the country is becoming more and more aware of the fact that diapers are a basic need for infants, toddlers, and those who suffer from incontinence, and that more people are willing to do something about it.

We have come very far in bringing attention to diaper need in the eight years since I began this journey in 2004. When I started The Diaper Bank in New Haven, CT there were very few diaper banks in America, so I looked to the example of the Diaper Bank of Southern Arizona, the nation’s first diaper bank. That program began in 1994 when a small consulting firm in Tucson, Arizona held a diaper drive during the holiday season to assist a local crisis nursery. Encouraged by the enthusiastic response, and seeing the great need in their community, the firm made the December Diaper Drive an annual tradition, and within five years they were collecting 300,000 diapers each December, benefiting families at 30 local social service agencies. In 2000, the diaper drive effort was spun off into an independent non-profit organization, the Diaper Bank of Southern Arizona, which continues to provide desperately needed diapers to the people of southern Arizona.

The Diaper Bank of Southern Arizona served as my inspiration in 2004 when I decided to start a diaper bank. Through my work with families in need New Haven, I learned that many of the hygiene products I took for granted, such as toilet paper, toothpaste, and diapers, were not available to people who had only food stamps to buy their groceries. The need for diapers, which are so critical for a baby’s health and comfort, was particularly acute. I started small, working out of my living room, but in a few years time, with the help of many others, what started as The New Haven Diaper Bank (now, The Diaper Bank) has grown into the nation’s largest diaper bank, distributing over 14 million diapers since its inception.