Category Archives: Research & Analysis

Mar 6 2014
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RWJF Scholars in the News: Nurse staffing and patient mortality, communicating about vaccines, specialized HIV training for NPs, 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 study led by Linda H. Aiken, PhD, FAAN, FRCN, RN, and covered by CNN.com, finds that hospital nurse-patient ratios and the share of nurses with bachelor’s degrees both have an important impact on patient mortality. Aiken, a research manager supporting the Future of Nursing: Campaign for Action and a member of the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) National Advisory Committee, found that increasing a hospital nurse’s workload by one patient increased by 7 percent the likelihood of an inpatient death within 30 days of admission. The same research revealed that a 10-percent increase in the number of nurses with bachelor’s degrees at a given hospital reduces the likelihood of a patient death by 7 percent. Aiken’s study has also been covered by the Guardian, Philly.com, and FierceHealthcare, among other outlets.

Public health messages aimed at boosting childhood vaccination rates may be backfiring, according to a new study led by RWJF Scholars in Health Policy Research alumnus Brendan Nyhan, PhD. Campaigns that use studies, facts, and images of ill children increased fears about vaccine side-effects among some parents, NBC News reports. In fact, messaging that debunked myths about links between vaccines and autism actually made parents less inclined to have their children inoculated. Time magazine online also covered the study.

The Johns Hopkins University School of Nursing has developed a new curriculum that provides specialized HIV training to nurse practitioners, with funding from the Health Resources and Services Administration, Medical Xpress reports. “The design of our program starts with the recognition that HIV care cannot be provided in a silo, that it needs to be integrated holistically into primary care," RWJF Nurse Faculty Scholar Jason Farley, PhD, MPH, said in a statement. Farley is the developer of the curriculum.

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Feb 27 2014
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Human Capital News Roundup: Risk of increased ADHD labeling, unnecessary emergency department scans, food labeling, 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:

In an op-ed for the New York Times, RWJF Investigator Award in Health Policy Research recipients Stephen Hinshaw, PhD, and Richard Scheffler, PhD, discuss how a major expansion of early childhood education could have an unintended consequence: a dramatic increase in the number of pre-school age children, particularly from low-income families, who are wrongly diagnosed with attention deficit hyperactivity disorder (ADHD). The writers recently authored a book, The ADHD Explosion: Myths, Medication, Money, and Today's Push for Performance. The Wall Street Journal also covered the book release, among other outlets.

A study by RWJF Clinical Scholars alumnus, Jeremiah Schurr, MD, MHS, identifies five tests commonly performed in emergency departments that are unnecessary for some patients. In an article in Long Island Newsday, Schurr explains that curtailing their use for patients who do not exhibit specific symptoms could reduce health care costs. Schurr’s research shows that the information gleaned from the tests—CT scans and MRIs for certain patients and blood tests for others—can be derived just as effectively through less expensive procedures.

MedPage Today interviews Jason Karlawish, MD, an RWJF Investigator Award recipient, on the treatment of Alzheimer’s disease. Karlawish emphasizes the importance of accurate diagnosis, proper medication, and family involvement and education. Read more about Karlawish’s work on Alzheimer’s disease on the Human Capital Blog.

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Feb 25 2014
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New Hope for Treatment of Rare Pediatric Disease

About 19 in every 100,000 American children under the age of five suffers from an inflammatory illness called Kawasaki Disease (KD) that can cause irreversible damage to the heart. If diagnosed early, it can usually be treated effectively, and children can be returned to health in just a few days. But between 10 and 20 percent of treated patients suffer from a persistent fever, or one that recurs after treatment, and they are at elevated risk of developing coronary artery aneurysms. A new study, led by Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program Scholar Adriana H. Tremoulet, MD, MAS, and published yesterday in The Lancet, offers new hope for patients with KD.

The symptoms of KD include prolonged fever associated with a rash, swollen neck glands, red eyes, swollen red lips, a condition physicians call strawberry tongue, and swollen hands and feet with peeling skin. Current treatment is infusion of intravenous immunoglobulin (IVIG) and aspirin. The IVIG carries the pooled antibodies from the blood plasma of more than 100,000 donors, and in the KD patient, it decreases the inflammation that causes heart damage. The treatment usually works, but some patients’ IVIG-resistance puts them at greater risk and in need of further treatment.

Tremoulet, a pediatric infectious disease specialist at Rady Children’s Hospital in San Diego, conducted a Phase III trial in which a synthetic antibody called infliximab was added to the standard IVIG and aspirin treatment. While the protocol did not affect the patients’ resistance, it had important positive results. “In our study,” Tremoulet said, “we demonstrated that a single dose of infliximab is safe in children with Kawasaki Disease and that this treatment reduced the inflammation in the body overall as well as in the arteries of the heart faster than just using standard treatment with intravenous immunoglobulin.”

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Feb 25 2014
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Physician Compensation Patterns Pose Challenges to Efforts to Incentivize Changes in How Care Is Delivered

Salary is the most common type of compensation for physicians in non-solo practice settings, many of whom are paid through a blend of methods, according to a new American Medical Association (AMA) Policy Research Perspectives report that says it provides a “rare glimpse” into how non-solo physicians are paid.

Just over 53 percent of non-solo physicians reported that all or most of their compensation came from salary, while nearly 32 percent said all or most of their compensation was based on personal productivity. The report points out that this breakdown “suggests that it may be difficult to align practice-level incentives that encourage judicious use of resources with physician-level incentives that do not.”

Ideally, the report says, financial and other incentives would encourage physicians to make the best care decisions possible for patients, providing them “the right care, in the right place, and at the right time,” but current incentives often do not encourage that approach.

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Feb 20 2014
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Human Capital News Roundup: Abuse of prescription opioids, thriving singles, smartphone safety nets, 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:

In suburbs, rural towns, and affluent areas, prescription opioids, such as Oxycontin and Opana, are the most common cause of overdose deaths, Helena Hansen, MD, PhD, writes in a Huffington Post opinion piece. Drug policies that unilaterally curb access to opioids can actually hurt users’ recovery efforts, writes Hansen, an RWJF Health & Society Scholars alumna. The piece was co-authored by Julie Netherland, New York deputy state director, Drug Policy Alliance. It recommends prioritizing public health over punitive responses.

Tina Bloom, PhD, RN, an RWJF Nurse Faculty Scholar, is part of a research team that developed a smartphone app to help domestic violence victims and their friends create safety plans. “This has been so well received by abused women because of the privacy and the chance to learn and weigh information,” Bloom told the Columbia Daily Tribune. “As survivors tell us, the computer doesn’t judge.”

Michigan Daily reports on a recent lecture by RWJF Health & Society Scholars alumnus Patrick Sharkey, PhD, describing his research into how urban violence affects childhood development. Sharkey shared evidence suggesting that children’s exposure to violence in their neighborhoods can negatively affect academic abilities; the conclusion is based on a study he conducted in which children exposed to violence performed significantly lower on a test administered a few days later.

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Feb 13 2014
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Human Capital News Roundup: Obesity, suicide prevention, syphilis, co-sleeping with infants, 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 deluge of articles, research, and books on obesity and diabetes are “the noise generated by a dysfunctional research establishment” and are not solving either epidemic, Gary Taubes, MSE, MS, writes in an opinion piece for the New York Times. “Making meaningful inroads ... requires that we know how to treat and prevent it on an individual level. We’re going to have to stop believing we know the answer, and challenge ourselves to come up with trials that do a better job of testing our beliefs.” Taubes received an RWJF Investigator Award in Health Policy Research. Read an interview with him about obesity and diabetes on the RWJF Human Capital Blog.

Finding healthy food, including fresh fruits and vegetables, lean meats, and low-fat dairy products, is more challenging for minorities living in urban areas than for others, according to research by RWJF Health & Society Scholars alumna Carolyn Cannuscio, ScD, ScM. Huffington Post’s Latino Voices features her study, which finds that most residents in urban settings have to bypass nearby corner stores offering little healthy food to find better options elsewhere.

In an opinion piece for the Seattle Times, RWJF Health & Society Scholars alumna Jennifer Stuber, PhD, writes that many health care professionals in the state do not feel prepared to handle suicide prevention and say training should be a requirement for licensure. Her piece was reprinted in Medical Xpress. Stuber’s work also was covered recently by Medical Daily and the New Republic. Read her RWJF Human Capital blog post on the subject.

In the Scientist, RWJF Health & Society Scholars alumna Kristin Harper, PhD, MPH, and colleagues analyze the origins of syphilis and discuss how understanding the history of the disease could help in developing a modern-day strategy to slow its spread.

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Feb 6 2014
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Tired Nurses Are More Likely to Play the Second-Guessing Game

What drives “decision regret,” the negative cognitive emotion that occurs when an actual outcome differs from the desired or expected outcome? For nurses, fatigue is a big factor, according to a study in the current issue of the American Journal of Critical Care.

The study found that nurses impaired by fatigue, loss of sleep, daytime sleepiness, and an inability to recover between shifts are more likely than well-rested nurses to report decision regret. And while decision regret reflects previous decisions and adverse outcomes, it may also contribute to work-related stress and compromise patient safety in the future, the researchers found.

“Registered nurses play a pivotal role as members of the health care team,” lead author Linda D. Scott, RN, PhD, NEA-BC, FAAN, associate dean for academic affairs and an associate professor at the University of Illinois at Chicago College of Nursing, said in a news release. “Proactive intervention is required to ensure that critical care nurses are fit for duty and can make decisions that are critical for patients’ safety.”

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Feb 6 2014
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Human Capital News Roundup: Avoiding aneurysms, healthy food, gun safety, 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:

In a Huffington Post Latino Voices blog, Harold Amos Medical Faculty Development Program alumna Paloma Toledo, MD, discusses obesity among Hispanic Americans and how parents can influence children’s behavior, particularly regarding physical activity. She also flags influences that impede efforts to improve health for Hispanic youth: “In the U.S., food advertising on Spanish-language television is more likely to promote nutritionally-poor food than English-language advertising, hindering Hispanic children.”

During months when low-income individuals have access to Earned Income Tax Credit benefits, they spend more on healthy food, according to a study by RWJF Scholars in Health Policy Research alumna Diane Whitmore Schanzenbach, PhD. The study suggests that people with low incomes also buy more healthy food when their income increases, reports the Wall Street Journal Real Time Economics blog.

Health care professionals could make a vital contribution to educating children about the dangers of gun-related injuries, according to a study by RWFJ Clinical Scholar John Leventhal, PhD. He told Fox News: “Pediatricians and other health care providers can play an important role in preventing these injuries through counseling about firearm safety, including safe storage.”

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Feb 5 2014
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Be Heart Smart: Addressing the High Burden of Cardiovascular Disease Among African-American Women

Nadia Winston, MSPH, is a graduate student at the University of Illinois at Chicago, School of Nursing, pursuing dual nurse practitioner studies in family practice and occupational health. She has a master of science in public health degree from Meharry Medical College and is a former scholar with the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College. This post is part of the “Health Care in 2014” series.

file Nadia Winston

Cardiovascular disease is the number one killer of African American women. It has become imperative for the nation to take back the reins of its health status and educate the public about this threat. The statistics are alarming. Black women are twice as likely to suffer from cardiovascular disease as women of other ethnicities. And according to the American Heart Association, cardiovascular disease kills nearly 50,000 African-American women annually. The reason for this disparity can be attributed to a lack of health knowledge, being overweight or obese, and lack of physical activity. Early intervention and action has been identified as the key to reducing this population’s risk of mortality from cardiovascular disease and related diagnoses.

file Vanessa Jones Briscoe

Addressing and raising awareness of the health risks associated with cardiovascular diseases for African American women has been quite challenging. Recognizing this issue, Vanessa Jones Briscoe, PhD, MSN, then a Health Policy Associate at the Center for Health Policy at Meharry Medical College, developed and implemented a culturally appropriate health education program to educate minority populations about unhealthy lifestyles. It is called the “Be Heart Smart” program.

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Feb 4 2014
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Dermatologists Are Happiest Specialists in Physician Lifestyle Report

In a survey of more than 31,000 U.S. physicians for Medscape’s 2014 Physician Lifestyle Report, dermatologists emerged as the specialists who are happiest both at home and at work. Seventy percent of dermatologists said they are very to extremely happy at home, slightly behind ophthalmologists. But at 53 percent, dermatologists topped the list by a considerable margin in reporting a high level of happiness at work.

Among the least happy specialists are family and emergency medicine physicians, with only 36 percent reporting great happiness at work, followed at 37 percent by internists and radiologists.

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