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Jul 22 2014
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A Closer Look at Contributors to Stress for Latinos

Gabriel R. Sanchez, PhD, is an associate professor of political science at the University of New Mexico (UNM), assistant director of the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at UNM, and director of research for Latino Decisions. Yajaira Johnson-Esparza is a PhD Candidate in the UNM department of psychology and an RWJF Fellow at the University. 

Gabriel Sanchez, PhD Gabriel Sanchez, PhD

A recent survey conducted by RWJF, NPR, and the Harvard School of Public Health focused our attention on the burdens that stress poses for Americans. We want to focus our attention in this blog post on factors that may be leading to stress among the Latino population. Although the experience of stress is very common, the experience and burden of stress is not uniform across people in the United States. 

One of the main findings that emerged from the recent RWJF/NPR/Harvard survey was the strong role of health problems in stress in the United States, with 27 percent of respondents noting that illness or disease was a major source of stress over the past year. In addition to the direct impact of being sick, the financial burdens associated with needing medical care can generate a lot of stress. We have found support for this finding in some of our own work at the UNM RWJF   Center for Health Policy. For example, a recent survey we helped produce found that 28 percent of  Latino adults indicated that because of medical bills, they have been unable to pay for basic necessities like food, housing, or heat, with 40 percent indicating they have had trouble paying their other bills. The financial stress associated with illness can have a devastating impact on Latinos.

Yajaira Johnson-Esparza Yajaira Johnson-Esparza

Latinos in the United States also face unique stressors from other Americans due to their language use, nativity, and experiences with discrimination. Being followed in a store, being denied employment or housing, and being told that you do not speak English well can all lead to stress for Latinos.

More specifically, the current political climate surrounding immigration politics and policy has led to an increase in discrimination directed toward Latinos, and consequently stress levels. Our Center has been tracking immigration laws passed at the state level over time; we have found a significant increase in passage of punitive laws during the economic recession, with more than 200 immigration laws being passed in 2009 alone.  A June 2011 impreMedia/Latino Decisions (LD) poll reveals that Latino voters are conscious of this tense landscape, as 76 percent of respondents believe that an anti-Hispanic and anti-immigrant environment exists today. 

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Jul 21 2014
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Federal Government Sets Aside Funds to Boost Access to Primary Care

The federal government announced on July 7 it had awarded more than $83 million to expand access to care by training hundreds of new primary care providers.

The money will be used to support primary care residency programs in family medicine, internal medicine, pediatrics, obstetrics and gynecology, psychiatry, geriatrics, and general dentistry at 60 health centers across the country. The expanded residency programs will help train more than 550 residents in coming academic year—about 200 more than were trained in the previous academic year, according to the U.S. Department of Health and Human Services (HHS). The funds will also be used to boost the number of states with teaching health centers from 21 to 24.

“This program not only provides training to primary care medical and dental residents, but also galvanizes communities,” said Mary K. Wakefield, PhD, RN, head of the Health Resources and Services Administration, a division of HHS. “It brings hospitals, academic centers, health centers, and community organizations together to provide top-notch medical education and services in areas of the country that need them most.”

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Jul 18 2014
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Building a Culture of Health at AcademyHealth Annual Research Meeting

RWJF Leadership Reception at the AcademyHealth annual meeting in San Diego in June 2014 RWJF Leadership Reception at the AcademyHealth annual meeting in San Diego in June 2014

At this year’s AcademyHealth Annual Research Meeting, held in San Diego, California June 8–10, the Robert Wood Johnson Foundation (RWJF) hosted “Building a Culture of Health: An RWJF Leadership Reception.” More than 100 RWJF scholars, fellows, and alumni representing 14 RWJF Human Capital programs joined with colleagues and friends of the Foundation for the gathering at the Hilton San Diego Bayfront. There, health providers, clinicians, researchers, and graduate students made and renewed the important professional connections that RWJF facilitates.

Among those attending the reception were RWJF Health & Society Scholars alumnus and RWJF Clinical Scholars Associate Program Director (University of Pennsylvania program site) David Grande, MA, MPA, who presented his paper, “How Do Health Policy Researchers Perceive and Use Social Media to Disseminate Science to Policymakers?,” at the meeting; RWJF Nurse Faculty Scholars Lusine Poghosyan, PhD, MPH, RN, and J. Margo Brooks Carthon, PhD, APRN, who chaired and served as a panelist, respectively, at a health care workforce session; and Clinical Scholars Tammy Chang, MD, MPH, MS, and Katherine A. Auger, MD, M.Sc., who were both chosen as recipients of the AcademyHealth Presidential Scholarship for New Health Services Researchers. This scholarship provides financial support to attend the meeting, and recognizes early-career researchers who demonstrate leadership ability and potential to contribute to the field of health services research.

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Jul 17 2014
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RWJF Scholars in the News: Gun violence, suicide, ‘structural’ versus ‘cultural’ competency, 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:

An NPR story quotes RWJF Health & Society Scholars program alumnus Andrew Papachristos, PhD, citing his extensive research on gun violence. Papachristos criticizes the lack of context in media coverage of violence, noting that incidents such as the series of shootings over the Fourth of July weekend in Chicago tend to be treated simply as a long stretch of violent incidents. “Treating Chicagoland violence as merely a tally necessarily dehumanizes its victims, but it also obscures so much of the larger story about that violence. It's data without context.” Not only is the murder rate steadily declining in Chicago, but there is a massive disparity in victims of these crimes: “Eighty-five percent of violence—any shootings—happens among 5 percent of people,” Papachristos says.

In an article about libertarianism and state laws related to guns and other topics, the Economist cites a study about the social costs of gun ownership by RWJF Investigator Award in Health Policy Research recipients Philip Cook, PhD, and Jens Ludwig, PhD. It finds that “more guns empirically lead to more gun-related violence, largely because legally purchased guns somehow end up in the hands of criminals via theft,” gun shows, and online sales, which are largely unregulated. To address these issues, Cook and Ludwig suggest making it costlier to buy guns in high-crime areas, and improving the records used to screen gun buyers by including more information on possible mental-health problems, among other proposals. (Free registration required to view article.)

A study co-authored by RWJF Health & Society Scholars program alumnus Alexander Tsai, PhD, MD, finds that men who are more socially connected are half as likely to commit suicide as men considered loners, NBC News reports. The study looks at data on nearly 35,000 men, ages 40 to 75, and finds that those who are more isolated are at greater risk, even if they are not mentally ill. “Public health practitioners think about things like cardiovascular disease as warranting public health attention,” says Tsai, suggesting that suicide may also need attention.

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Jul 16 2014
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Fourteen Nursing Schools to Receive Grants

The Robert Wood Johnson Foundation (RWJF) has announced the first 14 schools of nursing selected to receive grants to support nurses as they pursue their PhDs. Each of the inaugural grantees of the Future of Nursing Scholars program will select one or more students to receive financial support, mentoring, and leadership development over the three years during which they pursue their PhDs.

The Future of Nursing Scholars program is a multi-funder initiative. In addition to RWJF, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center, and the Rhode Island Foundation are supporting grants this year.

The program plans to support up to 100 PhD nursing candidates over its first two years.

In its landmark future of nursing report, the Institute of Medicine recommended that the country double the number of nurses with doctorates in order to support more nurse leaders, promote nurse-led science and discovery, and address the nurse faculty shortage. Right now, fewer than 30,000 nurses in the United States have doctoral degrees in nursing or a related field. 

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Jul 15 2014
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The Impact of Seasonal Birth-Rate Fluctuations on Measles, Other Vaccine-Preventable Diseases

Audrey Dorélien, PhD, is a 2012-2014 Robert Wood Johnson Foundation (RWJF) Health & Society Scholar studying demography, infectious diseases, and maternal and child health.

Audrey Dorélien

Reoccurring outbreaks of measles and other vaccine-preventable diseases are a major killer of children, particularly in sub-Saharan Africa. In 2012, more than 226,000 cases of measles were reported worldwide, with a little less than half of those in Africa.[1] For the World Health Organization to meet its global measles eradication goal and implement more effective supplemental vaccination programs, public health officials will need a better understanding of the mechanism driving seasonal and episodic outbreaks.

Infectious disease ecologists have demonstrated the importance of human demography, and in particular the influence of the birth rate on the dynamics of acute childhood immunizing (ACI) diseases. For instance in London, in the few years prior to 1950, the city experienced annual measles epidemics, but the dynamics changed to biennial epidemics as a result of a decline in the birth rate between 1950 and 1968.[2] How can the birth rate influence disease outbreaks? An outbreak can only occur when the fraction of the susceptible population exceeds a critical threshold. In the case of ACI disease, the majority of the susceptible population are young children; therefore the birth rate influences the rate at which the pool of susceptibles is replenished.

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Jul 14 2014
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Breakthrough Leaders in Nursing

The Future of Nursing: Campaign for Action has announced a new program to honor nurse leaders who are making a difference in their communities and to develop their leadership skills. The Campaign will be accepting nominations for its Breakthrough Leaders in Nursing award through August 15th.

Nominees must be licensed registered nurses engaged in a state Action Coalition of the Future of Nursing: Campaign for Action. Nominations can come from any member of a state Action Coalition, the Champion Nursing Coalition, or the Champion Nursing Council.

The ten nurses selected for this honor will receive national recognition and a Leadership Development Program scholarship from the Center for Creative Leadership, funded by the Robert Wood Johnson Foundation (RWJF).  

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Jul 14 2014
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Study Highlights Role for Non-Physicians in Preventing Childhood Blindness

A leading cause of preventable blindness in premature babies can be successfully identified by trained non-physician evaluators working remotely, according to a study published online by JAMA Ophthalmology. The number of ophthalmologists who conduct screenings for the condition, retinopathy of prematurity (ROP), has declined in the United States, while countries in parts of Latin America, Asia, and Eastern Europe have long-standing ophthalmologist shortages that contribute to high rates of childhood blindness caused by ROP.

“This study provides validation for a telemedicine approach to ROP screening and could help prevent thousands of kids from going blind,” lead investigator Graham E. Quinn, MD, MSCE, said in a news release from the Children’s Hospital of Philadelphia, where he is a pediatric ophthalmologist.

The study involved retinal images taken by neonatal intensive care unit nurses and transmitted to trained image readers at a central location. Ophthalmologists had also examined the infants, and the image readers identified 90 percent of the infants the ophthalmologists had flagged as needing further evaluation.

“Telemedicine potentially gives every hospital access to excellent ROP screening,” said Quinn. 

Read the study in JAMA Ophthalmology

Jul 11 2014
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How Stress Makes Us Sick

Keely Muscatell, PhD, is a social neuroscientist and psychoneuroimmunologist. She is a post-doctoral scholar in the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of California (UC), San Francisco and UC, Berkeley.

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Results from the recent NPR/RWJF/Harvard School of Public Health poll suggesting that Americans are living under high levels of stress probably don’t surprise anyone. In a way, I’ve been taking an informal version of this poll for the last six years, since when I tell people I meet on airplanes or at local bars that I study stress and health, I am unfailingly met with knowing glances and stories about stressors people are facing in their lives. Given that stress is pervasive (and problematic) in modern life, lots of current research in psychology and neuroscience is focused on understanding exactly how stress can get “into our brains” and “under our skin” to make us sick.

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When we think of illness, one of the first things that comes to mind is the immune system, with its lymph nodes, white blood cells, and antibodies hanging around to help us fight off infections and heal our injuries. An especially important component of the immune system involves inflammation. If you’ve ever gotten a paper cut, you’ve probably noticed that the area of skin around the cut tends to turn red and warm up shortly after the injury. This happens because proteins called “pro-inflammatory cytokines” swim through your blood stream to the site of the wound, where they call out to other immune cells to come to the area and help heal the cut. In the short term, this is a good thing; those little cytokines are a key part of healing. But if inflammation becomes widespread throughout the body, cytokines can lead to depression and even physical diseases, like arthritis and heart disease.

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Jul 11 2014
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Recent Research About Nursing, July 2014

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

Short Rest Between Nurses’ Shifts Linked with Fatigue

New research from Norway suggests that nurses with less than 11 hours between shifts could develop sleep problems and suffer fatigue on the job, with long-term implications for nurses’ health.

Psychologist Elisabeth Flo, PhD, of the University of Bergen in Norway, led a team of researchers that analyzed survey data from more than 1,200 Norwegian nurses, focusing on questions about how much time nurses had between shifts, their level of fatigue at work and elsewhere, and whether they experienced anxiety or depression.

Analyzing the data, they found that nurses, on average, had 33 instances of “quick returns” in the previous year—that is, shifts that began 11 hours or less after another shift ended. Nurses with more quick returns were more likely to have pathological fatigue or suffer from difficulty sleeping and excessive sleepiness while awake—both common problems for night workers.

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