Category Archives: Research

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 23 2014
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New RWJF Podcast Episode Features Keith Wailoo

Keith Wailoo Keith Wailoo, PhD

Tune in to the sixth episode of RWJF’s Pioneering Ideas podcast to hear from RWJF  Investigator Award in Health Policy Research recipient, premier medical historian and Princeton educator Keith Wailoo, PhD. RWJF’s Steve Downs, SM, joins Keith to discuss how deeply held cultural narratives influence our perceptions of health, and how today’s wild ideas are often tomorrow’s cutting edge innovations.

Visit iTunes to download this episode and subscribe to future episodes.

In this episode, we also look at innovations that ask, “What if?” and explore simple shifts in perspective:

  • OpenNotes’ Tom Delbanco and Jan Walker talk to RWJF’s Emmy Ganos about why they decided getting health care providers to share their notes with patients was an essential innovation—and where their work is headed next.
  • Founder and CEO of LIFT Kirsten Lodal talks to RWJF’s Susan Mende and shares some simple ideas with the potential to revolutionize our approach to helping people achieve economic stability and well being.
Oct 17 2014
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Stay Up to Date with RWJF!

Want to stay on top of the latest news from RWJF? Check out all the ways you can get the latest news delivered to you:

·         Sign up for Content Alerts, newsletters, and funding alerts

·         Read the Sharing Nursing’s Knowledge e-newsletter, then subscribe

·         Sign up to receive Charting Nursing’s Future policy briefs

·         Stay up to date on the Future of Nursing: Campaign for Action

Oct 16 2014
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RWJF’s Clinical Scholars Program: A Proud Legacy of Creating Change

Encouraging physicians to be not only agents of care, but agents of change: That’s the challenge the Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program has embraced for 45 years, and it’s a challenge the Foundation has met with “great success,” writes Bharat Kumar, MD, in an article in the American Medical Association’s ethics journal, Virtual Mentor.

In an era of increased activism and access to health care as evidenced by the creation of Medicare and Medicaid, a group of medical school professors envisioned the Clinical Scholars Program as a way to move beyond “the detached and passive model of medical practice” and instead “train physicians to become agents of change, not only in the clinic and in the hospital, but also in communities, in classrooms, and the halls of power,” Kumar writes. Three years after the program was launched in 1969 at five universities, with support from the Carnegie Corporation and the Commonwealth Fund, it came under the auspices of RWJF.

The article describes the program’s current objective—to provide post-doctoral training for young physicians in health services research, community-based participatory research and health policy research—and its current structure: training sites at the University of Michigan, the University of Pennsylvania, Yale University, and the University of California, Los Angeles; a national program office at the University of North Carolina; and a longtime collaboration with the U.S. Department of Veterans Affairs that supports positions for Clinical Scholars via affiliated Veterans Affairs medical centers.

The program’s final cohort of scholars, selected this year, will follow in the footsteps of more than 1,200 alumni, many of whom “have become leaders in health care policy and delivery,” Kumar writes, with roles in all levels of government and notable advancements in the fields of pediatrics, internal medicine, and emergency medicine.

Alumna Stacey Lindau, MD, says in the article that the program’s “traditions of promoting excellence, critical thinking, and service extend beyond the two to three years of training, effectively creating a pipeline of alumni dedicated to service.”

Read “The Robert Wood Johnson Clinical Scholars Program: Four Decades of Training Physicians as Agents of Change.”

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 15 2014
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Let’s Have a Conversation about Food that Goes Beyond Restriction and Restraint—and Resonates with Real People

Sonya Grier, PhD, MBA, is an associate professor of marketing at the Kogod School of Business at American University in Washington, D.C., and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2003-2005).

Sonya Grier Sonya Grier, PhD, MBA

Human Capital Blog: Congratulations on receiving the Thomas C. Kinnear award for your 2011 article in the Journal of Public Policy & Marketing on food well-being! Please tell us about the award.

Sonya Grier: The award honors articles published in the Journal of Public Policy & Marketing (JPP&M) that have made a significant contribution to the understanding of marketing and public policy issues. This year, eligible articles needed to have been published between 2010 and 2012. The marketing community was called upon to nominate articles for the award. JPP&M editorial review board members and associate editors then voted among the nominees.

Generously funded by Thomas C. Kinnear, his colleagues, friends and former students, and administered through the American Marketing Association  Foundation, the award’s purpose is to recognize authors who have produced particularly high-quality and impactful research in marketing and public policy.

HCB: How did your article do that?

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Oct 10 2014
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BSN Qualifications Recommended for the Nation’s Nurses: Four Years of Progress

Linda H. Aiken, PhD, RN, FAAN, is the Claire Fagin Professor of Nursing, professor of sociology, director of the Center for Health Outcomes and Policy Research, and senior fellow of the Leonard Davis Institute for Health Economics at the University of Pennsylvania. Olga Yakusheva, PhD, is an associate professor at the University of Michigan School of Nursing.

Linda Aiken Linda H. Aiken

Four years ago the Institute of Medicine’s (IOM) landmark report on the future of nursing was released. The study was remarkable in multiple respects including the interdisciplinary perspectives of national experts comprising the study committee, the breadth and scope of the study, its actionable recommendations, and the commitment of the Robert Wood Johnson Foundation (RWJF) to provide philanthropic funds to help implement the study’s recommendations—a rarity. One net result of the IOM Report, as viewed on the 4th anniversary of its release, is its notable impact on the commitment of stakeholders to finally make the transition of the nation’s nurse workforce to BSN qualifications, after many decades of limited progress.

Olga Yakusheva - medium enlarge Olga Yakusheva

Changing trends in nurse employment and education: The IOM recommended that 80 percent of nurses in the United States hold at least a baccalaureate in nursing (BSN) by the year 2020. The recommendation was quite bold considering that two-thirds of new nurses still graduated with less than a BSN, despite numerous previous reports and commissions over decades recommending the BSN as the entry qualification for professional nurses.  

While the percentage of nurses with bachelor’s and graduate education had been slowly increasing over time, when the IOM report was issued only about 49 percent of nurses held a BSN. However, the IOM’s recommendation, based upon a growing research base documenting that patient outcomes were better in settings that employed more BSN-qualified nurses, acted as a tipping point to mobilize responses from many stakeholders that together are impacting changes in nurses’ qualifications.

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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 3 2014
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Recent Research About Nursing, October 2014

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

Study: California’s Mandatory Nurse-Patient Ratio Law Reduces Work-Related Injuries

A 2004 California law mandating specific nurse-to-patient staffing standards in acute care hospitals has significantly reduced job-related injuries and illnesses for nurses, according to a study published online by the International Archives of Occupational and Environmental Health.

A team of researchers from the Schools of Medicine and Nursing at the University of California, Davis used data from the U.S. Bureau of Labor Statistics to compare illness and injury rates in California and other states before and after the law’s implementation. The data documented a downward trend nationwide, but also found that California’s workplace injury and illness rate declined even faster than the national rate.

In California, the researchers estimated that the law resulted in an average decline from 176 to 120 injuries and illnesses per 10,000 registered nurses—a 32-percent reduction. For licensed practical nurses, the rate went from 244 injuries to 161 per 10,000—a 34-percent reduction.

Lead author J. Paul Leigh, PhD, speculated in a news release that having more nurses available to help with repositioning patients in bed could help prevent back and shoulder injuries. Similarly, needle-stick injuries could be less common because nurses now conduct blood draws and other procedures in a less time-pressured manner.

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Oct 1 2014
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Quotable Quotes About Nursing, October 2014

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

“I’ve learned over the last couple of years, as my mother came to rely more on nursing assistance at home for daily tasks, that health care is all about what happens between people. It’s the relationship of trust between the patient and family members and a universe of medical professionals. Nowhere is the relationship more vital than between patient and nurse.

Nurses are the front line of care. Doctors parachute into our world and we into theirs, but nurses stay on the ground from crucial moment to moment.”
--Marsha Mercer, independent journalist, They Put the ‘Care’ in Health Care, The (Lynchburg, Va.) News & Advance, Sept. 28, 2014

“Unfortunately, due to the culture of the health care industry, nurses have usually taken a back seat to physicians and administrators when it comes to changing the policies and practices of optimizing care. However, there is a wealth of evidence that points to the vital and increasing leadership role nurses are taking in health care practices around the country.  ... The message to hospital administrators should be clear—if you’re looking to improve the quality of care and reduce costs, try talking to the people working on the front lines every day—talk to a nurse.”
--Rob Szczerba, PhD, MS, CEO of X Tech Ventures, Looking to Transform Healthcare? Ask a Nurse, Forbes, September 23, 2014

“I’ve been a nurse for 25 years and love what I do. But when we are forced to work overtime, it adds unnecessary stress, frustration and fatigue that can impair your ability to function at your best. You can’t think straight when you’ve been working 16 hours.”
--Terri Menichelli, Nurse., State Auditor Will Look into Health Care Overtime Law, The Citizen’s Voice (Wilkes-Barre, Pennsylvania), Sept. 19, 2014 

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