Category Archives: Diabetes

Sep 24 2014
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Helping ‘Care Partners’ Help Patients with Diabetes

Ann-Marie Rosland, MD, MS, is a research scientist at the VA Ann Arbor Center for Clinical Management Research, an assistant professor at the University of Michigan Medical School, and an alumna of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program (2006-2009). She recently received a U.S. Department of Veterans Affairs Merit Award to test a family engagement intervention for patients with diabetes.

Ann Marie Rosland

Human Capital Blog: Congratulations on your Veterans Health Administration (VA) Merit Award! The award recognizes your research into a family engagement intervention in the context of the VA’s patient-centered medical home program. How did your study work, and what did you find?

Ann-Marie Rosland: This study is unique in that we work with family member/patient pairs in managing diabetes. We call these family members “care partners.” This study asks the question:  “How we can best recognize and support the vital roles that patients’ family members often take in the care of chronic illnesses, so these care partners can have the largest positive impact on patients’ health and medical care?”

Our prior work has shown that the majority of people with diabetes, heart disease and other chronic conditions have a family member who is regularly involved with the care of these conditions. Some help to keep track of medications and refill them, some help to track and manage symptoms or sugar readings, many come to medical appointments and help patients communicate with their medical teams, and some help patients navigate the health care system. In general, patients who have support from family members tend to be more successful at managing chronic illness, particularly with eating healthier and exercising more. Yet patients and family tell us that care partners face barriers in helping with the medical side of care; for example, they can’t easily find out what medications or tests the patient’s medical team is recommending, or what health system programs are available to the patient.

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May 1 2014
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RWJF Scholars in the News: Worldwide diabetes epidemic, covering birth control services, 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:

“[D]iabetes has become a full-blown epidemic in India, China, and throughout many emerging economies,” writes Kasia Lipska, MD, an RWJF Clinical Scholars program alumna, in a New York Times opinion piece. Lipska details her experience treating patients in India, explaining that the country’s recent economic transition has created a “perfect storm of commerce, lifestyle, and genetics” that has led to a rapid growth in diabetes cases. She highlights how costly the disease is to manage, as well as the shortcomings of India’s health care infrastructure, warning that, without reforms, India will have to provide chronic care for more than 100 million diabetics in a few decades.

RWJF Scholars in Health Policy Research alumnus Michael Greenstone, PhD, co-authored an op-ed piece in the Los Angeles Times that praises a recent appellate court decision to uphold the U.S. Environmental Protection Agency’s mercury standards. The court’s majority ruled that the EPA had factored in costs when deciding how stringent the regulation should be, and that the monetized environmental benefits of the rule outweighed the costs, Greenstone writes.

A majority of Americans—69 percent—support the Affordable Care Act requirement that health insurance plans pay for birth control, according to a survey by Michelle Moniz, MD, a Clinical Scholar. The survey included more than 2,000 respondents, NBC News reports. The U.S. Supreme Court is expected to rule by June in a case in which two for-profit corporations assert that paying for insurance coverage of certain forms of birth control conflicts with the companies’ religious beliefs. Moniz’s survey was also covered by MSNBC and Newsweek, among other outlets.

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Apr 23 2014
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Saving Limbs, Saving Lives: Harold Amos Alum Honored for Research into Peripheral Arterial Disease

Ayotunde Dokun, MD, PHD, is an assistant professor of medicine at the University of Virginia Health System in Charlottesville, VA. He is also an alumnus of the Harold Amos Medical Faculty Development program (2009-2013), an initiative funded by the Robert Wood Johnson Foundation (RWJF) that supports faculty in academic medicine and dentistry who are from historically disadvantaged backgrounds.

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Human Capital Blog: Congratulations on your recent award from the American Heart Association! What does it mean for your work and for your career?

Ayotunde Dokun: It is a great honor to be recognized by the Peripheral Vascular Council of the American Heart Association with an early stage investigator award. For my work, it means the society recognizes the significance of what I have contributed to the field thus far. For my career, it’s a stepping stone hopefully to a brighter future as physician scientist.

HCB: The award recognizes the research and background of outstanding early-career researchers in the field of peripheral vascular disease. Can you describe your current work in this area?

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Apr 18 2014
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New on the RWJF Website

Two stories on the Robert Wood Johnson Foundation (RWJF) website report on new research by RWJF scholars.

An Incentive for Healthier Living: RWJF Scholars Find a Stronger Link Between Obesity and Kidney Disease

Vanessa Grubbs, MD, MPH, and Kirsten Bibbins-Domingo, MD, PhD, both alumnae of the Harold Amos Medical Faculty Development Program (AMFDP), have discovered that obesity appears to be a driver of diminished kidney function, independent of a number of common kidney conditions. This suggests that overweight patients could face kidney troubles even if they avoid hypertension, diabetes, or other such conditions. The researchers also found that the standard measure used to gauge kidney function might miss early signals of deterioration that a more sensitive test can detect. This suggests that clinicians could identify emerging problems in otherwise asymptomatic patients, and help steer them toward healthier habits early in life.

Reducing Adolescents’ Risky Behaviors

New studies from RWJF scholars seek early markers for substance abuse, explore young adult sleep patterns, and gather data on health care providers’ counseling. RWJF Health & Society Scholar Julie Maslowsky, PhD, and colleagues found that mental health problems in eighth graders are a likely marker for subsequent substance abuse issues. In a separate study, Maslowsky’s research team studied the sleep patterns of more than 15,000 teens, because getting too little or too much sleep is related to a number of mental and physical health problems, including depression and anxiety. The same story reports on a survey by Aletha Akers, MD, MPH, an AMFDP alumna, examining the counseling health care providers give to parents of adolescent patients. The topics parents most frequently recalled discussing were the ones least associated with adolescent morbidity.

Sep 9 2013
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Community Linkages Increase Access to Diabetes Prevention Education

Robin Whittemore, PhD, APRN, FAAN, is an associate professor at Yale School of Nursing. Whittemore has received national and international recognition for her work in behavioral interventions for type 1 and type 2 diabetes. One focus of her work has been to examine ways to improve access to health programs for vulnerable high-risk populations. She is the primary investigator on a study funded by the RWJF Interdisciplinary Nursing Quality Research Initiative to prevent diabetes among at-risk adults in public housing. This post originally appeared on the U.S. Department of Health and Human Services’ National Partnership for Action blog.

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Minority adults are at a disproportionate risk for developing type 2 diabetes, a challenging illness to manage that is a leading cause of morbidity and mortality in the U.S. Evidence indicates that lifestyle change programs, which incorporate healthy eating, physical activity and modest weight loss, can prevent or delay the development of type 2 diabetes. Yet, access to diabetes prevention programs is limited, particularly among minority and low-income adults.

To help address the issues with access to diabetes prevention programs, we designed a study to link existing community resources—public housing communities and a homecare agency— to minority and low-income adults at-risk for type 2 diabetes. Public housing communities provide housing at reduced rental costs for families of low socioeconomic status. We chose this setting because these communities often have the space and personnel to support a community-based program. The homecare agency consists of nurses who monitor and implement healthcare in a home environment, and are trusted health professionals in public housing communities.

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Jul 9 2013
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Recent Research About Nursing, July 2013

This is part of the July 2013 issue of Sharing Nursing's Knowledge.

NP-Doctor Co-Management of Geriatric Cases Leads to Improved Outcomes

New research finds that geriatric patients with chronic conditions may have better outcomes if their cases are co-managed by a nurse practitioner (NP) and a physician than by a physician alone.

David Reuben, MD, chief of the Geriatrics Division in the Department of Medicine at the David Geffen School of Medicine at the University of California, Los Angeles, reports on the research leading to that conclusion in the June 2013 issue of the Journal of the American Geriatrics Society. Reuben and colleagues studied the cases of 485 patients who had one of four chronic conditions: falls; urinary incontinence (UI); dementia/Alzheimer's disease; or depression. Some of their cases were managed by doctors alone, and others were co-managed by doctors and NPs.

The researchers then examined individual patients' charts, assessing the quality of their care using several specific quality indicators. They found that patients whose cases were co-managed generally had better care, and significantly better care for some conditions. "Quality scores for all conditions (falls, 80 percent vs. 34 percent; UI, 66 percent vs. 19 percent; dementia, 59 percent vs. 38 percent) except depression (63 percent vs. 60 percent) were higher for individuals who saw a NP," they wrote.

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Nov 2 2012
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Being Healthy Now Matters Later to Moms and Babies

Pamela K. Xaverius, PhD, is an assistant professor in the Department of Epidemiology at Saint Louis University, and a former grantee with the Robert Wood Johnson Foundation (RWJF) New Connections program. This post is part of a series in which RWJF scholars, fellows and alumni who are attending the American Public Health Association annual meeting reflect on the experience.

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As a former New Connections grantee from the Robert Wood Johnson Foundation, I was asked to blog about my experience with one of my posters at the 140th annual conference of the American Public Health Association (APHA) in San Francisco this week. The poster was entitled “Prevalence of Preconception Lifestyle Behaviors Between Women With and Without Diabetes.”

There has been a groundswell of activity across the U.S. around the idea that if women want to have healthy babies, they need to be healthy before they get pregnant (aka, preconception health). This idea fits well with the overall theme of the APHA conference this year: Prevention and Wellness Across the Lifespan.

My co-authors and I presented a poster on secondary analysis of data that looked at the relationship between lifestyle behaviors and diabetes status among women of reproductive age. The biggest takeaway that we wanted people to have from this poster was that 93 percent of women with diabetes are not intending a pregnancy, and 73.2 percent of them are not using any birth control method (40.5 percent) or using less effective birth control methods (32.7 percent). This is a recipe for significant public health concern, with the growing rates of diabetes coupled with the potentially deleterious consequences of unmanaged diabetes during pregnancy.

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Oct 18 2012
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Human Capital News Roundup: Rationing end-of-life care, nursing joint degree programs, diabetes diagnoses, 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 and grantees. Some recent examples:

Arthur Kellermann, MD, MPH, FACEP, was one of several experts taking part in a recent “Intelligence Squared U.S.” debate, grappling with the pros and cons of rationing end-of-life care, NPR reports. Kellermann is both an RWJF Clinical Scholars and RWJF Health Policy Fellows alumnus, and serves on the Clinical Scholars program’s National Advisory Committee.

The Mohawk Valley Business Journal in Central New York state reports on a joint nurse-training program that will allow high school graduates to earn both associate and bachelor’s degrees in nursing in four years, and sit for the National Council of State Boards of Nursing’s National Council Licensure Examination after three years. The program is funded by a grant from RWJF’s Academic Progression in Nursing (APIN) program.

Research co-led by Jennifer Wenzel, PhD, RN, an alumna of the RWJF Nurse Faculty Scholars program, finds that married South Korean women with diabetes say they believe that the stress of caring for their families played a role in contracting the disease, according to a United Press International (UPI) story. The study also found that many of the women "did not make enough time to care for themselves because of their obligations to the family," UPI reports, noting that the women often had difficulty managing their disease because their husbands and children disapproved of diabetes-friendly meals.

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Sep 27 2012
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Human Capital News Roundup: Life expectancy, the aging brain, diabetes prevention, 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 and grantees. Some recent examples:

A story in the New York Times reports on a study, co-authored by RWJF Health & Society Scholars Program Director Lisa Berkman, PhD, and RWJF Investigator Award in Health Policy Research recipient James Jackson, PhD, that finds the life expectancy of the country’s least-educated whites is decreasing. The story also cites research by Health & Society Scholar Jennifer Montez, PhD, which found similar trends for the least-educated Americans.

Christina Roberto, PhD, a Health & Society Scholar, spoke to USA Today about McDonald's posting calorie counts on its menu boards and drive-through menus, a move that could be required of all chain restaurants in the future. “In general, this is a hot topic,” she said. “The industry is concerned about policies that either [deter] customers from coming or hurt their bottom line.”

Health & Society Scholars alumnus Jason Block, MD, was also in the news to discuss fast food calorie counts. MedPage Today reports on research he led that finds many parents underestimate how many calories are in the fast food meals they buy for their school-age children.

The Paramus Post and the News Record report on some of the New Jersey Nursing Initiative (NJNI) scholars who have completed NJNI’s Faculty Preparation Program. Twenty of the program's Scholars graduated this year with advanced degrees that prepare them to serve as nurse faculty.

Nurse.com reports on the recent retirement of Shirley Chater, RN, PhD, FAAN, who was the national advisory committee chair for the RWJF Executive Nurse Fellows program since its inception in 1998. Learn more about Chater's impressive career here and here.

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Jun 14 2012
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Human Capital News Roundup: Allergies in kids, diabetes among the elderly, debate teams, 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 and grantees. Some recent examples:

A study by RWJF Physician Faculty Scholar Reshma Jagsi, MD, DPhil, finds female physicians considered to be among “the cream of the crop” make an average of $12,000 less a year than their male counterparts. The disparity persists even after accounting for physicians’ specialties, productivity, family status and other factors. HealthDay, Reuters, the Washington Post, Fox News and the Associated Press are among the outlets to report on the findings. Read more about the study.

Nurse.com reports on a study led by RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantees Michele Balas, RN, PhD, APRN-NP, CCRN, and William Burke, MD, that finds a series of evidence-based practices employed by a nurse-led health care team can reduce the risk of delirium for ICU patients and speed recovery after discharge.

Ruchi S. Gupta, MD, MPH, a Physician Faculty Scholar, is the author of a study that finds children who live in rural areas are less likely to have food allergies than children who live in cities. The study is the first to examine the prevalence of child food allergies by geographical region. CBS News, HealthDay, Parents Magazine’s High Chair Times blog and the Scientific American are among the outlets to report on the findings.

 

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