Category Archives: Genetics

May 22 2014
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RWJF Scholars in the News: DNA and depression, health impact of foreclosures, 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:

Hurricanes Katrina and Rita significantly increased the number of stillbirths in the Louisiana parishes most affected by the storms, according to a study by RWJF Health & Society Scholar Sammy Zahran, PhD. The research team concluded that 117 to 205 fetal deaths could be attributed to distress caused by the storms, the New York Times blog Well reports. “You can have two mothers with equal characteristics—age, race, and so on,” Zahran said. “[B]ut if one happens to be in a more severely destroyed area, the risk of stillbirth is higher.” The study was also covered by Daily Mail and HealthDay. Read more about Zahran’s work on the Human Capital Blog.

Genetics play an important role in whether stress makes people depressed, and in how quickly they recover, Madison.com reports. RWJF Health & Society Scholars alumnus Jason Fletcher, PhD, looked at data before and after the 9/11 attacks and correlated it with DNA information reported by survey respondents. He found that 60 percent of participants who carried a particular gene appeared to be at an increased risk for sadness after the attacks. “Overall, the evidence suggests that genetic endowments are an important source of variation in response to a stressful event, in producing some depressive symptoms in young adults,” Fletcher said. MedicalXpress also covered the study.

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Sep 6 2013
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Is the Brain Ready for Personalized Medicine? Studies Suggest Not Quite Yet.

Jason Karlawish, MD, is a professor of medicine, medical ethics and health policy at the University of Pennsylvania and the director of Penn’s Neurodegenerative Disease Ethics and Policy Program. He is the recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

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“Prescribe the right drug to the right patient at the right time” is not a new medical practice, but when a biomarker—that is, a measure of disease pathophysiology—or a gene makes this decision, that is a radically new medical practice. The promise of personalized medicine is that biomarker and gene driven algorithms will do much of the work of medicine. By predicting patients’ future health and the outcomes of an intervention, they will guide what doctors recommend to their patients. Like the theory of evidence-based medicine, personalized medicine promises a more objective, efficient and precise medical practice.

To date, personalized medicine has largely flourished “below the neck,” that is, in the care of patients with common medical diseases, particularly cancer and cardiovascular disease. In the last two decades though, the National Institutes of Health, the pharmaceutical industry, and researchers have invested substantial time and money in research such as the Alzheimer’s Disease Neuroimaging Initiative (called “ADNI”) dedicated to discovering and validating the biomarkers and genes that predict whether a brain will fail. This research is beginning to reshape how we talk about the diagnosis and treatment of the aging brain, an organ that is more and more, like hearts and bones, regarded as an organ “at risk.” As a result, clinicians, ethicists, and health care policy-makers are beginning to ask how we should practice personalized medicine for the seemingly healthy brain that is at risk for neurodegenerative dementias such as Alzheimer’s, Parkinson’s, Lewy Body Disease and frontotemporal lobar degeneration.

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Jun 20 2013
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Human Capital News Roundup: Verbal abuse among nurses, deinstitutionalization, prenatal genetic testing, 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:

Nearly half of newly licensed registered nurses have been verbally abused by colleagues, according to a study by the RWJF-funded RN Work Project. Those who reported being verbally abused had lower job satisfaction and unfavorable perceptions of their work environment, and were more likely to say they intended to leave their jobs within the next year. Nurse.com and the News Press report on the findings. Read more about the study.

Amy Dockser Marcus, AB, recipient of an RWJF Investigator Award in Health Policy Research and award-winning journalist for her coverage of cancer, wrote an article for the Wall Street Journal about long-term health effects for adult survivors of childhood cancer. Research shows that more than 95 percent of adult survivors suffer from a chronic health condition by the age of 45, the story reports.

Harold Pollack, PhD, MPP, wrote a piece for the Washington Post Wonkblog about the successes and failures of deinstutionalization. On the whole, he writes, moving individuals with disabilities out of large institutions into family- or community-based settings improved the lives of millions of Americans living with intellectual and developmental disabilities, like his brother-in-law. However, it was much less successful for Americans suffering from severe mental illness. Pollack is a recipient of an Investigator Award in Health Policy Research, and an alumnus of the RWJF Scholars in Health Policy Research program.

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Mar 28 2013
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Human Capital News Roundup: Testing for genetic conditions, discussing spirituality with patients, using emergency rooms, 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:

Patient-centered end-of-life care leads to happier patients who are in less pain and whose care costs less, RWJF/U.S. Department of Veterans Affairs Clinical Scholar Jonathan Bergman, MD, and his colleagues write in the journal JAMA Surgery. Such care is already provided,  the Los Angeles Times reports, at the UCLA Health System, where urology residents are receiving education about end-of-life care, and at the West L.A. Veterans Affairs Medical Center where researchers are integrating palliative care into cancer treatment.

The current system used to evaluate the appropriateness of emergency department visits—and sometimes to deny payment—is flawed, according to a study co-authored by RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, because it only takes into account a patient’s discharge diagnosis (for example, acid reflux), which is often not the reason they originally presented at the ER (chest pain). The researchers warn this could have serious implications, including dissuading patients from using the ER even when their symptoms indicate that they should, United Press International reports.

Susan Wolf, JD, recipient of an RWJF Investigator Award in Health Policy Research, spoke to the Boston Globe about new recommendations from a national organization of genetics specialists that “urge doctors who sequence a patient’s full set of genes for any medical reason to also look for two dozen unrelated genetic conditions, and to tell the individual if they find any of those conditions lurking in the DNA.” All of the genetic mutations on the list are rare, but some indicate an increased risk of cancer or heart disease. In some cases, the genetic results could also indicate that the patients' blood relatives have increased risk, as well.

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Nov 14 2012
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Social Environment Trumps Genetics When it Comes to Teen Friendships

Jason M. Fletcher, PhD, MS, is an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2010-2012) and an associate professor of health policy at Yale School of Public Health.   Fletcher was recently lead author of the study, “How Social and Genetic Factors Predict Friendship Networks,” published October 17 in the journal PNAS (Proceedings of the National Academy of Sciences). Fletcher and his colleagues found that important interactions between genetics and the social environment help determine friendship formation during high school.

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For our study, we used a national survey of adolescent friendships (Add Health, or the National Longitudinal Study of Adolescent Health) to follow up on and expand a study published last year that showed that specific genes, including a dopamine receptor gene (DRD2), may determine friendships among teens.

We found the idea of a biological basis for, in our view, the very sociologically driven outcomes of friendship formation to be too narrow and to not take into account the social and geographic constraints that underlie friendship links.  So in our research we show, using the same data as the previous study, that once we take account of schools and social environments, the previous genetic story is not confirmed by our data.

Indeed, we show that some schools produce friendships that are genetically similar, and others produce friendships that are genetically dissimilar.  And specific aspects of schools, like socioeconomic inequality, appear to partially determine the types of friendships that we observe school-by-school.

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Jul 26 2012
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Human Capital News Roundup: Genetic mutations that cause melanoma, depression in adolescents, 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:

The Las Vegas Sun interviewed RWJF Executive Nurse Fellows alumna Debra Toney, PhD, MS, BSN, FAAN, who was chosen by the Coca-Cola Company to carry the Olympic torch in the relay leading up the opening ceremony on July 27. Read more about Toney’s experience in the latest issue of Sharing Nursing’s Knowledge.

RWJF Harold Amos Medical Faculty Development Program alumnus Levi Garraway, MD, PhD, is part of a team conducting research on genetic mutations and cancer. Health Canal reports on their findings, including which sun-damaged cells in a tumor contribute to melanoma.

A study led by RWJF Health & Society Scholars alumna Margaret Sheridan, PhD, finds that childhood adversity produces measurable changes in children’s brains, Science Daily reports.  It affects the amount of both the brain’s white matter (which is necessary for forming connections) and its gray matter, the research team found. For the study, they analyzed brain scans of Romanian children who had been moved from an orphanage to quality foster care homes.

An article from The Atlantic cites a working paper by Health & Society Scholar Jason Fletcher, PhD, that finds “adults who suffer from adolescent depression ultimately make about 20 percent less money than their peers and are somewhat less likely to be employed.”

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May 24 2012
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Human Capital News Roundup: Electronic medical records, reducing gang-related violence, cancer-causing DNA mutations, and more.

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

RWJF Physician Faculty Scholar David G. Bundy, MD, MPH, also an alumnus of the RWJF Clinical Scholars program, spoke to the Baltimore Sun about a proposal being considered by Maryland health officials that would require children in the state to get more vaccines before attending school. “The recommendations for these immunizations are not new nationally,” Bundy said. “This is just updating the state’s requirement to reflect the existing recommendations. It just makes us all look like we’re in alignment with what we’re doing, and it tightens the safety net at schools for kids who may be missing vaccines.”

“They have been utilized in Texas, but not appropriately utilized,” RWJF Executive Nurse Fellows alumna Alexia Green, RN, PhD, FAAN, said of Advanced Practice Registered Nurses (APRNs), in an interview with Fox 34 (Lubbock, Texas). A new report finds that greater utilization of APRNs in Texas would save the state about $8 billion.

Mahshid Abir, MD, and Art Kellerman, MD, MPH, FACE, wrote an op-ed for USA Today about the benefits electronic health records provide for health care providers and patients, especially in the wake of natural disasters like last year’s deadly tornado in Joplin, Missouri. “The twister…heavily damaged St. John’s Regional Medical Center, sucking up patient files and X-rays and depositing them up to 70 miles away,” they write. “Fortunately, barely three weeks earlier, St. John’s had switched from paper to electronic health records… Even as the hospital’s 183 patients were being evacuated, St. John’s staff accessed and printed out their records from a remote site, and sent copies with patients to hospitals where they were transferred.” Abir is an alumnus of the RWJF/ U.S. Department of Veteran’s Affairs (VA) Clinical Scholars program, and Art Kellerman, MD, MPH, FACEP, is an alumnus of the RWJF Health Policy Fellows program and the Clinical Scholars program.

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May 17 2012
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Human Capital News Roundup: Genome sequencing of tumors, Medicare physician fees, cervical cancer among Latinas, and more.

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

Alejandra Casillas, MD, MPH, an RWJF Clinical Scholar, spoke to New America Media about why Latinas have the highest rates of cervical cancer. Many women don’t go to the doctor as much as recommended because of a cultural belief that their families come first, Casillas says, so raising awareness among men could help encourage more women to get Pap tests.

Healthcare Finance News reports on The Primary Care Team: Learning from Effective Ambulatory Practices (the LEAP Project), a recently launched RWJF initiative designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce. Learn more about the LEAP Project and read an RWJF Human Capital Blog post about it.

A team led by scientists from the Broad Institute and Dana-Farber Cancer Institute—including RWJF Harold Amos Medical Faculty Development Program alumnus Levi Garraway, MD, PhD—has sequenced the genomes of 25 metastatic melanoma tumors, MediLexicon reports. The first high-resolution views of the genomic landscape are published online in the journal Nature.

RWJF Scholar in Health Policy Research and political scientist Brendan Nyhan, PhD, gave comments to NPR’s Morning Edition about the political landscape, discussing why and how voters reject facts about the political parties or politicians to whom they are loyal. Nyhan’s ongoing research suggests that people may be better able to deal with cognitive dissonance—“the psychological experience of having to hold inconsistent ideas in one's head”—if they are first given an image or ego boost.

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Apr 25 2012
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On DNA Day, Let's Encourage More Nurses to Pursue Genetics

By Kathleen Hickey, EdD, FNP-BC, ANP-BC, FAAN, assistant professor, Columbia University School of Nursing and Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar. Hickey is president-elect of the International Society of Nurses in Genetics.

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Every April, people around the world celebrate “DNA Day,” a commemoration of the discovery of the structure of DNA in 1953 and the completion of the Human Genome Project in 2003. It’s an important day in scientific history, and its influence has spread far beyond the laboratory.

Genetics and nursing are closely linked, and many nurses—myself, included—have seen this connection firsthand. Long before we knew the full scope of the human genome, I worked as a nurse practitioner with cardiac patients. As I worked directly with many young patients, I learned that many of them had suffered a cardiac arrest, or lost a loved one to a cardiac arrhythmia. As more information became known about genetics, what I had seen in the clinical setting was confirmed—these patients were predisposed to these conditions by virtue of their DNA. Now I work in cardiogenetics, using my knowledge of genetics in combination with my skills as a nurse practitioner, to improve the outcomes for high-risk patients and prevent sudden cardiac death.

In 2009, I had the honor of being selected to attend the National Institute of Nursing Research’s Summer Genetic Institute. The two-month program, held at the National Institutes of Health (NIH), brought together nurses who were graduate students, faculty members, researchers, clinicians, and educators for intensive genetics training. There we were immersed in didactic lectures from NIH experts, engaged in hands-on bench experiments, and had the opportunity to develop a research proposal related to our own individual interests. This was critical to laying the foundation for my subsequent Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar research in the area of cardiogenetics.

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