Clinical Scholars

Alumni
Craig Evan Pollack, M.D., M.H.S., (‘09) and co-author Julia Lynch, Ph.D., a 2006 Investigator in Health Policy Research Program and an ‘05 alumna of the Scholars in Health Policy Research, published "The Health Status of People Undergoing Foreclosure in the Philadelphia Region" in the American Journal of Public Health. Pollack and Lynch recruited 250 people undergoing foreclosure and found that 36.7 percent met screening criteria for major depression, though nearly half had not been previously diagnosed. Compared to the community sample, those in the foreclosure sample were significantly more likely to be uninsured and to forego prescription medications due to cost. The authors conclude that public health practitioners may be able to improve health care access for these homeowners by leveraging current efforts to connect them with mortgage counseling agencies. The study received coverage in the Philadelphia Inquirer, U.S. News & World Report, Health Day and LiveScience.com, among others.

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• Clinical Scholars
• Executive Nurse Fellows
• Health & Society Scholars
• Investigator Awards in Health Policy Research
• Physician Faculty Scholars

Clinical Scholars

Kasia Lipska, M.D., Harlan M. Krumholz, M.D., S.M., director of the Yale Clinical Scholars Program, and Yale colleague Mikhail Kosiborod, M.D., published a letter in the August 15, 2009 Lancet challenging the choice of studies used in a May 23, 2009 article, “Intensive Glucose Control and Cardiovascular Outcomes.” They argue that more high-quality studies are needed to explore the specific cardiovascular benefits and risks of an increasingly complex array of antihyperglycaemic therapies.

Raina Merchant, M.D., is the lead author of “Cost-Effectiveness of Therapeutic Hypothermia After Cardiac Arrest,” published in Circulation: Cardiovascular Quality and Outcomes (published online before print August 4, 2009). Merchant and colleagues found that cooling unconscious cardiac arrest survivors can improve survival outcomes and is cost-effective when compared to other widely accepted treatments in modern health care. The study received coverage in ScienceBlog, Reuters Health Medical News and MedPage Today, among others.

Alumni
Joseph Ross, M.D., M.H.S., (‘06) and Yale program director Harlan Krumholz, M.D., S.M., co-authored a study in The New England Journal of Medicine (August 27, 2009), “Exposure to Low-Dose Ionizing Radiation from Medical Imaging Procedures.” They found that imaging procedures are an important source of exposure to ionizing radiation in the United States, and can result in high cumulative effective doses of radiation.

Heather Yeo, M.D., M.H.S.R., (‘08) and Kate Viola, M.D., (‘10) published the first study to take an in-depth look at surgical trainees at the national level in JAMA on September 23, 2009. “Attitudes, Training Experiences, and Professional Expectations of U.S. General Surgery Residents” profiles these residents, characterizing their attitudes, experiences, and expectations regarding training, while also examining differences by sex and training year. Yeo and colleagues found both high levels of satisfaction and sources of strain that vary by sex and training year. For example, most respondents expressed satisfaction with training and supportive peer relationships; but men were more likely than women to report that their program provides support, and that they can turn to faculty when having difficulties. Among the co-authors are Clinical Scholar program faculty Leslie Curry, Ph.D., M.P.H., Marcella Nunez-Smith, M.D., M.S., (‘05) and Harlan M. Krumholz, M.D., S.M., Program Director. The study received media coverage including Medical News Today, Yale Daily News, and Science Daily.

Executive Nurse Fellows

Jeanette Andrews, Ph.D., A.P.R.N.-B.C., F.N.P., associate dean for research and evaluation, and director of the Center for Community Health Partnerships in the Medical University of South Carolina’s College of Nursing, is the principal investigator of a multi-year smoking-cessation program for women in public housing. The “Sister to Sister” program will start in one neighborhood and rotate to others. Andrews led a promising pilot program of this research in Augusta, Ga. In that test, three out of four women involved at least cut back on their smoking, and half of them quit. The program launch was covered in the Charleston, S.C. Post and Courier.

Alumni
Linda Norlander, R.N., B.S.N., M.S., (‘04) is the co-author of Being Present: A Nurse’s Resource on End-of-Life Communication. The book offers strategies to help nurses talk with patients and families about their needs, hopes and wishes as they face their own death or that of a loved one.

Health & Society Scholars

Eran Magen, Ph.D., M.A., recently published a report in Psychological Science entitled “The Hidden Zero Effect.” The report details Magen’s research about reducing impulsivity. According to the hidden zero effect, phrasing a question presenting options such as whether to have a smaller amount of something good now, versus a larger amount of the same thing later, obscures the downsides to both options. The reasoning is that mentioning the zeros (i.e., “Would you rather have one cookie now and zero cookies an hour from now, or zero cookies now and two cookies an hour from now?”) focuses our attention on the costs of each choice, not just on the rewards. An article on the study appeared on PsychologyToday.com (September 21, 2009).

Alumni
Scholars Sarah Burgard, Ph.D., M.S., Jennie Brand, Ph.D., M.S., (‘06) and James House, Ph.D., program site co-director at the University of Michigan, published a study in Social Science & Medicine in September 2009. “Perceived Job Insecurity and Worker Health in the United States” examines episodic and persistent perceived job insecurity over periods of about three years to almost a decade. Results show that persistent perceived job insecurity is an important predictor of poorer self-rated health; and that while job losses or unemployment episodes are associated with perceived job insecurity, they do not account for its association with health.

Investigator Awards in Health Policy Research

Thomas H. Gallagher, M.D., (‘07) reviewed a medical-error case to discuss practices in communicating with patients about errors in JAMA’s Clinician’s Corner (August 12, 2009). Dr. Gallagher was also featured in JAMA’s "Author in the Room" teleconference on September 16, 2009. He was also a guest on the National Public Radio program, “Radio Times,” from WHYY in Philadelphia on August 18, 2009.

Alexandra Minna Stern, Ph.D., (’07) and Howard Markel, M.D., Ph.D., F.A.A.P., (’07) with Martin Cetron, M.D., director, Division of Global Migration and Quarantine at the Centers for Disease Control and Prevention (CDC), published “Closing The Schools: Lessons From The 1918–19 U.S. Flu Pandemic” as a Health Affairs Web exclusive on September 29, 2009. The paper offers lessons for policy-makers and community officials from the 1918–19 U.S. Flu Pandemic,” lessons that can be used to inform discussions around closing schools if the H1N1 pandemic spikes in the fall of 2009. Markel and Stern also published “What Mexico Taught the World About Pandemic Influenza Preparedness and Community Mitigation Strategies,” a commentary in JAMA (September 16, 2009). The commentary was referenced in a San Diego Union-Tribune article about Baja, California’s preparation for dealing with H1N1.

Physician Faculty Scholars

Aaron Caughey, M.D., Ph.D., published a paper, “Elective Induction of Labor Versus Expectant Management of Pregnancy,” in the August 18, 2009, issue of Annals of Internal Medicine. The study suggests that women who choose to induce labor may actually be at less risk of a C-section. In an August 18 San Francisco Chronicle article, Caughey encouraged doctors and their patients to give the induction a chance to work before they choose surgery over vaginal birth. The study was also featured in Reuters Health Medical News and the Boston Globe.

Michael Dulin, M.D., Ph.D., published an article, “A Population-Based Study Examining Language as a Predictor of Colorectal Cancer Screening Among Overweight and Obese Hispanic Adults in the United States,” in The Open Epidemiology Journal (2009 issue). The authors found that men with an elevated BMI who chose Spanish to complete a survey were less likely to receive the recommended screening for colorectal cancer (CRC). In order to reduce the morbidity and mortality related to CRC, public health programs designed to improve CRC screening access need to target this population.