Category Archives: Asthma

Aug 29 2014
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Pediatricians Need to Take Community-Based Approach to Addressing Chronic Conditions in Children

James Perrin, MD, FAAP, began a one-year term as president of the American Academy of Pediatrics (AAP) in January. A professor in the department of pediatrics at MassGeneral Hospital for Children and Harvard Medical School, Perrin received a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research in 1997.

James Perrin

Human Capital Blog: Congratulations on your new role as president of the American Academy of Pediatrics! What is your vision for the organization?

James Perrin: We are focused on addressing three main areas, which have really driven a lot of our thinking and, more importantly, our activity and change in the last several years.

First, we are working to help pediatric practices take on more community-based interventions to help young families raise their kids more effectively. There is a tremendous growth in the number of chronic diseases among children in four major areas: asthma, obesity, mental health, and neurodevelopmental disorders. We recognize these are not classic health conditions; they arise from and within communities, and both their prevention and their treatment are really community-based endeavors, as opposed to office-based activities.

Our second, and highly related priority, is an increased focus on early childhood development. We have understood the tremendous importance of early childhood for years, but there is now so much more science behind it. We know a lot more about how negative experiences and toxic stress can affect child development and how it can affect brain growth and neuroendocrine function. On the positive side, we also have more knowledge about the importance of reading to children, increasing language in the home, and other early-childhood interventions.

Thirdly, we have a better understanding of the tremendous impact of poverty on child health. Almost a quarter of American children live in households below the federal poverty line, and almost 45 percent live in households with incomes less than twice the federal poverty line. So a large number of American children are poor or near poor, and we know that poverty affects essentially everything related to child health. It makes those four categories of chronic conditions—asthma, obesity, mental health, and neurodevelopmental disorders—more prevalent and more serious, and it affects children’s responses to treatment. Lower-income kids with leukemia or cystic fibrosis, for example, have higher death rates than kids with the same diseases who are middle class. It’s impossible not to see on a daily basis how poverty affects child health.

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Apr 24 2014
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RWJF Scholars in the News: Markers for PTSD, inexcusable morbidity, nurse education, cigarette marketing, 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:

Neuroscientists at Harvard University studying trauma and the adolescent brain have identified markers that might help predict susceptibility to post-traumatic stress syndrome (PTSD), New England Public Radio (NEPR) reports. Kate McLaughlin, PhD, an RWJF Health & Society Scholars alumna, and colleagues were studying young people who’d been through serious adversity when the Boston Marathon bombing occurred. They surveyed some study participants who had already had brain scans about how much media coverage of the tragedy they’d watched and how they reacted emotionally, learning that children with certain neurobiological markers or previous trauma were more likely to report symptoms of PTSD. “The more that we can understand the neurobiological markers as well as the psychological and social markers ... the better able we’ll be to deliver early and effective interventions to prevent the onset of mental health problems,” she tells NEPR. Listen here.

“People think about asthma and think we must have a handle on it in the United States, but the grim reality is that most patients’ asthma in this country is uncontrolled,” David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus tells Nonprofit Quarterly in an interview. Van Sickle points to little progress in reducing asthma-related hospitalizations, and what he describes as “inexcusable morbidity” from the condition.  

RWJF Executive Nurse Fellows alumna Jane Kirschling, RN, PhD, FAAN, is featured in Nurse.com on the importance of nurse education. “We’re the largest single group of health care providers in the United States, and we’re there 24-7, 365 days a year for the care that’s provided,” Kirschling said. “That’s in hospitals, community settings and long-term care settings. So, we have to make that commitment as a discipline and as professional nurses to continue to expand our knowledge and our critical thinking skills, and we do that through advancing nursing education.”

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Dec 27 2013
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A Remedy for What Ails the Urban City

By Santa J. Ono and Greer Glazer

Santa J. Ono, PhD, is president of the University of Cincinnati. Greer Glazer, PhD, is dean and Schmidlapp professor of nursing at the University of Cincinnati College of Nursing, and an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. This piece first appeared in the Cincinnati Enquirer; it is reprinted with permission from the newspaper.

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The children of poor Cincinnati neighborhoods are 88 times more likely to require hospitalization to treat asthma than their peers across town. That’s an urban health disparity born of unequal access to the kind of consistent, attentive, high-quality health care that renders asthma a controllable condition.

In academic medicine, we chart the credentials of our staff and the test scores of our students. We tout the wizardry of the medical technology we bring to bear on exotic maladies. But too often we lose sight of the fact that the ultimate test of an academic medical center isn’t what’s inside the building, it’s what’s outside. If we are improving the health of the communities we serve, then we are truly succeeding.

By that score, we are falling short.

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Jul 19 2013
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Getting SMART About Asthma Education

Ruchi S. Gupta, MD, MPH, is an alumna of the Robert Wood Johnson Foundation Physician Faculty Scholars program. She is an associate professor of pediatrics and director of the maternal and child healthcare program at the Northwestern University Feinberg School of Medicine, and an attending physician at the Ann & Robert H. Lurie Children's Hospital of Chicago. Learn more at www.ruchigupta.com.

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This past spring, 12 students with asthma at James Hedges Elementary in Chicago’s Back of the Yards neighborhood took hundreds of pictures, filmed video Public Serve Announcements (PSAs), created a website, and rolled out a community intervention to improve asthma conditions. These activities were part of the Student Media-Based Asthma Research Team, or SMART program. We developed this program from a previous pilot program in Chicago’s Uptown neighborhood that empowered students to learn about their asthma and challenged them to create change in their own communities.

As the most common chronic condition in children and the most common cause of school absenteeism, asthma is responsible for 13 million days of school missed each year. Asthma disproportionately affects racial and ethnic minorities, as African Americans and Hispanics/Latino children have significantly higher asthma-related morbidity and mortality rates compared to White children. While evidence-based guidelines for asthma care have been available for 20 years, ethnic minorities have a lower likelihood of receiving or following proper asthma treatment. Across and within racial/ethnic groups, asthma care has been shown to be more effective when it is tailored to the individual community instead of one-size-fits-all intervention.

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Jun 28 2013
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Human Capital News Roundup: Asthma education, sleep deprivation in hospitals, nurses on boards, 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 dark blue dye used to identify lacerations and tears on the skin of rape victims doesn’t show up as well on dark skin, Phys.org reports, which means injuries that could move cases through the criminal justice system may not be documented. RWJF Nurse Faculty Scholars alumna Kathryn Laughon, PhD, RN, FAAN, is working to create a fluorescent dye that will show up on all skin types. WTVR-TV (Richmond, Va.) and Newsplex.com (Charlottesville, Va.) also report on her work.

The Chicago Tribune [subscription required] reports on a program that is teaching children how to control their asthma, how to recognize common triggers for asthma attacks, and how they can educate their communities about the disease. Ruchi S. Gupta, MD, MPH, an alumna of the RWJF Physician Faculty Scholars program, who spearheaded the asthma education program, said:  “These kids didn't know they had a voice, (that) they could actually use it to make a change… My dream is to have a map of Chicago and you click on a neighborhood and you can see these videos and tools the students have made in each neighborhood.” Central Kentucky News also reported the story. Read a post Gupta wrote for the RWJF Human Capital Blog about her research on food allergies.

“As a profession, we feel passionate about protecting the safety and quality of our patients [by] serving on committees and boards,” RWJF Senior Adviser for Nursing Susan Hassmiller, PhD, RN, FAAN, told AMN Healthcare about nurses serving as board members or in other leadership positions. “That means you have to raise your hand and say ‘I’ll do it.’ It’s a time commitment.”

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Apr 10 2013
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Recent Research About Nursing, April 2013

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

Survey of Nurses: Hospitals’ Patient Safety Programs Lacking

A new survey of hospital nurses in the United States, the United Kingdom, and China finds that nurses lack confidence in their hospitals’ safety programs.

The online survey, conducted by a research firm for the American Nurses Association (ANA) and GE Healthcare, included 500 respondents from the United States and 200 each from the United Kingdom and China. Each country's responses were given equal weight in the final results. Among the findings:

  • Ninety-four percent of nurses report that their hospitals have programs in place that promote patient safety, but only 57 percent believe those programs are effective.
  • Just 41 percent describe their hospital as “safe.”
  • Ninety percent of nurses believe it is important that nurses not be penalized for reporting errors or near misses, but 59 percent agree that nurses often hold back in reporting patient errors in fear of punishment (67 percent in the United States, 62 percent in the United Kingdom, and 49 percent in China). Sixty-two percent agree that nurses often hold back in reporting near misses for the same reason (69 percent in the United States, 65 percent in the United Kingdom, and 54 percent in China).
  • Thirty-three percent of nurses said that "poor communication among nurses at handoff" has increased the risk of patient safety incidents in their hospitals in the past 12 months. Thirty-one percent said "poor communication with doctors" has also increased the risk of patient safety incidents.

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Mar 8 2013
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Human Capital News Roundup: Emergency department ‘sticker prices,’ longevity among women, asthma control, 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 average emergency room visit costs 40 percent more than a month’s rent, according to a study led by RWJF Physician Faculty Scholar Renee Hsia, MD, MSc. The study also found the “sticker price” for emergency department care varies widely, the Washington Post Wonk Blog reports, with a sprained ankle ranging from $4 to $24,110. Among the other outlets to report on Hsia’s findings: Health Day, Bloomberg, and MSN.com. Read a post Hsia wrote for the RWJF Human Capital Blog about ambulance diversion and emergency room crowding.

RWJF Health & Society Scholar Jennifer Karas Montez, PhD, was a guest on CNN’s The Situation Room with Wolf Blitzer to comment on a recently released longevity study. Montez' research in this area has focused on longevity among women, and she found that low-educated women (especially those without a high school education) have seen declines in their life expectancy, while life expectancy for men has stayed steady or increased. The Associated Press also reported on Montez research.

Americans support government intervention in matters of public health, such as curbing obesity, U.S. News & World Report says in reporting on research conducted by Michelle M. Mello, JD, PhD, MPhil, an RWJF Investigator Award in Health Policy Research recipient. Three-fourths of respondents in a survey said they support laws that would discourage obesity in adults, with most favoring less-intrusive measures such as posting calorie counts.

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Feb 8 2013
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Human Capital News Roundup: Food billboards, pharmaceutical company gifts to medical students, tracking asthma, 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:

An op-ed in the Star-Ledger reflects on the contributions of Tom Kean, former governor of New Jersey, during his more than two decades of service on the RWJF Board of Trustees, including eight years as chairman of the Board. Learn more about Kean’s commitment to leadership and service.

The Washington Post reports on an inhaler with a built-in Global-Positioning System (GPS), designed by RWJF Health & Society Scholars alumnus David Van Sickle, PhD, MA, that sends a signal with the time and location to a remote server every time a patient uses it. The data is then sent regularly to patients and physicians to help provide more comprehensive treatment. The data can also be used to find asthma “hot spots” in cities, where attacks are triggered, Health & Society Scholar Meredith Barrett, PhD, said. Read more about Van Sickle’s work here and here.

Judi Hilman, director of the Utah Health Policy Project and an RWJF Community Health Leader, gave comments to the Deseret News about decisions and deadlines Utah will have to meet in 2013 to comply with the health reform law.

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Mar 5 2012
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RWJF Scholar Puts GPS Technology to Work Fighting Asthma

David Van Sickle, PhD, MA, an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program and founder and CEO of Asthmapolis, has created a new device called a Spiroscout. It is an inhaler with a built-in Global-Positioning System (GPS) that sends a signal with the time and location to a remote server every time a patient uses it. Asthmapolis tracks and analyzes the data and sends regular reports to patients and physicians, along with observations and recommendations.

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Last summer, RWJF’s Alumni Network talked with Van Sickle, an epidemiologist and medical anthropologist, and then this month, the RWJF Human Capital Blog followed up with a few more questions. The combined results of those conversations follow:

RWJF Alumni Network (AN): Have you always been working on asthma?

David Van Sickle: My whole career has been focused on asthma. I did my dissertation research on asthma in India and worked at the respiratory center in Arizona during grad school. When I was at the Centers for Disease Control and Prevention (CDC), I was working in outbreak investigations, trying to figure out where and when asthma was happening, so we could better target our public health activities.

AN: How did you get the idea for your company?

Van Sickle: At the national level, we suffer from a lack of data about the day-to-day burden of asthma. When I went to the University of Wisconsin with the RWJF fellowship, and began to look more closely at the clinical management of asthma, I realized that physicians also suffered from a lack of information on how their patients were doing. I thought we could solve these two problems with one new technology that tracked where and when people are using their inhalers, which provides an important signal of how well the disease is being managed.

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Sep 13 2011
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My Visit to the White House

David Van Sickle, Ph.D., is a former epidemic intelligence service officer with the Centers for Disease Control and Prevention, and a 2006 Robert Wood Johnson Foundation Health & Society Scholar at the University of Wisconsin School of Medicine and Public Health.

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This past June, I had the honor of being named one of 17 “Champions of Change” by the White House, in recognition of my work marrying emerging technologies to health care.

According to WhiteHouse.gov, “The Obama administration established the Champions of Change award to recognize and encourage ‘everyday heroes’ working to better their communities through hard work and creative solutions.” Many of these folks – such as awardee Todd Park, chief technology officer at the U.S. Department of Health and Human Services (HHS) – now occupy key roles in government where they are sparking new companies and revolutionizing industrial ecosystems in part by using whole new approaches to data.

As readers of the Robert Wood Johnson Foundation Human Capital Web site may recall, my work to develop a GPS-enabled asthma inhaler caught the attention of the Administration early last year, and I was invited to make a presentation at a Community Health Data Forum sponsored by HHS. The forum was an outgrowth of President Obama’s Community Health Data Initiative, which is focused on making HHS health data available so that software developers and others can put it to innovative and constructive use.

The idea behind the inhaler is to capture valuable data about asthma from daily life, by putting GPS technology to work tracking precisely when and where patients use their inhalers. That’s useful information to patients, because it means they can provide their physicians with the kinds of specifics that generally don’t make it into pen-and-paper logs – often because patients forget to keep track and instead fill them out days or weeks later, in the parking lot of their doctors’ offices, for example! But the device also has public health implications, because when we can identify patterns in asthma incidents, we can sometimes identify and then do something about environmental factors that cause them.

Asthmapolis, the company I formed to bring this to market, is gearing up to manufacture the first commercial version of the sensor and is busy hiring. We're up to six employees now and looking to hire two or three more. Our staff will help educate users and public health officials on the use of the product, design marketing materials, write related apps and more. It’s an exciting time in the life of the company, and it’s been an education moving along the path from idea to prototype to device and eventually to a marketable product. This fall we will launch in major health systems in three states.

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